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These scammers are really smart. Anybody could be a victim.

His hands trembled at first. Then his vision blurred. Finally, unable to control a malignant blood pressure condition, Tinley Park cardiac surgeon Banio Koroma lost his malpractice insurance, then his operating room privileges and finally his professional standing.

Fortunately, he lived in Illinois, where medical regulation has been so lax even the most desperate of doctors can find financial reward.

Koroma took refuge in home health care, a lucrative and growing industry rife with fraud and tainted by unscrupulous physicians who travel to patients’ homes in search of profit, then bleed money from taxpayer-financed programs.

The down-on-his-luck doctor took advantage of this loosely regulated world to exploit his patients and command a central role in a multimillion-dollar taxpayer swindle that breached the homes of 15,600 older adults getting services from a Chicago company called Mobile Doctors.

For adults hobbled by disability or disease who want to stay out of nursing homes or hospitals, home health care services can be a godsend.

For criminals who want to tap into federal Medicare dollars, it can represent a loosely guarded bank vault.

A Tribune investigation reveals that Illinois public health regulators proved unprepared for a surge in new home health care companies, doling out too many home health licenses too fast and failing to provide meaningful oversight.

Even today, most anyone can own a home health care business for a $25 license fee — no criminal background check required.

Consequently, the Chicago metropolitan area is a hot spot for fraud, deemed among the most corrupt regions nationally. In the last five years, federal investigators estimate, area home-health agencies have improperly collected at least $104 million of public dollars.

Many home health companies operate lawfully and in the best interests of their customers. But fraud is so pervasive throughout the industry, federal officials say, that for every conviction like Koroma’s, there are many other participants who are able to skate away.

As a result, already-vulnerable patients are put at risk.

Corrupt home health companies and complicit physicians as well as nurses secretly laced medical files with false diagnoses involving tens of thousands of Chicago-area patients, the Tribune found.

An analysis of federal court and enforcement files since 2012 shows that thousands of patients have been subjected to unwarranted procedures, therapies and tests; some were prescribed unneeded and powerful drugs.

Most victims were unaware that their medical histories were hijacked by swindlers — there is no legal requirement to notify or warn patients when fraud is uncovered, or when providers are convicted of crimes.

Case files show that a disabled man in his 80s was denied a wheelchair by a government insurance program because a Chicago-area business had falsely purchased one in the man’s name and then illegally pocketed the reimbursement check, according to AgeOptions in Oak Park, a federally funded advocacy group.

In another case, a hospitalized man was denied a transfer to a Chicago rehabilitation center because a home health company had fraudulently billed the government for nonexistent convalescent care.

“These scammers are really smart,” said Jason Echols, statewide director for a senior Medicare program at AgeOptions. “Anybody could be a victim.”

Sometimes, financial crimes jeopardize patients’ lives.

Debra Lingelbach, a 48-year-old mother from Rockford, suffered inexplicable chest pain. “My chest was hurting all the time,” she recounted in a video deposition involving a civil case. “Like someone was stabbing me in the chest.”

Yet her traveling physician, Charles DeHaan, declared that her lungs “sounded fine,” she said. DeHaan was part owner of a physician staffing company, which was exempt from public health licensing and oversight.

DeHaan pleaded guilty this year to two counts of felony health care fraud related to collecting $1.5 million for bogus examinations and inflated billings, federal court records show. Sentenced to 10 years in federal prison, he faces pending state charges, unrelated to Lingelbach, that involve accusations of sexual assaults involving multiple patients.

Three months after DeHaan’s arrest, civil court records show, Lingelbach was examined by a new physician who delivered a devastating diagnosis: advanced-stage lung cancer.

She died months later.

A playbook for fraud

Diana Jocelyn Gumila, manager of a physician-staffing business in Schaumburg, was furious.

More than 300 Chicago-area home health companies hired her company, Doctor at Home, to certify that patients were homebound and required skilled nursing care. When that happened, Gumila and company owners profited through payments from Medicare, a taxpayer-funded insurance program for those age 65 and older.

Profits flowed as long as patients remain certified — as long as nobody documented that patients were, in reality, healthy and active and did not require in-home care.

But some of Gumila’s physicians were too honest. A diagnosis is a subjective decision, she often tutored. She told one physician to “be an artist” and “paint the picture” to describe each patient — the more abstract, the better.

In a flurry of memos beginning in January 2012, she coaxed her staff of seven physicians and three physician assistants to “please minimize the use of the following words in your documentation: very stable and stable.”

Finally, in October 2013, Gumila confronted her most obstinate employee, Dr. Ewa Nowak, a newly hired Polish-educated immigrant who finished her medical training in Chicago.

Nowak had decertified a woman who was a long-standing patient of a Chicago home health company.

In her chart, Nowak wrote: “We met at the front of the patient’s house. She was coming back from grocery shopping with very heavy bags of groceries in her both arms. She walked from the train station three blocks. No complaints about any problem.”

But Gumila, 45, a registered nurse, overruled Nowak and recertified the woman as homebound, court records show.

Doctor at Home followed a standard playbook for fraud: Falsely certify patients as homebound and in need of nursing care, submit fraudulent bills to Medicare — and profits flow.

There are few checks and balances.

Unlike most branches of medicine where physician referrals are necessary to qualify for insurance coverage, Medicare allows home health agencies to recruit patients before they are certified for care. In Chicago, federal records show, this has spawned a shadow market of patient brokers who troll grocery stores, bus stops, churches and food pantries in search of susceptible adults.

Best of Android 2017 – Which smartphone really is the best?

e7be1_best-of-android-intro-announcement-branded-840x582 Best of Android 2017 – Which smartphone really is the best?

Every year, smartphones become more homogenous, the differences smaller and the risk (associated with the ever-increasing cost) higher. 2017 was no different — with every manufacturer bringing their best to the table, and with mainstream smartphones hitting the $1,000 mark for the first time, the age-old question becomes ever more important:

Which smartphone really IS the best?

Two years ago, we set out to answer this question for the very first time with Best of Android 2015, with Samsung’s Galaxy Note 5 topping five competitors to become the inaugural Phone of the Year. Last year, we made Best of Android even bigger, with the budget-friendly OnePlus 3T knocking out nine other flagships to take home the crown.

For 2017, the stakes are the highest they’ve ever been and we’re taking our end of year awards to a whole new level. Since the first Best of Android, we’ve spent over 1,000 hours revamping our reviews format to really help answer the most important question that we are asked. The resulting testing methodology will be used in every Android Authority review in 2018, but until then, we’re putting ten of the best phones of 2017 to the test.

The phones we’re featuring in our third annual Best of Android comparison are:

Throughout this week, we’ll walk you through each test, the results, and what it all means! Here’s what you can look forward to.

Testing, 1, 2, 3

All of our testing was conducted in our brand-new testing lab in San Francisco, which features an entirely blacked-out room, dedicated computer with testing gear and fixed equipment to ensure that every camera sample is taken from the same angle and position.

Throughout the tests, we’ve adopted either custom solutions of our own, off-the-shelf solutions that are widely recognized and respected, or partnerships with industry-leading companies who are experts in their respective fields.

Display

Smartphone displays don’t undergo drastic changes in design often, but 2017 saw almost every flagship adopt a new, taller aspect ratio, as the battle to shrink bezels and increase screen real estate heated up. Our tests haven’t changed much from previous years but the addition of gamma testing gave us another criterion by which to identify the smallest of differences.

Audio

Our audio tests take into consideration max bit-rates and major advancements in audio, as well as testing the loudness of the loudspeaker and the quality of the headphone jack output. The latter includes how loud the headphone jack actually gets, as well as the noise level, total harmonic distortion, and frequency response.

Battery

Last year, we developed our in-house custom battery testing tool to allow us to measure three key areas of battery life: video playback, gaming, and web browsing. Of course, real world usage is often a combination of these, so running a combination of these over a 90-minute period allows us to extrapolate what screen-on-time potentially could be. Your mileage may vary, but the results are certainly interesting.

This year, we’ve improved the app and tested more phones than ever before. We’ve also expanded our battery recharge time test to focus on the percentages gained at 15 minutes, 30 minutes, and 60 minutes from empty, as well as how long it takes to charge to full. With lots of competing standards, which one is the best? Stay tuned to find out!

e7be1_best-of-android-intro-announcement-branded-840x582 Best of Android 2017 – Which smartphone really is the best?

Camera

For most of 2017, we’ve been focusing our efforts on testing the nuances of smartphone cameras. Yes, it’s often about what looks best to you rather than what is technically the best – and we’ll be covering that as well – but we believe we have conducted the testing needed to confidently crown the winner of the all-new Camera of the Year award.

We’ve partnered with leading image testing company Imatest to collect and analyze the shots taken by all of our reviewed smartphones. All of the testing was conducted in a controlled environment, free of outside light and with the same exact lighting conditions for each test.

For our needs, we’ve selected eight key tests across the following categories:

  • Color and noise
  • Resolution
  • Video resolution

Of course, the numbers don’t matter to everyone and that’s why we’ve also conducted a camera shootout with all ten of these phones. If you’re into photography and the camera on your phone is important to you, stay tuned to find out which phone has the Camera of the Year!

Performance

Measuring smartphone performance becomes trickier with each new chipset generation. With most flagships featuring the same specs list – most of the devices are powered by the latest Qualcomm Snapdragon 835 processor – the differences are more and more minute. While we’re still creating and refining our own testing methods, we’ve chosen some of the industry leading benchmarks to help us take a closer look at performance.

User experience

Of course, a smartphone that’s good on paper isn’t necessarily good in real-world conditions. That’s why our User Experience section takes a look at the Hardware and Software features that help create the best all-round experience. We also take a look at the features that help a phone stand out from the competition, and dive into each of these devices in more detail.

e7be1_best-of-android-intro-announcement-branded-840x582 Best of Android 2017 – Which smartphone really is the best?

Value for money

As important as the question of “Which phone is the best” is, there’s another question that’s even more important to the next generation of smartphone owners: Which smartphone offers the best value for money?

Each smartphone offers something different to each user so quantifying this is the biggest challenge we’ve faced, but we’ve come up with a method that should provide a little clarity. By taking the cost of a device relative to the overall score it achieves throughout our 100+ point testing process, we can establish a base “value for money” indicator. From here, we compare each of the ten value for money indicators to find out which phone offers the Best Bang-for-your-buck!

The results

Now you know the testing, but how do we actually crown the winner? Across a total of 44 individual tests (and over 100 different criteria), we score each phone and give it a points tally depending on its ranking to each of the other devices. The best phone gets 10 points, second best gets 9 points, and so on, until the worst phone gets 1 point.

At the end, we tally up all the points, run it through our value for money indicator to get a final value for money score and then add both of those together. The winner is the phone with the most points overall, and with a maximum score of 440 available, everything is to play for!

Best of Android 2017 is our biggest and boldest comparison ever: 10 phones, 44 tests and only 1 winner – which phone will be crowned Phone of the Year 2017?

Nirave Gondhia

Now you know what to expect, join us later today as we kick things off with a look at the best smartphone displays of 2017!

Here’s the full order of what to expect for this week:

  • Monday: Best of Android 2017 – Display
  • Tuesday: Best of Android 2017 – Audio
  • Tuesday: Best of Android 2017 – Which camera LOOKS the best? (camera shootout)
  • Wednesday: Best of Android 2017 – Performance
  • Wednesday: Best of Android 2017 – Which camera IS technically the best? (technical comparison)
  • Thursday: Best of Android 2017 – Battery
  • Thursday: Best of Android 2017 – User Experience
  • Friday: The Phone of The Year 2017 is…

Which phone do you think will win? Let us know in the comments below and stay tuned! Remember, our Best of Android 2017 Mega Giveaway is running right now and we’re giving away the top three phones overall. You could be one of three winners to win one of these smartphones!

Check out the widget below to enter and get five extra entries using the unique code: BOAWTE.

Best of Android 2017 3 Phone Mega Giveaway!


Credits

Series Contributors: Rob TriggsGary Sims, Edgar Cervantes, Sam Moore, Oliver Cragg
Series Editors: Nirave Gondhia, Bogdan Petrovan, Chris Thomas

New Research Says Cheese Is A Health Food (Really!)

The saturated fat debate has long been raging in the health food world. Earlier this year, coconut oil made headlines as the American Heart Association declared it unilaterally unhealthy (mbg doctors largely disagree, with a few caveats). Now, a new saturated fat has fallen under the scrutiny of researchers: cheese.

Dairy has always been a dicey subject in the health food world. Many diets (paleo, vegan) tend to shun it, and some doctors point to it as the root of issues like inflammation, gut problems, and acne. The two primary exceptions are ayurveda, which embraces the milk by-product, and the of-the-moment keto diet, which relies on such a high-fat intake that cheese becomes practically a necessity.

In a new meta-analysis, researchers from China and the Netherlands analyzed 15 studies encompassing more than 200,000 people about the health effects of cheese. Thirteen of the studies analyzed went on for over 10 years. The findings?

Overall, people who consumed high levels of cheese were 10 percent less likely to have a stroke and 14 percent less likely to develop coronary heart disease than participants who consumed no cheese. More isn’t necessarily better, though. In the study, too much cheese was found to be as negative as too little, with the sweet spot hitting around 40 grams a day (about the size of a matchbook). Researchers didn’t specify whether one type of cheese was better than the rest.

Before you go out and gobble down a slice of pizza, keep in mind that there may be more to the story. According to functional medicine practitioner Will Cole, D.C., there are many factors, such as the rest of a person’s diet, that need to really be taken into consideration before making the claim that eating cheese every day is the key to minimizing heart disease. “Cheese is a high-fat food that can be very popular in ketogenic diets, and these diets have been shown to actually decrease bad oxidated cholesterol and increase good HDL cholesterol and lower inflammation levels, all markers of higher heart disease risk,” he says. “The key is to really examine the context of the diet outside of cheese intake since eating extremely high levels of cheese was also correlated with increased heart disease risk. People may be eating more processed foods in addition to cheese, which can negate the benefits of these healthy fats.” The take-away? Cheese is only one part of a diet, and while it may not be as harmful as previously thought, it’s also not a panacea—at least on its own.

Dr. Cole also notes the importance of the quality of said cheese. “Focus on grass-fed, organic dairy,” he says. “It’s also important to mention that not everyone tolerates dairy, even the grass-fed organic kind. We are all truly different, so listen to your own body.”

OK, so cheese might not be so bad, but what about butter? A functional medicine doc dives into the science.

Health Care Measures Everything Except What Really Matters To Seniors

877fb_960x0 Health Care Measures Everything Except What Really Matters To Seniors

Shutterstock

As board chair of a community hospital, I am often confronted with the dozens of quality and safety measures that state and federal regulators use to score and pay us, and private organizations use to rate us. And as someone who works to improve the quality of care for older adults, I am struck by how much all these measures miss when it comes to what really matters for seniors.

Here’s an example: Imagine an 85-year-old widow with mild dementia who lives alone at home. She comes to the emergency department of her local hospital with severe hip pain. She is treated quickly and efficiently in the ED. The orthopedic surgeon finds that she has severe arthritis and determines the best treatment is hip replacement surgery.

No complications

The surgery goes well. There are no complications. She gets no infections of any kind. She never falls during her hospitalization. All her doctors wash their hands coming in and out of her room. She gets a flu shot and a vaccine to lower her risk of pneumonia. Her pain medications are administered appropriately (not too much and not too little). Her nurses quickly respond to her call bell and her food is hot. With her permission, her daughter, who lives out-of-state, is kept well informed of her condition.

After a few days, the patient is discharged to a skilled nursing facility for rehab, and is not readmitted to the hospital for any reason directly related to her surgery. After a time in rehab she goes home.  Her surgery and hospitalization went smoothly. Everybody did their job and the hospital will get a great score based on all those required metrics.

Better outcomes

But did all that highly-rated medical treatment improve her life? Is she, in the most important sense, better off than before her surgery and hospitalization? Those questions are not so easily answered, and they largely are never addressed by all the star ratings and other quality and safety measures that hospitals must manage.

For example, could the patient have had a better outcome if, instead of hip surgery, her pain was better managed and she was encouraged to lose weight and make modest changes to her lifestyle?

The Health 202: Will CHIP crumble? States are getting really nervous.

THE PROGNOSIS

Congress is perfectly illustrating a potential pitfall with the GOP’s idea of capping Medicaid spending. Just look at how it’s neglecting another federal program that covers low-income children.

Never have lawmakers let funding lapse so long for the Children’s Health Insurance Program, a uniquely bipartisan U.S. safety net program that covers about 9 million low-income children and pregnant women. It’s been two months since the last authorization ran out, and although states had some initial wiggle room in their finances, that window is rapidly closing.

On Friday, Utah posted a notice online saying it probably will run out of CHIP funding by the end of January. Earlier in the week, Colorado notified families that their coverage might end early next year. Arizona, California, Ohio, Minnesota and the District are also nearing the end of their funding, as is Oregon, whose Democratic governor, Kate Brown, has directed the state’s health authority to continue financing CHIP through April out of its reserves.

It’s a situation prompting deep frustration from state authorities, who face the prospect of hundreds of thousands of their residents suddenly losing coverage. Now imagine this same situation, but applied to Medicaid, the program that covers far more Americans — around 70 million.

The reason Congress must reauthorize funding for CHIP is because it’s a block grant program, meaning that states are provided with a set amount of federal dollars instead of an ongoing funding stream (as with Medicaid).

Were Congress to convert Medicaid into block grants, as Republicans tried to do in multiple health-care bills this year, it’s feasible lawmakers might show the same delay in letting funding lapse, throwing states into uncertainty on an even larger scale.

“This is not a good advertisement for the people who want to bring you block grants in Medicaid,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families.

What’s also befuddling here is that Democrats and Republicans are in agreement to fund CHIP for five years. What they’re divided over is how to pay for it.

Democrats are refusing to sign onto a package passed by the House, which would pay for CHIP by charging higher Medicare premiums to wealthy seniors, shortening the grace period for marketplace enrollees who don’t pay their premiums and redirecting money away from the Affordable Care Act’s public health fund.

955d8_imrs The Health 202: Will CHIP crumble? States are getting really nervous.

George W. Bush vetoed several CHIP funding bills as president back in 2007. (AP Photo/Seth Wenig)

In 2007, CHIP funding was technically expired for months as President George W. Bush vetoed two funding bills. The difference then, however, was that Congress tided states over with short-term funding bills.

Brown told me she’s thankful her state has enough of its own resources to shore up CHIP for a while; otherwise, Oregon would be forced to notify people they would be losing their coverage right around the holiday season. The state has one of the largest CHIP populations  in the country; it covers one in every 10 Oregon children.

“That is absurd and bizarre and unacceptable,” Brown told me. “I can’t believe there isn’t more outrage … Congress is neglecting our most vulnerable children.”

Brown has recently held public events to pressure Congress to pass a CHIP bill (although it’s not at all apparent they’re paying attention on the other side of the country). Last week, she visited the Doernbecher Children’s Hospital in Portland, where she met with families who depend on the program for their coverage.

“This level of uncertainty is causing chaos on the ground,” Brown said.

The situation is extra infuriating for health advocates because ensuring kids have insurance is one of the few health-care policies both parties agree on. It’s largely because of CHIP that the rate of uninsured children has fallen to a record low of 4.5 percent. Under match rates boosted by the ACA, the federal government now provides 88 percent or more of every state’s CHIP costs.

“I have tried to look at this with a glass-half-full lens for some time, but it’s getting extremely difficult,” Alker said. “The fact they still haven’t gotten it across the finish line is enormously frustrating.”

Even Texas, a state with one of the highest uninsured rates that has often been slow to embrace coverage-expanding policies, has asked CMS for $90 million in leftover funds so it can delay starting to shut down its program. Texas Health and Human Services spokeswoman Carrie Williams told me that after conversations with CMS last week, the state is fairly confident it will get the extra cash infusion, which will allow it to keep running CHIP through February.

“We’re closely monitoring congressional efforts to reauthorize the program and are hopeful that it will be extended prior to the exhaustion of our current allotment,” Williams wrote.

Senate Majority Leader Mitch McConnell reacts to a reporter questions during a news conference Saturday. The Senate passed the tax bill early Saturday morning with a 51-49 vote. (AP Photo/Timothy D. Easley)

–Whelp, Senate Republicans couldn’t get to 50 votes on health care, but they managed to get there with taxes — and even had a vote to spare. In the wee hours of Saturday morning, they approved 51 to 49 their $1.5 trillion tax overhaul (making me doubly glad I’m a health not a tax reporter). The measure must still be reconciled with an earlier House-passed version before being sent to President Trump, but it’s a huge step for GOP leaders who engaged in a mad scramble to win over hesitant senators at the last minute.

Senate Majority Leader Mitch McConnell told the New York Times over the weekend that all his members were “just more comfortable” with taxes than health care. “Everybody really wanted to get to yes,” McConnell told the Times. “There was a widespread belief that this was just a good thing to do for the country and for us politically.”

If you read The Health 202 with any regularity, you know the Senate bill would repeal the ACA’s individual mandate to buy health insurance, but it does a lot of other stuff too. Its centerpiece is lowering the corporate tax rate from 35 percent to 20 percent; it also temporarily cuts tax rates for families and individuals until 2025 and kills a number of tax breaks. It would subject fewer people to the estate tax, a levy charged on huge inheritances, but stop short of eliminating that tax altogether.

“The tax package still must clear a couple more hurdles before it can become law,” The Post’s Erica Werner and Damian Paletta write. “There are numerous differences between the House and Senate versions, ranging from when certain tax cuts expire to how the estate tax is handled, and though none are seen as showstoppers, complications could arise…And the negotiations over the tax bill will proceed as Congress simultaneously faces a Dec. 8 deadline for government funding to expire. Nonetheless, GOP leaders still aim to get a final bill on Trump’s desk before Christmas.”

–The tax overhaul could also trigger another health-care element, though — big cuts to future Medicare spending, if Congress doesn’t duck “paygo” rules. If paygo applies, than automatic cuts to mandatory spending would have to take place, including a $25 billion cut to Medicare next year (4 percent of its total spending) and subsequent annual cuts.

955d8_imrs The Health 202: Will CHIP crumble? States are getting really nervous.

House Speaker Paul Ryan. (Photo by Chip Somodevilla/Getty Images)

But McConnell and top House Republican Paul Ryan (Wis.) pledged in a joint statement Friday to waive the 2010 “paygo” law, saying opponents of their tax overhaul who have been drawing attention to the potential for cuts are making false assumptions.

“Critics of tax reform are claiming the legislation would lead to massive, across-the-board spending cuts in vital programs…This will not happen,” McConnell and Ryan said. “Congress has readily available methods to waive this law, which has never been enforced since its enactment. There is no reason to believe that Congress would not act again to prevent a sequester, and we will work to ensure these spending cuts are prevented.”

–Hmmm. Congress has rammed major legislation through Congress down partisan lines. Sound familiar? For years, Republicans have criticized Democrats for using that approach to passing the 2010 ACA Yet when given the opportunity, they did exactly the same thing to get their tax overhaul across the finish line, my colleague Dave Weigel notes. What’s more, Republicans basically made no effort to win over even moderate Democrats who might have been gettable with a little more effort.

“The passage of the Tax Cuts and Jobs Act was often covered as a Republican family drama,” Dave writes. “Senate Democrats, 10 of whom face reelection next year in states won by President Trump, made cameo appearances — often when the president campaigned in their states. But even the most gettable Democrats, such as Sen. Joe Manchin III (D-W.Va.), were generally ignored by Republican negotiators as they brought their own party in line. Republicans have admitted as much.”

The first baby born as a result of a uterus transplant in the U.S. lies in the neonatal unit at Baylor University Medical Center in Dallas. (Baylor University Medical Center via AP)

AHH: For the first time in the United States, a woman born without a uterus has delivered a baby. Doctors at Baylor University say the baby was born to a woman who had a successful uterus transplant, making it the first such birth outside a Swedish hospital that pioneered the procedure in 2014, The Post’s Cleve R. Wootson reports. (That was Sahlgrenska University Hospital in Gothenburg, Sweden, where a total of eight babies have been born with the assistance of uterus transplants, per the New York Times.)

The successful transplant and birth are a major step for thousands of women unable to conceive, although Cleve notes that the transplants are meant to be temporary. The transplant gives women enough time to have a child and then the uterus is removed so the woman can stop taking the required immune-suppressing drugs. Baylor’s clinical trial is meant to include 10 woman and eight have received transplants so far, including the new mother. One woman is pregnant, two are trying to conceive and four others had failed transplants and had to have the organs removed.

“To make the field grow and expand and have the procedure come out to more women, it has to be reproduced,” Liza Johannesson, a uterus transplant surgeon who left the Swedish team to join Baylor’s group, told the New York Times. “It was a very exciting birth. I’ve seen so many births and delivered so many babies, but this was a very special one.”

OOF: The group Save My Care has launched this television ad against Sen. Susan Collins (R-Maine) for voting for the Senate tax bill that repeals the ACA’s individual mandate. Collins, who had voted against the Senate’s previous health-care bills, has said she supports repealing the mandate alone because its penalty is paid predominantly by lower and middle-income Americans. But supporters of the health-care law are outraged because the Congressional Budget Office has said 13 million fewer Americans would choose to get coverage without the mandate.

955d8_imrs The Health 202: Will CHIP crumble? States are getting really nervous.

Charlottesville, Virginia, where consumers are experiencing some of the biggest premium hikes in the country. (Photo by Norm Shafer/ For The Washington Post).

OUCH: Residents of Albemarle, Va., which includes the college town of Charlottesville, are seeing the biggest premium spikes in the country on the Obamacare marketplaces — and they’re directly feeling the pain because many of the town’s residents are people who buy their own insurance plans and earn too much money to qualify for federal subsidies.

The Wall Street Journal’s Stephanie Armour reports some area residents have grouped together, writing letters to lawmakers and starting a Facebook page to urge Congress not to repeal the individual mandate and to approve cost-sharing subsidies that help offset costs for lower-income consumers. They have access to only one insurer – Optima Health — after other insurers exited this year under heavy losses.

Residents told the Wall Street Journal they are making a personal plea to lawmakers. Before the overnight vote late last week, a few people drove to Capitol Hill to talk to staffers of Virginia members.

“People feel we’re victims in a really ugly political game,” 38-year-old Ian Dixon told the Journal. Dixon, an app developer in Charlottesville, said he will see his premiums for his family of four spike from $988 a month to $3,158 a month. “We have to take this up to Capitol Hill,” he said. 

–A few more readables from The Post and elsewhere:

POST PROGRAMMING: The Washington Post will gather top health officials, practitioners, thought leaders and advocates for a discussion about the fight against HIV/AIDS on Tuesday.

Coming Up

  • Axios hosts an event on the new era in health care on Tuesday.
  • Former vice president Al Gore will host a 24-hour live broadcast about climate activism through The Climate Reality Project on today and Tuesday.
  • The Senate Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies holds a hearing on addressing the opioid crisis on Tuesday.
  • The Center for Strategic and International Studies will host the launch of OPEC’s World Oil Outlook 2017 on Thursday.
  • The Senate Health, Education, Labor and Pensions Committee holds a hearing on the “Implementation of the 21st Century Cures Act: Responding to Mental Health Needs” on Wednesday.
  • The Senate Special Committee on Aging holds a hearing on “America’s Aging Workforce” on Wednesday.
  •  The Senate Health, Education, Labor and Pensions Committee holds a hearing on the “Implementation of the 21st Century Cures Act: Progress and Path Forward for Medical Innovation” on Thursday.
  • The House Veterans Affairs Committee holds a hearing on the VA Medical Surgical Prime Vendor Program on Thursday.

GOP ‘optimistic’ as tax bill heads to conference:

President Trump takes a victory lap after tax overhaul passes Senate:

“Saturday Night Live” addressed Michael Flynn’s cooperation in the Russia probe and the new allegations of sexual misconduct against powerful men:

Australian politician Tim Wilson asked his longtime partner to marry him during a speech on same-sex marriage:

The Health 202: Will CHIP crumble? States are getting really nervous.

THE PROGNOSIS

Congress is perfectly illustrating a potential pitfall with the GOP’s idea of capping Medicaid spending. Just look at how it’s neglecting another federal program that covers low-income children.

Never have lawmakers let funding lapse so long for the Children’s Health Insurance Program, a uniquely bipartisan U.S. safety net program that covers about 9 million low-income children and pregnant women. It’s been two months since the last authorization ran out, and although states had some initial wiggle room in their finances, that window is rapidly closing.

On Friday, Utah posted a notice online saying it probably will run out of CHIP funding by the end of January. Earlier in the week, Colorado notified families that their coverage might end early next year. Arizona, California, Ohio, Minnesota and the District are also nearing the end of their funding, as is Oregon, whose Democratic governor, Kate Brown, has directed the state’s health authority to continue financing CHIP through April out of its reserves.

It’s a situation prompting deep frustration from state authorities, who face the prospect of hundreds of thousands of their residents suddenly losing coverage. Now imagine this same situation, but applied to Medicaid, the program that covers far more Americans — around 70 million.

The reason Congress must reauthorize funding for CHIP is because it’s a block grant program, meaning that states are provided with a set amount of federal dollars instead of an ongoing funding stream (as with Medicaid).

Were Congress to convert Medicaid into block grants, as Republicans tried to do in multiple health-care bills this year, it’s feasible lawmakers might show the same delay in letting funding lapse, throwing states into uncertainty on an even larger scale.

“This is not a good advertisement for the people who want to bring you block grants in Medicaid,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families.

What’s also befuddling here is that Democrats and Republicans are in agreement to fund CHIP for five years. What they’re divided over is how to pay for it.

Democrats are refusing to sign onto a package passed by the House, which would pay for CHIP by charging higher Medicare premiums to wealthy seniors, shortening the grace period for marketplace enrollees who don’t pay their premiums and redirecting money away from the Affordable Care Act’s public health fund.

955d8_imrs The Health 202: Will CHIP crumble? States are getting really nervous.

George W. Bush vetoed several CHIP funding bills as president back in 2007. (AP Photo/Seth Wenig)

In 2007, CHIP funding was technically expired for months as President George W. Bush vetoed two funding bills. The difference then, however, was that Congress tided states over with short-term funding bills.

Brown told me she’s thankful her state has enough of its own resources to shore up CHIP for a while; otherwise, Oregon would be forced to notify people they would be losing their coverage right around the holiday season. The state has one of the largest CHIP populations  in the country; it covers one in every 10 Oregon children.

“That is absurd and bizarre and unacceptable,” Brown told me. “I can’t believe there isn’t more outrage … Congress is neglecting our most vulnerable children.”

Brown has recently held public events to pressure Congress to pass a CHIP bill (although it’s not at all apparent they’re paying attention on the other side of the country). Last week, she visited the Doernbecher Children’s Hospital in Portland, where she met with families who depend on the program for their coverage.

“This level of uncertainty is causing chaos on the ground,” Brown said.

The situation is extra infuriating for health advocates because ensuring kids have insurance is one of the few health-care policies both parties agree on. It’s largely because of CHIP that the rate of uninsured children has fallen to a record low of 4.5 percent. Under match rates boosted by the ACA, the federal government now provides 88 percent or more of every state’s CHIP costs.

“I have tried to look at this with a glass-half-full lens for some time, but it’s getting extremely difficult,” Alker said. “The fact they still haven’t gotten it across the finish line is enormously frustrating.”

Even Texas, a state with one of the highest uninsured rates that has often been slow to embrace coverage-expanding policies, has asked CMS for $90 million in leftover funds so it can delay starting to shut down its program. Texas Health and Human Services spokeswoman Carrie Williams told me that after conversations with CMS last week, the state is fairly confident it will get the extra cash infusion, which will allow it to keep running CHIP through February.

“We’re closely monitoring congressional efforts to reauthorize the program and are hopeful that it will be extended prior to the exhaustion of our current allotment,” Williams wrote.

Senate Majority Leader Mitch McConnell reacts to a reporter questions during a news conference Saturday. The Senate passed the tax bill early Saturday morning with a 51-49 vote. (AP Photo/Timothy D. Easley)

–Whelp, Senate Republicans couldn’t get to 50 votes on health care, but they managed to get there with taxes — and even had a vote to spare. In the wee hours of Saturday morning, they approved 51 to 49 their $1.5 trillion tax overhaul (making me doubly glad I’m a health not a tax reporter). The measure must still be reconciled with an earlier House-passed version before being sent to President Trump, but it’s a huge step for GOP leaders who engaged in a mad scramble to win over hesitant senators at the last minute.

Senate Majority Leader Mitch McConnell told the New York Times over the weekend that all his members were “just more comfortable” with taxes than health care. “Everybody really wanted to get to yes,” McConnell told the Times. “There was a widespread belief that this was just a good thing to do for the country and for us politically.”

If you read The Health 202 with any regularity, you know the Senate bill would repeal the ACA’s individual mandate to buy health insurance, but it does a lot of other stuff too. Its centerpiece is lowering the corporate tax rate from 35 percent to 20 percent; it also temporarily cuts tax rates for families and individuals until 2025 and kills a number of tax breaks. It would subject fewer people to the estate tax, a levy charged on huge inheritances, but stop short of eliminating that tax altogether.

“The tax package still must clear a couple more hurdles before it can become law,” The Post’s Erica Werner and Damian Paletta write. “There are numerous differences between the House and Senate versions, ranging from when certain tax cuts expire to how the estate tax is handled, and though none are seen as showstoppers, complications could arise…And the negotiations over the tax bill will proceed as Congress simultaneously faces a Dec. 8 deadline for government funding to expire. Nonetheless, GOP leaders still aim to get a final bill on Trump’s desk before Christmas.”

–The tax overhaul could also trigger another health-care element, though — big cuts to future Medicare spending, if Congress doesn’t duck “paygo” rules. If paygo applies, than automatic cuts to mandatory spending would have to take place, including a $25 billion cut to Medicare next year (4 percent of its total spending) and subsequent annual cuts.

955d8_imrs The Health 202: Will CHIP crumble? States are getting really nervous.

House Speaker Paul Ryan. (Photo by Chip Somodevilla/Getty Images)

But McConnell and top House Republican Paul Ryan (Wis.) pledged in a joint statement Friday to waive the 2010 “paygo” law, saying opponents of their tax overhaul who have been drawing attention to the potential for cuts are making false assumptions.

“Critics of tax reform are claiming the legislation would lead to massive, across-the-board spending cuts in vital programs…This will not happen,” McConnell and Ryan said. “Congress has readily available methods to waive this law, which has never been enforced since its enactment. There is no reason to believe that Congress would not act again to prevent a sequester, and we will work to ensure these spending cuts are prevented.”

–Hmmm. Congress has rammed major legislation through Congress down partisan lines. Sound familiar? For years, Republicans have criticized Democrats for using that approach to passing the 2010 ACA Yet when given the opportunity, they did exactly the same thing to get their tax overhaul across the finish line, my colleague Dave Weigel notes. What’s more, Republicans basically made no effort to win over even moderate Democrats who might have been gettable with a little more effort.

“The passage of the Tax Cuts and Jobs Act was often covered as a Republican family drama,” Dave writes. “Senate Democrats, 10 of whom face reelection next year in states won by President Trump, made cameo appearances — often when the president campaigned in their states. But even the most gettable Democrats, such as Sen. Joe Manchin III (D-W.Va.), were generally ignored by Republican negotiators as they brought their own party in line. Republicans have admitted as much.”

The first baby born as a result of a uterus transplant in the U.S. lies in the neonatal unit at Baylor University Medical Center in Dallas. (Baylor University Medical Center via AP)

AHH: For the first time in the United States, a woman born without a uterus has delivered a baby. Doctors at Baylor University say the baby was born to a woman who had a successful uterus transplant, making it the first such birth outside a Swedish hospital that pioneered the procedure in 2014, The Post’s Cleve R. Wootson reports. (That was Sahlgrenska University Hospital in Gothenburg, Sweden, where a total of eight babies have been born with the assistance of uterus transplants, per the New York Times.)

The successful transplant and birth are a major step for thousands of women unable to conceive, although Cleve notes that the transplants are meant to be temporary. The transplant gives women enough time to have a child and then the uterus is removed so the woman can stop taking the required immune-suppressing drugs. Baylor’s clinical trial is meant to include 10 woman and eight have received transplants so far, including the new mother. One woman is pregnant, two are trying to conceive and four others had failed transplants and had to have the organs removed.

“To make the field grow and expand and have the procedure come out to more women, it has to be reproduced,” Liza Johannesson, a uterus transplant surgeon who left the Swedish team to join Baylor’s group, told the New York Times. “It was a very exciting birth. I’ve seen so many births and delivered so many babies, but this was a very special one.”

OOF: The group Save My Care has launched this television ad against Sen. Susan Collins (R-Maine) for voting for the Senate tax bill that repeals the ACA’s individual mandate. Collins, who had voted against the Senate’s previous health-care bills, has said she supports repealing the mandate alone because its penalty is paid predominantly by lower and middle-income Americans. But supporters of the health-care law are outraged because the Congressional Budget Office has said 13 million fewer Americans would choose to get coverage without the mandate.

955d8_imrs The Health 202: Will CHIP crumble? States are getting really nervous.

Charlottesville, Virginia, where consumers are experiencing some of the biggest premium hikes in the country. (Photo by Norm Shafer/ For The Washington Post).

OUCH: Residents of Albemarle, Va., which includes the college town of Charlottesville, are seeing the biggest premium spikes in the country on the Obamacare marketplaces — and they’re directly feeling the pain because many of the town’s residents are people who buy their own insurance plans and earn too much money to qualify for federal subsidies.

The Wall Street Journal’s Stephanie Armour reports some area residents have grouped together, writing letters to lawmakers and starting a Facebook page to urge Congress not to repeal the individual mandate and to approve cost-sharing subsidies that help offset costs for lower-income consumers. They have access to only one insurer – Optima Health — after other insurers exited this year under heavy losses.

Residents told the Wall Street Journal they are making a personal plea to lawmakers. Before the overnight vote late last week, a few people drove to Capitol Hill to talk to staffers of Virginia members.

“People feel we’re victims in a really ugly political game,” 38-year-old Ian Dixon told the Journal. Dixon, an app developer in Charlottesville, said he will see his premiums for his family of four spike from $988 a month to $3,158 a month. “We have to take this up to Capitol Hill,” he said. 

–A few more readables from The Post and elsewhere:

POST PROGRAMMING: The Washington Post will gather top health officials, practitioners, thought leaders and advocates for a discussion about the fight against HIV/AIDS on Tuesday.

Coming Up

  • Axios hosts an event on the new era in health care on Tuesday.
  • Former vice president Al Gore will host a 24-hour live broadcast about climate activism through The Climate Reality Project on today and Tuesday.
  • The Senate Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies holds a hearing on addressing the opioid crisis on Tuesday.
  • The Center for Strategic and International Studies will host the launch of OPEC’s World Oil Outlook 2017 on Thursday.
  • The Senate Health, Education, Labor and Pensions Committee holds a hearing on the “Implementation of the 21st Century Cures Act: Responding to Mental Health Needs” on Wednesday.
  • The Senate Special Committee on Aging holds a hearing on “America’s Aging Workforce” on Wednesday.
  •  The Senate Health, Education, Labor and Pensions Committee holds a hearing on the “Implementation of the 21st Century Cures Act: Progress and Path Forward for Medical Innovation” on Thursday.
  • The House Veterans Affairs Committee holds a hearing on the VA Medical Surgical Prime Vendor Program on Thursday.

GOP ‘optimistic’ as tax bill heads to conference:

President Trump takes a victory lap after tax overhaul passes Senate:

“Saturday Night Live” addressed Michael Flynn’s cooperation in the Russia probe and the new allegations of sexual misconduct against powerful men:

Australian politician Tim Wilson asked his longtime partner to marry him during a speech on same-sex marriage:

Are iPhone X, Galaxy Note 8 at $1000 really 10 times better than $100 Nokia 2?

e120e_59ade468e4b09e7071c9a610-1280x7201sep05201753225poster Are iPhone X, Galaxy Note 8 at $1000 really 10 times better than $100 Nokia 2?

If you think it’s mad to spend nearly $1,000 on a Galaxy, Pixel, or iPhone, the Nokia 2 could be your answer for a good-looking smartphone. The best part is it can get the job done at a tenth of the price.

At just $100, the Nokia 2 gives you the basics with a few factors that make it stand out. It features a five-inch LCD display and quad-core Snapdragon 212 processor. That’s far off high-end specs, but the phone has a stylish finish and qualities that do count.

According to HMD Global, the custodian of the Nokia phone brand, the Nokia 2 should last two days on a single charge and comes with pure Android 7.1.1 Nougat.

Additionally, the company has established a solid track record for promptly delivering security updates to end-users — something that’s rare at this price.

e120e_59ade468e4b09e7071c9a610-1280x7201sep05201753225poster Are iPhone X, Galaxy Note 8 at $1000 really 10 times better than $100 Nokia 2?

The Nokia 2 should last two days on a single charge, says HMD Global, and comes with pure Android 7.1.1 Nougat.


Image: Nokia

Other core specs include an eight-megapixel rear camera and five-megapixel selfie shooter, 1GB RAM, 8GB in-built storage, and a MicroSD slot that supports up to 128GB.

It features a Gorilla Glass display and polycarbonate back. The phone is available black with gray edges, white with gray edges, and black with orange edges.

Basically, the Nokia 2 is effectively a high-end phone from a few years back and for the price could serve as a solid second phone. And yes, it has a 3.5mm headphone jack.

The phone arrives in the US as HMD Global celebrates its first birthday since taking over the Nokia brand after Microsoft’s mobile misadventure with Windows Phone and Nokia’s Lumia phones.

The company has so far released six smartphones and five basic phones, including the Nokia 3310, in 80 markets. The company also boasts strategic partnerships with Nokia, Google, Foxconn and Zeiss, which supplies the cameras for the top-end Nokia 8.

HMD also announced today that it will begin rolling out Android Oreo to its portfolio, starting with the Nokia 8.

The Nokia 2 is available at Best Buy, Amazon, and BH.

Previous and related coverage

Android Nokia 8 flagship goes high-end with dual camera and Zeiss optics

Leaked images offer a clear shot of the new Nokia 8 with Zeiss optics.

Nokia 5 review: A solid mid-range pure-Android contender

The Nokia 5 is a well-designed mid-range handset with excellent build quality, although several compromises have been made to achieve its attractive price point.

Nokia 3, First Take: Affordable Android, but beware the trade-offs

Nokia’s entry-level Android 7 phone looks good and includes NFC, but falls short on processing power and screen resolution.

Read more on smartphones

‘Avengers: Infinity War’ Trailer Is Finally Here to Really Break the Internet

The Avengers have assembled, again, and we’re seriously freaking out.

Marvel dropped the eagerly-anticipated first trailer for “Avengers: Infinity War” on Wednesday morning, after previewing different footage from the film and both Comic-Con and D23 earlier this year.

The sneak peek stars with each of the core superheroes saying, “There was an idea to bring together a group of remarkable people, to see if we could become something more, so when they needed us, we could fight the battles that they never could.”

“In time, you will feel what it’s like to lose, to feel so desperately that you’re right then to fail all the same,” Thanos is then heard saying, over shots of Doctor Strange, Bruce Banner, Tony Stark and Wong inside the Sanctum Sanctorum, Spider-Man’s “Spidey Sense” coming into action and Loki grabbing hold of the Tesseract, before the Mad Titan himself emerges in all his purple glory.

There are glimpses of Spider-Man’s amazing new suit, a bearded Captain America, blonde Black Widow and Vision getting his Infinity Stone ripped out of his head and Thanos flexing his Infinity Gauntlet. The most epic shot of the trailer, however, shows Cap, Widow, Bucky, Black Panther, Hulk, Iron Patriot, Falcon and Okoye running into battle in what appears to be Wakanda.

Capping it all off: a scene of Thor — still missing his eye after losing it in “Thor: Ragnarok” — asking “Who the hell are you guys” to the Guardians of the Galaxy.

The cast for this movie is massive, with Robert Downey Jr., Chris Evans, Scarlett Johansson, Chris Hemsworth, Chris Pratt, Zoe Saldana, Josh Brolin, Benedict Cumberbatch, Tom Holland, Elizabeth Olsen, Jeremy Renner, Tom Hiddleston, Chadwick Boseman, Mark Ruffalo, Vin Diesel, Karen Gillan, Anthony Mackie, Paul Bettany, Dave Bautista and probably 100 other superhero stars all expected to appear in the movie.


1e188_vanity-fair-heroes-main-300x250 'Avengers: Infinity War' Trailer Is Finally Here to Really Break the Internet

The trailer comes after President of Marvel Studios Kevin Feige teased some major changes to the MCU lineup after “Avengers 4,” which isn’t due out until 2019. The movie, according to him, will “bring things you’ve never seen in superhero films: a finale.” He added, “There will be two distinct periods. Everything before Avengers 4 and everything after. I know it will not be in ways people are expecting.”

“Infinity War” hits theaters May 4, 2018.

The trailer was very different from what fans saw at Comic-Con and D23 earlier this year, see how it compared by reading a breakdown of that sneak peek below:

The footage kicked off with the Guardians of the Galaxy rescuing Thor, who crashes into the Milano’s windshield as he drifts through space. It appears to happen after the events of “Ragnarok,” as he’s rocking his new ‘do. When he wakes up onboard the Guardians’ ship, his first words: “Who the hell are you guys?”

The rest of the footage was fast and furious, featuring appearances from pretty much EVERY Marvel star to date. Loki was spotted with the Tesseract, Spider-Man’s seen using his Spider-Sense and rocking the gold-trimmed suit unveiled at the end of “Homecoming,” Captain America’s rocking a new beard, Black Panther and The Winter Soldier are both seen kicking ass and Thanos himself got a lot of screen time. Perhaps most shocking off all, however, was Black Widow’s blonde hair!

The clip ended with the purple guy — looking more like Brolin than ever before — bringing hellfire down from the cosmos, as Peter Quill and Doctor Strange work together to fight back.

Is this wireless charger for the iPhone X really worth $50? Why yes, yes it is

There are dozens of wireless charging pads on Amazon that cost under $20, like this one from Choetech. With all the cheap options out there, can a $50 wireless charger really be worth the extra cash. In short, the answer is yes, definitely. The RAVPower Fast Wireless Charger is absolutely nothing like those inexpensive plastic chargers. It’s made of high-quality aluminum and it has a rubbery no-slip ring on the top to keep your iPhone X, iPhone 8, or Android phone in place. It also supports fast wireless charging at 7.5W, which Apple is enabling in the iOS 11.2 update on all 2017 iPhone models. Trust us, you’re going to love this charging pad.

Here’s what you need to know from Amazon’s product page:

* The fast wireless charging for newest iPhone will become available in a later iOS 11 update. Current iOS cannot support 7.5W fast charge. As of right now, standard charging is all it supports. Supports future iPhone 8 / 8 Plus / X up to 7.5W Charging: 50% faster than traditional 3.5W – 5W wireless chargers with a maximum 7.5W output.
* Compatible with All Qi-Enabled Phones: Includes the new iPhone 8, 8 Plus, iPhone X, Samsung Galaxy S8, S8 Plus, S7, S7 Edge, Note 5, and S6 Edge Plus; non-Qi enabled phones are still compatible but will require a Qi wireless charging cover to power up
* Wireless Charging, Unlimited Freedom: Place on the pad for instant wireless charging; no cables or wires needed to be connected to your phone
* Fast Free 24W QC 3.0 Adapter: Includes a powerful Quick Charge 3. 0 adapter that boosts the max output to 10W so selected Samsung Galaxy, Google Nexus, or Microsoft Lumia phones can charge even faster
* Portable, Practical, Stylish, and Safe: Lightweight, take anywhere size with silicone anti-skid design to prevent sliding; smart battery indicator; built-in over-current, over-voltage, and over-temperature protection systems

1ca64_41QLmZvxWvL._SL160_ Is this wireless charger for the iPhone X really worth $50? Why yes, yes it is

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Can A Computer Really Track Down Serial Killers Hiding Among Us?

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]]>Can A Computer Really Track Down Serial Killers Hiding Among Us?


f320d_coal-grid-uproxx Can A Computer Really Track Down Serial Killers Hiding Among Us?

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Serial killers are, officially, vanishingly rare. Contrary to what pop culture tells us, you’re more likely to get in a car wreck, shot in a robbery, or hit by lightning than fall afoul of a murderer. But that doesn’t mean they aren’t out there, and a computer algorithm digging through decades of murders may be the key to finding and stopping them.

The New Yorker has published a fascinating profile of Thomas Hargrove, a data-driven journalist who has been archiving and studying America’s murders (750,000+ cases) since 1976 for the Murder Accountability Project (MAP). Most of these cases are not committed by serial killers. They are the sad, ugly stories any journalist knows by heart; the abusive spouse nobody stopped, the petty argument that flared up into a tragedy, the cheater caught or attempting to cover their tracks. Yet Hargrove does uncover patterns:

In August of 2010, Hargrove noticed a pattern of murders in Lake County, Indiana, which includes the city of Gary. Between 1980 and 2008, fifteen women had been strangled. …Four years later, the police in Hammond, a town next to Gary, got a call about a disturbance at a Motel 6, where they found a dead woman in a bathtub. Her name was Afrikka Hardy, and she was nineteen years old. “They make an arrest of a guy named Darren Vann, and, as so often happens in these cases, he says, ‘You got me,’ ” Hargrove said. “Over several days, he takes police to abandoned buildings where they recover the bodies of six women, all of them strangled, just like the pattern we were seeing in the algorithm.”

Vann is going to trial in 2018 and is facing the death penalty. And it’s a victory for Hargrove, who’s convinced that data applied to crime statistics will uncover more serial killers. Hargrove, in fact, is convinced that there are at least two thousand active serial killers at large in America at the moment, according to his data. In particular, he’s concerned about a killer or killers that may have been active in the Atlanta area for at least forty years.

But are there really that many serial killers out there? That’s a tougher question than you might at first think. Keep in mind, algorithms only reflect the data we feed into them. In an analysis of an algorithm designed to help judges decide if criminals were more likely to reoffend, Pro Publica uncovered that the algorithm, despite efforts to remove race from the equation, consistently ranked non-white offenders more likely to commit future crimes, even if the white offender had a long record and the non-white offender had never committed a crime before. In fact, a teenage girl who idly picked up a bike from a driveway was seen as a greater risk than a hardened criminal.

And Hargrove admits that teasing out potential serial killers is largely a matter of guesswork, something he spent years building, working backwards from real cases. We are built to see patterns, as a species, and if you hunt for something specifically in the data, you may well find it even if it’s not there.

Still, as the New Yorker profile points out, MAP is a useful tool for understanding a crime we all fear, to take what’s vague and amorphous in our minds, defined more by fiction than fact, and put it in stark black and white, in numbers and points we can understand. And it helps us better understand the real form of crime in our communities. So even if Hargrove never finds another serial killer, he’s doing us all a public service.

(Via The New Yorker)


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    f320d_coal-grid-uproxx Can A Computer Really Track Down Serial Killers Hiding Among Us?

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Who Really Gets a Tax Increase if the Individual Mandate Goes Away?

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On government tables, it looks as if it’s low-income people. But the real losers would be higher up the income scale.

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Senator Orrin Hatch on Tuesday at the meeting of the Senate Finance Committee to address the tax overhaul.CreditTom Brenner/The New York Times

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Nov. 17, 2017

If Obamacare’s requirement to have health insurance is revoked by Congress, some people will choose to go without it, and the government will save money because it won’t have to pay to subsidize their plans.

Almost everyone agrees on that. But precisely how much the individual mandate matters, and who would really be worse off without it, are trickier questions.

New estimates show that the mandate’s repeal would give low-income Americans a big tax increase. But Republicans say that’s not true. And they have a point. Meanwhile, left out of the tax tables is the fact that some higher earners, who look as if they are getting more of a tax cut, will get hit with higher insurance premiums if the mandate is repealed.

The Congressional Budget Office currently estimates that eliminating Obamacare’s individual mandate will cause 13 million more people to become uninsured, and save the government $338 billion over 10 years. Most Republican lawmakers don’t really believe dropping the mandate would so severely lower the number of insured, a point they argued loudly when they were hoping to repeal Obamacare earlier this year.

After long resisting that idea, the budget office recently signaled that it agrees, and it plans to lower its estimates next year. But for now, Republicans have seized on the unadjusted estimates, because fewer people with government-subsidized insurance means more money to help them finance other parts of their tax overhaul bill.

It looks as if the tax bill rises for some people who drop coverage.

Here’s why: The subsidies Obamacare offers to low- and middle-income Americans who buy their own insurance take the form of refundable tax credits, a kind of government-issued gift card that can be used only to buy health insurance. But if fewer people who qualify for these gift cards choose to buy insurance, the government spends less in tax money for the population that qualifies. The tax scorekeepers count this reduction in tax credits as an increase in tax liability for the group. Individuals would not actually pay more in taxes.

If they don’t buy insurance and don’t get the gift card, is that really the same thing as paying more in taxes? Republicans say it is not.

“Nothing in our mark will impact the availability of premium subsidy credits,” said Senator Orrin Hatch of Utah, the chairman of the Senate Finance Committee, on Thursday, using a technical term for draft legislation. “This is the result of an assumption about economic behavior that is 100 percent voluntary.”

Mr. Hatch has a point. The subsidies may count, technically, as tax benefits, but they are relatively unusual in the tax code, because they can be used only to buy health insurance. People who get insurance can get a gift card. People who don’t get nothing. But if someone chooses not to buy insurance, does that mean they’ve lost out financially?

Some analysts consider those losses real losses, because it appears that some people are spurred to investigate their insurance options because of the mandate, then learn they qualify for free insurance. Without a mandate, they might remain uninsured. (And even some of those who don’t qualify for free insurance might end up better off buying it — people who contract an expensive disease, or get in a serious accident.)

“In my view, those people are definitely better off with coverage than without coverage,” said Aviva Aron-Dine, a senior fellow at the liberal Center on Budget and Policy Priorities. “They’re protected from financial catastrophe. They can get primary and preventive care. And the mandate gave them a nudge.”

But others say that if customers valued health insurance, they would buy it.

“Since the credits go exclusively to pay the premium, it’s a little weird,” said Len Burman, an institute fellow at the Tax Policy Center, a research group that evaluates tax laws.

Another weird thing that Mr. Burman noted is that the more expensive health insurance gets, the bigger a tax increase the change appears to be in the government estimates. Under the Affordable Care Act, people below a certain income cap can’t pay more than a percentage of their income to buy health insurance, so as prices go up, so do their subsidies. Economists think that lifting a requirement for healthy people to buy insurance will tend to make the resulting pool of customers sicker, driving up insurance premiums. But the actual cost of insurance for that group wouldn’t increase.

“The credits look more valuable, because the proposal sabotages the health market, and premiums go up,” he said.

Others will have a tax cut but face much higher premiums.

But if the low-income people who won’t get tax credits aren’t clearly worse off financially — after all, they could claim them again if they choose to buy insurance — there’s another group that is certain to suffer if the mandate goes away. Higher-income people, who don’t qualify for government gift cards, have to pay the full price of health insurance. Single people earning more than about $48,000, or families of four earning more than around $98,000, earn too much to qualify for any insurance subsidies.

The budget office estimates that eliminating the mandate would drive up premiums an average of 10 percent every year beyond their normal rate of increase. Based on this year’s prices, that would mean a price increase of more than $50 a month for a 40-year-old single customer in large sections of Nebraska and North Carolina, even for the very cheapest high-deductible plans on the market. Unsubsidized 40-year-old customers in Alaska, who qualify for credits at slightly higher rates of income, would face increases of more than $70 a month for the least-expensive plan. In the cheapest markets in the country, in Indiana and Texas, premiums would rise for single 40-year-olds by about $19 a month.

Such a premium increase could largely cancel out the tax benefits of the reform bill for many people in that income range who buy their own insurance. A Center on Budget and Policy Priorities analysis of the first draft of the Senate tax bill found that the average family earning between $50,000 and $75,000 would save around $750 on their taxes. Compare that with the $600 premium increase a single customer in Nebraska might face.

Both Susan Collins of Maine and Lisa Murkowski of Alaska, Republican senators whose votes may be needed to pass the tax bill, have expressed some concern about the premium increases for this group as a kind of hidden middle-class tax increase. Those changes may not show up as increases on a government table the way the missing tax credits appear for their lower-income neighbors. But the effect on their bottom line may be more significant.

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This is what a ruined Space Gray iPhone X really looks like

A few days ago, I told you how I “ruined” my iPhone X in less than a minute, and that many of you have probably done the same thing. All I actually did was use a regular silicone case that Apple makes and a cheap screen protector. You see, the iPhone is made of glass, and this time around it’s a lot more fragile and expensive to repair. One wrong drop and you may end up with an unresponsive screen or a faulty Face ID camera. Nobody wants that.

But let’s take a look at what a ruined iPhone X really looks like, and I’m not even talking about the units that were smashed by being dropped.

If you’re going caseless with the iPhone X, the glass isn’t the only thing you should worry about. The stainless steel frame, while more durable than aluminum, will scratch. That’s almost a non-issue, I thought at first, given that we’ve seen this before when the Apple Watch was first launched.

However, the following set of images will show you what scratched stainless steel may look like on the Space Gray version of the phone, and it sure isn’t pretty.

a906f_iphone-x-space-gray-scratches-1 This is what a ruined Space Gray iPhone X really looks likeImage Source: Weibo

Posted on Weibo by a Ice Universe, a Chinese gadget leaker, the images show what appear to be scratches acquired during regular usage. They’re noticeable along the bottom edge and on the sides. In fact, the following image shows a somewhat disturbing scratch, if we can call it that.

a906f_iphone-x-space-gray-scratches-1 This is what a ruined Space Gray iPhone X really looks likeImage Source: Weibo

It’s unclear whether the phone has sustained any kind of damage outside of normal use. The screen does appear to be intact though, and it seems to be protected by a glass cover.

a906f_iphone-x-space-gray-scratches-1 This is what a ruined Space Gray iPhone X really looks likeImage Source: Weibo

So you’d better think twice before deciding to use the iPhone X without some sort of protection. That is if you want to preserve its good looks for as long as possible. The obvious downside is that you’d be hiding those looks under protective gear that’ll add extra bulk to your iPhone.

Something really is wrong on the Internet. We should be more worried.

Something is wrong on the internet,” declares an essay trending in tech circles. But the issue isn’t Russian ads or Twitter harassers. It’s children’s videos.

The piece, by tech writer James Bridle, was published on the heels of a report from the New York Times that described disquieting problems with the popular YouTube Kids app. Parents have been handing their children an iPad to watch videos of Peppa Pig or Elsa from “Frozen,” only for the supposedly family-friendly platform to offer up some disturbing versions of the same. In clips camouflaged among more benign videos, Peppa drinks bleach instead of naming vegetables. Elsa might appear as a gore-covered zombie or even in a sexually compromising position with Spider-Man.

The phenomenon is alarming, to say the least, and YouTube has said that it’s in the process of implementing new filtering methods. But the source of the problem will remain. In fact, it’s the site’s most important tool — and increasingly, ours.

YouTube suggests search results and “up next” videos using proprietary algorithms: computer programs that, based on a particular set of guidelines and trained on vast sets of user data, determine what content to recommend or to hide from a particular user. They work well enough — the company claims that in the past 30 days, only 0.005 percent of YouTube Kids videos have been flagged as inappropriate. But as these latest reports show, no piece of code is perfect.

Similar algorithms serve as the engine behind almost all of the most successful tech companies, powering everything from Facebook’s news feed to Google’s search results (Google, incidentally, is the parent company of YouTube). Naturally, these mysterious tools have become convenient scapegoats for many of the content problems we face today, from bizarre videos aimed at vulnerable children to misinformation in news feeds during the 2016 election.

Clearly, Silicon Valley has some work to do. But in addition to demanding more accountability from companies after their tools go awry, we should demand more responsibility from ourselves. We need to think about whether we want to reduce our own reliance on corporate algorithms, and if so, how.

As the Internet has become an ever-larger part of our lives, we’ve come to rely on these proprietary bits of code as shortcuts for organizing the world. Algorithms sort through information and make decisions for us when we don’t have the capability (or perhaps just the energy) to do it ourselves. Need to distract the kids? Send ’em to the wildly educational world of YouTube. The app will pick out the safe videos — probably. The mechanism may be skewed by profit motives, biased by its data sets or just generally inscrutable, but is that any reason to give it up?

Why aren’t we more alarmed by this? Maybe because we’ve always used decision-making shortcuts, and they’ve always had flaws. How would we have chosen a children’s video before YouTube? Perhaps we’d act on a recommendation from a librarian, or a peer group, or even a National Legion of Decency list. These sources, too, were insular, subject to personal biases and limited in scope.

Still, there were meaningful differences between those old-school shortcuts and today’s machine-learning algorithms. The former had at least some oversight and regulation; it’s unlikely that a public library would lend out nursery rhyme snuff films. Shared community values made it clear which choices were being favored, and why. And human judgment — today almost quaint — occasionally allowed for serendipity in a positive direction. One might come across a resource not carefully calibrated to agree only with one’s stated preferences, and be the better for it.

Is there any way to steer our current algorithmic regime in that more human direction? It’s not clear how. Some lawmakers have suggested that companies release their algorithms for public review; others propose regulating corporate algorithms. For now, the lesson for everyday users may just be an urgent need for increased awareness, a reminder that maybe we shouldn’t place all of our trust in a decisionmaking function that we don’t fully understand. Frightening children’s videos are, among other things, a wake-up call. If there’s something wrong on the Internet, we should do more than just watch.

Read more about this topic:

Meg van Achterberg: Jimmy Kimmel’s Halloween prank can scar children. Why are we laughing?

The Post’s View: Facebook can’t protect elections on its own

Pixel won’t get KRACK fix until December, but is that really a big deal?

8d30a_System-up-to-date-android-update-800x444 Pixel won't get KRACK fix until December, but is that really a big deal?

In October, security researchers discovered a major vulnerability in a Wi-Fi’s WPA2 security called “KRACK.” This “Key Reinstallation Attack” can disrupt the initial encryption handshake that happens when an access point and a device first connect, allowing an attacker to read information assumed to be securely encrypted. It’s possible to totally defeat WPA2 encryption using KRACK, allowing a third party to sniff all the Wi-Fi packets you’re sending out. Any device that uses Wi-Fi and WPA2 is most likely vulnerable to the bug, which at this point is basically every wireless gadget on Earth.

Google and the rest of the OEMs are working to clean up Android’s KRACK epidemic, and, on Monday, Google addressed the bug in the November Android Security Bulletin. A patch was posted this week to the Android Open Source Project (AOSP) repository, and, at the same time, Google started rolling out a November security update to Google Pixel and Nexus devices. But if you read the bulletin closely, you’ll see the November security patch for Google devices does not contain the KRACK fix.

Did Jurassic Park really channel The Goonies? The Internet wants to know

Jurassic Park fans, hold on to your butts! While it’s not unusual for Steven Spielberg to cheekily drop in a few cinematic references now and then in his films – like putting a hieroglyphic C3PO and R2D2 in Raiders of the Lost Ark or an homage to himself by sticking the Ark of the Covenant in Kingdom of the Crsystal Skull – the Internet has managed to dig up what is probably the ultimate dino-powered tribute… to (drum roll please)… The Goonies of all movies!

Some eagle-eyed Netizens have posted pictures that purport to show the park’s scheming computer programmer, Dennis Nery (played by Seinfeld star Wayne Knight), decked out in duds that are a clear homage to the clothes worn by Goonies kids Chunk, Mouth and Mikey. Check out the mosaic Twitter user Shawn Robare put together and see for yourself!

Either Spielberg’s too clever by half with this easter egg, or someone in Jurassic Park‘s costume department was having a little fun. In any case, we got to hand it to Robare and other fanboys like Reddit user shadewfb for the find.

Nedry’s yellow rain jacket when he’s trying to escape Isla Nublar is a near carbon copy to Mikey’s slicker in The Goonies and the same applies pretty much to the other two outfits – like the pattern on Nedry’s Hawaiian shirt when he’s doing a deal for the dino embryos , albeit the color of the flowers are slightly different.

 

Spielberg, of course, is credited for dreaming up the story and executive producing the 1985 comedy adventure, which was helmed by Richard Donner. The Goonies followed a band of kids hunting for gold left behind by pirate One Eyed Willy in order to save their parents’ homes from a bunch of predatory developers and is now considered something of an ’80s classic, especially thanks to tributes by the makers of Stranger Things.

No word from Spielberg’s camp whether indeed the nod was intentional. Perhaps next time he can try working Sloth into the next Indiana Jones?

Google on flooding the internet with fake news: Leave us alone, we’re trying really hard… *sob*

Comment Google has responded in greater depth after it actively promoted fake news about Sunday’s Texas murder-suicide gunman by… behaving like a spoilt kid.

On Monday, countless netizens noted that the prominently placed Twitter-fed “carousel” of tweets featured on Google’s first page of search results contained links to obviously false claims about the cowardly killer, including that he was a Muslim convert, a member of the antifascist movement, a member of a Bernie Sanders political group, and supported Hillary Clinton.

The search engine-slash-ad giant has a market cap of $725bn, makes $90bn in annual revenue, has over 50,000 employees, is absurdly profitable, and serves over one billion users every day. Google responded to this week’s complaints by itself complaining that its “ranking algorithms are changing second by second and represent a dynamic conversation that is going on in near real-time.”

It also pointed out that the “top stories” news section above the carousel didn’t contain any fake news – unlike a month earlier when it did following the Las Vegas mass shooting.

But that was a quick, defensive first response. Having had time to reflect on the issue, the Silicon Valley monster’s “public liaison for search” and former Search Engine Land blog editor Danny Sullivan gave a more, um, considered response in a series of tweets.

“Bottom line: we want to show authoritative information. Much internal talk yesterday on how to improve tweets in search; more will happen,” he promised, before noting that the completely bogus information had only appeared “briefly.”

Getting better all the time

He then noted and defended Google’s spreading of fake news following the Las Vegas murder spree: “This only happened for a few thousands who searched for [the gunman’s] name, not for general searches relating to the Las Vegas shooting.”

And Sullivan pointed out that – actually – Google had done really well this time not actively promoting false information, even finding time to pat himself on the back. “Early changes put in place after Las Vegas shootings seemed to help with Texas. Incorrect rumors about some suspects didn’t get in…”

But back to the, you know, false information spread on Google’s search pages following this recent shooting in Texas: “The tweets we carry in results should reflect useful information. We’re not happy with ourselves they didn’t,” adding again, “even if for a short time…”

Anyway, everyone just needs to leave Google alone. S’not fair that everyone is criticizing the multi-billion-dollar faceless corporation just because it promotes false information to billions of people.

“Right now, we haven’t made any immediate decisions. We’ll be taking some time to test changes and have more discussions,” he went on, before finishing up: “Not just talk. Google made changes to Top Stories and is still improving those. We’ll do same with tweets. We want to get this right.”

All of which sounds absolutely marvelous and well intentioned, and of course we should give it time to think it over… if you assume that Google is a little startup with 10 employees and 1,000 users rather than one of the world’s largest corporations and for billions the first source of information about what is going on in the world.

Amazingly, Sullivan and his team don’t appear to have considered what everyone else in the entire world would do in a similar situation: test it and perfect in private, rather than shovel crap into public view.

Wake up and smell the coffee substitute

In fact, even though Google – and Facebook and Twitter – were handed their ass last week in US Congress for their roles in spreading thousands of fake stories created by the Russian government’s propaganda arm to more than a hundred million Americans, it doesn’t seem to have permeated the advertising goliath’s brain that it should do more than promise to do better.

In fact, such is the level of Googly delusion that even when people on Twitter suggested that Google kill off the carousels until they work properly, Sullivan responded with a screen grab of a search for “Ronan Farrow” that demonstrated how useful it is. In this case, it showed off the news and Twitter carousel results related to Farrow’s journalistic work.

“It does work in many cases and useful, such as here. Yanking it potentially makes search worse for other queries. So better if can improve,” said Sullivan. In other words, sure Google’s shoddy Twitter-fed carousel of shame is utterly terrible, but hey, it works sometimes.

Only one problem: the screen grab highlighted the exact same problem all over again. “The second [tweet in the carousel] is a quote tweet that doesn’t include the tweet being quoted, the third is someone just tweeting the same link as the first tweet,” noted tech scribe Peter Bright. “I think that’s a really low bar for making search results better.” ®

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There’s now a really nice Windows phone available on Verizon, and …

9e965_HP-Elite-x3-front-facing-640x640 There's now a really nice Windows phone available on Verizon, and ...

Early in 2016, HP announced the Elite X3, a high-end Windows 10 Mobile phone that was, well, actually really nice. A then-current Snapdragon 820, 4GB RAM, dual SIM, 6 inch 2560×1400 AMOLED screen, iris and fingerprint recognition, Qi and PMA wireless charging, waterproof, 16MP rear and 8MP front cameras: it was the kind of thing flagships are made of.

HP was aiming the phone at corporate customers, but there was a sticking point; it didn’t support CDMA, which meant it wasn’t compatible with Verizon’s legacy 3G network (though LTE service areas would have been fine). With Verizon having an estimated 50 percent of the corporate phone market, this was a big problem. While Windows Phone 8 had CDMA support, its successor, Windows 10 Mobile, did not—part of the fallout of the Nokia layoffs. This meant that even though phones like the X3 and Lumia 950 and 950 XL had the right radio hardware in their Qualcomm processors to work on Verizon’s network, they were in practice restricted to T-Mobile and ATT, the US’s GSM carriers.

But even though Microsoft is no longer developing new features for Windows 10 Mobile, it turns out that for whatever reason, someone at Redmond has been busying themselves with writing CDMA support. And lo, it’s actually shipped: the Microsoft Store now has a Verizon version of the x3.

There’s a slim possibility that it is being sold as a pure LTE device using VoLTE for voice and simply losing service if you should find yourself in an area with only CDMA/EVDO coverage, but I don’t think so. The spec listing claims both CDMA and EVDO support, so it seems to be the real deal. In July, there were some signs that this was in the cards, as release notes for new firmware revisions noted bug fixes when using the phone on CDMA networks.

Even more remarkably, although the phones were listed as “in stock” a few hours ago, they’re now showing as sold out.

This leads us, of course, to wonder why. Why develop the CDMA capability at all, and why release it to market?

The release of a working CDMA telephony stack shows that Microsoft still hasn’t given up on the idea of some kind of Windows device offering some kind of phone-like capabilities.

Microsoft’s efforts to unify and componentize Windows are continuing and are now in their third phase, named Windows Core OS (the first phases being MinWin and OneCore). One goal of this work is to unify the user interface components; presently the Start menu on desktop Windows and that on Windows 10 Mobile are different, unrelated programs. In Windows Core OS, they won’t be. This Windows development is believed to be occurring in tandem with the development of a new piece of hardware, codenamed “Andromeda.” That’s a piece of hardware that will have among other things telephony capabilities.

As for bringing it to market, I’d guess it’s some combination of fulfilling a contractual obligation and perhaps wanting to get some real-world testing of that new CDMA capability.

So there we have it. Two years after it might possibly have done the platform any good and more than a year too late for the Elite x3, Windows 10 Mobile now has proper CDMA and EVDO support.

There’s now a really nice Windows phone available on Verizon, and I’m not sure why

9af83_HP-Elite-x3-front-facing-640x640 There's now a really nice Windows phone available on Verizon, and I'm not sure why

Early in 2016, HP announced the Elite X3, a high-end Windows 10 Mobile phone that was, well, actually really nice. A then-current Snapdragon 820, 4GB RAM, dual SIM, 6 inch 2560×1400 AMOLED screen, iris and fingerprint recognition, Qi and PMA wireless charging, waterproof, 16MP rear and 8MP front cameras: it was the kind of thing flagships are made of.

HP was aiming the phone at corporate customers, but there was a sticking point; it didn’t support CDMA, which meant it wasn’t compatible with Verizon’s legacy 3G network (though LTE service areas would have been fine). With Verizon having an estimated 50 percent of the corporate phone market, this was a big problem. While Windows Phone 8 had CDMA support, its successor, Windows 10 Mobile, did not—part of the fallout of the Nokia layoffs. This meant that even though phones like the X3 and Lumia 950 and 950 XL had the right radio hardware in their Qualcomm processors to work on Verizon’s network, they were in practice restricted to T-Mobile and ATT, the US’s GSM carriers.

But even though Microsoft is no longer developing new features for Windows 10 Mobile, it turns out that for whatever reason, someone at Redmond has been busying themselves with writing CDMA support. And lo, it’s actually shipped: the Microsoft Store now has a Verizon version of the x3.

There’s a slim possibility that it is being sold as a pure LTE device using VoLTE for voice and simply losing service if you should find yourself in an area with only CDMA/EVDO coverage, but I don’t think so. The spec listing claims both CDMA and EVDO support, so it seems to be the real deal. In July, there were some signs that this was in the cards, as release notes for new firmware revisions noted bug fixes when using the phone on CDMA networks.

Even more remarkably, although the phones were listed as “in stock” a few hours ago, they’re now showing as sold out.

This leads us, of course, to wonder why. Why develop the CDMA capability at all, and why release it to market?

The release of a working CDMA telephony stack shows that Microsoft still hasn’t given up on the idea of some kind of Windows device offering some kind of phone-like capabilities.

Microsoft’s efforts to unify and componentize Windows are continuing and are now in their third phase, named Windows Core OS (the first phases being MinWin and OneCore). One goal of this work is to unify the user interface components; presently the Start menu on desktop Windows and that on Windows 10 Mobile are different, unrelated programs. In Windows Core OS, they won’t be. This Windows development is believed to be occurring in tandem with the development of a new piece of hardware, codenamed “Andromeda.” That’s a piece of hardware that will have among other things telephony capabilities.

As for bringing it to market, I’d guess it’s some combination of fulfilling a contractual obligation and perhaps wanting to get some real-world testing of that new CDMA capability.

So there we have it. Two years after it might possibly have done the platform any good and more than a year too late for the Elite x3, Windows 10 Mobile now has proper CDMA and EVDO support.

The Health 202: If the GOP really wanted to repeal key parts of Obamacare, they could use their tax plan to do it

THE PROGNOSIS

Flanked by House Speaker Paul Ryan and House Ways and Means Chairman Kevin Brady, President Trump speaks about tax reform legislation at the White House on Thursday. (Drew Angerer/Getty Images)

There’s an opportunity through the GOP tax revamp introduced yesterday to dramatically overhaul how most Americans get their health insurance. But Republicans aren’t going there.

The single biggest carve-out in the U.S. tax code is for health plans offered by employers, who don’t have to pay federal income or payroll taxes on their monthly premiums. This exemption — created shortly after World War II as a way for employers to boost job benefits even amid wage controls — has made employer-sponsored plans the chief source of health insurance for Americans. But it is also blamed for contributing to the country’s health-care spending binge and costing people their health insurance whenever they change jobs.

You heard that right — the way to shift the U.S. health-care system back to one that’s more market-driven, where people are encouraged to shop around for the best deal, is through a tax change, not through Obamacare repeal. The health-care bills Congress recently tried to pass would have affected the one-quarter of Americans who buy coverage on their own through the marketplaces created by the Affordable Care Act or via Medicaid. But way more people — about half of all Americans — receive health coverage through their jobs.

The biggest policy reforms are often the hardest, and that’s true in this case. Even though most conservative and liberal health economists agree that decoupling health insurance from the workplace could improve the U.S. health-care system in the long run, employers overwhelmingly oppose the idea. And any such move would likely spark a massive public outcry from the 150 million Americans who get insurance through their jobs.

The tax draft that House Republicans released yesterday doesn’t propose any changes to the employer exemption, even though Speaker Paul Ryan (R-Wis.) advocated capping the deduction in his “Better Way” agenda last year.

This is not just a Republican issue. Democrats also regarded capping or even scrapping the employer tax break as too politically risky as they were writing the ACA back in 2010. Instead, they decided to tax high-cost health plans through the “Cadillac tax,” which didn’t appear to hit Americans so directly.

There’s another way Republicans have ducked controversy in their tax bill: by so far excluding a repeal of the ACA’s individual mandate to buy coverage (something Trump is already pushing for on Twitter). Some conservatives, including Sen. Tom Cotton (R-Ark.), urged leaders to tack it on to the draft proposal, and the idea was even being tossed around Wednesday night as the final details were being crafted.

“I have what I will call maybe a creative idea, a novel idea, but one that I think is gaining momentum in the Senate and in the House,” Cotton told reporters yesterday. “We can repeal the individual mandate of Obamacare.” 

But for now at least, the House tax plan doesn’t try to touch Obamacare. That could change as Trump — and conservative lawmakers and their allies in the interest group world —  keep pushing for a a long-sought victory in that arena.

Trump had demanded individual mandate repeal in two tweets Wednesday:

Trump again told House Republicans in a meeting yesterday that he wants to roll back the individual mandate in the tax bill — perhaps in the Senate, two lawmakers in attendance told the Hill.

“He just said he liked the idea and he had asked the senators about it and they said they were considering it,” said Rep. Kristi Noem (R-S.D.), who participated in the  meeting at the White House.

Don’t get us wrong: The House tax bill contains plenty of other controversial elements that Republicans will have to navigate if they have any hope of passing a final restructuring into law. The measure slashes corporate and individual income tax rates and jettisons numerous tax breaks Americans and businesses have used for years to limit their costs, my colleagues Damian Paletta and Mike DeBonis report. In the coming weeks, lobbyists will be furiously pressuring Congress to protect their preferred deductions.

The tax bill does propose to do away with one health-care tax break — a deduction on medical expenses beyond 10 percent of gross income. The deduction particularly benefits low-income families in which someone has a serious chronic condition requiring high-cost medical equipment or therapy. 

Per my colleague Glenn Kessler:

From the top Democrat on the Senate Finance Committee: 

Cleaning up the tax code so you can lower overall tax rates might be a worthy goal — it’s riddled with exemptions, deductions and other loopholes that make filing taxes extremely complicated and cost the government tons of money every year. But for just about every carve-you try to repeal, there will be a an interest group fighting to protect it. Exactly so with the medical expense deduction:

From Lisa Mascaro, who covers Congress for the Los Angeles Times and Chicago Tribune:

Oh, and there’s another tweak worth mentioning in the GOP tax proposal. Page 10 of the tax plan says parents can start a tax-exempt “529” college savings account for an “unborn child.”

“The provision provides that an unborn child may be treated as a designated beneficiary or an individual under section 529 plans,” the plan says. “An unborn child means a child in utero. A child in utero means a member of the species homo sapiens, at any stage of development, who is carried in the womb.”

That inclusion prompted praise from anti-abortion advocates. March for Life President Jeanne Mancini said she hopes lawmakers will also eventually expand the child tax credit to include the unborn. “A child in the womb is just as human as you or I yet, until now, the U.S. tax code has failed to acknowledge the unborn child,” Mancini said in a statement.

But Rep. Diana DeGette (D-Colo.), chairwoman of the congressional Pro-Choice Caucus, wondered this: “What’s next, giving a Social Security number to a zygote?”

Former CMS Administrator Andy Slavitt poked fun, too:

For more in-depth coverage of the tax fight, read my colleague Tory Newmyer over at The Finance 202. Sign up for his daily newsletter here.

eebaf_imrs The Health 202: If the GOP really wanted to repeal key parts of Obamacare, they could use their tax plan to do it

President Trump shakes hands with New Jersey Governor Chris Christie (R) after declaring the opioid crisis a ‘public health emergency.’ (JIM LO SCALZO/EPA-EFE/REX/Shutterstock)

AHH: If you listen to President Trump talk about the opioid crisis, you might think it’s only a criminal justice issue. But the final report from his opioid commission rather surprisingly treats opioid abuse mostly as a medical issue, notably avoiding rhetoric indicating a return to the war on drugs, Vox’s German Lopez writes.

“Consider the context,” German writes. “The commission was focused on a big drug crisis, established by a Republican administration, and chaired by a Republican governor — a recipe that just a few decades or even years ago would have guaranteed that much of the report would have focused on how to punitively crack down on drugs through the criminal justice system.”

Yet the commission mostly treats the epidemic as a public-health issue. Take this excerpt: “It is time we all say what we know is true: addiction is a disease,” the commission writes. “However, we do not treat addiction in this country like we treat other diseases. Neither government nor the private sector has committed the support necessary for research, prevention, and treatment like we do for other diseases.”

And just one of the commission’s 56 recommendations is punitive. It suggests increasing penalties for fentanyl, a synthetic painkiller that is 50 to 100 times stronger than morphine. A few of the commission’s recommendation’s also call on law enforcement to target drug trafficking organizations and bolster efforts to intercept fentanyl being sent via mail.

German compares this language to a strategy blueprint released by the Office of National Drug Control Policy in 1989 during the cocaine crisis. “We should be tough on drugs — much tougher than we are now,” that report said. In a televised address about the issue, then-President George H.W. Bush spoke about drug abusers more as culprits, not as victims.

Of course, the commission’s recommendations are just that —  recommendations. German described the report as a “step forward” but it’s up to the Trump administration to act.

eebaf_imrs The Health 202: If the GOP really wanted to repeal key parts of Obamacare, they could use their tax plan to do it

(iStock/Getty Images/Image Source)

OOF: The House plans today to approve a bill funding the Children’s Health Insurance Program, more than a month after funding for the program covering 9 million low-income kids technically expired. But Democrats are still refusing to support the measure because they don’t like how it’s paid for. “A partisan morass over how to pay for the legislation all but ensures that state governments and millions of children will get little relief from the uncertainty that has faced the programs since funding officially expired a month ago,” the New York Times’ Robert Pear reports.

It’s a testament to the level of partisan rancor that grips Washington, Robert writes, since CHIP has typically been one of the few bipartisan areas of agreement in Congress. The lack of funding is sparking uncertainty among states, which depend on federal CHIP financing to keep their programs running. “Unsure when Congress will provide more funds, some states have begun drafting notices to inform families that they could lose coverage. And lawmakers have shown little urgency in responding,” Robert writes.

Democrats and Republicans have agreed they want to fund CHIP for five years and community health centers for two years.The sticking point: Coming up with the $23 billion needed to pay for it all.

“House Republicans want to take money from a fund created by the Affordable Care Act that pays for a wide range of public health efforts, like preventing diabetes, vaccinating children, reducing the use of tobacco and fighting the opioid epidemic,” Robert writes. It would also shorten the grace period for consumers who fail to pay their share of premiums for Obamacare premiums. 

“Republicans say that some states have used the prevention fund as a slush fund, and that some consumers have abused the grace period to obtain a full year’s coverage while paying premiums for only nine months,” Robert writes. “Democrats are outraged that Republicans insist on offsetting every dollar of new spending on the child health program while pushing a tax bill that could add as much as $1.5 trillion to federal budget deficits over 10 years.”

Tujuana Bigelow sits outside her home in Glenarden, Md. Bigelow’s son Warren Webb, may have died as a result of medical errors at the United Medical Center Nursing home. (Michael Robinson Chavez/The Washington Post)

OUCH: Officials at D.C.’s only public hospital failed to report to regulators key details about a patient left alone to die at the facility’s nursing home in August, the Post’s Peter Jamison reports.

An incident report submitted to the D.C. Department of Health — and obtained by The Post through a public records request — left out information about the case of 47-year-old Warren Webb, which would likely have triggered an investigation of the long-term care unit at beleaguered United Medical Center. It didn’t disclose that Webb died, let alone that he repeatedly cried out for help, complained of shortness of breath and was left lying on the floor for at least 20 minutes by his nurses after he rolled out of bed — details reported by The Post based on interviews with eyewitnesses and a time-stamped audio recording of the incident.

Instead, the Aug. 25 report says Webb “was lower [sic] to the floor in sitting position when observed sliding out of his bed” and “was encouraged to wait for staff before attempting to get out of bed by himself.” In response to a question on the reporting form that asks whether medical treatment was necessary, hospital officials wrote, “No.”

“The report’s omissions could intensify scrutiny of the hospital by D.C. lawmakers,” Peter writes. “Next week the D.C. Council is scheduled to vote on whether it will renew a $4.2 million contract for Veritas of Washington, a politically connected consulting firm that has been running UMC since last year.”

eebaf_imrs The Health 202: If the GOP really wanted to repeal key parts of Obamacare, they could use their tax plan to do it

Sen. Tammy Baldwin (D-Wis.) (Photo by Astrid Riecken/Getty Images)

–One of Washington’s least-kept secrets is the revolving door between federal agencies and the drug companies they regulate. Several Democratic senators want to crack down on how quickly people can rotate between the two worlds, our colleagues Scott Higham and Lenny Bernstein report.

Sen. Tammy Baldwin (D-Wis.) is lead sponsor on  measure to establish a two-year period barring officials from the DEA and FDA from assisting drug companies with lobbying efforts. The legislation broadens the definition of “lobbying contact” to include activities such as strategy sessions. It also limits activities by pharmaceutical officials if they are hired to work in the federal government.

“The pharmaceutical industry has a deep-rooted and strong influence in Washington, and a revolving door between drug companies and government cannot undermine the safety of our communities,” Baldwin said.

The introduction of the bill follows a joint investigation by The Post and CBS’s “60 Minutes” that explored how a little-known provision in an Obama-era law crippled the DEA’s enforcement efforts. The legislation is co-sponsored by Sens. Dianne Feinstein (Calif.), Kamala D. Harris (Calif.), Ed Markey (Mass.), Maggie Hassan (N.H.), Jeanne Shaheen (N.H.) and Tom Udall (N.M.) and Baldwin said she plans to encourage Republicans to sign on as well. 

eebaf_imrs The Health 202: If the GOP really wanted to repeal key parts of Obamacare, they could use their tax plan to do it

CMS Administrator Seema Verma. (Pete Marovich/Bloomberg)

–Three major hospital lobbying groups say they will sue the Centers for Medicare and Medicaid Services over a rule finalized this week that would cut what hospitals are paid under the federal 340B drug discount program. Currently, nonprofit hospitals that qualify for the program receive 6 percent more than the sale price of drugs. But the finalized rule cuts that payment down to 22.5 less than the sale price, which will result in a 1.6 billion decrease in payments, Axios reports

The American Hospital Association, America’s Essential Hospitals and the Association of American Medical Colleges said they plan to sue over the rule, which indicates the Trump administration was siding with drugmakers and doctors who say hospitals are abusing the 340B program. It applied to just 1 percent of hospitals back when it was created in 1992, but has since dramatically expanded. By 2014 an estimated 45 percent of all Medicare acute care hospitals participated in the program, according to a 2015 overview by Medicare Payment Advisory Commission. 

A few more reads from The Post and beyond:

DON’T MISS THIS: The Post and Live Nation will bring the “Can He Do That?” podcast to a live audience at the Warner Theatre on Tuesday, Nov. 7. In this live taping, political reporters Bob Woodward, David Fahrenthold and Karen Tumulty will join host Allison Michaels to review the past year in President Trump’s White House and the biggest moments that made people wonder “Can He Do That?” Tickets can be purchased now at Live Nation. Attendees will also receive a free 30-day digital subscription to The Washington Post. 

MORE POST PROGRAMMING: The Washington Post hosts Secretary of Veterans Affairs David Shulkin for a discussion that will include his department’s efforts to curb the veterans’ suicide rate, address post-traumatic stress disorder and other health concerns on November 9.

Today

  • The Brookings Institution holds an event on policy approaches to the opioid crisis.

Coming Up

  • The American Enterprise Institute hosts an event on Puerto Rico after Hurricane Maria on November 6.

  • Axios hosts an event on a new era in cancer innovation with former Vice President Joe Biden and former first lady Jill Biden on November 8.

  • The American Enterprise Institute holds an event on the opioid crisis with Rep. Greg Walden (R-Ore.) on November 13.

  • STAT holds an event on the FDA on November 13.

Here’s a video explainer on the House GOP’s tax plan:

House Minority Leader Nancy Pelosi (D-Calif.) called the Republican’s tax plan a “ponzi scheme:”

President Trump jokes that his mother would have never thought he would be president:

Seth Meyers takes a closer look at the GOP tax plan and President Trump’s comments after the recent attack in New York:

What Android gaming really needs

Razer has just unveiled its much anticipated first smartphone, a device it bills to be made by gamers for gamers. While the street creds of the Razer Phone, as far as specs go, is undoubtedly the smartphone equivalent of a top-tier gaming PC, at the end of the day, it is pretty much just that: a top-tier smartphone. Its mere existence necessarily raises the question of what a gaming smartphone really is. But perhaps the deeper question that needs to be asked is whether it is what Android gamers and Android gaming needs today. Sadly, it really isn’t and Android gaming needs more than just a self-proclaimed “for gamers” smartphone in order to thrive.

Read the rest of this page »




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