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Earth’s 2016 surface temperatures were the warmest since modern record keeping began in 1880, according to independent analyses by NASA and the National Oceanic and Atmospheric Administration (NOAA). Globally-averaged temperatures in 2016 were 1.78 degrees Fahrenheit warmer than the mid-20th century mean, and 2016 was also the third year in a row to set a new record for global average surface temperatures.

A report just released by the Natural Resources Defense Council carries a warning of dire consequences that can come from reneging on our nation’s climate commitments to rein in carbon pollution. The report, “Killer Summer Heat, Paris Agreement Compliance Could Avert Hundreds of Needless Deaths in America’s Cities,” warns that abandoning the U.S. climate commitment in the Paris pact could cause a spike in excess deaths on dangerous summer days by the 2090s, but that enormous human misery could still be avoided by adhering to, not undoing, a former action plan to reduce carbon pollution from the nation’s largest sources: power plants and vehicles.

City dwellers are especially vulnerable to climate impacts because of the heat island effect. Urban areas are hotter than suburban and rural areas because of their concentration of buildings, pavement and roofing, which intensify the heat. The elderly, the young, the poor, and people of color are most vulnerable to summer heat in the cities.

To reach their conclusions, the report authors relied on analysis using a weather classification system called Spatial Synoptic Classification, which researchers have used since at least 1996 to study relationships between dangerous weather and human health.


Writer Elisabeth Rosenthal has worked as a physician and says it’s far more lucrative in the U.S. health system to provide a lifetime of treatments than a cure. In her new book, “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back,” Dr. Rosenthal explains for the first time how various social and financial incentives have encouraged a disastrous and immoral system to spring up organically in a shockingly short span of time. To a degree unlike any other country in the world, the U.S. healthcare system has become so user-unfriendly and so complicated that even most doctors don’t understand it.

Elisabeth Rosenthal is currently editor-in-chief of Kaiser Health News and before that she was a reporter covering health care for the New York Times, but before that she worked as a physician at New York Presbyterian Hospital.

In her book, Rosenthal breaks out the economic rules of the dysfunctional American medical market in which, for example, more competition does not mean better prices for the consumer. In fact, it can and does drive prices up. Unlike any other economic market, the standard in our healthcare is “usual and customary,” which does not allow the open market to work as it should. Insurance companies say they will pay whatever is usual and customary in your area, even if that happens to be five times as much as the original drug or service cost. This has become an inflationary concept over time. When a medical procedure or drug has become known to have been sold at a higher than usual price in a certain area, it will quickly rise to that same price in other areas. In this way, it becomes whatever the market will bear, up to its highest limit, quite unlike in other countries where regulations have set reasonable caps to prices for medical drugs and services. As a result of this inflationary practice, we are not getting what we should in a really competitive market where consumers make the choices that set prices.

This contradicts the premise of a competitive market, that by our shopping for the hospital or procedure with the cheapest cost the price will eventually be brought down. We are told that we should be “good consumers” of health care, but in order to do that we need to know what things cost. When we try to get that information, we are told “it depends on your insurance” or “we don’t know.” Also, most of the time when dealing with non-elective health issues we don’t have a lot of choice. We may be told we need a certain procedure or are given a requisition for a particular lab test. We need to be in the habit of always checking to make sure such things are included in our insurance network coverage in order to avoid being hit with out of pocket costs. We are not always informed of this, however.

Another economic rule of our dysfunctional medical market is a lifetime of treatment is preferable to a cure. There are always two sides involved in setting a price, what is right for health care and what is right for business. We can’t expect a for-profit healthcare business to be run like a charity. A pill that would cure diabetes would kill a multi-billion-dollar business market. It is much better to have effective treatments that need to continue to be given over a person’s lifetime than to give them something to make the disease go away overnight.

Consolidation of hospitals was a good idea in the beginning to provide more efficient specialization of services, but it has grown to the point where now you have mini-monopolies with an enormous sway over price. Cities with the most healthcare consolidation tend to have the highest prices for health care.

Unique also to the American healthcare system is the application of codes to medical billing. Our codes originally evolved from an international system for classifying and tracking disease epidemiologically, and it got perverted into something more toxic. Over time, people have learned to manipulate the financial function to itemize for costs of various special interest parties involved. We are not always informed but patients have a right to ask for a fully itemized bill that should be examined carefully. Often we can identify things that need to be questioned and corrected.

There are many questions patients need to ask in advance of hospital and doctor visits in order to avoid unnecessary or high costs. Use of patient advocates have become necessary in our system. We are all vulnerable to surprise medical bills. You have to watch your own back. Ask who is involved in your medial care that you may not have been told about. Failure to ask simple questions like “who are you?”, “who called you?” and “will I be charged?” makes us complicit in allowing the dysfunctional American medical market to continue.

Rosenthal’s book explains the workings of a medical system lacking transparency. It is about what we can do both to navigate the maze that is American healthcare and to demand far-reaching reform. “An American Sickness” is the frontline defense against a healthcare system that no longer has our own well-being at heart.


Other articles of interest in this Summer 2017 TMIS eNewsletter:

* American Cities Initiative invests in American cities to help city leaders respond to emerging issues, generate innovation, and advance policy that moves the nation forward.

* New paper reviews growing evidence that obesity, type 2 diabetes and metabolic syndrome are inflammatory conditions worsened by vaccinations.

* Company presents science behind mechanism of action of cannabidiol (CBD) and its treatment of chemotherapy-induced neuropathic pain.

* New scientific survey of U.S. moms and grandmothers shows concern that not enough is being done about air pollution and climate change.

* Topical cannabinoid-based skin cream to provide relief for millions for psoriasis sufferers will soon be available.

* Osteopathic physicians find poor posture while using electronic devices is a main contributor to chronic neck and back pain.

* “An Inconvenient Sequel: Truth to Power” to be released in movie theaters July 28th.

* New book, “Grapes and Health,” offers a review of current science linking eating grapes to better health.

* Veterinarians use MLS Laser Therapy on animals with effective results where time is a critical factor.


I am grateful to be in a collaborative business with many talented and skilled professionals. Additional feedback and recommendations for our products and services at TM Information Services are always welcome.

- Mary Michele McLaughlin

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