America’s weak gun laws enable shootings by terrorists and extremists

“America’s weak gun laws make it much easier to commit shootings like these. This is a widely known fact, including among terrorist groups. Back in 2011, a now-dead American al-Qaeda operative, Adam Gadahn, said as much in a video to supporters”

“Every country is home to extremists and other hateful individuals. People of every country get into arguments and fights with friends, family, and peers. But in the US, it’s much more likely that someone who’s extreme, hateful, or otherwise angry is able to pull out a gun and kill someone — there are so many guns around and few barriers to obtaining the weapons.”

“The research, compiled by the Harvard School of Public Health’s Injury Control Research Center, is also pretty clear: After controlling for variables such as socioeconomic factors and other crime, places with more guns have more gun deaths. Researchers have found this to be true not only with homicides but also with suicides”

“the US is not an outlier when it comes to overall crime”

“Instead, the US appears to have more lethal violence specifically, driven in large part by the prevalence of guns.”

“Researchers have found that stricter gun laws could help. A 2016 review of 130 studies in 10 countries, published in Epidemiologic Reviews, found that new legal restrictions on owning and purchasing guns tend to be followed by a drop in gun violence, a strong indicator that restricting access to guns can save lives. A review of the US evidence by RAND also linked some gun control measures, including background checks, to lower rates of injuries and deaths. A growing body of evidence from Johns Hopkins researchers further supports the efficacy of laws that require a license to buy and own guns.

That doesn’t mean bigots and extremists will never be able to carry out shootings in places with stricter gun laws. Even the strictest gun laws can’t prevent every shooting.

Guns are not the only contributor to violence, either. Other factors include, for example, poverty, urbanization, alcohol consumption, and the strength of criminal justice systems.”

These 3 supertrees can protect us from climate collapse

“As more trees are cut down, there will be more frequent droughts, endangering food and water supplies, and livelihoods for millions of people.

That’s why giants like Brazil nut trees are so vitally important. Their ability to produce rain that feeds and cools the rest of the Amazon — and the region — is a true superpower.”

“Our current climate crisis is a result of humans putting too much carbon dioxide in the atmosphere. Luckily, trees (and other natural systems) can remove and store some of that carbon. The stilt mangrove is unusually good at this task.”

“It’s why preserving and restoring mangroves is being hailed as a promising “negative emissions technology.””

How meritocracy harms everyone — even the winners

“the bulk of the reason why our colleges, particularly our elite colleges, are filled with kids of rich parents isn’t that. Instead, it’s that rich parents spend enormous sums of money not on bribing anybody but on educating their children, on getting their children into prestigious kindergartens and high schools, on coaches and tutors and music teachers, and this means the children of rich people simply do better on the merits.

And so the big problem that we face isn’t merely that the rich cheat, it’s that the meritocracy favors the rich even when everybody plays by the rules.”

What’s going on with TikTok, China, and the US government?

“TikTok, the short-form video app that’s been downloaded 1.5 billion times, is one of the most exciting and goofiest places on the internet, and possibly the only truly fun social media network in 2019. It is also based in China — and that’s the part that has some users, and now, politicians, concerned.”

“US politicians’ concern over TikTok began with an investigation the Guardian published on September 25, which revealed leaked documents that showed TikTok instructing its moderators to censor videos that mentioned topics sensitive to the Communist Party of China: Tiananmen Square, Tibetan independence, and the religious group Falun Gong, for instance. The Guardian’s investigation came after the Washington Post noted that a search for Hong Kong-related topics on TikTok showed virtually zero content about the ongoing and widely publicized pro-democracy protests, which were a major topic on other social media sites at the time. ”

Healthcare.gov glitches almost ruined the end of open enrollment. Is there a better way?

“In the Netherlands, people who don’t sign up for their universal private coverage during the annual enrollment period are automatically enrolled in a plan and have to pay a premium 20 percent higher than what they would have paid if they signed up voluntarily. The Dutch have achieved 99 percent coverage under such a system, which shares other features with Obamacare (like subsidies and the ban on preexisting conditions).”

A CT scan costs $1,100 in the US — and $140 in Holland

“for medical services, other wealthy countries are often paying half the price — or less — as private insurers in the United States.

The Netherlands, consistently ranked as one of the best health care systems in the world by advanced metrics, spends a quarter of what American insurers do on hip and knee replacements. A CT scan costs $1,100 in the United States and $140 in Holland. There are only a handful of isolated instances — childbirth in the United Kingdom, an angiogram or cataract surgery in New Zealand — where the cost of a particular service even approaches the US price.”

“The US is still the wealthiest country in the world. It’s home to the world’s leading biopharmaceutical industry. It tends to have the most cutting-edge treatments. All this contributes to higher prices here than elsewhere. But one big and unavoidable culprit is the lack of price regulation.

Private insurers, which cover more than half of Americans, negotiate with private providers and drug companies to set their prices. They do have some leverage (by denying a provider or drugmaker access to their patients) but it is more limited than in other countries. There is certainly significant price variation within the United States (with CT scans, for example, can cost anywhere from $250 to $1,500 depending on the location), but on average, prices for US private insurance are significantly higher than those seen under other kinds of health systems.

In some of the countries studied by the Health Care Cost Institute, like the UK, the government actually employs doctors and owns hospitals. Others, like Australia, have a universal public insurance program.

Even the Netherlands, which has a fully privatized insurance scheme, has placed more government controls on prices than the United States. Insurers there use global budgets, also common in single-payer systems, to pay providers, capping the amount they’re willing to pay per year to cover all of the services their customers need. It’s a hard limit on health care spending for the coming year, and then providers and payers negotiate prices for individual services based on that budget cap. It’s very different from private insurance in the United States, which is generally open-ended depending on how much medical care is used in a given year — and the price for those services.

Because of America’s high prices, there is a $3.5 trillion industry invested in the status quo.”

We have a solution for the opioid epidemic. It’s dramatically underused.

“Medications like methadone, as well as buprenorphine and naltrexone, are considered the gold standard of care for opioid addiction. Studies show that the medications reduce the mortality rate among those patients by half or more, and keep people in treatment better than non-medication approaches.

Yet rehab facilities in the US often treat medications with skepticism or even scorn, while embracing approaches with little if any peer-reviewed scientific evidence”

“Medication isn’t the only effective way to treat opioid addiction. Other approaches, including cognitive behavioral therapy, motivational interviewing, and contingency management, also have evidence backing up their ability to treat addiction.

Still, for opioid addiction, medications “should be the first-line option,” Keith Humphreys, a drug policy expert at Stanford, told me. “Not forced, but every single person should be offered that in any decent program treating opioid addiction.””

“despite their effectiveness, the available medications are often stigmatized with a common trope that they “replace one drug with another.” On its face, this is literally true: The medications do substitute, say, heroin or alcohol.

But the context matters. The issue with addiction is not just drug use. Most people use some kind of drug — caffeine, alcohol, or medications. Some people are even dependent on these drugs, whether someone needs coffee to get going in the morning or insulin to survive.

What makes addiction a medical disorder is not just drug use or even dependence, but continued, compulsive use despite negative consequences. So someone would be unable to stop using heroin even when it poses serious risks to his health, career, or family. It’s only then that drug use becomes a drug use disorder.

The medications alleviate those problems, turning a drug use disorder back into just drug use. That’s why they reduce all sorts of drug-related problems, including the risk of death.”

““No other medication is prescribed in this way,” Sue, of the Harm Reduction Coalition, said.

Buprenorphine can be prescribed in a traditional health care setting, but it too faces unique restrictions. Doctors have to go through an eight-hour training course to get certification to prescribe it, and nurse practitioners and physician assistants have to go through a 24-hour training course. The restrictions are one reason that, according to the White House opioid commission’s 2017 report, 47 percent of US counties — and 72 percent of the most rural counties — had no physicians who could prescribe buprenorphine as of 2016.

Since methadone and buprenorphine are opioids themselves, the rules are meant to make it harder to get and illegally sell the medications for misuse. (Naltrexone, the non-opioid option, doesn’t face similar restrictions.) But the laws and regulations have also helped create an environment in which rehab facilities are more likely to try unproven methods than medication-based treatments with decades of scientific evidence.”

The Secret to Saving the Lives of Black Mothers and Babies

“black women across the country are 320 percent more likely to die from pregnancy-related complications than white women. In Buncombe County, where Asheville is located, black babies were nearly four times as likely as white babies to die before their first birthday. These woeful statistics cut across economic and educational lines, as pregnant black women with a college degree die at five times the rate of their white counterparts. Experts say the causes are complex and bound up with the stress of living in a society that discriminates against people of color—from a lack of diversity in the medical profession to implicit bias in the way providers treat patients. In 2017, the American College of Obstetricians and Gynecologists said maternal health disparities “ cannot be reversed without addressing racial bias,” adding that “structural and institutional racism contribute to and exacerbate these biases.””