#was forced to take a nutrition course last semester and then this semester the last 6 lectures of my biochem course are all about nutrition

[a-dream-deferred]

i hate you nutrition i hate you nutrition i hate you nutrition i hate you i hate you i hate you

[csolarstormhealthjournal]

Category: Medical event.

Content warning: Digestive trouble.

So it seems that last Tuesday afternoon, I came down with a partial bowel obstruction, as I've done times before.

Last time I stayed at home and rode it out, because it was during the pandemic and my mom simply said the ER wasn't an option. Normally all the advice says to go in, get a really unpleasant tube stuck down your nose into your stomach, so they can take pressure off your intestines by sucking everything out of them so the swelling in the intestines can go down in peace. I didn't do it that time, and it went away anyway by just avoiding food and slowly drinking fluids.

Which was FABULOUS. Because there are few medical treatments I hate more than nasalgastric tubes! So much so, that I literally pulled one out in my SLEEP one time! They are awful going in, it's awful to talk, swallow spit, anything with that fucking rigid tube in the back of your throat connecting your nasal opening and your esophagus like a stick in a puppet. I wouldn't recommend it!

To think maybe there were times I went in for obstructions and got that tube when I didn't necessarily need it! That time I pulled one out in my sleep, my obstruction still went away without it. And then one time in 2018, the doctor insisted on a really thick tube, and my mom still remembers the way I screamed when they forced it in. The pain was awful. It's probably why she said going to hospital wasn't an option. Even if the pandemic made it difficult, I could've still technically gone.

This is one of my biggest medical bogeymen. Not only is one of the most unpleasant conditions to have when your digestive system just shuts down and your intestines hurt, but it also affects normal life afterward when I starve myself to make sure it doesn't happen again. In the time after my 2018 event, I lost 20 pounds. Not only did the lack of nutrition make it hard to go to school, but I also dropped caffeine from my diet, which sucks for students or anyone involved with college really. And going further, I was so stressed trying to get help for my condition, get alternative pain treatments so I could reduce my pain meds in case they were the culprit, that I ended up taking time off school. Then the semester I went back, the pandemic happened!

So when the one during the pandemic happened, I found it a blessing in disguise to stay home. It was scary to not have help and I was feeling bad of course, but I learned that at least I don't always need a tube. In a way, it kind of healed some of that earlier trauma.

This event feels a bit more complicated. This time the symptoms don't feel as severe, but they feel deep seated. Like, without medical help I wonder if they'll really get better before two weeks, and that's a long time to eat one scrambled egg a day and drink lemon-lime Liquid IV mix. Yet...I am drinking, I am eating something, my digestive system is moving, the problem is my progress is much slower than it was last time. I've tried chicken noodle soup, saltines, a half an avocado, and they all made me feel kind of worse. I have yet to find that next step toward easing myself into the diet I had.

I don't know if I'm making the right decisions here. In a sense I'm doing better with this one than last time, since I've been going to the park and trying to live more or less ordinarily, but without food I'm more batty than usual. I get dizzy, confused, irritated, sometimes I just run out of energy and get back into bed for six hours at a time, and no matter how I try to keep myself distracted I have trouble not thinking about food and the obstruction.

And though I'm trying to gradually ease myself back into eating - today it was mashed potatoes - I'm afraid that I'll fail and it'll just get sucked up a tube. Today I called my general physician's clinic and asked to speak to a nurse, at least to maybe get a CT Scan. The longer I go like this, the harder it will be to just go about my day.

[rayraystudies]

8, 9, and 31 for the ask meme! c:

Studyblr Asks

8. What classes are you taking right now?

This semester I’m taking: Pharmacology 2 (it’s a continuation of the course I took last year), Biomedical Communications, Nutritional Toxicology, and a research course.

9. Favorite class out of everything you’ve ever taken and why?

Honestly it would have to be a tie between pathology and anatomy from last year! I really enjoyed the way my professor taught the pathology course - he had lots of funny anecdotes and while it was a lot of material it wasn’t anything superfluous and unnecessary. Anatomy was just fascinating, especially because I got to go into lab and work with actual human cadavers!

31. Do you talk to your teachers/professors a lot?

Haha I’m notoriously bad at doing this - I speak to some professors more then others (my anatomy prof from last year is also my advisor for my project so I’ve spoken to her a lot and even had lunch with her multiple times). I am getting better at forcing myself to speak to professors though! I tend to function on the logic that I only need to speak to a prof if I need help, and google has the answer to everything - I’m trying to break that habit!

[stoicgambino]

Growth

After graduating from college, I know what growth looks like and I have seen it within myself- exponentially, specifically within the last 6 months. Growth has presented itself in ways that never manifested in me; besides the obvious human growth. I had never seen growth until after my first semester of college. Coming home that first semester put my whole life into perspective. Following the winter of 2014, I experienced growth again in several seasons of my life (summer 2016, summer 2017, spring 2018, and now). And each time it reminded me who I was, who I was becoming, and where I was going.

I was a naive Haitian-American girl who lacked confidence in her academic abilities. In high school after reading The Scarlet Letter we did an activity in my English class where my peers would assign each person a letter and why they deserved this letter.  Unfortunately, I received the letter “I”. I for insecure. Insecure not because of my confidence in my looks but insecure about my own opinions as if fear crippled my voice to speak freely. It hurt my feelings but I took that perspective and worked on changing it. It has always been interesting to me that I define myself by academic abilities, after all I have been a student for a large majority of my life. This may have been the biggest “crutch” on my journey of growth. And even today I still struggle with being naive, but I work actively to not be. My choice to further my education has made me contemplate my academic abilities. Thoughts like “maybe I should change my career path”, “my GPA is average”, “my extracurriculars are not unique”, “I’ve re-taken one too many courses”, and the throat cutter “I’m not going to get in” have always hindered my self confidence in my academics. Even after all the work I put in to receiving a Bachelors of Science in Nutritional Sciences I constantly fight the thoughts of self doubt. Reassurance from the Bible, my family, and my mentors have helped push me past those thoughts. I WILL GET IN.

I now consider myself a young and beautiful Haitian-American who is educated and ready to take on the world. I’ve always wondered why I’ve had to endure certain circumstances but they were all part of my growth. Without these experiences of through thick and thin, I wouldn’t be in a position to press forward. I would be weak, and not able to withstand the pressures of adulthood. Puberty may have started early but it wasn’t until my 20th birthday that I really began to feel beautiful. It wasn’t until then that I understood that my blackness is enough. It’s sad really, but I love how society now (especially the Black Diaspora community) has come together and embraced everything about the black experience.

I can’t forget to mention love. Or should I call it lust? A mix of both really. My love life has evolved my maturity. Letting go. Being broken. Opening up and being vulnerable to new people. Having fun. It supposedly comes with the college experience. It was great and then some *side eyes*.

Adulting has been the independent factor responsible for my exponential growth since May 12, 2018 lol. It has literally forced me to face reality, a reality that I have created and only God can change. I guess I’m saying all of this to say, I’m growing out of Fransisca the student and into Fransisca the individual. I will always be a student of life but I’m learning not to let what I know but rather what I want to know define me as a person. Actually I don’t want to be defined. I just want to be.

Fin.

Until next time(;

[steternetwork]

February Fic Recs

Once again, thanks for all the contributions, and sorry that I’m running a bit late on this.

In no particular order, here are the community’s February Fic Recs!

Warnings may apply

I'm Powerful with a Little Bit of Tender by hsmith Complete. Rated G.

“It was an accident, Stilinski, calm down.” “Calm down? Calm down?! Are you fucking kid-.” “How could we have known he was a demon, Stiles? He just seemed like a normal guy last night,” Scott shrugged, looking guilty. “How could you have…? Look at him, Scott! No ‘normal guy’ is that smug, it’s not physically possible!” Stiles waved his arms to indicate the demon’s whole body, pointing with more vigour when he noticed Peter’s smirk. Rant-a-thon by Ragga Complete. Rated T. So Stiles may be having a bad day. Or a week. Or a semester. But he knows he just needs to blow off some steam and then he will be better than ever. And accosting a random guy and blurting out his entire life story? That sounds like the perfect idea! And as it turned out, it was.

Or, Stiles rants a lot and then Peter feeds him. And soulmates.

Alpha&Omega by Mellow (SweetCandy) WIP. Rated E.

Peter Hale, successful businessman and Alpha werewolf, doesn't want an Omega no matter how much his sister urges him to finally claim a mate. He has never been interested in an Omega. At least until he runs into one Stiles Stilinski at his nephew's birthday party, who falls for him in more than just one way. Of Soulmates and Sparks by covarla Stetopher. Complete. Rated E.

John leaned forward slightly and looked at the marks. He jerked back and looked at Stiles. “You have two soulmates?” he asked incredulously.

Stiles’s eyes slipped over to Chris and Peter again and then he looked away. He nodded.

The Sheriff swore under his breath. “You said you didn’t know who your soulmate was,” John said. He sounded both confused and at the same time frustrated.

Stiles licked his lips and unconsciously took another step backwards. “That may have been inaccurate,” he replied softly.

Safe Harbour by cywscross Stetopher. Complete. Rated T.

Peter didn't think he'd find a home here. He certainly didn't think he'd find a home with two other men.

Chris and Stiles prove him wrong.

It's a Curse by lostwithoutmyanchor (mysourwolf) Complete. Rated T.

“You must be Stiles,” Peter said casually. “I thought perhaps you might have heard of me.”

And yeah! Of course Stiles had heard of Professor Peter Hale.

what have we become by nezstorm Complete. Rated G. "Run away with me," Stiles says one morning actually managing to make Peter falter in his steps, one leg still out the window.

What is normal anyways? by sociallyawkwardfangirl21  Complete. Rated E. AO3-locked.

When Stiles meets Parker online, he can't believe his luck. They have amazing conversations, and he fulfills a need Stiles hadn't realized he had. He has no clue who Parker really is but for Stiles that's a good thing. The line separating them, that distant connection, can be severed whenever he wants. This illusion of control lets Stiles feel free to explore this new side of his sexuality. However, little does he know that a poorly angled camera shot is going to give him away, and Peter won't be quite as happy with the distance between him and his baby boy. Hostile Takeover by kiranightshade Complete. Rated T. Alternate season 4 where Peter gains a new roommate in Eichen...for about five minutes. Then all hell breaks loose. Hot and Bothered by islandgirl_246 Complete. Rated T.

Peter rolled over and groaned. He felt like someone had taken a jack-hammer to the inside of his skull, and sandpaper to his throat. He groaned again, but tried to shift his body towards the edge of the bed to swing his feet to the floor.

The room swam when he attempted to stand and he was forced to plop his butt back down onto his 1000 count sheets and wait for the wave to pass. Shit, he couldn’t afford to get sick. He had a meeting with the Jessic Group this morning and Talia would have his ass if he was late.

Comfort Wolf by MusicLover19 WIP. Rated E. Stiles comes back from the interaction with Gerard and finds a wolf in his room. Cue bonding, eyes rolling and most of all, feeling safe.

Failing by TriDom Stetopher. WIP. Rated E.

Stiles goes home to Beacon Hills after five years away. He gets set up in an apartment with the help of his dad and starts taking classes at the local university. The town is old and it's boring, it's safe and it's stable. It's just the kind of place that Stiles needs to get his feet back underneath him, after managing to completely fuck his life.

Not Stella by Fidelius Complete. Rated T. AO3-locked.

Stiles isn't Stella. He never was. Not even when people thought he was. He's Stiles. His biggest hope is that his soul mate's wrist says his name. His biggest fear is that his soul mate's wrist says her name.

Little Stiles by sunshine (sunshinepiveh) Steter. Sterek. Complete. Rated E.

Werewolves are known and live in largely separate societies from humans. Some werewolves will take on human pets or littles to care for as their own. These humans volunteer themselves for the opportunity, sometimes to escape lives they cannot contend with, and often to fulfil certain needs of their own.

This is my first story of this sort, where Stiles lives with 24/7 age play under the care of both Derek and Peter (who are not romantically involved with one another). I've read and enjoyed several such fics, many of which are dub-con, but this fic is meant to be read as entirely SSC/RACK. It is also highly sexual age play, so be aware of that going in. All parties are well above the age of consent.

I've also taken liberties as to how Stiles' nutritional needs are met, or not textbook safe sexual practices at all times. Please do not use a work of fiction as a guidebook for real play.

[bnvupdates]

The Difficulties of Remote Schooling in Poor Communities

There’s no denying that in a matter of a few short months, the novel coronavirus has transformed “normal” life as we knew it. And perhaps the biggest impact has been on our children, who were forced to spend the last months of the 2020 spring semester trying to adjust to distance learning.

Now, as the debate rages about how to keep the schools that have reopened safe, there’s a student population for whom the stakes are especially high. 

Unequal Access

Despite our best efforts, education in the United States has never yet lived up to its promise of “equality,” but that reality is especially felt today. Students in poor communities simply do not have access to the remote learning resources that more affluent school districts can provide. And they’re paying a dear price.

The first and most significant challenge of remote learning in poor communities, of course, is the lack of access both to the needed technology and to the internet.

Though the digital divide may have shrunk in recent years in the United States, it continues to exist in many of the nation’s poorer communities. That means that millions of American children may not have reliable access to a smartphone, tablet, laptop, or PC.

Even when children have the technology they need to learn remotely, though, they may not have the internet access required to be successful. This could be due to the family’s financial inability to subscribe to a high-speed internet or broadband service, or it could be due to a lack of internet accessibility, especially in poorer rural communities.

Nutritional Needs

In addition to challenges with access, children in impoverished communities are likely facing even more significant problems due to the closure of the schools. More than 35 million children across the United States receive free or reduced-cost breakfasts and lunches while at school.

In the face of the shutdown, schools turned to pick up lunches to ensure that children received the food they need for as long as the schools remain closed. And yet the children of families who lack transportation to the pick-up site, or whose parents work during the designated pick up times, are at risk of going without.

Learning Support

Even when the tech is available, broadband access is running smoothly, and the cupboards are stocked with nutritious food to keep kids’ bellies full and their minds focused, students in poor communities aren’t necessarily home free. 

Remote learning is a challenge under the best of circumstances. However, students in underprivileged environments may lack the resources they need to learn on digital platforms. For some students, screen time can be detrimental to focus and comprehension.

Image: Pixabay

Screens have also been shown to negatively impact children’s quality of sleep, which will only further exacerbate difficulties in concentrating and absorbing new learning content. At the same time, parents are likely already feeling overwhelmed by potential job loss, the financial and psychological strain of the lockdown, and the fear of the virus itself. 

In the face of all this, they may feel simply unable to help their child learn in this entirely new way.

Help and Hope

Despite the particular hardships that children in poor communities must face during this shift to remote learning, there is hope. Resources are available to support students and their families living in poverty in this unprecedented time and no matter the need, from housing support and nutritional assistance to access to educational resources and medical care.

Likewise, communities nationwide are finding creative ways to ensure that families have the resources they need. This includes at-home delivery of free and low-cost meals for families without transportation. It even means grassroots initiatives designed to provide rent and mortgage assistance for struggling families and to ensure secure housing for the housing insecure. 

And what that all boils down to is the ability to ensure that children’s most fundamental needs are met, from housing to nutrition to remote learning access. Once that’s done, children’s chances of succeeding at distance education are going to be far greater.

The Takeaway

The sudden and sweeping transition to remote learning has been proven to be a formidable challenge for students, parents, and teachers alike. However, it is students from poor communities who have had to face the greatest obstacles. This includes not only barriers to technology and broadband access but also challenges in shifting to the digital learning environment itself. 

In addition, these children have had to face the specter of hunger and possibly even of homelessness. Their parents have been faced with the overwhelming responsibility of caring for their families through one of the worst crises in modern history. And yet it is possible for students from impoverished communities to thrive in the distance learning environment. What it takes, above all, is the social commitment to ensuring that these children and their families have the support they need and deserve.

from https://ift.tt/33y2cFW

[onlinecoachdan-blog]

What Is The Purpose Of Your Life?

I want my life to have a clear meaning.

Right now something's broken inside me. Boredom and sadness always come when I get disappointed in my hobbies, because sometimes, instead of offering me what I really want, they give anger and confusion (which if fine, but it does go over the top every few months). What is it that I really want?

Also, I don't have the courage to find the job while attending to the University: I have to complete the homework every week. Should I still try? I really-really want to buy the life purpose course, but I can't, because I don't have a job at the moment.

I'm currently a freshman in college and I am working towards being an actuary because I'm exceptional at mathematics and I want to earn a decent living. Recently though, I have been coming to realize what life is really about and its not really the size of your house that matters its the people inside it. With that being said, and with all the news as of late, I cant help but wonder what I truly want to do with my life. Even before this video I realized that being an actuary was only what other people wanted me to be, or so I perceived. Almost like some sort of socially constructed pathway for me and people intellectually like me.

But now that I am going through some sort of coming of age, I have a particular need/want to help people. Now this is where my problem lays:  Is helping people as a profession what I truly want to do? Or do I really want to find some career path that I love and help people as a byproduct or even as a hobby of mine? Either way I realize most people would take it as a noble pursuit and thats not why I do it. I would be doing it solely to make myself truly happy on the inside. Not some fake shit that can be sold to me from some greedy corporate manager. Any help would be greatly appreciated!

I'm finishing a masters degree in engineering. Unsure what I want to do, but employment at this level requires high level of specialization. Can't travel, I have too many loans. I've had a decent amount of experiences outside academia in terms of the social realm but I can't seem to find anything tangible that I like. Any time I've seen what an engineer does in a corporation, it bores me. I find myself prodding my own brain and reading, I am almost dreading applying for jobs. 

How refreshing it is to know I was conscious enough to do this on my own. In college I excelled quickly and discovered I really like teaching and tutoring others. Out of college I became a web and app designer/developer. I once again excelled but the job became boring. I learned I hated sitting inside with little human interaction staring at a computer all day. However that career gave me the income to do a lot of new things like martial arts, fitness, and nutrition education. I'm now leaving the world of computers, I've started a fitness business to TEACH/TRAIN fitness and nutrition.

I just graduated from a community college last semester, and I am not sure what to do with my life at this moment, I currently work at a corporation warehouse. I don't like my job because it gets extremely hot in there. It pays well, but its hot and I get one day off now. I have been told by people at the job and my parents that I should go back to school. My plan was to work for a little more and take some time off from school for a semester. I don't want to go back and not take classes I am not interested, I wanted to pursue psychology, but my mind was in it for the money more then the enjoyment of the work. I didn't go further because I don't know how to handle helping people.

I am 45, with a post graduate degree and I have all the money I need. I have no passion whatsoever. I have reached a plateau. I guess I just wanted to make money and now that I have it, I don't feel like working at all. I have probably worked 2-3 days out of every 3 months for the past 4 yrs. and those times I worked, I had to force myself cuz things were starting to go south. I have lost a lot of time and money I could have had and enjoyed but I just don't want to do anything. Literally nothing! Changing my job is not an option and would make no difference, I still want to do nothing. How the heck do I find passion and motivation to get out of my resort like mansion?! My shopper buys my food; my cook makes the food; and my cleaning lady does the cleaning. Everything I want is right here. I don't think you'd want to leave if you were here. How do I find the hunger and the fire? How do I get out of the house and get back to society? I have no desire. Well actually, I do have the desire to have a passion. Can you help?

I was one of those guys that knew what he wanted at an early age. I was a musician from age 12 and all I could think about was being a great player. I tuned pro at 17, made   my living as a pro, at 30 it was over. I was done. But I had lived my dream. I was never happier, but I just couldn't do it anymore. I knew I was something more. I realized I did it all for ego. for that "approval"  That ego identity didn't fit anymore. So here I am 20 years later, There is nothing that gives my authentic self, motivation. I have tried everything. The things I love, I cannot make money at in known framework. I am almost ready to become a hermit, or monk. I have experienced the joy of passion. its like what do you do after you have been to the moon? what else is there?

I graduated and started working nearly 4 years ago. And I have changed 3 companies already. I also want to upgrade me, to allow myself to see new things, to learn, etc. But my history of changing job too many times impacts me badly right now. It seems that all recruiters do NOT like this, and I have been unemployed for 7 months, failing lots of interviews. Please share with your thinking and how to get out of this situation?

I'm 23 and looking for my purpose. I know for a fact I want to help people in some way. For the longest time I thought psychiatric work would be my career but whenever I truly think about it, I want to make a bigger impact in peoples lives. It's frustrating being so close but not being able to specifically know what it is I really want to do with my life. I'm definitely not settling for something small though.

I've been fortunate to have been able to do everything you've suggested except travel the world so far. Funny, but I'm happiest when I'm covered in paint. Doesn’t matter if I'm painting walls, furniture, or a painting. I need to make that into a steady income somehow!

I seriously have a problem with finding my passion. sometimes i'm passionate about something and sometimes I’m not. For example, I loved playing soccer like for my whole life and when I became the captain of the team and the best player there I felt like wanting to try something new despite having a great chance of being a successful soccer player. I left soccer for bodybuilding. I read a lot about nutrition and everything about gaining muscles and getting fit and I got the size I always wanted and same story looking for something new. That's really frustrating sometimes I'm crazy about something and sometimes I'm not.

I'm into arts but I'm already turning 17 so I feel like if I go to art school now I missed out on so much. And I'm in A school that is considered "smart" and I feel like if I go to art everyone in my school will find me stupid? I know this sounds stupid but these are my worries.

I'm a sophomore in High School but I have a a really big problem. I actually don't know what career to focus on I need to to come up with an idea fast I don't have time to explore I just need to know what I'm really good at. So I can choose the right courses for my career , I don't wanna end up choosing the wrong courses at the end of the day when I really find my passion I won't be able to pursue it because I didn't have the right foundation.

RESOURCES

https://psychcentral.com/lib/how-do-you-figure-out-your-lifes-purpose/

http://coachinginst.com/online

http://coachinginst.com/career/

https://www.bustle.com/articles/197962-12-life-coaches-give-you-their-best-career-advice-for-2017

https://www.nytimes.com/2007/06/19/business/smallbusiness/18webshifting.html

[oovitus]

Forget “career hacks”… Here’s the real key to career success that almost no one is talking about.

We live in a world of ‘quick-starts’, ‘how-to-guides’, ‘career hacks’. This article is none of those. It’s a different kind of success story. And a powerful lesson on how to get ahead in health, fitness, and wellness, or any other field.

++++

Success secrets.

Productivity hacks.

Tips, tricks, and quick formulas.

I’m often asked to share these as advice; the requests come when I’m being interviewed on podcasts, speaking at conferences, talking to journalists.

People who want to get ahead in health, fitness, and wellness — or just about any other field — want to know:

How did you go from starting a health and fitness website with your buddy…

… to running a 150-million dollar company with about 100 team members and nearly 100,000 clients across 120 countries.

… to advising companies like Apple, Equinox, Nike, and Titleist.

… to being selected as one of the smartest/most influential people in the field?

And they really want to know:

What tip, method, shortcut do you recommend to help others do the same?

As you can probably tell, I’m not a big fan of these kinds of questions.

Can’t blame people for asking, though.

After all, I also want to learn from the people who’ve gone before me, the people who’ve succeeded in the way I hope to succeed.

But here’s the problem:

I could rhyme off a bunch of tips about my morning routine that allow me to run a business while being a father of four. But I don’t think they’ll matter much unless you’re also a father of four and already running a successful business.

Likewise, I don’t believe it was magical morning routines, or growth hacks, or tricks and tips that put me on the road to success in the first place.

In fact, I think it was something completely different.

Something that isn’t often talked about.

I call it “going down the rabbit hole”.

I remember it like it was yesterday.

It was a fresh Autumn day.

I was 21 years old, it was my first semester away at University, and I had an appointment with my first-ever guidance counselor.

I was ambitious, I had big goals, and I was excited to get some advice on how to plan my future.

I assumed the meeting would go something like this: He’d listen to me talk about my passions, about my goals, and he’d help me create an academic plan. Maybe even make suggestions for volunteer or internship opportunities.

As I gushed about my love for all things exercise and nutrition, about how it was my goal to have a successful career working with pro sports teams, athletes, and exercisers looking to eat, move, and live better, his face was stolid.

I was completely unprepared for what he said next:

“That’s nice… but there’s not much of a career in that for you. We have to be realistic here. There are too few jobs and the chances you’ll get one of them is almost zero. You’re a smart guy. Why don’t we sign you up for Pre-Med? Med school will be a great path for you.”

I walked out, head down, backpack dragging the ground behind me.

Days went by and, yes, the fog eventually lifted.

I figured… maybe he was wrong. Maybe I needed a second opinion. So, over the next few weeks, I asked around. Looking for a glimmer of hope.

Almost everyone gave the same advice.

Be sensible. Become a doctor. Forget this weird exercise obsession.

I was a 21-year-old from a blue-collar immigrant family. Who was I to not take advice from all these educated people? So I did the responsible, sensible thing. I signed up for Pre-Med, and I plotted my course to medical school.

At the same time, a part of me was mad. Really mad.

Who were they to tell me what my potential was? To squash my dream?

So, partly out of spite, but mostly out of this magnetic draw I felt towards health and fitness, sport and performance, I began living a double life.

I scraped together every dollar I had. During evenings and weekends I attended seminars covering fitness, nutrition, and sport related topics. I read everything. I wrote articles for free; I volunteered with gyms and sports teams.

Throughout, I still fully expected to attend med school.

But, eventually, some strange and interesting paths opened up.

I found a peer group that was passionate about the things I was interested in. (Surprise: I didn’t find them in my 4th year Chemistry and Physics classes.) And I stumbled upon formal and informal mentors.

Almost magically, more opportunities appeared, including offers to attend grad school in Exercise Science and Nutritional Biochemistry. Invitations to coach high-level athletes. Contracts to write for influential publications.

Still, after graduating with my Pre-Med degree (and minors in Philosophy and Psychology), it was no small feat to turn down the Med School offers. The voices were still in my head. But I did.

And instead of going to Med School…

…I fell down the health, fitness, and nutrition rabbit hole.

Here’s what I’ve come to realize:

Before Doctor Berardi, before Precision Nutrition, before I could have ever seen where it all would take me, I did something that many people felt unwise: I followed my passion.

Not because it was part of some master plan. But because everything I learned about health, fitness and nutrition made me want to learn more.

So, although I didn’t quit my day job, I didn’t quit dreaming either.

Instead of fighting my own intrinsic motivation, I went with it.

Instead of paddling upstream, I went with the current.

I went down the rabbit hole.

And here I am today.

The hidden costs of having “A Master Plan”.

When it comes to our careers, our relationships, even our health and fitness, we’re often taught to plot very strategically.

Whether it’s from guidance counselors, business advisors, teachers, courses, e-books, blogs, podcasts, well-intentioned parents, or (seemingly) the whole Internet, we’re taught that we need to plan our path down to every step.

(“Life hackers” and proponents of “accelerated learning” teach us that we can even leapfrog a few of these steps. Bonus!)

So, that’s what we do.

We make checklists, knock off each item, rush to completion, and pray that our calculated maneuvering will lead to success or accomplishment or connection (or whatever we think we’ll need to feel happy).

Unfortunately, this particular approach may have a cost.

It might prevent us from experiencing some of the best, brightest, and most unexpectedly rewarding moments in life.

Even worse, it might prevent us from deep learning and mastery, which has been proven to give us satisfaction, meaning, and, if you’re a competitive person, a “leg up on the competition”.

Here’s an approach I like much better.

I’ve found that there’s tremendous joy — and surprising, unexpected rewards — that come from “going down the rabbit hole”.

From looking deeply, intensely at something you’re really passionate about.

From learning everything you can about it.

And from going “all in”.

If there is a formula for the kind of success most people want, even if they don’t know what that looks like yet, it might be something like this:

Strong personal mission           + High competency           + System for execution           = Personal and career satisfaction

Have a look around.

You’ll find there’s almost nothing more powerful than someone with a deeply held motivation to do their work plus high level of skill plus a blueprint or system for executing every day.

Most people (in any field) have only one or two of those.

In some cases, that might be enough.

However, if you have all three, you’ll be amazed at what happens.

It doesn’t even matter where you’re starting from, or in what career you begin.

It’s interesting to note that most of the people on the Precision Nutrition team started in totally different fields:

Precision Nutrition co-founder Phil Caravaggio: Started as a software engineer.

Curriculum developer Krista Scott-Dixon: Started as a college professor in a different field.

Coach and exercise director Craig Weller: Started in the Navy special operations forces.

Coach and client care specialist Krista Schaus: Started as a police officer.

Coach Brian St. Pierre: Started at his Dad’s paint store.

Client care specialist Sarah Masi: Started in a house cleaning business.

Then there are the thousands of Precision Nutrition Certification graduates.

In the last 6 months I’ve met:

mothers coaching online while on maternity leave,

graduates fresh out of school ready to do something meaningful,

boomers coming out of retirement to give something back,

surgeons dropping their scalpels and turning to preventative care,

investment bankers leaving the financial world, and helping others lead healthier lives.

None of these folks would have guessed their future would include working in health, fitness, and wellness, coaching clients, and changing lives.

But here they are today.

And let’s not forget the reason they’re here…

Each did something that most people don’t.

They went “all in” on learning about their passion.

Even before they quit their day jobs.

Even before deciding:

“Yes, this is going to be my next career!”

They learned everything there is to know for the sheer joy of it. They talked to the best experts. They did courses and certifications.

They went down the rabbit hole.

And they had a blast doing it.

Then came the unintended, unexpected rewards.

The inevitable paths and opportunities that seem to magically appear; the stuff you can’t possibly know about when you’re just starting out.

Stuff like:

The satisfaction of learning everything there is to know about something meaningful to you.

The deep personal pride that comes from putting in countless hours and finally mastering that thing.

The surprising career paths that spring up, almost magically, opportunities you never knew existed or never considered right for you, and

The unexpected joy you never thought you could get from work.

However, that’s all stuff for later.

For now, you just have to start, from wherever you are.

Take whatever your passion is, whatever you’re excited about, whatever you’re hesitating on, whatever your inner voice tells you to explore and…

…go explore THAT thing.

Go down the rabbit hole.

You won’t be worse off.

Chances are, it’ll change your life.

What to do next: Some tips from Precision Nutrition

1. ‘Fess up to yourself.

You probably already know what that ‘thing’ is; the one that lights you up and makes you tick.

It’s the thing you can’t stop reading about and researching, just for fun, even when it’s late at night and you know it’s really time to go to bed.

It’s the thing you can’t stop talking about… maybe the thing you’re driving your family members nuts about because you just can’t shut up about it.

It’s the thing you’re totally hooked on. You can’t get enough. You might even say you’re a little bit obsessed.

That thing? Embrace it.

You don’t necessarily have to plan a career change or do anything drastic. Just give yourself permission to ‘go down the rabbit hole’ of learning, exploration and experimentation.

2. Look for role models.

Who’s already doing what you would like to be doing? Who is inspiring or fascinating to you?

Watch for the people who are involved in the field or a subject that interests you.

Is there a way to learn from them, watch them, talk with them, or ask questions?

Don’t just expect them to give you the magic formula. But take advantage of every opportunity to observe and learn.

And don’t discount people who aren’t on Instagram or getting all the attention, either. Ask yourself: Who else is working in this industry? Who else can I learn from?

Cast a wide net. Aim to observe and learn all you can.

3. Put your hand up.

Look for opportunities to ask questions, get feedback, and learn all you can.

Attend a lecture and participate in the Q&A.

Write letters to your role models.

Volunteer.

Do stuff: Write articles, join projects, conduct experiments. Do it for free, in your spare time. Do it in the name of learning, and for the joy of it.

Don’t worry too much about the payoff now. Just plant the seeds.

4. Continue your education.

Education doesn’t just have to come from traditional schooling (not that there’s anything wrong with that). These days, plenty of options are available, for just about any industry.

If you ask me, there’s never been a better time to learn anything. Courses, books, certifications, master classes… the world is your educational oyster.

The trick: choose educational opportunities from places that are proven, who you trust and respect. Take your time and do your research.

And then, after you’ve signed up, make sure to show up.

And go all in.

Is health, fitness, and nutrition your passion?

Obviously it’s mine.

If it’s yours too, and you’d like to go down the rabbit hole with me, consider the Precision Nutrition Level 1 Certification. The next group kicks off shortly.

What’s it all about?

The Precision Nutrition Level 1 Certification is the world’s most respected nutrition education program. It gives you the knowledge, systems, and tools you need to really understand how food influences a person’s health and fitness. Plus the ability to turn that knowledge into a thriving coaching practice.

Developed over 15 years, and proven with nearly 100,000 clients and patients, the Level 1 curriculum stands alone as the authority on the science of nutrition and the art of coaching.

Whether you’re already mid-career, or just starting out, the Level 1 Certification is your springboard to a deeper understanding of nutrition, the authority to coach it, and the ability to turn what you know into results.

[Of course, if you’re already a student or graduate of the Level 1 Certification, check out our Level 2 Certification Master Class. It’s an exclusive, year-long mentorship designed for elite professionals looking to master the art of coaching and be part of the top 1% of health and fitness coaches in the world.]

Interested? Add your name to the presale list. You’ll save up to 33% and secure your spot 24 hours before everyone else.

We’ll be opening up spots in our next Precision Nutrition Level 1 Certification on Wednesday, April 4th, 2018.

If you want to find out more, we’ve set up the following presale list, which gives you two advantages.

Pay less than everyone else. We like to reward people who are eager to boost their credentials and are ready to commit to getting the education they need. So we’re offering a discount of up to 33% off the general price when you sign up for the presale list.

Sign up 24 hours before the general public and increase your chances of getting a spot. We only open the certification program twice per year. Due to high demand, spots in the program are limited and have historically sold out in a matter of hours. But when you sign up for the presale list, we’ll give you the opportunity to register a full 24 hours before anyone else.

If you’re ready for a deeper understanding of nutrition, the authority to coach it, and the ability to turn what you know into results… this is your chance to see what the world’s top professional nutrition coaching system can do for you.

The post Forget “career hacks”… Here’s the real key to career success that almost no one is talking about. appeared first on Precision Nutrition.

Forget “career hacks”… Here’s the real key to career success that almost no one is talking about. published first on

[gfuniv1200-blog]

Learning Journey

Life has many milestones from learning to walk, talk and read to leaving home to start university. From these milestones comes a vast amount of learning. My learning journey started way before my memories started, but the first major moment I really remember making an impact on me was when my grandpa died. I remember not really understanding why everyone was sad. At the funeral, I looked around and had the sudden realization that I would never see him again. Now I look back on this personal learning moment as when I realized life doesn’t last forever.

 A lighter and more formal learning moment occurred in grade 6. During this year I remember learning how to do long division. This has stuck with me because the following year, with a different teacher, we were taught long division differently which made things confusing. I spent time relearning how the other teacher taught and this it has never left me since.

 When I was 12 years old I began volunteering at an animal shelter where I had a personal learning experience. Being around animals and seeing how horribly treated many of them were made me realize my passion for animals. This experience meant a lot to me and has changed the course of my life by leading me to become a vegetarian.

 This volunteer position lead to my first job when I was around 15. This position taught me a lot of informal things, the most striking was how to do laundry. Being a spoilt only child, I was never expected to do this at home. The owner was incredibly shocked about having to teach a 15 year old how to do laundry. I was very embarrassed but it forced me learn a lifelong skill before going to university.

 When signing up for classes for high school in grade 8 our teacher gave us suggestions on what stream of classes to take, academic or applied. I was suggested applied for most of my classes and I was devastated. This taught me that I needed to work harder to reach my goal of getting into university. I ended up ignoring the suggestions and took academic everything which made me realize I’m extremely stubborn and I had capacity to do more.

 Surprise, surprise grade 9 math was a struggle for me. I remember crying on the first day because I understood nothing. I ended up getting a tutor. For some reason throughout my life to this point I thought it was embarrassing or sad if you had needed a tutor. The tutor ending up really helping me with that class. I realized I shouldn’t be afraid to ask for extra help if I don’t understand something. This is still something I struggle with today. Once coming to university, I was unsure who I could ask for help with such big classes. This semester my goal is to reach out to more school resources like the Library’s Writing Center or SLGs.

 Math came back to haunt me in grade 12. I took calculus and was shocked that it wasn’t easy like the majority of the other high school classes were for me and I ended up dropping the class. I was extremely unhappy and feared the idea of failure. At this point in time I applied to universities for a bachelor of science, which I needed calculus for. This meant I couldn’t go to university the following year. Although I thought this was a hugely detrimental to my life in the moment it allowed me time to reflect and learn personally. It also allowed me time to find what I really wanted to do based upon my interests and strengths, which was going into Human Nutrition. I truly learnt there isn’t just one path to get you places.

 I decided to do a 13th year at high school. This made me learn a lot about myself and had multiple personal learning moments. I worked at Walmart for a year and it taught me I want more than a minimum wage cashier job. It wasn’t a bad job but it was boring and repetitive and I knew that wasn’t what I wanted for the rest of my life.  I have always been a person who enjoys a challenge and doesn’t like to follow a routine so this alines with my personality.

 About a half a year into working at Walmart I put in my resignation due to having too many hours to handle and I wasn’t enjoying the job. On what was supposed to be my last day my coworkers talked to the store manager about making an exception for the minimum hours to work because I was a dependable and hard working. This was the first time I realized how I act truly affects others. It made me think about how much the people I work with impact my mood. From that point on I tried to keep a more positive attitude while working to potentially improve others to make the environment more enjoyable.

 The first semester of university has been a major learning experience for me. I thought making friends would be easy living in residence but it wasn’t. I learnt quickly how to be self-reliant quickly since I didn’t have friends or family to lean on anymore. This was a negative learning experience but positive things came out of it. I became closer to my parents and it pushed me to step out of my comfort zone and try to make friends in different places. Meeting more people and making new friends is definitely something I still need to work on and is a goal for this semester.

 First semester I also learnt that I have to do more work than just showing up to class to succeed. During the first half of the semester I neglected doing work for chemistry and it got me a 34% on the midterm. Although this was a very negative moment it pushed me to do the work for the remainder of the course and I ended up finishing with a 67% which I was extremely happy with. This experience taught me that I need to practice in order to understand more mathematical concepts.  I have developed better organization skills and study habits.

Writing this blog post has made me realize I would like to work on my writing skills potentially by going to the Library Writing Centre. I’ve never been a confident writer which causes stress while working on assignments like this. Its something that could greatly improve my university experience if worked on. I also realized I should take more time to reflect on my experiences, so much so that I would like to make it a goal of mine for the next semester. It could make me a stronger learner and help me understand how to preform better. 

[cvasps]

My Thoughts Monday: Hakan Andersson’s Review of The Seminar

Today's My Thoughts Monday is a Hakan Andersson's recount of his trip to RVA for The 2017 Seminar.

On 21-22 July I was invited to lecture at the University of Richmond's wonderfully beautiful campus. For the seventh consecutive year the University and coach Jay DeMayo hosted the Central Virginia Sport Performance Seminar. The target group was mainly strength and conditioning coaches in colleges and professional sport but it also attracted other practitioners, including therapists and also researchers in sport science.

The speaker list was great and the rather small size venue with a limited number of attendees participating allowed for some fantastic social interaction during the breaks, lunches, and dinners along with great networking throughout the seminar between speakers, attendees, and exhibitors.

There was a small but high quality exhibition, displaying cutting edge technology. It was an excellent format of finding business and cooperation partners for the exhibitors, and a great way to get a hands on demonstrations for coaches and others in attendance.

The subject of my lecture was technique and physique for sprint development. The fact that I was invited is an acknowledgement that Americans respect and are interested in Swedish sport and Swedish coaching – despite the fact that they themselves are incredibly successful in many sports and strength and conditioning for team team sports is according to my view usually performed in a more professional way in the United States than in Sweden.

What stood out the most was definitely the level of the speakers. They did not only present very interesting and thought provoking information they also presented in a very professional manner. One thing that struck me and it seem to be the same all over the world; almost all the presenters were male and 95% of the attendees were also male! Where are all the female researchers and coaches?

A book was also published in connection with the seminar (The Manual Vol. 2) featuring myself and several lecturers from this year's and previous year's seminar write about different aspects of training and development of sports. The book is called Manual 2 and can be ordered at http://cvasps.com/product/manual-vol-2/. On the website you can also download lectures presentations.

Jay DeMayo had as usually invited an impressive row of lecturers and first out on Friday was Doug McKenney. Dough McKenney was the first full-time strength and conditioning coach in the NHL when he was employed by Pittsburgh Penguins in 1985. McKenney was also a pioneer in NHL performing systematic speed tests on ice. McKenney later worked for no less than 18 seasons in the Buffalo Sabre organization-with the standing goal of constantly improving the team's performance level.

In addition, McKenney worked very close to the other coaches, physiotherapists and physicians with rehabilitation of injured players - to quickly and safely help them return to their optimal gaming performance.

McKenny also explained the importance of adapting the conditioning training following the team's playing schedule and stressed the importance of maintaining training even when the team is on so-called "road trips" with up to 4 matches in a week. McKenney put particular emphasis on teaching players about the important relationship between healthy nutrition, body composition, speed, strength, aerobic and anaerobic endurance.

His lecture focused a lot on how optimal hydration and energy fulfillment can maximize performance and reduce the risk of injury. His success can be measured with the impressive consequence that his team often scored in the smallest amount of man-games-missed category throughout his NHL career. He also emphasized the importance of constant personal communication with all players-something that takes time but always has to of top priority.

Lecturer number two was Matt Thome from Michigan Tech University. Matt Thome, like many other American coaches, has a University degree in Exercise Science. Matt Thome is the university's head strength and conditioning coach in American football and basketball and also teaches at the universities in several courses in biomechanics each semester.

Thome talked a lot about training and adaptation and in his opinion training can often be improved by reducing the volume in favor of quality, this for optimal development, but also to avoid overloading with consequential overuse and injuries. Thome's view of this is summarized very well with the following illustration.

Day two started with really well with coach Keenan Robinson. Keenan is the United States Swimming High Performance Director and has worked with swimmers from the North Baltimore Aquatics Club, University of Michigan, Arizona State and USA Swimming for many years, mostly in collaboration with legendary swim coach Bob Bowman. Their success they have had has been tremendous and their athletes' Olympic medals are approaching 50! Their premier swimmer is undoubtedly Michel Phelps for whom Keenan has coached since since his younger teens. Keenan Robinson talked about the importance of swimming at low intensity to tolerate high intensity training and strength train not only for performance but also to avoid injuries. Keenan also spoke about swimming as a sport with a high working ethic and a sport with well-developed high-performance culture.

Brett Bartholomew was perhaps the seminars most driven and dynamic speaker. Brett Bartholomew works as a consultant worldwide in performance-related subjects but is also a writer and is the author of the book "Conscious Coaching". Brett Bartholomew has worked extensively in American football and athletics but also with various assignments within the US Special Forces. Some of Brett Bartholomew's advice was to seek knowledge outside your comfort zone. To be truly successful in sport, you need to be more "interdisciplinary". One can learn a lot from other areas as within the corporate world or social sciences. Many of the problems we encounter in coaching are based on sociology, psychology, management and organizational leadership.

Brett felt that what we do in sport is unique in a way, but it is not "special" because we often try to solve the same issues that are encountered in the professional world around us. "In terms of information that you can use to improve performance specifically, the best resource is your phone or a good handshake. Go and meet and talk with other coaches, leaders or researchers. Offer them to buy lunch and or dinner and keep your mouth shut and let them do the majority of the talking."

Next out was East Tennessee State University Assistant Professor and High Performance Coach, Dr. Brad DeWeese. Dr. DeWeese has, for a number of years, contributed to the success of many athletes in several different sports with a total 20 OS medals and 7 World Championships. Dr. DeWeese is not just a coach; he is also a researcher and has produced a number of publications in the subjects Strength Training and Speed.

Dr. DeWeese spoke a lot about sprint technique and strength training for the development of speed but also a whole lot about periodization. He effectively punctured all the ideas that periodization is dead and out, but in today's sports with often quite short general preparation periods and long competition periods, training must, in many ways, be planned differently than through classical periodization which is still valid in many Olympic sports. Classical periodization involves relatively long preparation periods and clearly defined periods of high performance and top form.

The last speaker was Assistant Professor and High Performance Coach, Dr. Brian Man. Dr Bryan Mann has previously competed in the sport of power lifting and is the deputy director of All graduation at the University of Missouri where he has been active since 2004. Dr Mann is a researcher and author and has published several research publications as well as written four books in the field of resistance training. Dr Mann has also worked as a personal adviser for strength development for the world champion in shot put in 2009 and iVM 2004, 2008 and 2010; Christian Cantwell.

Dr. Mann focused his lecture on velocity-based strength training (VBT). An area in which he also published the book "Developing Explosive Athletes - Use of Velocity Based Training in Training athletes" around. Dr Mann considered that through VBT and the feedback received in each repetition, the quality of strength training definitely increases, but also that you in that way get bigger transfers to other qualities like jump and sprint ability. He referred to a study by Randell et al., which showed significantly greater improvements in strength, jumping ability and speed for a group that trained with feedback compared to another group exercising the same things but without feedback. Dr. Mann also spoke warmly around the concept; Strength training with the load in which the athlete produces the highest power, and this is true, according to Dr Mann, especially if you want to develop explosive strengths and speed. Dr Man also categorized strength training in a slightly different way, based on average speed in a lift.

In summary, a very good and well-organized seminar, actually one of the best seminars I’ve attended! I can strongly recommend CVASPS!

Learn More Here: My Thoughts Monday: Hakan Andersson’s Review of The Seminar

[grgedoors02142]

Cerebral Palsy Didn't Stop This College Junior. Obamacare Repeal Might.

HILLIARD, Ohio ― Justin Martin, 21, is in many respects a typical junior at Kenyon College. He lives in an off-campus apartment, which he shares with six other guys. He’s majoring in English, helps run a student improv group, and last semester he took five courses instead of the usual four ― a “terrible idea,” he now concedes. Sometimes he pulls all-nighters to write papers or study for exams, drawing sustenance from soda and chocolate-covered almonds. And sometimes he stays up late just to have long arguments with his roommates ― like over whether it’s OK to ban campus speeches by white supremacists (Martin says no) or whether the seventh Harry Potter novel was the worst (Martin says yes).

But in one respect, Martin is unique on the Kenyon campus and rare among college students in general. He has cerebral palsy, the disease that severely impairs muscle movement. Martin cannot walk or care for himself without assistance. His life in college ― getting to room with his fellow students, carrying a more-than-full course load ― is a testimony to many things, including supportive administrators and his own stubborn determination. But, Martin says, none of this would be possible if it wasn’t for the help of government programs. And perhaps the most important among them is Medicaid, the federal-state health insurance program that provides coverage to the needy, including people with disabilities.

Most people think of Medicaid as a program for able-bodied, non-elderly adults and their children ― a form of “welfare” that some Americans tolerate and others resent because they think, rightly or wrongly, that it’s subsidizing people too lazy to work. But one-third of the program’s spending is on people with disabilities. Although they account for a much smaller fraction of Medicaid enrollees, there are roughly 9 million people in this category, and almost all have unusually severe health care needs. On average, Medicaid spends more than four times on somebody with disabilities than it does on an able-bodied adult.

Martin is living at his family’s home on the outskirts of Columbus for the summer. When I visited him there recently, he pointed out some of the places that Medicaid money goes. There is the lift-and-pulley system that operates along a track in the ceiling, similar to the one in his campus apartment. It takes him from his bedroom into the bathroom when he needs to use the toilet or take a shower. To get around, he uses a motorized wheelchair that can change its shape in order to stretch out his legs or make him stand. For longer trips, there’s a van with a lift for the wheelchair. Martin can’t be truly alone, because he requires help with some basic functions ― a list, he frequently notes, that includes “wiping my butt.” That means paying for caregivers who, at school, must be on call around the clock. 

Buying and installing the equipment costs many thousands of dollars. Paying those caregivers costs many thousands more, on an ongoing basis. Martin’s father, who lost his factory job several years ago, drives trucks for a living. His mother, who used to work in state government, now has a job at a university. That position provides health insurance, but the plan, like most commercial insurance policies, wouldn’t cover the array of equipment and services Martin needs ― especially the ones that allow him to live independently. Medicaid, in combination with some other government programs, does. And now some of that coverage is at risk because of Republican efforts to repeal the Affordable Care Act.

The American Health Care Act, the bill that the House of Representatives passed in May and that the Senate is now using as the basis for its repeal legislation, would cut approximately $1 trillion from federal health plans over the next decade, according to the Congressional Budget Office. Although few people realize it, a portion of that cut has nothing to do with “Obamacare” per se. It’s the creation of a different funding formula for Medicaid that would affect the entire program. The purpose of this change is to limit the money Washington sends to the states in order to finance their programs. Conservative lawmakers want to scale back the funding even more, either in the repeal bill itself or in subsequent legislation.

The champions of this legislation, including Trump administration officials like Health and Human Services Secretary Tom Price and Republican leaders in Congress like House Speaker Paul Ryan (R-Wis.), deny that these cuts would hurt people like Martin. They say eliminating recent Medicaid expansions and putting the program on a tighter budget would ultimately make it more financially sustainable. And they say that states, given more flexibility over how to manage Medicaid within their borders, would respond by finding ways to innovate. “We believe strongly that the Medicaid population will be cared for in a better way under our program,” Price said during a CNN interview in May.

It’s impossible to disprove these claims. But Medicaid’s history offers reason to be highly skeptical. Funding for the program is already threadbare. And plenty of state officials ― mostly, though not exclusively, Republican ― already want to reduce their share of Medicaid appropriations even more. Cuts at the federal level could embolden these officials, or merely force them to respond in kind because of how the program’s financing works. Either way, coverage for disabilities would be a likely target for cuts, in part because that coverage represents such a large fraction of program spending now.

It’s almost incomprehensible what would my life look like without these services, because there would be no ‘my life’ without these services. Justin Martin describes how Medicaid has influenced his life

Martin knows all about this because he’s watched such efforts play out in Ohio, as state lawmakers have tried to limit spending on programs that affect him. And although he realizes that Medicaid has some big problems, as all large programs do, he thinks few people understand the critical role it plays for people like him ― or the threat that even relatively modest funding cuts pose.

“Really there’s not a single area of my life that hasn’t at some point come into contact with Medicaid dollars,” Martin says. “It’s almost incomprehensible what would my life look like without these services, because there would be no ‘my life’ without these services. It gets impossible to disentangle.”

How Medicaid Quietly Became So Essential

Medicaid has been around for a little more than 50 years. For most of that period, it has been something of a political afterthought. Former President Lyndon Johnson didn’t even mention Medicaid when he signed the bill creating it, instead focusing on Medicare, the program for seniors that the same legislation authorized. Over time, Medicaid grew gradually and frequently without fanfare, with lawmakers like former Rep. Henry Waxman (D-Calif.) quietly slipping amendments into larger pieces of legislation in order to expand eligibility or services for children and low-income adults. 

Sometimes people with disabilities benefitted directly from such initiatives. And sometimes they benefitted indirectly from other policy changes. Legislation in the early 1970s created a new federal standard for disabilities and, in the process, made millions of people with mental or physical impairments eligible. In the late 1990s, the Supreme Court ruled that states had an obligation to provide people with disabilities a chance to live independently. Most states used their Medicaid programs to comply, by expanding their versions of the program to cover more services outside of institutions, whether in the home or in the community more generally.

All of these expansions have filled critical needs. Lawmakers added coverage of extra medical screenings for children in response to studies showing that poor nutrition, exposure to environmental hazards, and other conditions associated with poverty put these kids at much greater risk of disease and developmental delays. (These screenings would later yield the data that allowed a Michigan public health expert to expose the Flint water crisis.)

A similar rationale was behind the expansions of services for people with disabilities. The changes followed exposure of wretched conditions in group homes ― and a growing realization, backed by science, that people with mental and physical limitations can not only live at home but also hold jobs and participate in everyday activities.

The transformation for people with disabilities has been dramatic, if still incomplete, as Martin knows. “Do you want to live independently in your home with your family or in college, or do you want to live in a crappy group home with black mold in the walls that looks like it’s about to keel over any second?” he says. “That’s really the stark reality of what we are dealing with here.”

Providing these services generates large bills. Because Medicaid is an entitlement, the federal government’s commitment to paying those bills is open-ended. Washington offers matching funds to states and, as long as states abide by the program’s rules, the federal government provides however much money it takes to cover everybody who becomes eligible. Over the years, that’s become more and more expensive. Today the program accounts for roughly 10 percent of the federal budget. For states, it’s 15 or 20 percent of total spending, on average, depending on how you count.

Republican Plans Represent A Fundamental Change

Conservatives have responded to Medicaid’s growth by fighting to limit the government’s financial exposure. In the 1990s, then-House Speaker Newt Gingrich (R-Ga.) and Republicans proposed that the federal government give state officials fixed sums of money each year, based on a predetermined formula, regardless of how expensive care for the Medicaid population had gotten or how many had enrolled. The effort failed, but the idea of transforming Medicaid funding has been a cornerstone of Republican budgets under now-House Speaker Paul Ryan (R-Wis.). It’s a crucial, if underappreciated, feature of the American Health Care Act. Under the legislation’s terms, states would have two options for Medicaid funding going forward ― a newly modified version of the Gingrich “block grants” or a system of “per capita caps.”

Under the per capita caps, the federal government would use a predetermined formula to set the level of its contribution towards state Medicaid programs. That contribution would be on a per-person basis, so that the total federal contribution would vary with enrollment ― rising as more people sign up for the program, falling as fewer do, and thereby making the system more sensitive to changing economic conditions than a block grant would be. House Republicans also set the caps at levels designed to soften their blow ― by, among other things, allowing for the relatively higher expenses from Medicaid’s aged and disabled population. At least initially, the caps might be high enough that the federal contribution would come close to what most states would spend otherwise.

But the whole point of introducing a per capita cap is the same as introducing a traditional block grant ― to apply some kind of limit to what government spends on Medicaid. The wonky particulars of the formula (like using 2016 as a base year for calculations) mean that, over time, the gap between those caps and the expense of maintaining today’s coverage levels would likely grow, and that’s assuming the cap in the House bill doesn’t change. Conservative senators are already lobbying hard to tighten it. Even if they don’t succeed, the mere existence of a cap would give lawmakers a simple, potentially more palatable method for dialing back federal contributions in the future. Having brought the cap into existence, they could simply lower it. The federal budget proposal that the Trump administration released last month calls for doing just that.

It’s like cutting your fire department budget while your house is on fire. It doesn’t get rid of the fire. It just gets rid of your firetruck. Martin on Republican plans to cut funding for Medicaid

The Republicans most enthusiastic about these cuts, and the intellectuals who agree with them, say that restricting the money that states get for Medicaid would prod them into eliminating waste and spending their dollars more judiciously. Even the program’s most ardent defenders would concede it could use improvement. But overall, Medicaid is already an extremely lean program, paying less for medical services than either Medicare or private insurance does. The program’s total, per-beneficiary costs are also rising less quickly than those costs in those other insurance programs.

Medicaid’s most glaring weakness is that many beneficiaries struggle to find specialists willing to accept such low payments ― an issue that Republicans frequently cite when they defend their agenda, as if their reforms would make the problem better. In reality, spending less on Medicaid is bound to make that problem worse. The same goes for other parts of Medicaid that specifically serve people with disabilities and currently have waiting lists because they lack funding to handle more enrollees. (Some conservatives have suggested the Affordable Care Act has made the waiting lists longer, by diverting state money into the expansion of coverage for able-bodied adults. The data does not support this.)

“Cuts in disability spending don’t make the overall number of disabled people requiring services in the state go down,” Martin notes. “Those people are still there. There’s just less money for them. … It’s like cutting your fire department budget while your house is on fire. It doesn’t get rid of the fire. It just gets rid of your firetruck.”

What GOP Plans Would Mean For People With Disabilities

It’s impossible to predict exactly how each state would respond if federal matching funds for Medicaid began to decline. Republicans are telling the truth when they say their proposal would give state officials more discretion over how to allocate Medicaid funds. In theory, those officials could leave services for people with disabilities alone while seeking cuts elsewhere. A few states might actually use the cuts as an impetus to rethink the structure of their Medicaid programs, in order to deliver better, more efficient care. When the right conditions exist, states have found ways to innovate before.

But if history is any indication, the vast majority of states would respond in cruder, simpler ways. They would probably start by trimming further what their programs pay to care providers. After that, they would likely seek to reduce coverage itself. Benefits for people with disabilities would be an obvious target, because that’s where so much of the money is and because key services like home- and community-based care are among those Medicaid treats as optional, making it technically easy for states to scale them back.

“They’re not optional for [the beneficiary] but they’re optional for the state,” says Andy Schneider, who spent decades working on Medicaid in Congress and for the Obama administration before joining the faculty at Georgetown University. “And the state is going to be under relentless pressure, year after year, to find ways to reduce its spending.”

It’s even possible that cutting federal contributions to Medicaid could have precisely the opposite effect that conservatives hope it would ― stifling innovation, like the ongoing effort to move people out of institutions, rather than fostering it. “Those reforms require upfront investments in order to produce savings over the long-run, something states can’t do when they have to make immediate across-the-board cuts in response to the House bill’s cost-shifts,” Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities, says.

We know where the cost lies in Medicaid ― it lies with the aged and disabled. John Corlett on the people Medicaid cuts would harm the most

Advocates in Ohio are similarly wary of promises that the Republican health care bill would spare people with disabilities from harm. “We know where the cost lies in Medicaid ― it lies with the aged and disabled,” John Corlett, who ran the state’s Medicaid program before he became president of the Center for Community Solutions, says. “They are vulnerable, they are the most dependent on those Medicaid services, and the effect on them could be much more profound.” In fact, says Michael Kirkman, executive director of Disability Rights Ohio, the real question is how, not whether, the reductions have an impact. “I am confident that cutting Medicaid funding to the state will harm people with disabilities in some fashion, I just don’t know what that is at this point,” he says.

Recent history in the state suggests these fears are well-founded, as Martin can attest. In 2015, as a high school student, he testified before state officials about the potential impact of a proposal to eliminate Medicaid payments for some of his care workers. Earlier this year, he was back in Columbus to protest yet another proposed cut to home care workers ― this time, with a posse of Kenyon classmates alongside him. “There are few people who deserve to be at Kenyon every day, few who have fought to be here and worked their assess off to be here the way that Justin has,” one said of Martin. Another testified about his own disability, autism, and how seeing Martin on campus gave him the courage to be more open about it.

Martin’s activism has generated coverage in local papers and, of course, the Kenyon Collegian, though he has mixed feelings about the publicity. “I don’t want to be the person that has to talk about politics and defend my basic humanity over and over again. You know, I have friends, I watch movies, I eat a lot of Cool Ranch Doritos. Everybody deserves to live a life independent from politics,” he says.

But Martin also knows that many people are even more dependent on Medicaid than he is. “I’m actually sort of an easy case when it comes to disability. [Medicaid benefits] allow me to live a full and happy life, allow me to be clean and independent and safe. But they don’t literally, fundamentally keep me alive. They’re not oxygen, or life-saving medication." And many of the people who depend on those things, Martin knows, "don’t have the luxury of going down to the state house to speak.”

The Medicaid Debate Is Bigger Than Medicaid

The alternative to cutting Medicaid, as Republicans now propose, is funding it at current levels or beyond. That entails its own tradeoffs. Money for the Affordable Care Act’s Medicaid expansion comes primarily from cuts in what Medicare pays providers and insurers, along with taxes that fall on the wealthy and health care corporations. Republicans plan to repeal those taxes. The rest of Medicaid draws on general revenue, which means the federal government pays for it with some combination of taxes, reduced spending elsewhere and higher deficits.

Martin has thought a lot about how to defend such a large fiscal commitment to Medicaid in the current political climate ― a time when the House speaker recalls dreaming up Medicaid cuts as a college student while jabbering over a keg of beer, and a candidate for president openly mocks a reporter with disabilities yet still manages to win the election. One answer is that misfortune can happen to anybody; in Martin’s case, the misfortune was an extremely premature birth and a damaged cerebellum. And when misfortune can happen to anybody, everybody benefits from a truly protective safety net.

Another answer is that society is richer, metaphorically and literally, when people with disabilities are able to study, work and contribute their skills and talents. For Martin, that means becoming an English teacher, ideally at a public school. “What appeals to me about public education is you take..

from DIYS http://ift.tt/2sc5wVx

[rtscrndr53704]

Cerebral Palsy Didn't Stop This College Junior. Obamacare Repeal Might.

HILLIARD, Ohio ― Justin Martin, 21, is in many respects a typical junior at Kenyon College. He lives in an off-campus apartment, which he shares with six other guys. He’s majoring in English, helps run a student improv group, and last semester he took five courses instead of the usual four ― a “terrible idea,” he now concedes. Sometimes he pulls all-nighters to write papers or study for exams, drawing sustenance from soda and chocolate-covered almonds. And sometimes he stays up late just to have long arguments with his roommates ― like over whether it’s OK to ban campus speeches by white supremacists (Martin says no) or whether the seventh Harry Potter novel was the worst (Martin says yes).

But in one respect, Martin is unique on the Kenyon campus and rare among college students in general. He has cerebral palsy, the disease that severely impairs muscle movement. Martin cannot walk or care for himself without assistance. His life in college ― getting to room with his fellow students, carrying a more-than-full course load ― is a testimony to many things, including supportive administrators and his own stubborn determination. But, Martin says, none of this would be possible if it wasn’t for the help of government programs. And perhaps the most important among them is Medicaid, the federal-state health insurance program that provides coverage to the needy, including people with disabilities.

Most people think of Medicaid as a program for able-bodied, non-elderly adults and their children ― a form of “welfare” that some Americans tolerate and others resent because they think, rightly or wrongly, that it’s subsidizing people too lazy to work. But one-third of the program’s spending is on people with disabilities. Although they account for a much smaller fraction of Medicaid enrollees, there are roughly 9 million people in this category, and almost all have unusually severe health care needs. On average, Medicaid spends more than four times on somebody with disabilities than it does on an able-bodied adult.

Martin is living at his family’s home on the outskirts of Columbus for the summer. When I visited him there recently, he pointed out some of the places that Medicaid money goes. There is the lift-and-pulley system that operates along a track in the ceiling, similar to the one in his campus apartment. It takes him from his bedroom into the bathroom when he needs to use the toilet or take a shower. To get around, he uses a motorized wheelchair that can change its shape in order to stretch out his legs or make him stand. For longer trips, there’s a van with a lift for the wheelchair. Martin can’t be truly alone, because he requires help with some basic functions ― a list, he frequently notes, that includes “wiping my butt.” That means paying for caregivers who, at school, must be on call around the clock. 

Buying and installing the equipment costs many thousands of dollars. Paying those caregivers costs many thousands more, on an ongoing basis. Martin’s father, who lost his factory job several years ago, drives trucks for a living. His mother, who used to work in state government, now has a job at a university. That position provides health insurance, but the plan, like most commercial insurance policies, wouldn’t cover the array of equipment and services Martin needs ― especially the ones that allow him to live independently. Medicaid, in combination with some other government programs, does. And now some of that coverage is at risk because of Republican efforts to repeal the Affordable Care Act.

The American Health Care Act, the bill that the House of Representatives passed in May and that the Senate is now using as the basis for its repeal legislation, would cut approximately $1 trillion from federal health plans over the next decade, according to the Congressional Budget Office. Although few people realize it, a portion of that cut has nothing to do with “Obamacare” per se. It’s the creation of a different funding formula for Medicaid that would affect the entire program. The purpose of this change is to limit the money Washington sends to the states in order to finance their programs. Conservative lawmakers want to scale back the funding even more, either in the repeal bill itself or in subsequent legislation.

The champions of this legislation, including Trump administration officials like Health and Human Services Secretary Tom Price and Republican leaders in Congress like House Speaker Paul Ryan (R-Wis.), deny that these cuts would hurt people like Martin. They say eliminating recent Medicaid expansions and putting the program on a tighter budget would ultimately make it more financially sustainable. And they say that states, given more flexibility over how to manage Medicaid within their borders, would respond by finding ways to innovate. “We believe strongly that the Medicaid population will be cared for in a better way under our program,” Price said during a CNN interview in May.

It’s impossible to disprove these claims. But Medicaid’s history offers reason to be highly skeptical. Funding for the program is already threadbare. And plenty of state officials ― mostly, though not exclusively, Republican ― already want to reduce their share of Medicaid appropriations even more. Cuts at the federal level could embolden these officials, or merely force them to respond in kind because of how the program’s financing works. Either way, coverage for disabilities would be a likely target for cuts, in part because that coverage represents such a large fraction of program spending now.

It’s almost incomprehensible what would my life look like without these services, because there would be no ‘my life’ without these services. Justin Martin describes how Medicaid has influenced his life

Martin knows all about this because he’s watched such efforts play out in Ohio, as state lawmakers have tried to limit spending on programs that affect him. And although he realizes that Medicaid has some big problems, as all large programs do, he thinks few people understand the critical role it plays for people like him ― or the threat that even relatively modest funding cuts pose.

“Really there’s not a single area of my life that hasn’t at some point come into contact with Medicaid dollars,” Martin says. “It’s almost incomprehensible what would my life look like without these services, because there would be no ‘my life’ without these services. It gets impossible to disentangle.”

How Medicaid Quietly Became So Essential

Medicaid has been around for a little more than 50 years. For most of that period, it has been something of a political afterthought. Former President Lyndon Johnson didn’t even mention Medicaid when he signed the bill creating it, instead focusing on Medicare, the program for seniors that the same legislation authorized. Over time, Medicaid grew gradually and frequently without fanfare, with lawmakers like former Rep. Henry Waxman (D-Calif.) quietly slipping amendments into larger pieces of legislation in order to expand eligibility or services for children and low-income adults. 

Sometimes people with disabilities benefitted directly from such initiatives. And sometimes they benefitted indirectly from other policy changes. Legislation in the early 1970s created a new federal standard for disabilities and, in the process, made millions of people with mental or physical impairments eligible. In the late 1990s, the Supreme Court ruled that states had an obligation to provide people with disabilities a chance to live independently. Most states used their Medicaid programs to comply, by expanding their versions of the program to cover more services outside of institutions, whether in the home or in the community more generally.

All of these expansions have filled critical needs. Lawmakers added coverage of extra medical screenings for children in response to studies showing that poor nutrition, exposure to environmental hazards, and other conditions associated with poverty put these kids at much greater risk of disease and developmental delays. (These screenings would later yield the data that allowed a Michigan public health expert to expose the Flint water crisis.)

A similar rationale was behind the expansions of services for people with disabilities. The changes followed exposure of wretched conditions in group homes ― and a growing realization, backed by science, that people with mental and physical limitations can not only live at home but also hold jobs and participate in everyday activities.

The transformation for people with disabilities has been dramatic, if still incomplete, as Martin knows. “Do you want to live independently in your home with your family or in college, or do you want to live in a crappy group home with black mold in the walls that looks like it’s about to keel over any second?” he says. “That’s really the stark reality of what we are dealing with here.”

Providing these services generates large bills. Because Medicaid is an entitlement, the federal government’s commitment to paying those bills is open-ended. Washington offers matching funds to states and, as long as states abide by the program’s rules, the federal government provides however much money it takes to cover everybody who becomes eligible. Over the years, that’s become more and more expensive. Today the program accounts for roughly 10 percent of the federal budget. For states, it’s 15 or 20 percent of total spending, on average, depending on how you count.

Republican Plans Represent A Fundamental Change

Conservatives have responded to Medicaid’s growth by fighting to limit the government’s financial exposure. In the 1990s, then-House Speaker Newt Gingrich (R-Ga.) and Republicans proposed that the federal government give state officials fixed sums of money each year, based on a predetermined formula, regardless of how expensive care for the Medicaid population had gotten or how many had enrolled. The effort failed, but the idea of transforming Medicaid funding has been a cornerstone of Republican budgets under now-House Speaker Paul Ryan (R-Wis.). It’s a crucial, if underappreciated, feature of the American Health Care Act. Under the legislation’s terms, states would have two options for Medicaid funding going forward ― a newly modified version of the Gingrich “block grants” or a system of “per capita caps.”

Under the per capita caps, the federal government would use a predetermined formula to set the level of its contribution towards state Medicaid programs. That contribution would be on a per-person basis, so that the total federal contribution would vary with enrollment ― rising as more people sign up for the program, falling as fewer do, and thereby making the system more sensitive to changing economic conditions than a block grant would be. House Republicans also set the caps at levels designed to soften their blow ― by, among other things, allowing for the relatively higher expenses from Medicaid’s aged and disabled population. At least initially, the caps might be high enough that the federal contribution would come close to what most states would spend otherwise.

But the whole point of introducing a per capita cap is the same as introducing a traditional block grant ― to apply some kind of limit to what government spends on Medicaid. The wonky particulars of the formula (like using 2016 as a base year for calculations) mean that, over time, the gap between those caps and the expense of maintaining today’s coverage levels would likely grow, and that’s assuming the cap in the House bill doesn’t change. Conservative senators are already lobbying hard to tighten it. Even if they don’t succeed, the mere existence of a cap would give lawmakers a simple, potentially more palatable method for dialing back federal contributions in the future. Having brought the cap into existence, they could simply lower it. The federal budget proposal that the Trump administration released last month calls for doing just that.

It’s like cutting your fire department budget while your house is on fire. It doesn’t get rid of the fire. It just gets rid of your firetruck. Martin on Republican plans to cut funding for Medicaid

The Republicans most enthusiastic about these cuts, and the intellectuals who agree with them, say that restricting the money that states get for Medicaid would prod them into eliminating waste and spending their dollars more judiciously. Even the program’s most ardent defenders would concede it could use improvement. But overall, Medicaid is already an extremely lean program, paying less for medical services than either Medicare or private insurance does. The program’s total, per-beneficiary costs are also rising less quickly than those costs in those other insurance programs.

Medicaid’s most glaring weakness is that many beneficiaries struggle to find specialists willing to accept such low payments ― an issue that Republicans frequently cite when they defend their agenda, as if their reforms would make the problem better. In reality, spending less on Medicaid is bound to make that problem worse. The same goes for other parts of Medicaid that specifically serve people with disabilities and currently have waiting lists because they lack funding to handle more enrollees. (Some conservatives have suggested the Affordable Care Act has made the waiting lists longer, by diverting state money into the expansion of coverage for able-bodied adults. The data does not support this.)

“Cuts in disability spending don’t make the overall number of disabled people requiring services in the state go down,” Martin notes. “Those people are still there. There’s just less money for them. … It’s like cutting your fire department budget while your house is on fire. It doesn’t get rid of the fire. It just gets rid of your firetruck.”

What GOP Plans Would Mean For People With Disabilities

It’s impossible to predict exactly how each state would respond if federal matching funds for Medicaid began to decline. Republicans are telling the truth when they say their proposal would give state officials more discretion over how to allocate Medicaid funds. In theory, those officials could leave services for people with disabilities alone while seeking cuts elsewhere. A few states might actually use the cuts as an impetus to rethink the structure of their Medicaid programs, in order to deliver better, more efficient care. When the right conditions exist, states have found ways to innovate before.

But if history is any indication, the vast majority of states would respond in cruder, simpler ways. They would probably start by trimming further what their programs pay to care providers. After that, they would likely seek to reduce coverage itself. Benefits for people with disabilities would be an obvious target, because that’s where so much of the money is and because key services like home- and community-based care are among those Medicaid treats as optional, making it technically easy for states to scale them back.

“They’re not optional for [the beneficiary] but they’re optional for the state,” says Andy Schneider, who spent decades working on Medicaid in Congress and for the Obama administration before joining the faculty at Georgetown University. “And the state is going to be under relentless pressure, year after year, to find ways to reduce its spending.”

It’s even possible that cutting federal contributions to Medicaid could have precisely the opposite effect that conservatives hope it would ― stifling innovation, like the ongoing effort to move people out of institutions, rather than fostering it. “Those reforms require upfront investments in order to produce savings over the long-run, something states can’t do when they have to make immediate across-the-board cuts in response to the House bill’s cost-shifts,” Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities, says.

We know where the cost lies in Medicaid ― it lies with the aged and disabled. John Corlett on the people Medicaid cuts would harm the most

Advocates in Ohio are similarly wary of promises that the Republican health care bill would spare people with disabilities from harm. “We know where the cost lies in Medicaid ― it lies with the aged and disabled,” John Corlett, who ran the state’s Medicaid program before he became president of the Center for Community Solutions, says. “They are vulnerable, they are the most dependent on those Medicaid services, and the effect on them could be much more profound.” In fact, says Michael Kirkman, executive director of Disability Rights Ohio, the real question is how, not whether, the reductions have an impact. “I am confident that cutting Medicaid funding to the state will harm people with disabilities in some fashion, I just don’t know what that is at this point,” he says.

Recent history in the state suggests these fears are well-founded, as Martin can attest. In 2015, as a high school student, he testified before state officials about the potential impact of a proposal to eliminate Medicaid payments for some of his care workers. Earlier this year, he was back in Columbus to protest yet another proposed cut to home care workers ― this time, with a posse of Kenyon classmates alongside him. “There are few people who deserve to be at Kenyon every day, few who have fought to be here and worked their assess off to be here the way that Justin has,” one said of Martin. Another testified about his own disability, autism, and how seeing Martin on campus gave him the courage to be more open about it.

Martin’s activism has generated coverage in local papers and, of course, the Kenyon Collegian, though he has mixed feelings about the publicity. “I don’t want to be the person that has to talk about politics and defend my basic humanity over and over again. You know, I have friends, I watch movies, I eat a lot of Cool Ranch Doritos. Everybody deserves to live a life independent from politics,” he says.

But Martin also knows that many people are even more dependent on Medicaid than he is. “I’m actually sort of an easy case when it comes to disability. [Medicaid benefits] allow me to live a full and happy life, allow me to be clean and independent and safe. But they don’t literally, fundamentally keep me alive. They’re not oxygen, or life-saving medication." And many of the people who depend on those things, Martin knows, "don’t have the luxury of going down to the state house to speak.”

The Medicaid Debate Is Bigger Than Medicaid

The alternative to cutting Medicaid, as Republicans now propose, is funding it at current levels or beyond. That entails its own tradeoffs. Money for the Affordable Care Act’s Medicaid expansion comes primarily from cuts in what Medicare pays providers and insurers, along with taxes that fall on the wealthy and health care corporations. Republicans plan to repeal those taxes. The rest of Medicaid draws on general revenue, which means the federal government pays for it with some combination of taxes, reduced spending elsewhere and higher deficits.

Martin has thought a lot about how to defend such a large fiscal commitment to Medicaid in the current political climate ― a time when the House speaker recalls dreaming up Medicaid cuts as a college student while jabbering over a keg of beer, and a candidate for president openly mocks a reporter with disabilities yet still manages to win the election. One answer is that misfortune can happen to anybody; in Martin’s case, the misfortune was an extremely premature birth and a damaged cerebellum. And when misfortune can happen to anybody, everybody benefits from a truly protective safety net.

Another answer is that society is richer, metaphorically and literally, when people with disabilities are able to study, work and contribute their skills and talents. For Martin, that means becoming an English teacher, ideally at a public school. “What appeals to me about public education is you take..

from DIYS http://ift.tt/2sc5wVx

[porchenclose10019]

Cerebral Palsy Didn't Stop This College Junior. Obamacare Repeal Might.

HILLIARD, Ohio ― Justin Martin, 21, is in many respects a typical junior at Kenyon College. He lives in an off-campus apartment, which he shares with six other guys. He’s majoring in English, helps run a student improv group, and last semester he took five courses instead of the usual four ― a “terrible idea,” he now concedes. Sometimes he pulls all-nighters to write papers or study for exams, drawing sustenance from soda and chocolate-covered almonds. And sometimes he stays up late just to have long arguments with his roommates ― like over whether it’s OK to ban campus speeches by white supremacists (Martin says no) or whether the seventh Harry Potter novel was the worst (Martin says yes).

But in one respect, Martin is unique on the Kenyon campus and rare among college students in general. He has cerebral palsy, the disease that severely impairs muscle movement. Martin cannot walk or care for himself without assistance. His life in college ― getting to room with his fellow students, carrying a more-than-full course load ― is a testimony to many things, including supportive administrators and his own stubborn determination. But, Martin says, none of this would be possible if it wasn’t for the help of government programs. And perhaps the most important among them is Medicaid, the federal-state health insurance program that provides coverage to the needy, including people with disabilities.

Most people think of Medicaid as a program for able-bodied, non-elderly adults and their children ― a form of “welfare” that some Americans tolerate and others resent because they think, rightly or wrongly, that it’s subsidizing people too lazy to work. But one-third of the program’s spending is on people with disabilities. Although they account for a much smaller fraction of Medicaid enrollees, there are roughly 9 million people in this category, and almost all have unusually severe health care needs. On average, Medicaid spends more than four times on somebody with disabilities than it does on an able-bodied adult.

Martin is living at his family’s home on the outskirts of Columbus for the summer. When I visited him there recently, he pointed out some of the places that Medicaid money goes. There is the lift-and-pulley system that operates along a track in the ceiling, similar to the one in his campus apartment. It takes him from his bedroom into the bathroom when he needs to use the toilet or take a shower. To get around, he uses a motorized wheelchair that can change its shape in order to stretch out his legs or make him stand. For longer trips, there’s a van with a lift for the wheelchair. Martin can’t be truly alone, because he requires help with some basic functions ― a list, he frequently notes, that includes “wiping my butt.” That means paying for caregivers who, at school, must be on call around the clock. 

Buying and installing the equipment costs many thousands of dollars. Paying those caregivers costs many thousands more, on an ongoing basis. Martin’s father, who lost his factory job several years ago, drives trucks for a living. His mother, who used to work in state government, now has a job at a university. That position provides health insurance, but the plan, like most commercial insurance policies, wouldn’t cover the array of equipment and services Martin needs ― especially the ones that allow him to live independently. Medicaid, in combination with some other government programs, does. And now some of that coverage is at risk because of Republican efforts to repeal the Affordable Care Act.

The American Health Care Act, the bill that the House of Representatives passed in May and that the Senate is now using as the basis for its repeal legislation, would cut approximately $1 trillion from federal health plans over the next decade, according to the Congressional Budget Office. Although few people realize it, a portion of that cut has nothing to do with “Obamacare” per se. It’s the creation of a different funding formula for Medicaid that would affect the entire program. The purpose of this change is to limit the money Washington sends to the states in order to finance their programs. Conservative lawmakers want to scale back the funding even more, either in the repeal bill itself or in subsequent legislation.

The champions of this legislation, including Trump administration officials like Health and Human Services Secretary Tom Price and Republican leaders in Congress like House Speaker Paul Ryan (R-Wis.), deny that these cuts would hurt people like Martin. They say eliminating recent Medicaid expansions and putting the program on a tighter budget would ultimately make it more financially sustainable. And they say that states, given more flexibility over how to manage Medicaid within their borders, would respond by finding ways to innovate. “We believe strongly that the Medicaid population will be cared for in a better way under our program,” Price said during a CNN interview in May.

It’s impossible to disprove these claims. But Medicaid’s history offers reason to be highly skeptical. Funding for the program is already threadbare. And plenty of state officials ― mostly, though not exclusively, Republican ― already want to reduce their share of Medicaid appropriations even more. Cuts at the federal level could embolden these officials, or merely force them to respond in kind because of how the program’s financing works. Either way, coverage for disabilities would be a likely target for cuts, in part because that coverage represents such a large fraction of program spending now.

It’s almost incomprehensible what would my life look like without these services, because there would be no ‘my life’ without these services. Justin Martin describes how Medicaid has influenced his life

Martin knows all about this because he’s watched such efforts play out in Ohio, as state lawmakers have tried to limit spending on programs that affect him. And although he realizes that Medicaid has some big problems, as all large programs do, he thinks few people understand the critical role it plays for people like him ― or the threat that even relatively modest funding cuts pose.

“Really there’s not a single area of my life that hasn’t at some point come into contact with Medicaid dollars,” Martin says. “It’s almost incomprehensible what would my life look like without these services, because there would be no ‘my life’ without these services. It gets impossible to disentangle.”

How Medicaid Quietly Became So Essential

Medicaid has been around for a little more than 50 years. For most of that period, it has been something of a political afterthought. Former President Lyndon Johnson didn’t even mention Medicaid when he signed the bill creating it, instead focusing on Medicare, the program for seniors that the same legislation authorized. Over time, Medicaid grew gradually and frequently without fanfare, with lawmakers like former Rep. Henry Waxman (D-Calif.) quietly slipping amendments into larger pieces of legislation in order to expand eligibility or services for children and low-income adults. 

Sometimes people with disabilities benefitted directly from such initiatives. And sometimes they benefitted indirectly from other policy changes. Legislation in the early 1970s created a new federal standard for disabilities and, in the process, made millions of people with mental or physical impairments eligible. In the late 1990s, the Supreme Court ruled that states had an obligation to provide people with disabilities a chance to live independently. Most states used their Medicaid programs to comply, by expanding their versions of the program to cover more services outside of institutions, whether in the home or in the community more generally.

All of these expansions have filled critical needs. Lawmakers added coverage of extra medical screenings for children in response to studies showing that poor nutrition, exposure to environmental hazards, and other conditions associated with poverty put these kids at much greater risk of disease and developmental delays. (These screenings would later yield the data that allowed a Michigan public health expert to expose the Flint water crisis.)

A similar rationale was behind the expansions of services for people with disabilities. The changes followed exposure of wretched conditions in group homes ― and a growing realization, backed by science, that people with mental and physical limitations can not only live at home but also hold jobs and participate in everyday activities.

The transformation for people with disabilities has been dramatic, if still incomplete, as Martin knows. “Do you want to live independently in your home with your family or in college, or do you want to live in a crappy group home with black mold in the walls that looks like it’s about to keel over any second?” he says. “That’s really the stark reality of what we are dealing with here.”

Providing these services generates large bills. Because Medicaid is an entitlement, the federal government’s commitment to paying those bills is open-ended. Washington offers matching funds to states and, as long as states abide by the program’s rules, the federal government provides however much money it takes to cover everybody who becomes eligible. Over the years, that’s become more and more expensive. Today the program accounts for roughly 10 percent of the federal budget. For states, it’s 15 or 20 percent of total spending, on average, depending on how you count.

Republican Plans Represent A Fundamental Change

Conservatives have responded to Medicaid’s growth by fighting to limit the government’s financial exposure. In the 1990s, then-House Speaker Newt Gingrich (R-Ga.) and Republicans proposed that the federal government give state officials fixed sums of money each year, based on a predetermined formula, regardless of how expensive care for the Medicaid population had gotten or how many had enrolled. The effort failed, but the idea of transforming Medicaid funding has been a cornerstone of Republican budgets under now-House Speaker Paul Ryan (R-Wis.). It’s a crucial, if underappreciated, feature of the American Health Care Act. Under the legislation’s terms, states would have two options for Medicaid funding going forward ― a newly modified version of the Gingrich “block grants” or a system of “per capita caps.”

Under the per capita caps, the federal government would use a predetermined formula to set the level of its contribution towards state Medicaid programs. That contribution would be on a per-person basis, so that the total federal contribution would vary with enrollment ― rising as more people sign up for the program, falling as fewer do, and thereby making the system more sensitive to changing economic conditions than a block grant would be. House Republicans also set the caps at levels designed to soften their blow ― by, among other things, allowing for the relatively higher expenses from Medicaid’s aged and disabled population. At least initially, the caps might be high enough that the federal contribution would come close to what most states would spend otherwise.

But the whole point of introducing a per capita cap is the same as introducing a traditional block grant ― to apply some kind of limit to what government spends on Medicaid. The wonky particulars of the formula (like using 2016 as a base year for calculations) mean that, over time, the gap between those caps and the expense of maintaining today’s coverage levels would likely grow, and that’s assuming the cap in the House bill doesn’t change. Conservative senators are already lobbying hard to tighten it. Even if they don’t succeed, the mere existence of a cap would give lawmakers a simple, potentially more palatable method for dialing back federal contributions in the future. Having brought the cap into existence, they could simply lower it. The federal budget proposal that the Trump administration released last month calls for doing just that.

It’s like cutting your fire department budget while your house is on fire. It doesn’t get rid of the fire. It just gets rid of your firetruck. Martin on Republican plans to cut funding for Medicaid

The Republicans most enthusiastic about these cuts, and the intellectuals who agree with them, say that restricting the money that states get for Medicaid would prod them into eliminating waste and spending their dollars more judiciously. Even the program’s most ardent defenders would concede it could use improvement. But overall, Medicaid is already an extremely lean program, paying less for medical services than either Medicare or private insurance does. The program’s total, per-beneficiary costs are also rising less quickly than those costs in those other insurance programs.

Medicaid’s most glaring weakness is that many beneficiaries struggle to find specialists willing to accept such low payments ― an issue that Republicans frequently cite when they defend their agenda, as if their reforms would make the problem better. In reality, spending less on Medicaid is bound to make that problem worse. The same goes for other parts of Medicaid that specifically serve people with disabilities and currently have waiting lists because they lack funding to handle more enrollees. (Some conservatives have suggested the Affordable Care Act has made the waiting lists longer, by diverting state money into the expansion of coverage for able-bodied adults. The data does not support this.)

“Cuts in disability spending don’t make the overall number of disabled people requiring services in the state go down,” Martin notes. “Those people are still there. There’s just less money for them. … It’s like cutting your fire department budget while your house is on fire. It doesn’t get rid of the fire. It just gets rid of your firetruck.”

What GOP Plans Would Mean For People With Disabilities

It’s impossible to predict exactly how each state would respond if federal matching funds for Medicaid began to decline. Republicans are telling the truth when they say their proposal would give state officials more discretion over how to allocate Medicaid funds. In theory, those officials could leave services for people with disabilities alone while seeking cuts elsewhere. A few states might actually use the cuts as an impetus to rethink the structure of their Medicaid programs, in order to deliver better, more efficient care. When the right conditions exist, states have found ways to innovate before.

But if history is any indication, the vast majority of states would respond in cruder, simpler ways. They would probably start by trimming further what their programs pay to care providers. After that, they would likely seek to reduce coverage itself. Benefits for people with disabilities would be an obvious target, because that’s where so much of the money is and because key services like home- and community-based care are among those Medicaid treats as optional, making it technically easy for states to scale them back.

“They’re not optional for [the beneficiary] but they’re optional for the state,” says Andy Schneider, who spent decades working on Medicaid in Congress and for the Obama administration before joining the faculty at Georgetown University. “And the state is going to be under relentless pressure, year after year, to find ways to reduce its spending.”

It’s even possible that cutting federal contributions to Medicaid could have precisely the opposite effect that conservatives hope it would ― stifling innovation, like the ongoing effort to move people out of institutions, rather than fostering it. “Those reforms require upfront investments in order to produce savings over the long-run, something states can’t do when they have to make immediate across-the-board cuts in response to the House bill’s cost-shifts,” Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities, says.

We know where the cost lies in Medicaid ― it lies with the aged and disabled. John Corlett on the people Medicaid cuts would harm the most

Advocates in Ohio are similarly wary of promises that the Republican health care bill would spare people with disabilities from harm. “We know where the cost lies in Medicaid ― it lies with the aged and disabled,” John Corlett, who ran the state’s Medicaid program before he became president of the Center for Community Solutions, says. “They are vulnerable, they are the most dependent on those Medicaid services, and the effect on them could be much more profound.” In fact, says Michael Kirkman, executive director of Disability Rights Ohio, the real question is how, not whether, the reductions have an impact. “I am confident that cutting Medicaid funding to the state will harm people with disabilities in some fashion, I just don’t know what that is at this point,” he says.

Recent history in the state suggests these fears are well-founded, as Martin can attest. In 2015, as a high school student, he testified before state officials about the potential impact of a proposal to eliminate Medicaid payments for some of his care workers. Earlier this year, he was back in Columbus to protest yet another proposed cut to home care workers ― this time, with a posse of Kenyon classmates alongside him. “There are few people who deserve to be at Kenyon every day, few who have fought to be here and worked their assess off to be here the way that Justin has,” one said of Martin. Another testified about his own disability, autism, and how seeing Martin on campus gave him the courage to be more open about it.

Martin’s activism has generated coverage in local papers and, of course, the Kenyon Collegian, though he has mixed feelings about the publicity. “I don’t want to be the person that has to talk about politics and defend my basic humanity over and over again. You know, I have friends, I watch movies, I eat a lot of Cool Ranch Doritos. Everybody deserves to live a life independent from politics,” he says.

But Martin also knows that many people are even more dependent on Medicaid than he is. “I’m actually sort of an easy case when it comes to disability. [Medicaid benefits] allow me to live a full and happy life, allow me to be clean and independent and safe. But they don’t literally, fundamentally keep me alive. They’re not oxygen, or life-saving medication." And many of the people who depend on those things, Martin knows, "don’t have the luxury of going down to the state house to speak.”

The Medicaid Debate Is Bigger Than Medicaid

The alternative to cutting Medicaid, as Republicans now propose, is funding it at current levels or beyond. That entails its own tradeoffs. Money for the Affordable Care Act’s Medicaid expansion comes primarily from cuts in what Medicare pays providers and insurers, along with taxes that fall on the wealthy and health care corporations. Republicans plan to repeal those taxes. The rest of Medicaid draws on general revenue, which means the federal government pays for it with some combination of taxes, reduced spending elsewhere and higher deficits.

Martin has thought a lot about how to defend such a large fiscal commitment to Medicaid in the current political climate ― a time when the House speaker recalls dreaming up Medicaid cuts as a college student while jabbering over a keg of beer, and a candidate for president openly mocks a reporter with disabilities yet still manages to win the election. One answer is that misfortune can happen to anybody; in Martin’s case, the misfortune was an extremely premature birth and a damaged cerebellum. And when misfortune can happen to anybody, everybody benefits from a truly protective safety net.

Another answer is that society is richer, metaphorically and literally, when people with disabilities are able to study, work and contribute their skills and talents. For Martin, that means becoming an English teacher, ideally at a public school. “What appeals to me about public education is you take..

from DIYS http://ift.tt/2sc5wVx

[rtawngs20815]

Cerebral Palsy Didn't Stop This College Junior. Obamacare Repeal Might.

HILLIARD, Ohio ― Justin Martin, 21, is in many respects a typical junior at Kenyon College. He lives in an off-campus apartment, which he shares with six other guys. He’s majoring in English, helps run a student improv group, and last semester he took five courses instead of the usual four ― a “terrible idea,” he now concedes. Sometimes he pulls all-nighters to write papers or study for exams, drawing sustenance from soda and chocolate-covered almonds. And sometimes he stays up late just to have long arguments with his roommates ― like over whether it’s OK to ban campus speeches by white supremacists (Martin says no) or whether the seventh Harry Potter novel was the worst (Martin says yes).

But in one respect, Martin is unique on the Kenyon campus and rare among college students in general. He has cerebral palsy, the disease that severely impairs muscle movement. Martin cannot walk or care for himself without assistance. His life in college ― getting to room with his fellow students, carrying a more-than-full course load ― is a testimony to many things, including supportive administrators and his own stubborn determination. But, Martin says, none of this would be possible if it wasn’t for the help of government programs. And perhaps the most important among them is Medicaid, the federal-state health insurance program that provides coverage to the needy, including people with disabilities.

Most people think of Medicaid as a program for able-bodied, non-elderly adults and their children ― a form of “welfare” that some Americans tolerate and others resent because they think, rightly or wrongly, that it’s subsidizing people too lazy to work. But one-third of the program’s spending is on people with disabilities. Although they account for a much smaller fraction of Medicaid enrollees, there are roughly 9 million people in this category, and almost all have unusually severe health care needs. On average, Medicaid spends more than four times on somebody with disabilities than it does on an able-bodied adult.

Martin is living at his family’s home on the outskirts of Columbus for the summer. When I visited him there recently, he pointed out some of the places that Medicaid money goes. There is the lift-and-pulley system that operates along a track in the ceiling, similar to the one in his campus apartment. It takes him from his bedroom into the bathroom when he needs to use the toilet or take a shower. To get around, he uses a motorized wheelchair that can change its shape in order to stretch out his legs or make him stand. For longer trips, there’s a van with a lift for the wheelchair. Martin can’t be truly alone, because he requires help with some basic functions ― a list, he frequently notes, that includes “wiping my butt.” That means paying for caregivers who, at school, must be on call around the clock. 

Buying and installing the equipment costs many thousands of dollars. Paying those caregivers costs many thousands more, on an ongoing basis. Martin’s father, who lost his factory job several years ago, drives trucks for a living. His mother, who used to work in state government, now has a job at a university. That position provides health insurance, but the plan, like most commercial insurance policies, wouldn’t cover the array of equipment and services Martin needs ― especially the ones that allow him to live independently. Medicaid, in combination with some other government programs, does. And now some of that coverage is at risk because of Republican efforts to repeal the Affordable Care Act.

The American Health Care Act, the bill that the House of Representatives passed in May and that the Senate is now using as the basis for its repeal legislation, would cut approximately $1 trillion from federal health plans over the next decade, according to the Congressional Budget Office. Although few people realize it, a portion of that cut has nothing to do with “Obamacare” per se. It’s the creation of a different funding formula for Medicaid that would affect the entire program. The purpose of this change is to limit the money Washington sends to the states in order to finance their programs. Conservative lawmakers want to scale back the funding even more, either in the repeal bill itself or in subsequent legislation.

The champions of this legislation, including Trump administration officials like Health and Human Services Secretary Tom Price and Republican leaders in Congress like House Speaker Paul Ryan (R-Wis.), deny that these cuts would hurt people like Martin. They say eliminating recent Medicaid expansions and putting the program on a tighter budget would ultimately make it more financially sustainable. And they say that states, given more flexibility over how to manage Medicaid within their borders, would respond by finding ways to innovate. “We believe strongly that the Medicaid population will be cared for in a better way under our program,” Price said during a CNN interview in May.

It’s impossible to disprove these claims. But Medicaid’s history offers reason to be highly skeptical. Funding for the program is already threadbare. And plenty of state officials ― mostly, though not exclusively, Republican ― already want to reduce their share of Medicaid appropriations even more. Cuts at the federal level could embolden these officials, or merely force them to respond in kind because of how the program’s financing works. Either way, coverage for disabilities would be a likely target for cuts, in part because that coverage represents such a large fraction of program spending now.

It’s almost incomprehensible what would my life look like without these services, because there would be no ‘my life’ without these services. Justin Martin describes how Medicaid has influenced his life

Martin knows all about this because he’s watched such efforts play out in Ohio, as state lawmakers have tried to limit spending on programs that affect him. And although he realizes that Medicaid has some big problems, as all large programs do, he thinks few people understand the critical role it plays for people like him ― or the threat that even relatively modest funding cuts pose.

“Really there’s not a single area of my life that hasn’t at some point come into contact with Medicaid dollars,” Martin says. “It’s almost incomprehensible what would my life look like without these services, because there would be no ‘my life’ without these services. It gets impossible to disentangle.”

How Medicaid Quietly Became So Essential

Medicaid has been around for a little more than 50 years. For most of that period, it has been something of a political afterthought. Former President Lyndon Johnson didn’t even mention Medicaid when he signed the bill creating it, instead focusing on Medicare, the program for seniors that the same legislation authorized. Over time, Medicaid grew gradually and frequently without fanfare, with lawmakers like former Rep. Henry Waxman (D-Calif.) quietly slipping amendments into larger pieces of legislation in order to expand eligibility or services for children and low-income adults. 

Sometimes people with disabilities benefitted directly from such initiatives. And sometimes they benefitted indirectly from other policy changes. Legislation in the early 1970s created a new federal standard for disabilities and, in the process, made millions of people with mental or physical impairments eligible. In the late 1990s, the Supreme Court ruled that states had an obligation to provide people with disabilities a chance to live independently. Most states used their Medicaid programs to comply, by expanding their versions of the program to cover more services outside of institutions, whether in the home or in the community more generally.

All of these expansions have filled critical needs. Lawmakers added coverage of extra medical screenings for children in response to studies showing that poor nutrition, exposure to environmental hazards, and other conditions associated with poverty put these kids at much greater risk of disease and developmental delays. (These screenings would later yield the data that allowed a Michigan public health expert to expose the Flint water crisis.)

A similar rationale was behind the expansions of services for people with disabilities. The changes followed exposure of wretched conditions in group homes ― and a growing realization, backed by science, that people with mental and physical limitations can not only live at home but also hold jobs and participate in everyday activities.

The transformation for people with disabilities has been dramatic, if still incomplete, as Martin knows. “Do you want to live independently in your home with your family or in college, or do you want to live in a crappy group home with black mold in the walls that looks like it’s about to keel over any second?” he says. “That’s really the stark reality of what we are dealing with here.”

Providing these services generates large bills. Because Medicaid is an entitlement, the federal government’s commitment to paying those bills is open-ended. Washington offers matching funds to states and, as long as states abide by the program’s rules, the federal government provides however much money it takes to cover everybody who becomes eligible. Over the years, that’s become more and more expensive. Today the program accounts for roughly 10 percent of the federal budget. For states, it’s 15 or 20 percent of total spending, on average, depending on how you count.

Republican Plans Represent A Fundamental Change

Conservatives have responded to Medicaid’s growth by fighting to limit the government’s financial exposure. In the 1990s, then-House Speaker Newt Gingrich (R-Ga.) and Republicans proposed that the federal government give state officials fixed sums of money each year, based on a predetermined formula, regardless of how expensive care for the Medicaid population had gotten or how many had enrolled. The effort failed, but the idea of transforming Medicaid funding has been a cornerstone of Republican budgets under now-House Speaker Paul Ryan (R-Wis.). It’s a crucial, if underappreciated, feature of the American Health Care Act. Under the legislation’s terms, states would have two options for Medicaid funding going forward ― a newly modified version of the Gingrich “block grants” or a system of “per capita caps.”

Under the per capita caps, the federal government would use a predetermined formula to set the level of its contribution towards state Medicaid programs. That contribution would be on a per-person basis, so that the total federal contribution would vary with enrollment ― rising as more people sign up for the program, falling as fewer do, and thereby making the system more sensitive to changing economic conditions than a block grant would be. House Republicans also set the caps at levels designed to soften their blow ― by, among other things, allowing for the relatively higher expenses from Medicaid’s aged and disabled population. At least initially, the caps might be high enough that the federal contribution would come close to what most states would spend otherwise.

But the whole point of introducing a per capita cap is the same as introducing a traditional block grant ― to apply some kind of limit to what government spends on Medicaid. The wonky particulars of the formula (like using 2016 as a base year for calculations) mean that, over time, the gap between those caps and the expense of maintaining today’s coverage levels would likely grow, and that’s assuming the cap in the House bill doesn’t change. Conservative senators are already lobbying hard to tighten it. Even if they don’t succeed, the mere existence of a cap would give lawmakers a simple, potentially more palatable method for dialing back federal contributions in the future. Having brought the cap into existence, they could simply lower it. The federal budget proposal that the Trump administration released last month calls for doing just that.

It’s like cutting your fire department budget while your house is on fire. It doesn’t get rid of the fire. It just gets rid of your firetruck. Martin on Republican plans to cut funding for Medicaid

The Republicans most enthusiastic about these cuts, and the intellectuals who agree with them, say that restricting the money that states get for Medicaid would prod them into eliminating waste and spending their dollars more judiciously. Even the program’s most ardent defenders would concede it could use improvement. But overall, Medicaid is already an extremely lean program, paying less for medical services than either Medicare or private insurance does. The program’s total, per-beneficiary costs are also rising less quickly than those costs in those other insurance programs.

Medicaid’s most glaring weakness is that many beneficiaries struggle to find specialists willing to accept such low payments ― an issue that Republicans frequently cite when they defend their agenda, as if their reforms would make the problem better. In reality, spending less on Medicaid is bound to make that problem worse. The same goes for other parts of Medicaid that specifically serve people with disabilities and currently have waiting lists because they lack funding to handle more enrollees. (Some conservatives have suggested the Affordable Care Act has made the waiting lists longer, by diverting state money into the expansion of coverage for able-bodied adults. The data does not support this.)

“Cuts in disability spending don’t make the overall number of disabled people requiring services in the state go down,” Martin notes. “Those people are still there. There’s just less money for them. … It’s like cutting your fire department budget while your house is on fire. It doesn’t get rid of the fire. It just gets rid of your firetruck.”

What GOP Plans Would Mean For People With Disabilities

It’s impossible to predict exactly how each state would respond if federal matching funds for Medicaid began to decline. Republicans are telling the truth when they say their proposal would give state officials more discretion over how to allocate Medicaid funds. In theory, those officials could leave services for people with disabilities alone while seeking cuts elsewhere. A few states might actually use the cuts as an impetus to rethink the structure of their Medicaid programs, in order to deliver better, more efficient care. When the right conditions exist, states have found ways to innovate before.

But if history is any indication, the vast majority of states would respond in cruder, simpler ways. They would probably start by trimming further what their programs pay to care providers. After that, they would likely seek to reduce coverage itself. Benefits for people with disabilities would be an obvious target, because that’s where so much of the money is and because key services like home- and community-based care are among those Medicaid treats as optional, making it technically easy for states to scale them back.

“They’re not optional for [the beneficiary] but they’re optional for the state,” says Andy Schneider, who spent decades working on Medicaid in Congress and for the Obama administration before joining the faculty at Georgetown University. “And the state is going to be under relentless pressure, year after year, to find ways to reduce its spending.”

It’s even possible that cutting federal contributions to Medicaid could have precisely the opposite effect that conservatives hope it would ― stifling innovation, like the ongoing effort to move people out of institutions, rather than fostering it. “Those reforms require upfront investments in order to produce savings over the long-run, something states can’t do when they have to make immediate across-the-board cuts in response to the House bill’s cost-shifts,” Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities, says.

We know where the cost lies in Medicaid ― it lies with the aged and disabled. John Corlett on the people Medicaid cuts would harm the most

Advocates in Ohio are similarly wary of promises that the Republican health care bill would spare people with disabilities from harm. “We know where the cost lies in Medicaid ― it lies with the aged and disabled,” John Corlett, who ran the state’s Medicaid program before he became president of the Center for Community Solutions, says. “They are vulnerable, they are the most dependent on those Medicaid services, and the effect on them could be much more profound.” In fact, says Michael Kirkman, executive director of Disability Rights Ohio, the real question is how, not whether, the reductions have an impact. “I am confident that cutting Medicaid funding to the state will harm people with disabilities in some fashion, I just don’t know what that is at this point,” he says.

Recent history in the state suggests these fears are well-founded, as Martin can attest. In 2015, as a high school student, he testified before state officials about the potential impact of a proposal to eliminate Medicaid payments for some of his care workers. Earlier this year, he was back in Columbus to protest yet another proposed cut to home care workers ― this time, with a posse of Kenyon classmates alongside him. “There are few people who deserve to be at Kenyon every day, few who have fought to be here and worked their assess off to be here the way that Justin has,” one said of Martin. Another testified about his own disability, autism, and how seeing Martin on campus gave him the courage to be more open about it.

Martin’s activism has generated coverage in local papers and, of course, the Kenyon Collegian, though he has mixed feelings about the publicity. “I don’t want to be the person that has to talk about politics and defend my basic humanity over and over again. You know, I have friends, I watch movies, I eat a lot of Cool Ranch Doritos. Everybody deserves to live a life independent from politics,” he says.

But Martin also knows that many people are even more dependent on Medicaid than he is. “I’m actually sort of an easy case when it comes to disability. [Medicaid benefits] allow me to live a full and happy life, allow me to be clean and independent and safe. But they don’t literally, fundamentally keep me alive. They’re not oxygen, or life-saving medication." And many of the people who depend on those things, Martin knows, "don’t have the luxury of going down to the state house to speak.”

The Medicaid Debate Is Bigger Than Medicaid

The alternative to cutting Medicaid, as Republicans now propose, is funding it at current levels or beyond. That entails its own tradeoffs. Money for the Affordable Care Act’s Medicaid expansion comes primarily from cuts in what Medicare pays providers and insurers, along with taxes that fall on the wealthy and health care corporations. Republicans plan to repeal those taxes. The rest of Medicaid draws on general revenue, which means the federal government pays for it with some combination of taxes, reduced spending elsewhere and higher deficits.

Martin has thought a lot about how to defend such a large fiscal commitment to Medicaid in the current political climate ― a time when the House speaker recalls dreaming up Medicaid cuts as a college student while jabbering over a keg of beer, and a candidate for president openly mocks a reporter with disabilities yet still manages to win the election. One answer is that misfortune can happen to anybody; in Martin’s case, the misfortune was an extremely premature birth and a damaged cerebellum. And when misfortune can happen to anybody, everybody benefits from a truly protective safety net.

Another answer is that society is richer, metaphorically and literally, when people with disabilities are able to study, work and contribute their skills and talents. For Martin, that means becoming an English teacher, ideally at a public school. “What appeals to me about public education is you take..

from DIYS http://ift.tt/2sc5wVx

[omcik-blog]

New Post has been published on OmCik

New Post has been published on http://omcik.com/welfare-and-food-stamps-helped-this-homeless-single-mom-get-back-on-her-feet/

Welfare and food stamps helped this homeless single mom get back on her feet

by Ryan Prior   @CNNMoney May 5, 2017: 12:26 PM ET

Stephanie Land had next to nothing when she checked into a Port Townsend, Washington, homeless shelter with her baby daughter Mia almost nine years ago. Fleeing an abusive relationship, she had no family to turn to, no job and only about $200 to her name.

Over the next several years, Land relied on a system of federal benefits and tax credits, as well as assistance from non-profits and churches to build a new life. The patchwork of programs helped her pay for food, rent, child care, health care and eventually tuition — when she decided to pursue a bachelor’s degree at the University of Montana.

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“Without these programs,” Land said, “I would have probably lost custody of my daughter or would have been forced to live in a car somewhere.”

Related: CNNMoney readers save man from homelessness

A few months after checking into the homeless shelter, Land began taking online college courses. She paid for the courses using Pell Grants, student loans and the Women’s Independence Scholarship, which offers scholarships to survivors of domestic violence.

A couple of years later, she and her daughter moved into low-income housing in Missoula, Montana, where the University of Montana’s creative writing community seemed like a dream. But first, she had to take a year off school to establish residency so she could qualify for the cheaper in-state tuition.

To get by, Land cleaned houses. Her pay started at $8 an hour and gradually she earned a little more. “It is unaffordable to work for minimum wage. I spent so much time working for so little,” she said.

After paying for cleaning supplies and transportation to clients’ houses, Land would bring home $300 to $400 a month. She also had about $1,000 a month from her student loans. About $875 of that went toward rent for the two-bedroom apartment she and her daughter had moved into. Her other expenses — Internet, car insurance, cell phone service, gas and credit card debts — ate up much of the rest.

“We really didn’t have money for food at all,” Land said. So she turned to food stamps and the Special Supplemental Nutrition Program for Women, Infants and Children, known as WIC, to help buy the groceries each month.

For her, it was one of the most humiliating parts of being in poverty. “Everyone on welfare says buying groceries is horrible,” Land said. “You’re always being watched.”

The WIC checks she used were large and obvious so she often bought groceries late at night. “Even the cashier would grumble, and hated doing a WIC checkout,” she said.

Related: From shelter to startup: One Egyptian immigrant’s success story

The checkout process took much longer, leaving many disgruntled customers waiting behind her. “You’re welcome,” she recalled more than one customer snarling at her, as though they had personally paid for her family’s groceries.

The cost of childcare — at $650 a month — would have easily eclipsed her entire budget, but grants from the Child Care and Development Fund helped cushion the blow.

At times, she said, “it got really, really bad.” Desperate for even the smallest amount of aid to help pay a heating bill, she’d call every number she could. “You get really good at scrambling, relentless at finding programs.”

Even an unexpected bill for $10 could send her “over the edge,” she said.

So could taking a heavy course load at school.

Related: Once a boy from the Bronx, he now creates supersonic passenger planes

At one point, Land was taking a fairly full load of 15 credit hours per semester and her work hours dropped below the 20 hours per week required to qualify for food stamps.

“I lost my food benefits when I desperately needed them,” she said. “You make progress and then get pushed back, as though you are being put ‘in your place.'”

She felt the system made it nearly impossible to transition off welfare. Once one advanced toward the cusp of the poverty line, “you could gain $100 in income, and lose $500 in grants.”

This, she said, is where the perception of welfare recipients being lazy comes from. Leaders from across the political spectrum have also acknowledged this stigma, including President Obama, who said in a 2011 town hall, “I’ve seen it, where people weren’t encouraged to work, weren’t encouraged to upgrade their skills, were just getting a check, and over time their motivation started to diminish.”

Land said she wished her school credit hours could have been put toward welfare’s work requirement so that she could have still “earned” her benefits. In her eyes, getting a college education was helping her to become self-sufficient.

After six years of classes and struggling to get by, Land finally graduated with a bachelor’s degree in English in 2014. Her second daughter was born a month later. And she started writing. Her articles and essays have since appeared in the New York Times, the Washington Post, The Guardian and several other publications. Last year, an article she wrote for Vox about her time cleaning houses went viral. It later resulted in a book deal with Hachette Books.

The money she has earned enabled her to stop relying food stamps. At the time, she posted on Facebook: “I did it, guys. I wrote my way out of poverty.”

Land now brings in a steady income as a writer and can support herself and her children independently. She recently got married for the first time. And, she said, she and her husband are now looking to buy a home.

CNNMoney (New York) First published May 5, 2017: 12:26 PM ET

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[politicalfilth-blog]

Cornell Student Exposes the GMO Propaganda that is Pushed in University

We Are Change

Article Via: Alt Healthworks

My name is Robert, and I am a Cornell University undergraduate student. However, I’m not sure if I want to be one any more. Allow me to explain.

Cornell, as an institution, appears to be complicit in a shocking amount of ecologically destructive, academically unethical, and scientifically deceitful behavior. Perhaps the most potent example is Cornell’s deep ties to industrial GMO agriculture, and the affiliated corporations such as Monsanto. I’d like to share how I became aware of this troubling state of affairs.

Throughout my secondary education, I’ve always had a passion for science. In particular, physics and mathematics captured my fascination. My sophomore AP physics teacher, Mr. Jones, became my main source of motivation to succeed. He convinced us students that our generation was crucial to repairing humanity’s relationship to science, and how we would play key roles in solving immense global issues, such as climate change. Thank you Mr. Jones! Without your vision, I would have never had the chance to attend such an amazing university.

I came to Cornell as freshman, deeply unaware of our current GMO agriculture paradigm, and my university’s connection to it. It just wasn’t on my radar quite yet. After two years of school, I was rather uninspired to continue traditional study. I never felt quite at ease, jumping through hoops, taking classes and tests that didn’t inspire me, in exchange for a piece of paper (degree) that somehow magically granted me a superior life. I know many undergraduates fit right in with the university education model, and that’s fantastic. I certainly didn’t, and my mental and physical health began to suffer as a result. I was left with no choice but to take a leave of absence, and pursue another path.

Instead, I began to self-study nutrition in earnest, honestly, out of pure necessity. Luckily, I found Cornell Professor Emeritus T. Colin Campbell’s legendary epidemiological research on nutrition and human disease. His evidence was so clear that I quickly transitioned to a plant-based diet. This personal dietary shift had profound benefits, dispelled my depression, and led me to a deep fascination with the precursor to nutrition: agriculture. I became particularly interested in agroecology. I was astonished to learn that there existed alternatives to chemical-intensive, corporate-controlled models of agriculture, and that they were far safer, more effective, and more sustainable. During my time away from Cornell, I participated in three unique seasons of agroecological crop production, with incredible results. I am immensely grateful for these experiences.

It’s impossible to study and practice agroecology without becoming deeply aware of the other end of the spectrum: the genetic modification of our food supply, ruled by giant agribusiness corporations.

  Currently, the vast majority of U.S. commodity crops (corn, soy, alfalfa, sugar beet) are genetically engineered to either withstand Roundup herbicide or produce Bt toxin pesticide. These “technologies” are ecologically damaging and unsafe. The majority of these crops go to feed animals in factory farms. The remainder generally gets converted into corn syrup, white sugar, vegetable oil, or biofuels — you know, good stuff! This combined approach of growing GMO commodity monoculture crops, and feeding them to factory-farmed livestock, is one of the most ecologically destructive forces our planet has ever seen. It’s also a leading contributor to climate change. In fact, some experts believe it to be the leading cause.

As Professor T. Colin Campbell will tell you, the foods that come from this system (animal products and processed foods) are responsible for causing the vast majority of chronic disease. That’s a story for another day.

Cornell’s GMO Propaganda Campaign

I came back to Cornell a changed person, with a drastically different perspective. I was in for quite a shock, however: I sat in on a course entitled “The GMO Debate.” I was expecting members of an intellectual community coming together, with proponents and critics of GMO food each giving the best verified evidence they had to support their cause. Given all that I had learned about GMO agriculture, I was excited to participate for the “GMO skeptic” side.

The GMO Debate course, which ran in the fall of 2015, was a blatant display of unscientific propaganda in an academic setting. There were a total of 4 active professors in the course, and several guest speakers. They took turns each session defending industrial agriculture and biotechnology with exactly zero critical examination of GMOs. In spite of the course’s name, there was a complete lack of actual “debate.” Here are some of the more memorable claims I heard that fall semester:

* GMO food is necessary to feed the world * There is no instance of harm from agricultural GMOs * Glyphosate, the main ingredient in Roundup, is safer than coffee and table salt * If you believe in science, you must believe in GMO technology * The science of genetic engineering is well understood * “What off-target effects?” … when asked about the proven biochemical risks of GE technology * Vitamin A rice is curing children of Vitamin A deficiency (even though the IRRI, the research institute responsible for rolling it out, says it won’t be ready for some years) * Current pesticides and herbicides don’t pose an ecological or human health risk * Bt is an organic pesticide, therefore Bt GMO crops are safe and pose no additional risk * Bt crops work just fine — but we are now engineering insects as a complementary technology — to make the Bt work better * “Are you scared of GMO insects? Because you shouldn’t be.” * GMO crops are the most rigorously tested crops in the history of food * “If [renowned environmentalist] Rachel Carson were alive today, she would be pro-GMO”.

It gets better. During the semester, emails were released following a Freedom of Information Act request, showing that all four of the professors in the class, as well as several guest speakers, the head of Cornell’s pro-GMO group “Alliance for Science,” and the Dean of the College of Arts and Life Sciences were all copied in on emails with Monsanto. This was part of a much larger circle of academics promoting GMO crops on behalf of the biotech industry. Jonathan Latham PhD, virologist and editor of independentsciencenews.org, documented this in an article titled “The Puppetmasters of Academia.” I highly recommend giving it a read, for further context.

Perhaps saddest of all was the inclusion of several visiting African agriculture-academics in the course. They were brought here by the “Cornell Alliance for Science. ” This organization was completely funded by a $5.6 million grant from the Bill and Melinda Gates Foundation, and appears to espouse only pro-GMO rhetoric. For those of you who are unaware, Bill Gates is a proponent of using agricultural biotechnology in Africa, India, and other developing regions. So in essence, a group of African representatives got indoctrinated into the industrial and GMO agriculture framework, and were sent home to disseminate this information … after all, who could question the expertise of an Ivy League powerhouse such as Cornell?

I then learned of Cornell’s deep historic ties to the biotech industry, which explained what I witnessed in the “GMO Debate” course. Notable examples include the invention of both the controversial bovine growth hormone, and the particle bombardment (“gene gun”) method of creating GMO crops. Both of these cases are connected to Monsanto.

To say the least, I was completely stunned.

What I’m Going to Do About All of This

You didn’t think I was just going to complain about a pro-GMO, industry-sponsored Cornell all day, did you? Good, because I have come up with a plan to create actual, lasting change on campus: a student-led, expert-backed, evidence-based GMO course.

I have decided to host an independent course on the current GMO paradigm, in response to Cornell’s course. It will be held on campus, but will have zero influence from Cornell or any biotech organization. Every Wednesday evening, from September 7th to November 16, we will host a lecture. This lecture series is completely free, open to the entire Cornell community and broader public, and will be published online (for free, forever) at my project, gmowtf.com.

There will be several experts and scientists coming in to lecture for this course. Frances Moore Lappé, of ‘Diet for a Small Planet’ and ‘World Hunger: 10 Myths’ fame, will be introducing the course on September 7, via video presentation. She will be speaking on how GMO agriculture is unnecessary to end world hunger.

Steven Druker is a public interest attorney and author of the powerful book ‘Altered Genes, Twisted Truth: How the Venture to Genetically Engineer Our Food Has Subverted Science, Corrupted Government, and Systematically Deceived the Public,’ which Jane Goodall (in her foreword) hails as “one of the most important books in the last 50 years.” He will be giving two lectures that elaborate on the themes in the book’s subtitle and demonstrate that the GMO venture has been chronically and crucially dependent on deception, and could not survive without it.

Jonathan Latham PhD will be giving two lectures, on the dangers of Roundup Ready and Bt crops, respectively. He will also be participating in our special October 5 debate, representing the anti-GMO panel, alongside Michael Hansen PhD, a senior scientist for the Consumers Union. Jonathan has direct experience genetically modifying organisms, so his expertise is guaranteed.

Allison Wilson PhD is a geneticist and editor/science director of the Bioscience Resource Project. She will be giving a lecture on how GMOs are actually created, to dispel any industry myths of precision, accuracy, or deep genetic understanding.

Belinda Martineau PhD is a geneticist with an interesting history — she was on the team of genetic engineers that created the first commercial GM food crop, the Flavr Savr Tomato. She authored a book on her experience, titled “First Fruit: The Creation of the Flavr Savr Tomato and the Birth of Biotech Foods.” Her lecture will be a historical and personal account of the science, regulation, and commercialization of genetically engineered foods, effectively giving context for today’s GMO paradigm.

My personal scientific hero, T. Colin Campbell, who started me on this whole journey years ago, will not be speaking on GMOs per se … but will address some critically important, related topics: academic freedom and scientific integrity. He began his Cornell career over half a century ago, and has “seen it all.” He has fascinating anecdotes that will illuminate these campus-wide issues beautifully.

Jane Goodall, if you’re reading this, you are personally invited to take time out of your busy schedule to come and give the final capstone lecture. I know how passionate you are about saving our species, our planet, and all of its beautiful inhabitants. Your wise presence in this project would take it to the next level. Alternatively, please consider a short video interview. This offer stands indefinitely. Same for Vandana Shiva!

All in all, our independent GMO lecture series will focus on real threats and real solutions to our current ecological crisis … and perhaps most importantly, will feature 100% less Monsanto influence than Cornell’s course! Sounds good to me.

Taking It Further

I’m on my second leave of absence from Cornell to work on this project, and due to my experiences, I have somewhat given up on a Cornell degree … not that I was ever intensely focused on attaining one. This GMO course is by far the most important thing I can do with my Cornell “career.” However, it is just the beginning of my plan.

Remember the $5.6 million Bill Gates gave Cornell through his foundation, to push the pro-GMO propaganda? Well, to coincide with our course, we’re launching an initiative to raise the same amount of money or more to sponsor more appropriate forms of agriculture, educational outreach, and activism.

Go to gmowtf.com for more information, but in essence, this would finance:

* Continued grassroots educational activism at Cornell, and similar programs in other compromised universities (UC Davis and Berkeley, University of Florida, etc.) across the country. * A plant-based, NON-GMO independent dining hall for Cornell students. It would source as close to 100% organic and local food as possible. Ideally, it would be cheaper than Cornell’s plan (plant-based eaters won’t subsidize expensive meat and dairy for omnivorous eaters). * gmowtf.com as a permanent, free, independent, constantly updated resource for GMO science, policy, news, etc. … also the GMO course would remain online * My dream: a research farm focused on rigorous analysis of agroecological practices. There is an infinitum of fascinatingly effective agroecological techniques that are underrepresented in the scientific community (in favor of faddist, ineffective GMO “technology”). * Completely paying off student debt for a group of 10-15 undergraduates who are willing to help spread this message to the Cornell community.

Mr. Gates, if you truly care about feeding the world in a safe and sustainable manner, and if you are truly dedicated to science and to the kind of open, fact-based discourse on which it depends, I implore you to learn the important facts about which you have apparently been misinformed — and which are being systematically misrepresented by the Cornell organization you are funding.

You can easily gain illumination by reading “Altered Genes, Twisted Truth” by Steven Druker, one of our key contributors to our independent GMO course. You might find Chapter 11, on the ramifications and risks of altering complex information systems, of particular interest. You are, after all, the world’s most famous software developer!

As that chapter demonstrates, biotechnicians are significantly altering the most complex yet least understood group of information systems on earth — the ones that undergird the development and function of living organisms. Yet, they fail to implement the kind of safeguards that software engineers have learned are imperative when making even minor revisions to life-critical human-made systems. Can this be legitimately called science-based engineering?

Bill, feel free to reach out to any of the experts in our course, and don’t be hesitant to update your views on GMO agriculture in light of new understanding. A genuine scientist lives by this principle.

I invite you all to go to gmowtf.com and explore my proposals more. Please bear with the construction of the site in the coming weeks, in preparation for our amazing GMO course!

We live in somewhat of a scientific dark age. Our universities have become extensions of corporate power, at the cost of our health, livelihoods, and ecology. This has to stop, yesterday.

We cannot afford to spread lies to our undergraduate students. Cornell, please reconsider your ways. Until you do, I will be doing everything in my power to counter your industry GMO propaganda efforts with the facts.

With love, Robert Schooler

Article originally seen at AltHealthworks.com and was authored by Nick Meyer

The post Cornell Student Exposes the GMO Propaganda that is Pushed in University appeared first on We Are Change.

from We Are Change https://wearechange.org/cornell-student-exposes-gmo-propaganda-pushed-university/