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Porter Ranch doctor reveals gas leak health concerns – KABC

A new study by a local doctor revealed serious health concerns for residents living near the Aliso Canyon natural gas leak.

Porter Ranch physician Dr. Jeffrey Nordella said he found high levels of chemicals in patients living near the gas facility.

Nordella launched an in-depth health program after noticing a high number of his patients becoming sick. He said the level of carcinogens in his patients were significantly higher than the general population, showing a dire need for a comprehensive long-term health study.

“I didn’t think we would find too much in a toxicology aspect of this, but lo and behold we did,” Nordella said.

The doctor released his findings at a town hall meeting Saturday, where the results shocked residents as high levels of lithium were found in more than 100 patients.

Nordella said hair sampling led them to the water supply where they found traces of lithium.

The doctor said more serious health risks are possible from long-term exposure as the Aliso Canyon gas storage field continues their operation.

“If it continues on, then what are you doing? You’re continuing the exposure, and that is not acceptable in my opinion as a physician,” Nordella said.

Southern California Gas Company said other studies have been conducted that show no long term health risks.

The Department of Water and Power also issued a statement that said in part, “LADWP conducts extensive water quality testing across the city on a continuous basis and, in fact, conducted additional testing of the water served in the Porter Ranch neighborhood during and after the leak at SoCal Gas’ Aliso Canyon natural gas storage facility. At no time was the water served by LADWP to customers in Porter Ranch unhealthful nor was there evidence of anything unusual or unhealthful found in the water.”

To read the LADWP’s full statement, click here.

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Emerald Health Therapeutics: Cannabis Science Catalyst

With the demand for cannabis whether medical or recreational expected to expand exponentially in the next few years, numerous companies are moving in the sector to expand production, open distribution facilities, and even develop therapeutic treatments. Emerald Health Therapeutics (OTCQX:EMHTF) is one company working on all fronts to develop end-to-end control of the processes while the stock still trades under the radar.

Emerald Health has been stuck just over $1 for a year now despite strategic moves that place the company in major growth mode in the cannabis market. Is this the Canadian company to invest in the wave of adult users and medical consumption of cannabis products?

Big Joint Venture

Emerald Health is a Canadian based licensed cannabis producer working on multiple fronts to expand cannabis production, focus on clinical research work, improve extraction expertise and product development, and expand distribution channels. The most notable and visible move is on the expansion of cannabis production.

The company is working on a fully owned production facility in Metro Vancouver that will include a 50,000 sq. ft. growing area in phase 1 to support the production of at least 5,000 kg cannabis flower per annum. Phase 2 will begin construction immediately after completing phase 1 with the ability to grow to 1 million sq. ft. The development is positive, but the real news is the large scale joint venture that provides the company with credibility.

Back in June, Emerald Health formed a 50/50 joint venture with Village Farms (OTCQX:VFFIF). The later is an established large-scale greenhouse grower of produce that views cannabis as a more profitable product opportunity. The company operates over 10.5 million sq. ft. of greenhouse space in both British Columbia and Texas plus partner greenhouses around North America.

The JV starts with Village Farms contributing a 1.1 million sq. ft. greenhouse facility covering 25 acres previously growing tomatoes to the production of cannabis. Emerald Health will contribute $20 million to the deal.

The JV expects to yield 15x the amount that Emerald Health expects to grow at its own facility from phase 1 construction. As well, Village Farms has another 3.7 million sq. ft. in greenhouse facilities covering 110 acres to contribute to the program to provide a total potential yield of 300,000 kg per annum.

Outside of the scale of the operation, the inclusion of Village Farms adds credibility to Emerald Health. Village Farms had 2016 revenues of C$206 million and EBITDA of C$12.5 million. The company has a sizable business already and decided the most profitable option was to form a JV with Emerald Health to grow cannabis versus the existing multi-million dollar business.

The goal is to have both of these facilities up and producing cannabis in 2018 ahead of legalization of the adult-use market in Canada. The sheer scale of the planned operation does raise some red flags.

Deloitte does predict the Canadian market reaching demand of 600,000 kg by 2021. A retail value of up to $8.7 billion and a total industry of $22.6 billion is naturally very attractive, but Emerald Health has plans to potentially meet 50% of the market demand alone. The JV isn’t moving forward directly on the full 4.8 million sq. ft. so investors will want to ensure the company doesn’t over expand supply and pull down cannabis prices while opportunity might exist to export cannabis to other countries.

Therapeutics Plan

While cannabis production is the original area of growth, upside exists in developing therapies that solve unmet medical needs. Unlike some other players mostly focused on either path, Emerald Health is pursuing the full spectrum to succeed in the market for cannabis with a push towards treatment solutions.

The company recently hired a CEO with a background in drug development. Chris Wagner has spent 25 years in building biotech companies with his most prominent work at Aspreva Pharma after working for 10 years at Eli Lily (LLY). In the process, he worked on several major drug developments and developed partnerships with other big pharma companies to market drugs.

Chairman Avtar Dillon has a background in drug development having been the CEO of Inovio Pharma (INO) and remains the Chairman now. As well, the sits on the board of the Cannabis Association of Canada placing executives in influential positions in the industry. Several other executives have held key roles at pharma firms suggesting a push toward clinical research not as apparent in the recent announcements and focus on growing cannabis.

The company formed a clinical advisory board that includes multiple PHDs from North America, Italy and Spain. The board provides Emerald Health with experts in the field of cannabinoids and general specialization in related fields of pharmaceutical product development.

Corresponding with that move, Emerald Health Therapeutics’s scientific advisors released news of a promising discovery related to the treatment of neurodegenerative diseases. The advisors found that THCA, a naturally occurring non-psychotropic cannaboid, has the potential to teat Huntington disease amongst other neurodegenerative diseases.

The advisors published the findings in the British Journal of Pharmacology. Per Edward Munoz, PhD, Chief Scientific Officer and Professor of Immunology at the University of Cordoba (Spain):

A large number of patients suffer from neurodegenerative diseases and they are not responsive to available medical treatments. Our research data provide further evidence that cannabinoids hold therapeutic potential for a wide range of diseases and condition, including, neurodegeneration, which, represents a significant unmet medical need.

The company plans to work towards clinical trials based on the THCA cannabis oils Emerald Health offers. The good news is that the investment thesis is not based on clinical research, but rather this area is a potential catalyst for the stock.


After raising C$27.2 million prior to fees back in April, Emerald Health listed a cash balance of C$36.2 million at the end of June. At the time, the company still has $18 million remaining to pay Village Farms on the JV.

The market will closely want to watch the quarterly results as the company ramps up cannabis production and sales into 2018.

The stock has generally not moved since the big JV announcement so the market may not understand the magnitude of the deal. As some examples of the missing value, Village Farms is worth a reported $123 million from growing tomatoes and cucumbers. Aphria (OTCQB:APHQF) is worth roughly $863 million from generating 1/10th the revenues as Village Farms due to growing and selling medical cannabis.

Emerald Health traded at $1.20 about a year ago when the company had limited plans regarding cannabis production facilities and no formal move into cannabis science. The fully diluted market value is now about $142 million assuming the exercise of the outstanding options and warrants that bring the diluted share count to 121.5 million. Exercising of these options and warrants will provide additional cash for expansion and clinical trials.


The key investor takeaway is that Emerald Health still has to finish construction and conversion of multiple facilities to even grow cannabis at large scale. A large opportunity exists and market values support this move by the company, but Emerald Health hasn’t proven this ability as of yet.

The risk would appear small, but investors always need to consider the downside possibility. The JV with Village Farms provides some credibility to the plans and the stock is cheap relative to sector plays like Aphria, especially considering the massive scale of the JV. The bigger risk would appear the potential to over supply the market with cannabis though investors will only have to deal with that concern several years down the road.

The best part of the story is the configuration of a management team and scientific advisory board to work on cannabis science. Emerald Health has the expertise to advance clinical trials, but the best part of the investment is that the stock hardly trades based on the cannabis production and extraction work. An investor gets any positive clinical developments as a bonus with the market valuation down at $140 million.

As typical with small cap in emerging growth sectors, the stock is only recommended for a diversified portfolio willing to accept capital losses.

Disclosure: I/we have no positions in any stocks mentioned, and no plans to initiate any positions within the next 72 hours.

I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article.

Additional disclosure: The information contained herein is for informational purposes only. Nothing in this article should be taken as a solicitation to purchase or sell securities. Before buying or selling any stock you should do your own research and reach your own conclusion or consult a financial advisor. Investing includes risks, including loss of principal.

Editor’s Note: This article covers one or more stocks trading at less than $1 per share and/or with less than a $100 million market cap. Please be aware of the risks associated with these stocks.

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2 Senators Strike Deal on Health Subsidies That Trump Cut Off

Mr. Trump appeared to back the deal, even as he berated insurance companies, declared the Affordable Care Act “virtually dead” and promised the demise of the health law in due time.

“It’ll get us over this intermediate hump,” the president said at a Rose Garden news conference, describing it as “a short-term solution so that we don’t have this very dangerous little period.”

Passage of the deal negotiated by Mr. Alexander and Ms. Murray is still far from assured. If approved, the agreement could provide a reprieve for the Affordable Care Act that would prevent 2018 premiums from increasing as much as they might otherwise have gone up. But consumers in many states will still face double-digit rate increases, and in many counties, health plans will be available from only one insurance company.

Moreover, Mr. Trump and other Republicans are still intent on repealing much of the Affordable Care Act, and an executive order issued last week by Mr. Trump could destabilize markets in 2019 and later years by encouraging sales of health plans that skirt the coverage requirements of the health care law.

“For a period of one year, two years, we will have a very good solution,” Mr. Trump said. “But we’re going to have a great solution, ultimately, for health care.”

Mr. Alexander, the chairman of the Senate health committee, said that in addition to funding the payments to insurers, the deal would also give states “more flexibility in the variety of choices they can give to consumers” — a change that should appeal to Republicans eager to give states more say over health care.

“This takes care of the next two years,” Mr. Alexander said. “After that, we can have a full-fledged debate on where we go long-term on health care.”


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The agreement bears the hallmarks of bipartisanship. For Republicans, state governments would find it easier to obtain waivers from certain requirements of the Affordable Care Act. But there would be explicit protections for low-income people and people with serious illnesses.

Consumers of any age would be allowed to obtain catastrophic insurance plans that typically have low monthly premiums but high deductibles and other out-of-pocket costs. Catastrophic plans provide protection against serious illnesses and injuries, but consumers must pay most routine medical expenses themselves.

Under current law, catastrophic plans are available only to people who are under the age of 30 or have received an exemption from the federal coverage requirement because they cannot afford other insurance.

For Democrats, not only would the cost-sharing reductions be brought back, but millions of dollars would be restored for advertising and outreach activities that publicize insurance options available in the health law’s open enrollment period, which starts next month. The Trump administration had slashed that funding.

“We will spend about twice as much or more than President Trump wanted to expend,” Mr. Alexander promised.

Accusing Mr. Trump of taking steps to “sabotage health care in our country,” Ms. Murray said, “I’m really glad that Democrats and Republicans agree it’s unacceptable, and that the uncertainty and dysfunction cannot continue.”

Senator Chuck Schumer of New York, the Democratic leader, hailed the agreement as a model for how the two parties could work together on other issues, such as taxes.

“I don’t expect the Republicans to give up their goal of repealing A.C.A.,” Mr. Schumer said. “But in the meantime, stabilizing the system, preventing chaos and stopping the sabotage is in everybody’s interest.”


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The fate of the cost-sharing subsidies has been in doubt since a federal district judge ruled in 2016 that the payments to insurers were unconstitutional, because Congress had never appropriated money for them. Mr. Trump, whose administration has been taking steps to undermine operation of the health law, declared last week that he would stop the payments.

If the cost-sharing payments were cut off and premiums increased, many low-income people would receive more financial assistance, in the form of larger tax credits, to help pay the higher premiums. But many middle-income people who do not receive such assistance would have to bear the additional cost on their own.

A coalition of state attorneys general filed suit on Friday, and Congress immediately came under pressure to take action to ensure that the payments would continue. Doctors, hospitals and insurers, as well as the National Governors Association and the U.S. Chamber of Commerce, urged lawmakers to provide the funding.


Yes, You Can Still Enroll in Obamacare: Five Answers to Questions About Getting Covered

Some changes you should know about.

Mr. Alexander said that he spoke with Mr. Trump over the weekend, and that the president encouraged his efforts with Ms. Murray, the top Democrat on the Senate health committee. But it remains to be seen whether conservative-leaning Republicans will get on board with the agreement, and whether the House will accept it.

It is not clear how the agreement might move through Congress. Supporters of funding the subsidies could push to have the deal included in a measure to keep the government open past Dec. 8. Democratic votes will be needed to fund the government, and the health care deal could come to fruition when Democratic leverage is particularly strong.

Some Republicans have already said they do not wish to provide what they describe as a bailout to insurers.

“I think it would be a mistake for Congress to provide billions in bailouts to insurance companies without providing meaningful relief to the millions of Americans who have been hurt by Obamacare,” Senator Ted Cruz of Texas said Tuesday before the deal was announced.

Mr. Alexander said the agreement would include “the strongest possible language” to guarantee that money provided for cost-sharing payments goes to the benefit of consumers, not insurance companies. “I want that, Senator Murray wants that, the president wants that,” he said.


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The Senate majority leader, Mitch McConnell of Kentucky, gave no indication on Tuesday about when — or whether — the chamber might move ahead with the plan drawn up by Mr. Alexander and Ms. Murray.

Senator John Thune of South Dakota, a member of the Senate Republican leadership, said there would be “a sense of urgency to move a bill,” since Mr. Trump intended to stop the payments right away.

The House is away for a weeklong recess, and a spokesman for Speaker Paul D. Ryan of Wisconsin declined to comment.

A leading conservative in the House, Representative Mark Walker of North Carolina, the chairman of the Republican Study Committee, immediately declared the deal to be “unacceptable.”

“Obamacare is in a ‘death spiral,’ ” Mr. Walker said. “Anything propping it up is only saving what Republicans promised to dismantle.”

Another leading conservative, Representative Mark Meadows of North Carolina, the chairman of the hard-line House Freedom Caucus, described the agreement as a “good start,” but said “much more work needs to be done.”

“Most importantly,” he added, “it bears repeating: Republicans cannot allow short-term solutions to become a distraction to repealing and replacing Obamacare — something we’ve promised to do for seven years.”

Correction: October 17, 2017

An earlier version of a picture caption with this article misstated the date on which Senators Patty Murray and Lamar Alexander were shown during a hearing of the Senate Committee on Health, Education, Labor and Pensions. The hearing was in September, not last week.

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Health care order expands insurance






Trump’s actions to modify the Obamacare insurance marketplace could result in higher prices and fewer insurers.
Video provided by Newsy

For all the headlines about “dismantling Obamacare,” President Trump’s executive order will likely have less of an impact than its supporters hope or critics fear. Still, it represents a modest step toward giving consumers more choices and expanding millions of Americans’ access to lower cost insurance that better fits their individual needs.

First, understand what this order is not. It neither takes anyone’s insurance away nor removes protections for people with pre-existing conditions.

What it does is allow small businesses that band together to buy group insurance plans to be treated the same way as big companies are today. That includes the ability to buy insurance across state lines, and an exemption from some of Obamacare’s expensive mandated benefits. Plans might offer fewer benefits, but they could cost a lot less.

OUR VIEW:Trump sells out your health insurance

Individuals within a company still can’t be charged more or denied coverage because of their health, but companies with healthier work forces could receive lower overall premiums. And purchasing insurance across state lines challenges the power of the insurance cartel’s monopoly power in some states.

If individuals end up being allowed to buy insurance on these association plans, it would dramatically expand options for millions of Americans.

This wouldn’t come close to fixing all of Obamacare’s problems, but it’s still a win for consumers.

This executive order should be considered separately from the administration’s effort to stop paying price stabilization subsidies to insurance companies. In that case, the administration is essentially complying with a federal court ruling that the subsidies were illegal. Yes, if the subsidies stop it could further destabilize insurance markets, but that was starting to happen anyway.

Ideally, Congress should have rewritten the Affordable Care Act, and in using an executive order to rewrite parts of the health care law, President Trump is following a route repeatedly trod by President Obama. Only this time, the president’s actions will give consumers more freedom rather than less.

Michael D. Tanner is a senior fellow at the Cato Institute.

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On Health, de Blasio Focuses on Crises and Inequality

But when fears of Ebola gripped the city during his first year in office, Mr. de Blasio employed similar theatrics to calm fears — hugging an Ebola patient and eating at a restaurant where that man had dined — and he used his pulpit to support the broader efforts by medical workers to combat the deadly virus.

In the mayor’s first term, pedestrian political calculations and battles with Albany have tainted some of his efforts on issues related to public health. But in general, the bigger and more serious the crisis, the better the results.


Mr. de Blasio hugging Dr. Craig Spencer, who tested positive for Ebola in 2014.

Ruth Fremson/The New York Times

He was a steady hand during the Ebola pandemic fear, and the city’s health agencies have done an effective job educating the public about the Zika virus as it spread across South America and the Caribbean.

It is difficult to assess how much or how quickly Mr. de Blasio, or most mayors for that matter, has had an effect on the health of the city. Mr. de Blasio’s predecessor, Michael R. Bloomberg, spent an unusual amount of capital to combat obesity and smoking.

And even though Mr. de Blasio made a rhetorical sport of denigrating all things related to Mr. Bloomberg, he has chosen to keep and expand on some of his predecessor’s most important public health initiatives, including the fight against tobacco and pushing for calorie labeling at restaurants.

Judging Mr. de Blasio’s record is made more difficult because one of his main goals — addressing inequality in health care — requires multiagency cooperation and the programs can take years to show results.

There is also no simple metric to measure the physical well being of the city’s residents over only four years, but the Health Department’s annual summary of vital statistics tracks some key indicators, including life expectancy, infant mortality and the leading causes of death.


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Most notably, death rates attributed to three of the leading causes of death in the city — heart disease, cancer and influenza/pneumonia — have continued to fall during the de Blasio administration, extending the decline seen under the Bloomberg administration, when life expectancy in the city increased by three years.

Still, city officials said that wide disparities remain in the health of New Yorkers based on income, race and where they live.

The infant mortality rate for non-Hispanic blacks was three times higher than non-Hispanic whites, and the rate for Puerto Rican New Yorkers was 2.3 times higher, according to the data.


Chirlane McCray, the mayor’s wife, has spearheaded ThriveNYC, a plan to overhaul the city’s mental health system, and a separate initiative to reduce opioid deaths.

Chang W. Lee/The New York Times

The de Blasio administration has started a number of initiatives to fight these disparities, including using city property for primary care clinics to share space with community-based organizations focused on health.

One of the mayor’s most important initiatives has come in response to a problem that cities and towns across the country are dealing with: opioid addiction. The other, ThriveNYC — an effort to help New Yorkers with issues related to mental health — is personal; the mayor’s wife, Chirlane McCray, who is leading the program, has spoken about her parents’ depression and the drug use of her daughter, Chiara.

More than 170,000 calls, texts and chats have flowed into a confidential mental health hotline since it was established last October, forcing the Health Department to expand its staff.

Like in much of the country, opioid addiction and overdose deaths are on the rise in the city. The mayor, again with Ms. McCray playing a central role, announced a $38 million initiative to reduce opioid deaths by 35 percent over the next five years.

Fighting the opioid crisis also requires close coordination with the police. This year, the mayor announced that every opioid overdose — fatal and nonfatal — would be investigated, dedicating 84 police officers to this task.


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But Mr. de Blasio has had a harder time fulfilling his campaign promises related to health — essentially a single-topic platform on the fate of community hospitals, and one in particular, Long Island College Hospital.

“It was a clearly a key part of his campaign and it played a major role in separating him from the other candidates,” said James R. Tallon Jr., president of the United Hospital Fund of New York.

It was a fight he lost, and perhaps learned from.

Last year, when Mount Sinai Beth Israel, an 825-bed hospital that has served downtown Manhattan for more than 125 years, announced that it was closing its building and replacing it with a smaller one, City Hall was largely silent. It seemed resigned that there was little the administration could do to change the reality of the economic picture facing hospitals: Beth Israel was one of 19 hospitals in the city that have either closed or overhauled how they operate since 2000.


Mount Sinai Beth Israel is one of 19 hospitals in New York that have either closed or overhauled how they operate since 2000.

Joshua Bright for The New York Times

Nonetheless, Mr. de Blasio has vowed to protect all of the city’s 11 hospitals managed by the Health + Hospitals Corporation.

“No matter the odds, the mayor will always fight when it comes to New Yorkers’ health care,” said Olivia Lapeyrolerie, a spokeswoman for the mayor, referring to Long Island College Hospital and hospitals across the city.

City Hall has been working to restructure the organization and offered an infusion of $2 billion in subsidies for the public hospital system that, according to a 2016 report by the mayor’s office, was “on the edge of a financial cliff.”

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“Unlike what has happened in other cities, Health + Hospitals will remain a vibrant public system — it is not for sale and the city will not abandon it,” according to the 55-page report.

But the financial stability of the city’s hospitals are vulnerable to forces far beyond the control of City Hall. Specifically, it is hard to predict how proposed changes to the Affordable Care Act being debated in Washington will affect the city.

For example, the increase in the number of people with Medicaid coverage under the health law would seem to be a boon to city hospitals, since they are required to treat anyone regardless of whether or not they have insurance. But the report found that once people gained insurance and more health care choices, many chose not to go to public hospitals. Still, public hospitals are the only options for the million New Yorkers who have no insurance, many of them undocumented immigrants. When treating those patients, the hospitals pick up the cost.


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Dr. Herminia Palacio, the deputy mayor for Health and Human Services, said that Mr. de Blasio subscribes to the theory that when it comes to public health, a holistic approach is necessary.

The point, she said, is that many aspects of the mayor’s agenda — from affordable housing to education — play a role in public health. She quoted Dr. Rudolf Virchow, a 19th century German doctor, for providing the guiding vision on City Hall’s approach.


The city has created Neighborhood Health Action Centers in places like East Harlem to provide a variety of services under one roof.

Hiroko Masuike/The New York Times

“Medicine is a social science,” she said. “And politics is nothing but medicine on a large scale.”

Under the city’s Department of Health and Mental Hygiene, the department has created the Center for Health Equity, which focuses attention on certain neighborhoods deprived of sufficient resources and attention. Just like there are high-crime areas in the city, there are also sections — like parts of North and South Brooklyn and Harlem — that are high-disease areas. And similar to the police using CompStat data to develop strategies for reducing crime in certain areas, the city can use its extensive health data to push interagency health initiatives in specific areas.

To further the goal, the city is revitalizing underutilized Health Department buildings in some neighborhoods to provide more direct health services and to create partnerships between public hospital clinical services and community-based organizations. The initiative expands on the already robust network of district public health offices, providing a variety of services under one roof. In April, the department announced the creation of three Neighborhood Action Health Centers in East Harlem, Brownsville, Brooklyn, and Tremont in the Bronx.

On a tour of a health center in East Harlem, it was evident how grouped together services could provide vital resources to a neighborhood in desperate need of them.

Mac Levine, who runs a nonprofit that uses after-school programs to get children in high-crime neighborhoods focused on activities like urban gardening, had been struggling to find space for her headquarters for eight years.

Since moving into the Harlem building, she said, the group has doubled the number of volunteers to 1,000, and the number of children it serves has increased to 5,000 from 2,700.


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Her office is next door to a group that is working to improve the nutrition for new and expectant mothers. And that office is next to the Association to Benefit Children, which provides mental health support to young children among other services. In September, when a child was shot and killed a block from the center, the organization sent out its rapid response team to provide counseling, but it also is now present in the neighborhood so people can just walk in and get help.

Dr. Mary T. Bassett, the commissioner of the city’s Department of Health and Mental Hygiene since January 2014, said that she and the mayor shared the same vision for trying to improve the health outcomes for the city’s poorest residents.


A tai chi class at the Neighborhood Health Action Center in East Harlem.

Hiroko Masuike/The New York Times

“We both agreed wholeheartedly that inequality was driving poor health outcomes, disproportionally affecting communities of color,” she said. “I knew he wanted someone with a vision, and he wanted bold steps to move his progressive agenda.”

But Mr. de Blasio’s first four years will likely be remembered for how the city handled events beyond his or anyone’s control.

When a doctor, Craig Spencer, returned to New York from West Africa and tested positive for Ebola in 2014, hysteria threatened to outpace reason.

Around the same time, Kaci Hickox was ordered by Gov. Chris Christie to be held in a quarantine tent in New Jersey for three days after she returned from working as a nurse in Sierra Leone, even though she never tested positive for the virus. She was then released on the condition she return to her home in Maine — which also sought to quarantine her.

Dr. Spencer, by contrast, had traveled around the city before he was diagnosed with having the virus.

Mr. de Blasio and Dr. Bassett made it a point to eat at the Meatball Shop, where Dr. Spencer had dined. And when he was finally released from the hospital, the mayor was the first to offer him a hug.

He also championed the other medical workers who went to Africa to combat the virus at a time when many were being stigmatized when they returned home.


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“My tenure as commissioner has been dominated by microbes,” Dr. Bassett said. “In each challenge, whether it was Ebola, Legionnaires’ disease, or Zika, the mayor has shown unwavering support for public health.”

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The Health Plans Trump Backs Have a Long History of Disputes

The short-term medical plans promoted in President Donald Trump’s new executive order on health care have a long history of customer disputes over pre-existing conditions and denied claims – just the sort of scenarios that were being weeded out by Obamacare.

The Affordable Care Act pushes Americans to buy comprehensive long-term coverage; the Obama administration limited short-term plans to three months and prevented them from being extended. The temporary plans are geared toward people who are between jobs or considering retirement. 

But on Oct. 12, Trump directed his department heads to consider allowing the policies to last almost a year and to make them renewable, a move that could undermine Obamacare by dividing the insured between cheaper healthy customers and those with costly ailments.

The short-term plans have attracted as many as 1 million people, some of whom were left swimming in debt when their health took a turn. The federal government flagged the plans at least as far back as 1992, when a General Accounting Office report found they’d left nearly 400,000 members and their beneficiaries with $123 million in unpaid medical claims in a four-year span.

Take Dawn Jones, a former product-liability attorney at King and Spalding in Atlanta who left the firm in 2014 to start her own practice. She bought a short-term plan from Golden Rule Insurance, a unit of UnitedHealth Group Inc., so she’d be covered between jobs, according to court documents. Then, she was diagnosed with breast cancer.

Despite showing evidence she was unaware of the cancer when she bought the policy, the insurer didn’t pay for Jones’s treatment, leaving her with a $400,000 medical bill, according to a complaint she filed against the company in September 2016. Jones claimed the insurer breached its duty to provide coverage “for her medically necessary, life-saving breast cancer treatment.”

“Only after Golden Rule had collected its full six-months of premiums from plaintiff, did it deny all claims related to her breast cancer diagnosis and treatment,” her lawyer wrote in the complaint.

Preexisting Conditions

But the judge sided with Golden Rule and dismissed the case in August, finding the policy agreement clearly stated that preexisting conditions wouldn’t be covered, even if the customer was unaware of the condition. Jones wasn’t diagnosed until after she bought her policy. Neither she nor her lawyer returned a call for comment. 

Tracey Lempner, a UnitedHealth spokeswoman, had no comment.

Avoiding such scenarios under Obamacare meant penalizing Americans who didn’t buy insurance and forcing insurers to accept customers regardless of preexisting conditions, among other rules. That has increased costs for healthy people, many Republicans have claimed.

The short-term plans would create another option outside of the ACA, and would not be “subject to costly Obamacare mandates and rules,” according to a summary of Trump’s directive. The order came on the heels of Republicans’ failed attempts to repeal the ACA. Hours after the order, Trump also said he would cut off subsidies to insurers.

On Monday, Trump said his decision to end cost-sharing reduction payments will help force bipartisan talks. Lawmakers led by Republican Senator Lamar Alexander and Democrat Patty Murray have been working across the aisle to try to stabilize the health law, chiefly to avoid rate hikes.

California-Led Group Asks Court to Keep Obamacare Subsidies

The short-term plans “are an unfortunate end-run around what the ACA was supposed to do,” said Rachel Geman, an attorney who sued another insurer over the denial of her client’s claims. “It seems logical that we’ll have more underlying problems and more lawsuits by expanding these types of plans.”

Implementing Trump’s directive will likely require new regulations, meaning that the plans it’s expected to encourage wouldn’t be available until new rules are in place.

“This executive order is good news for consumers,” said Jeff Smedsrud, a co-founder of, an online shopping site for short-term plans and other types of health coverage. “Given all the uncertainty about health-care reform — whether Obamacare stays or goes — it is natural for consumers to want to ‘punt’ a decision about their long-term health insurance until some future date.”

According to Smedsrud, the niche market for short-term plans also includes people who are turning 26 and coming off a parent’s plan, as well as people whose income is too high to qualify for Obamacare subsidies but don’t make enough to afford a high-deductible “bronze” ACA plan.

Niche Market

“There is a niche market for short-term medical,” Smedsrud said.

Joel Ario, a former state insurance regulator who’s now a managing director at Manatt Health, said short-term plans have a role as long as they’re truly short-term and aren’t pitched as an alternative to major medical coverage.

“Most insurance regulators would tell you that these short-term plans tend to be sold in ways that unwary consumers are often surprised by, and suffer from,” said Ario, who previously worked on the ACA at the Department of Health and Human Services.

Lawsuits over short-term plans have been filed from coast to coast in recent years. 

Californian Mohammed Azad in January sued Tokio Marine HCC over a short-term policy he purchased in 2015. Shortly after buying the plan, Azad had three separate health incidents that required doctor visits, and the company denied his claims and demanded years’ worth of detailed records about his medical history, according to the suit. 

Azad also accused the insurer of training employees at a third-party company to answer its customer-service calls about denied claims to “deceive or otherwise obstruct policyholders” seeking to resolve their disputes, according to the complaint.

‘Never Paid’

“Azad never received any refund of his premiums, and defendants never paid any of Azad’s claims,” according to the complaint. “Ultimately, Azad paid his medical bills himself.”

The case was dismissed in September, with Azad accepting an unspecified settlement, instead of filing an amended complaint, court records show. His lawyer, Geman, said the insurers are free to refuse coverage to people with preexisting conditions, but they still have to follow through on their policies when new health problems arise.

Doug Busker, a spokesman for Tokio Marine HCC, said the company doesn’t comment on litigation. He said the company stopped offering the plans earlier this year.

“Companies can abuse the privilege of exemption over preexisting conditions,” Geman said in a phone call. “It is a vehicle to deny coverage.”

In another case, William Masterson of Arkansas sued Starr Indemnity Liability Co. in 2013 after the company denied a claim for more than $300,000 in expenses incurred after he was diagnosed with throat cancer during his policy period. The case settled.

Masterson’s lawyer, Robert Coleman, declined to comment on the details. But he expressed surprise that Trump wanted to increase the use of short-term policies, saying the general rule that Americans benefit from more choice doesn’t always apply.

“With insurance it doesn’t work that way,” Coleman said in a phone call from his office in Arkansas. “You gotta put everyone in the same pot.”

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Health Care Back on Congress’s Front Burner

WASHINGTON—The Senate this week will grapple with President Donald Trump’s decision to stop making subsidy payments to health insurers, with lawmakers seeking a deal that would keep the money flowing while Republicans try to fold in conservative-oriented health-care priorities.

It remains unclear whether a package could emerge that attracts support from a critical mass of senators and also from House Republicans. That could be put to the test quickly, as Sens. Lamar Alexander (R., Tenn.) and Patty Murray (D., Wash.) are expected…

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A Staggering Blow to US Health Care

Just hours after announcing some new ways to destabilize the health-insurance markets created by the Affordable Care Act, on Thursday President Donald Trump delivered a direct blow to a crucial aspect of the law itself: No longer will the federal government reimburse insurance companies for reducing out-of-pocket costs for poorer customers, as the law requires them to do.

This long-feared step compounds all the damage the president has so far inflicted, by pushing insurers to hike premiums or leave the individual insurance market altogether. Trump may not recognize the harm this does to Americans’ health and peace of mind. But Congress should. Democrats and Republicans must come together to officially appropriate the payments that the president has recklessly ordered to be withheld.

A bipartisan effort to shore up the individual insurance market was under way in the Senate just a month ago, before a last-ditch attempt to repeal Obamacare stopped it in its tracks. Its leaders — Republican Lamar Alexander of Tennessee and Democrat Patty Murray of Washington — need to pick up where they left off.

In return for Republicans’ agreeing to fund the so-called cost-sharing reduction payments to insurers, Democrats could allow states greater leeway to determine the minimum requirements for insurance policies sold on their exchanges. But that discretion can’t be unlimited: States should not be allowed to simply waive Obamacare’s “essential health benefits.”

First, however, the bipartisan conversation must resume.

On Friday morning, Trump tweeted that Obamacare is “imploding.” In fact, he has used every tool at his disposal to make it collapse. His decision to end cost-sharing payments throws the individual health-insurance market into chaos just as the fall enrollment season is about to begin. Chaos, indeed, seems to have been Trump’s intent, or he would not have ended the payments so abruptly. Now it’s Congress’s responsibility to shore up the law and stabilize the health-care system.

    –Editors: Mary Duenwald, Michael Newman.

    To contact the senior editor responsible for Bloomberg View’s editorials: David Shipley at

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This Is The Latest Asian Country To Become A Hot Spot For Chinese Medical Tourists

COMO Shambala Estate

Practicing Tai Chi at a residential health retreat in Bali, Indonesia

From being one of the most underutilized passports in the world, Chinese tourists have breathed new life recently into airlines, cruise ships and the global hospitality industry as a whole. Much of the journeying began after looser visa restrictions negotiated by the government started in the late ’90s. The country went from 10 million outbound movements in 2000 to 122 million recorded this past year , according to figures from the China Tourism Academy (CTA). To put those numbers into perspective, only 11 countries in the world have a total population comparable to that size.

Chinese travelers took full advantage of the eight-day long “Golden Week” holiday, one of two week-long national holidays observed by mainland China, to globe-trot. Many though opted not to sightsee, but rather to take the opportunity to improve their health. Chinese online travel booking site Ctrip revealed 500,000 Chinese travelled overseas for medical-related services in 2016, a five-fold jump year-on-year.

COMO Shambhala Estate

Patient doctor medical consultation

Amongst the most popular destinations for the Chinese to visit was Thailand, recording over nine million trips from China so far this year. But database provider Euromonitor found that Indonesia posted the highest tourism volume growth of 30% so far in 2017. A long-time favorite of Australians, Bali became a hot spot for Chinese travelers — their numbers surpassed the Aussies for the first time ever reaching 150,000 arrivals, becoming the second most visited island by Chinese tourists after Phuket. And that’s even with the imminent danger of Mount Agung threatening to erupt at any moment.

Indonesia is a popular destination among Chinese tourists. Image: Vecteezy.

Wanderlusting for wellness 

“I want to relieve stress, I want more energy, I want to feel better, lose weight, I want to be happy.” This is what the majority of Dr. Nancy Kim’s patients tell her. She is the oriental medicine consultant at the COMO Shambhala Estate deep in the jungles of Bali where travelers retreat for a heaping dose of mental and physical healing.

COMO Shambhala Estate

COMO Shambhala Estate accommodation.

The estate started offering Ayurveda, an ancient Indian remedy system 13 years ago, long before the wellness boom became mainstream. The property has since branched into acupuncture, Balinese therapy, chi gong, herbal therapy, and even gyro-tonics that is said to promote longevity.

Ctrip’s findings showed that the average spending on medical tourism is around ten times greater than regular outbound Chinese travel. “Most of my patients are very successful professionals… they are overworked, overfed, undernourished and unfulfilled,” says Kim as she profiles the typical guest that checks into the retreat. “We simplify the experience of health to make it approachable.”    

COMO Shambhala Estate

Acupuncture treatments

Splurging on health tourism

The statistics from Ctrip also concluded that medical care services ranked fourth among the top 10 leisure activities that the site has to offer — whether for general health exams, early cancer screening, genetic-testing or cosmetic surgery which is extremely popular for affluent females traveling to South Korea. Japan’s cancer prevention and early detection programs are also amongst the costliest, but the high price tag doesn’t stop the Chinese from coming. Medical tourism services have now extended to treatments such as placenta anti-aging, living cell therapy, hepatitis c health care and physical therapy.

China’s medical outbound tourism spending is forecasted to grow through 2022.

Another resident doctor of naturopathy at COMO, Dr. Vinod Nair takes a holistic approach by reading a patient’s pulse and giving a facial diagnosis incorporating the five elements of nature — metal, wood, water, fire and earth. He subscribes to the belief that physical ailments are manifestations of emotions and the mind. In his practice, Nair interprets dreams and prescribes exercise and food as medicine.

COMO Shambhala Estate

Meditation to restore health by balancing the body’s natural energy system.

Make Indonesia a medical destination

As analysts declare Indonesia the “next wave” destination to watch, the local government is targeting 10 million Chinese tourists by 2019. The country is creating three additional tourism focused economic zones and are in the process of courting foreign investors to build more hotels, resorts and entertainment facilities. “Starting next year, we’ll offer just wellness programs without lodging,” Kim says of COMO’s plans to bring more travelers to the property.

To further develop so called “special-interest tourism,” the tourism and health ministry have made it a priority to make Indonesia a medical and wellness destination. To encourage more inbound traffic, Joko Widodo’s administration has plans to roll out stimulus for airlines to open more routes beyond Bali and Jakarta . Meanwhile the Indonesian Chamber of Commerce has called on China to increase the number of flight connections to at least 25 Chinese cities.

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Obesity among all US adults reaches all-time high

(CNN)The United States will not be escaping the obesity epidemic crisis anytime soon: Nearly 40% of adults and 19% of youth are obese, the highest rate the country has ever seen in all adults, according to research released Friday by the National Center for Health Statistics.

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