V.A. Shuns Medical Marijuana, Leaving Vets to Improvise

7W4TV6V23ZFBJOX2N7Z5A4UJVQSANTA CRUZ, Calif. — Some of the local growers along the coast here see it as an act of medical compassion: Donating part of their crop of high-potency medical marijuana to ailing veterans, who line up by the dozens each month in the echoing auditorium of the city’s old veterans’ hall to get a ticket they can exchange for a free bag.

One Vietnam veteran in the line said he was using marijuana-infused oil to treat pancreatic cancer. Another said that smoking cannabis eased the pain from a recent hip replacement better than prescription pills did. Several said that a few puffs temper the anxiety and nightmares of post-traumatic stress disorder.

“I never touched the stuff in Vietnam,” said William Horne, 76, a retired firefighter. “It was only a few years ago I realized how useful it could be.”

The monthly giveaway bags often contain marijuana lotions, pills, candies and hemp oils, as well as potent strains of smokable flower with names like Combat Cookies and Kosher Kush. But the veterans do not get any medical guidance on which product might help with which ailment, how much to use, or how marijuana might interact with other medications.

SOURCE:https://www.nytimes.com/2018/07/25/us/marijuana-veterans

Philly mayor wants to evict Jay Z’s music fest amid Meek Mill drama

As controversy continues to rage in Philadelphia over rapper Meek Mill’s probation case — the city mayor’s office has moved to boot the popular Made in America festival created by Meek’s Roc Nation label founder Jay Z.

A rep for Philly Mayor Jim Kenney dropped a bombshell Tuesday that “This is the last year [the fest] will be held on the [Ben Franklin] Parkway.” That was apparently news to Jay Z and Roc Nation — as well as the concert’s promoter, Live Nation.

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Jay Z fired back on Wednesday, revealing in a statement that the mayor’s office also tried to cancel this year’s fest — which will feature Meek Mill, Nicki Minaj and Post Malone, Sept. 1 and 2.

“We are disappointed that the Mayor… would evict us from the heart of the city, through a media outlet, without a sit-down meeting, notice, dialogue or proper communication,” the hip hop mogul wrote. “It signifies zero appreciation for what Made In America has built alongside the phenomenal citizens of this city.”

He added, “In fact, this administration immediately greeted us with a legal letter trying to stop the 2018 event.”

Roc Nation COO Desiree Perez exclusively told us that she’d previously tried to reach out to the mayor’s office and never heard back before the city publicly said the fest would move. “I’d love to have a conversation,” she said. “We’re shocked. We couldn’t believe it. We don’t have a clue about the hostility we’ve received.”

Jay Z said the minority-owned fest that’s included Rihanna, Kanye West and Pearl Jam, has brought $102.8 million to the city, paid $3.4 million in rent and employed thousands.

Reports said that Made in America’s five-year contract ended in 2017 and was renewed for one year.

A rep for the mayor told Philly.com: “When the festival first started, it was intended to provide a unique attraction to the city on the otherwise quiet Labor Day weekend… Over the years, tourism has grown… and the need for an event of this scale at this location may no longer be necessary.”

Jay Z asked in his statement, which he released as an op-ed to the website, “How does an administration merely discard an event that generates millions … and employs the city’s people as if we are disposable now that we have served our purpose?”

Some music fans speculated the city might be targeting a hip-hop-heavy lineup. “Roc Nation got a call that the administration wanted to see this year’s lineup,” which Roc Nation refused, a source said. “What does that have to do with the city?”

The Mayor called the issue a “misunderstanding” and said in a statement to Page Six: “The City of Philadelphia supports the Made in America festival and is greatly appreciative of all that it has done for Philadelphia. We are committed to its continued success and thank them for their partnership. We hope to be able to resolve what has been an unfortunate misunderstanding. We are working with Roc Nation and Live Nation to resolve this issue and we are committed to continuing our partnership with the Made in America festival.”

Hidden From View: The Astonishingly High Administrative Costs of U.S. Health Care

It takes only a glance at a hospital bill or at the myriad choices you may have for health care coverage to get a sense of the bewildering complexity of health care financing in the United States. That complexity doesn’t just exact a cognitive cost. It also comes with administrative costs that are largely hidden from view but that we all pay.

Because they’re not directly related to patient care, we rarely think about administrative costs. They’re high.

A widely cited study published in The New England Journal of Medicine used data from 1999 to estimate that about 30 percent of American health care expenditures were the result of administration, about twice what it is in Canada. If the figures hold today, they mean that out of the average of about $19,000 that U.S. workers and their employers pay for family coverage each year, $5,700 goes toward administrative costs.

Such costs aren’t all bad. Some are tied up in things we may want, such as creating a quality improvement program. Others are for things we may dislike — for example, figuring out which of our claims to accept or reject or sending us bills. Others are just necessary, like processing payments; hiring and managing doctors and other employees; or maintaining information systems.

That New England Journal of Medicine study is still the only one on administrative costs that encompasses the entire health system. Many other more recent studies examine important portions of it, however. The story remains the same: Like the overall cost of the U.S. health system, its administrative cost alone is No. 1 in the world.

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Using data from 2010 and 2011, one study, published in Health Affairs, compared hospital administrative costs in the United States with those in seven other places: Canada, England, Scotland, Wales, France, Germany and the Netherlands.

At just over 25 percent of total spending on hospital care (or 1.4 percent of total United States economic output), American hospital administrative costs exceed those of all the other places. The Netherlands was second in hospital administrative costs: almost 20 percent of hospital spending and 0.8 percent of that country’s G.D.P.

At the low end were Canada and Scotland, which both spend about 12 percent of hospital expenditures on administration, or about half a percent of G.D.P.

Hospitals are not the only source of high administrative spending in the United States. Physician practices also devote a large proportion of revenue to administration. By one estimate, for every 10 physicians providing care, almost seven additional people are engaged in billing-related activities.

It is no surprise then that a majority of American doctors say that generating bills and collecting payments is a major problem. Canadian practices spend only 27 percent of what U.S. ones do on dealing with payers like Medicare or private insurers.

Another study in Health Affairs surveyed physicians and physician practice administrators about billing tasks. It found that doctors spend about three hours per week dealing with billing-related matters. For each doctor, a further 19 hours per week are spent by medical support workers. And 36 hours per week of administrators’ time is consumed in this way. Added together, this time costs an additional $68,000 per year per physician (in 2006). Because these are administrative costs, that’s above and beyond the cost associated with direct provision of medical care.

In JAMA, scholars from Harvard and Duke examined the billing-related costs in an academic medical center. Their study essentially followed bills through the system to see how much time different types of medical workers spent in generating and processing them.

At the low end, such activities accounted for only 3 percent of revenue for surgical procedures, perhaps because surgery is itself so expensive. At the high end, 25 percent of emergency department visit revenue went toward billing costs. Primary care visits were in the middle, with billing functions accounting for 15 percent of revenue, or about $100,000 per year per primary care provider.

“The extraordinary costs we see are not because of administrative slack or because health care leaders don’t try to economize,” said Kevin Schulman, a co-author of the study and a professor of medicine at Duke. “The high administrative costs are functions of the system’s complexity.”

Costs related to billing appear to be growing. A literature review by Elsa Pearson, a policy analyst with the Boston University School of Public Health, found that in 2009 they accounted for about 14 percent of total health expenditures. By 2012, the figure was closer to 17 percent.

One obvious source of complexity of the American health system is its multiplicity of payers. A typical hospital has to contend not just with several public health programs, like Medicare and Medicaid, but also with many private insurers, each with its own set of procedures and forms (whether electronic or paper) for billing and collecting payment. By one estimate, 80 percent of the billing-related costs in the United States are because of contending with this added complexity.

Read More:https://www.nytimes.com/2018/07/16/upshot/costs-health-care-us.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news

Kendrick Lamar and SZA Call “All the Stars” Lawsuit an “Overreach”

Kendrick Lamar and SZA are calling BS on a copyright infringement lawsuit. Back in February, British-Liberian artist Lina Iris Viktor sued the TDE artists over the official music video for “All the Stars.” The artist claimed the visual—directed by Dave Meyers and the Little Homies—featured elements of her gold-patterned work, and therefore infringed on her copyright.

“Why would they do this?” Viktor told the New York Times earlier this year. “It’s an ethical issue […] Cultural appropriation is something that continually happens to African-American artists, and I want to make a stand.”

Viktor is currently suing for damages as well as a cut of “All the Stars” profits; however, Kendrick and SZA’s legal team insist the artist’s lawsuit is “the epitome of litigation overreach.”

According to legal documents obtained by Pitchfork, the defendants argue that the music video did not use stolen elements from Viktor’s work; and even if it did, the art had no effect on the record’s massive success.

Their motion reads in part:

Common sense and logic dictate that the alleged 19-second use of the Artwork in the Video is far more speculative (and, in any event, no less speculative) a reason for people’s decisions to stream or buy the Single or Album […] Any attempt by Plaintiff to tie such decisions to the alleged use is especially suspect due to the added uncertainty as to whether people who play the Video actually watch it instead of just listening to the audio, and, if they do watch, whether they do so until the final minute when the alleged use occurs.

The document goes on to list Kendrick’s and SZA’s accolades, insisting their popularity and talent is what led “All the Stars” to become so profitable—not the alleged stolen art. They also argue that Viktor’s claim for reputation damages should be dismissed.

Viktor’s attorney responded to the motion with the following statement: “The defendants have filed a motion for partial summary judgment asking the Court to preclude indirect damages, i.e. damages for defendants’ profits from the sale of the single and the album attributable to the infringement in the music video. We have been expecting this motion and we are confident that the law on this issue is in our favor.”

SOURCE:https://www.complex.com/music/2018/07/kendrick-lamar-sza-request-all-stars-lawsuit-dismissed

Two-thirds of people banned from BART are black — and agency isn’t asking why

Two-thirds of the people BART banished from its property last year were black, and a committee the agency set up to monitor potential civil rights violations in the unique exclusion program isn’t scrutinizing the racial disparity.

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BART banned more people from the system in 2017 than in previous years in an effort to protect riders and employees. Agency officials say the use of these prohibition orders — which last from one month to a year — has paid off.The program, though, is booting black people from trains and stations at far higher rates than others, raising concerns about racial profiling.Of the 315 people barred from the Bay Area’s backbone transit system last year, 209, or 66 percent, were identified by police officers as black, according to BART data. Fifteen percent were identified as white and 12.5 percent as Latino.

A 2015 BART survey of weekday customers, the latest available, found that 12 percent were black, 44 percent were white, 23 percent were Asian or Pacific Islander, and 18 percent were Hispanic.

Ben Carson vs. the Fair Housing Act

27STATE1-superJumboThe contempt of the housing and urban development secretary, Ben Carson, for the Fair Housing Act of 1968 has blinded him to policies that are in the nation’s best interest, and made him a prime target for lawsuits and court intervention. Last year, for example, the Federal District Court in Washington stopped the Department of Housing and Urban Development from derailing an Obama-era program that helps low-income families receiving federal assistance to find homes in middle-class communities with good schools, transportation and jobs. Now, the court would be wise to bar HUD from shelving another set of rules — those that require communities to analyze segregation and submit plans for remedying it as a condition for drawing down billions of dollars in federal aid.

new lawsuit filed by fair housing groups shows that HUD’s decision last January to suspend the segregation rule — in the absence of notice, public consultation or even plausible explanation — violates federal law. If the suspension is allowed to stand, it will essentially vacate federal oversight of as much as $5.5 billion a year in development money that is being parceled out to nearly 1,000 jurisdictions around the country. Freed from federal scrutiny, jurisdictions with proven histories of using federal money to confine low-income families in impoverished, racially isolated areas would be free to carry on business as usual. The Fair Housing Act, which turned 50 last month, was meant to solve America’s segregation problem by requiring state and local governments that accepted federal aid to “affirmatively further” fair housing goals — which meant making credible efforts to roll back segregation, which the federal government itself had fostered through discriminatory mortgage policies. But elected officials from both parties sold out that promise, allowing state and local officials to continue policies that sustained even egregious forms of segregation without fear of losing access to federal dollars. Governments that received federal aid were required only to produce vague, nonbinding analyses of “impediments” to fair housing. These were essentially filed away and had no real impact on housing development decisions.

The Obama administration wrestled with this issue in a legally prescribed rule-making process that lasted several years and involved extensive consultation with stakeholders. The rule, which became effective in 2015, defined compliance with the “affirmatively furthering” provision of the Fair Housing Act as “replacing segregated living patterns with truly integrated and balanced living patterns, transforming racially and ethnically concentrated areas of poverty into areas of opportunity, and fostering and maintaining compliance with civil rights and fair housing laws.”

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Marijuana sellers plan big parties as California pot legalization begins

7W4TV6V23ZFBJOX2N7Z5A4UJVQLive music. Free T-shirts. A “Fweedom” celebration with mystery prize boxes worth up to $500, and a shot at a behind-the-scenes tour. Marijuana legalization arrives Monday in California with lots of hoopla, but only a handful of cities will initially have retail outlets ready to sell recreational pot. By Thursday afternoon, California had issued only 42 retail licenses. Another 150 applications were pending, and regulators planned to work a second straight weekend to review them. Los Angeles and San Francisco were late to approve local regulations, meaning no recreational pot shops there will open their doors Monday.

The lucky few outlets with licenses — mainly in San Diego, the Bay Area, the Palm Springs area and Santa Cruz — think they have an edge being first out of the gate.

But excitement about California joining the growing list of states and Washington, D.C., with legal recreational weed is tempered with the stresses of ensuring shelves are stocked in the face of uncertain demand. The state issued its first 20 retail licenses two weeks ago and an additional 22 have trickled out since, some for already established medical marijuana businesses that have thrived in California for two decades and will continue.

Alex Traverso, a spokesman for the California Bureau of Cannabis Control, said a dozen employees were vetting applications to “issue as many licenses as we can” in the coming days.

The temporary permits represent just a sliver of the thousands of licenses expected to eventually be issued for retail recreational sales. Local permits are a prerequisite for the state licenses, and many cities — including Los Angeles, San Francisco and Long Beach — have yet to issue any local rules, putting huge swaths of the state on the sidelines for opening day. The Palm Springs area had nine of the state’s first retail licenses, including seven in Cathedral City, population 54,000.

San Diego had eight. Santa Cruz and San Jose had four each, and others were scattered around the Bay Area and the state’s northern reaches. An outlet known as Caliva in San Jose is promoting the “Fweedom” celebration Monday with the prize boxes and exclusive tours of its growing areas, along with massages, acupuncture, waffle desserts and music with “mellow beats.”

A county supervisor will attend a 7 a.m. ribbon-cutting ceremony at Kind Peoples in Santa Cruz. Its chief executive, Khalil Moutawakkil, said pot has long been “a huge part” of the culture of the oceanfront college town.

Berkeley Patients Group, which opened as a medical marijuana dispensary in 1999 and has received a permit for recreational sales, expects lines around the block to mark opening day. The mayor of the city is expected at a ribbon-cutting ceremony at 6 a.m.

“You’ll see the people who have been consumers for decades and they were for legalization back in the ’60s,” said Sean Luse, chief operating officer. “But you’re also going to see a more mainstream group of people who were waiting for the green light.”

Harborside is planning brass bands at its locations in Oakland and San Jose, with flags and T-shirts for the first 100 people in line.

A few outlets with recreational licenses are passing on the hoopla.

For them, excitement at being first out of the gate is tempered with the stresses of complying with new regulations. Golden State Greens, with a modest storefront amid car repair shops and budget hotels in San Diego, houses a bustling business that has sold marijuana for medical purposes since 2015. It will open its doors at 7 a.m. Monday, like it does every other day of the year.

After California voters approved recreational weed last year, the shop changed its name from Point Loma Patients Consumer Cooperative, reflecting its ambitions for a broader clientele. “We’re planning for the worst and hoping for the best,” said Adam Knopf, its chief executive. “There are a lot of unknown factors but we’re prepared.”

Gary Cherlin, chief executive of Desert Organic Solutions Collective in North Palm Springs, received holiday news of his recreational sales permit as he devised promotional packages with hotels aimed at tourists who come for warm winters. He said being among the first shops to sell recreational pot means less competition.

“I don’t know how many more are coming but they don’t have a lot of time left,” he said.

Mount Shasta Patients Collective, which opened three years ago in the northern part of the state as a medical dispensary, has already turned away people coming for recreational pot.

Others with medical marijuana cards have been stocking up ahead of price increases expected after recreational weed is legal.

“We’ll have all hands on deck,” general manager Austin Freeman said of opening day. “It could be really hectic.”