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How A Deregulated Internet Could Hurt America’s Classrooms

714f2_loading-net-neutrality_slide-5e18f3e6c8718b709e9134226a0b31d339b2e219-s1100-c15 How A Deregulated Internet Could Hurt America's Classrooms

Schools across the country are nervously watching to see if the Federal Communications Commission chooses to repeal Obama-era regulations that protect an open internet, often referred to as “net neutrality.”

The 2015 rules are meant to prevent internet providers, such as Comcast, ATT and Verizon, from controlling what people can watch and see on the internet. Companies can’t block access to any websites or apps, and can’t meddle with loading speeds.

Educators rely heavily on technology in the classroom, so the repeal vote — expected Thursday — could dramatically impact the way students learn.

“One of the key elements of the internet is that it provides immediate access to a huge range of high-quality resources that are really useful to teachers,” says Richard Culatta, CEO of the International Society for Technology in Education. He previously led the Department of Education’s Office of Educational Technology during the Obama administration.

“But when carriers can choose to prioritize paid content over freely available content, schools really are at risk,” he says.

In Virginia, fifth-grade teacher Molly Fuller uses the internet with students struggling in math to help reinforce the skills they need online. They can play math-based computer games, or see a digital diagram of a math problem broken down. She also uses computers to teach her students how to find good sources versus bad sources.

“We’re trying to teach them those real-world skills,” she says. Repealing the current regulations, she says, “it’s going to really hinder their ability to learn.”

Kristin Ziemke, teaches third-graders in Chicago and says internet access allows her students to collaborate and interact with experts on topics they are passionate about.

She belongs to The Educators Collaborative — a group of educators that organize online and share innovative lesson plans that incorporate the internet. She helped that organization craft a note for their website in support of net neutrality.

“We believe that under the current FCC designation, the internet is more free and open,” the statement said. “This allows educators, students, and families access to information, apps, websites, and videos they feel will best support learning, creative thinking, and informed citizenship.”

“When we look at technology in our lives,” Ziemke says, “this is going to cause a huge shift in schools.”

She says a byproduct of rolling back the regulations will be a decrease in creativity for all students — and for those in low-income districts — she’s worried they’ll lack access to information.

Studies have shown discrepancies in access to internet, especially with poor schools and in rural schools that lack high-speed internet. The federal E-Rate program, which helps eligible schools and libraries have affordable access to phone and internet services, was redesigned and refunded just last year helped try and patch that gap.

Now 94 percent of school districts in the U.S. have access to high-speed internet and more than 118,000 school and libraries use the E-rate program.

“The internet for the first time leveled that playing field because it didn’t matter if you were in a wealthy school or an under resourced school,” says Culatta.

But still — there are lasting divides — not all students have access to high speed internet. A recent Pew Research study found that 5 million, most low income, school-aged children do not have access to broadband internet connection.

Some Democrats in the Senate are worried that deregulation of net neutrality will widen inequity.

And it’s not just teachers that are concerned about the FCC’s decision. Librarians across the country have also raised concerned over access.

“We depend increasingly on access to the internet for purpose of research, for purpose of learning.” says Jim Neal, President of the American Library Association.

The repeal of the regulations will be devastating to low-income communities that rely on public libraries to access information, he says. Libraries offer community members without home internet a place to search for health information, apply for jobs, even pay their bills. they also serve students — who use computers to do research for projects or homework.

“This could undermine the quality of the education that our students are receiving,” Neal says.

Librarians who work on college campuses say net neutrality is vital for students who rely heavily on research.

“The internet is essential to all our functions,” says Katherine Ahnberg, an academic librarian at the University of Pennsylvania “We teach students how to critically analyze information they come across.”

The FCC is set to vote at 10:30 a.m. EST on Thursday.

Editor’s Note: NPR’s legal counsel has filed comments with the FCC on the net neutrality proposal, in opposition to deregulation. You can read them here.

Generation at risk: America’s youngest facing mental health crisis

Alex Crotty was just 11 when things started feeling wrong.

It wasn’t just a matter of being unhappy. She always felt empty and miserable — never content or connected to other children. For years, she suffered alone, filled with shame. She switched schools, but that didn’t help.

d0faa_tdy_health_cynthia_anxiety_171212_1920x1080.today-inline-vid-featured-desktop Generation at risk: America's youngest facing mental health crisis

“I didn’t feel unloved. I just felt numb to the world. Like, I was surrounded by great things, but just I couldn’t be happy. And I didn’t know why that was,” Alex told NBC News.

Finally, at 14, she decided to break her silence. “I can’t feel anything,” Alex simply told her mother, Heather Olson of New York. “So she just gave me a hug, cradled me in her arms on the bed, and was like, ‘Well can you feel me? Can you feel my love?'”

“A hug and kisses was the only thing that came to mind at the spur of the moment, but that was precisely what she needed to start the journey forward,” Olson said.

Alex was diagnosed with major depression and anxiety. Now 16, she is in therapy and on medication. She’s far from alone.

d0faa_tdy_health_cynthia_anxiety_171212_1920x1080.today-inline-vid-featured-desktop Generation at risk: America's youngest facing mental health crisisCourtesy Heather Olson

There is an acute health crisis happening among members of the youngest generation of Americans, with critical implications for the country’s future.

The Centers for Disease Control and Prevention reports that 1 in 5 American children ages 3 through 17 — about 15 million — have a diagnosable mental, emotional or behavioral disorder in a given year.

Only 20 percent of these children are ever diagnosed and receive treatment; 80 percent — about 12 million — aren’t receiving treatment.

d0faa_tdy_health_cynthia_anxiety_171212_1920x1080.today-inline-vid-featured-desktop Generation at risk: America's youngest facing mental health crisis

Recent research indicates that serious depression is worsening in teens, especially girls, and the suicide rate among girls reached a 40-year high in 2015, according to a CDC report released in August.

“Child and adolescent mental health disorders are the most common illnesses that children will experience under the age of 18. It’s pretty amazing, because the number’s so large that I think it’s hard to wrap our heads around it,” said Dr. Harold Koplewicz, founding president of The Child Mind Institute, a nonprofit children’s mental health advocacy group.

Over the next few months, NBC Nightly News will examine the state of American children’s mental health, including reports on what has led to this increase — especially in anxiety and depression — treatment obstacles, promising research and innovative programs to help children.

Is your toddler depressed?

Mental health problems may actually start much earlier than previously thought.

A toddler who is crying for hours and angrily stomping his or her feet may not be having a temper tantrum, but showing signs of depression. Research suggests that 1 percent to 2 percent of children 2 to 5 years old have depression, said Dr. Joan Luby, director of the Early Emotional Development program at the Washington University School of Medicine in St. Louis and a pioneer in the study of the condition in preschoolers.

She believes untreated depression in toddlers can lead to more depression later in life.

“Young children are more cognitively sophisticated, more emotionally sophisticated, than we previously understood. They have complex emotions. They’re aware of emotions in their environment. They feel emotions like guilt,” Luby said. “They have all the prerequisites of what depressive symptoms are.”

d0faa_tdy_health_cynthia_anxiety_171212_1920x1080.today-inline-vid-featured-desktop Generation at risk: America's youngest facing mental health crisis

That may show up as constant sadness and low self-esteem. A child may not want to play with a favorite toy or with friends over a sustained period of time.

Vickey Harper of St. Louis became worried when her 2-year-old daughter, Myla, began having “scary” tantrums that sometimes lasted almost an hour. The girl would scream, kick and hit her mother in the face.

“My gut was just telling me that something was not right,” Harper said. Mental illness runs in the family, but she was surprised when doctors suggested Myla had depression.

The girl is taking part in Luby’s research to see whether early intervention can make a difference. Parents are coached on how to play with and respond to their kids — exercises meant to help kids recognize their emotions, like being sad, angry or nervous. The hope is that will help them learn to control those feelings and “change a lifelong trajectory,” or prevent episodes of depression later in life, Luby said.

Now, Myla’s long tantrums are gone.

“She is not the same kid that walked into those therapy sessions,” Harper said. “She can tell me when she’s feeling something. She still yells sometimes, but it’s on a much smaller scale.”

Why adolescents are so vulnerable

Teens are known for their moodiness, and adolescence — a particularly turbulent time of life — is one of the most vulnerable periods to develop anxiety and depression. About 50 percent of cases of mental illness begin by age 14, according to the American Psychiatric Association. A tendency to develop depression and bipolar disorder nearly doubles from age 13 to age 18.

But for teens like Alex Crotty, depression is very different from adolescent angst, Koplewicz said.

“Teenagers have a different kind of depression. They don’t seem sad. They seem irritable,” he said. “This really has an effect on your concentration, which will affect school. It will affect your desire to continue playing sports. It’ll affect your desire of being with your friends.”

d0faa_tdy_health_cynthia_anxiety_171212_1920x1080.today-inline-vid-featured-desktop Generation at risk: America's youngest facing mental health crisis

Warning signs also include the duration and the degree of symptoms, he said. Take notice if your teen is experiencing moodiness or irritability for more than two weeks and it’s occurring every day, for most of the day, and if you see a change in sleep patterns and a change in desire to work and socialize.

Teenagers also think about suicide more often — and 5,000 young people take their own lives every year in the United States, Koplewicz added.

For years, Alex was too scared to reach out for help because she thought that if she told her parents about her depression, they wouldn’t believe her or they would overreact and send her to a “psych ward,” she said.

It’s why The Child Mind Institute is collecting brain scans from 10,000 children and teens, hoping to identify biological markers of psychiatric illness. The project could improve the diagnosis and treatment of mental disorders.

After medication and therapy, Alex is doing great.

“I am so much stronger after coming out of this,” she said, urging other kids to speak up. “If you always feel like something’s wrong, talk to somebody. If you feel like you’re blaming things on yourself all the time, talk to somebody. Just if things don’t feel good, talk to somebody.”

America’s healthiest and least healthy states

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Generation at risk: America’s youngest facing mental health crisis …

Alex Crotty was just 11 when things started feeling wrong.

It wasn’t just a matter of being unhappy. She always felt empty and miserable — never content or connected to other children. For years, she suffered alone, filled with shame. She switched schools, but that didn’t help.


7c546_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis ...


“I didn’t feel unloved. I just felt numb to the world. Like, I was surrounded by great things, but just I couldn’t be happy. And I didn’t know why that was,” Alex told NBC News.

Finally, at 14, she decided to break her silence. “I can’t feel anything,” Alex simply told her mother, Heather Olson of New York. “So she just gave me a hug, cradled me in her arms on the bed, and was like, ‘Well can you feel me? Can you feel my love?'”

“A hug and kisses was the only thing that came to mind at the spur of the moment, but that was precisely what she needed to start the journey forward,” Olson said.

7c546_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis ...


7c546_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis ...

Alex was diagnosed with major depression and anxiety. Now 16, she is in therapy and on medication. She’s far from alone.

There is an acute health crisis happening among members of the youngest generation of Americans, with critical implications for the country’s future.

7c546_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis ...


7c546_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis ...

The Centers for Disease Control and Prevention reports that 1 in 5 American children ages 3 through 17 — about 15 million — have a diagnosable mental, emotional or behavioral disorder in a given year.

Only 20 percent of these children are ever diagnosed and receive treatment; 80 percent — about 12 million — aren’t receiving treatment.

Recent research indicates that serious depression is worsening in teens, especially girls, and the suicide rate among girls reached a 40-year high in 2015, according to a CDC report released in August.

Related: Anxiety, irritability may be first warning signs of depression in kids

“Child and adolescent mental health disorders are the most common illnesses that children will experience under the age of 18. It’s pretty amazing, because the number’s so large that I think it’s hard to wrap our heads around it,” said Dr. Harold Koplewicz, founding president of The Child Mind Institute, a nonprofit children’s mental health advocacy group.

Over the next few months, NBC Nightly News will examine the state of American children’s mental health, including reports on what has led to this increase — especially in anxiety and depression — treatment obstacles, promising research and innovative programs to help children.

Related: Generation at risk: Children at center of America’s opioid crisis

Is your toddler depressed?

Mental health problems may actually start much earlier than previously thought.

A toddler who is crying for hours and angrily stomping his or her feet may not be having a temper tantrum, but showing signs of depression. Research suggests that 1 percent to 2 percent of children 2 to 5 years old have depression, said Dr. Joan Luby, director of the Early Emotional Development program at the Washington University School of Medicine in St. Louis and a pioneer in the study of the condition in preschoolers.

She believes untreated depression in toddlers can lead to more depression later in life.

“Young children are more cognitively sophisticated, more emotionally sophisticated, than we previously understood. They have complex emotions. They’re aware of emotions in their environment. They feel emotions like guilt,” Luby said. “They have all the prerequisites of what depressive symptoms are.”

That may show up as constant sadness and low self-esteem. A child may not want to play with a favorite toy or with friends over a sustained period of time.

7c546_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis ...


7c546_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis ...

Vickey Harper of St. Louis became worried when her 2-year-old daughter, Myla, began having “scary” tantrums that sometimes lasted almost an hour. The girl would scream, kick and hit her mother in the face.

“My gut was just telling me that something was not right,” Harper said. Mental illness runs in the family, but she was surprised when doctors suggested Myla had depression.

The girl is taking part in Luby’s research to see whether early intervention can make a difference. Parents are coached on how to play with and respond to their kids — exercises meant to help kids recognize their emotions, like being sad, angry or nervous. The hope is that will help them learn to control those feelings and “change a lifelong trajectory,” or prevent episodes of depression later in life, Luby said.

Now, Myla’s long tantrums are gone.

“She is not the same kid that walked into those therapy sessions,” Harper said. “She can tell me when she’s feeling something. She still yells sometimes, but it’s on a much smaller scale.”

Why adolescents are so vulnerable

Teens are known for their moodiness, and adolescence — a particularly turbulent time of life — is one of the most vulnerable periods to develop anxiety and depression. About 50 percent of cases of mental illness begin by age 14, according to the American Psychiatric Association. A tendency to develop depression and bipolar disorder nearly doubles from age 13 to age 18.

But for teens like Alex Crotty, depression is very different from adolescent angst, Koplewicz said.

“Teenagers have a different kind of depression. They don’t seem sad. They seem irritable,” he said. “This really has an effect on your concentration, which will affect school. It will affect your desire to continue playing sports. It’ll affect your desire of being with your friends.”

Related: Suicides in teen girls hit 40-year high

Warning signs also include the duration and the degree of symptoms, he said. Take notice if your teen is experiencing moodiness or irritability for more than two weeks and it’s occurring every day, for most of the day, and if you see a change in sleep patterns and a change in desire to work and socialize.

Teenagers also think about suicide more often — and 5,000 young people take their own lives every year in the United States, Koplewicz added.


7c546_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis ...


For years, Alex was too scared to reach out for help because she thought that if she told her parents about her depression, they wouldn’t believe her or they would overreact and send her to a “psych ward,” she said.

It’s why The Child Mind Institute is collecting brain scans from 10,000 children and teens, hoping to identify biological markers of psychiatric illness. The project could improve the diagnosis and treatment of mental disorders.

After medication and therapy, Alex is doing great.

“I am so much stronger after coming out of this,” she said, urging other kids to speak up. “If you always feel like something’s wrong, talk to somebody. If you feel like you’re blaming things on yourself all the time, talk to somebody. Just if things don’t feel good, talk to somebody.”

Generation at risk: America’s youngest facing mental health crisis

Alex Crotty was just 11 when things started feeling wrong.

It wasn’t just a matter of being unhappy. She always felt empty and miserable — never content or connected to other children. For years, she suffered alone, filled with shame. She switched schools, but that didn’t help.


d832c_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis


“I didn’t feel unloved. I just felt numb to the world. Like, I was surrounded by great things, but just I couldn’t be happy. And I didn’t know why that was,” Alex told NBC News.

Tune in to NBC Nightly News Sunday night for more

Finally, at 14, she decided to break her silence. “I can’t feel anything,” Alex simply told her mother, Heather Olson of New York. “So she just gave me a hug, cradled me in her arms on the bed, and was like, ‘Well can you feel me? Can you feel my love?’”

“A hug and kisses was the only thing that came to mind at the spur of the moment, but that was precisely what she needed to start the journey forward,” Olson said.

d832c_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis


d832c_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis

Alex was diagnosed with major depression and anxiety. Now 16, she is in therapy and on medication. She’s far from alone.

There is an acute health crisis happening among members of the youngest generation of Americans, with critical implications for the country’s future.

d832c_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis


d832c_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis

The Centers for Disease Control and Prevention reports one in five American children, ages 3 through 17 — some 15 million — have a diagnosable mental, emotional or behavioral disorder in a given year.

Only 20 percent of these children are ever diagnosed and receive treatment; 80 percent — some 12 million — are not receiving treatment.

Recent research indicates serious depression is worsening in teens, especially girls and the suicide rate among girls reached a 40-year high in 2015, according to a CDC report released in August.

Related: Anxiety, irritability may be first warning sign of depression in kids

“Child and adolescent mental health disorders are the most common illnesses that children will experience under the age of 18. It’s pretty amazing because the number’s so large that I think it’s hard to wrap our heads around it,” said Dr. Harold Koplewicz, founding president of The Child Mind Institute.

Over the next few months, NBC Nightly News will examine the state of American children’s mental health, including reports on what has led to this increase — especially in anxiety and depression — treatment obstacles, promising research and innovative programs to help children.

Related: Generation at risk: Children at center of America’s opioid crisis

Is your toddler depressed?

Mental health problems may actually start much earlier than previously thought.

A toddler who is crying for hours and angrily stomping his feet may not be having a temper tantrum, but showing signs of depression. Research suggests 1 to 2 percent of children 2 to 5 years old have depression, said Dr. Joan Luby, director of the Early Emotional Development program at the Washington University School of Medicine in St. Louis and a pioneer in the study of the condition in preschoolers.

She believes untreated depression in toddlers can lead to more depression later in life.

“Young children are more cognitively sophisticated, more emotionally sophisticated than we previously understood. They have complex emotions. They’re aware of emotions in their environment. They feel emotions like guilt,” Luby said. “They have all the prerequisites of what depressive symptoms are.”

That may show up as constant sadness and low self-esteem. A child may not want to play with a favorite toy or her friends over a sustained period of time.

d832c_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis


d832c_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis

Vickey Harper of St. Louis became worried when her 2-year-old daughter Myla began having “scary” tantrums that sometimes lasted almost an hour. The girl would scream, kick and hit her mother in the face.

“My gut was just telling me that something was not right,” Harper said. Mental illness runs in the family, but she was surprised when doctors suggested Myla had depression.

The girl is taking part in Luby’s research to see if early intervention can make a difference. Parents are coached on how to play with and respond to their kids — exercises meant to help kids recognize their emotions, like being sad, angry or nervous. The hope is that will help them learn to control those feelings and “change a lifelong trajectory,” or prevent episodes of depression later in life, Luby said.

Now, Myla’s long tantrums are gone.

“She is not the same kid that walked into those therapy sessions,” Harper said. “She can tell me when she’s feeling something. She still yells sometimes, but it’s on a much smaller scale.”

Why adolescents are so vulnerable

Teens are known for their moodiness, and adolescence — a particularly turbulent time of life — is actually one of the most vulnerable periods to develop anxiety and depression. Some 50 percent of cases of mental illness begin by age 14, according to the American Psychiatric Association. A prevalence to develop depression and bipolar disorder nearly doubles from age 13 to age 18.

But for teens like Alex Crotty, depression is very different than adolescent angst, Koplewicz said.

“Teenagers have a different kind of depression. They don’t seem sad, they seem irritable,” he noted. “This really has an effect on your concentration, which will affect school; it will affect your desire to continue playing sports, it’ll affect your desire of being with your friends.”

Related: Suicides in teen girls hit 40-year high

Warning signs also include the duration and the degree of symptoms, he said. Take notice if your teen is experiencing moodiness or irritability for more than two weeks and it’s occurring every day, for most of the day, plus you see a change in sleep patterns and a change in desire to work and socialize.

Teenagers also think about suicide more often — and 5,000 young people actually take their own lives every year in the U.S., Koplewicz added.


d832c_toddler_sot_for_digital.nbcnews-ux-1080-600 Generation at risk: America's youngest facing mental health crisis


For years, Alex was too scared to reach out for help because she thought that if she told her parents about her depression, they wouldn’t believe her or overreact and send her to a “psych ward,” she said.

It’s why The Child Mind Institute is collecting brain scans from 10,000 children and teens, hoping to identify biological markers of psychiatric illness. The project could improve the diagnosis and treatment of mental disorders.

After medication and therapy, Alex is doing great.

“I am so much stronger after coming out of this,” she said, urging other kids to speak up. “If you always feel like something’s wrong, talk to somebody. If you feel like you’re blaming things on yourself all the time, talk to somebody. Just if things don’t feel good, talk to somebody.”

Innovation is key to solving America’s health-care problems

<!– –>


81fc0_104693972-GettyImages-127871289-biotech.530x298 Innovation is key to solving America's health-care problems

Medical technology innovation

In the last 30 years, breakthroughs in medical technology have transformed the treatment of cardiovascular disease with implantable defibrillators and drug-coated stents, of Type I diabetes with the sensor-based pumps and the advent of the artificial pancreas, and of spine, hip and knee surgery with implantable prostheses. Now, advancements in medical technology are addressing debilitating neurological diseases like Parkinson’s, incontinence and sleep apnea. With investment and imagination, the future of medical technology to help people seems almost unlimited.

Breakthrough drugs

Decades of scientific investment in genetics, genomics and proteomics have led to treating the immune system as the most promising way to cure cancer and other debilitating diseases. Breakthroughs in personalized medicine like immunotherapy and CAR-T therapy hold the potential for genuine cures, not just palliative treatments.

To make these high-priced treatments more affordable, they should be offered on a sliding scale based on ability to pay. Meanwhile, a wider array of generic drugs should be approved for traditional drugs such as statins to lower the overall cost of drug therapy. In addition, the multiple layers of drug distribution should be creatively disintermediated by direct-to-consumer approaches, thus dramatically cutting the overall cost of drug therapy.

Innovation in health-care delivery

In recent years, focus on health-care delivery has been making doctors and hospitals more efficient, leading to shortening appointments to less than 10 minutes — only enough time to issue a prescription without thorough diagnosis — often creating misdiagnosis and excessive drug use. Instead, we need to rethink the entire health-care delivery system by changing the basic model of one-to-one physician-patient interaction in a traditional health care institution by providing health care in community centers, YMCAs and retail centers like MinuteClinic (now owned by CVS), using nurses, allied health professionals and group classes.

Hospitals need to undergo massive consolidation to ensure that severe diseases and complex treatments can be carried out in the highest-volume centers that will lead to improved outcomes at lower costs. This will require clear movement away from fee-for-service to innovative health plans covering total costs with people having a fiscal stake in their health.

Innovative use of information

Health care’s information technology is woefully inadequate. From inability to match patient records with claims data to inadequate cost accounting data to poor transparency of prices to consumers, health care has been unable to provide even the basics of information. Now, however, opportunities to use the internet to connect patients and their basic information like EKGs to their physicians and health-care teams, along with artificial intelligence and big data married with patient data, offer entirely new fields for innovation, improved diagnosis, treatment and after-care.

Leading healthy lives

This fifth category of innovation – leading healthy lives – holds the greatest promise of all, as self-care becomes the new primary care. It is well known that unhealthy life styles account for 50 to 70 percent of health-care costs. For example, America’s obesity epidemic is the leading cause of Type II diabetes, heart disease, and spine, hip and knee issues. Yet instead of focusing on enabling people to lead healthy lives, we concentrate downstream on those who are sick and extremely ill to the point of nonrecovery.

To enable Americans to lead healthy lives, we should focus on three basic areas: 1) eating healthy, 2) physical fitness, and 3) stress reduction. How can innovation change life styles? Let’s look at some examples:

  1. Eating healthy. Innovative food and beverage companies, such as Boulder Brands and Suja Juice are transforming eating and drinking habits along with products like Earth Balance all-natural spreads, Udi’s gluten-free cereals and baked goods, and organic juices.
  2. Physical fitness. A relatively simple device like Fitbit has become transformative in changing people’s behavior by walking at least 10,000 steps per day or exercising in Lifetime Fitness clubs that focus on healthy living.
  3. Stress reduction. The mindfulness movement is revolutionizing daily behaviors that reduce stress through myriad mindfulness practices. Don’t know how to meditate? Innovative on-line products like Headspace provide guided meditation sessions and mindfulness training.

Today, the usage of these products is heavily concentrated among the middle and upper social-economic classes. The key now is to get them as ubiquitous as mobile phones by offering them in local communities and at lower prices.

For decades, American health-care systems have been mired in trying to become more efficient with essentially the same methods. What is needed to transform health care’s broken system is much more radical transformation that these innovations can bring. Rather than looking for political solutions to a broken system, the focus must shift to innovation to create more radical approaches that create entirely new systems.

Commentary by Bill George, a senior fellow at Harvard Business School, former chairman and CEO of Medtronic, and the author of “Discover Your True North.” He is a CNBC contributor. Follow him on Twitter @Bill_George.

For more insight from CNBC contributors, follow

@CNBCopinion

on Twitter.

81fc0_104693972-GettyImages-127871289-biotech.530x298 Innovation is key to solving America's health-care problems



J-PAL North America calls for proposals from governments and health care organizations

Topics: SHASS, Abdul Latif Jameel Poverty Action Lab (J-PAL), Government, Policy, Poverty, Cities, Health care, Political science, Research, Grants, Funding, Social sciences

Renesas Electronics America Highlights End-to-End Solutions for the Internet of Medical Things at BIOMEDevice 2017

SANTA CLARA, Calif.–(BUSINESS WIRE)–Renesas Electronics America Inc., a premier supplier of advanced
semiconductor solutions, today announced it will highlight design
innovation for the Internet of Medical Things (IoMT) at BIOMEDevice
2017
. At booth #421, the company will showcase a variety of
connected medical device technologies that enable device manufacturers
to reduce design risk and accelerate time to market, enabling the
creation of end-to-end connected healthcare and medical products.
BIOMEDevice takes place on December 6-7, 2017, at the San Jose
Convention Center in San Jose, California.

Technology Demonstrations

At booth #421, Renesas Electronics America, along with partners
DeviceLab, HWI, and MedM, will share insights on solutions and
techniques that allow IoMT system developers to take their devices from
prototype to market quickly and effectively.

  • In-Transit Medication Management (ITMM)
    Solution:
    With the introduction of biologic-based drugs,
    expansion of the international drug trade, and new regulations (Drug
    Supply Chain Security Act – DSCSA) requiring stricter oversight of
    drugs during transportation, the pharma supply chain will need to be
    monitored closely in the future. During the show, Renesas will display
    its Renesas ITMM Reference Solution, which showcases the Renesas
    Synergy™ Platform featuring the Synergy S3 and RL78/G1D
    microcontrollers (MCUs). The solution enables data logger
    manufacturers to achieve quick time to market by having:

    • Multiple sensors that can track temperature, humidity, GPS
      location, tampering, shock and pressure
    • Mobile capabilities that allow users to scan the NFC tag, linear,
      or 2D barcode on a medicine package to help identify the medicine
      being tracked
    • Secure, reliable and low-power method for communicating to the
      mobile device
  • Personal Medication Adherence (PMA) Solutions:
    The advent of the IoMT has brought various technologies to the
    forefront that, when applied to PMA devices, can help resolve some of
    the issues we currently face due to medication non-adherence.
    Featuring the Synergy Platform, Renesas will demonstrate how PMA
    solutions can:

    • Verify, remind, log report medicine usage
    • Track medicine environmental exposure
    • Enable caregivers, doctors or pharmacists to engage with the
      patient
  • DeviceLab Apollo™ IoT Hospital Bed:
    Named after the mythological Greek god of healing and medicine,
    the Apollo platform is DeviceLab’s solution to address numerous
    medical industry needs, including rapid development time, longevity in
    product lifecycle, RTOS certification for safety-critical
    applications, and robust processing capability. Featuring a
    full-size translucent mannequin on a custom-designed examination
    table, Apollo™ is integrated in the internal structure of the patient
    bed, simulating monitors, device controls and touchscreen color
    displays and other medical applications.

    Apollo features
    several Renesas solutions to accomplish the platform’s objectives,
    including Renesas
    RZ microprocessors
    , and Synergy
    S7 and S3 MCUs. Renesas technologies are integrated in the Apollo™
    designs with various wireless interfaces for Bluetooth, Wi-Fi and
    cellular.

  • HWI NICE1 Cold + Compression System:
    Advanced cold and compression therapies have proven successful for
    physical rehabilitation environments. The HWI NICE1 Cold + Compression
    System offers an option for athletes who are also exploring solutions
    that deliver precise cold therapy quickly and efficiency to stimulate
    healing. The system circulates cool water in a medical compression
    sleeve, which:

    • Regulates water temperature
    • Controls compression pressure and time of therapy

    The HWI system leverages the Renesas RX63N
    MCU
    with Direct Drive LCD platform, graphics API for easy
    graphics importing, and medical software lifecycle process
    management.

  • MedM Remote Patient Monitoring Platform:
    MedM’s Remote Patient Monitoring (RPM) Platform enables medical device
    manufacturers to design end-to-end solutions allowing healthcare
    professionals to monitor patients’ vitals outside of the clinical
    setting. To achieve a quick path from prototype to productization, the
    MedM platform leverages the Renesas
    Healthcare Meters kit
    featuring the Synergy S3 and RL78/G1D MCUs.
    The BIOMEDevice demonstration will showcase:

    • Activity monitoring, BGM, BPM and SpO2/HRM monitoring
    • Mobile app and cloud-based access to patient vitals data
    • Cloud connectivity via mobile device or MedM gateway

For more information about Renesas’ Medical Device Solutions, stop by
booth #421 at BIOMEDevice 2017.

For more information about Renesas, follow Renesas Electronics America
at @RenesasAmerica on Twitter and https://www.facebook.com/RenesasAmericas/.

About Renesas Electronics America

Renesas Electronics America Inc., a subsidiary of Renesas Electronics
Corporation (TSE:
6723
), delivers trusted embedded design innovation with complete
semiconductor solutions that enable billions of connected, intelligent
devices to enhance the way people work and live—securely and safely. The
number one global
supplier of microcontrollers, and a leader in Analog Power and SoC
products, Renesas provides the expertise, quality, and comprehensive
solutions for a broad range of Automotive, Industrial, Home Electronics
(HE), Office Automation (OA), and Information Communication Technology
(ICT) applications to help shape a limitless future. Learn more at renesas.com.

(Remarks) Renesas Synergy is a trademark of Renesas Electronics
Corporation. Apollo is a trademark of DeviceLab Inc. All other
registered trademarks or trademarks are the property of their respective
owners.

Rural America Is Building High-Speed Internet the Same Way It Built Electricity in the 1930s

From sticking antennae on grain silos to teaching neighborhood teens how to do home installs, it’s fascinating to document all the innovative ways underserved communities are building their own internet. But for many rural areas of America with little or no access to broadband, the answer to closing the digital divide could be something that predates the internet itself.

Electric cooperatives were developed across the US in the 1930s as part of FDR’s New Deal. These not-for-profit organizations received federal subsidies to build out electricity infrastructure to power up rural America. Co-op members pay to join, and pay for their electric usage, but any extra money is reinvested into the co-op, or paid back to members.

Now, many of these co-ops are taking on the digital divide by offering high speed fiber optic internet to the home for their members. As of this year, 60 electric cooperative across the US have started broadband projects, according to a recent policy brief published by the Institute for Local Self-Reliance, a nonprofit that advocates for local solutions for sustainable development.

2995e_blank Rural America Is Building High-Speed Internet the Same Way It Built Electricity in the 1930s

“If you go back five or six years there were five or fewer electric co-ops that were doing fiber internet to businesses and residents,” said Christopher Mitchell, co-author of the paper and the director of community broadband networks for ILSR, in a phone interview. “Now there are 60 and I’m guessing there will be more than 100 by the end of next year.”

Mitchell explained that electric co-ops are uniquely well positioned to start community owned internet projects, because they own all of the infrastructure connecting homes in the area. In many cases, the co-ops are already investing in gigabit fiber loops to keep their systems online, so the only hurdle is sending out fiber to the home.

But that’s not cheap—and the cost is the main reason cited by Big Telecom for why it doesn’t make sense for them to build out to rural communities where there may only be a handful of customers. To cover the cost, some co-ops have opted to apply for grants or one-time subsidies. Others, such as the Co-Mo Electric Co-op in central Missouri, haven’t relied on government funds at all, opting instead to fund the project themselves with the help of a bank loan.

“In our experience, electric cooperatives can build fiber networks in rural areas at population densities of greater than five homes per linear mile without needing any subsidies,” Mitchell said. “Below that, they should get one-time subsidies, but then they can continue to operate the network without needing any further funding.”

Compared with other options like wireless broadband, high-speed fiber to the home delivered by a local electric co-op actually ends up being more affordable in the long-run, according to Mitchell, because the infrastructure doesn’t need to be replaced.

But just as many communities are beginning to jump on the co-op craze, President Trump’s leadership at the Federal Communications Commission could set up roadblocks to co-ops looking to expand to internet. In his move to dismantle net neutrality rules, FCC Chairman Ajit Pai has made it clear he does not consider the internet a utility, which is how these co-ops are treating it, and some of them may be looking to FCC-backed grants, such as the Connect America Fund, to get up and running.

But Mitchell told me even if the FCC is less willing to award funds to co-ops, he still expects this trend to continue, with local communities taking the same approach to the internet as they did to electricity so many years ago.

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America wakes up to the dark side of the internet – Axios

The Senate tax bill would raise only $458 billion in increased revenue from economic growth over the next decade and will increase the deficit by more than $1 trillion, according to the Joint Committee on Taxation. It would increase GDP by .8 percent relative to current law over 10 years.

Why this matters: Republicans, who conventionally are against adding to the federal debt, have been insisting their tax bill pays for itself, and thus they are fine with voting for it. The official government analyst says it doesn’t, but don’t expect that to change any GOP votes that weren’t already in question.

Holiday Helping Hand, Mental Health of America team up to give holiday cheer

CLOSE

The goal of the Holiday Helping Hand Program, a joint project from the Journal and the United Way of the Dutchess County-Orange Region, is to raise funds for local organizations during the holidays. It’s in its 35th year. Video by Jack Howland/Poughkeepsie Journal
Wochit

For Diane Brothers, the holiday season isn’t always the most joyful time of the year. 

“With me being on a fixed income, things were struggling,” the 47-year-old stay-at-home mom said. 

But with the help of gift card from Mental Health America of Dutchess County last year, Brothers said she was able to get her 10-year-old daughter and 17-year-old son gifts: clothes, socks and underwear. 

Holiday Helping Hand raises $1.3M across decades

HELPING HAND: ‘The stress was relieved:’ Easing financial burdens

EDITORIAL: Keep alive the legacy of Holiday Helping Hand

“I was very thankful, and blessed,” the City of Poughkeepsie resident said. “Mental Health of America is a great support system for our community.” 

For those like Brothers, the burden of purchasing Christmas gifts or preparing a holiday feast can make the season less than enjoyable. 

But local families living with the realities of mental illnesses get some financial relief with these gift cards, through the Holiday Helping Hand program. 

“There’s so much pressure in society that everyone needs to have everything,” said Andrew O’Grady, executive director of Mental Health America Dutchess County. “Unfortunately, not everyone can.” 

In its 35th year, Holiday Helping Hand is a is a joint project by the Poughkeepsie Journal and United Way of the Dutchess-Orange Region.

Last year, the program raised $33,650, which this year is funding more than 30 local charitable programs such as holiday dinners, gift giveaways for kids, and assistance with paying everyday necessities like utility bills. 

O’Grady said the $2,000 awarded to Mental Health America this season will go toward purchasing 100 $20 gift cards to both local grocery stores and Toys R’ Us. The cards will go to 75 families, O’Grady said, dependent on each family’s needs. 

“Most of the people we work with live below or at the poverty level,” he said. “These families maybe don’t have the ability to have a good meal, or provide small items for their children.”

Throughout the year, Mental Health of America provides a number of programs, O’Grady said, ranging from a homeless day shelter to family support and individual adult care management, “where we are one-on-one with people in the community who struggle with mental health or addiction issues.” 

“One of the reasons we’ve supported this organization in the past is that they work with a vulnerable population, handling challenges with mental illness and the homeless,” said Melissa Clark, United Way’s regional director of community impact.

Abbott Brant: abrant@poughkeepsiejournal.com; 845-437-4809; Twitter: @AbbottBrantPoJo

How to Donate 

Holiday Helping Hand is a joint project from the Poughkeepsie Journal and the United Way of the Dutchess County-Orange Region that raises money for local charities and organizations that, in turn, host events like holiday dinners, children’s programs and gift card distributions to those in need.

To donate online, go to www.uwdor.org/donate-hhh2017 or mail a check to Holiday Helping Hand, United Way of the Dutchess-Orange Region, 75 Market St., Poughkeepsie, NY 12601. Checks should be made payable to Holiday Helping Hand. All donations will benefit Dutchess County residents. 

 

 

 

Holiday Helping Hand, Mental Health of America team up to give holiday cheer

CLOSE

The goal of the Holiday Helping Hand Program, a joint project from the Journal and the United Way of the Dutchess County-Orange Region, is to raise funds for local organizations during the holidays. It’s in its 35th year. Video by Jack Howland/Poughkeepsie Journal
Wochit

For Diane Brothers, the holiday season isn’t always the most joyful time of the year. 

“With me being on a fixed income, things were struggling,” the 47-year-old stay-at-home mom said. 

But with the help of gift card from Mental Health America of Dutchess County last year, Brothers said she was able to get her 10-year-old daughter and 17-year-old son gifts: clothes, socks and underwear. 

Holiday Helping Hand raises $1.3M across decades

HELPING HAND: ‘The stress was relieved:’ Easing financial burdens

EDITORIAL: Keep alive the legacy of Holiday Helping Hand

“I was very thankful, and blessed,” the City of Poughkeepsie resident said. “Mental Health of America is a great support system for our community.” 

For those like Brothers, the burden of purchasing Christmas gifts or preparing a holiday feast can make the season less than enjoyable. 

But local families living with the realities of mental illnesses get some financial relief with these gift cards, through the Holiday Helping Hand program. 

“There’s so much pressure in society that everyone needs to have everything,” said Andrew O’Grady, executive director of Mental Health America Dutchess County. “Unfortunately, not everyone can.” 

In its 35th year, Holiday Helping Hand is a is a joint project by the Poughkeepsie Journal and United Way of the Dutchess-Orange Region.

Last year, the program raised $33,650, which this year is funding more than 30 local charitable programs such as holiday dinners, gift giveaways for kids, and assistance with paying everyday necessities like utility bills. 

O’Grady said the $2,000 awarded to Mental Health America this season will go toward purchasing 100 $20 gift cards to both local grocery stores and Toys R’ Us. The cards will go to 75 families, O’Grady said, dependent on each family’s needs. 

“Most of the people we work with live below or at the poverty level,” he said. “These families maybe don’t have the ability to have a good meal, or provide small items for their children.”

Throughout the year, Mental Health of America provides a number of programs, O’Grady said, ranging from a homeless day shelter to family support and individual adult care management, “where we are one-on-one with people in the community who struggle with mental health or addiction issues.” 

“One of the reasons we’ve supported this organization in the past is that they work with a vulnerable population, handling challenges with mental illness and the homeless,” said Melissa Clark, United Way’s regional director of community impact.

Abbott Brant: abrant@poughkeepsiejournal.com; 845-437-4809; Twitter: @AbbottBrantPoJo

How to Donate 

Holiday Helping Hand is a joint project from the Poughkeepsie Journal and the United Way of the Dutchess County-Orange Region that raises money for local charities and organizations that, in turn, host events like holiday dinners, children’s programs and gift card distributions to those in need.

To donate online, go to www.uwdor.org/donate-hhh2017 or mail a check to Holiday Helping Hand, United Way of the Dutchess-Orange Region, 75 Market St., Poughkeepsie, NY 12601. Checks should be made payable to Holiday Helping Hand. All donations will benefit Dutchess County residents. 

 

 

 

America wakes up to the dark side of the internet

Sen. John McCain released a statement Thursday saying he will support the GOP tax cuts bill: “I believe this legislation, though far from perfect, would enhance American competitiveness, boost the economy, and provide long overdue tax relief for middle class families.”

Why it matters: This bill sure seems likely to pass the Senate, where it then goes to conference.

The Health 202: This hotel CEO thinks he can fix America’s opioid abuse problem

THE PROGNOSIS

Gary Mendell is leading an initiative for insurers to embrace evidence-based approaches to addiction treatment. Mendell is pictured at a panel discussion hosted by The Post in May 2016. (Photo by Jared Soares)

Yes, President Trump has declared opioid abuse a national emergency. But a hotel CEO is leading a much more targeted – and more promising – effort to address the country’s rampant addiction problem.

Gary Mendell, the chairman of HEI Hotels Resorts who lost his son to drug addiction six years ago, has convinced four of the five major U.S. insurers – Aetna, UnitedHealth, Cigna and several of the Blue Cross plans – and a dozen smaller companies to sign onto eight principles of care for patients struggling with addiction.

The hope is that these insurers, which cover a total of nearly 250 million patients, will jumpstart a new era for addiction treatment in the United States by making it easier for patients to access key medications proven effective in helping ease off opioids. The aim is also to direct these patients to the best doctors who use treatments actually backed by science.

The problem right now isn’t so much a lack of treatment – there are more than14,500 drug-abuse treatment facilities in the United States. What’s severely crippling the system is a widespread lack of knowledge about how best to help someone struggling with addiction, according to Mendell. Unlike for other illnesses like cancer or heart disease, where there’s a well-known standard of care, far fewer standards exist for opioid addiction.

“What we all care about is that every American in this country who has a substance use disorder gets treatment based on evidence just like every other disease,” Mendell told me.

Patients too often don’t know where or how to seek help and providers don’t always know which treatments are most effective, Mendell says. Is behavioral therapy enough? Or is medication a better approach? What about a combination of the two?

“You can go to 10 different treatment programs and you will get 10 different approaches,” Mendell said. “No one has any idea who is doing what.”

37307_imrs The Health 202: This hotel CEO thinks he can fix America's opioid abuse problem

A drug addict in recovery listens to a counselor at a substance abuse treatment center in March 2016 in Westborough, MA. (Photo by John Moore/Getty Images)

The problem extends to insurers, which often don’t know which providers are delivering the best care for patients trying to overcome opioid addiction. Mendell said that’s why he’s starting with this corner of the health-care industry, since insurers are instrumental in the kind of treatments patients can access because of the contracts they set up with providers.

The task force Mendell assembled last spring, through his nonprofit group Shatterproof, also includes top names in policy and advocacy: Don Berwick, former director of the Centers for Medicare and Medicaid Services; Michael Botticelli, former director of the Office of National Drug Control Policy; and former ONDCP deputy director Tom McLellan, among others.

In crafting its eight recommendations – released earlier this month – the task force drew heavily from the November 2016 U.S. Surgeon General’s Report on Alcohol, Drugs and Health. Among the evidence-based recommendations are universal screening, coordinated physical and mental care and, perhaps most importantly, access to FDA-approved medications.

The next step is for insurers to start promoting these principles in specific ways and on a defined timeline, said Josh Rising, director of health-care programs at The Pew Charitable Trusts, which is hosting the task force meetings.

For example, he’d like to see insurers ease the prior authorization process patients must go through to obtain three medications — methadone, buprenorphine and naltrexone — shown to be effective in treating people with opioid addiction. Insurers can identify which health providers tend to prescribe these medications.

“Payers play a key role in driving treatments,” Rising said.

Mendell lost his son, Brian, in 2011 after seeking out a series of providers who presented conflicting approaches to the role of medication in treatment. Brian was showing marked improvement at a treatment program in Arizona, where he was finally prescribed suboxone along with also receiving counseling for anxiety. But when Brian transferred to an outpatient program in Los Angeles some months later, and pressured by his doctors to phase down his medications, things took a turn for the worse.

That resistance to using medication for substance abuse disorders is one of chief things that needs to change, Mendell stresses.

Dr. Edwin Chapman sees patient who is being treated with a medication that contains buprenorphine and naloxone in Dec. 2014 in Washington, DC. The medication is used for an addiction to opiates. (Photo by Matt McClain/ The Washington Post)

Clinical research indicates that patients given medication are more likely to recover than if they’re only treated with residential stays or a 12-step program. But because providers are still resistant to prescribing these medications, fewer than half of all people in the United States who could benefit from addiction medication are able to access it, according to research by Pew.

“This is done for all other diseases,” Mendell said. “It’s just not done for addiction.”

The eventual goal is for the recommendations to be adopted by nonprofit groups — like the National Quality Forum and the National Association of Healthcare Quality — that create widely accepted standards of care. And then for Medicare and Medicaid – the government’s two big health insurance programs – to come on board too. (Some state Medicaid programs, for example, don’t cover all three of those medications used in substance abuse treatment.)

But for now, the task force is focusing on the major insurance companies because they can sometimes adapt more quickly than public programs, which often take years to assume new approaches, Rising said.

“We identified private payers for this particular task force in part because there was a sense that they might be more nimble,” Rising said.

To Mendell, that’s the quickest and most likely way to start getting helpful treatment to the estimated 21 million Americans who abuse opioids. The problem is acute; fatalities have multiplied in recent years. The number of deaths involving opioid overdoses tripled between 1999 and 2015, according to CDC data.

“It’s a 9/11 every eight or nine days and no one is talking about it,” Mendell said.

AHH: Medical professionals are starting to acknowledge a reality few people are aware of: People living with undetectable levels of HIV cannot transmit the virus. It’s a historic moment, our colleague Lenny Bernstein reports, because the public recognition could destigmatize the 1.2 million Americans living with HIV, perhaps make people more comfortable with getting tested and provide comfort and relief for couples with one HIV positive partner.

Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said at an international conference in July that people with undetectable viral loads in their blood cannot transmit the virus. And in September, the CDC released a letter stating that people who are taking daily medication “and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner.” There are now more than 500 organizations in 67 countries that agree, Lenny notes.

What does it mean to have an undetectable viral load? It means that fewer than 200 copies of the virus is in a milliliter of blood, Lenny explains. People with HIV should maintain that level or lower for at least six months before they can be considered incapable of sexually transmitting the virus. Those who take daily medications can potentially bring viral loads to 50 or even 25 copies.

“Like many developments in the four-decade history of HIV, this one has been slow to gain acceptance among mainstream health-care providers,” Lenny writes. “Many are not aware of it or must unlearn the habit of drilling safe-sex lessons into patients, as they have been doing almost since the AIDS epidemic began. HIV-positive people also must alter deeply ingrained beliefs that nothing good can come of revealing their status.”

Progress begets further questions: Like what happens if someone forgets to take their daily medication or if someone fluctuates above or below the 200-copy threshold over time? There aren’t yet evidence-based answers to these questions, experts say.

37307_imrs The Health 202: This hotel CEO thinks he can fix America's opioid abuse problem

(Getty Images/ISTOCKPHOTO)

OOF: New research reveals the sugar industry concealed findings of studies it funded revealing that sugar was indeed harmful, and instead pointed a finger at the effects of fats. The industry never disclosed the findings of research it funded in the 1960’s in the midst of debate on the effects of sugars and fats on cardiovascular health, our colleague Marwa Eltagouri reports.

Here’s what they found about the effects of sugar: Researchers from the University of California at San Francisco found that the Sugar Research Foundation funded research in 1968 looking at the relationship between sugar consumption and heart disease, and concluded rats  a high-sugar diet exhibited increased levels of triglycerides, or fatty substances in the bloodstream, Marwa writes. Studies also found a connection between sugar consumption and enzymes linked to bladder cancer.

What happened to that research? Researchers behind the new report said it’s likely the sugar industry stopped the study and never published the results. “This is continuing to build the case that the sugar industry has a long history of manipulating science,” Stanton Glantz, a professor of medicine at U.C.S.F. and author of the report told the New York Times.

In a statement last week, the Sugar Association chided the new UCSF report and dismissed it as “a collection of speculations and assumptions about events that happened nearly five decades ago.” 

Marbell Castillo holds her granddaughter, Maia Powell during a check up-appointment at Burke Pediatrics on October 31 in Burke. Maia is insured through the Children’s Health Insurance Program. (Photo by Matt McClain/The Washington Post)

OUCH: It’s been nearly two months since Congress missed its deadline to extend funding for the Children’s Health Insurance Program for 9 million low-income kids. Officials in nearly a dozen states are preparing to notify families that CHIP is running out of money for the first time since its creation two decades ago, putting coverage for many at risk by the end of the year, our colleagues Colby Itkowitz and Sandhya Somashekhar write.

“Many states have enough money to keep their individual programs afloat for at least a few months, but five could run out in late December if lawmakers do not act,” Colby and Sandhya write. “Others will start to exhaust resources the following month. “The looming crunch, which comes despite CHIP’s enduring popularity and bipartisan support on Capitol Hill, has dismayed children’s health advocates.”

“We are very concerned, and the reason is that Congress hasn’t shown a strong ability to get stuff done,” said Bruce Lesley, president of Washington-based First Focus, a child and family advocacy organization. “And the administration is completely out, has not even uttered a syllable on the issue. How this gets resolved is really unclear, and states are beginning to hit deadlines.”

37307_imrs The Health 202: This hotel CEO thinks he can fix America's opioid abuse problem

President Donald Trump speaks to the media last week at his private club, Mar-a-Lago. (AP Photo/Alex Brandon, File)

–The Trump administration has made some recent proposals to cut the costs of high drug prices, such as changing how Medicare reimburses hospitals for certain drugs and proposing an idea to pass drug rebates directly to seniors. But there’s one thing the administration isn’t doing: cracking down on the pharmaceutical companies themselves, The Post’s Carolyn Y. Johnson writes.

“President Trump swept into office threatening to bring the hammer down on high drug prices, accusing pharmaceutical companies of ‘getting away with murder,'” Carolyn writes. His actions could “ultimately lower out-of-pocket drug prices for some. But there’s one part of the health-care system so far being spared any real pain: the drug companies themselves.”

“The most interesting thing about all this is it’s all under the umbrella of drug pricing, but frankly … it looks as if they’re hitting everybody except the drug industry. Which is fairly amazing,” Ronny Gal, a senior research analyst at investment firm Sanford C. Bernstein told Carolyn.

So what exactly has the Trump administration done to make changes to drug costs? 1. Earlier this month, the Centers for Medicare and Medicaid Services finalized a rule that slashes the amount Medicare reimburses hospitals for drugs purchased through the 340B drug discount program. 2. CMS has requested feedback on a proposal to provide rebates negotiated between drug companies and health plans  directly to seniors who are buying the prescriptions. Carolyn notes this would increase premiums but decrease the price that individuals pay when filling prescriptions.

“Both of the rules that we’ve seen take direct aim at what patients who are ill are actually paying, out-of-pocket, so it’s a very good first step,” said Rena Conti, a health economist at the University of Chicago. “It doesn’t go back to lowering prices. But to the extent that we get intermediaries — which include physicians and hospitals, but also pharmacies and insurers — out of the business out of making money off the high price of drugs, the system will be hopefully be more efficient and more transparent.”

And during the Thanksgiving holiday, Trump promised to have another go at repealing and replacing Obamacare after Congress finishes its work on a tax overhaul:

–A few more choice selections from The Post and around the Internet:

Today

  • The Children’s National Health System and Food Allergy Research and Education host “An Evening of Food for Thought.”

Coming Up

  • The Senate Health, Education, Labor and Pensions Committee holds a hearing on the nomination of Alex Azar to serve as the Secretary of Health and Human Services on November 29.

Rep. John Conyers Jr. (D-Mich.) said he will step down as the top Democrat on the House Judiciary Committee amid an ethics probe of sexual misconduct claims:

Several lawmakers called for changes to the way Congress handles allegations of sexual misconduct after two prominent Democrats were accused of impropriety:

The top 4 moments from the Miss Universe pageant:

Watch Jay-Z stop a concert to tell a 9-year-old girl she can be president:

iPhone X Will Cost Over $2100 in Brazil When Released in South America Next Month

Apple has updated its website to indicate that the iPhone X launches in three additional Latin American countries in early December.


Namely, the iPhone X will be released in Colombia starting December 1, Chile on December 7, and Brazil on December 8. The device will be available from select carriers and authorized resellers in each country.

In Brazil, the iPhone X will also be on display and available to purchase from the country’s two Apple Stores at VillageMall in Rio de Janeiro and the Morumbi shopping center in São Paulo. Inventory will likely be extremely limited.

iPhone X will start at 6,999 Brazilian reals in Brazil, the equivalent of slightly more than $2,150 USD based on current exchange rates. That’s more than double the iPhone X’s starting price of $999 in the United States.

Apple’s prices in Brazil being significantly higher than in the United States is partly the result of the country’s 60 percent duty on imported products valued up to $3,000, and likely other factors such as stricter labor laws.

Apple hasn’t provided iPhone X pricing information for Chile or Colombia, or release dates for other countries in South America.

iPhone X first launched November 3 in the United States and over 50 other countries. The device was also released in Israel today and arrives in 13 additional countries, including Malaysia, South Korea, Thailand, and Turkey, tomorrow.

iPhone X orders on Apple’s website now ship in an estimated 1-2 weeks around the world, down from 5-6 weeks after the device first launched.

Cutting SALT Is Good For America’s Health

https://pixabay.com/

taxes are complicated

Americans consume a lot of sodium, and many doctors believe it would do us good to cut back on the salt. The recent debate over federal tax reform has highlighted a different kind of salt that we should also cut: the state and local tax (SALT) deduction.

Many politicians from both sides of the aisle are against cutting SALT, but its elimination will make the tax code more progressive, simpler, and help fund cuts in tax rates , which in turn will help economic growth.

Under current law, taxpayers who itemize their deductions can deduct their state and local income or sales taxes—but not both—and their property taxes from their federal taxable income. The Senate bill would eliminate this SALT deduction altogether, while the House bill would save the property tax portion but cap it at $10,000.

Supporters of SALT argue that taxpayers shouldn’t pay federal taxes on the money used to pay state and local taxes. This isn’t a bad argument, but most people don’t use SALT for that purpose. Instead, they rely on the standard deduction to lower their federal taxable income. In 2014, only 28% of all federal income tax filers itemized and claimed the SALT deduction. The other 72% used the standard deduction.

So despite what SALT supporters say, eliminating it won’t mean that most people will begin paying federal taxes on money used to pay state and local taxes. This is especially true if the standard deduction is doubled, as is the case with the current House bill.

Politicians and voters making the largest uproar about the elimination of SALT tend to be from high-income, high-tax states such as Connecticut, New York, New Jersey, and California. And understandably so; according to the Tax Policy Center, the average deduction in each of those states was over $17,000 in 2014, more than double the roughly $7,000 average in Florida and other southern and western states. Without the SALT deduction, taxes may rise considerably for many people in high-tax states.

But if we want the tax code to be more progressive, this isn’t a bad thing. In general the SALT deduction favors the high-income people of these high-tax states. In 2014, only about 10% of tax filers making less than $50,000 claimed the SALT deduction, while about 81% of filers making over $100,000 claimed it.

America is about to kill the open internet – and towns like this will pay the price

It’s Saturday morning at a café near the museum in Winlock, Washington, and Michelle Conrow is eating brunch while surfing the internet on her laptop. What might seem a banal activity for many is a luxury for Michelle. The internet at her house just outside the town is primitive by today’s standards, with speeds similar to the dial-up days of the 1990s. It took three days to download Microsoft Office to her new computer.

Many of the 1,300 residents in this rural area, which was once the US’s second largest egg producer, report frustratingly slow connections. There’s no binging on the latest must-watch Netflix show or streaming music on Spotify to suit your mood. No quick downloading of a podcast for your journey to work as you grab your coat. No running several devices simultaneously as parents catch up with internet banking or shopping on Amazon while their children chat on social media and watch YouTube videos.

Quick Guide

Net neutrality

Net neutrality is the idea that internet service providers (ISPs) treat everyone’s data equally – whether that’s an email from your mother, a bank transfer or a streamed episode of Stranger Things. It means that ISPs, which control the delivery pipes, don’t get to choose which data is sent more quickly, and which sites get blocked or throttled (for example, slowing the delivery of a TV show because it is streamed by a video company that competes with a subsidiary of the ISP) and who has to pay extra. For this reason, some have described net neutrality as the “first amendment of the internet”.

In February 2015, the Federal Communications Commission (FCC) voted to more strictly regulate ISPs and to enshrine in law the principles of net neutrality. The vote reclassified wireless and fixed-line broadband service providers as title II “common carriers”, a public utility-type designation that gives the FCC the ability to set rates, open up access to competitors and more closely regulate the industry. Two years on, Trump’s new FCC chairman, Ajit Pai, a former Verizon lawyer, has pushed to overturn the 2015 order arguing they overstep the FCC’s jurisdiction and hinder corporate innovation. On 18 May, the FCC voted to support a new proposal that would repeal the order and started a 90-day period in which members of the public could comment. A final vote is expected in December.

Some have no broadband at all because the only provider, CenturyLink, has maxed out its system and there is a waiting list to get a connection, while others live outside the service area. Conrow and others have been complaining about the service for years. And if the internet’s top regulator, the Federal Communications Commission (FCC), gets its way, Conrow worries things may never get better.

In 2015, under Obama, the FCC passed the open internet order, which treated the regulation of broadband as a utility, similar to electricity or water, something seen as essential to modern life. Among other rules companies were officially banned from offering tiered services – fast and slow lanes for different service in an attempt to preserve “net neutrality” – the principle that all traffic online should be treated equally. An ombudsman was established to police complaints about net neutrality.



A man walks out of the Federal Communications Commission (FCC) headquarters in this photo taken with a tilt-shift lens in Washington, D.C., U.S Photograph: Bloomberg/via Getty Images

With the FCC now under Republican control those plans are now on the chopping block. The regulator has outlined its plans to scrap the open internet rules and will vote to implement its plans in December.

Conrow’s husband Matthew works from home as a programmer for a company in Los Angeles. He gets just enough bandwidth to allow him to do his job, but said: “Nobody can touch the internet while I’m working because any drain at all kills it. We’re paying for 3Mbps. When I check my network, I get about 2.2max, usually less than two. The IT techs down in LA watch my connection in and they’re like: ‘Gee, your connection’s terrible!’.”

Conrow, a mail carrier, said: “Thankfully I don’t have to use the internet during the day, but I’d like to use it for more when I get home. We don’t stream anything – movies, Spotify … I’m really bummed out I can’t watch Stranger Things. We have to download podcasts overnight it takes so long.”

A couple of years ago, Conrow set up Winlock Needs Internet and residents banded together to lobby the cable company, politicians and the FCC for improvements to the service outside the town centre – but nothing has changed. Conrow says that their efforts, which included holding a town meeting with a representative from the cable company, have worn them down and they are increasingly resigned to the situation.

Conrow said: “There’s little financial return on the high cost of digging lines and putting in fibre in small, spread out communities.”

A spokesman for CenturyLink told the Guardian: “Based on our current plans and timeline, we have no plans at this time to build out our infrastructure in this area.

“The actual speed customers experience will vary depending on not only the bandwidth provided to the customer by CenturyLink, but also other factors outside of CenturyLink’s control such as customer location, the quality of the customer’s equipment and wiring within the home, and the websites accessed by the customer.”

Conrow is worried about plans put forward by the FCC chairman Ajit Pai, appointed by Donald Trump in January, to scrap the Obama-era protections. Last August he also proposed lowering the standards for high-speed internet.

Conrow said: “If the FCC lowers the requirements for what qualifies as high-speed internet and they hamstring net neutrality it would effectively shut down our hopes for useful connections. Nothing I’ve heard from Ajit Pai has left me feeling optimistic.”

She added: “We don’t have a choice as far as internet providers. If net neutrality goes out the window, we lose the choice about what they’re sending down the pipeline to us.”

In some ways, the digital situation in rural Winlock gives a glimpse of what service could be like if FCC oversight is curtailed, net neutrality is rolled back and internet providers are allowed to block or throttle traffic, or offer “fast lanes” to websites that pay extra for the privilege.



‘I wake up at 3am so that I can work in my office and have enough bandwidth.’ Photograph: Michael Bocchieri/Getty Images

Mike Griffee, a chaplain at the Lewis Country Chaplaincy Services, lives just outside Winlock. He has difficulty doing online training courses without the screen freezing, finding it’s better to get up early when fewer people are online in his neighbourhood.

Griffee said: “It’s not just the training, we like to stream stuff from Netflix or Amazon in the evening, but there’s a lot of time you’re waiting and it’s buffering. It can take two hours instead of one to watch Midsomer Murders. It’s infuriating.”

Conrow added: “I’ve heard from parents that their kids struggle too, with more school assignments being done online.”

Patti Angeliz Sugita has no CenturyLink connection at her house a couple of miles from Winlock and gets her internet via satellite.

Sugita, who runs an animal rescue charity, has six satellite dishes at her property and finds the service better at night. “I wake up at 3am so that I can work in my office and have enough bandwidth to download files and upload videos needed for the charity.

“I can’t stream without constant buffering and towards the end of the month I can hardly access necessary sites.”

When the Conrows moved to Winlock from Los Angeles 10 years ago, they checked there was internet at the house before closing the deal.

“We moved up here … and found we were on the cusp of what the nearest hub could handle. It is enough to get a trickle,” Matthew Conrow said.

Being left behind by the internet also exacerbates an economic divide, he said.

“Properties are for sale and people come to look and hear they’ll have to live at dial-up speeds. Across the freeway is Toledo, which has fibre to every person’s door. It’s like: ‘Well I’m going to buy over there then’.”

He believes the internet should be treated as a public utility. “Someone needs to say, ‘you need to get the internet infrastructure out to these people’, because this is a basic need now, with schooling and working practices.

“It’s that feeling of being left behind from a basic service. You feel like you’re disconnecting, whether it’s colleagues in LA talking about a show you’ve not watched, or not being able to get Alexa. Then there’s the whole concept of the internet of things where everything in your house is connected to the internet – where does that leave us?”

Michelle Conrow picks up a book about the history of the US postal service lying next to her laptop, flicking through the pages.

“It talks about when there was a debate over whether we should have service to rural areas. It was all the same arguments about why we shouldn’t – too expensive, it doesn’t return the investment – and why we should – farmers need the news, people need to order things. It was a similar debate with the telephone, electricity … we’ve been here before.

“Are we going to end up with the internet for everybody just like these services that seem so obvious now?” She pauses. “I worry we won’t.”

If you want to see what America would be like if it ditched net neutrality, just look at Portugal

  • The Federal Communications Commission is planning to ditch net neutrality, which requires internet providers to treat all data online equally.
  • A Portuguese internet provider shows what the American internet could look like if net neutrality is scrapped.
  • One company charges people more for additional data based on the kind of app they want to use, such as those for messaging or for video.

On Tuesday, the US Federal Communications Commission announced that it planned to vote on an order to roll back Obama-era rules governing net neutrality.

Simply put, net neutrality means that all data on the internet is treated equally. An internet service provider can’t prioritize certain companies or types of data, charge users more to access certain websites and apps, or charge businesses for preferential access.

Advocates of net neutrality argue that it ensures a level playing field for everyone on the internet. Telecoms firms, however, are largely against it because of the additional restrictions it places on them.

But with the Republican-majority FCC likely to vote on December 14 in favor of rolling back the order, what might the American internet look like without net neutrality? Just look at Portugal.

The country’s wireless carrier Meo offers a package that’s very different from those available in the US. Users pay for traditional “data” – and on top of that, they pay for additional packages based on the kind of data and apps they want to use.

eb0c6_94696b56d2df01724f4d538583c191b8edb219a1-800x483 If you want to see what America would be like if it ditched net neutrality, just look at Portugal

Really into messaging? Then pay €4.99 ($5.86 or £4.43) a month and get more data for apps like WhatsApp, Skype, and FaceTime. Prefer social networks like Facebook, Instagram, Snapchat, Messenger, and so on? That’ll be another €4.99 a month.

Video apps like Netflix and YouTube are available as another add-on, while music (Spotify, SoundCloud, Google Play Music, etc.) is another, as is email and cloud (Gmail, Yahoo Mail, iCloud, etc.).

Net-neutrality advocates argue that this kind of model is dangerous because it risks creating a two-tier system that harms competition – people will just use the big-name apps included in the bundles they pay for, while upstart challengers will be left out in the cold.

For example: If you love watching videos, and Netflix is included in the video bundle but Hulu isn’t, you’re likely to try to save money by using only Netflix, making it harder for its competitors.

And without net neutrality, big-name apps could theoretically even pay telecoms firms for preferential access, offering them money – and smaller companies just couldn’t compete with that. (It’s not clear whether any of the companies named above have paid for preferential access.) An ISP could even refuse to grant access to an app at all unless they paid up.

Democratic Rep. Ro Khanna of California originally shared the Meo example on Twitter in October.

“In Portugal, with no net neutrality, internet providers are starting to split the net into packages,” he wrote. “A huge advantage for entrenched companies, but it totally ices out startups trying to get in front of people which stifles innovation. This is what’s at stake, and that’s why we have to save net neutrality.”

Technically, Portugal is bound by the European Union’s net-neutrality rules, but loopholes allow certain kinds of pricing schemes like the one outlined above.

Yonatan Zunger, a former Google employee, recently retweeted Khanna’s tweet, adding: “This isn’t even the worst part of ending net neutrality. The worst part happens when ISPs say ‘we don’t like this site’s politics,’ or ‘this site competes with us,’ and block or throttle it.”

America is about to kill the open internet and town like this will pay the price

It’s Saturday morning at a café near the museum in Winlock, Washington, and Michelle Conrow is eating brunch while surfing the internet on her laptop. What might seem a banal activity for many is a luxury for Michelle. The internet at her house just outside the town is primitive by today’s standards, with speeds similar to the dial-up days of the 1990s. It took three days to download Microsoft Office to her new computer.

Many of the 1,300 residents in this rural area, which was once the US’s second largest egg producer, report frustratingly slow connections. There’s no binging on the latest must-watch Netflix show or streaming music on Spotify to suit your mood. No quick downloading of a podcast for your journey to work as you grab your coat. No running several devices simultaneously as parents catch up with internet banking or shopping on Amazon while their children chat on social media and watch YouTube videos.

Quick Guide

Net neutrality

Net neutrality is the idea that internet service providers (ISPs) treat everyone’s data equally – whether that’s an email from your mother, a bank transfer or a streamed episode of Stranger Things. It means that ISPs, which control the delivery pipes, don’t get to choose which data is sent more quickly, and which sites get blocked or throttled (for example, slowing the delivery of a TV show because it is streamed by a video company that competes with a subsidiary of the ISP) and who has to pay extra. For this reason, some have described net neutrality as the “first amendment of the internet”.

In February 2015, the Federal Communications Commission (FCC) voted to more strictly regulate ISPs and to enshrine in law the principles of net neutrality. The vote reclassified wireless and fixed-line broadband service providers as title II “common carriers”, a public utility-type designation that gives the FCC the ability to set rates, open up access to competitors and more closely regulate the industry. Two years on, Trump’s new FCC chairman, Ajit Pai, a former Verizon lawyer, has pushed to overturn the 2015 order arguing they overstep the FCC’s jurisdiction and hinder corporate innovation. On 18 May, the FCC voted to support a new proposal that would repeal the order and started a 90-day period in which members of the public could comment. A final vote is expected in December.

Some have no broadband at all because the only provider, CenturyLink, has maxed out its system and there is a waiting list to get a connection, while others live outside the service area. Conrow and others have been complaining about the service for years. And if the internet’s top regulator, the Federal Communications Commission (FCC), gets its way, Conrow worries things may never get better.

In 2015, under Obama, the FCC passed the open internet order, which treated the regulation of broadband as a utility, similar to electricity or water, something seen as essential to modern life. Among other rules companies were officially banned from offering tiered services – fast and slow lanes for different service in an attempt to preserve “net neutrality” – the principle that all traffic online should be treated equally. An ombudsman was established to police complaints about net neutrality.



A man walks out of the Federal Communications Commission (FCC) headquarters in this photo taken with a tilt-shift lens in Washington, D.C., U.S Photograph: Bloomberg/via Getty Images

With the FCC now under Republican control those plans are now on the chopping block. The regulator has outlined its plans to scrap the open internet rules and will vote to implement its plans in December.

Conrow’s husband Matthew works from home as a programmer for a company in Los Angeles. He gets just enough bandwidth to allow him to do his job, but said: “Nobody can touch the internet while I’m working because any drain at all kills it. We’re paying for 3Mbps. When I check my network, I get about 2.2max, usually less than two. The IT techs down in LA watch my connection in and they’re like: ‘Gee, your connection’s terrible!’.”

Conrow, a mail carrier, said: “Thankfully I don’t have to use the internet during the day, but I’d like to use it for more when I get home. We don’t stream anything – movies, Spotify … I’m really bummed out I can’t watch Stranger Things. We have to download podcasts overnight it takes so long.”

A couple of years ago, Conrow set up Winlock Needs Internet and residents banded together to lobby the cable company, politicians and the FCC for improvements to the service outside the town centre – but nothing has changed. Conrow says that their efforts, which included holding a town meeting with a representative from the cable company, have worn them down and they are increasingly resigned to the situation.

Conrow said: “There’s little financial return on the high cost of digging lines and putting in fibre in small, spread out communities.”

A spokesman for CenturyLink told the Guardian: “Based on our current plans and timeline, we have no plans at this time to build out our infrastructure in this area.

“The actual speed customers experience will vary depending on not only the bandwidth provided to the customer by CenturyLink, but also other factors outside of CenturyLink’s control such as customer location, the quality of the customer’s equipment and wiring within the home, and the websites accessed by the customer.”

Conrow is worried about plans put forward by the FCC chairman Ajit Pai, appointed by Donald Trump in January, to scrap the Obama-era protections. Last August he also proposed lowering the standards for high-speed internet.

Conrow said: “If the FCC lowers the requirements for what qualifies as high-speed internet and they hamstring net neutrality it would effectively shut down our hopes for useful connections. Nothing I’ve heard from Ajit Pai has left me feeling optimistic.”

She added: “We don’t have a choice as far as internet providers. If net neutrality goes out the window, we lose the choice about what they’re sending down the pipeline to us.”

In some ways, the digital situation in rural Winlock gives a glimpse of what service could be like if FCC oversight is curtailed, net neutrality is rolled back and internet providers are allowed to block or throttle traffic, or offer “fast lanes” to websites that pay extra for the privilege.



‘I wake up at 3am so that I can work in my office and have enough bandwidth.’ Photograph: Michael Bocchieri/Getty Images

Mike Griffee, a chaplain at the Lewis Country Chaplaincy Services, lives just outside Winlock. He has difficulty doing online training courses without the screen freezing, finding it’s better to get up early when fewer people are online in his neighbourhood.

Griffee said: “It’s not just the training, we like to stream stuff from Netflix or Amazon in the evening, but there’s a lot of time you’re waiting and it’s buffering. It can take two hours instead of one to watch Midsomer Murders. It’s infuriating.”

Conrow added: “I’ve heard from parents that their kids struggle too, with more school assignments being done online.”

Patti Angeliz Sugita has no CenturyLink connection at her house a couple of miles from Winlock and gets her internet via satellite.

Sugita, who runs an animal rescue charity, has six satellite dishes at her property and finds the service better at night. “I wake up at 3am so that I can work in my office and have enough bandwidth to download files and upload videos needed for the charity.

“I can’t stream without constant buffering and towards the end of the month I can hardly access necessary sites.”

When the Conrows moved to Winlock from Los Angeles 10 years ago, they checked there was internet at the house before closing the deal.

“We moved up here … and found we were on the cusp of what the nearest hub could handle. It is enough to get a trickle,” Matthew Conrow said.

Being left behind by the internet also exacerbates an economic divide, he said.

“Properties are for sale and people come to look and hear they’ll have to live at dial-up speeds. Across the freeway is Toledo, which has fibre to every person’s door. It’s like: ‘Well I’m going to buy over there then’.”

He believes the internet should be treated as a public utility. “Someone needs to say, ‘you need to get the internet infrastructure out to these people’, because this is a basic need now, with schooling and working practices.

“It’s that feeling of being left behind from a basic service. You feel like you’re disconnecting, whether it’s colleagues in LA talking about a show you’ve not watched, or not being able to get Alexa. Then there’s the whole concept of the internet of things where everything in your house is connected to the internet – where does that leave us?”

Michelle Conrow picks up a book about the history of the US postal service lying next to her laptop, flicking through the pages.

“It talks about when there was a debate over whether we should have service to rural areas. It was all the same arguments about why we shouldn’t – too expensive, it doesn’t return the investment – and why we should – farmers need the news, people need to order things. It was a similar debate with the telephone, electricity … we’ve been here before.

“Are we going to end up with the internet for everybody just like these services that seem so obvious now?” She pauses. “I worry we won’t.”

How the computer revolution is deepening America’s partisan divide …

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