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Need answers on progressive plans for health care? This lawmaker’s a good place to start.

WASHINGTON — Single-payer health care is hot right now among Democrats, but Rep. Pramila Jayapal, D-Wash., got there early — first as an activist and then as a legislator.

She’s a co-chair of the Medicare For All Caucus, which has over 70 members. Now she’s trying to give single-payer backers more electoral clout by founding the Medicare For All PAC, an organization devoted to backing like-minded candidates.

The organization arrives at a critical time for single-payer advocates. While Medicare For All has made huge strides within the Democratic Party, there are internal debates about its viability and the issue is likely to play a big role in the 2020 presidential contest. Republicans are already attacking single-payer in midterm races around the country, providing an early test for supporters.

Jayapal spoke with NBC News’ Benjy Sarlin recently about her new PAC, the role she hopes to play in passing Medicare For All, and how she responds to its critics on the right. The conversation is below, edited for length and clarity.

NBC NEWS: What do you hope to achieve by starting a PAC focused on this specific issue?

JAYAPAL: Looking at the momentum around the country, we have this incredible opportunity where I think Medicare For All has become a mainstream idea, if you will.

The Affordable Care Act was a big part of getting there, of getting Americans to believe health care is a right, not a privilege, but there are still a lot of problems with the system we have. It’s my firm belief that until we have a system where the government funds health care for everyone and provides health care for everybody that we’re not going to have that kind of quality affordable health care.

Pramila Jayapal represents Washington's 7th Congressional District, located in Seattle. She is the first Indian-American woman elected to the House of Representatives.
Pramila Jayapal represents Washington’s 7th Congressional District, located in Seattle. She is the first Indian-American woman elected to the House of Representatives.Courtesy of the Office of Pramila Jayapal.

I formed the PAC to really help candidates that are on board with this idea, that want some more education, want some more support, and are ready to go out and talk about it in a real way with their constituents.

NBC News: We’re in a period where there’s a debate over what Medicare For All means. Some people interpret it as single-payer health care, others talk about plans where everyone has an option to buy into a Medicare-like plan. How does your PAC define it and why is this distinction important?

JAYAPAL: I think the closest bill we have, and I think we’re still looking at it to see what changes we might want to make, is the Senate version of the Medicare For All bill, Bernie Sanders’ bill.

For me, it’s not enough to just have a Medicare buy-in, I really think we need a transformation of the system so that we can take out a lot of the costs that are coming through both in the administration of our current health care system, but also in terms of things like pharmaceutical drug prices.

We want to endorse people who are wholeheartedly in for a full transformation. I think people who say ‘Medicare For All,’ but in the next sentence say ‘and we have to take 20 steps to get there,’ that’s not likely to be where we’re going to put our money. This is a crisis and people are dying, and I don’t think we have the time to just add a portion of the American public every year.

NBC News: Could the PAC play a role in determining which presidential candidates are taking this issue seriously?

JAYAPAL: It’s absolutely our intention to be relevant in the 2020 presidential election. I believe that we’re going to have a lot of support and that will give us some money that we can use to help those candidates that are running for president that are ready to embrace bold change and not incremental change.

NBC News: This has mostly been a debate between Democrats until recently. But there’s a new explosion of ads by Republicans attacking Medicare For All. Are you concerned about a conservative backlash?

JAYAPAL: I honestly think Republicans are wrong about this. All the polling shows that this is an issue that does really well, not just in Democratic districts, but in Republican districts as well. When you look at Red to Blue candidates — we’re talking about Democratic candidates in swing districts — 20 percent are endorsing Medicare For All. I think there’s a real opportunity here and I think that anybody who is trying to run on a platform that is opposing a Medicare For All plan is actually going to be in trouble.

NBC News: Most of the attacks are similar in substance. They say it will cost $32 trillion, that it will require new taxes, that if you like your employer plan, you’ll lose it. Do you get questions from your constituents about these issues? How do you respond?

JAYAPAL: My constituents recognize and people across the country recognize that these are just fear-mongering tactics, that they’re not real.

The reality is that people are struggling under the burden of health costs now. They know the system doesn’t work. They know they have pre-existing conditions covered through the Affordable Care Act that now Republicans are trying to strip away.

Image: Senator Bernie Sanders
Senator Bernie Sanders (I-VT) speaks during an event to introduce the “Medicare for All Act of 2017″ on Capitol Hill on September 13, 2017 in Washington.Yuri Gripas / Reuters

But I do think there’s more work we have to do both within our own party and with the public in general to say okay, what does this really look like and how do we address some of the real concerns out there and how do we make sure we’re talking about them in ways that help people to start to feel even more comfortable with it. Intuitively, I think the American people know this is the right thing to do, but they do want a little bit more of a road map to how we get there.

NBC News: Some new Republican ads raise the issue of undocumented immigrants, saying they could be covered under a single-payer plan. The single-payer bills in the House and Senate leave this ambiguous. How do you think Democrats should manage the issue?

JAYAPAL: I think we have to be clear in standing up for immigrants and fighting on behalf of immigrants across this country who are making the economy work, but we also can’t be distracted.

If they want to turn every issue into an issue about immigration, I think we have to point out that they’re the ones stripping health care away from Americans in every single district across the country. They are the ones trying to make it impossible for people with pre-existing conditions to get their health care, they’re trying to make it impossible for seniors to get their Medicaid paid for.

NBC News: Do you think that a health care plan should cover undocumented immigrants?

JAYAPAL: I think the health care plan should cover as many people as possible, every single American. When we were pushing for the Affordable Care Act, the idea that people who live in this country and who do work should be able to access health care I think was very important.

What I would do is pass comprehensive immigration reform. Why do we have 11 million undocumented immigrants? The only reason is so that they can be scapegoats.

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Editorial: Pull up a chair, good health is everyone’s business – Quad

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Eat your way to good health with CSIRO gut diet

  1. Thief demands drugs, takes them, collapses
  2. Jane’s vital message for all women
  3. Man charged for running over emus
  4. Babies among five stabbed at day care centre
  5. Man glassed with beer bottle at quiet Hills street

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Share it! – Encouraging good health

In August we asked the question,

“How does your congregation or school encourage good health among members, students and/or workers?”

Here are some responses.

Donna Gahr, member, Royal Redeemer Lutheran Church, North Royalton, Ohio:

“We have a wonderful nurse who works at our church. She organizes blood pressure checks, Red Cross blood donations, Lifeline screenings, etc. She even writes a monthly column for our church mailing.

“We also have many activities for old and young alike: golf outings, an annual garage sale to raise money for missions, a women’s retreat to give the ladies a day of relaxation, and great bus trips for the seniors to enjoy. Our youth have more activities than can be mentioned in this space!

“Twice a year there is Servant Saturday where congregational members go to homes of those who need help with various projects or to a nursing home to help out. Thanksgiving is the best of all! Our church serves Thanksgiving dinner to those who have nowhere to go. Dinners are also delivered to shut-ins. This is a huge annual outreach!

“These are all activities that help keep our congregation healthy! We thank God for His goodness in our church and our lives!”

Candice Bicondoa, teacher, Prince of Peace Lutheran School, Saint Cloud, Minn.:

“For the past two years we have had a step challenge for the faculty of my school. At the beginning of the year we draw to see which of the two teams you will be on. We record our steps at the end of each week to see which team won.

“The first year we did it we saw quite a few students come back from Christmas break with Fitbits of their own. I have students throughout the day ask how many steps I have because they want to beat me. It has been a lot of fun!

“Last year our principal also introduced a water challenge. For each day you drink your eight glasses, you get a point. It has been wonderful motivation to keep moving and staying hydrated.”

Our next “Share It!” question:

Does your church or school do anything special to observe Thanksgiving?

Send your answer to or look for the question on the LCMS Facebook page and post your response there. We’ll share the best answers in the November edition of “Share It!”

Posted Sept. 21, 2018

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Good Health: The choice is yours – Los Angeles Post

As I lay on the gurney, the anesthesiologist, who looks young enough to be a junior in high school, asks me how my pain level is.  I tell her it is at eight. She asks, “Are you sure it is not higher. You seem awfully uncomfortable.”

I tell her there is no single spot that stands out. “I am feeling lots of different types of pain from head to toe. There’s not a part of me that does not hurt”

She informs me along with the usual drug they give me for my procedure she intends to give me a little Fentanyl to knock out the pain. “Great, they’re going Michael Jackson on me,” I say to myself.

Making matters worse, I have been off my anti-inflammatory for a week so along with this flare up of nerve pain from a neck injury, I am feeling all my arthritic joints thanks to years of beating myself up playing sports and working out. I may still look good from outward appearance, but there are days I feel like I am crumbling inside.

My doctor comes in and we talk a bit. He’s a great doctor who takes time to listen and explain things. He tells me he hopes today’s epidural lasts longer than my previous one which did its job for about two months. He wants to know if I have consulted with a surgeon regarding the prospect of fusion surgery for my neck. He explains to me there is not a lot they can do for the thoracic spine due to it being so difficult to get to.

We talk a bit about exercise. I tell him how much I have enjoyed returning to running the past year when he says, “About that. Your stenosis in your neck is worse. Each time your foot takes a stride the impact is adding to the problem. It’s your choice if you continue, but if you are looking to avoid neck surgery, you might want to stop.”

At least it was not an order which I do not do well with. The last time I was ordered to stop running was after the accident that has led me to this point in life. I lost ten years of running, but spent each day thinking of the day I could return to my favorite activity. Actually, make that my favorite drug. When I finally got my body functioning to the point I could run again and when I got the green light to give it a try, I was like an alcoholic being told I could drink beer just so long as I lay off the hard stuff.

In my case, the hard stuff meant pavement. I returned to running sticking to just the soft thick grass and dirt at my local park and was amazed at how quickly and naturally it came back to me. For my birthday this summer, I celebrated with a two hour run. Yes, I was hooked again.

Climbing the hills are some of the best challenges for runners and bicyclists, on the road or in the dirt.

Now, I have to ask myself whether or not I am willing to live the cycle of life I have been on that allows me to enjoy an early morning run while my spine and I feel fresh and elongated, knowing by days end it will be compressed, burning, and sending me messages of pain down my arms, or do I give it up just as I have had to give up lifting weights?  For the normal person, this is an easy decision to make. For the junkie, it is extremely difficult.

I have relied on running all my life. It is no surprise to me the ten most depressing years of my life were the ones spent away from it. By depressing, I mean depression in the worst sort of way. It’s been something I battled with since childhood and without knowing so at the time, it was why running was such a part of me. Running laps by myself while my classmates played kickball during PE in elementary school allowed me to turn inward and tune out the world. It released the endorphins I needed to balance what my brain was lacking to help me remain happy, at least in the eyes of others.

Now that I am older, I tell my doctor the reason I really want to run now is to help my bones stay healthy. Since I can’t lift weights, he doesn’t even want me to haul in heavy bags of groceries which is embarrassing for me, I need an activity with some sort of impact to keep my bones from turning brittle. He tells me to use a bike or elliptical machine, both of which I have, and to walk.

I want to plead my case, but inside, I know he is right. It’s time I face the music and pay one costlier bill for the life I have lived. I’ll stop running.

Then again, maybe I will stop once I wear out the new Nike shoes I purchased last month. I tell myself, “Are you serious? Do you hear what you are saying?  If you do not quit now, you never will.”

Yesterday was my first day run free. I did not go to the park as I would normally have done. Instead, after my runner’s warm up, I turned on some music and hopped up on my elliptical. For 40 minutes I tuned out altogether. I focused on the same spot on the side door of my garage and just worked away my frustration in much of the same manner as I did when my 5thgrade class would head out to play kickball.

Then I climbed onto my stationary bike and began peddling away for another hour. Yes, I had a lot to work out inside my head. After, I did some stretching before cleaning up and heading off to one of my three part time jobs, teaching PE to a group of 7thand 8thgraders at a small charter school.

When I returned home, it was about 4pm, the bewitching hour, or the time of day when I begin to really feel all my pain. There was a very slight burning in my mid back but otherwise I felt pretty good. No neck pain. No arm discomfort. No knee stiffness which was something I felt only on the days I ran.

It was just the first day of my own personal recovery, but it was a successful one even though I had thoughts of wanting to run today after watching my students go through a running workout. I arrived home in a much better mood and felt no need to run to the medicine cabinet where my Vicodin and muscle relaxants await.

It was a victory for me, but I know it was just the first day. The challenge will come on days when I have been away from running long enough to forget how it was hurting my spine more than helping my spirit. Winter looms and I will grow tired of being confined to my gym in my garage. I will want to get out and enjoy the cold air, gray skis, or morning mist and run.

Running will always be a part of me. It has allowed me to make it this far in life. Now, I have to say goodbye to it which is painful. To lose something you love as much as I love to run is not easy. I am reminded of the pain I have felt when it was time to say goodbye to a pet. You hate having to face the harsh reality of the finality of what will be missing from your life, but I tell myself there will still be more life ahead.

I remind myself this is my decision to make and think of what I often have told students over the course of my teaching career, “We live and die by the choices we make.” I am choosing to live a new life, knowing it is, in the long run, the best choice for me.

Goodbye my friend.  You will be missed, but you will always be a part of me.

Photos by Tim Forkes



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Next Radio Conference Finds Medium In Good Health

LONDON — The annual Next Radio event bills itself as “the radio ideas conference”, and the ideas, statistics and announcements come thick and fast in quick-fire nine or eighteen-minute sessions throughout the day.

The conference, held in London’s historic Royal Institution, saw the launch of the first professional cloud-based radio automation system, by RCS President and CEO, Philippe Generali. RCS says that the new system is the first of its kind to be able to import GSelector logs, the first to be able to integrate traffic, and the first to feature voice-tracking in the cloud.

I pray for your good health: PM to Ajay Maken

New Delhi: Prime Minister Narendra Modi on Thursday wished for “good health and wellbeing” of Congress leader Ajay Maken, who suffering from an orthopaedic ailment.

“Dear Ajay Maken Ji, I pray for your good health and wellbeing,” Prime Minister Modi tweeted while tagging the Congress leader.

Earlier in the day, Maken announced on Twitter that he is “suffering from an irreversible and progressive orthopaedic ailment.”

“Deeply touched by the outpouring of good wishes and concern about my health. I’m suffering from an irreversible and progressive orthopaedic ailment, which is extremely painful, but not life-threatening. Seeking 3rd opinion on the exact cause-To arrest progression and obliterate pain,” Maken wrote.

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Your Good Health: Seeing podiatrist a good step for odd foot sensations

Dear Dr. Roach: I’m a 63-year-old male diagnosed with chronic myelogenous leukemia, Type 2 diabetes and coronary heart disease. I am 5 feet, 11 inches and weigh 240 pounds. I have two stents and take Sprycel for the CML. My levels are good, and the coronary disease is under control.

For a few years I’ve had what feels like “cotton balls” under the skin in the area of the balls of my feet. Now it feels as if the feeling is migrating to the arch. While not too uncomfortable, it is almost impossible to walk barefooted. Some type of foot covering is needed to keep from noticing the feeling.

My doctor says it’s the diabetes, and to lose weight or see a podiatrist. Other than losing the weight, do you have any feeling about this?


Cotton-ball sensation is one way that many people describe the beginning of neuropathy, a general term for a variety of different conditions that affect the nerves of the body.

In a person with cancer (like CML, chronic myelogenous leukemia, a cancer of the bone marrow) and a new symptom, it is always wise to consider whether it could be due to the cancer, the treatment for the cancer or something else. In your case, usually CML is not associated with neuropathy. However, the medicine you are taking, dasatinib (Sprycel), has been associated with a severe kind of reversible neuropathy. I read the case reports of this condition carefully, and I doubt that is what is going on with you, as the symptoms you have are different from those reported.

People with longstanding diabetes frequently develop a particular disease of the nerves, diabetic neuropathy. This almost always begins with sensation changes in the feet. I agree with your doctor that diabetes is the most likely cause.

Seeing a podiatrist is absolutely a good idea. He or she can test you for this condition (usually a careful physical exam will make the diagnosis), in addition to looking carefully for any early signs or risk factors for injury or infection.

You also should learn how to do a daily inspection of your feet and recognize the signs, so you can get to medical attention promptly should any damage to your feet occur. The podiatrist will make sure you have appropriate footwear.

Many people with diabetes benefit from weight loss, but the important thing is to be sure your diabetes is under good control. This is achieved through good diet, regular exercise and medication, if needed, in addition to weight loss in people who are overweight.

Dear Dr. Roach: I suspect you’ve covered this topic, but thought I’d check. My niece recently was diagnosed with breast cancer. Radiation was recommended. Her mother said that first she’d have to boost her immune system. Is it possible to do that?


Radiation is a common treatment after breast cancer surgery. It’s done to reduce the risk of recurrence, depending on the exact type of cancer.

Boosting the immune system is a new adjunct for many types of cancer. There are several ways to do this: One is to genetically modify the patient’s own immune T-cells, but many other techniques are in trials now.

However, if your niece’s mother is talking about supplements, I’d be cautious. Supplements that are promoted to boost the immune system generally are ineffective at doing so.

Making sure your niece has proper nutrition, gets good sleep and experiences as little stress as is manageable are ways to prevent stress on the immune system.

Everyone could benefit from those deceptively simple steps, but especially a person being treated for cancer.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to


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To Your Good Health: International travelers still must be aware of the Zika virus

Q: My son and his new wife went on a dream honeymoon that has since turned into a nightmare. They went to Costa Rica and of course were bitten by mosquitoes. Upon returning home, they were told about the Zika virus. One person told them to wait six months before trying to have a baby; another source said to wait two years. They are in their mid-30s and want to have a baby. What do you know about this scary virus?

A: Zika virus is transmitted by mosquitos and is present in many areas of the Americas, Caribbean and Pacific. There has been an ongoing outbreak over the past few years. Zika is related to yellow fever, dengue and West Nile virus. One major concern about Zika is that it can cause neurological complications, sometimes severe, in babies born to women who were infected during pregnancy. Also, Zika may temporarily affect fertility in infected men. Zika can be transmitted sexually.

Couples who are planning pregnancy should avoid areas where Zika transmission occurs (see For couples who have been exposed or who might have been infected, the most conservative recommendation I have read is six months. This is based on a finding of Zika RNA in men up to 188 days after having symptoms of Zika, even though no sexually transmitted cases have been reported more than six weeks after the man had symptoms of Zika (men and women may also transmit Zika after an illness without recognized symptoms). Given how severe the infection can be to the developing fetus, I think six months is the right amount of time, but two years is unnecessary.

Q: I am a postmenopausal woman with osteoporosis (my T-score is -3.2) in my spine. I used alendronate, but stopped because it caused bone pain. I haven’t been on any medication for a few months now, but I have started walking 40 minutes every day and I use weights. Also, I monitor my calcium and vitamin D carefully. My last bloodwork all came back good. My doctor would like me to try Tymlos. I can’t find much information about it except that it hasn’t been out long and may cause osteosarcoma. Do you know what the chance of this might be? A similar drug, Forteo, is not covered by my insurance, even though it has been around longer.

A: Abaloparatide (Tymlos) is an analog of parathyroid hormone. It works against osteoporosis by stimulating bone growth. This is different from the mechanism of alendronate (Fosamax) and related drugs; those work by preventing bone reabsorption.

Teriparatide (Forteo) indeed works the same way as Tymlos. During drug testing, teriparatide was found to increase the risk of a type of bone cancer, osteogenic sarcoma, in rats. Because of this, the Food and Drug Administration required a black-box warning, the agency’s highest degree of caution. However, a study on women who have taken Forteo showed no cases of osteogenic sarcoma in the first seven years of the study, and only a handful of cases have ever been reported in people taking Forteo. In fact, the number of cases reported is less than would have been expected if there were no association between the drug and the cancer. It appears so far that Forteo does not increase risk for bone cancer, and there’s no reason to expect that Tymlos will do so.

Dr. Keith Roach’s column runs in Wednesday’s Extra.

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Alternate cooking oils for good health

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