Nelson Wolff Says uncompensated health care costs absorbed by Texas hospitals are adding $1,800 a year to Texas private insurance rates.

Explanation: Wolff said uncompensated health care costs absorbed by Texas hospitals are adding $1,800 a year to private insurance rates. His figure strikes us as worthy of skepticism partly because research on this topic seems to be driven by up-front assumptions--some of them fiercely debated. As troubling, the figure reflects 2009 estimates reached using a previous estimate of how much of such costs were passed through in 2005, nearly a decade ago. We found no post-2009 state-by-state estimates of the cost impact, while other analyses have found that although cost-shifting occurs, private insurance rates are not greatly affected. This claim, which retains an element of truth.

Health Care, Public Health, State Budget, Texas, Nelson Wolff,

Bexar County’s top elected official gave a pocketbook reason for Texas to expand Medicaid as encouraged by the federal health care law known as Obamacare. Nelson Wolff, the county’s judge, prefaced his April 1, 2013, remarks by saying he had just received a root canal. "Getting Medicaid expansion in Texas is more painful," Wolff said during a Capitol press conference with Democratic lawmakers and other advocates. Earlier that day, Gov. Rick Perry and other Republican leaders had reiterated their opposition to expanding Medicaid, which they termed a costly, broken program. Wolff, saying he was speaking for the state’s major public hospital districts, said that if Medicaid is expanded, "it would cut down" on emergency room visits, "on unnecessary patients going there and help people that really, really do need it." Wolff then said it’s estimated that some $1,800 is added to "your private insurance rates" due to uncompensated care given by "hospitals throughout Texas," a figure we spotted in Patricia Kilday Hart’s April 2, 2013, Houston Chronicle column on the press conference. Is that so? Concern about such cost shifting is even written into the federal health care law, as noted by Hoover Institution fellow and Stanford University professor John F. Cogan and others in a 2011 paper. The 2010 law says "the cost of providing uncompensated care to the uninsured was $43 billion in 2008. To pay for this cost, health care providers pass on the cost to private insurers, which pass on the cost to families. This cost-shifting increases family premiums by on average over $1,000 a year." By email, Bexar County spokeswoman Laura Jesse told us the judge drew the $1,800 figure from a March 24, 2009, report from the Washington-based Center for American Progress, which says it was founded to "provide long-term leadership and support to the progressive movement." The report says that nationally in 2009, this cost-shift amounted to $1,100 per average family premium and $410 per average individual premium, with the Texas cost-shift being $1,800 per average family premium and $630 per average individual premium, according to a chart. Case closed? Not so fast, because research conflicts over the extent of cost-shifting. Also, there is uncertainty the amounts can be estimated state to state. Vicki Anderson of Austin, who helped write a January 2013 report commissioned by Texas Impact and Methodist Healthcare Ministries of South Texas, Inc. on projected local tax effects of expanding Medicaid, told us by email that pinning down the impact of uncompensated care on private insurance rates is challenging in part because such calculations inevitably start from varying amounts of spending attributed to uncompensated care, causing the estimated effect on private insurance premiums to vary as well. Nationally, PolitiFact colleagues have noted that the study cited by Wolff, which updated figures developed in a 2005 analysis commissioned by the liberal-leaning Families USA, has been contradicted by more recent analyses estimating such cost-shifting to be far less costly. Let’s look at the approach that delivered the figure aired by Wolff and then at the contradictory reports. For each state, the Center for American Progress said it assumed the same percentage increases in premiums due to such cost-shifting in 2009 that the Families USA report earlier estimated for 2005. The center then applied the percentages to the latest state-by-state premium data as reported by a federal panel, according to its report, also growing each resulting figure by the change in national private health expenditures as reported and tracked by the U.S. Centers for Medicare and Medicaid Services from 2006 to 2009. We didn’t find a copy of the 2005 report, but Families USA issued a 2009 report, "Hidden Health Tax: Americans Pay a Premium," describing follow-up research it commissioned from Milliman, Inc., an actuarial consulting firm, that drew on federal data on medical spending to conclude that in 2008, uncompensated care costs drove up average private family insurance rates nationally by $1,017. The report says the methodology was similar, though not identical, to the one used for its 2005 study. The report did not present state-by-state figures. By phone, Families USA analyst Kathleen Stoll told us: "I didn’t feel we could pin it down state by state." A report appendix says the research assumed that the cost of all uncompensated care is shifted to the insured. But Stoll, elaborating, told us researchers reached the "cost" figure in its report in a couple steps. First, she said, the group estimated total charges to the uninsured not covered by the patients themselves or sources like charity care or federal aid sent to hospitals for that purpose. The resulting figure was then discounted by 49 percent to reflect the share of total charges that a hospital or other provider would need to shift to insured patients to "operate at the same margins as they do when they set charges for services that are covered by insurance reimbursement," Stoll emailed. Studies that have led to considerably lower estimates of the impact of cost-sharing on private insurance rates do not assume the same level of pass-through costs. In an August 2008 Health Affairs article, noted in a February 2013 PolitiFact Ohio fact check, George Mason University professor Jack Hadley and others said that "cost shifting as a result of uncompensated care probably has only a very small impact on private insurance premiums." Specifically, the authors said, the amount potentially associated with cost shifting represents at most 1.7 percent of private health insurance costs. The analysis had no state-by-state cost-shift estimates. By telephone, Hadley told us the research drew on hospital spending on uncompensated care over 20 years and looks at how much privately insured patients were charged for care. He said private insurance costs were more likely to be affected by Medicare rates or the relative concentration of hospitals in communities than ups and downs in expenditures on uncompensated care. Summing up, Hadley said, it does not follow that family private insurance policies in Texas cost $1,800 more due to cost shifting, though he sees a public-relations appeal to such statements. The actual effect of cost-shifting might be $150 to $200 per private family policy, he said. In contrast, he said, most uncompensated care is paid for by government, meaning tax revenue. Informed of Hadley’s analysis, California consultant Peter Harbage, an author of the center report cited by Wolff, said by email that Hadley’s analysis counted certain expenditures, such as government aid for graduate medical education, as helping to cover the costs of the uninsured. Those assumptions are wrong, Harbage said, or at least not entirely correct. We were getting the picture: Different researchers started from conflicting assumptions, which are open to dispute. Earlier, in September 2009, PolitiFact identified major disagreement on the significance of cost-shifting and rated as Half True a claim by President Barack Obama that families were paying $900, on average, "in higher premiums because of uncompensated care." Obama’s claim echoed the Families USA studies. But in 2008, the respected Kaiser Family Foundation released a report questioning the methodology of the initial Families USA study and hypothesizing that cost-shifting is not that significant. Let's step back and explain what the experts are counting. They use federal data on medical expenditures to calculate the total amount spent on care for the uninsured. Then they subtract whatever the uninsured themselves paid for care, then what government and charities paid. The remainder of the cost is what people with insurance are paying for through higher premiums, according to Families USA. The Kaiser study documented fluctuations in private premiums over many years, and concluded that the data don't seem to correlate with costs for the uninsured. Rather, cost-shifting is "more strongly related to fluctuations in payments by Medicare and Medicaid," Kaiser said. The Kaiser study also did not set a per-policy cost-shift figure the way the Families USA study did. Kaiser said instead that cost-shifting might account for 1.7 percent of all private premiums. So, who is right? PolitiFact in Washington reviewed the Families USA and Kaiser studies and did not see obvious problems or conflicts. Barring fresh evidence, the differences seemed to reflect genuine disagreement among experts about methodological approaches to a complex issue. By phone, Harbage told us the Kaiser researchers approached the cost-shifting analysis with two major differences from how Families USA tackled the topic. Kaiser, he said, assumed more government spending on the uninsured, reducing the costs that could be shifted to private insurance rates, and also did not assume that every health care provider invariably maximizes profits, which Families USA did. "Smart people can come to different conclusions," he said. Our ruling Wolff said uncompensated health care costs absorbed by Texas hospitals are adding $1,800 a year to private insurance rates. His figure strikes us as worthy of skepticism partly because research on this topic seems to be driven by up-front assumptions--some of them fiercely debated. As troubling, the figure reflects 2009 estimates reached using a previous estimate of how much of such costs were passed through in 2005, nearly a decade ago. We found no post-2009 state-by-state estimates of the cost impact, while other analyses have found that although cost-shifting occurs, private insurance rates are not greatly affected. This claim, which retains an element of truth, rates .


Mice regrow brain tissue after stroke with bioengineered gel

Explanation: The news release summarizes a study on whether a gel — introduced into stroke-damaged areas of mouse brains — can stimulate the regrowth of neurons and blood vessels. The findings suggest that it can. But that’s a far cry from proving that this regrowth can function as normal brain tissue and, therefore, be “stroke-healing” in humans. Still, the news release is one of the better releases we’ve seen in terms of  making it clear that the study was in mice. Mice is referenced in the headline and throughout. Compared to many news releases we review that have to do with rodent research, this one was also more cautious with its language than most. A more substantial discussion of the harms and benefits of this experimental treatment would have made the release even stronger. This study is part of a growing body of research called “stroke neural repair,” referring to the  replacement of brain tissue damaged by a lack of blood flow, with new brain tissue. Although stroke is declining as a cause of death in the US, the fact that mortality from stroke is declining faster than the incidence, means we’re likely to see an increase in the number of people who become chronically disabled from the disease. That’s why there’s such intense interest in repairing brain tissue damaged from stroke. As further headway is made in this important area of research, some key questions for journalists and readers will be: is the new growth really functioning brain tissue? If so, how do we know it’s truly functional? And ultimately, the most difficult question of all, can it work in an integrated way with the rest of the brain?

stroke neural repair,University of California - Los Angeles

The featured treatment is a gel in developmental phase. The price is likely unknown, and not including it seems reasonable. The news release mentions: “After 16 weeks, stroke cavities in mice contained regenerated brain tissue, including new neural networks — a result that had not been seen before. The mice with new neurons showed improved motor behavior, though the exact mechanism wasn’t clear.” Although we appreciate the inclusion of the caveat that the gel’s mechanism of action is unclear, we’re not given any sense of just how much of an improvement in the motor skills of the mice was observed. And can it actually be attributed to the new growth? Harms are not mentioned and are relevant. The gel is a foreign substance being introduced into the brain. Did it trigger any kinds of reaction in the surrounding normal tissue? Did it cause any systemic symptoms? The news release provides only the briefest synopsis of the study protocol. It mentions the gel provides a scaffolding to support the regrowth of brain tissue and blood vessels. Then it’s implied these tissues are functional since the mice with regrowth “showed improved motor behavior.” But we’re given no data or insights into the significance of either the regrowth or the observed motor changes. Likewise, were the regenerated brain tissue and blood vessels normal? Functional? There’s just not enough evidence to justify the moniker “a new stroke-healing gel.” There’s no disease mongering here. The release also adds context by stating how many Americans are living with the outcomes of stroke. Funding is listed as from the NIH. The authors stated they had no financial conflicts of interest. The release doesn’t discuss any of the current treatments available to patients injured by stroke. Nor does it mention any other related techniques currently under investigation. It’s made fairly clear that the gel used in this study was developed by the authors, is experimental, and most likely not available for widespread use. Although we’re told this is a “first-of-its-kind finding,” and the treatment is a “new” stroke-healing gel, readers may have benefited from learning how this approach compares to other, related techniques currently under investigation. A quick search of ongoing research in this area reveals several things are being tried including drugs, growth factors, monoclonal antibodies, stem cells, and even brain stimulation techniques. With one glaring exception, this is a strong point of the news release. It’s made quite clear this is research in mice that is not currently applicable to humans. Unjustified cause-and-effect language is not used. The exception? Use of the term “stroke-healing gel.” The gel would only be truly “stroke-healing” if it resulted in the damaged area fully reverting to it’s original, pre-stroke level of functioning.


Zinc eaten at levels found in biofortified crops reduces 'wear and tear' on DNA

Explanation: This news release describes a new study looking at the correlation between zinc intake and DNA damage and consequently makes a case for biofortified crops like zinc rice and zinc wheat. Although the release does an exemplary job explaining the role zinc plays in our bodies, it doesn’t quite explain how this brief, small trial of 18 healthy men demonstrates the impact of zinc on cellular health. It uses vague, broad language to describe the study’s findings and dedicates only one sentence to detail the study design. Part news release, part policy article and part biofortification promotion, the release argues for the need for food-based interventions, like crop biofortification, to address malnutrition and mineral deficiency around the world based on a small study of 18 healthy American men. That may be due to the fact that the research was funded by HarvestPlus, a research program advocating for biofortification to breed higher levels of micronutrients directly into staple food crops. We wish this funding source was disclosed in the news release, as well as the question of how prevalent the practice of biofortification already is around the world. Most US news releases relate studies like this one to dietary supplements, but this news release addresses hidden hunger and malnutrition. Zinc deficiency is a public health issue in many developing countries, especially those with rice-based diets. Access to seafood, red meat and poultry (foods rich in zinc) is also a challenge for many vulnerable populations. If crop biofortification is proven to be a safe, reliable and cost-effective way to deliver essential vitamins and minerals to nutrient-deficient populations, then it should be seen as a much needed food-based intervention to improve global health.

UCSF Benioff Children's Hospital Oakland,zinc

Although zinc can be found in everyday foods such as oysters and red meat, the mineral can also be taken as a dietary supplement. A bottle of 100 zinc tablets goes for about $4 to $6 at the local drug store. Since there is no discussion of costs in this news release, we give it a Not Satisfactory rating here. There is absolutely no discussion of any benefit data in the news release. Only vague, sweeping language is used to describe the effect of increased zinc intake. For example, the release states that the addition of 4 milligrams of extra zinc a day “can have a profound, positive impact on cellular health that helps fight infections and diseases” and “reduce oxidative stress and damage to DNA.” In addition, the news release does not describe how the benefit was measured. It only mentions that scientists “used the parameter of DNA damage to examine the influence of zinc on healthy living.” How did scientists exactly count DNA strand breaks? We would have liked to have seen some numbers here, which is why we give the news release a Not Satisfactory rating. We wish the news release mentioned that too much zinc is also harmful. According to the National Institutes of Health, increased zinc intake could lead to nausea, vomiting, loss of appetite, stomach cramps, diarrhea and headaches. When people take too much zinc for a long time, they sometimes have problems such as low copper levels, lower immunity and low levels of HDL cholesterol — sometimes referred to as the “good” cholesterol. While this study was about food fortified with zinc, the news release was vague about how people should acquire their zinc, and this confusion could encourage people to reach for a bottle of zinc supplements. For this reason, we give the news release a Not Satisfactory rating. Only one sentence was dedicated to the study design. We only know from the news release that the six-week study was randomized and controlled, as “scientists measured the impact of zinc on human metabolism.” We aren’t told how many people participated in the trial, how they took the zinc (through meals or supplementation), how much zinc was given and whether the study was blinded. According to the original journal article, it turns out only 18 men took part in the trial. There was no control group per se, but participants were put on a controlled diet, in which zinc was depleted for two weeks and then repleted for the next four weeks. The study was not blinded. We feel the news release should have pointed out that all of these factors introduce potential for bias into the trial. Here’s one more point: Reducing DNA damage does not necessarily translate into better health outcomes, like increased life expectancy or lower rates of cardiovascular disease. Our bodies normally have mechanisms to repair DNA damage, which happens on a daily basis. And how are scientists so confident that zinc was specifically responsible for these lower numbers of DNA strand breaks? We would have liked to have seen more discussion on the study design and limitations, which is why we give the news release a Not Satisfactory rating here. There is no explicit disease mongering in this news release. However, the reference to “excessive DNA damage” from insufficient zinc consumption and the statement that “Zinc also helps limit inflammation and oxidative stress in our body, which are associated with the onset of chronic cardiovascular diseases and cancers” could plant fear in some readers’ minds. None of the authors reported conflicts of interest related to the study. The research was supported by a grant from HarvestPlus, a research program advocating for biofortification to breed higher levels of micronutrients — like iron, zinc and vitamin A — directly into staple food crops. Additional funding came from the NIH Office of Dietary Supplements. The news release does not disclose these funding sources, which is why we give it a Not Satisfactory rating here. The alternatives here are to eat more natural foods rich in zinc or to take dietary supplements. Some sources of zinc include oysters, red meat, poultry, beans, nuts, whole grains and breakfast cereals. Supplements contain several forms of zinc, including zinc gluconate, zinc sulfate and zinc acetate. According to the National Institutes of Health, research has not established whether differences exist among forms of zinc in absorption, bioavailability or tolerability. As we mentioned in the Costs section, a bottle of 100 zinc tablets is priced around $4 to $6. Since these alternatives are not discussed, we give the news release a Not Satisfactory rating. We wish the news release could have talked more about existing zinc fortification efforts around the world, since it’s not clear in the release whether zinc fortification practices are already in place. In the original journal article, researchers mention the zinc fortification programs initiated in more than 30 countries and point out how Bangladesh increased its rice zinc concentration by 50 percent through its biofortification methods. For this reason, we give the news release a Not Satisfactory rating. The news release states that this research is the first to show how modest increases in dietary zinc reduces oxidative stress and damage to DNA. The news release does not include unjustifiable, sensational language.


Little Lauren Renee Pingel was in a car accident in Amarillo, Texas, and despite being strapped in a car seat, was severely injured.  Her grandmother has issued an email request for prayer.

Explanation: Pray for 3-year-old Lauren Renee Pingel in Amarillo, Texas

This story is true… and the latest news is that after serious injuries, a long season of treatment, little Lauren has been released from the hospital on 7/26/01 to return home. (The details are in the example below.) The accident happened on December 15, 2000. Lauren endured several surgeries to drain fluid from the brain and dealing with the swelling of the brain. She also had lung problems. Comments


Over 200 visitors enroll in New Mexico medical pot program.

Explanation: New Mexico’s medical cannabis program is attracting enrollment from outside the state after legislative reforms did away with an in-state residency requirement.

Health, General News, New Mexico, Marijuana, Medical marijuana

November enrollment statistics from the state Health Department show that 215 cannabis patients reside outside the state. New Mexico medical marijuana provider Ultra Health said Friday that nonresident patients are coming primarily from the neighboring state of Texas and from as far away as Illinois and Michigan. Total patient enrollment climbed to 78,810. That is an 18% increase since November 2018. Per-patient enrollment in the cannabis program is highest in rural Sierra, Quay and Lincoln counties. Recently approved qualifying conditions for medical cannabis such as opioid use disorder are attracting patients to the program. In November, there were 120 patients contending with opioid use problems and 21 with Alzheimer’s disease. New Mexico health officials are considering petitions to open up the cannabis program to patients with attention deficit and hyperactivity disorder and to prescriptions for animals by veterinarians. The state prohibits recreational marijuana use and sales.


Boy on hospital floor dominates Britain’s election campaign.

Explanation: A 4-year-old boy in a Spider-Man top lying on a hospital floor took center stage Monday in Britain’s election campaign, as the opposition painted his plight as a symptom of the country’s ailing health system and branded Prime Minister Boris Johnson heartless for avoiding looking at his photo.

Brexit, England, International News, General News, Elections, Jeremy Corbyn, Campaigns, Health, Business, London, Boris Johnson, Europe

The story of 4-year-old Jack, splashed across the front page of the left-leaning Daily Mirror newspaper, overshadowed campaigning for Thursday’s general vote as Johnson and his Conservatives hunted for crucial votes in traditional Labour Party strongholds. Labour leader Jeremy Corbyn, meanwhile, toured southwest and central England, where his left-of-center party is trying to cling on to key constituencies. All 650 seats  in the House of Commons seats are up for grabs in this election, which is also expected to break Britain’s political impasse over Brexit and determine its future relationship with the European Union. Jack’s mother, Sarah Williment, told the Mirror she covered him with coats to keep him warm as he awaited assessment at Leeds General Infirmary last Tuesday. Rushed to hospital amid fears he had pneumonia, Jack was eventually diagnosed with flu and tonsillitis and sent home. Williment told the newspaper she usually votes Conservative, but will be voting Labour for the first time this week. Both Labour and Johnson’s Conservatives are pledging to pour funds into Britain’s state-funded National Health Service after years of only modest increases under Conservative governments. Corbyn accuses Johnson of planning to put Britain’s cherished health service “up for sale” in post-Brexit trade negotiations with the United States — a charge that Johnson strongly denies. It was Johnson’s clumsy reaction to the story that turned it viral. A video of the prime minister briefly declining to look at a photo of Jack had been viewed more than a million times by mid-afternoon Monday. In the clip of the interview, ITV reporter Joe Pike said to Johnson: “You refuse to look at the photo. You’ve taken my phone and put it in your pocket, prime minister.”  Johnson then took the phone out of his pocket, looked at the photo on the screen, and said: “It’s a terrible, terrible photo. And I apologize obviously to the families and all those who have terrible experiences in the NHS.”  He subsequently returned the phone and apologized for taking it. Labour Party health spokesman Jonathan Ashworth blamed the situation on Conservative funding cuts and said the prime minister’s initial refusal to look at the photo “is a new low for Boris Johnson. It’s clear he could not care less.” The spat came as opinion polls give the Conservatives a lead, but as many as one in five voters remain undecided. This election is especially unpredictable because the question of Brexit cuts across traditional party loyalties. Britain is now scheduled to leave the EU on Jan. 31. Underscoring the significance of those shifting allegiances, Johnson’s first campaign stop was in the eastern port of Grimsby targeting Labour voters who also backed leaving the EU in the U.K.’s 2016 referendum. Wearing a white jacket, hat and rubber boots, Johnson lugged a crate of fish across the floor of a fish market in the town that has been ruled by the Labour Party for 74 years. Johnson said he was “taking nothing for granted” in the final days of campaigning. He later swapped his white fish market garb for a bright yellow high-visibility jacket as he campaigned in northeast England. The Conservatives had a minority government before Thursday’s election. Johnson pushed for the vote, which is taking place more than two years early, in hopes of winning a majority of seats in the House of Commons and breaking Britain’s political impasse over Brexit. He says if the Conservatives win a majority, he will get Parliament to ratify his Brexit divorce deal and take the U.K. out of the EU by Jan. 31. Labour is promising to renegotiate the divorce deal, then give voters the choice in a referendum of leaving the EU on those terms or remaining in the bloc. Speaking in London, Labour Party official John McDonnell outlined what a Labour government would do in its first 100 days if elected — including making good on election pledges to nationalize public utilities and launch a “green industrial revolution” to tackle climate change. He also said the party would hammer out a new Brexit deal to be put to a second referendum. “Despite all his promises, it is clear to all now that far from getting Brexit done, under Johnson, Brexit won’t be done for years or we risk a catastrophic no deal,” McDonnell said. ___ Follow AP’s full coverage of Brexit and British politics at: https://www.apnews.com/Brexit


Tom Hanks, wife Rita Wilson test positive for coronavirus in Australia.

Explanation: Oscar-winning actor Tom Hanks and his wife, actress Rita Wilson, have both tested positive for coronavirus in Australia, the actor said on Twitter.

Hanks said that he and Wilson, both 63, were tested in Australia, where he is working on a film, after they felt tired and achy with slight fevers. “To play things right, as is needed in the world right now, we were tested for the coronavirus and were found to be positive,” Hanks said in the tweet. The film star said that he and Wilson would be “tested, observed and isolated” for as long as required. The couple are the first major U.S. celebrities known to have contracted COVID-19. The coronavirus has infected more than 1,000 people in the United States. “Not much more to it than a one-day-at-a-time approach, no? We’ll keep the world posted and updated,” Hanks tweeted. Hanks had traveled to Australia to begin filming an upcoming movie about Elvis Presley. He is set to play Presley’s manager, Colonel Tom Parker, in the Warner Bros. production. “We have been made aware that a company member from our Elvis feature film, which is currently in pre-production in The Gold Coast, Australia, has tested positive for COVID-19,” Warner Bros said in a statement. “We are working closely with the appropriate Australian health agencies to identify and contact anyone who may have come in direct contact with the individual. “The health and safety of our company members is always our top priority, and we are taking precautions to protect everyone who works on our productions around the world,” the studio said. The Warner Bros statement did not mention Hanks. The actor is staying on the Gold Coast, east coast of Australia, which has one of the country’s main Hollywood studios and where filming was to take place. “The Elvis biopic filming has been closed down. I understand it will be 14 days quarantine and testing and ... our heart goes out to Tom and his wife,” Tom Tate, mayor of the Gold Coast, said in a press conference. The couple’s son Chet took to Instagram to say he had spoken with his parents on the phone and that both were fine and there was no cause for major concern. “Yeah, it’s true, my parents got coronavirus. Crazy,” he said in a video message. “They’re not even that sick. They’re not worried about it, they’re not trippin but they’re going through the necessary health precautions obviously.”  Wilson appeared on Monday on a chat show of free-to-air broadcaster Nine Entertainment Co Holdings Ltd. The network said employees who had been in contact with her would be tested for the coronavirus and quarantined for 14 days. Hanks won best actor Academy Awards for his role in 1994’s “Philadelphia” in which he plays a man stricken with AIDS, and “Forrest Gump” the following year. Wilson has appeared in such films as “Sleepless in Seattle” and “Runaway Bride”. The coronavirus has infected more than 121,000 people in 118 countries while over 4,300 people have died due to the virus, a Reuters tally shows. In the United States at least 37 people have died from the respiratory illness.


1st federal opioid crisis trial to focus on distribution.

Explanation: The case is about the conduct of a group of companies in two Ohio counties, but far more than that is riding on the first federal trial on the opioid crisis, expected to open Monday in Cleveland.

Opioids, Epidemics, Trials, Business, Health, Lawsuits, Cleveland, General News, Ohio, U.S. News

The counties are looking for money to help them fight and fix the epidemic, while families who lost loved ones to overdoses are seeking justice. The companies, meanwhile, say they followed the law and are aren’t to blame for the crisis. “This is not your typical tort product liability case. It’s really about an epidemic,” said Carl Tobias, a professor in the law school at the University of Richmond. “There are so many different motivations among so many different players, it’s virtually impossible to know what would be good.” State, local and tribal governments plus hospitals and others have filed a total of more than 2,600 lawsuits against drugmakers, distributors and pharmacies seeking to hold them accountable for the nation’s opioid crisis, which has been linked to more than 400,000 deaths in the U.S. since 2000. That includes fatal overdoses from both prescription opioids and illegal ones such as heroin and illicitly made fentanyl. The Cleveland case focuses on just two of those claims, from Ohio’s Cuyahoga and Summit counties. But the case is a legal bellwether intended to signal how rulings might go in other cases in federal court, so it’s being closely watched by the drug industry and advocates. Just six companies remain in the case after a series of settlements, including one with Johnson & Johnson and a tentative deal with OxyContin maker Purdue Pharma, which has since filed for bankruptcy protection. They are drugmaker Teva, which owns Cephalon and Actavis; the major distributors AmerisourceBergen, Cardinal Health and McKesson; the smaller distributor Henry Schein; and pharmacy chain Walgreens in its capacity as a distributor. The heart of most opioid lawsuits is a claim that drug companies improperly marketed the powerful painkillers to doctors and other prescribers, overselling the benefits and understating the risks of a class of drugs long linked to addiction. In the only opioid crisis case to go to trial so far in state court, an Oklahoma judge ruled against Johnson & Johnson and ordered the company to pay $572 million in damages. With just one drugmaker left in the federal trial, the Cleveland case is expected to focus on how the drugs were distributed: Were the companies obligated to halt shipments of suspicious orders and, if so, did they comply? In legal filings, the companies have asserted that they should not be found liable. The drugs were prescribed by doctors with orders filled by pharmacies. The federal Drug Enforcement Administration kept raising the quota for how many should be made even as overdoses rose. Distributors argue that their function was mostly as a delivery service. “The distributors’ role is to help ensure that medicines prescribed by licensed doctors are delivered to licensed pharmacies, so they are available for patients who need them, when they need them, where they need them,” the three large distributors said in a joint statement issued after settlement negotiations hit an impasse on Friday. “We have to balance our mission to deliver medicines to pharmacies and hospitals when and where they need them against our important efforts to prevent and detect illegal diversion of those drugs.” The companies said they were prepared to mount a vigorous defense. Federal distribution data released as part of the Cleveland litigation showed they moved a massive quantity of drugs. An Associated Press analysis of federal drug distribution data found that in 2012, enough prescription opioids were shipped for every man, woman and child in the U.S. to have a 20-day supply. In court filings, the companies have questioned the fairness of the trial, saying it should be longer than seven weeks and that splitting 100 hours among them for questioning witnesses is not adequate. Witnesses expected to be called during the opening days of testimony include two experts on addiction, an official with the Summit County Alcohol, Drug Addiction and Mental Health Service Board, a fire chief and Travis Bornstein, whose son Tyler fatally overdosed in 2014 at age 18. U.S. District Court Judge Dan Polster, who is handling the Cleveland trial and overseeing all the opioid suits in federal courts, has long been pushing for settlements as a way to distribute money and make a difference in the fight against a complicated epidemic. Last week, Teva, the three major distributors and Johnson & Johnson, were working on a deal that North Carolina Attorney General Josh Stein said would have been worth about $48 billion in cash and free treatment drugs over time. The deal was intended to resolve all the suits against the companies, not just the claims to be heard in Cleveland. Attorneys general, lead lawyers for local governments and CEOs of the companies met for a daylong negotiating session in Cleveland on Friday. They could not get a deal completed but talks were to continue. The differences were not only between the companies and the government entities, but also between the attorneys general and local government attorneys about how the money would be distributed. On Sunday, a committee helping guide Purdue’s bankruptcy sent a letter to defendants in cases across the country suggesting they might be able to contribute to a fund and have the bankruptcy judge handling Purdue’s case end suits against them, too. David Humes, a Delaware man whose son Greg died of a heroin overdose in 2012, has dedicated himself to fighting the opioid epidemic. He does not want to wait for hundreds of lawsuits to work their way through courts to see major nationwide action. “The longer these several hundred municipal suits take is a delay in getting help for the people who most need it,” he said. But he also was critical of the settlement proposals on the table: “The offers we’ve seen so far are nothing close to the right settlement,” he said. ___ Mulvihill reported from Cherry Hill, New Jersey. ___ Follow Mulvihill at http://www.twitter.com/geoffmulvihill and Smyth at http://www.twitter.com/jcarrsmyth


Nearly 40 percent of his McAllen-area constituents suffer from obesity.

Poverty, Public Health, Texas, Eddie Lucio, Jr.,

Longtime state Sen. Eddie Lucio, D-Brownsville, highlighted two problems that come together in his district at the Southern Obesity Summit in Nashville, Tenn. Noting that Brownsville and McAllen are among the poorest cities in the U.S., Lucio said, "Because higher rates of poverty are associated with poorer health care outcomes, it should come as no surprise that McAllen is also one of the most obese areas of the country," according to his prepared remarks for the opening session Nov. 17, 2013. "Nearly 40 percent of my constituents there suffer," he said. Lucio cited via email an April 12, 2013, McAllen Monitor news story which said the McAllen-Edinburg-Mission region was "the fattest metro area in the United States" in 2012 based on a Gallup poll. He emailed us a link to the Gallup report released April 11, 2013, which drew on the Gallup-Healthways Well-Being Index, an annual effort to analyze factors including social, financial and physical conditions of U.S. adults. Gallup used Hidalgo County as the boundary for the McAllen metropolitan statistical area. Only the southeastern part of Hidalgo County is in Lucio’s District 27, according to the Texas Legislative Council’s map, but we did not find a more precise breakdown of obesity statistics. By phone, Gallup-Healthways research director Dan Witters told us that the index uses information gathered nationwide in English and Spanish phone interviews. The survey reached about 350,000 U.S. adults throughout 2012 and had a margin of error of plus or minus 0.2 percentage points. Witters emailed us results for the nine largest Texas metropolitan statistical areas, as defined by the U.S. Census Bureau, where Gallup-Healthways was able to field 300 or more responses in 2012. Insufficient responses excluded Brownsville-Harlingen, which would have been ninth-largest out of the ten top MSAs. Of the nine regions, the McAllen-Edinburg-Mission metro area had the highest share of obese residents: 38.5 percent. Austin-Round Rock was the skinniest, at 22.7 percent. Percentage of obese residents in nine of the 10 largest Texas MSAs for 2012, Gallup-Healthways: McAllen-Edinburg-Mission -- 38.5% Beaumont-Port Arthur -- 32.5% San Antonio -- 31.4% Corpus Christi -- 31.2% Dallas-Fort Worth-Arlington -- 26.7% El Paso -- 26.7% Houston-Sugar Land-Baytown -- 26.6% Killeen-Temple-Fort Hood --  25.3% Austin-Round Rock -- 22.7% Nationally, Boulder, Colo., was Gallup-Healthways’ skinniest metropolitan statistical area with 12.5 percent obesity. The nationwide average was 26.2 percent. To calculate obesity, Witters said, Gallup-Healthways asked respondents for their height and weight, then calculated body-mass index, with a BMI of 30 or above considered obese. (To find yours, the National Institutes of Health say, "Multiply your weight in pounds by 703. Divide that answer by your height in inches. Divide that answer by your height in inches again." Or use an online calculator like these.) Witters said that In phone interviews, "men tend to say they’re taller, women say they’re a bit lighter" than they are. Gallup-Healthways did not modify its results to account for this, he said, but as a general rule of thumb adding 20 percent to 25 percent to BMI corrects for such self-reporting. Seeking another indicator of obesity in the McAllen region and elsewhere in Texas, we turned to the Texas Department of State Health Services. That agency defines the state’s metropolitan statistical areas differently than the federal government -- for example, splitting Dallas/Plano/Irving from Fort Worth/Arlington -- but like Gallup used Hidalgo County as the McAllen region. The McAllen area topped a 2012 list of large metro areas that spokeswoman Christine Mann gave us by phone. Percentage of obese residents in seven of the largest Texas MSAs for 2012, Department of State Health Services: McAllen-Edinburg-Pharr -- 44.7% El Paso MSA -- 34.1% Fort Worth-Arlington -- 31.8% San Antonio MSA -- 28.9% Houston-Baytown-Sugar Land -- 27% Dallas-Plano-Irving -- 26.5% Mann said the average for Texas in 2012 was 29.2 percent. Texas’ health services department collects its data in the annual Texas Behavioral Risk Factor Surveillance System telephone survey, and like Witters noted that people tend to underreport their health risk factors in phone interviews. The 2012 BRFSS was conducted throughout the year; the BMI portion had 8,530 respondents and a 95 percent confidence interval, Mann said. Our ruling Lucio said nearly 40 percent of his McAllen-area constituents suffer from obesity. McAllen’s metropolitan statistical area in 2012 had 38.5 percent obesity among adults, according to the Gallup-Healthways study. A state survey that year suggested that nearly 45 percent of the region’s residents were obese. We rate Lucio’s statement as . – The statement is accurate and there’s nothing significant missing.


Beta-Propiolactone is in vaccines and is known to cause cancer, suspected gastrointestinal, liver, nerve and respiratory, skin and sense organ poison. It may be present in trace amounts of some vaccines. It is potentially carcinogenic, but only in much larger amounts than would be in a vaccine. The antibiotics gentamicin sulfate and polymyxin b are in vaccines and can cause allergic reactions ranging from mild to life-threatening. Traces of these antibiotics can end up in certain vaccines, but would only cause a reaction in someone severely allergic. Genetically modified yeast, animal, bacterial and viral DNA in vaccines can be incorporated into the recipient’s DNA causing unknown genetic mutations. Modified DNA can be used in the production of some vaccines, but is very unlikely to end up in the final product. Even if it did, there’s no evidence it can cause mutations. Glutaraldehyde is in vaccines and is poisonous if ingested and causes birth defects in animals. There are trace amounts in some vaccines from manufacturing, and not enough to cause harm. Formaldehyde is in vaccines and causes cancer in humans among other issues and is banned from vaccines in most European countries. It’s not banned in Europe. There are only trace amounts in certain vaccines and not enough to be carcinogenic. Latex rubber is in vaccines and causes life-threatening allergic reactions. Latex is used in the packaging of some vaccines, which could potentially cause harm if someone’s strongly allergic to it. Human and animal cells from sources like aborted foetuses are in vaccines and are linked to childhood leukaemia and diabetes. They may be used in certain vaccines’ production, but are unlikely to make it to the final product. Mercury (aka thimerosal or thiomersal) is in vaccines and can damage brain, gut, liver, bone marrow, nervous system and kidneys, is linked to autoimmune disorder, autism. Thiomersal isn’t in any UK vaccines any more. This is down to concern around a slightly different mercury-based chemical. MSG is in vaccines and is linked to birth defects, developmental delays, infertility and is banned in Europe. It’s not banned in Europe. It’s used in some vaccines to stabilise them. There’s no strong evidence it causes these problems in humans. Neomycin sulphate, an antibiotic, is in vaccines and can lead to epilepsy, brain damage and allergic reactions. Trace amounts of this antibiotic may end up in certain vaccines. If you are allergic to it could cause an allergic reaction. Phenol / phenoxyethanol is in vaccines and is used as antifreeze. It is toxic to all cells and can destroy the immune system. These chemicals have been used in vaccines as preservatives. They are not in antifreeze. Polysorbate 80 and 20 are in vaccines and cause cancer in animals and are linked to autoimmune issues and infertility. Tiny amounts of Polysorbate 80 is in a type of flu vaccine. There isn’t evidence ingesting it is linked to these issues in humans. Tri(n) butylphosphate is in vaccines and is potentially damaging to the kidneys and the nervous system. We can find no evidence of this being used in vaccines in the UK. Claim 1 of 14


The murders of two television journalists in Virginia renewed the debate about gun control in America. On Fox News’ The Five, panelist Juan Williams said he feels more threatened by the number of guns on the street in New York and Washington, D.C., than he does by the militant Muslim group ISIS. Show co-host Eric Bolling shot back, "In countries where there are higher, more strict gun laws, there is more gun violence." We decided to see if Bolling had his facts straight. We couldn’t find proof that he did, and neither Bolling nor Fox News got back to us to show otherwise. There is no hard and fast yardstick to compare gun laws across nations, but there are some rough indicators. The United States is unusual in framing gun ownership as a right, so at the most basic legal level, most countries begin from a more restrictive starting point. There’s helpful data on gun regulation in other countries from the Graduate Institute of International and Development Studies in Geneva, Switzerland. According to the group’s 2011 small arms survey, personal protection is not a sufficient reason to own a weapon in Australia and the United Kingdom. In fact, in the United Kingdom, the 1996 slayings of 16 school children in Scotland led to a ban on private handguns. Japan also bans handguns. Canada requires all would-be gun owners to get a license to own a gun. They must pass a background check and complete a safety course. If they then go and buy a weapon, they must register it. They can buy a gun for personal protection, but they must show that they face an imminent threat and that police protection is not good enough. In a previous fact-check, a researcher at the study center in Geneva told us that Australia, Japan, Singapore, South Africa and the United Kingdom have some of the strictest gun regulations. Comparing gun violence The studies we found measured gun violence in terms of the rate of firearm-related homicides. By that standard, America ranks worst among every country of comparable economic status. David Hemenway at Harvard’s School of Public Health has looked at gun deaths across nations. "If we look at high-income countries, the weakest gun control laws are in the United States, and we have by far the most gun violence," Hemenway said. "At the other extreme are the U.K. and Japan, which have the strongest gun laws, and they have among the lowest levels of gun violence." The World Bank provides a list of high-income countries. Based on data from the United Nations Office on Drugs and Crime and reporting by the Guardian, America does top the list for the rate of murder by gun fire with a rate of 2.97 deaths per 100,000. Chile comes next, but Chile is not on the list of wealthy nations with strict gun laws. (The full list is here.) In the wealthy group with strict laws, the data undercut Bolling’s claim. Country Homicide by firearm rate per 100,000 population United States 2.97 Canada 0.51 Australia 0.14 United Kingdom 0.07 Japan 0.01 Source: UNODC, Guardian For the countries that have tougher gun laws but lower wealth than the United States, South Africa has a higher rate of gun violence, 17.03 deaths per 100,000, and Singapore has a lower rate, .02 deaths per 100,000. Our ruling Bolling said that countries with tougher gun laws have more gun violence. The data show that among countries more like America economically, nations with stricter regulation have much lower rates of gun-related homicides. South Africa has tougher laws but is much poorer, and it is the only exception. Bolling described a pattern that does not exist. We rate this claim .


Film academy president keeps job following investigation.

Explanation: The Academy of Motion Picture Arts and Sciences has concluded its review of a misconduct allegation against film academy president John Bailey and determined that no further action is required.

Entertainment, Movies, North America, Science, Academy of Motion Picture Arts and Sciences, Anita Hill

The film academy said late Tuesday that Bailey will remain in his position, which he has held since August. Bailey, a cinematographer whose credits include “Groundhog Day,” ″The Big Chill” and “As Good as It Gets,” had previously denied the allegation that he attempted to touch a woman inappropriately on a movie set a decade ago. The film academy says the membership and administration committee and its sub-committee took his response, the claim and corroborating statements into account in its review. Outside counsel was also consulted, including from Ivy Kagan Bierman who is an adviser to the Anita Hill-chaired Commission on Eliminating Sexual Harassment and Promoting Equality in the Workplace. The committee’s unanimous conclusion was also backed by the academy’s Board of Governors. Bailey’s attorney David Schindler did not immediately reply to an email seeking comment. The investigation comes as the academy has sought to make the fight against sexual misconduct a central goal after the wave of revelations beginning in October that brought down movie mogul Harvey Weinstein and spread throughout the industry. Bailey was two months into his presidency in October when Weinstein’s membership was revoked. Prior to Weinstein, only one other person has had their film academy membership withdrawn, and that was for loaning out awards screeners. At the time, Bailey said in a memo to members that the academy “can be a part of a larger initiative to define standards of behavior and to support the vulnerable women and men who may be at personal and career risk because of violations of ethical standards by their peers.” The academy adopted its first code of conduct in December, which stipulated that the academy is no place for “people who abuse their status, power or influence in a manner that violates standards of decency,” and made it easier to suspend or expel members. The claim against Bailey investigated by the academy was received on March 13. In its statement Tuesday, the academy said it will refrain from discussing the specifics of the claim out of respect for the confidentiality of the claimant and Bailey. The organization’s goal, the statement said, is “to encourage workplace environments that support creativity, equality, and respect.” ___ AP Entertainment Reporter Andrew Dalton contributed from Los Angeles.


When people enter the service, there’s not a mental health evaluation.

National, Health Care, Military, Michael McCaul,

The second shooting at the Texas military base Fort Hood in less than five years has reopened wounds -- and old debates. During the Sunday morning political shows on April 6, 2014, typical questions over base security and concealed carry rules on military installations emerged in the wake of the deadly shooting last week, with politicians and pundits mostly assuming their party-line positions. But there was some bipartisan consensus that the military should take a closer look at the mental health of enlisted service members. On Fox News Sunday, Rep. Michael McCaul, a Texas Republican who chairs the House Homeland Security Committee, said the effort should start at sign-up. "When people enlist in the military, there is a physical check but there's not a mental health evaluation when people enter the service," McCaul. "I think this will be a good idea to, No. 1, screen out individuals that may have mental illness problems. No. 2, have a baseline so that when they return home, we can compare that to where they are when they come back." We were unfamiliar with the process men and women go through to enlist and imagine McCaul’s claim about mental health evaluations caught the attention of viewers as well. So we decided to check it out. No formal process Officials have not yet identified a motive that caused Army Spec. Ivan A. Lopez to open fire at the Fort Hood base, killing three and injuring more than a dozen. Lopez was being treated for depression and was screened for post traumatic stress disorder, though Army officials have said mental health was "not the direct precipitating factor" in the shooting. McCaul’s office pointed us to legislation introduced by Rep. Glenn Thompson, R-Penn. on March 27, 2014 -- coincidentally, just days before the shooting -- called the "Medical Evaluation Parity for Service Members Act." The bill would require a medical evaluation before an individual enlists in the armed forces. According to the legislation, "Although the military currently has a baseline measurement process for physical health, the military does not currently have similar standards for mental health." Speaking in favor of the bill, retired Army colonel and director of legislation for the National Guard Association of the United States Peter Duff said, "Not having a baseline is a neglectful disservice to our military members and veterans who risk their lives for our nation." The bill has the support from various military and veteran organizations, including Veterans of Foreign Wars, National Guard Association of the United States, Reserve Officers Association, Reserve Enlisted Association, Association of the U.S. Navy, National Military Family Association and Military Officers Association of America, as well as the American Psychological Association. A mental health examination is not listed in a description of the application procedure on the United State Military Entrance Processing Command website or in the Military Entrance Processing Station regulations. That’s all pretty strong evidence that no separate examination for identifying mental health disorders in enlistees exists, at least not in a similar form as the physical new recruits must go through. What does exist? But is there any evaluation the armed services conduct upfront? In addition to an aptitude test, as part of the initial screening, military officials review the medical records of potential service members for their mental health history. Col. Rebecca I. Porter, chief of the behavioral health division of the Office of the Army’s Surgeon General, told the Washington Post that the application process "includes a review of whatever medical records we have available, as well as asking potential soldiers to complete questionnaires where they might disclose information. We look for past diagnoses or past treatments, or other indicators of behavioral problems." Porter said a past suicide attempt, mood disorders like depression or bipolar disorders or drug abuse could all preclude someone from gaining admittance to one of the service branches. But much of that review requires the individual to have a documented medical history or to offer information that they may have problems. Such an admission would likely mean they would not be accepted. "People who want to come into the Army are no fools," Dr. Elspeth Ritchie, a former chief psychiatrist in the Army, told the Los Angeles Times. "They know if you say you had a past suicide attempt, you're probably not going to get in." A recent study from the medical journal JAMA Psychiatry conducted in consultation with the U.S. Army found 1 in 5 servicemembers had a mental health disorder before they even enlisted. Once enlisted, however, service members are prone to frequent mental health evaluations before and after deployment. "We have a series of evaluation of any soldier, sailor, airman, Marine, Coast Guardsman who's deployed prior to their deployment," Retired Lieutenant General Eric Schoomaker told NPR. "They have access to mental health and physical health care providers, as well, while they're on deployment. And when they return from deployment, within 30 days of their being redeployed, they have another series of examinations with the help of their small unit leader down-range, which is then married up with further assessments that take place when they hit the ground back at home station." Mental health evaluations can also be recommended by the overseeing officer. "If the chain of command becomes aware of a change in the soldier’s behavior, he can ask the soldier to be seen at a behavioral health clinic," Porter said in her Post interview. "Or if a commander had questions about a soldier’s fitness for duty, they could do a command-directed mental health evaluation, in which case a soldier is referred for evaluation with the understanding that the behavioral health provider will provide feedback to the commander." Not everyone in the military community agrees that a mental health evaluation upfront would be helpful. Schoomaker, a surgeon in the Army until 2012, recently told the Los Angeles Times that such a process "would just lead to driving the problems further underground." Our ruling McCaul said "there's not a mental health evaluation when people enter the service." Compared to the physical medical examination potential enlistees go through, there is no separate, specific examination of a recruit’s mental health. While the armed services review past medical records for a history of mental health issues and allow for the applicant to offer any additional information, it has not prevented a sizable number of individuals with mental health problems from acceptance. Lawmakers and military officials can debate what steps should or should not be taken, but we can’t find any flaw in McCaul’s characterization of the current procedures. We rate it .


Under Hillary Clinton, State Department "officials were sending official thank-yous to people who gave to the Clinton Foundation.

Corrections and Updates, Foreign Policy, PunditFact, Grover Norquist,

Opinion polls consistently show that if there’s one thing Hillary Clinton is up against with voters, it’s that too many of them question her honesty. Anti-tax advocate Grover Norquist, president of Americans for Tax Reform, fed into that theme during an interview on Fox Business with host Maria Bartiromo on March 24, 2016. Norquist segued from talking about her presidential campaign fundraising to the "mixing of her official job as secretary of state and the Clinton Foundation." Norquist said, "We now know (that) officials were sending official thank-yous to people who gave to the Clinton Foundation. Letting them know ‘wink, wink, nudge, nudge’ that you didn’t just give to the Clinton Foundation. Hillary Clinton, secretary of state, appreciates what you’ve done." We wondered if Norquist's allegation was correct. When President-elect Barack Obama considered making Hillary Clinton his secretary of state, the immediate concern was that foreign interests might curry favor at the State Department by supporting her husband’s efforts at the Clinton Foundation and the Clinton Global Initiative, also called CGI. To clear the way for Clinton’s nomination, those organizations agreed to a number of measures to avoid real and apparent conflicts. Among the changes, the foundation would publish the names of its donors and separate itself from the Clinton Global Initiative. Bill Clinton would not raise funds for CGI, and CGI itself would no longer accept donations from foreign governments or hold events outside the United States. After all that, did Clinton's State Department really cross the line by sending officials thanks to the foundation's donors? We asked Norquist’s spokesman John Kartch for the source behind the statement that State Department officials were sending thank-yous to people who gave to the Clinton Foundation. Kartch sent us a link to a page on the website of Judicial Watch, which describes itself as a conservative educational group. Judicial Watch posted a number of documents it received through a Freedom of Information Act request to the State Department. The first few pages in the collection were an exchange of emails between Clinton’s chief of staff Cheryl Mills and other top aides at the State Department, and Amitabh Desai, director of foreign policy at the Clinton Foundation. (Before joining the foundation, Desai was a legislative aide to then-Sen. Hillary Clinton.) Desai wanted Secretary Clinton to speak at the closing session of the Clinton Global Initiative meeting on Sept. 25, 2009. The conversation begins on Aug. 22, 2009, with this letter from Desai to Mills and Huma Abedin, Clinton’s deputy chief of staff, at the State Department:  To decode the lingo of CGI, "HRC" is Hillary Rodham Clinton, "WJC" is William Jefferson Clinton and "commitments" are agreements among aid groups, governments and often corporations to work on a particular project. Desai’s list of three commitments included: Launching a media campaign to reduce sexual violence against girls. It involved the U.S. Centers for Disease Control and Prevention, several United Nations agencies, a large Brazilian ad agency and a foundation set up by a former hedge fund owner. Promoting the use of vitamin and mineral fortified food among poorer Indian households. It involved a major Indian food corporation. Expanding a micro-insurance fund. It involved an investment fund that had raised $44 million to provide small insurance policies in poor communities. Mills at the State Department answered, "I think this if fine but here's my question - how does this work - are these announced before or after she speaks and what relationship are they supposed to bear to what she says?" Desai said commitments are announced throughout the conference. "We could give you a list of all announcements as they get scheduled as we get closer to the meeting, and anything else that would be helpful." Mills replied, "It would be helpful to have list of commitments during whole session so she can reference more than those just around her speech." The final words in this email chain come from Caitlin Klevorick, a former consultant to the foundation who became a special assistant in the Secretary of State’s office. "One question is if we want to see if there is a decent mass of fs (food security) related commitments to announce together at closing as a ‘mega’ commitment," Klevorick wrote. That is the sum total of the interactions between State Department and Clinton Foundation staff, according to the emails obtained by Judicial Watch. We asked Kartch at Americans for Tax Reform if we had missed anything and did not hear back. Tom Fitton, president of Judicial Watch, said he sees clear collaboration between the two entities. "State Department and Clinton Foundation staff worked together on how Mrs. Clinton could thank Foundation supporters for their commitments during a speech, which Mrs. Clinton did," Fitton said. "Mrs. Clinton, as the result of work by her aides and a Clinton Foundation representative, provided an official thank you during her speech." This is different from Norquist’s claim. Norquist said State Department officials were sending official thank-yous. The emails don’t describe that. Further, in her actual speech, Clinton didn’t thank anyone for contributing money. Early on, she did express her appreciation, but that was aimed at governments, not donors. "As secretary of state, I really, in terms of protocol, should be acknowledging all of the heads of state and heads of government who are here, but there are far too many," Clinton said. "So let me just express my deep appreciation for your involvement and for your presence here. We look forward to working with you and your governments as we move forward on the new agenda of the Obama administration." A moment later, she praises the entire audience. "This is an exceptional gathering of people, who have made exceptional commitments to bettering our world. We see it in everything you do. It seems a good opportunity, given the talent, the energy and the passion in this room, to talk about an exceptional global challenge, chronic hunger and what we all can do about it." Clinton spent the bulk of her speech talking about the White House policy to combat hunger. At the end, she told the audience, "We need your ideas and your feedback, and we need your active support in any and every capacity." Kathleen Clark, who specializes in public sector ethics law at Washington University in St. Louis, told told us she didn’t see any smoking gun in the emails Norquist offered as evidence. Our ruling Norquist said that State Department officials were sending official thank-yous to donors to the Clinton Foundation. We looked at the source documents he relied on and found nothing that supported his version of events. State Department staff did ask for lists of projects and partners in preparation for a speech Clinton was to give at a Clinton Global Initiative meeting. However, there is no hint that any staff member expressed official appreciation to any donor. There is no indication that money for those projects flowed through CGI. Finally, Clinton thanked governments for showing up, but didn’t thank donors. She praised the audience in general, but that would include many who were on the receiving end of CGI’s efforts. The documents do not say what Norquist suggested they said. We rate this claim . Correction: An earlier version of this story said the Clinton Global Initiative and the Clinton Foundation separated in 2009. Actually, the groups separated in 2010.


Every day, four North Carolinians die from a medication or drug overdose.

Drugs, Public Health, Public Safety, Science, States, North Carolina, Greg Murphy,

The fight to limit the availability of prescription painkillers in North Carolina is being led in part by the only medical doctor in the N.C. General Assembly. Rep. Greg Murphy, a Republican from Greenville who is also a urology surgeon, is the primary sponsor of what’s being called the STOP Act. That stands for "Strengthen Opioid Misuse Prevention." In the past several weeks, he has promoted his bill with a sobering statistic. "Every day, four North Carolinians die from a medication or drug overdose," Murphy said in early March, when he first introduced the bill. "I prescribe these medications daily and I see the problem first hand." Murphy has often been quoted or paraphrased in the news repeating some version of that claim about the deadliness of drug overdoses, most recently on Monday when the bill passed the House of Representatives unanimously. It’s a popular argument for a popular bill, which has support from lawmakers of both parties as well as a vocal ally in Democratic Attorney General Josh Stein. In addition to other provisions, the bill would reduce the amount of pain pills a doctor could prescribe to most patients on their initial visits. The idea is that fewer pills will lead to fewer opportunities for abuse or addiction. The STOP Act passed the N.C. House 114-0 and is now in the Senate. But we wondered whether the morbid statistic that’s driving much of the conversation is actually correct. How deadly are prescription pills? In 2015, according to the N.C. Department of Health and Human Services, 1,370 people died of unintentional poisonings. Of those deaths, 93 percent (1,274) were drug overdoses – everything from painkillers to cocaine to heroin. That’s an average of 3.5 deaths daily, which is in line with Murphy’s claim of four a day. Nearly the same number of people died in 2015 from unintentional drug overdoses as died from gunshots. If you also include intentional overdoses, then drugs were deadlier than both guns and car crashes. A 2016 Robert Wood Johnson Foundation study found the counties with the highest rates of drug overdose deaths are all in western or southeastern North Carolina. But even though Murphy phrased his claim broadly about all drug overdoses, his bill doesn’t target street drugs like cocaine and heroin. The STOP Act is only aimed at limiting the supply of prescription painkillers. Prescription pills were involved in 738 unintentional overdose deaths in 2015. That’s two a day – certainly troubling, but only about half of Murphy’s claim. However, experts agree there’s a strong link between painkillers and heroin, since they give the same type of high, and heroin tends to be cheaper and more widely available to addicts. "When we talk to people who are injecting heroin, they all got there through prescription opioids," said Steve Marshall, an epidemiologist and director of UNC-Chapel Hill’s Injury Prevention Research Center. "It's not some of them. It's all of them." Marshall said it would be fair for Murphy to count heroin overdose deaths when promoting the STOP Act, if not cocaine overdose deaths. Cocaine, unlike heroin and painkillers, is not an opioid. Just under 1,000 North Carolinians died from an unintentional opioid overdose in 2015 (see here for county-level data). That’s an average of 2.7 per day – again, not exactly what Murphy said, but not far off. Last year California medical company Castlight Health ranked four North Carolina cities among the top 25 nationwide for painkiller abuse. Wilmington, the company’s study said, had the country’s highest rate of opioid abuse. The report found more than half of the prescriptions issued for painkillers in Wilmington are being abused. Kay Sanford, another UNC-Chapel Hill epidemiologist, is credited with discovering the rising trend of prescription pill addiction and overdoses in North Carolina in the early 2000s. She said many people have been replacing painkillers with heroin in the last few years. "The number of people dying from prescription opioids, in North Carolina and nationwide, has gone down while the number of people dying from heroin has gone up," Sanford said. "So when you combine those two, it's basically the same number." Yet in Murphy’s favor, at least one piece of brand-new research has made the argument that cocaine should be included in these counts, too. In February researchers with several federal government agencies published a paper that argued cocaine overdoses can be linked back to the increased use of opioids like painkillers. "Opioids, primarily heroin and synthetic opioids, have been driving the recent increase in cocaine-related overdose deaths," the study concluded. Our ruling Rep. Greg Murphy has been promoting his STOP Act, which would limit access to prescription painkillers, by saying that drug overdoses kill four people a day in North Carolina. That’s basically accurate (it’s 3.5 per day) but prescription pills alone are only responsible for 2 deaths a day – half of what Murphy said. However, there’s wide agreement in the scientific community that for such counts it makes sense to lump heroin and painkillers together (which cause 2.7 deaths a day) and some research has argued for including cocaine deaths, too. Even if his statistics are slightly inflated, Murphy’s general point – that opioid addiction is leading to multiple deaths per day in North Carolina – is correct. We rate this claim .


KT McFarland, Trump's pick for his national security team, outed her gay brother as he was dying from AIDS.

Explanation: Thus, the argument can be made that by publishing the contents of personal, inter-family communications, New York Magazine outed McFarland’s brother, not McFarland. While it remains unclear whether her letters were ever actually delivered, it does remain possible that she “outed” her brother to her parents. However, we have no definitive proof of that, as McFarland’s mother denied knowledge of them.

On 28 November 2016, the Washington Blade posted a story reporting that Fox News analyst Kathleen Troia “KT” McFarland, who has been tapped by President-elect Donald Trump to serve as his deputy national security adviser, “outed” her gay brother who was, at the time, dying of AIDS. Multiple other publications followed suit with similar headlines. However, the stories link back to a 2006 profile in New York Magazine, where McFarland clearly did not want to speak about her brother. It was the magazine that dug up letters she had written to her parents more than a decade earlier: KT’s father worked the night shift as a train dispatcher in Madison, Wisconsin. The eldest of four, KT had a brother here in New York City who had followed her to George Washington University and then worked as an analyst. “Ummmm. He was sick and then he died,” is all she would say when pressed. Michael Troia had aids; his obituary listed three “companions.” KT, the moderate in this race, couldn’t abide his sexual orientation. Shortly after she discovered Mike had aids, she wrote her parents lengthy, angry, almost Gothic letters in which she outed her brother, blamed her father for his troubles as well as those of her and her other siblings, and cut off contact with her parents. “Have you ever wondered why I have never had anything to do with Mike and have never let my daughters see him although we live only fifteen minutes away from each other?” she wrote. “He has been a lifelong homosexual, most of his relationships brief, fleeting one-night stands.” The father’s behavior had surfaced for McFarland as recovered memory. She said a shrink put her up to writing the letter; reached for comment, her mother, Edith Troia—KT has since made up with her parents—denied the account. “Wouldn’t that make a great book?” she said. “Please be kind. You could be casting dark shadows on this whole race.” The profile was published while McFarland was in the midst of an ultimately unsuccessful campaign to be the Republican nominee challenging an incumbent Hillary Clinton for the U.S. Senate seat in New York. Clinton would go on to win against John Spencer, who beat McFarland in the primaries. The story line accusing McFarland of cold-heartedly outing her dying brother seems to be an attempt at unfairly painting her in a negative light — and it is nothing new. The New York Post went with the same theme at the time, cribbing off the same New York Magazine article, in a 25 June 2006 story headlined, “Hill Foe ‘KT’ outed her dying brother.”  But the reality around the circumstances are much more complicated, having to do with a troubled family history and a letter that was made public against her will during the throes of a political campaign. With the New York Magazine story looming, McFarland’s camp scrambled to get ahead of the story, contacting the New York Times a week before it was published to give her side. She released a statement to the Times saying that she grew up in a physically abusive household, and on the advice of a therapist, wrote two candid letters to her parents in 1992, which somehow surfaced and were made public more than a decade later. Her statement to the Times read: Like too many Americans, I was raised in a household where physical abuse occurred. It was something that left in me deep emotional scars, which I struggled to deal with for many years. In seeking to put a painful past behind me, I wrote two candid letters to my parents in 1992 at the advice of a counselor. Now, in the midst of a political campaign, those letters have found their way into the hands of a magazine reporter. Her mother, when contacted by the Times, refused to comment. McFarland recounted snippets of what was an apparently painful family history, while noting that whatever her relationship was with her brother, she never had any intention of making his personal affairs public: In the statement last night, Ms. McFarland said that her personal life is ”fair game” in the Senate race, but her brother’s private affairs should not be an issue. ”Mike passed away in 1995, and his choice of lifestyle and the abuse he suffered as a child were not something he chose to make public while he was alive,” Ms. McFarland said. ”I respectfully request that his memory remain private to all those who loved him.”


County contracts mental health provider for Montana jail.

Explanation: County officials in Montana have voted in favor of two short-term contracts to provide mental health services in the county jail after officials did not renew a health provider’s contract.

Health, Helena, General News, Montana, Mental health

The Lewis and Clark County Commission has contracted the Center for Mental Health temporarily while moving to hire two jail behavioral therapists and a case manager, the Independent Record reported Tuesday. The decision comes when the jail did not have a therapist for a month and the previous provider’s contract expired, officials said. One of the contracts provides therapy services to inmates for $110 each hour to the county with a cap of $22,000 until Feb. 28, or until the county hires its staff, jail officials said. Another contract secures the services of the Center for Mental Health at $500 a day with a cap of $30,000 to cover staffing for an on-call mobile crisis response team, officials said. These services are not additional services, but instead are designed to bring standards up to industry baselines, officials said.


Breast cancer diagnosis gets a boost with gammagrams

Explanation: This story describes a new breast imaging modality that relies on injecting a radioactive label into the bloodstream and using a gamma radiation detector to see if tissue in the breast lights up, presumably identifying cancer cells. It is described as less painful than mammograms and perhaps cheaper than MRI. The story mentions the lack of evidence for its use as a test but at the same time provides perhaps overly enthusiastic patient anecdotes. The story makes good use of possibly disinterested experts, but their cautious statements may be overmatched by happy consumers and radiologists who have invested in the technology. The important caveat, appearing but perhaps overwhelmed in the story, is that it is not yet known whether the test works as well as current technologies (mammograms, ultrasounds and MRI), nor whether it can improve health outcomes. Whether or not it is cheaper than another test is less relevant than whether the information generated has clinical value. If this story had provided some hard data about how well or poorly this new test performs in relation to standard practice, we would have thought more highly of it. But kudos for putting this caveat so high in the story (4th sentence):  "not enough studies have been done to show it saves lives and money" and for trying to inject some caveats throughout.

Costs for this test were included. Does it not seem odd that there are different prices charged for a test depending on who is paying? It is instructive that this was reported in the story, though a little more information about this practice would have been useful. The story did mention that it is not yet known whether this test is of benefit to women. So we’ll give the story the benefit of the doubt. That said – there was a lot of space given to anecdotes about how pleased patients were to have had the test. Patient satisfaction was enhanced because the test was less invasive than a biopsy and there was very quick turnaround to get back information on test results. While these are real benefits, the story should have explored the value of these things in the context of unknown utility for the test. The harms of the test were not explicitly reported. Injection of a label that emits gamma irradiation may or may not be risky; the article is silent on this. Most important is the issue of relying on a test for which the outcomes remain uNPRoven. Could this test miss a certain subset of cancers allowing them to progress? Might it identify lesions that aren’t cancers, causing undo concern and lead to unnecessary treatment? The story failed to detail the implications of relying on an uNPRoven technology or the harms that might result. The story mentioned several times that the utility of this test has not yet determined. But the story persisted in presenting arguments favoring the use of this test. This was an important shortcoming of the piece. So while the story did include a clear statement that ‘there’s not a shred of evidence’ that this technology will find more cancers, the story included a comment from a patient who stated she was ‘happy to know her cancer had not returned’. The unknowns described in the story would indicate that her trust is unfounded. The story should have pointed out the potential harm of relying on an uNPRoven technology. Did not engage in overt disease mongering. The headline for the story was not consistent with the content, but that’s not the reporter’s fault. The story included quotes from a clinician who has invested in the equipment needed to run this test for his practice as well as from a clinician with radiological imaging expertise. In addition, there were patient quotes attesting to consumer pleasure with the test. It would have been very helpful to include critical assessment for how the test results could be validated. The story mentioned breast biopsy and MRI imaging as other possible options available to women in need of follow-up assessment to their mammogram results. For completeness, the story should have included mention of ultrasound as a follow-up to assess a mass observed with a mammogram. The story was clear that there is limited availability for this test. The story reported appropriately about a potentially useful test for determining more quickly whether a finding on a mammogram is related to a breast cancer or not. Does not appear to rely on a press release.


Vaping illness, deaths likely very rare beyond U.S., experts say.

Explanation: E-cigarette or vaping-linked lung injuries that have killed 29 and sickened more than 1,000 people in the United States are likely to be rare in Britain and other countries where the suspect products are not widely used, specialists said on Monday.

Experts in toxicology and addiction said they are sure that the 1,299 confirmed and probable American cases of serious lung injuries linked to vaping are “a U.S.-specific phenomenon,” and there is no evidence of a similar pattern of illness in Britain or elsewhere. “What’s happening in the U.S. is not happening here (in Britain), nor is it happening in any other countries where vaping is common,” said John Britton, a professor and respiratory medicine consultant and director of the UK Centre for Tobacco & Alcohol Studies at Nottingham University. “It’s a localised problem,” he told a London briefing. U.S. investigators and health officials have said there may be more than one cause for the cases of vaping lung illness. They have also pointed to vaping oils containing THC, the psychoactive ingredient in marijuana, as being especially risky. In Britain, which currently has 3.6 million regular e-cigarette users, such oils are banned and advertising of vapes is much more tightly regulated than in the United States, said Ann McNeill, a professor of tobacco addiction at the Institute of Psychiatry Psychology & Neuroscience at King’s College London. She and Britton also noted that rates of tobacco cigarette smoking - which can cause lung cancer and heart disease and is known to kill about half of all those who do it - are dropping more rapidly in Britain than in the United States. This is partly due to tobacco smokers switching to nicotine-containing e-cigarettes to help them quit, they said. “It would be a great shame if people were deterred from using e-cigarettes because of what’s happening in the U.S.,” McNeill told reporters. India, which has the world’s second-largest population of adult smokers, last month announced a ban on the sale of e-cigarettes, citing concerns about the U.S. cases. And in Malaysia, which has banned the sale of vape liquids containing nicotine since 2015, the health minister says he is now considering a total e-cigarette sales ban. Asked whether he thought such bans made sense from a public health policy standpoint, Britton said he disagreed with India’s decision and similar ones in the United States, because they send a message to tobacco smokers to continue smoking. “It’s a no-brainer - if you stay on cigarettes you will lose a day of life for every four days that you smoke,” he said. “A flat-out ban (on e-cigarettes) will kill people.”


China dangles a potentially harmful new threat in trade war.

Explanation: Facing new trade sanctions and a U.S. clampdown on its top telecommunications company, China issued a pointed reminder Wednesday that it has yet to unleash all its weapons in its trade war with the Trump administration.

Beijing, Global trade, AP Top News, International News, General News, Politics, North America, Business, China, Asia Pacific, Health, Technology

Chinese state media warned that Beijing could cut America off from exotic minerals that are widely used in electric cars and mobile phones. The threat to use China’s rich supply of so-called rare earths as leverage in the conflict has contributed to sharp losses in U.S. stocks and sliding long-term bond yields. For months, the world’s two biggest economies have been locked in a standoff over allegations that China deploys predatory tactics — including stealing trade secrets and forcing foreign companies to hand over technology — in a drive to supplant U.S. technological dominance. The Trump administration has imposed 25% tariffs on $250 billion in Chinese imports and is planning to tax the $300 billion in imports that have so far been spared. And it escalated the stakes this month by putting the Chinese telecom giant Huawei on a blacklist that effectively bars U.S. companies from supplying it with computer chips, software and other components without government approval. The U.S. claims Huawei is legally beholden to China’s ruling Communist Party, which could order it to spy on their behalf. Washington has offered no evidence that the Huawei has done that, however. Huawei is trying to beat back one punitive U.S. measure in federal court. In a motion filed late Tuesday in eastern Texas, the company argued that a 2018 law that bars it from selling telecom gear to U.S. government agencies and contractors should be struck down as unconstitutional. The move for summary judgment in a case filed against the U.S. government in March says the law violates a constitutional prohibition against “trial by legislature” of individual entities. Congress thus acted unconstitutionally when it “adjudicated Huawei’s guilt and blacklisted it,” the motion argues. An attorney representing Huawei in the U.S. case, Glen Nager of Jones Day, asserts that Congress alone cannot constitutionally impose punishment on an individual company — which the punitive law does in singling out Huawei by name. The law “is intended to drive Huawei out of the U.S. — i.e., to banish it,” Nager argued. It “stigmatizes Huawei as a tool of the Chinese government” with no right to a fair hearing, he added. Steven Schwinn, a professor at John Marshall Law School in Chicago, suggested that Huawei’s arguments fall short constitutionally, and “given that this relates to national security, we can expect the courts to be fairly deferential to the government.” The nationalistic Chinese newspaper Global Times warned that China has plenty of ways to retaliate against the United States, including the threat of cutting off supplies of rare earths. China last year produced 78% of the world’s rare earths, according to researchers at Bank of America Merrill Lynch. If the U.S. fails to exercise restraint, it will see that “China is far from running out of cards, and we have the will and determination to fight the U.S. to the end,” the paper’s editorial said. An official of China’s top economic planning agency did not rule out using rare earths as a countermeasure against “the U.S.’s unwarranted suppression.” President Xi Jinping visited rare earth-related businesses in southeastern Jiangxi province earlier this month. He called rare earths “an important strategic resource” while stressing the importance of owning independent core technologies, the state-run China Daily reported. China has used rare earths as a cudgel before. Five years ago, the World Trade Organization slapped down China’s attempt to restrict the export of rare earths, rejecting its claim that it just wanted to protect the environment and conserve supplies. Instead, the move appeared to be aimed at hurting Japan with which Beijing was having a diplomatic tiff. Scott Kennedy, director of the project on the Chinese economy at the Center for Strategic and International Studies, said the Chinese might benefit even less if they try to weaponize rare earths again. “It’s not the threat that it was ... when the Chinese threatened to cut off the Japanese,” he said. First, users of rare earths have stockpiled the minerals for a “rainy day.” Second, they also have figured out how to “use less rare earth to achieve the same results” in such products as lasers and magnets. And third, different minerals and chemicals are increasingly being used as rare earth substitutes. Kennedy predicts that once investors have “realized the threat wasn’t as dire, markets would bounce back.” Still, he isn’t optimistic about the U.S.-China trade negotiations, which broke off May 10 after an 11th round of talks failed to produce an agreement. U.S. officials accused the Chinese of reneging on agreements they’d made in earlier rounds. “The Chinese first are going to have to signal they will talk,” he said. Then they will have to go back to where they stood before they backpedaled on earlier concessions. “I don’t see any body language from the Chinese that they’re about to do that,” Kennedy said. ___ Wang reported from Beijing, and Bajak from Boston. Associated Press video producer Olivia Zhang in Shenzhen, China, and writer Christopher Bodeen in Beijing contributed to this report.