Podcasts about public health fund

On this week's podcast, the National Association of County and City Health Officials' Adriane Casalotti, Chief of Government and Public Affairs and Lauren Mastroberardino, Government Affairs Senior Specialist welcome Victoria Van de Vate, NACCHO's new Director of Government Affairs. The team provided an update on government funding and the newly elected Speaker of the House of Representatives. They also discussed a letter that NACCHO and 110 other public health organizations sent to the Senate opposing a proposal to cut $980 million from the Prevention and Public Health Fund, also known as the Prevention Fund, in order to provide funding for the Primary Care and Health Workforce Act. Later in the program (9:17), NACCHO Senior Program Analyst Francis Higgins spoke with two representatives from local health departments that are doing overdose prevention work: Sixto Aguirre, a CPSW/Case Manager II, Peer Supported Probation at the Rio Arriba Department of Health and Human Services in New Mexico, and Seth Dewey, a Health Educator at the Reno County Health Department in Kansas. Both are NACCHO overdose prevention award recipients. Nearly 110,000 Americans died of overdose in 2022. Aguirre and Dewey discussed their lived experiences, how they got connected to their overdose prevention work, and what their local health departments are doing in response to the crisis. Local health departments are integrating people with lived and living experience into overdose prevention work to strengthen their activities and the communities they serve. Also, they are working with community partners to promote the health and safety of people who use drugs, to support folks who are interacting with the criminal legal system, and to prevent overdose.

What happens to an infectious agent once it leaves the human body? Well, it ends up in our cars, airplanes, food, water, and soil. If we know how that contagion behaves “in the wild”, then we'll be able to kill it, filter it, or otherwise prevent it from proliferating, and potentially improve the lives of millions of people in the process. This is the study of Environmental Microbiology and it's a topic that today's guest has spent more than 30 years trying to understand. Dr. Syed Sattar is Professor Emeritus of Microbiology at the Faculty of Medicine, University of Ottawa. He is also a co-founder and Chief Scientific Officer at CREM CO.  He's a world-renowned expert who regularly advises national and international agencies like the World Health Organization (WHO), and private-sector companies. We're also joined by Bahram Zargar, CEO of CREM CO. This is a company built on top of Dr. Sattar's extensive body of work that aims to speed the assessment, development, and promotion of innovative and sustainable strategies for environmental control of harmful microbes for a safer tomorrow. It blends engineering with environmental microbiology to enable a whole new level of scientific rigor. You'll learn: What happens to infectious agents once they leave the body? What can we do with that knowledge? How air travel and the international food market have eliminated borders in the battle against infectious disease. How engineering can support Infection Prevention and Control (IPAC) by enabling scientific rigor and validation. How this science can be used to develop new barrier technologies. What is lacking in today's IPAC efforts and where does it need to go? How disinfectants can lead to their own form of resistance (i.e. bugs resistant to cleaning) and may even contribute to antibiotic resistance. What's the biggest challenge in matching IPAC innovations with potential buyers in the healthcare system? Why we need to enable our “foot soldiers” (i.e. the cleaning staff and environmental services teams at hospitals) with proper training and tools to win this war. Why it's important for innovators and manufacturers to be more scientifically responsible (i.e. don't chase the bug of the month). Why the government needs to increase funding for research and development in IPAC. Why it's so important to stand on the shoulders of the IPAC greats that came before us and build on their work. A few key points that I'd like to highlight: There's very little money set aside by governments for research and development in IPAC. If there's no money, then the best researchers aren't motivated to go after these issues and innovation is starved. We've seen that recently in the U.S with the constant attack on the Prevention and Public Health Fund. We rely on our cleaning staff and Environmental Services (EVS) teams to do a very important job in the hospital, but we don't treat that position with much respect. “If our soldiers are not well trained and ill-equipped for battle, then how do we expect to win the war against the spread of infection?” In a world of increasing antibiotic-resistance and anti-microbial resistance, we must focus on prevention in IPAC.   This episode originally aired on The #HCBiz Sow on May 17, 2017.

Clostridium difficile (klos-TRID-e-um dif-uh-SEEL), often called C. difficile or C. diff impacts 453,000 people every year. And with 29,000 associated deaths, it takes more lives than AIDS and drunk-driving combined. Yet, most people have never even heard of it. That's a big problem because you can't protect yourself from a threat when you don't even know it exists. The impact on the business of healthcare is significant too. A study published in the American Journal of Infection Control found that C. diff-associated diarrhea (CDAD) increases hospital costs by 40% per case (an average of $7,285 ) and puts those infected at high risk for longer hospital stays and readmissions.  Some even believe those numbers are likely underestimated. C. diff presents us with an interesting problem at the cross-section of Infection Prevention and Control (IPAC). It's an environmental bacterium that's found pretty much everywhere and is difficult to kill, but it's usually held in check by the good bacteria in our bodies. The problem usually occurs when a patient is in a weakened state from some other healthcare intervention. That may be an antibiotic treatment for another healthcare-associated infection or chemotherapy, etc. With our bodies in a weakened state and our good bacteria depleted by antibiotics, we become susceptible to C. diff. So, it's important that we avoid unnecessary antibiotics and execute on all the other IPAC practices like proper hand hygiene and surface cleaning in the hospital so that, as our guest puts it, we can disrupt the chain of events that allow to C. diff to proliferate.   This episode originally aired on The #HCBiz Show! on April 26th, 2017.   On this episode, we're joined by the co-founder and Executive Director of the Peggy Lillis Foundation (PLF), Christian John Lillis.  Like so many people who've dedicated their lives to driving change in the healthcare industry, Christian has a very powerful “why”. He lost his mother to a clostridium difficile (C. diff) infection in April 2010. After struggling with the fact that he lost his mother to a disease he never heard of, and later finding out that it impacts so many people, Christian, along with his brother Liam, founded PLF and are building a nationwide C. diff awareness movement by educating the public, empowering advocates and shaping policy. Christian gives us a deep and personal take on his family's experience with C. Diff and the work that the Peggy Lillis Foundation is doing to help. We discuss: What is clostridium difficile (C. diff)? Is C. diff a Healthcare-Associated Infection (HAI) or something else? How important are hand hygiene and environmental cleaning in preventing the spread of C. diff? Why haven't more people heard of C. diff? Why is it so hard to measure the true impact of C. diff on our health system? How do we fix that? Why do only some states require reporting on outbreaks? How does that affect the business of healthcare? How does it affect the patients? What is the Prevention and Public Health Fund? Why is it under fire and what is the impact to the CDC, states and beyond? What is the financial impact of C. diff?   Christian's story is powerful and it's full of wisdom that can help patients, families, and providers. In our quest to unravel the business of healthcare, it's important to understand the people we serve and how our work impacts their lives. This is a crash course and I hope it touches you as it did me. Enjoy. For more details visit DeepDive.tips

Measles is back in the United States and is currently spreading quickly; the number of cases in the United States in 2019 has already surpassed the number of cases in all of last year. In this episode, get highlights from two Congressional hearings addressing the measles outbreak, which answered a lot of questions about the dangers of the disease, what is causing the outbreak, what is being done about it by the government, and what we can do to help. Please Support Congressional Dish – Quick Links Click here to contribute monthly or a lump sum via PayPal Click here to support Congressional Dish for each episode via Patreon Send Zelle payments to: Donation@congressionaldish.com Send Venmo payments to: @Jennifer-Briney Send Cash App payments to: $CongressionalDish or Donation@congressionaldish.com Use your bank's online bill pay function to mail contributions to: 5753 Hwy 85 North, Number 4576, Crestview, FL 32536 Please make checks payable to Congressional Dish Thank you for supporting truly independent media! Recommended Congressional Dish Episodes CD190: A Coup for Capitalism Additional Reading Article: New York City vaccination order shines spotlight on insular Jewish community by Lenny Bernstein, Lena H. Sun, and Gabrielle Paluch, The Washington Post, April 11, 2019. Tweet: Congratulations to Netanyahu from Rep. Jeff Duncan, April 11, 2019. Article: 78 new measles cases reported nationwide since last week, CDC says by Debra Goldschmidt, CNN, April 8, 2019. Article: More Americans have gotten measles this year than in 2018 - and it's only April by Sara Chodosh, Popular Science, April 8, 2019. Article: Australia ramps up measles warnings as cases jump, Yahoo News, April 7, 2019. Article: Judge lifts Rockland's measles emergency order banning unvaccinated children from public by Jenna DeAngelis, CBS Local New York, April 5, 2019. Article: In three months, US measles cases surpass 2018 numbers by Carolyn Wilke, The Scientist, April 2, 2019. Article: The measles virus was down and out. Now it's primed for a comeback by Helen Branswell, Stat News, March 26, 2019. Article: Footage contradicts U.S. claim that Nicolas Maduro burned aid convoy by Nicholas Casey, Christoph Koettl, and Deborah Acosta, The New York Times, March 10, 2019. Article: Measles cases mount in Pacific northwest outbreak by Jonathan Lambert, NPR, February 8, 2019. Article: Measles cases at highest for 20 years in Europe, as anti-vaccine movement grows by Sarah Boseley, The Guardian, December 21, 2018. Article: Vitamin A: Benefits, deficiency, toxicity and more by Jillian Kubala, Healthline, October 4, 2018. Article: Vitamin A protects against measles: Top Doctor by Sylvia Booth Hubbard, Newsmax Health, February 3, 2015. Research Article: Measles-induced encephalitis by D.L. Fisher, S. Defres, and T. Solomon, QJM International Journal of Medicine, May 26, 2014. Research Article: Measles inclusion-body encephalitis caused by the vaccine strain of measles virus by A. Bitnun, P. Shannon, A. Durward, P.A. Rota, W.J.Bellini, C. Graham, E. Wang, E.L. Ford-Jones, P. Cox, L. Becker, M. Fearon, M. Petric, and R. Tellier, PubMed, October 29, 1999. Resources Center for Disease Control and Prevention: Measles, Mumps, and Rubella (MMR) Vaccine Safety Center for Disease Control and Prevention: Measles (Rubeola): Transmission Center for Disease Control and Prevention: Vaccine Information Statements (VISs) Center for Disease Control and Prevention: Vaccine Safety: Autism Health Resources & Services Administration: HRSA Data and Statistics: Vaccine Compensation National Institute of Health: Anthony S. Fauci, M.D., NIAID Director Vaccine Adverse Event Reporting System (VAERS): Table of Reportable Events Following Vaccination Washington State Department of Health: Measles Outbreak 2019 Website: generationrescue.org Sound Clip Sources Hearing: Vaccines Save Lives: What is Driving Preventable Disease Outbreaks, Senate Committee on Health, Education, Labor & Pensions, Senate.gov, March 5, 2019. C-SPAN Witnesses: Dr. John Wiesman: Secretary of Health for Washington State Jonathan A. McCullers, MD: Professor and Chair, Department of Pediatrics, University of Tennessee Health Science Center, Pediatrician-in-Chief, Le Bonheur Children's Hospital, Memphis, TN Saad B. Omer, MBBS, MPH, PhD: William H. Foege Professor Of Global Health Professor of Epidemiology & Pediatrics, Emory University, Atlanta, GA John G. Boyle, President And CEO: Immune Deficiency Foundation, Towson, MD Ethan Lindenberger: Student, Norwalk High School, Norwalk, OH Sound Clips: 20:00 Dr. John Wiesman: As of yesterday, Washington State's measles outbreak had 71 cases plus four cases associated with our outbreak in Oregon and one in Georgia. Containing a measles outbreak takes a whole community response led by governmental public health. The moment they suspected cases reported, disease investigators interviewed that person to determine when they were infectious, who they were in close contact with and what public spaces they visited. If still infectious, the health officer orders them to isolate themselves so they don't infect others, notifies the public and the about the community about the public places that they were in when they are infectious and stands up a call center to handle questions. We also reach out to individuals who were in close contact with the patient. If they are unvaccinated and without symptoms, we ask them to quarantine themselves for up to 21 days. That's how long it can take to develop symptoms and we monitor them so that we quickly know if they develop measles. If they show symptoms, we get them to a healthcare provider and obtain samples to test for measles and if they have measles, we start the investigation process all over again. This is a staff and time intensive activity and is highly disruptive to people's lives. Responding to this preventable outbreak has cost over $1 million and required the work of more than 200 individuals. 21:15 Dr. John Wiesman: So what do we need from the federal government? First, we need sustained, predictable and increased federal funding. Congress must prioritize public health and support the prevention and public health fund. We are constantly reacting to crises rather than working to prevent them. The Association of state and territorial health officials and over 80 organizations are asking you to raise the CDC budget by 22% by FY22 this will immediately bolster prevention services, save lives, and reduce healthcare cost. Second, our response to this outbreak has been benefited greatly from the Pandemic and All Hazards Preparedness Act, so thank you. The Public Health Emergency Preparedness Cooperative Agreement in the hospital preparedness programs authorized by this law are currently funded $400 million below funding levels in the 2000s. More robust funding is needed and I strongly urge you to quickly reauthorize POPRA because many of the authorizations expired last year. Third, the three 17 immunization program has been a flat funded for 10 years without increased funding. We cannot afford to develop new ways to reach parents with immunization information nor maintain our electronic immunization systems. Fourth, we need federal leadership for a national vaccine campaign spearheaded by CDC in partnership with states that counter the anti-vaccine messages similar to the successful TRUTH tobacco prevention campaign. We have lost much ground. Urgent action is necessary. 46:15 Sen. Lamar Alexander (TN): In your opinion, there's no evidence, reputable evidence, that vaccines cause autism? Jonathan McCullers: There is absolutely no evidence at this time that vaccines cause autism. Sen. Lamar Alexander (TN): Dr. Omer, do you agree with that? Saad B. Omer: Absolutely. Sen. Lamar Alexander (TN): Doctor Wiesman, do you agree with that? Dr. John Wiesman: I do. Sen. Lamar Alexander (TN): Mr. Boyle, do you agree with that ideal? John Boyle: I do. Sen. Lamar Alexander (TN): Mr Lindenbergeer? Ethan Lindenberger: I do. 47:30 Dr. John Wiesman: The choice to sort of make exemptions more difficult - to get them to be a sort of as burdensome as not getting the vaccine - is incredibly important. In Washington state, as you know, we have two bills right now that are looking to remove the personal exemptions from a vaccine for school entry and for child care entry. I think that's one of the tools that we have and that we should be using for this. 47:45 Dr. John Wiesman: I will also say in Washington state, another problem we have is that about 8% of our kids are out of compliance with school records so that we don't even know if they're vaccinated or would like exemptions and we have to tackle that problem as well. 1:05:45 Sen. Rand Paul (KY): Today though, instead of persuasion, many governments have taken to mandating a whole host of vaccines including vaccines for nonlethal diseases. Sometimes these vaccine mandates have run a muck when the, as when the government mandated a rotavirus vaccine that was later recalled because it was causing intestinal blockage in children. I'm not a fan of government coercion, yet given the choice, I do believe that the benefits of most vaccines vastly outweigh the risks. Yet it is wrong to say that there are no risks to vaccines. Even the government admits that children are sometimes injured by vaccines. Since 1988 over $4 billion has been paid out from the Vaccine Injury Compensation Program. Despite the government admitting to in paying $4 billion for vaccine injuries, no informed consent is used or required when you vaccinate your child. This may be the only medical procedure in today's medical world where an informed consent is not required. Now, proponents of mandatory government vaccination argue that parents who ref use to vaccinate their children risk spreading these disease to the immunocompromised community. There doesn't seem to be enough evidence of this happening to be recorded as a statistic, but it could happen. But if the fear of this is valid are we to find that next we'll be mandating flu vaccines. Between 12 and 56,000 people die from the flu or are said to die from the flu in America and there's estimated to be a few hundred from measles. So I would guess that those who want to mandate measles will be after us on the flu next. Yet the current science only allows for educated guessing when it comes to the flu vaccine. Each year before that year's flu vaccine is, or strain is known, the scientists put their best guess into that year's vaccine. Some years it's completely wrong. We vaccinate for the wrong strain of flu vaccine. Yet five states already mandate flu vaccines. Is it really appropriate, appropriate to mandate a vaccine that more often than not vaccinates for the wrong flu strain. As we contemplate forcing parents to choose this or that vaccine, I think it's important to remember that force is not consistent with the American story, nor is force considered consistent with the liberty our forefathers saught when they came to America. I don't think you have to have one of the other, though. I'm not here to say don't vaccinate your kids. If this hearing is for persuasion, I'm all for the persuasion. I vaccinated myself. I vaccinated my kid. For myself and my children I believe that the benefits of vaccines greatly outweigh the risks, but I still do not favor giving up on liberty for a false sense of security. Thank you. 1:13:20 Sen. Elizabeth Warren (MA): This administration has repeatedly sought to cut the Prevention and Public Health Fund, which supports key immunization programs, and they've continued their efforts to weaken the Medicaid program, which covers all of the recommended vaccines for children and for many adults as well. I am glad that most of my colleagues are on the same page about the importance of vaccines. Now let's make sure we're also on the same page about the importance of public health funding, so people get access to those vaccines. 1:28:30 Jonathan McCullers: So Mississippi does not allow any nonmedical exemptions, and they have nearly a 100% rate of immunization at school entry. They pay a lot of attention to it. Tennessee's in the middle, they allow religious exemptions, but not philosophical exemptions. In Tennessee, we have about a 97% vaccination rate of kindergarten entry, but we've seen the rate of nonmedical exemptions under the religious exemption triple in the last 10 years, so you can predict where that's going. Arkansas ,on the other hand, allows both religious and philosophical exemptions and has a rate that's around 93 to 94% below the level for community immunity. Hearing: Confronting a Growing Public Health Threat: Measles Outbreaks in the U.S., Committee on Energy and Commerce, Subcommittee on Oversight and Investigations, House of Representatives, C-SPAN, February 27, 2019. Witnesses: Dr. Nancy Messonnier Director of the National Center for Immunization and Respiratory Diseases Dr. Anthony Fauci Director of the National Institute of Allergy and Infectious Diseases (NIAID) Sound Clips: 3:42 Chairman Diana Degette (CO): The national measles vaccination rate of children between 19 and 35 months old is currently at 91%. That may seem high to some, but given the highly contagious nature nature of measles, it's well below the 95% vaccination rate that's required to protect communities and give it what it's known as herd immunity. This so called herd immunity is particularly vital to protecting those who cannot be or are not yet vaccinated against the measles, such as infants or those with prior medical conditions who are at a higher risk of suffering severe complications from the vaccine. 4:30 Chairman Diana Degette (CO): While the overall national rate of MMR vaccinations is currently at 91%, the rate in some communities is much lower. Some are as low as 77%. 9:15 Rep. Brett Guthrie (KY): Every state except three have enacted religious exemptions for parents who wish not to vaccinate their children. There are 17 states allow a personal philosophical exemption, which means that most people can opt out for any reason. For example, in Washington state, just 0.3% of Washington's families with kindergartners use a religious exemption. While 3.7% of families use a personal exemption and 0.8% use a medical exemption. Vaccine exemptions have increased in the past three years to a median 2.2% of kindergardeners among all states. 10:00 Rep. Brett Guthrie (KY): After the Disneyland linked outbreak to measles in 2014, the state of California ended the religious and personal exemption for vaccines. The Washington legislature is working on legislation that substantially narrows the exemptions for vaccination that would eliminate the personal or philosophical exemption while tightening the religious exemption. In recent weeks, take legislators in New Jersey, New York, Iowa, Maine, and Vermont, have proposed eliminating religious exemptions for vaccines. However, last week, the Arizona House Health and Human Service Committee approved three bills to examine exemptions for mandatory vaccinations. 23:25 Dr. Nancy Messonnier: From January 1st to February 21st, 159 cases of measles have been confirmed in 10 states, including California, Colorado, Connecticut, Georgia, Illinois, Kentucky, New York, Oregon, Texas, and Washington. In 2018, 372 people with measles were reported from 25 states and the district of Columbia. Most cases have been unvaccinated. 24:15 Dr. Nancy Messonnier: Nationally, we enjoy high measles vaccination coverage. However, there are pockets of people who are vaccine hesitant, who delay or even refuse to vaccinate themselves and their children. Outbreaks of measles occur, when measles gets into these communities of unvaccinated people. Those choosing not to vaccinate, tend to live near each other. Some of these are what we call close knit communities. People who share common religious beliefs or racial ethnic background. Others are people who have strong personal belief against vaccination. 25:15 Dr. Nancy Messonnier: Vaccine hesitancy is the result of a misunderstanding of the risk and seriousness of disease combined with misinformation regarding the safety and effectiveness of vaccines. However, the specific issues fueling hesitancy varies by community. Because vaccine hesitancy remains a highly localized issue, the strategy to address these issues need to be local with support from CDC. Strong immunization programs at the state and local levels are critical to understanding the specific issues and empowering local action. CDC also works to support state and local public health efforts through research to understand these reasons and develop targeted strategies to address hesitancy. 28:40 Dr. Anthony Fauci: Measles virus is one of the most contagious viruses that we know among the pathogens that confront mankind. As mentioned, that if an individual gets into a room with someone who has measles, and that person is coughing and sneezing, there's about a 90% chance that that person. That is very unlike other diseases like influenza and other respiratory diseases when the hit rate, although it's high, is nothing, uh, approaching 90%. 30:00 Dr. Anthony Fauci: As was mentioned prior to the vaccine era, there were about 3 million deaths each year. The decrease was dramatic. There were 21 million lives that were saved from vaccines between the year 2000 and 2017. But as shown on the last bullet on this slide, there are 110,000 deaths still today in the world, which means there's the danger of the reinsertion of measles from other countries, and if we're not protected. 31:00 Dr. Anthony Fauci: Well, let's take a look at some of the things that I mentioned about the disease itself. Fever, cough, rash, as was mentioned by Dr. Burgess, again, contagious from four days before the rash to four days after. So people are spreading measles before they really know that they actually have measles. We have a group of individuals who are particularly at risk for complications, infants and children, pregnant women, immunocompromised, and even adults. If you're not protected and you get infected, adults have a high incidence of complications. You've heard about the complications. They are not trivial. One out of 10 with ear infections, which could lead to deafness, pneumonia in one out of 20 cases, and encephalitis one in a thousand. A very rare occurrence called subacute sclerosing panencephalitis, seven to 10 years after an individual develops measles, they can have a very devastating neurological syndrome, no known cure, and is vaccine preventable. 34:15 Dr. Nancy Messonnier: Taking care of your health, eating well, exercising, getting enough sleep: Those are all parts of a healthy lifestyle, but the only way to protect against measles is to get vaccinated. It's a safe and effective vaccine, and parents should go ahead and get vaccinated. 36:00 Chairman Diana Degette (CO): What are the risks inherent in the vaccine itself? I think that might be one reason why, um, some, some parents are choosing not to vaccinate their children as they believe that the risks with the vaccine outweigh the benefits. Dr. Nancy Messonnier: I think you're exactly right and I think in the setting of not a lot of measles cases around, parents weigh in their mind the risks and benefits and think they shouldn't vaccinate. Truth is this is an incredibly safe vaccine. We have a host of experience with it. The vaccine's been used for a really long time. We in the United States enjoy one of the most robust systems to monitor the safety of vaccines. And that's why we can say with confidence that this is a safe vaccine. The most common side effects are a sore arm, which goes away pretty quickly. 42:00 Rep. Brett Guthrie (KY): I've heard some parents claim that measles vaccine can cause brain inflammation known as encephalitis. Is that true? Dr. Anthony Fauci: Brain inflammation? Rep. Brett Guthrie (KY): Encephalitis? Can the measles vaccine cause encephalitis? The vaccine? Dr. Anthony Fauci: The vaccine? No. Rep. Brett Guthrie (KY): There's no cases? Chairman Diana Degette (CO): The Chair will remind all persons in the audience that manifestation of approval or disapproval of proceedings is in violation of the rules of the house and its committees. Gentlemen may proceed. Dr. Nancy Messonnier: In healthy children, the MMR vaccine does not cause brain swelling or encephalitis. Rep. Brett Guthrie (KY): So if a, if a child was unhealthy when they're vaccinated? Dr. Nancy Messonnier: So, there are rare instances of children with certain very specific underlying problems with their immune system and who the vaccine is contra indicated. One of the reasons its contra indicated is in that very specific group of children, there is a rare risk of brain swelling. Rep. Brett Guthrie (KY): Would the parent know if their child was in that category before… Dr. Nancy Messonnier: Certainly, and that's why parents should talk to their doctor. 43:15 Rep. Brett Guthrie (KY): So there's another thing that's that people can self medicate with vitamin A to prevent measles and not do the vaccine. Is that, what's the validity of that in your opinion? Dr. Anthony Fauci: Well, the history of vitamin A and measles goes back to some very important and I think transforming studies that were done years ago in, in sub Saharan Africa, is that with vitamin A supplements, particularly in vitamin A deficiency that children who get measles have a much more difficult course. So vitamin A associated with measles can actually protect you against some of the, uh, toxic and adverse effects. Importantly, since in a country, a developed nation where you really don't have any issue with vitamin A deficiency, that you don't really see that transforming effect. But some really good studies that were done years ago show that vitamin A supplementation can be very helpful in preventing the complications of measles. Rep. Brett Guthrie (KY): It doesn't prevent the onset of measles if, if you're not… Dr. Anthony Fauci: No. Rep. Brett Guthrie (KY): is that what you're saying? It doesn't want to put words in your mouth. Dr. Anthony Fauci: It doesn't prevent measles. But it's important in preventing some of the complications in societies in which vitamin A deficiency might exist. 46:10 Rep. Jan Schakowsky (IL): I'm trying to understand what has happened between 2000 and 2019 and why we're, we've fallen so far from the public health success stories, um, when the CDC actually said that there we had eradicated in the United States, uh, measles in, in, in 2000. So Dr. Messonnier, yes or no: Do you believe the primary cause of the spike and measles outbreak over the past few years is due to vaccine hesitancy and misinformation? Dr. Nancy Messonnier: Yes and no. I think vaccine hesitancy is a, is a word that means many different things. Parents have questions about vaccines, they get those questions answered. That isn't what you should call a hesitancy. So I do believe that parents concerns about vaccine leads to under vaccination and most of the cases that we're seeing are an unvaccinated communities. However, if you look nationally at measles vaccination coverage, there were other things that are associated with low coverage. Um, for example, living in a rural area versus an urban area. Rural areas have lower vaccine coverage with measles. Schakowsky: How would you account for that? Messonnier: Well, I think that there are other things besides the sole choice that are around access to care. For example, kids without health insurance have lower measles vaccination coverage. Schakowsky: So generally lack of access to care. Messonnier: In addition to parents making decisions not to vaccinate their kids. Yes. 50:20 Rep. Michael Burgess (TX): I do feel obligated dimension that vitamin A is not like vitamin C. You may not take unlimited quantities of vitamin A with impunity. It is a fat soluble vitamin and it is stored in the body. Uh, so don't go out and hyper dose on vitamin A because it, uh, it will not accrue to your long-term benefit. 54:15 Rep. Michael Burgess (TX): Did the measles, mumps, rubella vaccine ever contain mercury or thimerosal? I'll need a verbal answer for the clerk. Dr. Anthony Fauci: No. It's preservative free. 56:00 Dr. Nancy Messonnier: So measles was identified as eliminated in the United States in 2000 because there was no longer sustained transmission in the US. However, measles continues to circulate globally, which means unvaccinated US travelers can be exposed to measles and bring it back home with them, and folks in their families and their communities, if they're not protected by vaccine, are at risk. And measles is so incredibly contagious that it can spread really quickly. So yes, we should be concerned. 57:00 Rep. Frank Pallone (NJ): What role do you see this spread of disinformation online playing in, in, in the rise of, um, of these outbreaks? Dr. Anthony Fauci: Yeah, I believe Mr. Pallone, that it plays an important role. It's, it's not the only one but, but I believe it plays an important role. And I think the classic example of that was the disinformation associated with the relationship between measles, vaccination and autism, which, uh, back when it came out, uh, years ago, there was a big concern that this was the case when it was investigated. It became clear that the data upon which those statements were made were false and fraudulent. And the person who made them had his medical license revoked in England. And yet, as you know very well, the good news about the Internet is that it spreads important information. That's good. And the bad news about the Internet is that when the bad information gets on there, it's tough to get it off. And yet people refer to things that have been proven to be false. So this information is really an important issue that we need to try and overcome by continuing to point people to what's evidenced based and what's science-based. So in, in so many respects, we shouldn't be criticizing people who get these information that's false because they may not know it's false. We need to try and continue to educate them to show them what the true evidence base is. But in direct answer to your question, that is an important problem, disinformation. Rep. Frank Pallone (NJ): Now do you think that the promotion of this inaccurate and fear based messages, would you consider that in itself a threat to public health? Dr. Anthony Fauci: Yes, of course. I think the spread of false information that leads people into poor choices, even though they're well meaning in their choice, it's a poor choice based on information. I think that's a major contribution to the problem that we're discussing. (lady behind him holds up a book titled “Autism Epidemic”) 1:04:00 Dr. Anthony Fauci: But when you have a highly effective, and I want to underscore that because measles is one of the most effective vaccines that we have of any vaccine that a massive public health effort could lead to eradication. Because we don't have an animal vector, we don't have an intermediate host. We don't have a vector that transmits it. It is just person to person transmissibility. So theoretically we could eradicate it. The problem between eradication and elimination, if you eliminate it like we did in this country in 2000 as long as this measles somewhere, you always have the threat of it reemerging if you let down the umbrella of herd immunity. 1:05:00 Dr. Nancy Messonnier: Dr. Fauci is correct about Madagascar, but I think Americans don't realize that in 2018 there were also outbreaks in England, France, Italy, and Greece. American travelers going abroad need to think about their immunization status, not just when they're going into countries like Madagascar, but even going to Europe. 1:11:45 Rep. Jeff Duncan (SC): And one of the world's measle outbreaks right now, it's happening in Brazil where people fleeing a completely broken country of Venezuela are spreadingeas measles and - madam chair- I'd like to submit for the record, an NPR article, "The collapse of health system sends Venezuelans fleeing to Brazil for basic medical needs." And I'll submit that for the record. Um, they've been in a unvaccinated population because of the collapse of the failed socialist state in Venezuela where there should be an instructive example for some of us in this committee room of the lack of that sort of medical treatment of vaccinations. I would note that the humanitarian aid that countries like the U.S. are trying to send to Venezuela is being burned on bridges by the Maduro regime instead of actually being used to help his own people. This includes vaccinations, like the ones we're discussing today. There were measles vaccinations that were burned on the bridges as part of the relief effort to Venezuela. 1:18:30 Rep. Kathy Castor (FL): I was a little confused by the last line of questioning that they're, the alarm should be over, uh, immigration and, and asylum seekers. You have a comment on that, Dr. Fauci? Dr. Anthony Fauci: Well, I, I think what Dr. Messonnier said is absolutely correct. If you look at the known outbreak, so if you take the outbreak in the Williamsburg section of Brooklyn in New York City and in Rockland County, it was a relatively closed group who had a rate of vaccination that was below the level of a good herd immunity. A person from Israel understandably came over legally as a visitor into the community. And then you had a massive outbreak in New York. The Somali community in Minnesota, the same thing happened. You had a group there who had a lower rate that went below the cutoff point for herd immunity. Some immigrant came in as one of the members of the community, was a relatively closed community, and that's what you have. So I think when you talk about outbreaks, it really transcends some of the demographic issues that you were talking about, about lower income or rural versus urban. It really is an a closed community that we're seeing it. Castor: with lower vaccination rates. Fauci: Right, exactly. So a lower vaccination rates. 1:23:45 Rep. Paul Tonko (NY): In response to the spotlight on the monetization of misinformation about vaccines and the ways in which platforms are being manipulated to promote anti vaccination messaging, some companies have announced new policies. For instance, Facebook says it is working on its algorithms to prevent anti-vaccination content from being recommended to users. Pinterest has decided to remove all vaccination related posts and searches, even accurate information. And YouTube just recently announced that it would prevent channels that promote anti-vaccination content from running advertising. Dr Fauci, do you think these actions are a step in the right direction to ensure parents and families have access to science-based factual health information? Dr. Anthony Fauci: Obviously it's a very sensitive subject because it then gets in the that borderline between the, you know, the essentially crushing of information that might actually be useful information. However, having said that, I do think that a close look and scrutiny at something that is egregiously incorrect has some merits of taking a careful look as to whether, one, you want to be participating in the dissemination of that. Always being careful about not wanting to essentially curtail freedom of expression. You still want to make sure you don't do something that is so clearly hazardous to the health of individuals. Rep. Paul Tonko (NY): I appreciate that. And Dr. Messonnier, as the agency charged with protecting our national public health, what efforts are underway at CDC to counter the online proliferation of anti vaccination disinformation. Dr. Nancy Messonnier: As a science based agency, CDC really focuses on making sure that we get scientifically credible information available to the folks at the front lines it needed every day. In order to do that, we do scan social media to see what issues are arising and what questions are emerging to make sure that we can then gather the scientifically appropriate answers and get that to our partners in the front line so that they can talk to patients about that information. 1:30:30 Dr. Nancy Messonnier: The concept of herd immunity is that by vaccinating an individual, you don't just prevent them from getting disease, but you also prevent them from transmitting it to others. And what that means is that in our community, individuals who, for example, can't get the vaccine because they're too young, or they have some kind of illness that prevents it, are still protected by the cushion of protection provided by their community. Radio Interview: National Security Advisor Ambassador John Bolton, Hugh Hewitt Book Club, February 1, 2019. Hugh Hewitt: There are reports of Venezuela shipping gold to the United Arab Emirates. The UAE is a very close ally of ours. Have you asked the UAE to sequester that gold? John Bolton: Let me just say this. We’re obviously aware of those reports consistent with what we did on Monday against PDVSA, the state-owned oil monopoly where we imposed crippling sanctions. Steven Mnuchin, the Treasury Secretary, is implementing them as we speak. We’re also looking at cutting off other streams of revenue and assets for the Maduro mafia, and that certainly includes gold. And we’ve already taken some steps to neutralize gold that’s been out of the country used as collateral for bank loans. We’ve frozen, and our friends in Europe, have frozen a substantial amount of that. We want to try and do the same here. We’re on top of it. That’s really all I can say at the moment. White House Daily Briefing: Trump Administration Officials Announce Sanctions on Venezuelan Oil Sector, C-SPAN, January 28, 2019. Speakers: Steve Mnuchin - Treasury Secretary John Bolton - National Security Advisor Sound Clips: 7:43 Steven Mnuchin: But effective immediately, any purchases of Venezuelan oil by U.S. entities, money will have to go into blocked accounts. Now, I've been in touch with many of the refineries. There is a significant amount of oil that's at sea that's already been paid for. That oil will continue to come to the United States. If the people in Venezuela want to continue to sell us oil, as long as that money goes into blocked accounts, we'll continue to take it. Otherwise, we will not be buying it. And again, we have issued general licenses, so the refineries in the United States can continue to operate. 9:06 Steven Mnuchin: The purpose of sanctions is to change behavior. So when there is a recognition that PDVSA is the property of the rightful rulers, the rightful leaders, the president, then, indeed, that money will be available to Guaido. Interview: Jenny McCarthy talks to CNN on how she cured her sons Autism caused by VACCINATIONS, CNN, October 23, 2008. Documentary: Mission, Measles - The Story of a Vaccine, Co-produced by US Public Health Service and Merck, C-SPAN/American History TV, 1964. 3:30 Narrator: As of this time, measles is by far our most serious epidemic childhood disease. Although nearly half a million cases are reported each year, the actual number is probably closer to 4 million. 3:45 Narrator: In 1961 after the polio vaccines had reduced the deaths from that disease to 90, that same year 434 measles deaths were reported. In the less developed countries of the world, the toll taken by measles is much greater. In Nigeria, it is estimated that one out of four babies contracting measles dies from it. The tragic toll of measles is also told in a neighboring republic Upper Volta, where in one village, an epidemic killed 113 out of 115 children who got the disease. Across the ocean in Chile, measles accounts for half of all childhood deaths from acute communicable diseases each year.     Community Suggestions See Community Suggestions HERE. Cover Art Design by Only Child Imaginations Music Presented in This Episode Intro & Exit: Tired of Being Lied To by David Ippolito (found on Music Alley by mevio)

Another shutdown, another dingleberry-filled temporary funding law! In this episode, learn about the new law that reopened the government after the 6 hour shutdown by providing funding until March 23 and be one of the few people in the country who will know about the random goodies that hitchhiked their way into law. Miranda Hannah joins Jen for the thank yous. Please Support Congressional Dish Click here to contribute using credit card, debit card, PayPal, or Bitcoin Click here to support Congressional Dish for each episode via Patreon Mail Contributions to: 5753 Hwy 85 North #4576 Crestview, FL 32536 Thank you for supporting truly independent media! Recommended Congressional Dish Episodes CD147: Controlling Puerto Rico CD128: Crisis in Puerto Rico Additional Reading Article: Get ready: Here comes another bs* budget commission by Stan Collender, Forbes, March 4, 2018. Report: Let Pentagon carry over FY18 budget boost so money isn't wasted, key lawmaker says by Joe Goud, Defense News, February 22, 2018. Report: Key health care provisions of bipartisan Budget Act of 2018 by Baker Donelson Bearman Caldwell & Berkowitz PC, Lexology, February 22, 2018. Article: Can updated tax credits bring carbon capture into the mainstream? by Emma Foehringer Merchant, Green Tech Media, February 22, 2018. Article: The shutdown clock is still ticking and that causes chaos throughout the government by Deirdre Shesgreen, USA Today, February 19, 2018. Report: Congress passes legislation to help foster children weather opioid epidemic by Lizzy Francis, Fatherly, February 13, 2018. Report: USA extends nuclear tax credit deadline, World Nuclear News, February 12, 2018. Report: House passes stopgap spending bill to end government shutdown by Lindsey McPherson, Roll Call, February 9, 2018. Report: The health 202: Republicans kill Obamacare's controversial "death panel" by Paige Winfield Cunningham, The Washington Post, February 9, 2018. Article: Why this tax bill may accidentally give huge leverage to the Freedom Caucus next year by Catherine Rampell, The Washington Post, December 20, 2017. Report: CMS announces big expansion to Medicare Advantage value-based insurance design model by Leslie Small, Fierce Healthcare, November 22, 2017. Report: House votes to repeal ObamaCare's Medicare cost-cutting board by Nathaniel Weixel, The Hill, November 2, 2017. Article: The pros and cons of switching to a Medicare Advantage Plan by John Bulliner, Medicare.com, January 24, 2017. Article: A single senator is blocking reform of the foster care system by Ryan Grim, Huffpost, December 6, 2016. Article: A sweeping reform of the foster care system is within reach but hanging by a thread by Ryan Grim, Jason Cherkis, and Laura Barron-Lopez, Huffington Post, December 2, 2016. Article: Congress to consider scaling down group homes for troubled children by Joaquin Sapien, ProPublica, May 20, 2015. Additional Viewing Hearing: A way back home: Preserving families and reducing the need for foster care, US Senate Committee on Finance, August 4, 2015. Hearing: No place to grow up: How to safely reduce reliance on foster care group homes, US Senate Committee on Finance, May 19, 2015. Bill Outline H.R. 1892: Bipartisan Budget Act of 2018   Division A: Honoring Hometown Heroes Act Sec. 10102: Allows the flag to be flown at half staff when a first responder dies at work. Division B: Supplemental Appropriations, Tax Relief, and Medicaid Changes Relating to Certain Disasters and further extension of continuing appropriations Title I: Gives $2.36 billion to the Department of Agriculture, available until the end of 2019, to pay for "expenses related to crops, trees, bushes, and vine losses" caused by Hurricanes Harvey, Irma, Maria, and other hurricanes and wildfires that took place in 2017. Companies who have crop insurance can have 85% of their losses covered by our tax money Companies who didn't buy crop insurance can have up to 65% of their losses covered by our money Title I: Gives $14 million to Puerto Rico's food program but says the money is for infrastructure grants for infrastructure damaged by Hurricanes Irma and Maria Sec. 20101: Changes the law to allow livestock producers to collect payments for cows they sold at reduced prices, instead of just dead ones, and eliminates the $20 million cap on total payouts for livestock producers. Sec. 20201: Orders the Secretary of Commerce to issue a waiver within 120 days of the provisions of the Marine Mammal Protection Act which prohibit the capture of marine mammals for three infrastructure projects designed to reduce land loss in Louisiana. It says the waiver for the projects "will remain in effect for the duration of the construction, operations and maintenance of the projects. No rule-making, permit, determination, or other condition or limitation shall be required when issuing a waiver pursuant to this section." Title IV: Gives $15 billion to the Army Corps of Engineers to repair damages caused by natural disasters $10 billion has to be spend in areas impacted by Hurricanes Harvey, Irma, and Maria Repairs made in Puerto Rico and the US Virgin Islands "shall be conducted at full Federal expense" Title V: Provides $1.652 billion for the "Disaster Loans Program Account" but $618 million of that can be spend on "administrative expenses to carry out the disaster loan program" Title VI: Adds $23.5 billion to FEMA's "Disaster Relief Fund" Sec. 20604: Adds religious institutions to the definition of a "Private Nonprofit Facility", which makes them eligible to receive tax money for disaster aid services. Sec. 20605: Says the Federal government will pay 90% of the costs for 2017 wildfire disasters. Title XI: Provides $1.374 billion for the Federal highway "Emergency Relief Program", with the Federal government paying 100% of the costs for Puerto Rico Title XI: Provides $28 billion in disaster relief for housing and infrastructure. $11 billion must be spent on areas hit by Hurricane Maria $2 billion of that will be spent on upgrades to electrical power systems Sec. 20102: Allows victims of wildfires in CA to borrow up to $100,000 from their own retirement accounts and pay it back within 3 years. Sec. 20103: Allows companies that had to close due to wildfires to get a credit for up to 40% of their employees' wages, up to $6,000 each. Sec. 20104: Suspends limitations on charitable contributions made before December 31, 2018 for relief efforts in the California wildfire disaster area Sec. 20301: Provides an extra $3.6 billion for Puerto Rico and $106 million for the US Virgin Islands for Medicaid Puerto Rico can get $1.2 billion more if Puerto Rico implements a new process for transmitting data to the Transformed Medicaid Statistical Information System (T-MSIS) and if it creates a Medicaid fraud control unit Subdivision 3: Extends 2017 government funding levels until March 23, 2018. Funds the census Forces the sale of $350 million worth of oil from the Strategic Petroleum Reserve Division C: Budgetary and other matters Sec. 30101: Sets the budget limits for 2018 and 2019 2018 $629 billion for defense $579 billion for non-defense 2019 $647 billion for defense $597 billion for non-defense Sec. 30102: Zeroes out the balances on the PAYGO budget scorecard. Sec. 30204: Requires the Secretary of Energy to sell 30 million barrels of oil from the Strategic Petroleum Reserve every year from 2022-2025 and 35 million per year in 2026 and 2027. Lowers the amount of oil we must have in reserves from 450 million barrels to 350 million barrels Sec. 30301: Suspends the debt ceiling entirely until March 1, 2019. Division D: Revenue Measures Subtitle A, Subtitle B, and Subtitle C: Extend 31 tax credits Sec. 40402: Extends until 2021 but then phases out tax credits for residential solar electricity, solar water heaters, small wind energy turbines, and geothermal heat pumps. Sec. 40411: Extends until 2022 and then phases out a 30% credit for fiber-optic solar, fuel cell, and small wind energy property, eliminating the credits entirely by 2024. Sec. 40501: Extends and expands tax credits for nuclear power facilities Sec. 41119: Extends an existing tax credit for carbon sequestration technology for 6 years and changes it so that more money is rewarded for each ton of carbon captured and eliminates a cap on how many tons were eligible for credits (it was 75 million tons). Division E: Health and Human Services Extenders Title I: Extends the authorization for the Children's Health Insurance Program through 2027 and adds $48 million per year for 2023-2027 for enrollment assistance. Title II: Extends Medicare programs Sec. 50302: Authorizes voluntary telehealth appointments for people receiving at-home dialysis treatments for end state renal disease, as long as they see a doctor in-person every 3 months. Sec. 50321: Expands a test program, which began in 2015 with 7 States, to all States. The program allows privately administered Medicare Advantage plans flexibility to design custom insurance plans for people with certain chronic diseases. Sec. 50322: Starting in 2020, privately administered Medicare Advantage plans will be able to offer extra benefits for people with chronic health conditions and uniformity requirements will be waived for those plans. Sec. 50323: Starting in 2020, privately administered Medicare Advantage plans can include "telehealth benefits" Sec. 50341: Starting sometime in 2019, some Medicare administrators will be allowed to offer incentives up to $20 to encourage seniors to encourage them to come to appointments with their primary care doctors. The money collected will not be considered taxable income. The Secretary of Health and Human Services can cancel this program at any time for any reason. Sec. 50412: Increased criminal and civil fines for Federal health care program fraud Sec. 50502: Updates the abstinence education program and increases funding from $50 million to $75 million in 2018 and 2019 Sec. 50711: Creates a program funding State efforts to provide mental health care, substance abuse treatment, and parenting counseling to parents in order to prevent their children from being placed in foster care. Sec. 50712: Allows foster care payments to be given to licensed residential treatment facilities if the facility welcomes the child to live with its parent as long as the facility provides parenting classes and family counseling. Sec. 50745: Requires States to require every child-care institution to run fingerprint-based checks of national crime information databases on any adult working in their facility. Sec. 50901: Funds Community Health Centers with $3.8 billion for 2018 and $4 billion for 2019 Sec. 52001: Repeals the Independent Payment Advisory Board Title XII: Offsets Sec. 53103: Requires Medicaid to count lottery winnings as income when determining Medicaid eligibility Sec. 53105: Rescinds $985 million from the Medicaid Improvement Fund, which is meant to improve oversight of Medicaid contracts and contractors. Sec. 53107: Reduces pay for outpatient physical and occupational therapists for care their assistant's provide to 85 percent of the rate that would have otherwise been paid. Sec. 53114: Increases the percentage that people who make over $500,000 per year pay for Medicare premiums from 80% to 85%. Sec. 53115: Empty's the Medicare Improvement Fund by eliminating all $220 million. Sec. 53116: Accelerates the closing of the prescription drug "donut hole" for seniors by moving up a decrease in out of pocket prescription costs to 25% by one year - it's now 2019 - and by increasing the percentage that drug manufacturers must discount their drugs from 50% to 70%. Sec. 53119: Cuts $1.35 billion from the Prevention and Public Health Fund over the next 10 years. Division G: Budgetary Effects Exempts the entire law from the PAYGO scorecard and the Senate PAYGO scorecards. Resources Bill Overview: H.J.Res. 45 Pay As You Go Act of 2010 Bill Summary: Pay-As-You-Go Act of 2010 Bill Scorecard: Pay-As-You-Go Act Scorecard August 4, 2017 Budget Notice: 2017 Statutory Pay-As-You-Go Act Annual Report Committee on Finance Report: An Examination of Foster Care in the United States and the Use of Privatization Government Debt Info: The Debt to the Penny and Who Holds It Government Debt Info: Interest Expense on the Debt Outstanding Louisiana State Government: Coastal Protection and Restoration Authority Infrastructure Projects Visual Resources 20 Years of Congress Budget Prograstination in One Chart Sound Clip Sources Senate Remarks: Senator Paul on Budget Cap Increases in Two-Year Budget, C-SPAN, February 8, 2018. Senator Rand Paul: The bill is nearly 700 pages. It was given to us at midnight last night, and I would venture to say no one has read the bill. No one can thoroughly digest a 700-page bill overnight, and I do think that it does things that we really, really ought to talk about and how we should pay for them. Senator Rand Paul: So the reason I’m here tonight is to put people on the spot. I want people to feel uncomfortable. I want them to have to answer people at home who said, how come you were against President Obama’s deficits, and then how come you’re for Republican deficits? Isn’t that the very definition of intellectual dishonesty? If you were against President Obama’s deficits and now you’re for the Republican deficits, isn’t that the very definition of hypocrisy? People need to be made aware. Your senators need to answer people from home, and they need to answer this debate. We should have a full-throated debate. Senator Rand Paul: You realize that this is the secret of Washington. The dirty little secret is the Republicans are loudly clamoring for more military spending, but they can’t get it unless they give the Democrats welfare spending, so they raise all the spending. It’s a compromise in the wrong direction. We should be compromising in the direction of going toward spending only what comes in. And yet this goes on and on and on. Senator Rand Paul: For the umpteenth time, Congress is going to exceed their budget caps. We had something passed back in 2010. It was called PAYGO. It was supposed to say, if you’re going to pay new money, you had to go find an offset somewhere else. You could only pay as you go. It was sort of like a family would think about it. If you’re going to spend some more money, you either got to raise your income or you’ve got to save some money. You know how many times we’ve evaded it since 2010? Thirty-some-odd times. Senator Rand Paul: So the bill’s going to exceed the budget caps by $296 billion. And that’s not counting the money they don’t count, all right? So these people are really, really clever. Imagine them running their fingers together and saying, how can we hide stuff from the American people? How can we evade the spending caps so we can be even more irresponsible than we appear? So, 296 is the official number; about $300 billion over two years that will be in excess of the budget caps. But there’s another $160 billion that’s stuck into something called an overseas contingency fund. The budget caps don’t apply there. So we’re $300 billion for two years over the budget caps; then we’re another 160 billion over the caps—they just don’t count it. They act as if it doesn’t matter; we’re just not going to count it. Senator Rand Paul: The spending bill’s 700 pages, and there will be no amendments. The debate, although it’s somewhat inside baseball that we’re having here, is over me having a 15-minute debate, and they say, woe is me; if you get one, everybody’ll want an amendment. Well, guess what? That would be called debate. That would be called an open process. That would be called concern for your country—enough to take a few minutes. And they’re like, but it’s Thursday, and we like to be on vacation on Fridays. And so they clamor. But we’ve been sitting around all day. It’s not like we’ve had 100 amendments today, we’re all worn out, we can’t do one more. We’re going to have zero amendments—zero, goose egg, no amendments. Senator Rand Paul: So over the past 40 years, four times have we actually done the right thing—passed 12 individual appropriation bills, bundled them together, have a budget, and try to do the right thing. You know, there’s no guarantee that everybody’ll be wise in their spending, but it’s got to be better; it can’t be worse. What do we do instead? It’s called a continuing resolution. We glom all the bills together in one bill, like we’ve done tonight—Republicans and Democrats clasping hands—and nobody’s going to look at it. Nobody’s going to reform the spending. As a consequence, wasteful spending is riddled throughout your government. Only four times in 40 years have we done the appropriation process the way we’re supposed to. Senator Rand Paul: The last thing I’ll get to is something called the debt ceiling. The debt ceiling is something that has been a limitation on how much we spend, and we have to vote on it, and it’s an unpleasant vote. And so they try to either do it for a long period of time or try to stretch it beyond elections. So this bill, the 700-page bill that no one read, that will continue all the spending and will not reform your government and is irresponsible—the one we will pass later tonight—that 700-page bill also allows the debt ceiling to go up. Historically, we would let the debt ceiling—our borrowing limit—we would let it go up a dollar amount. We’d say, well, we’ve got to borrow money, and it looks like we’re going to need a trillion dollars. But you know the way they do it now? It’s like everything else around here: We bend, break the rules, and then somehow there’s a little bit of deviousness to it. The debt ceiling will go up in an unspecified amount. So as much as you can borrow between now and November, go for it. So there is no limitation. The debt ceiling becomes not a limitation at all. Senator Rand Paul: And the media doesn’t even get it. The media does you such a disservice. They can’t even understand what’s going on sometimes. They’re like, bipartisanship has broken out. Hallelujah! Republicans and Democrats are getting along. And in reality, they should be telling you, look for your wallet; check your pants to make sure they haven’t taken your wallet, because when both parties are happy and both parties are getting together and doing stuff, guess what? They were usually looting the Treasury. And that’s what this bill does. It’s going to loot the Treasury. It spends money we don’t have. We will have a trillion-dollar deficit this year. Press Briefing: Presidential Remarks on Federal Spending, C-Span, June 9, 2009.   Community Suggestions Video: The Political Vigilante: Graham Learns About MMT Part 1  Video: The Political Vigilante: Graham Learns About MMT Part 2 See more community suggestions HERE.   Cover Art Design by Only Child Imaginations Music Presented in This Episode Intro & Exit: Tired of Being Lied To by David Ippolito (found on Music Alley by mevio)

  Right before Christmas, the government was temporarily funded for the fourth time this fiscal year, but this latest funding law came with a few surprises. In this episode, a feisty Jen outlines the law to expose a favor to the war industry, damage to the Affordable Care Act, a bad sign for the Children’s Health Insurance Program, a giant loophole that paved the way for a new mountain of government debt, and more. You’ll also learn about an “uncontroversial” bill that reduces accountability for foreign fighters who abuse women and that showers literal gifts upon a secretive Drug War commission. But it’s not all bad news! There’s also a reason for hope. Recommended Congressional Dish Episodes CD161: Veterans Choice Program Please Support Congressional Dish Click here to contribute using credit card, debit card, PayPal, or Bitcoin Click here to support Congressional Dish for each episode via Patreon Mail Contributions to: 5753 Hwy 85 North #4576 Crestview, FL 32536 Thank you for supporting truly independent media! Register for Podfest: Pay It Forward Bills H.R. 1370: Continuing Appropriations Act, Department of Defense Missile Defeat and Defense Enhancements Appropriations Act, CHIP and Public Health Funding Extension Act, 2018 Division A Section 1001: Extends 2017 funding levels until January 19, 2018 Section 1002: Delays the repeal of FISA warrantless spying authorities until January 19, 2018. Division B Title I: Missile Defeat and Defense Enhancements Appropriates over $3.8 billion for emergency ballistic missile equipment and research. Title II: Missile Construction Enhancements Appropriates $200 million, available until September 30, 2022 to construct an emergency missile field in Alaska Title III: General Provisions Section 2001: Clarifies that the money in this law for the Department of Defense will be in addition to the money it will be appropriated for 2018. Section 2002: For the extra money given to the military in this law, this section creates an exception to the rule that says that no new projects can be started with it. Section 2003: Clarifies that this money is being appropriated as an emergency requirement. Division C: Health Provisions Title I:: Public Health Extenders Section 3101: Appropriates $550 million for community health centers and $65 million for the National Health Service Corps for the first half of 2018 Section 3102: Appropriates $37.5 million for a program for type I diabetes for the first half of 2018 Section 3103:: Cuts [the authorization for the Prevention and Public Health Fund](http://uscode.house.gov/view.xhtml?req=(title:42%20section:300u-11%20edition:prelim) - 2019: Authorization decreases from $900 million to $800 million (was originally supposed to be $2 billion annually) - 2020 & 2021: Authorization decreases from $1 billion to $800 million - 2022: Authorization decreases from $1.5 billion to $1.25 billion. Title II: Children's Health Insurance Program (CHIP) Section 3201: Appropriates $2.85 billion for the Children's Health Insurance Program through March 31, 2018, which is a cut from previous appropriations. Division D: VA Choice Section 4001: Appropriates an additional $2.1 billion for the Veteran's Choice Program. Division E: Budgetary Effects Section 5001: The budgetary effects of the money for CHIP and VA Choice on the PAYGO scorecard will not be counted. Section 5002: The effects of the tax bill (the "Reconciliation Act" authorized by H. Con. Res. 71) will not be considered in the PAYGO budget. S.371: Department of State Authorities Act, Fiscal Year 2017, Improvements Act   Section 2: Orders a bunch of foreign policy related reports to be given to the Appropriations Committees in the House and the Senate. Section 3: Changes the original law signed in December 2016 to remove the requirement for "swift and effective disciplinary action against" police or troops of UN countries who sexually exploit or abuse people during their peacekeeping missions. In it's place, the requirement will be that the countries will have to "appropriately hold accountable" their personnel, which is left undefined. Section 10: Allows members of the Western Hemisphere Drug Policy Commission to "solicit, accept, use, and dispose of gifts, bequests, or devises of money, services, or property, both real and personal, for the purpose of carrying out any duty, power, or authority of the Commission." Additional Reading Article: Retirements of veteran Republicans fuel GOP fears of losing House majority by Mike DeBonis, The Washington Post, January 10, 2018. Article: Drug policy: Our unfinished business in the Americas by Reps. Eliot L. Engel and Matt Salmon, Huffington Post Report: Congress rushes Pentagon $4b for missile defense improvements by Marcus Weisgerber, Defense One, December 22, 2017. Report: House, Senate pass CR with emergency funding for missile defense, Navy ship repair by Justin Doubleday, Inside Defense, December 21, 2017. Article: Collision-damaged USS McCain arrives at Yokosuka for repairs by Leon Cook, Stars and Stripes, December 13, 2017. Article: USS Fitzgerald departs Yokosuka for Mississippi from U.S. 7th Fleet Public Affairs, America's Navy, December 8, 2017. Article: Could the U.S. actually shoot down a North Korean missile? by Larlsa Epatko, PBS, November 28, 2017. Article: Trump administration proposes $2.1 billion expansion of Fort Greely missile-defense base by Tim Ellis, AlaskaPublic.org, November 14, 2017. Press Release: AK delegation applauds major missile defense increase in Trump administration's budget request by Matt Shuckerow, DonYoung.house.gov, November 6, 2017. Report: Counternarcotics: Overview of U.S. efforts in the western hemisphere, U.S. Governtment Accountability Office, October 13, 2017. Article: Fort Greely stands firm in face of North Korean threat by Sean Kimmons, Department of Defense, October 11, 2017. Article: Doomsday Deflector: What is the THAAD missile system, where is the US program deployed and how does it work? by Patrick Knox, The Sun, September 4, 2017. News Report: Hudson Institute congratulates John Walters on congressional appointment to Western Hemisphere Drug Policy Commission by Hudson Institute, PR Newswire, June 29, 2017. Article: There's a flaw in the homeland missile defense system. The Pentagon sees no need to fix it by David Willman, The LA Times, February 26, 2017. Press Release: Engel measure to reassess drug policy headed to president's desk, Committee on Foreign Affairs, December 10, 2016. Article: The US government is literally arming the world, and nobody's even talking about it by William D. Hartung, Mother Jones, July 30, 2016. Article: U.S. missile defense system is 'simply unable to protect public,' report says by David Willman, The LA Times, July 14, 2016. Article: A test of America's homeland missile defense system found a problem. Why did the Pentagon call it a success? by David William, The LA Times, July 6, 2017. Report: Standard Missile-3 by Zach Berger, Missile Defense Advocacy, June 2017. Article: 'Double down' in fight against opioid abuse by Mary Bono, USA Today, March 6, 2017. Report: Assessment of DOD's reports on status of efforts and options for improving homeland missile defense, U.S. Government Accountability Office, February 17, 2016. Article: Bring back the war on drugs by William Bennett and John P. Walters, Boston Globe, September 9, 2015 Report: Fort Greely to get $50 million toward missile defense system by The Associated Press, Army Times, December 16, 2014. Article: Does missile defense actually work? by Roger A. Mola, Airspacemag.com, April 9, 2013. Resources Budget of the U.S. Government: Fiscal Year 2018 Department of Defense: Budget Amendment Fiscal Year 2018 Department of Defense: FY 2018 Budget Amendment Department of Defense: Military Installations Overview Fort Greely, Alaska Department of the Navy: FY 2018 Emergency Contingency Operations Amendments OpenSecrets.org: Boeing Co. Client Profile 2017 OpenSecrets.org: Faegre Baker Daniels Consulting Profile 2017 OpenSecrets.org: Raytheon Co. Client Profile 2017 Twitter Post @JordanUhl: Members of Congress Not Seeking Reelection Visual References Boeing Co Stock Summary Sound Clip Sources Hearing: U.S. Defense Strategy in South Asia; House Committee on Armed Services; October 3, 2017 C-Span Video Witnesses: - Joseph F. Dunford Jr. - James N. Mattis 57:25 James Mattis: I think the most important thing is that we get budget predictability and certainty, because without that, we cannot take the—adjust our forces and get predictability into our budgets that permits us to gain the best bang for the buck, to put it bluntly. We’re going into the ninth year with a continuing resolution. As you know, I cannot make new starts under that, even if the cyber domain or the space domain require that we do new things we’ve not had to do before to maintain our competitive edge. Cover Art Design by Only Child Imaginations Music Presented in This Episode Intro & Exit: Tired of Being Lied To by David Ippolito (found on Music Alley by mevio)

President Trump declared the opioid crisis a “national public health emergency” this week, directing a variety of federal agencies and administrators to focus on fighting this issue. Declaring the opioid crisis a “national public health emergency” instead of a “national emergency” makes a significant difference in sources of funding, administrative jurisdiction, and actions that Congress can take. Jeremy Slevin, associate director of advocacy for the Center for American Progress' Poverty to Prosperity program, details the pitfalls the Trump administration faces in fighting the opioid crisis. Saul Anuzis, former chairman of the Michigan Republican Party, talks about a reasonable and constitutional path to change the electoral college into a winner-take-all system through the National Popular Vote Interstate Compact.

The American Health Care Act, the Republican plan for a new health care system, passed the House of Representatives at lightning speed. In this episode, get the backstory on the reckless process used to pass the bill, learn how it changed from the original version, and find out how the Congressional Budget Office expects the bill would affect you. Please support Congressional Dish: Click here to contribute using credit card, debit card, PayPal, or Bitcoin Click here to support Congressional Dish for each episode via Patreon Mail Contributions to: 5753 Hwy 85 North #4576 Crestview, FL 32536 Thank you for supporting truly independent media! Recommended Congressional Dish Episodes CD146: Repeal & Replace Bill Outline H.R. 1628: American Health Care Act of 2017 Bill Outline Title I: Energy and Commerce Subtitle A: Patient Access to Public Health Programs Section 101: Repeals the Prevention and Public Health Fund at the end of 2018 Section 103: Prohibits any Federal funding for any non-profit that performs abortions for a year Subtitle B: Medicaid Program Enhancement Section 111 : Reduces Medicaid funding Section 112: Ends the Medicaid expansion... For people under 65 years old whose income is less than 133% of the poverty line at the end of 2019 Ends the States' option to cover these people's families at the end of 2017 People in this category who have Medicaid on December 31, 2019 will be grandfathered in and will keep their insurance as long as they never go off of Medicaid for more than one month The Federal funding increase for states covering grandfathered individuals will only apply for people enrolled as of March 1, 2017 and is capped at 80% reimbursement rate Repeals the requirement that Medicaid cover “essential health benefits” as of January 1, 2020. Section 114: Prevents Medicaid for lottery winners Section 115: Gives $10 billion extra over five years to the “non-expansion States” Section 116: Forces States to verify Medicaid eligibility every six months and gives them more enforcement money Section 117: Allows States deny people Medicaid if they are not participating in "work activities" The State decides how long the person has to work for in order to get Medicaid The State can't deny Medicaid to... Pregnant women or to women who have had a baby within the last 60 days Kids under age 19 Only parents with kids under the age of 6 or a disabled child Gives the States more money for enforcement Subtitle C – Per Capita Allotment for Medical Assistance Section 121: Caps Medicaid funding on a per capita basis. States that spend too much one year will have their Medicaid cut the following year States will be allowed to get 10 year block grants instead Subtitle D: Patient Relief and Health Insurance Market Stability Section 131: Repeals the lower out-of-pocket limits for low-income people effective in 2020 Section 132: Creates a "Patient and State Stability Fund" to be administered by the Secretary of Health and Human Services to give money to the States until the end of 2026. Funds can be used for: Helping "high-risk individuals" buy insurance if they don't get coverage through their employer Giving money to insurance companies ("incentives") so they will lower premiums Taxpayers will pay insurance companies 75% of the claims made between $50,000 and $350,000 "Promoting access" to preventative care, including dental and vision Maternity & newborn care Mental health care and substance abuse treatment Reduction of out-of-pocket costs for people enrolled in health insurance in the State The fund is appropriated with $15 billion per year until 2020 and $10 billion per year until 2026. There will be an extra $8 billion a year put into the fund from 2018-2023 to pay for increased premiums and out-of-pocket costs of people in States that get a waiver In order to receive money from the Federal fund, States will have to match an increasing percentage, starting with 7% in 2020 increasing to 50% by 2026 An extra $15 billion "Federal Invisible Risk Sharing Program" will go directly to health insurance companies. The rules in terms of whose claims will be paid for, the percentage of their premiums that would be paid, and the dollar amount at which the government will starting covering the insurance companies' costs will be determined by the Secretary of Health and Human Services Section 133: Starting in 2019, people who purchase insurance after a coverage gap of 63 days will be charged a 30% penalty for a year. The insurance companies get to keep all the extra money. Section 134: The requirements that bronze, silver, gold, platinum level plans exist and must cover certain percentages of expenses and “essential health benefits” are repealed effective January 1, 2020. Section 135: Allows insurance companies to charge older people five times more than younger people (they’re currently allowed to charge three times more) Section 136: Starting in 2018, States can apply for a waiver for the individual and small group insurance plans from the national “essential health benefits” requirements and instead allow States to determine what essential health benefits need to be covered by insurance companies. Waiver applications from States are automatically approved after 60 days Waivers will be granted if the State says that doing so would do at least one of the following: Reduce premiums Increase enrollment Stabilize the insurance market Increase the number of health plans offered. Waivers will be valid for 10 years and continuation requests will be automatically approved Starting in 2019, states can also get waivers that would allow insurers to charge different rates based on people's health status ("pre-existing conditions") if they did not have coverage for at least 63 days in lieu of the 30% surcharge. States can get this waiver as long as that state participates in the high-risk funds to help pay for individuals and insurance companies' costs. Insurance companies could limit coverage during the "enforcement period", not permanently. Section 137: Health insurers can't set rates based on gender and "Nothing in this act shall be construed as permitting health insurance issuers to limit access to health coverage for individuals with preexisting conditions." Title I: Committee on Ways and Means Subtitle A: Repeal and Replace of Health-Related Tax Policy Section 201: Starting in 2018, the limits on the amount of advanced-paid tax credits that can be taken back from low income people will be repealed. Section 202: Allows tax credits to be used on “catastrophic-only” health insurance plans that are not listed on the exchanges and prohibits tax credits for any plan that covers abortions. Section 203: Repeals the tax credit for employers with fewer than 25 employees who want to provide health benefits to their employees starting in 2020 and prohibits tax credits for any health plan that covers abortion. Section 204: Reduces the tax penalties for failing to purchase insurance to $0 and back dates it to be effective in 2016. Section 205: Reduces the tax penalties for employers who fail to provide health benefits to their employees to $0 and back dates it to be effective in 2016. Section 206: Delays the start of a tax on insurance companies which charges a 40% excise tax on “Cadillac plans”, which charge premiums more than $10,200/year ($850/month) for individuals until 2026. The 40% is only on the extra premiums charges above the cap. Section 207: Starting in 2017, over-the-counter drugs can be purchased with Health Savings Accounts (HSA). Section 208: Starting in 2017, taxes on money from health savings accounts that is not used for medical expenses will be cut in half (from 20% to 10%) Section 209: Starting in 2017, the $2,500 limit on the amount that can be taken out of an employee’s paycheck for employer health plans that use “flexible savings accounts” is repealed. Section 210: Starting in 2017, repeals a 2.3% tax, paid by manufacturers or importer, on sales of medical devices that are not generally purchased by the general public at retail stores. Section 211: Beginning in 2017, businesses who provide retiree prescription drug benefits that are at least as valuable as Medicare Part D can get a federal drug subsidy. This provision will allow those businesses to deduct the entire cost of providing that coverage even though a portion of the drug coverage is offset by the subsidy they receive. Section 212: People can get a tax deduction for medical care that is not paid for by insurance if those expenses exceed 10% of their gross income; this provision reduces that to 5.8 % starting in 2017. Section 213: No changes are actually made because the text of the new paragraphs are exactly the same as current law. Section 214: Starting in 2020, this bill creates a new tax credit structure tied to age instead of income for people making under $75,000 per year (the credits gradually reduce the more you make over $75,000) Credit amounts: Under age 30: $2,000/yr Ages 30-40: $2,500/yr Ages 40-49: $3,000/yr Ages 50-59: $3,500/yr Over age 60: $4,000/yr The credits are capped at $14,000 per family for the five oldest individuals People can only get the tax credits if they are ineligible for employer-provided plans Credits can't be used to buy insurance that covers abortions Married couples are forced to file jointly if they want the health coverage tax credits There are exceptions for couples who don't live together & domestic abuse victims Section 215: Starting in 2018, increases the amount than can be put in Health Savings Accounts Individual contribution limit raised from $2,250 to $5,000 per year. Family contribution limit raised from $4,500 to $10,000. Section 216: Starting in 2018, married couples over the age of 55 with high deductible plans will be able to contribute more to joint health savings accounts Section 217: Starting in 2018, if a health savings account is opened within 60 days of a person getting coverage with a high deductible, medical expenses for those 60 days will be eligible for payment from the HSA Subtitle B: Repeal of Certain Consumer Taxes Section 221: "Repeal of tax on prescription medications" Starting in 2017, a fee paid by pharmaceutical manufacturers and distributors will be repealed Section 222: "Repeal of health insurance tax" Starting in 2017, a fee on large health insurance companies, which is tied to and increases with premium growth rates, would be repealed. Subtitle C: Repeal of Tanning Tax Section 231: Starting on July 1, 2017, the 10% tax on indoor tanning is repealed. Subtitle D: Remuneration from Certain Insurers Section 241: Starting in 2017, insurance companies can get tax deductions on employee pay between $500,000 and $1 million. Subtitle E: Repeal of Net Investment Income Tax Section 251: Starting in 2017, a 3.8% tax on net income from stock market investments over $200,000 will be repealed. H.R. 2192 - To amend the Public Health Service Act to eliminate the non-application of certain State waiver Additional Reading Article: The most important part of the Republican health bill is mostly getting ignored by Matthew Yglesias, Vox, May 9, 2017. Article: GOP Health Bill Leaves Many 'Pre-Existing Condition' Protections Up To States by Bram Sable-Smith, NPR, May 8, 2017. Article: The 4 Big Changes To Health Care In The Latest GOP Bill by Anna Maria Barry-Jester, FiveThirtyEight, May 2, 2017. Article: The MacArthur Amendment Language Race in the Federal Exchange and Risk Adjustment Coefficients, Health Affairs, April 25, 2017. Article: Gripes About Obamacare Aside, Health Insurers Are in a Profit Spiral by Jeff Sommer, The New York Times, March 18, 2017. Article: Health insurance industry rakes in billions while blaming Obamacare for losses by Amy Martyn, Consumer Affairs, November 1, 2016. Report: Health Care Legislation Eliminates Tax Deduction Related to Medicare Part D Subsidy - Potential Accounting Impact This Quarter, Deloitte, March 31, 2010. Article: More Americans Went Uninsured in 2009 Than in 2008 by Elizabeth Mendes, Gallup, January 8, 2010. References CBO Cost Estimate: H.R. 1628 American Health Care Act of 2017 Life of the bill in the Rules Committee: H.R. 1628 - American Health Care Act of 2017 HealthCare.gov: Federal Poverty Level GovTrack: American Health Care Act of 2017 Votes OpenSecrets: Thomas MacArthur OpenSecrets: Rep. David Schweikert - Top Industries OpenSecrets: Rep. Gary Palmer Sound Clip Sources Hearing: House Rules Committee Meeting on Republican Health Care Bill Amendment, House of Representatives, April 6, 2017. Timestamps & Transcripts 03:48 Rep Jim McGovern: We’re meeting on an amendment affecting millions of people’s healthcare, that came out of a backroom about an hour ago, with no vetting at all. I think the amendment, it was—the text was stamped, I think at 11:24 a.m. We were noticed for this meeting at 11:52. We waived the traditional hour so we can kind of move on with it, but there was no vetting at all, no process whatsoever, just a couple of good old boys with a typewriter, saying maybe this will work. 8:00 Rep Jim McGovern: If you guys want to deal with healthcare, introduce a bill; get co-sponsors on the bill; have the relevant committees—committees like Ways and Means, and Energy and Commerce—do hearings, that’s a radical idea; invite people who know something about this issue—invite patients and patient-advocate groups and doctors and heads of hospitals, and invite some of your friends in the insurance industry—to come up and weigh in on your proposal; then you could do markups. Then get a CBO estimate, and after you get a CBO estimate and it’s marked up, then you come to Rules Committee, and you advance a bill to the floor. 13:40 Rep David Schweikert: If we were to actually have just sort of the top-line math question and say, let’s strip away some of the rhetoric and ideology and just sort of say “math,” when we look at our healthcare-utilization data, it’s functionally a hockey stick. Fifty percent of our population, the healthiest 50 percent, only use about three percent of healthcare costs, but our least healthy—our folks with chronic conditions, our brothers and sisters who really do suffer out there or have multiple issues laddered up—they represent five percent of that population, represents 50 percent of our spending. So you have this situation where we as a society, as a community, we’ve decided that guaranteed issue is out there, so now how do we find premium efficiency, rate efficiency? And as long as we’ve made this decision over here as a society, the fastest, most efficient thing we could do is actually sort of laddering some of that risk at that very top end. Last thing, and this may require a little more diving into it, and looking around, this is a smart committee, so you understand these things, if you were the actuaries building your rate profile, the ability to say we believe providing coverage for this population is going to cost this, you always have to design in a shock absorber because you wake up tomorrow and some people sign up for this coverage who have a chronic condition. The beauty of this type of risk-sharing model is that shock absorber that you have to build into your rate model can be substantially less because your top-end exposure is actually mitigated. So this was an occasion of, was there something we could do for lowering and making much more predictable the rate environment for that individual market, and this, I think, was the most elegant, simple way to get there. 38:55 Rep Alcee Hastings: In the brief time I’ve had to review it, the measure will provide $15 billion for the high-risk pools. Is that correct? All right. The language, specifically, setting it for is, “For the purpose of providing funding for the program there is appropriated, out of any money in the Treasury not otherwise appropriated, $15 billion for the period beginning January 1, 2018”—am I right?—“and ending on December 31, 2026.” So that’s $15 billion over a 10-year period of time. Get it straight, America. If this measure were to become law—there was a conservative gentleman, I can’t pull his name up right now, that said in the great scheme of things, it’s chump change because it simply would not provide the necessary money over the nine-year period of time. Hearing: Rules Committee Hearing H.R. 1628 and H.R. 2192, House of Representatives, May 3, 2017. Timestamps & Transcripts 24:05 Rep Jim McGovern: As you mentioned in your testimony, we found out last week that the MacArthur amendment mysteriously exempted Congress from the damaging effects of this bill, and I say mysteriously because nobody seems to know who put the provision in. And as the Vox reporter who uncovered the exemption put it, and I quote, “No one will fess up to putting the Congress exemption in the AHCA amendment.” Apparently, Representative MacArthur, your office told her that the Senate Budget added it, and the Senate Budget said no, in fact they didn’t. So, I guess I’m just curious. My first question is, where precisely did this exemption come from, and who thought that this bill was good enough for American families but not good enough for Congress? Mr. MacArthur, you wrote the amendment; did you put the provision in? Or Mrs. McSally, your bill tries to fix it; do you know anything about how the exemption got in there in the first place? Rep Martha McSally: Want to go? This budget-reconciliation process is not intuitive to really anyone. I mean, this is very arcane, and so as we’ve been going through this process in the House, trying to comply with Senate rules, content can only apply if it’s referred to specific Senate committees. And— McGovern: So somebody consciously knowing that—someone consciously moved the legislation forward without — McSally: So, again, my understanding is in order to comply with these arcane Senate rules of budget reconciliation, where if a matter is going to be referred to some other committee other than the ones that are listed in the original budget resolution, then it’ll no longer be applicable and the budget-reconciliation process doesn’t go forward. So, all I know is I heard it didn’t apply, and I said let’s fix it. McGovern: Who put it in? Who put the exemption in the first place? McSally: Yeah, and it specifically—just to be clear, it specifically related to his amendment. It’s not related to other provisions in the middle. So… McGovern: Yeah, so who put this exemption in in the beginning? Rep Tom MacArthur: Well, first, I don’t believe that members of Congress or our staffs should receive any special treatment, and I don’t think anybody believes that. McGovern: But Mrs. McSally’s bill— MacArthur: Well, as— McGovern: It’s not an amendment, it’s a bill; but it’s just to fix the fact that, is it a drafting error, or did somebody intentionally try to exempt Congress? MacArthur: It’s not an error, but the challenge, as Mrs. McSally has said, the challenge is getting House policy, drafting House policy, to conform with Senate rules. And I had every intention in drafting my amendment that there would be no special exception for Congress. Senate rules required us to accomplish this— McGovern: What Senate rules? Did you talk to the Senate parliamentarian? Who did…? MacArthur: I didn’t personally, but the requirement is because exempting us would require to go to a different committee that we needed to accomplish this through a stand-alone bill, which we have. Mrs. McSally has introduced it. I’m an original co-sponsor. I hope you’ll support the bill. I think it’s worthy of support, and none of us should want to exempt Congress— McGovern: None of us do, but from where we’re sitting, it looks like you guys get your hands caught in the cookie jar and then get exposed and then decided to fix it after a reporter uncovered it. MacArthur: Well, that’s your interpretation. I wouldn’t describe it that way. I think we fixed the issue in the only way that the Senate suggested that we could and that was through a stand-alone bill that was introduced around the same time. 28:56 Rep Jim McGovern: I think anybody who’s watching this is scratching their head, wondering how in the world can Congress be dealing with healthcare issues in a way where we don’t have hearings, where fixes are being worked out in a back room, and we’re just seeing the language for the first time right now, that their input is being pushed aside—American people don’t matter—all so that it could be a vote before we go in recess because the president wants us to. I mean, I think healthcare’s a very personal issue, it’s very important, and people want us to get it right, and I don’t think anybody here believes that we’re getting this right, even those of us with different opinions, in the process that we’re utilizing here. I’ve got to be honest with you, this process, to put it bluntly, is a goddamn mess. I mean, it really is. And I don’t know how anyone can defend it. Fixes upon fixes to fix the fixes to fix the fixes—and it’s going to be brought to the floor tomorrow, and we’re going to have a debate, and that’s how we’re going to serve our constituents? You guys can defend it, and you’ll have to defend it, but I think you’re going to be surprised how upset the American people are going to be. 37:30 Rep Fred Upton: My—our amendment, I should say, is carefully targeted at those states that may seek a waiver. Obviously, there are none today. I don’t know what Governor Scott or the future governor will do. Unknown Speaker: I’ll get to him in a minute. Upton: All right. Well, I know I talked to my governor this morning. He’s not interested in seeking a waiver. Unknown Speaker: Mm-hmm. Upton: I would guess that most governors—maybe all, I don’t know—will not seek a waiver, and in that case, my amendment just covers something if maybe it happens. And one of the reasons why we targeted the money—so it’s $8 billion: it’s a billion the first year; a billion the second year; and two billion, years, each, three, four, and five—because chances are if a governor does take this course, you’ll have fewer at the beginning than at the end. I ask the question, is five billion enough to cover those that might need some help if a governor sought a waiver in that first year, because remember, after the first year they have continuous coverage. Unknown Speaker: That's right. Upton: The answer, not a lot of facts behind it, but the answer was, five billion should probably cover that, in which case a number of us said, well, we want to make sure that it is covered. And that’s why it is eight billion and not five. 40:54 Rep Jim McGovern: Who did you ask? I mean, that’s the whole point of a CBO is because we want to get a nonpartisan— Rep Fred Upton: We don’t have a CBO score. McGovern: Right. So who? Who did you—who gave you these figures? Rep Alcee Hastings: Eight billion. Upton: Who? I'm sorry, who? McGovern: You said you asked— Upton: No, no. I know Mr. Hastings’ had an answer. I didn’t hear what he said. Hastings: No. You asked for the five billion, was that enough. Who? Upton: I asked, I asked— Hastings: And he asked who. Upton: I asked some of the drafters—so I made this proposal—I’m not a lawyer, like you—I asked legislative counsel, I asked a number of staff very tied into the—what is the estimate. They thought five billion would cover it. 51:25 Rep Alcee Hastings: And to predict for you what I think is going to happen in the Senate: I think they take health security a little more seriously and is a more moderate body than we are, and so you can reasonably expect that when you pass this tomorrow on the slimmest of margins that you may never see it again, and you will not see it in the form that it’s in. So let’s just have at it. I’ve had my fun. I hope you continue to have yours, and some of you ain’t going to be here the next time that we meet after 2018. Tell your body I said so. Music Presented in This Episode Intro & Exit: Tired of Being Lied To by David Ippolito (found on Music Alley by mevio) Cover Art Design by Only Child Imaginations

What happens to an infectious agent once it leaves the human body? Well, it ends up in our cars, airplanes, food, water and soil. If we know how that contagion behaves "in the wild", then we'll be able to kill it, filter it, or otherwise prevent it from proliferating, and potentially improve the lives of millions of people in the process.  This is the study of Environmental Microbiology and it's a topic that today's guest has spent more than 30 years trying to understand. Dr. Syed Sattar is Professor Emeritus of Microbiology at the Faculty of Medicine, University of Ottawa. He is also a co-founder and Chief Scientific Officer at CREM CO.  He's a world-renowned expert who regularly advises national and international agencies like the World Health Organization (WHO), and private-sector companies. We're also joined by Bahram Zargar, CEO of CREM CO. This is a company built on top of Dr. Sattar's extensive body of work that aims to speed the assessment, development, and promotion of innovative and sustainable strategies for environmental control of harmful microbes for a safer tomorrow. It blends engineering with environmental microbiology to enable a whole new level of scientific rigor. You'll learn: What happens to infectious agents once they leave the body? What can we do with that knowledge? How air travel and the international food market have eliminated borders in the battle against infectious disease. How engineering can support Infection Prevention and Control (IPAC) by enabling scientific rigor and validation. How this science can be used to develop new barrier technologies. What is lacking in today's IPAC efforts and where does it need to go? How disinfectants can lead to their own form of resistance (i.e. bugs resistant to cleaning) and may even contribute to antibiotic resistance. What's the biggest challenge in matching IPAC innovations with potential buyers in the healthcare system? Why we need to enable our "foot soldiers" (i.e. the cleaning staff and environmental services teams at hospitals) with proper training and tools to win this war. Why it's important for innovators and manufacturers to be more scientifically responsible (i.e. don't chase the bug of the month). Why government needs to increase funding for research and development in IPAC. Why it's so important to stand on the shoulders of the IPAC greats that came before us and build on their work. A few key points that I'd like to highlight: There's very little money set aside by governments for research and development in IPAC. If there's no money, then the best researchers aren't motivated to go after these issues and innovation is starved. We've seen that recently in the U.S with the constant attack on the Prevention and Public Health Fund. We rely on our cleaning staff and Environmental Services (EVS) teams to do a very important job in the hospital, but we don't treat that position with much respect. "If our soldiers are not well trained and ill-equipped for battle, then how do we expect to win the war against the spread of infection?" In a world of increasing antibiotic-resistance and anti-microbial resistance, we must focus on prevention in IPAC. Subscribe on iTunes Sign-up for our weekly newsletter! About CREM CO CREM Co is a contract and R&D laboratory uniquely positioned to provide value to the infection prevention and control (IPAC) industry as well as those working in health-related environmental microbiology and molecular biology. CREM Co has the expertise for handling all major classes of pathogens in water, food, air, municipal wastes as well as on animate and inanimate surfaces. It can assess disinfectants and antiseptics using internationally accepted test protocols. Its state-of-the-art aerobiology facilities are designed to study airborne microbes and decontamination of indoor air. Building on the rich history of the Centre for Research on Environmental Microbiology, CREM Co will continue to focus on the assessment, development, and promotion of innovative and sustainable strategies for environmental control of harmful microbes for a safer tomorrow. http://www.cremco.ca/ CREM CO on LinkedIn CANADIAN RESEARCHERS TEST INDOOR AIR DECONTAMINATION APPLIANCES FOR CARS Indoor air as a vehicle for human pathogens: Introduction, objectives, and expectation of outcome And this is a post about the event in Buffalo that we mentioned: Using Chemical Microbicides to Interrupt the Environmental Spread of Pathogens Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter. You'll get one email from me each week detailing: New podcast episodes and blog posts. Content or ideas that I've found valuable in the past week. Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else. The question of the week. Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime. About the Infection Prevention and Control Series This episode is part of The #HCBiz Show's Infection Prevention and Control (IPAC) series. We'd like to thank our partners InfectionControl.tips and the Center of Excellence for Infection Prevention and Control (COE IPAC) for their support and guidance with the series. About InfectionControl.tips InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services. About Center of Excellence for Infection Prevention and Control (COE IPAC) Center of Excellence for Infection Prevention and Control (COE IPAC) is a collaborative effort to accelerate and support new solutions that hold the promise of significantly advancing infection prevention and control. On a quarterly basis, the Center of Excellence will evaluate at least 3 international innovations – giving them access to independent testing, publication as well as a US commercialization site The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.   Soundtrack credit: Acid Lounge by FoolBoyMedia

Clostridium difficile (klos-TRID-e-um dif-uh-SEEL), often called C. difficile or C. diff impacts 453,000 people every year. And with 29,000 associated deaths, it takes more lives than AIDS and drunk-driving combined. Yet, most people have never even heard of it. That's a big problem because you can't protect yourself from a threat when you don't even know it exists. The impact on the business of healthcare is significant too. A study published in the American Journal of Infection Control found that C. diff-associated diarrhea (CDAD) increases hospital costs by 40% per case (an average of $7,285 ) and puts those infected at high risk for longer hospital stays and readmissions.  Some even believe those numbers are likely underestimated. C. diff presents us with an interesting problem at the cross-section of Infection Prevention and Control (IPAC). It's an environmental bacterium that's found pretty much everywhere and is difficult to kill, but it's usually held in check by the good bacteria in our bodies. The problem usually occurs when a patient is in a weakened state from some other healthcare intervention. That may be an antibiotic treatment for another healthcare-associated infection or chemotherapy, etc. With our bodies in a weakened state and our good bacteria depleted by antibiotics, we become susceptible to C. diff. So, it's important that we execute on all the other IPAC practices like proper hand hygiene and surface cleaning in the hospital so that, as our guest puts it, we can disrupt the chain of events that allow to C. diff to proliferate. Episode 005 (part 4 of our IPAC series): On this episode, we're joined by the co-founder and Executive Director of the Peggy Lillis Foundation (PLF), Christian John Lillis.  Like so many people who've dedicated their lives to driving change in the healthcare industry, Christian has a very powerful "why". He lost his mother to a clostridium difficile (C. diff) infection in April 2010. After struggling with the fact that he lost his mother to a disease he never heard of, and later finding out that it impacts so many people, Christian, along with his brother Liam, founded PLF and are building a nationwide C. diff awareness movement by educating the public, empowering advocates and shaping policy. Christian gives us a deep and personal take on his family's experience with C. Diff and the work that the Peggy Lillis Foundation is doing to help. We discuss: What is clostridium difficile (C. diff)? Is C. diff a Healthcare-Associated Infection (HAI) or something else? How important are hand hygiene and environmental cleaning in preventing the spread of C. diff? Why haven't more people heard of C. diff? Why is it so hard to measure the true impact of C. diff on our health system? How do we fix that? Why do only some states require reporting on outbreaks? How does that affect the business of healthcare? How does it affect the patients? What is the Prevention and Public Health Fund? Why is it under fire and what is the impact to the CDC, states and beyond? What is the financial impact of C. diff? Christian's story is powerful and it's full of wisdom that can help patients, families, and providers. In our quest to unravel the business of healthcare, it's important to understand the people we serve and how our work impacts their lives. This is a crash course and I hope it touches you as it did me. Enjoy. ~Don Lee   About Christian John Lillis Christian John Lillis is executive director of The Peggy Lillis Foundation (PLF), which he co-founded with his brother, Liam, following the death of their mother from a clostridium difficile (C. diff) infection in April 2010. PLF is building a nationwide C. diff awareness movement by educating the public, empowering advocates and shaping policy. He was previously managing director of prospect strategy & research at Teach For America. With more than 15 years' experience as a frontline fundraiser and behind-the-scenes strategist for healthcare, LGBT rights, and education organizations, he led prospect identification and research programs that increased resource development both nationally and regionally. Prior to joining Teach For American in November 2009, Christian served in a variety of roles for a diverse group of nonprofits, including as Director of Development for In The Life Media, Director of Major Gifts for the National LGBTQ Task Force, and Associate Director of Development Research for NYU Langone Medical Center. Throughout his career, Christian has been a frequent speaker at conferences including the Mid-Atlantic Researchers Conference and Creating Change: The National Conference on LGBT Equality. He was also a contributor to Prospect Research: A Primer for Growing Nonprofits by Cecilia Hogan. Christian is an adviser to the Patient Voice Institute and Gulf Coast C. diff Collaborative, as well as a member of Consumers Union Safe Patient Project and Chicago Area Patient-Centered Outcomes Research Network. He is a former member of the board of directors of the Center for Lesbian and Gay Studies at the City University of New York and the Association of Professional Researchers for Advancement (APRA) of Greater New York. Christian began his fundraising career at Lambda Legal Defense & Education Fund. He holds a B.A. in Political Theory from Brooklyn College, where he served as a term as President of the Lesbian, Gay, Bisexual and Transgender Alliance and won The Donald G. Whiteside Poetry Award his senior year. Christian is a native of Brooklyn, New York. He currently lives in Park Slope with his husband, Chris Young, and their rescued “beagle baby”, April. His hobbies include Tae Kwon Do (he is a black belt), Zumba, reading comic books and JD Robb's “In Death” series, and poetry writing. About the Peggy Lillis Foundation Mission: The Peggy Lillis Foundation is building a nationwide clostridium difficile awareness movement by educating the public, empowering advocates, and shaping policy. Vision: We envision a world where C. diff is rare, treatable and survivable. https://peggyfoundation.org/ 2017 C. diff Summit & National Strategy Meeting Facebook: https://www.facebook.com/PeggyFoundation/ Twitter: @PeggyFund Mentioned on the show: The Uncounted: The deadly epidemic America is ignoring. A Reuters report. Catastrophic Care: Why Everything We Think We Know about Health Care Is Wrong: One of my favorite books on healthcare. Be prepared to be jarred and probably angry, but more aware of what's going on in the business of healthcare. Also, a good listen on Audible at 1.25 speed. Patient Mortality During Unannounced Accreditation Surveys at US Hospitals About the Infection Prevention and Control Series This episode is part of The #HCBiz Show's Infection Prevention and Control (IPAC) series. We'd like to thank our partners InfectionControl.tips and the Center of Excellence for Infection Prevention and Control (COE IPAC) for their support and guidance with the series. About InfectionControl.tips InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services. About Center of Excellence for Infection Prevention and Control (COE IPAC) Center of Excellence for Infection Prevention and Control (COE IPAC) is a collaborative effort to accelerate and support new solutions that hold the promise of significantly advancing infection prevention and control. On a quarterly basis, the Center of Excellence will evaluate at least 3 international innovations – giving them access to independent testing, publication as well as a US commercialization site. The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.   Soundtrack credit: Acid Lounge by FoolBoyMedia

More bills than anyone could possible read were passed by a branch of Congress in June, including the 994 page National Defense Authorization Act (NDAA), four government funding bills, and thirty bills governing a wide range of topics, including Wall Street, MediCare, fishing, carbon dioxide emissions, stolen art, chemical storage, taxes, and more. Please support Congressional Dish: Click here to contribute with PayPal or Bitcoin; click the PayPal "Make it Monthly" checkbox to create a monthly subscription Click here to support Congressional Dish for each episode via Patreon Mail Contributions to: 5753 Hwy 85 North #4576 Crestview, FL 32536 Thank you for supporting truly independent media! New Congressman Rep. Trent Kelly of Mississippi's 1st district was sworn into office Emergency The Obama Administration continued the national emergency declared in Executive Order 13405 on June 16, 2006 with respect to Belarus Bulletin: Prospects for Belarus' Membership in the WTO by Anna Maria Dyner, The Polish Institute of International Affairs, July 31, 2013. Laws H.R. 2048: USA Freedom Act Outlined and discussed in Congressional Dish Episode 98: The USA Freedom Act H.R. 2620: United States Cotton Futures Act Hearing: House Agriculture Committee, June 17, 2015. Exempts cotton from foreign companies from part of the United Sates Cotton Futures Act, which will allow foreign cotton companies to participate in cotton futures trading. Current law only allows 100% U.S. cotton to be traded on the futures exchange. Passed the House of Representatives and the Senate by voice votes Sponsored by Rep. David Scott of Georgia's 13th district His #2 contributor is ICE Group, (stands for Intercontinental Exchange) which is a network of financial exchanges and clearing houses; it operates eleven exchanges, including three in the United States, Canada, and Europe that deal with agriculture futures. The company has ten lobbyists and has spent over $1.3 million lobbying for the last Congressional election. In the last election cycle, ICE Group gave more to Rep. David Scott than to any other politician, and over the years, the company has given Rep. David Scott at least $73,850. 1 page H.R. 1626: DHS IT Duplication Reduction Act Makes the DHS submit a report about the department's technology and gives them no additional money to complete it. Passed the House of Representatives and the Senate by voice votes Sponsored by Rep. Will Hurd of Texas's 23rd district 2 pages Bills H.R. 1735: National Defense Authorization Act Passed the House of Representatives 269-151 The version passed by the House of Representatives received a veto threat by President Obama Passed the Senate with changes 71-25 Sponsored by Rep. Mac Thorneberry of Texas's 13th district 994 pages Weird advertisement for the NDAA H.R. 2685: Department of Defense Appropriations Act Passed the House of Representatives 278-149 Received a veto threat from President Obama Sponsored by Rep. Rodney Frelinghuysen of New Jersey's 11th district 170 pages H.R. 2596: Intelligence Authorization Act for Fiscal Year 2016 Passed the House of Representatives 247-178 Received a veto threat from President Obama Sponsored by Rep. Devin Nunes of California's 22nd district 63 pages H.R. 2578: Commerce, Justice, Science, and Related Agencies Appropriations Act, 2016 Passed the House of Representatives 242-183 Received a veto threat from President Obama Sponsored by Rep. John Culberson of Texas's 7th district 218 pages H.R. 2577: Transportation, Housing, and Urban Development, and Related Agencies Appropriations Act Passed the House of Representatives 216-210 Received a veto threat from President Obama Sponsored by Mario Diaz-Balart of Florida's 25th district 354 pages H.R. 1335: Strengthening Fishing Communities and Increasing Flexibility in Fisheries Management Act Hearing: House Rules Committee, May 19, 2015. Changes the rules for management of an overfished fishery so that there is no hard deadline (currently 10 years) to replenish the fishery and adds exceptions, including one that allows the overfishing to continue if replenishment can't be done "without significant economic harm to the fishery". Doubles the amount of time an emergency regulation can adjust a fishery management plan. Adds economic impact to "fishing communities" to the list of factors that need to be considered when creating catch limits and exempts for some fish with short life spans. Regional Fishery Management Council meetings will have to be posted online All requirements of the the National Environmental Policy Act and all related implementing regulations will be deemed approved if the Regional Fishery Management Council completes a fishery impact statement. Creates a pilot program for using electronic monitoring at fisheries. Repeals independent peer-reviewed analysis' of the quality of statistics collected on fishing populations and a requirement for catch limits for Gulf of Mexico red snapper for recreational and commercial fishermen Ensures that this law will trump the National Marine Sanctuaries Act, the Antiquities Act, and the Endangered Species Act Prohibits the government from factoring in red snapper killer during the removal of offshore oil rigs when determining catch limits. Prohibits the government from factoring fish caught by foreign vessels in the U.S. economic zone when determining catch limits. Requires new guidelines be issued that will use nongovernmental sources for fisheries management decisions. Passed the House of Representatives 225-152 Received a veto threat from President Obama Sponsored by Rep. Don Young of Alaska His #4 contributing industry for the upcoming election is Fisheries and Wildlife; he has taken $9,000 from them for this election cycle as of 9/11/15. 57 pages H.R. 2042: Ratepayer Protection Act of 2015 Hearing: House Rules Committee, June 23, 2015. Prohibits any final rule to address carbon dioxide emissions from existing fossil-fuel powered electric utilities from being enforced until all lawsuits and appeals filed within 60 days of the final rule's publication are complete. Exempts states from complying with a final rule addressing carbon dioxide emissions from existing fossil fuel powered plants if the Governor informs the EPA that the rule would increase rates or have a significant adverse effect on the reliability of the State's electricity system. Hydropower will be counted as renewable energy Passed the House of Representatives 247-180 Received a veto threat from President Obama Sponsored by Rep. Ed Whitfield of Kentucky's 1st district His #1 and #2 industries for the upcoming election are Oil and Gas and Electric Utilities; he's taken $46,100 from Oil and Gas and $38,500 from Electric Utilities as of 9/11/15. Over the course of his Congressional career, he has taken at least $771,315 from Electric Utilities and $562,097 from Oil and Gas. 6 pages H.R. 2289: Commodity End-User Relief Act Hearing: House Rules Committee, June 2, 2015. Extends operations of the Commodity Futures Trading Commission Limits the rules and regulations that can be enacted on futures commissions merchants Adds seven more considerations (including alternatives to regulation) to the requirements of cost-benefit analysis of regulations. Orders the CFTC cost benefit analysis to be reviewed by a judge. Allows the traders to be regulated to challenge new CFTC rules directly to the US Court of Appeals, the second most powerful court in the country. Limits the subpoena power of the CFTC Removes the requirement that the CFTC be immune from lawsuits that arise from sharing data about swaps with domestic and foreign authorities and backdates this change to July 21, 2010, the effective date of Dodd Frank Financial Reform. Adds "a utility operations-related swap" to the list of swaps that can be traded, which allows gambling on the future of natural gas or electric generation, purchases, sales, supplies or delivery. Exempts traders from being classified and regulated as a "swaps dealer" if they trade less than $8 billion (current CFTC rule exemption limit is $3 billion). Expands the number of financial models swaps dealers will be allowed to use to determine how much actual money they need to hold onto. Passed the House of Representatives 246-171 Received a veto threat from President Obama Sponsored by Rep. Michael Conaway of Texas's 11th district His top contributor for the upcoming election is Depository Trust & Clearing Corporation, which is a swaps clearing house; he received $15,000. His top 5 contributors over the course of his career are, in this order, the American Institute of CPA's an international association of accountants, KPMG LLP, a multinational corporation specializing in auditing and regulation compliance, PricewaterhouseCoopers, and even larger multinational corporation specializing in regulation compliance, Energy Future Holdings Corp, a portfolio of energy companies, and Deloitte LLP, the self-proclaimed "world's largest" multinational corporation that specializes in auditing and risk management. From these five companies, Conaway has taken at least $319,873. 80 pages H.R. 1190: Protecting Seniors' Access to Medicare Act of 2015 Hearing: House Rules Committee, June 16, 2015. Repeals the Independent Payment Advisory Board, which is designed to suggest solutions if Medicare costs get out of control. Drastically cuts funding for the Prevention and Public Health Fund, cutting it by a total of $8.8 billion by 2026, which is a 61% cut. Passed the House of Representatives 244-154 Received a veto threat from President Obama Sponsored by Rep. Phil Roe of Tennessee's 1st district His #1 contributing industry over the course of his career is Health Professionals; he has taken $435,088 as of 9/11/15. 3 pages H.R. 160: Protect Medical Innovation Act of 2015 Hearing: House Rules Committee, June 16, 2015. Repeals the medical device excise tax The effects of this repeal on the budget will not be counted The Joint Committee on Taxation estimates that this will increase the budget deficit by $24.4 billion Passed the House of Representatives 280-140 Received a veto threat from President Obama Sponsored by Rep. Erik Paulsen of Minnesota's 3rd district His #3 contributing industry over the course of his career has been Pharmaceuticals/Health Products; he has taken at least $654,929. His #4 contributing industry has been Health Professionals; from them, he has taken $622,645. 4 pages H.R. 2200: CBRN Intelligence and Information Sharing Act of 2015 Allows the Office of Intelligence an Analysis of the Department of Homeland Security to share information and work with the Intelligence community to analyze possible chemical, biological, radiological, and nuclear attacks. Allows the Department of Homeland Security to share information related to terrorist attacks with the public. Passed the House of Representatives 420-2 Sponsored by Rep. Martha McSally of Arizona's 2nd district 6 pages H.R. 805: DOTCOM Act of 2015 Press Release: NTIA Announces Intent to Transition Key Internet Domain Name Functions, March 14, 2014. Prohibits the transition of NTIA's functions in Internet domain name registry until 30 days after a report is submitted. Passed the House of Representatives 378-25 Sponsored by Rep. John Shimkus of Illinois's 15th district 4 pages H.R. 2576: TSCA Modernization Act Eliminates a requirement that EPA use the "least burdensome requirements" when regulating toxic chemicals Orders the EPA to do risk evaluations on chemicals used, stored, sold or disposed of by commercial companies. The risk evaluations will not consider cost If the risk evaluation is requested by a manufacturer, the manufacturer will pay for the risk assessment The EPA will be required to do at least 10 risk assessments per year "subject to the availability of appropriations". Adds an exemption for "replacement parts" from the EPA rules prohibiting chemicals unless the replacement parts "contribute significantly to the identified risk". Adds the requirement that any rules created "shall provide for a reasonable transition period." Eliminates the requirement for an informal hearing when making rules about toxic chemicals. Creates a "critical use exemption" option for the EPA if the requirement is not "cost-effective", if it would "significantly disrupt the national economy, national security, or critical infrastructure" The exemption would be valid for 5 years at a time The exemption will include conditions on the use of the toxic chemical Allows data to be shared with State, local, or tribal governments and with health care professionals to assist with diagnosis or treatment. Forces companies that want to keep information confidential to explain their reasons and automatically releases the information to the public in 10 years, unless the company justifies the confidentiality again in writing. Eliminates caps of fees that can be collected and creates a "TSCA Service Fee Fund" to collect, store, and disperse the funds to pay for the EPA's costs for regulating chemicals. Passed the House of Representatives 398-1 Sponsored by Rep. John Shimkus of Illinois's 15th district 48 pages H.R. 1615: DHS FOIA Efficiency Act of 2015 Orders the Chief Freedom of Information Act Officer of the Department of Homeland Security to update Freedom of Information Act regulations within 90 days of the bill's passage. Orders the Chief FOIA Officer to identify the total annual cost of implementing the FOIA within 90 days. Orders the Chief FOIA Officer to identify unnecessary actions taken in the course of processing requests and eliminate them within a year of identifying them. Orders the Chief FOIA Officer to develop a plan to to process requests electronically. Orders the Chief FOIA Officer to issue guidance to the necessary people to reach the goal of reducing the FOIA request backlog by 50 percent by 2018. Passed the House of Representatives 423-0 Sponsored by Rep. Buddy Carter of Georgia's 1st district 7 pages S.611: Grassroots Rural and Small Community Water Systems Assistance Act Authorizes $15 million per year until 2020 to provide technical assistance to small public water systems. Passed the Senate by a voice vote Sponsored by Senator Roger Wicker of Mississippi 5 pages S. 653: Water Resources Research Amendments Act Adds a requirement for additional research into new water treatments into the Water Resources Research Act Requires an evaluation of water resource research projects every three years and withdraws funds from projects that do not qualify based on the evaluation. Authorizes $13.5 million per year through 2020. Passed the Senate by a voice vote Sponsored by Senator Ben Cardin of Maryland 5 pages H.R. 2088: United States Grain Standards Act Reauthorization Act of 2015 Reauthorizes the Department of Agriculture's process for grain inspections until September 30, 2020. Forces the Secretary of Agriculture to waive weighting and inspections of grain in an "emergency, a major disaster"; currently, the Secretary has the option to do so, but does not have to. A "major disaster" is defined to specifically include "a sever weather incident causing a region-wide interruption of government services". Changes the location of export inspections to specifically "export elevators" at export port locations. Widens the criteria for who is qualified to perform official inspections by deleting a list of requirements. Delegations of authority to conduct grain inspections to a State will expire every five years, and my be renewed. Adds a public comment period before the Secretary can delegate inspection responsibility to a State and requires a notice in the Federal Register announcing if the State was approved and the rational for the decision. The State would have to give at least 90 days notice advanced notice in writing to the Dept. of Agriculture if they want to stop performing grain inspections, unless there has been a major disaster. The public must be given online a list of the States delegated to perform official inspections, which needs to be updated at least twice a year. Passed the House of Representatives by a voice vote Sponsored by Rep. Michael Conaway of Texas's 11th district His #2 contributing industry over the course of his career has been Crop Production and Basic Processing; he has taken at least $646,470. 18 pages H.R. 2051: Mandatory Price Reporting Act of 2015 Extends mandatory price reporting requirements for livestock until September 30, 2020. Clarifies that reports are expected on days the Dept. of Agriculture is open for business, including days when the government is "on shutdown or emergency furlough as a result of a lapse in appropriations". Allows transactions between pork packers and producers to take place using a new pricing formula. Changes the definition of an importer of lamb to include anyone who imports an average of 1,000 metric tons per year; currently importers have to comply with regulations if they import and average of 2,500 metric tons of lamb per year. Changes the definition of a lamb packer to someone who owns 50% or more of a facility and slaughters an average of 35,000 heads of lambs per year; currently if they slaughter 75,000 lambs per year. Passed the House of Representatives by a voice vote Sponsored by Rep. Michael Conaway of Texas's 11th district 8 pages H.R. 2394: National Forest Foundation Reauthorization Act of 2015 Reauthorizes and appropriates $3 million per year until 2018 for the National Forest Foundation Act, which established a partnership with a non-profit to study and restore national forests. This is triple the previous funding. Passed the House of Representatives by a voice vote Sponsored by Rep. Glenn Thompson of Pennsylvania's 5th district 3 pages H.R. 235: Permanent Internet Tax Freedom Act Article: Internet tax moratorium extended again by Grant Gross, IDG News Service, December 15, 2014. Makes the moratorium on Internet access taxes permanent. Passed the House of Representatives by a voice vote Sponsored by Rep. Bob Goodlatte of Virginia's 6th district 2 pages H.R. 889: Foreign Cultural Exchange Jurisdictional Immunity Clarification Act Prohibits art imported into the United States to be temporarily displayed from being seized by the United States, even if that art is discovered to have been stolen. This immunity does not apply to art stolen by the Nazis. Passed the House of Representatives by a voice vote Sponsored by Rep. Steve Chabot of Ohio's 1st district 5 pages S. 184 and H.R. 1168: Native American Children’s Safety Act Requires criminal background checks of any person who lives in a house applying to provide foster care to an Indian child and prohibits placement if anyone in the home is found to have committed certain crimes. This will not apply to emergency foster care placement Both bills passed the Senate and the House of Representatives by voice votes S. 184 was sponsored by Senator John Hoeven of North Dakota and H.R. 1168 was sponsored by Kevin Cramer of North Dakota S. 184: 12 pages H.R. 1168: 10 pages S. 246: Alyce Spotted Bear and Walter Soboleff Commission on Native Children Act Establishes the Alyce Spotted Bear and Walter Soboleff Commission on Native Children. All 11 members will be appointed by the President and Congressional leaders and their appointments will be for the entire duration of the commission. The Commission's job will be to complete a study on the effectiveness of programs aimed at the health and education of native children and to make recommendations for fixing the inadequacies. The Commission will terminate 90 days after they submit their report. Authorizes, but does not appropriate, $2 million. Passed the Senate by a voice vote Sponsored by Senator Heidi Heitkamp of North Dakota 27 pages H.R. 404: Authorizing early repayment of obligations to the Bureau of Reclamation within the Northport Irrigation District in the State of Nebraska Allows Nebraska landowners to repay construction debts at any time. Passed the House of Representatives by a voice vote Sponsored by Rep. Adrian Smith of Nebraska's 3rd district 3 pages H.R. 1493: Protect and Preserve International Cultural Property Act Directs the State Department to designate an existing employee to coordinate efforts to protect art around the world from being stolen and/or destroyed. Establishes a committee, which will meet once a year and be made up of representatives from various Federal agencies, who will "coordinate and inform Federal efforts to protect international cultural property". Blocks importation of "archaeological or ethnological material of Syria" starting 120 days after the bills enactment. The import restrictions will expire in five years, but can be extended. Passed the House of Representatives by a voice vote Sponsored by Rep. Eliot Engel of New York's 16th district 19 pages S. 253: Federal Communications Commission Consolidated Reporting Act Orders a public report every two years on competition, availability of services, and regulatory barriers to entry into the communications services business. Repeals an annual public report on privatization of the communications services industry, which includes public comments. Repeals an annual report on foreign and domestic competition in the communications satellite market. Eliminates an annual report on the "status of competition in the market for the delivery of video programming". Eliminates the requirement that a report on cable industry price be completed annually. Eliminates the requirement that a report on regulatory barriers be reviewed every three years. Eliminates an FCC analysis "of whether any of such competitors have a dominant share of the market" Passed the Senate by a voice vote Sponsored by Sen. Dean Heller of Nevada 16 pages S. 565: Federal Vehicle Repair Cost Savings Act Encourages Federal agencies to use remanufactured vehicle parts to maintain Federal vehicles. Passed the Senate by a voice vote Sponsored by Sen. Gary Peters of Michigan 4 pages H.R. 2570: VBID for Better Care Act Establishes a three year demonstration project to test "value-based insurance" for Medicare patients at two Medicare Advantage sites. Value based insurance allows insurance companies flexibility with co-payments, allowing them to lower co-payments for services deemed to be "high value" preventative services and increasing rates for services with uncertain value. It's designed to "create financial disincentives for poor health choices". The demonstration projects would not allow increases in co-payments to discourage the use of services. Passed the House of Representatives by a voice vote Sponsored by Rep. Diane Black of Tennessee's 6th district 17 pages H.R. 2507: Increasing Regulatory Fairness Act Extends the amount of time between proposed Medicare rate changes are announced and when they can go into effect from 60 days to 90 days. Requires more information about why the changes are being implemented. Passed the House of Representatives by a voice vote Sponsored Rep. Kevin Brady of Texas's 8th district 4 pages H.R. 2505: Medicare Advantage Coverage Transparency Act Requires an annual report to Congress detailing the location and number of people enrolled in Medicare, Medicare Advantage, and Medicare Part D. Passed the House of Representatives by a voice vote Sponsored by Rep. Mike Kelly of Pennsylvania's 3rd district 4 pages H.R. 2582: Securing Seniors' Health Care Act Prohibits the government from terminating a contract for a Medicare Advantage organization because it fails to meet minimum quality standards until the end of 2018. Passed the House of Representatives by a voice vote Sponsored by Rep. Vern Buchanan of Florida's 16th district 10 pages H.R. 1633: DHS Paid Administrative Leave Accountability Act of 2015 Article: Administrative Leave Restrictions at DHS Backed, FedWeek, July 8, 2015. Orders a report to be completed by the Department of Homeland Security four times per year on the number of people on paid administrative leave for more than six months and the cost associated. Passed the House of Representatives by a voice vote Sponsored by Rep. Barry Loudermilk of Georgia's 11th district 7 pages H.R. 1646: Homeland Security Drone Assessment and Analysis Act Orders a report on how commercially available small and medium sized drones could be used to commit terrorist attacks and what the Department of Homeland Security could do to stop this type of attack. Passed the House of Representatives by a voice vote Sponsored by Rep. Bonnie Watson Coleman of New Jersey's 12th district 4 pages H.R. 1637: Federally Funded Research and Development Sunshine Act of 2015 Orders an annual report on the Federally funded research projects being conducted by the Department of Homeland Security Passed the House of Representatives by a voice vote Sponsored by Rep. John Ratcliffe of Texas's 4th district 3 pages H.R. 2390: Homeland Security University-based Centers Review Act Orders an annual report on the effectiveness of using universities to conduct Department of Homeland Security research. Passed the House of Representatives by a voice vote Sponsored by Rep. Bennie Thompson of Mississippi's 2nd district 5 pages June Hearings Senate Committee on Foreign Relations: Security Assistance in Africa, June 4, 2015. Senate Committee on Foreign Relations: Trade Promotion and Capacity Building in the Asia-Pacific Region, June 16, 2015. House Committee on Transportation and Infrastructure: Western Hemisphere Drug Interdiction Efforts, June 16, 2015. House Committee on Financial Services: The Impact of the International Monetary Fund: Economic Stability or Moral Hazard?, June 17, 2015. House Committee on Oversight and Government Reform: Drones: The Next Generation of Commerce?, June 17, 2015. House Committee on Energy and Commerce: A National Framework for the Review and Labeling of Biotechnology in Food, June 18, 2015. House Committee on Foreign Affairs: The Future of Property Rights in Cuba, June 18, 2015. Senate Committee on Foreign Relations: American Energy Exports, June 23, 2015. Senate Caucus on International Narcotics Control: Cannabidiol, June 24, 2015. House Committee on Homeland Security: DHS' Efforts to Secure .Gov, June 24, 2015. House Committee on Transportation and Infrastructure: The State of Positive Train Control Implementation in the United States, June 24, 2015 House Committee on Ways and Means: Repatriation of Foreign Earnings as a Source of Funding for the Highway Trust Fund, June 24, 2015 Senate Committee on Agriculture, Nutrition, and Forestry: Country of Origin Labeling, June 25, 2015 Senate Committee on Banking, Housing, and Urban Affairs: Global Impact of a Greek Default, June 25, 2015. Jen's Podcast Appearances September 9, 2015 episode of American Workers Radio Music Presented in This Episode Intro & Exit: Tired of Being Lied To by David Ippolito (found on Music Alley by mevio) Money, Money, Money by The Undercover Hippy (found on Music Alley by mevio)