Global cost of obesity-related illness to hit $1.2tn a year from 2025

The Guardian reports: The cost of treating ill health caused by obesity around the world will top $1.2tn every year from 2025 unless more is done to check the rapidly worsening epidemic, according to new expert estimates.

Obesity and smoking are the two main drivers behind the soaring numbers of cancers, heart attacks, strokes and diabetes worldwide, grouped together officially as non-communicable diseases. They are the biggest killers of the modern world.

The United States faces by far the biggest treatment bill, with a rise from $325bn per year in 2014 to $555bn in just eight years’ time, partly because of the high cost of medical care in the US. But all countries are looking at a very steep rise in costs that will be unaffordable for most. In the UK, the bill is set to rise from $19bn to $31bn per year in 2025. The NHS chief executive, Simon Stevens, has already warned that obesity threatens to bankrupt the NHS.

Over the next eight years, the experts say, the US will spend $4.2tn on treating obesity-related disease, Germany will spend $390bn, Brazil $251bn and the UK $237bn if these countries do not do more to try to prevent it. [Continue reading…]

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After a decade of reduction, global hunger is rising again due to conflict and climate change

Quartz reports: After a decade of progress made to cut the number of undernourished people on Earth, global hunger appears to be rising again.

The primary driver of growing hunger is the increase of conflicts around the world, many of which have been compounded by climate change, according to the 2017 State of Food Security and Nutrition report published by the United Nations Food and Agricultural Organization (FAO) on Sep. 15.

Among the 815 million undernourished people—representing more than one in 10 people alive today—more than 489 million live in parts of the world afflicted by armed conflicts. Many of these are regions that have suffered years of violence, including the Horn of Africa, the Great Lakes of Africa, and the parts of the Middle East affected by the Syrian War. Countries outside these regions that have faced similar ongoing conflict include South Sudan, Yemen, Cameroon, Chad, Nigeria, Afghanistan, Pakistan, and India. [Continue reading…]

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In the Caribbean, colonialism and inequality mean hurricanes hit harder

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A satellite image of Hurricane Irma spiraling through the Caribbean.
NOAA/AP

By Levi Gahman, The University of the West Indies: St. Augustine Campus and Gabrielle Thongs, The University of the West Indies: St. Augustine Campus

Hurricane Maria, the 15th tropical depression this season, is now battering the Caribbean, just two weeks after Hurricane Irma wreaked havoc in the region.

The devastation in Dominica is “mind-boggling,” wrote the country’s prime minister, Roosevelt Skerrit, on Facebook just after midnight on September 19. The next day, in Puerto Rico, NPR reported via member station WRTU in San Juan that “Most of the island is without power…or water.”

Among the Caribbean islands impacted by both deadly storms are Puerto Rico, St Kitts, Tortola and Barbuda.

In this region, disaster damages are frequently amplified by needlessly protracted and incomplete recoveries. In 2004, Hurricane Ivan rolled roughshod through the Caribbean with wind speeds of 160 mph. The region’s economy took more than three years to recover. Grenada’s surplus of US$17 million became a deficit of $54 million, thanks to decreased revenue and the outlays for rehabilitation and reconstruction.

Nor were the effects of a 7 magnitude earthquake that rocked Haiti in 2010 limited to killing some 150,000 people. United Nations peacekeepers sent in to help left the country grappling, to this day, with a fatal cholera outbreak.

A tent city in post-earthquake Haiti.
Fred W. Baker III/Wikimedia Commons

These are not isolated instances of random bad luck. As University of the West Indies geographers who study risk perception and political ecology, we recognize the deep, human-induced roots of climate change, inequality and the underdevelopment of former colonies – all of which increase the Caribbean’s vulnerability to disaster.

[Read more…]

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Poor diet is a factor in one in five deaths, global disease study reveals

The Guardian reports: Poor diet is a factor in one in five deaths around the world, according to the most comprehensive study ever carried out on the subject.

Millions of people are eating the wrong sorts of food for good health. Eating a diet that is low in whole grains, fruit, nuts and seeds and fish oils and high in salt raises the risk of an early death, according to the huge and ongoing study Global Burden of Disease.

The study, based at the Institute of Health Metrics and Evaluation at the University of Washington, compiles data from every country in the world and makes informed estimates where there are gaps. Five papers on life expectancy and the causes and risk factors of death and ill health have been published by the Lancet medical journal.

It finds that people are living longer. Life expectancy in 2016 worldwide was 75.3 years for women and 69.8 for men. Japan has the highest life expectancy at 84 years and the Central African Republic has the lowest at just over 50. In the UK, life expectancy for a man born in 2016 is 79, and for a woman 82.9.

Diet is the second highest risk factor for early death after smoking. Other high risks are high blood glucose which can lead to diabetes, high blood pressure, high body mass index (BMI) which is a measure of obesity, and high total cholesterol. All of these can be related to eating the wrong foods, although there are also other causes. [Continue reading…]

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Want to fix America’s health care? First, focus on food

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Poor diet hurts our health and our wallets.
Lukas Goja/Shutterstock.com

By Dariush Mozaffarian, Tufts University

The national debate on health care is moving into a new, hopefully bipartisan phase.

The fundamental underlying challenge is cost – the massive and ever-rising price of care which drives nearly all disputes, from access to benefit levels to Medicaid expansion.

So far, policymakers have tried to reduce costs by tinkering with how care is delivered. But focusing on care delivery to save money is like trying to reduce the costs of house fires by focusing on firefighters and fire stations.

A more natural question should be: What drives poor health in the U.S., and what can be done about it?

We know the answer. Food is the number one cause of poor health in America. As a cardiologist and public health scientist, I have studied nutrition science and policy for 20 years. Poor diet is not just about individual choice, but about the systems that make eating poorly the default for most Americans.

If we want to cut down on disease and achieve meaningful health care reform, we should make it a top nonpartisan priority to address our nation’s nutrition crisis.

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Company Town captures ‘quiet tragedy’ of community polluted by big business

 

The Guardian reports: The documentary Company Town opened in New York City on Friday night, for a short run at Cinema Village on East 12th Street. Introducing a sold-out screening, New York state attorney general Eric Schneiderman said co-directors Natalie Kottke-Masocco and Erica Sardarian had captured one of the “quiet tragedies that are taking place all across America all the time”.

The film tells the story of Crossett, Arkansas, a small town dominated by a huge Georgia-Pacific paper mill owned by the Koch brothers, Charles and David, hugely influential Republican donors with a deeply contentious – activists would say appalling – record on the environment. People who live in Crossett blame the mill for the heedless dumping of cancer-causing chemicals they say pollutes drinking water and shortens already straitened lives.

“This is a story that never gets told,” Schneiderman said, “and it takes tremendous commitment to get to the quiet tragedies that are taking place all across America all the time.

“The environmental movement really has not done as good a job perhaps as we should have done carrying the essential message that people who are poor and without power are always on the front lines of pollution and environmental justice.” [Continue reading…]

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Trump’s war on science

In an editorial, the New York Times says: The news was hard to digest until one realized it was part of a much larger and increasingly disturbing pattern in the Trump administration. On Aug. 18, the National Academies of Sciences, Engineering and Medicine received an order from the Interior Department that it stop work on what seemed a useful and overdue study of the health risks of mountaintop-removal coal mining.

The $1 million study had been requested by two West Virginia health agencies following multiple studies suggesting increased rates of birth defects, cancer and other health problems among people living near big surface coal-mining operations in Appalachia. The order to shut it down came just hours before the scientists were scheduled to meet with affected residents of Kentucky.

The Interior Department said the project was put on hold as a result of an agencywide budgetary review of grants and projects costing more than $100,000.

This was not persuasive to anyone who had been paying attention. From Day 1, the White House and its lackeys in certain federal agencies have been waging what amounts to a war on science, appointing people with few scientific credentials to key positions, defunding programs that could lead to a cleaner and safer environment and a healthier population, and, most ominously, censoring scientific inquiry that could inform the public and government policy. [Continue reading…]

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Why so many people don’t ‘just leave’ when a major hurricane hits

Eleanor Goldberg writes: Historic storm or not, many Floridians have no choice but to stay put when the winds rise.

Those who don’t evacuate before huge storms are often criticized for “choosing” to stay behind. A 2010 study from Northwestern found that the majority of observers looked favorably on Hurricane Katrina victims who had evacuated, calling them “hardworking and self-reliant.” Those who didn’t leave were described as “lazy, negligent and stubborn.”

Such harsh judgments didn’t match the reality of the situation.

Fourteen percent of the people who remained in New Orleans during Hurricane Katrina had a physical disability. Fifty-five percent of them didn’t have access to a car or another way to leave. And 68 percent didn’t have either money in the bank or a useable credit card, Pacific Standard Magazine reported in 2015. [Continue reading…]

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Cholera spreads as war and poverty batter Yemen

The New York Times reports: The Yemeni farm laborer was picking crops in a hot field when the call came. His children, all seven of them, had fallen gravely ill.

Some were vomiting, others had diarrhea, and all were listless, indicating that they had fallen victim to the latest disaster to afflict this impoverished corner of the Arabian Peninsula: one of the worst outbreaks of cholera infection in recent times.

The laborer, Abdulla Siraa, set about frantically trying to raise money to treat the children — $240, or about six times what he typically earns in a month — and raced as fast as he could on the 30 miles home over roads virtually destroyed in Yemen’s civil war.

“I spent the whole journey reciting Quranic verses and praying for the survival of my children,” he said.

But when he arrived, he learned that his 4-year-old daughter, Ghadeer, had already died, after hours of calling out for him, though the rest of his children would survive.

For much of the world, cholera, a bacterial infection spread by water contaminated with feces, has been relegated to the history books. In the 19th century, it claimed tens of millions of lives across the world, mainly through dehydration and electrolyte imbalance.

That ended with modern sanitation and water systems. When it pops up now, it is usually treated easily with rehydration solutions and, if severe, with antibiotics.

But the war currently battering Yemen has damaged infrastructure and deepened poverty, allowing the disease to come roaring back. Cholera is also on the rise in the Horn of Africa because of long-simmering conflicts there. Yemen’s African neighbors, Somalia, South Sudan, Ethiopia and Kenya, have had a total of about 96,000 cholera cases since 2014, international aid groups say.

The crises in Africa, however, pale in comparison to the one in Yemen. [Continue reading…]

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The chimpanzees’ materia medica

Linda Nordling writes: Fancy eating a kroma fruit? How about a prickly badi? Or zoobo leaves?

If you are feeling unwell, perhaps you should. These West African plants are part of a ‘jungle pharmacy’ sought out by wild chimpanzees to treat ailments ranging from worm infestations to bacterial infections. And because humans share 98% of their DNA with chimps, and are susceptible to some of the same diseases, they might work on people too.

At least that is the theory behind a research project in Côte d’Ivoire that is screening such plants for possible human treatments. So far it has identified compounds that able to kill bacterial and yeast infections in a petri dish, and even some that seem to inhibit cancer development. Eventually, such discoveries could lead to new antibiotics, antifungals or cancer treatments.

But drug discovery is a long road, and these compounds have only passed the first hurdle says Constant Ahoua, the Ivorian botanist in charge of the project. Ahoua, a postdoctoral researcher at the Afrique One-ASPIRE programme based in Abidjan, has been studying chimp diets for a decade. For his PhD he screened 27 plant species eaten by wild chimps, specifically targeting those not already known to be used in traditional human medicine. Of the extracts he made from the plants, 18% were active against bacteria and 5% against yeasts.

Next up, Ahoua will publish a paper on the anti-cancer compounds he discovered in his research. “We found seven compounds that inhibit cancer-triggering enzymes, and two of them are completely new,” he says. [Continue reading…]

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Good news, despite what you’ve heard

Nicholas Kristof writes: Just since 1990, more than 100 million children’s lives have been saved through vaccinations and improved nutrition and medical care. They’re no longer dying of malaria, diarrhea or unpleasant causes like having one’s intestines blocked by wriggling worms. (This is a good news column, but I didn’t say it wouldn’t be a bit gross.)

“There are deworming campaigns now, so it’s much rarer that we go into surgery for obstruction and see a big mass of worms,” explained Agatha Neufville, the nursing director at the Ganta United Methodist Hospital.

Nine out of 10 Americans say in polls that global poverty has been staying the same or worsening. So let’s correct the record.

There has been a stunning decline in extreme poverty, defined as less than about $2 per person per day, adjusted for inflation. For most of history, probably more than 90 percent of the world population lived in extreme poverty, plunging to fewer than 10 percent today.

Every day, another 250,000 people graduate from extreme poverty, according to World Bank figures. About 300,000 get electricity for the first time. Some 285,000 get their first access to clean drinking water. When I was a boy, a majority of adults had always been illiterate, but now more than 85 percent can read.

Family planning leads parents to have fewer babies and invest more in each. The number of global war deaths is far below what it was in the 1950s through the 1990s, let alone the murderous 1930s and ’40s. [Continue reading…]

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U.S. lags behind much of developed world in social progress

Bloomberg reports: America leads the world when it comes to access to higher education. But when it comes to health, environmental protection, and fighting discrimination, it trails many other developed countries, according to the Social Progress Imperative, a U.S.-based nonprofit.

The results of the group’s annual survey, which ranks nations based on 50 metrics, call to mind other reviews of national well-being, such as the World Happiness Report released in March, which was led by Norway, Denmark, and Iceland, or September’s Lancet study on sustainable development. In that one, Iceland, Singapore, Sweden, and the U.S. took spots 1, 2, 3, and 28—respectively.

The Social Progress Index released this week is compiled from social and environmental data that come as close as possible to revealing how people live. “We want to measure a country’s health and wellness achieved, not how much effort is expended, nor how much the country spends on healthcare,” the report states. Scandinavia walked away with the top four of 128 slots. Denmark scored the highest. America came in at 18. [Continue reading…]

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How Trump ended up as a putrid bag of toxins

The Washington Post reports: President Trump reportedly eschews exercise because he believes it drains the body’s “finite” energy resources, but experts say this argument is flawed because the human body actually becomes stronger with exercise.

Trump’s views on exercise were mentioned in a New Yorker article this month and in “Trump Revealed,” The Washington Post’s 2016 biography of the president, which noted that Trump mostly gave up athletics after college because he “believed the human body was like a battery, with a finite amount of energy, which exercise only depleted.”

Exercise does deplete stores of glucose, glycogen and fats from the body’s tissues, but these fuels are restored when a person eats, said Michael Jonesco, a sports medicine and orthopedics specialist at Ohio State University’s Wexner Medical Center. [Continue reading…]

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Mountains of the mind: ‘I’ve become part of the landscape and it’s become part of me’

Kevin Rushby writes: We begin in darkness and head up towards the light. It is that time just before the dawn when it’s neither day nor night. Down near Lake Coniston, I can hear an owl and a curlew calling, both claiming the hour for themselves. “I like to come this early,” says Sion. “There’s no one else around. I can’t handle crowds. I get confused.”

It’s 4.30am and I am with Sion Jair, 67, and his partner, Wendy Kolbe, 63, and we are heading up the Old Man of Coniston, an 803-metre Lake District fell noted for its sharp ascent and great panoramas of southern lakeland. Or at least we hope so: there are some clouds massing in the east.

For Sion, this has become a daily ritual, adopted seven years ago when a visit to the doctor changed his life for ever. “I had been feeling permanently tired, and suffering some memory problems. It meant I couldn’t get out walking, you see, and when I can’t walk, I really shut down.”

After tests, the doctor diagnosed chronic anaemia from vitamin B12 deficiency. Injections usually sort that out, but Sion reacted badly to the shots and, without them, was given three years to live. Determined not to give in, he set about walking in earnest, covering around 10 miles a day. “Eventually, it worked. I reckon it cured me of the chronic fatigue,” he says.

But there was another blow. The anaemia had been masking signs of dementia. Given the particular type of condition he was suffering from, he was warned that he could expect periods of total memory loss, mood swings and eventually the inability to look after himself. Sion had become one of the estimated 25 million people worldwide suffering this progressive neurodegenerative disease, as feared now as the Black Death was in its day.

“It was quite scary,” says Sion, adding, in something of an understatement, “I didn’t like the idea.”

Sion’s response was typical of him: he walked even more. Not just the Old Man, but other fells, too: Scafell Pike, Helvellyn, Blencathra, Dollywaggon Pike – all the greats. “I’ve done them so often, I know them blindfolded.” And all this he did without any technological intermediaries, smartphone or GPS – just the steady rhythm of his feet. On one occasion he did 12 peaks and 28 miles in 22 hours, raising cash for his three favourite charities: the Alzheimer’s Society, Mountain Rescue and the Great North Air Ambulance. He also walked in Wales – he walked the Snowdon horseshoe more than 200 times – and Scotland, but it was in Coniston that he found his walking mantra. I suppose you could call it his Coniston Old Man-tra. [Continue reading…]

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‘Most non-communicable diseases are spread by big corporations’

Pacific Standard reported in 2016: [Cristin] Kearns is one of the only people who have found evidence that cane- and beet-sugar manufacturers contributed to public-health problems. That’s thanks in part to her having worked as a dentist both in private practice and in a low- income clinic, which helped her realize something was amiss when conversations about dental health rarely included considerations of sugar. But it’s more a tribute to her doggedness, her willingness to comb through even the most obscure corners of library archives, and her persistence even in the face of a large and well-funded target.

She’s also unusual in the world of academia, where she’s settled for now as a research fellow at the University of California–San Francisco. Most folks who study sugar and health at universities are chemists, biologists, or epidemiologists. They examine sugar’s effects on the body, or they analyze data about whether people who eat more sugar are more likely to be in poor health. No other academic researchers study the secret workings of sugar refiners’ science campaigns.

But companies’ activities — including how they formulate their food, how their advertising and marketing affect what people buy, and their scientists’ roles in crafting nutritional guidelines — could help explain a number of major public-health problems. They could be especially important to understanding so-called non-communicable diseases, such as cancer, diabetes, and heart disease, which don’t spread from person to person the way cholera or the flu do.

“Most non-communicable diseases are spread by big corporations,” says Stanton Glantz, a public-health researcher famed for his analysis of tobacco industry documents in the 1990s, “because profit-maximizing behavior leads them to be out pushing products which end up causing disease.” Glantz is Kearns’ mentor at UCSF. “If you’re interested in disease control, in addition to understanding the detailed mechanics of how smoking causes heart disease or how smoking causes cancer at a molecular level, you’ve got to be looking up at what forces are out there that are promoting the disease because they’re making a lot of money doing it.”

Evidence of corporations’ influence on science can lead to certain policy changes that biological and epidemiological evidence alone cannot. “This kind of research is very useful to make the point that, yeah, you simply can’t have these guys at the table,” says Richard Daynard, an expert on public health law at Northeastern University School of Law in Boston. Simply knowing that a product can be bad for people’s health isn’t enough to convince the governmental organizations to remove industry folks from policy discussions. There must be evidence of company wrongdoing too. [Continue reading…]

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The Trump administration is ill-prepared for a global pandemic

The Washington Post reports: The Trump administration has failed to fill crucial public health positions across the government, leaving the nation ill-prepared to face one of its greatest potential threats: a pandemic outbreak of a deadly infectious disease, according to experts in health and national security.

No one knows where or when the next outbreak will occur, but health security experts say it is inevitable. Every president since Ronald Reagan has faced threats from infectious diseases, and the number of outbreaks is on the rise.

Over the past three years, the Centers for Disease Control and Prevention has monitored more than 300 outbreaks in 160 countries, tracking 37 dangerous pathogens in 2016 alone. Infectious diseases cause about 15 percent of all deaths worldwide.

But after 11 weeks in office, the Trump administration has filled few of the senior positions critical to responding to an outbreak. There is no permanent director at the CDC or at the U.S. Agency for International Development. At the Department of Health and Human Services, no one has been named to fill sub-Cabinet posts for health, global affairs, or preparedness and response. It’s also unclear whether the National Security Council will assume the same leadership on the issue as it did under President Barack Obama, according to public health experts.

“We need people in position to help steer the ship,” said Steve Davis, the chief executive of PATH, a Seattle-based international health technology nonprofit working with countries to improve their ability to detect disease. “We are actually very concerned.”

In addition to leaving key posts vacant, the Trump administration has displayed little interest in the issue, health and security experts say. The White House has made few public statements about the importance of preparing for outbreaks, and it has yet to build the international relationships that are crucial for responding to global health crises. Trump also has proposed sharp cuts to government agencies working to stop deadly outbreaks at their source.

The slow progress on senior-level appointments — even those, such as the CDC director, that do not require Senate confirmation — is hobbling Cabinet secretaries at agencies across the government. Temporary “beachhead” teams the White House installed are hitting the end of their appointments. The remaining civil servants have little authority to make major decisions or mobilize resources.

An HHS spokeswoman declined to comment on personnel decisions. An NSC official, who was not authorized to speak publicly, said the administration recognizes that global health security is a national security issue and that America’s health depends on the world’s ability to detect threats wherever they occur.

Trump’s NSC does not have a point person for global health security as Obama’s did, but global health security is part of the overall portfolio of Tom Bossert, Trump’s homeland security adviser, another NSC official said.

Global health experts warn that a pandemic threat could be as deadly as a nuclear attack — and is much more probable. [Continue reading…]

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EPA chief, rejecting agency’s science, chooses not to ban insecticide

The New York Times reports: Scott Pruitt, the head of the Environmental Protection Agency, moved late on Wednesday to reject the scientific conclusion of the agency’s own chemical safety experts who under the Obama administration recommended that one of the nation’s most widely used insecticides be permanently banned at farms nationwide because of the harm it potentially causes children and farm workers.

The ruling by Mr. Pruitt, in one of his first formal actions as the nation’s top environmental official, rejected a petition filed a decade ago by two environmental groups that had asked that the agency ban all uses of chlorpyrifos. The chemical was banned in 2000 for use in most household settings, but still today is used at about 40,000 farms on about 50 different types of crops, ranging from almonds to apples.

Late last year, and based in part on research conducted at Columbia University, E.P.A. scientists concluded that exposure to the chemical that has been in use since 1965 was potentially causing significant health consequences. They included learning and memory declines, particularly among farm workers and young children who may be exposed through drinking water and other sources. [Continue reading…]

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The hidden risks of Trump’s EPA cuts: Birth defects, bad air

Bloomberg reports: President Donald Trump pledged during the 2016 campaign that he would only “leave a little bit” of federal rules that protect human health and the environment. Now about 50 former officials of the U.S. Environmental Protection Agency are firing back in a lengthy analysis that details, program by program, what amounts to a starvation diet for the EPA.

Calling themselves the Environmental Protection Network, they worked through both Republican and Democratic administrations. The group’s members are putting aside their differences over policies and programs to stop what they say “appears to be nothing less than a full-throttle attack on the principle underlying all U.S. environmental laws—that protecting the health and environment of all Americans is a national priority.”

Even before formally registering as a nonprofit organization, the network has put together a 50-page analysis of the president’s proposed EPA budget, based partly on the White House’s fiscal 2018 budget blueprint. The blueprint, released on March 16, sketched out top-line cuts of 31 percent of the agency’s budget and 21 percent of its staff. The new administration’s targeting of the agency requires an independent, expert assessment of what’s happening there, the group says. [Continue reading…]

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Why Obamacare defeated Trumpcare

Jonathan Chait writes: With the collapse of the House health-care bill, the cause of repealing Obamacare, a right-wing obsession for seven years and a day, has died. The flame will never be fully extinguished in the hearts of the true believers — after all, in right-wing think tanks and other places far removed from electoral politics, anti-government zealots still dream of phasing out Social Security or Medicare. But the political project dedicated to restoring the pre-Obamacare status quo, in which people too sick or poor to afford their own insurance without the subsidies and regulations of the Affordable Care Act could be safely ignored, is gone forever. And it is dead for the best possible reason, the reason that undergirds all social progress: because a good idea defeated a bad one.

Conservatives have already collapsed into mutual recriminations for their failure. Reporters have blamed Trump’s deal-making skills. Trump’s loyalists are loudly blaming Paul Ryan. “I think Paul Ryan did a major disservice to President Trump, I think the president was extremely courageous in taking on health care and trusted others to come through with a program he could sign off on,” Chris Ruddy, CEO of the right-wing site Newsmax and a longtime friend of Trump’s, tells Bloomberg. “The president had confidence Paul Ryan would come up with a good plan and to me, it is disappointing.” David Brooks blames both Trump and Congress. “The core Republican problem is this,” he writes. “The Republicans can’t run policy-making from the White House because they have a marketing guy in charge of the factory. But they can’t run policy from Capitol Hill because it’s visionless and internally divided.”

The American Health Care Act is a truly horrendous piece of legislation. But it did not become the vehicle for the Obamacare repeal effort because Trump, or Ryan, or anybody insisted on it over some other option. It became the repeal bill because nobody in the Republican Party had a better idea. [Continue reading…]

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