Trump nominee reaffirms support for assault on Medicare and Medicaid


By Zaida Green
19 January 2017

Republican Representative Tom Price, president-elect Donald Trump’s nominee to head the Department of Health and Human Services (HHS), reiterated his intention to repeal Obamacare and his support for the dismantling of Medicaid and gutting of Medicare, in testimony before the Senate Wednesday.

Over the course of the nearly four-hour confirmation hearing, Price made clear his intent to keep unfettered the right of the healthcare industry to profit from mass suffering, calling for the transformation of Medicaid into a state-run program funded via federal block grants and refusing to commit to maintaining any of the minimal patient protections afforded by the Affordable Care Act, generally referred to as Obamacare.

Speaking before the Senate Health, Education, Labor and Pensions Committee, Price gave few details on the Republicans’ plan to replace Obamacare. While claiming, “Nobody is interested in pulling the rug out from anybody,” Price refused to give a timetable or any other specific details on a substitute health plan, suggesting that any replacement legislation would be implemented piecemeal, leaving open the possibility that the 30 million people who have gained minimal health care coverage through the ACA’s exchanges and Medicaid expansion could be left stranded without health insurance for an indefinite length of time.

Price, who was chairman of the House Budget Committee, refused to commit to Trump’s repeated campaign promise that his administration would not impose any cuts to Medicare and Medicaid, claiming that dollars were “the wrong metric” to measure resources for patient care. The Empowering Patients First Act (EPFA), the legislation which Price proposed in 2015 to replace the ACA last year, would cut $449 billion from Medicare and $1.1 trillion from Medicaid over the next decade.

Price gave vague and non-committal answers to questions about whether replacement legislation would maintain the limited protections afforded by the ACA, such as the prohibition on lifetime caps on most benefits; the requirement that insurance companies not exclude coverage for pre-existing conditions; the requirement that health plans include benefits such as mental health care, emergency services, and prescription drug coverage; and the right of young people to receive coverage from their parents’ insurance plans up to the age of 26.

All of Price’s answers amounted to variations on the themes of “patient choice” and the freedom “for every American to access the type of coverage they want.” In reality, this is the “freedom” to be either sucked dry by insurance companies for minimal coverage, to pay even more for comprehensive coverage, or to gamble on health and go without any coverage at all.

On the other hand, Price spoke sympathetically of the insurance companies preparing the premiums they would levy on patients in 2018, saying that “What they need to hear from all of us, I believe, is a level of support and stability in the market.”

Senate Democrats mounted a cynical assault against Price, citing Trump’s lying promise about not touching Medicare and Medicaid and repeatedly asking Price if he would uphold it, thus presenting the billionaire president-elect as sympathetic to these government-run health insurance programs, and giving themselves a pretext for collaborating with the new administration.

Democratic Senators Elizabeth Warren of Massachusetts and Al Franken of Minnesota referred to the billionaire real estate mogul’s recent comment that his administration would give “insurance for everybody”, and attempting to wring out of Price a commitment to Trump’s supposed promise.

Senator Bernie Sanders, the self-described “democratic socialist” who ran for presidency in the Democratic primary, urged Price, “Will you work with us on this?” as he questioned him on whether he would support the opening up of a market to cheaper imported prescription drugs.

The Democrats also criticized the blatant conflict of interest in Price holding investments of hundreds of thousands of dollars in pharmaceutical and medical device companies as he introduced bills that would boost the profits of these companies.

One senator, Democrat Christopher Murphy from Connecticut, pointing worryingly to the financial backgrounds of the rest of Trump’s cabinet, said, “I raise [these conflict of interests issues] because I think there’s great concern … [among] Americans that this whole administration is starting to look like a get-rich scheme.”

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50 Years Later, Here Are 3 Big Ways the Summer of Love Is Still with Us

The ideals of the Human Be-In remain woven through American culture.

Members of Jefferson Airplane performing at the KFRC Fantasy Fair and Magic Mountain Music Festival in Marin County, California, United States in June, 1967
Photo Credit: Bryan Costales ©2009 Bryan Costales, licensed CC BY-SA 3.0-Bcx.Org:, Wikimedia Commons CC BY-SA 3.0; Jefferson Airplane, Marin County, CA, 1967

Born of the simple intention to unite people in the name of connection and love, an event on the polo fields of Golden Gate Park half a century ago sparked a cultural paradigm shift unrivaled in the U.S. since World War II. But this time it was the antithesis to war that would reshape America: the Summer of Love.

The impetus for that fateful summer was called the Human Be-In, in a nod to the peaceful sit-ins waged by university students in the preceding years against racial segregation. In the years surrounding the Summer of Love, the frigid prospect of nuclear war loomed, minorities and women were rising up against myriad oppressions and the government was cracking down on mind-altering substances like LSD and cannabis. The Summer of Love and its values of free expression, love, peace, activism, and psychedelic exploration of consciousness were the backlash.

The early acid-rock sounds of Grateful Dead, Jefferson Airplane, Big Brother and the Holding Co. and others mixed with the words of boundary-pushing poets and psychedelic pioneers to gather 75,000 or so young people in the park. They spilled out into the five-block radius of the Haight-Ashbury neighborhood with fresh smells, sounds and ideals that came to shape the era’s iconography.

Bill McCarthy, founder of the Unity Foundation, co-produced a 50-year anniversary celebration of the Be-In in San Francisco this week.

“It’s important that we celebrate the past, celebrate the victories, triumphs and challenges of the past, but at the same time look at what’s happening today,” he said. “We’re saying yes, in 1967 this all happened, so let’s rededicate ourselves to that. But let’s also see what’s happening today that can build community, build empathy with people all over the world that are struggling.”

He said given the current political climate, with Trump’s impending inauguration and all that’s bound to come with it, there is more reason than ever to “activate ourselves.” He said when you take the “long view” from 1967 to now, it’s obvious that we’re moving forward.

“The values we treasure and movements we created are still stronger than they ever have been,” he said. “When there’s darkness in the world, the thing that feeds darkness is fear. The last thing we should do right now is be fearful.”

Fifty years since the Be-In, as the digital age re-molds the economy, values and skylines of San Francisco and beyond, the ideals of the Human Be-In remain woven through our culture in ways we rarely pause to acknowledge. From the sounds of activism to the shape of companies to that box of free stuff out on the corner, many hippie dreams are alive and well in 2017.

Annie Oak, founder of the Women’s Visionary Congress, a nonprofit dedicated to exploring altered states of consciousness, says the prevalence of psychedelics in the 1960s and ’70s is directly related to the ideas put forth by young people at the time.

“These substances allowed people to think way outside the box and also question social systems,” she said. “The hippies here really put forward a liberal political consciousness and humanist values that impacted society.”

Here are three modern cultural shifts that have their roots in the psychedelic Summer of Love.

1. Collectivism, from communal living to open-source software. 

Annie Oak says communal living, which is everywhere now, was born in the Summer of Love. So, she says, are collectivist projects like the Haight-Ashbury Free Clinic, which is still in operation, offering medical treatment free of charge.

“These ideas of collectivism really launched larger ideas like the open-source software movement and creative commerce,” she notes. “These are ideas that are commonplace now.”

Michael Gosney has produced Digital Be-Ins over the years at Be-In anniversaries to pay homage to the initial Be-In of ’67 and to look to the future. He was involved in early desktop publishing and digital media in San Francisco in the late ’80s. It was the dawn of personal computers, and his magazine was covering early Macintosh creativity. He describes the publication as a “nexus of artists and tech people coming together.”

Between ’85 and ’92 he observed that psychedelics—which made their debut in modern culture during the Summer of Love—heavily influenced the creation of digital media. He says the software programmers who worked on digital music, animation, photography and video were influenced by psychedelics.

“I noticed the preponderance of psychedelic influence in the programming community with the engineers that were inventing these new tools,” he said. “Psychedelic influence was extremely powerful, and really that’s how people were seeing the vision of digital networks and so forth. It very much came out of the influence of psychedelics.”

2. Activism and alternative media.

The mainstream newspapers in 1967 were not about to promote the Be-In event. An underground, independent zine called the Oracle, produced for free in Haight-Ashbury, was the first to cover what would become the catalyst for the hippie days and cultural revolution.

“The Oracle was the first to write about the Be-In, so it helped launch the alternative press,” Annie Oak of WVC says. “And there were also underground radio stations that helped promote the events, so the whole alternative media movement really was moved along by the Be-In and the Summer of Love.”

Oak notes that the environmental movement was also taking place in Haight-Ashbury at the time. The local community organized in the ’60s against a proposed freeway project that would run through the panhandle portion of Golden Gate park, connecting Golden Gate Bridge with the Peninsula. The community organized in protest on the same polo grounds where the initial Be-In took place, and their uprising eventually killed the freeway project. This was in 1964, but Oak says the power of community organizing was a key motif of the ’67 Be-In and its cultural imprints.

“The freeway was one of the important predecessors of the Be-In activism and gathering that took place also in the polo grounds three years later, and the later protests against the war,” she said. “Timothy Leary kind of set the tone with his famous phrase, turn on, tune in, drop out, which kind of set the tone for the Be-In. But what really happened here is people kind of turned on to activism, and then took over. They took over big sections of our culture and changed it in positive ways.”

Oak notes the irony that because of the proposed freeway project, which would have displaced many residents, the Haight-Ashbury neighborhood harbored lower-income residents like students and minorities. As the years passed following the Summer of Love, the neighborhood became an iconic tourist destination. Today, as wealthy techies have been drawn to the city for its iconic allure, lower-income residents are priced out.

“Haight-Ashbury sort of personified the transition between the beat generation—the poets and jazz hipsters that were embracing a lot of the black jazz culture—and the hippies, who then kind of came into what was then a black neighborhood,” Oak says. “And, to some degree, later that movement ironically gentrified the neighborhood, and a lot of the black community then left. It was a very complex form of gentrification, and that gentrification is still happening.”

Bill McCarthy of Unity Foundation said in planning the Be-In anniversary this year he had a conversation with author and historian Dennis McNally about how the mainstream media of the time co-opted the Summer of Love.

“[McNally] was saying… the media created the hippie and created this—how we should look at the culture, and that was part of the downfall,” McCarthy said. “And to that I said, well, Dennis, the beautiful thing now is we can create our own media. We’re not saddled by ABC, NBC, CBS, whatever anymore. We have our own media vehicles.”

3. Cannabis legalization and psychedelic science are influencing mainstream medicine.

Two years prior to the Summer of Love, the psychedelic beloved by many young people who associated LSD with spiritual enlightenment and creative expression was criminalized, like cannabis before it. Retaliating against the Summer of Love and the progressive concepts it launched, President Richard Nixon waged the racist, violent (and ultimately failed) war on drugs that vilified psychedelics and cannabis in the public eye for decades.

Cannabis and most psychedelics remain federally illegal to this day, though the pendulum is starting to swing back. Eight U.S. states have legalized weed for adult use, and this decade the first U.S. government-approved human trials assessing psychedelics in tandem with psychotherapy treatment are showing overwhelmingly positive results. Most of the studies are sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS), a nonprofit group founded by Rick Doblin in 1986.

Doblin said the Summer of Love set society on a path toward important cultural shifts.

“Since the iconic Summer of Love, 50 years ago, marijuana has gone from being a heavily demonized drug used by rebellious youth to a medicine, with one of the largest growing demographics being elderly people,” he said. “Psychedelics now are being investigated as tools used in scientific research for therapeutic uses, a catalyst of spirituality, art and creativity, acceptance of death and we are now facing their legitimization and acceptance as medical tools.”

In addition, MAPS is conducting studies of MDMA’s potential to help treat post-traumatic stress disorder, researching the use of ibogaine for opiate addiction and “implementing ayahuasca research for PTSD and broadening psychedelic harm reduction outreach for more widespread acceptance into our culture,” Doblin said. Similar to the path of cannabis in culture, he predicts psychedelics will first be accepted medicinally, then for their broadened spiritual and cultural uses.

“One day people will take for granted that psychedelics are legal, are highly prized, and help people make positive contributions to society,” he said.

April M. Short is a yoga teacher and writer who previously worked as AlterNet’s drugs and health editor. She currently works part-time for AlterNet, and freelances for a number of publications nationwide.

Obamacare defenders extol health care overhaul as boon to corporate profits


By Kate Randall
5 January 2017

President Obama appeared on Capitol Hill Wednesday to urge congressional Democrats to defend his signature domestic measure, the Affordable Care Act (ACA). Vice President-elect Mike Pence also made an appearance, reiterating that President-elect Donald Trump’s first order of business will be the repeal of the program popularly known as Obamacare.

The Republican-controlled Senate voted 51 to 48 Wednesday to take a first step toward repealing the ACA by agreeing to take up a budget resolution that will clear the way for repealing major provisions of the health care law. It is unclear at this point what form this will take, but through the budget reconciliation process, Republicans aim to repeal or nullify provisions of the law that affect spending and taxes.

Trump and the Republicans have indicated that they may seek to retain some of the program’s more popular features, such as allowing young adults to stay on their parents’ plans until age 26 and prohibiting insurers from discriminating against people with preexisting conditions, although it is unclear how this would be funded.

House Minority Leader Nancy Pelosi, Senate Minority Leader Charles Schumer, former presidential candidate Bernie Sanders and other Democrats appeared at a press conference Wednesday saying that repealing the ACA will “make America sick again” and lead to “grandma living in the guest room.”

But while the drama over the fate of Obamacare plays out on Capitol Hill, proponents of the legislation have come forward to make clear what, in fact, their defense of Obamacare is really about.

The health care overhaul was never about providing universal or even near-universal, decent quality health care for the American people. It was about restructuring the US health care system so as to sharply reduce costs for corporations and the government, at the expense of the health and longevity of working people.

An extensive article in Monday’s New York Times, which begins on page one and fills two entire inside pages, enthusiastically outlines far-reaching changes in the delivery of health care already implemented under Obamacare, and makes clear the changes are driven by an agenda of slashing costs, not for consumers, but for the insurance companies, hospital chains and pharmaceutical corporations.

The article quotes Nancy-Ann DeParle, a White House aide, who recalls Obama telling her he wanted a health care “reform” that would do away with the “creaky old delivery system.”

The two major elements of the old system Obama targeted for destruction were employer-provided health insurance, deemed too generous and expensive, and the so-called “fee for service” model, in which insurance companies had to cover most or all of the cost of each exam, procedure or prescription ordered by health care providers.

By means of financial penalties and inducements to doctors, hospitals and other health care providers, Obamacare aims to replace “fee for service” with a so-called “value-based” system. As the Times article makes clear, the overriding criterion for “value” is not the quality of care, but rather the cost—the lower the cost to corporate interests and the state, the higher the supposed “value.”

“Value-based” is a euphemism for the rationing of health care along class lines. The wealthy get the best care money can buy. The working class and poor get poorer care while paying higher out-of-pocket costs.

As Dr. R. Michael Meneghini, an orthopedic surgeon with Indiana University Health in Fishers, Indiana, told the Times, “These reforms are all intended to slow down the consumption of health care resources in the United States. We are careening at a rapid rate to a two-tier system. The public who can’t afford it goes to a public hospital and gets free health care. Those who have money get to pay for really nice care.”

The extension of health insurance—stripped down and loaded with high premiums, high deductibles and high co-pays—to less than half of the tens of millions of uninsured Americans was always a subordinate aspect of the Obama administration’s health care overhaul. That part of the plan was designed to benefit the insurance companies by forcing those not insured by their employer or the government, via Medicare or Medicaid, to purchase private insurance. It also benefited the hospital chains by reducing the number of uninsured they were forced to treat at their own expense.

And it served a marketing function, allowing the administration to package a deeply regressive program as a progressive social reform—a step in the direction of universal health care.

Under Obamacare, Medicare and Medicaid are used to push through cost-cutting innovations that are then extended throughout the entire health care system. In 2015, the Obama administration set a goal for half of all payments to Medicare—the government program that covers 55 million seniors and the disabled—to be tied to the “quality” of care provided by doctors and hospitals, instead of the quantity, by 2018. This measure passed with overwhelming bipartisan support.

In its January 3 article, the Times provides the example of the Indiana University Health (IU) system, which performed 3,900 hip replacements and knee replacements in the year ended June 30. Doctors there “are under pressure from Medicare and private insurers to manage and coordinate care for their patients before and after surgery. And, they say, payment for their services is continually being squeezed.”

For example, in an effort to slash costs, operating rooms at IU are now stocked with color coded “value trackers” that give a green light to lower-cost surgical products, a red light to high-cost products, and a yellow light to those in between.”

The Times, which has been the leading champion of Obamacare from its inception, expands on the virtues of these cost-cutting measures in an opinion piece by Tina Rosenberg posted on Wednesday, in which she writes that the “transformation of America’s health care system” under the ACA “moves health care away from a fee-for-service model, which pays doctors and hospitals according to the number of procedures they do, toward value-based care, which pays based on what helps patients get better.”

The column’s headline, “A Bipartisan Reason to Save Obamacare,” points to the right-wing basis of its defense of Obamacare. Rosenberg hails the fact that under the ACA’s Center for Medicare and Medicaid Innovation, more than a third of Medicare payments to providers now depend on “value” instead of volume. She praises the “ACA’s reform showpiece,” the Accountable Care Organization, a “team of providers” that has “financial incentives to keep the patient healthy and hold down costs.”

An op-ed piece in the Wall Street Journal makes a direct appeal in defense of Obamacare to private insurance companies and large employers on the basis of a benefit near and dear to their hearts: bigger profits. Titled “Stand Up for ObamaCare, CEOs,” the piece is co-authored by Dr. Ezekiel Emanuel, a chief architect of the Affordable Care Act.

The piece argues that the replacement proposal for the ACA offered by House Speaker Paul Ryan would lead to 4 million fewer insured people by 2026, while 9 million would lose coverage under another Republican plan. Even though these people would be unable to pay for care, the authors write, they would end up in emergency rooms and urgent care centers, and the “costs will be rolled into the line item ‘uncompensated care’—which is ultimately paid for by higher prices on every one else.”

Dr. Emanuel has predicted that with Obamacare as its model, employer-sponsored health care, a benefit won in bitter struggles by American workers in the last century, will become a thing of the past by 2025, with employers providing small stipends to their employees to purchase private insurance, or dumping their coverage altogether.

Trump’s pick to head the Department of Health and Human Services, Tom Price, advocates the total or partial repeal of Obamacare as part of a scheme to begin the dismantling of both Medicare and Medicaid and their transformation into voucher programs, in which seniors and poor people would be given government subsidies that would cover only a fraction of the cost of private insurance.

The current debate over the Affordable Care Act is a debate between thieves. Neither Obama and the Democrats nor Trump and the Republicans have in mind the interests of the American population. Their sole aim is the defense of the capitalist system and the profits of the health care industry.

A genuine solution to the health care crisis requires putting an end to medicine-for-profit and providing free, high-quality health care for all as a basic social right. This can be taken forward only by establishing socialized medicine under a workers’ government based on socialist principles, including the nationalization of the health care corporations and their transformation into publicly-owned and democratically controlled institutions.

For people with mental illness Carrie Fisher was a queen

I have nothing to say on Fisher’s performance as Leia. Leia I know only as a pop culture icon, a Halloween costume; two plaited doughnuts and a Friends episode. I know she means a lot to a lot of people, however. I know kids who grew up in the 70s adored her; I know fans paid thousands for cosplays and meet-and-greets and that the instalment of the franchise in cinemas now has her digitised presence. Tributes from her fellow cast and crew members have poured forth.

But Leia wasn’t the Fisher I held close. The first time I encountered her, the big brown eyes and the flared nostrils and that husk’n’cackle, was in 2006, watching The Secret Life of the Manic Depressive. Stephen Fry visits a manic Fisher at home. I didn’t recognise her but I recognised the mania. Who was this woman? Immediately I fell down a YouTube rabbit hole of interviews and performances. Hour passed. My eyes went wet with laughing, then dried with tiredness, and the black outside turned grey and flat. I crawled into bed and felt somehow changed. Somehow, and it might sound trite but who cares – she’d say it as it was – less alone.

Carrie Fisher
 Carrie Fisher in 1980. Photograph: Express/Getty Images

Fisher always spoke about addiction and mental illness straight up: “I am mentally ill. I can say that. I am not ashamed of that. I survived that. I am still surviving it, but bring it on.” Fisher was saying these things years before the rest of us; before celebrity as advocacy; before think pieces; before people were awarded with actual awards for it (she has an hilarious bit on being named Bipolar Woman of the Year).

We saw her at her best but she showed us the workings out too.

Her creative writing about mental illness was brilliant. There aren’t many people who can write it well; who can peel back the truth of it and get to the rawness and somehow make it soft, or at least, make it not as raw, touchable; but she did.

Often Fisher made it funny too, which is an even greater gift. Her 2008 memoir Wishful Drinking – what a title, what cover artwork – is a great example (“No matter how I go, I want it reported that I drowned in moonlight, strangled by my own bra”). Her 1987 semi-autobiographical novel, Postcards from the Edge, detailed time in rehab. Her second memoir, the Princess Diarist, revealed her affair with Harrison Ford, writing of her feelings for him (“at least five, sometimes as many as seven”).

I read an interview this week in which the British prime minister, Theresa May – stay with me – said she had “never had a female role model”. Bizarre. I’ve lost three of mine this year alone: Victoria Wood, Caroline Aherne and now Carrie Fisher. Because Fisher was a female role model for me. She pushed back last year against insidious sexism (“stop debating whether I aged well”). She was a woman with mental illness who refused to be painted as an hysteric, a histrionic; sexist archetypes beloved by the early psychoanalyst set. She was successful not because of a gold bikini or because of famous parents but because of smarts and talent and, yes, beauty, and wit and determination and kindness.

She crackled with life on this planet, in this galaxy. One of the things she would say to reassure those with mental illness was: “you can lead a normal life, whatever that is”. Hers was an extraordinary one.

Obamacare repeal’s hidden secrets: tax cuts for the rich, a new burden for seniors, Medicaid downsizing and mor

Obamacare repeal is coming — piece by piece and in the worst possible way
(Credit: Reuters/Scott Morgan/AP/J. Scott Applewhite/Photo montage by Salon)

As wonderful as the Affordable Care Act has been for millions of previously uninsured Americans, I’m not breaking any news by observing that it’s a tremendously complicated set of laws aimed at reforming an insanely complicated insurance industry. The wonky nature of the law is perhaps the biggest advantage the Republicans will have when it comes to repealing and replacing it next year.

Few A-list pundits and even fewer lawmakers can adequately talk about what’s in Obamacare. (You might recall how the president-elect described part of the law as covering “kids who live with their parents,” which actually isn’t part of the law.)

Likewise, few pundits and lawmakers understand how treacherous it will be to destroy the ACA and voters themselves understand even less. This dynamic has created a huge loophole through which the GOP has relentlessly injected misinformation and outright lies. Again, the more complicated the law happens to be, the easier it is to confuse and mislead voters.

For example, House Speaker Paul Ryan and the congressional Republicans, not to mention 2012 presidential candidate Mitt Romney, continuously screeched about how the ACA had ruined Medicare. That’s completely untrue. The ACA extended the solvency of Medicare by 11 years, while trimming billions in waste, fraud and abuse. The ACA also phases out the Medicare Part-D “doughnut hole” — the coverage gap whereby elderly Americans previously were forced to pay for meds out of pocket or go without. But the relationship between Medicare and Obamacare is complicated, so it’s easy for Ryan and others to engage in demagoguery.

Here’s a few more things you won’t hear Republicans talking about anytime soon.

The ACA is much more than just the Patient Protection and Affordable Care Act. There’s the ACA law, of course, but there’s also another separate law that amended the ACA. Known as the Health Care and Education Reconciliation Act of 2010, this second ACA-related law contains all of the budget-related measures linked to Obamacare, including the individual mandate, the Medicaid expansion, the federal subsidies for lower-income Americans, the aforementioned closure of the “doughnut hole,” a Medicare tax increase on Americans earning more than $250,000 and so on.

Things become more complicated when we discover that the Student Aid and Fiscal Responsibility Act was attached to the 2010 health care reconciliation act as a rider. This third piece of the ACA puzzle included major student-loan reforms, including the expansion of Pell grants as well as the implementation of President Barack Obama’s plan for eliminating private banks from the federal student aid program, effectively reducing student loan debt while also cutting the deficit by billions.

That’s certainly a mouthful. But all that stuff is part of the package collectively known as Obamacare, and the GOP is ready to kill it all. They’ll start with the 2010 health care reconciliation act  because they have the votes. Every single reform you just read about in the previous paragraph (and more) will likely be repealed by the next Congress. To do so, the GOP needs only 51 votes in the Senate due to a rule that allows for a majority “reconciliation” vote on budget-related bills. The Senate Democrats can’t filibuster a repeal of the 2010 health care reconciliation act and they lack the votes to block the reconciliation process unless a few Republicans flip sides and join them.

In any case, the GOP needs only 51 votes in the Senate to repeal the mandate, the subsidies, the closing of the doughnut hole, the Medicaid expansion and all those tasty student loan reforms. Any “Never Hillary” millennials who voted for Jill Stein or stayed home because Clinton didn’t adequately adopt Bernie Sanders’ debt-free college plan should be especially alarmed by this news. So should elderly Americans, who’ll have no choice but to endure a grand reopening of the doughnut hole, forcing them to go without medication or to pay out of pocket for a month or two each year. Again, this is the part of the bill that the GOP will be able to easily repeal. And they will.

On top of all that, a 51-vote repeal of the Health Care and Education Reconciliation Act of 2010 will also include a huge tax break for wealthy earners. When we say “huge,” we mean it. Scrapping this act will result in a $346 billion tax cut over 10 years for families earning more than $250,000. That’s great news for rich people, but horrible news for the rest of us.

Making matters worse, repealing the 2010 health care reconciliation act — or doing away with it along with its sister-law, the ACA — could strip as many as 37 million Americans of their health care coverage. Let’s do the numbers. There are about 12.5 million adults with coverage through the ACA, with another 18 million people covered under the Medicaid expansion, along with young people and kids who are covered under their parents’ plans or via the Children’s Health Insurance Program, which Obamacare expanded with greater benefits. Furthermore, if Republicans haphazardly repeal the law, it could destabilize the health insurance industry, forcing insurers to abandon the individual marketplace and retreating to strictly group plans.

We haven’t even mentioned all the known knowns in a repeal process. We know that the Republicans don’t have a viable replacement plan for Obamacare. We also know that Democrats will filibuster a repeal of the ACA law, which they have enough votes to do. But the structure of the law can’t hold up for long if it’s missing the financial elements contained in the reconciliation act. The upshot will be mayhem and, as time rolls on, a lot of uninsured sick or injured people whose health care will be stripped away from them, thanks to greedy and vindictive Trump supporters who have been brainwashed by a superficial horse-race news media and a lying GOP into thinking the ACA is a disaster.

Weirdly, a large majority of Americans love the individual parts of the ACA, but many cringe when they hear the portmanteau “Obamacare.” Hence, the repeal is more about sticking it to Obama than anything else. Sadly, tens of millions of Americans will lose their health care simply because Trump voters yearned for Obama payback. It’s difficult to describe how tragic that is. Rank ignorance could rewind the clock to a time when thousands of Americans died every month because they lacked health insurance.

Bob Cesca is a regular contributor to He’s also the host of “The Bob & Chez Show” podcast, and a weekly guest on both the “Stephanie Miller Show” and “Tell Me Everything with John Fugelsang.” Follow him on Facebook and Twitter.

Ecstacy drug reborn as medicine

How MDMA is being used to treat trauma

Ecstacy isn’t just for fun anymore: the FDA says it provides real hope for treating PTSD

This article was originally published on The Conversation. Read the original article.

On Nov. 30 the FDA approved a Phase III clinical trial to confirm the effectiveness of treating post-traumatic stress disorder (PTSD) with MDMA, also known as Ecstasy.

This news appeared in headlines throughout the world, as it represents an important – yet somewhat unorthodox – advance in PTSD treatment.

However, the media have largely been referring to Ecstasy – the street name for this drug – as the treatment in this trial, rather than MDMA (3,4-methylenedioxymethamphetamine). This can lead to misunderstanding, as recreational Ecstasy use is a highly stigmatized behavior. Using this terminology may further misconceptions about the study drug and its uses.

While Ecstasy is in fact a common street name for MDMA, what we call Ecstasy has changed dramatically since it became a prevalent recreational drug. Ecstasy now has a very different meaning – socially and pharmacologically.

Ecstasy tablets.
Drug Enforcement Agency Media Library

Social misunderstanding

It is understandable why the media have referred to this drug as Ecstasy rather than MDMA. Not only has much of the public at least heard of Ecstasy (and would not recognize MDMA), but this also increases shock value and readership.

But referring to a therapeutic drug by its street name (such as Ecstasy) is misleading – especially since MDMA is known to be among the most popular illicit drugs used at nightclubs and dance festivals. This leads some to assume that street drugs are being promoted and provided to patients, perhaps in a reckless manner.

About 80-85 percent of high school seniors and young adults disapprove of someone even trying Ecstasy once or twice. But stigmatizing attitudes tend to be much harsher than mere disapproval.

I investigated stigma toward Ecstasy users, and among young adults (age 18-25) who reported no lifetime use of the drug, many reported strong negative feelings toward those who use Ecstasy.

“Ecstasy” is in fact often used to refer to MDMA, but a lot of Ecstasy in the U.S. often contains little to no MDMA. While many assume the term Ecstasy means or at least implies MDMA, others believe (or know) that Ecstasy tends to be an adulterated drug when purchased “on the street.”

Pharmacological misunderstanding: A brief history of drug purity

When Ecstasy boomed in popularity in the early 1980s, it tended to consist of pure MDMA, or sometimes its chemical sister MDA (3,4-methylenedioxyamphetamine). But after MDMA became illegal in the U.S. in 1985, purity began to decrease.

Throughout the 1990s and 2000s, drugs such as cocaine, ketamine and methamphetamine were common adulterants in Ecstasy.

As a party drug, many people didn’t know or even care that ecstasy was supposed to be MDMA, but others specifically sought pure MDMA, rather than adulterated products. Demand grew. While pills said to be pure MDMA were certainly marketed and sold throughout the 1990s, more expensive Ecstasy in powder form (sold in capsules) slowly grew in demand. Within a few years this exploded into what we know now as “Molly.”

Molly is commonly marketed as being pure MDMA. But in recent years we have found that Molly is often the furthest thing from pure MDMA. Synthetic cathinones, also known as “bath salts,” appear to be the most common adulterants or outright replacements.

Ecstasy-related deaths

Deaths related to Ecstasy use appear to have increased in recent years, but many of these deaths appear to have been largely dependent on environmental conditions. MDMA can raise blood pressure and interfere with regulation of body temperature, which can certainly make it dangerous, especially in large doses and to those with preexisting conditions.

But what we often fail to consider is that Ecstasy-related deaths have tended to occur after hours of dancing – often in very hot conditions (such as crowded nightclubs or at festivals in 85 degree Fahrenheit or higher temperature), without adequate rest or proper hydration, or both.

Would these deaths have occurred without Ecstasy? Probably not. But most of these outcomes were very much dependent on extreme environmental conditions.

Many deaths in the U.S. related to Ecstasy or Molly use have also involved co-use of drugs such as alcohol, or unintentional use of “bath salts” or other adulterants, or a combination. In Europe, however, deaths have been increasing due to use of very high-potency pills (over 200 mg).

Extreme environmental conditions, adulterants, use of high-potency Ecstasy products, and ignorance about drug effects are all potential recipes for disaster when Ecstasy is used, especially when harm reduction techniques are not applied.

Is it really appropriate, then, to compare the therapeutic use of MDMA in this study to individuals using illegal, adulterated, or high-potency ecstasy, and dancing for hours in the heat?

The researchers are using pure MDMA, and in low doses. The drug is also used under medical supervision in a safe office, and patients receive medical clearance before entering the trial.

Misconceptions continue

MDMA is by no means a new drug, but misconceptions have continued for decades. MDMA was discovered over a century ago, and the drug’s effects have been researched and documented for decades.

Knowledge about the drug’s potential therapeutic value is nothing new, either. We have known this since the 1970s, but have largely lacked the formal research supporting its efficacy. The drug was administered by thousands of therapists in the early 1980s before it hit the nightclub scene and was made illegal in 1985. Many therapists and advocates fought to keep MDMA legal when it was banned, and some of these fighters – primarily Rick Doblin and the Multidisciplinary Association for Psychedelic Studies (MAPS), have continued to fight for decades, to gain approval for clinical trials of MDMA to be conducted.

It’s easy to view MDMA as just a dangerous party drug, but it was used for therapeutic purposes way before it exploded into nightlife. All our lives we’ve been taught illicit drugs are bad, but so few of us know the history of these drugs prior to their criminalization.

We also tend to focus on the negative publicized effects, and many individuals still believe misinformation such that MDMA use puts holes in the brain, drains spinal fluid, or causes Parkinson’s disease.
As drugs like MDMA and psilocybin move back into the spotlight as having therapeutic value, we must understand that while we may see various drugs as having “bad” uses, this doesn’t mean they are “bad” substances. Some of these drugs appear to be very useful in medical or therapeutic contexts.We also often forget to consider that these same stigmatized drugs may also have important medical value. For example, amphetamine has been a drug of abuse since the 1930s, but it is efficacious in treating ADHD under the trade name Adderall. And despite increasing abuse of opioids in the U.S., these pills are still highly efficacious in treating pain. Like opioids and amphetamine, MDMA appears to have its place in medicine.

The Conversation

Joseph Palamar, Assistant Professor of Population Health, New York University Langone Medical Center

Aldous Huxley, Dying of Cancer, Left This World Tripping on LSD (1963)

Aldous Huxley put himself forever on the intellectual map when he wrote the dystopian sci-fi novel Brave New World in 1931. (Listen to Huxley narrating a dramatized version here.) The British-born writer was living in Italy at the time, a continental intellectual par excellence.

Then, six years later, Huxley turned all of this upside down. He headed West, to Hollywood, the newest of the New World, where he took a stab at writing screenplays (with not much luck) and started experimenting with mysticism and psychedelics — first mescaline in 1953, then LSD in 1955. This put Huxley at the forefront of the counterculture’s experimentation with psychedelic drugs, something he documented in his 1954 book, The Doors of Perception.

Huxley’s experimentation continued right through his death in November 1963. When cancer brought him to his death bed, he asked his wife to inject him with “LSD, 100 µg, intramuscular.” He died later that day, just hours after Kennedy’s assassination. Three years later, LSD was officially banned in California.

By way of footnote, it’s worth mentioning that the American medical establishment is now giving hallucinogens a second look, conducting controlled studies of how psilocybin and other psychedelics can help treat patients dealing with cancer, obsessive-compulsive disorder, post-traumatic stress disorder, drug/alcohol addiction and end-of-life anxiety. The New York Times has more on this story.

For a look at the history of LSD, we recommend the 2002 film Hofmann’s Potion(2002) by Canadian filmmaker Connie Littlefield. You can watch it here, or find it listed in our collection of Free Movies Online.

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