As food and beverage developers, I am sure you all have seen the Vanilla price increase that's been trending upward.
In fact, compared to about 2 years ago, the price of vanilla now is nearly 6 times as much! Last year, we saw the first price jump when growers held back product to get higher prices. However, this year, the cyclone that tore through Madagascar is the culprit of yet another price upsurge.
According to several sources, Madagascar produces around 85% of the world's vanilla crop. Vanilla pods are grown on tropical vines, taking about three years for each plant to produce mature beans. Therefore, the turnaround time for fresh vanilla is significantly slower compared to typical annual crops.
An article I stumbled upon from Financial Times presented this chart above that gives a clear picture of the price increase.
ISN'T THAT JUMP IN PRICE INSANE?
The demand for vanilla is miraculous, as it is an ingredient in many different areas of the food and beverage industry. However, with the Vanilla price increase, manufacturers are going to have to try to find other options.
Fortunately for you all, we are here to help.
If you haven't already guessed, EFP has something for you. Three somethings, actually. We have three different syrups that have been applied to in applications to greatly influence the flavor of vanilla in food/beverage systems.
Don't forget – if powder products can be used in your formulation, our Non Carrier WS-100-Ss might knock your socks off when you experience the flavor impact.
Contact us today and see how you can enhance your vanilla flavor with our natural flavor enhancers. Caramelized Sugars and water will do the trick. let us show you how!


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Q: Extracting `:` pairs with regex there is a textarea and want to extract with key:value (something like below image)

I have a regex but not working as expected
/([^\s][a-zA-Z!]+:(\s)?"?([a-z0-9\s.]+)"?[^ $])/gi

if the user enters the below string at that time regex break the group key:value.
is:"browser" browser: "chrome 11.11 V" node: error type:"Error"
expected group:
is:"browser"
browser: "chrome 11.11 V"
node: error
type:"Error"

A: You can use

const text = 'is:"browser" browser: "chrome 11.11 V" node: error type:"Error"';
const re = /(\w+):\s*(?:"([^"]*)"|(\S+))/g;
let dict = {}, m;
while(m = re.exec(text)) {
  dict[m[1]]=(m[3] || m[2]);
}
console.log(dict);

// Or just get all matches:
console.log(text.match(re))

See the regex demo. Details:

*

*(\w+) - Group 1: one or more word chars

*: - a colon

*\s* - zero or more whitespaces

*(?:"([^"]*)"|(\S+)) - either of

*

*"([^"]*)" - ", 0+ non-commas (captured in Group 2), "

*| - or

*(\S+) - Group 3: one or more non-whitespaces chars.

A: Regex:
/([a-zA-Z!]+:\s*[" ]?([a-z0-9\s.]+)[" $])/gi

Text:
sdfd:"dsffs" dsfd: "dsf demo" sfd: dsf fdsff:"fdsfsdf"

List:
sdfd:"dsffs"
dsfd: "dsf demo"
sfd: dsf
fdsff:"fdsfsdf"

redpajama_set_name: RedPajamaStackExchange


Levi Tolson was born in Ossett in 1891, the sixth son of Ossett mason contractor Wilson Tolson and his wife Mary (nee Horton) who had married in 1878. In 1891, the Tolson family were living in Headlands, Ossett and there were seven children of which six were boys. By 1911, Wilson Tolson was a widower, having lost his wife Mary in 1906, and the family were living then at Runtlings House, Ossett.
The 5th (Service) Battalion of the Queen's Own Cameron Highlanders was formed at Inverness in August 1914 as part of K1 and came under orders of 26th Brigade in the 9th (Scottish) Division. They moved to Aldershot and in February 1915 went to Bordon. They landed at Boulogne on the 10th of May 1915.
"Private Levi Tolson of the Cameron Highlanders, a well-known Ossett young man, the sixth son of Mr. Wilson Tolson of Runtlings House, Ossett, is reported missing, and believed to be a prisoner in enemy hands. In a letter his company officer expresses regret at losing him 'as he was a good fellow, in fact, a real Cameron - and the Camerons fight like tigers.' Private Tolson worked fro his father as a mason before enlistment."
Levi Tolson's army service record has not survived but it is known that he enlisted in Ossett and was posthumously awarded the British and Victory campaign medals. He was not awarded the 1914/15 Star indicating that he did not serve overseas on or before 31st December 1915.
Above: Bapaume in ruins during WW1.
Private Levi Tolson is remembered on Panel 74 at the Pozieres Memorial 3, Somme, France. Pozieres is a village 6 kilometres north-east of the town of Albert. The Memorial encloses Pozieres British Cemetery which is a little south-west of the village on the north side of the main road, D929, from Albert to Pozieres.
The Pozieres Memorial relates to the period of crisis in March and April 1918 when the Allied Fifth Army was driven back by overwhelming numbers across the former Somme battlefields, and the months that followed before the Advance to Victory, which began on 8 August 1918. The Memorial commemorates over 14,000 casualties of the United Kingdom and 300 of the South African Forces who have no known grave and who died on the Somme from 21 March to 7 August 1918.
The Corps and Regiments most largely represented are The Rifle Brigade with over 600 names, The Durham Light Infantry with approximately 600 names, the Machine Gun Corps with over 500, The Manchester Regiment with approximately 500 and The Royal Horse and Royal Field Artillery with over 400 names.
Above: The Ossett Tolson family with Levi Tolson in uniform bottom row centre.
"Private Fred H. Tolson, the fourth son of Mr. Wilson Tolson of Ossett has been wounded in France. Describing in a letter to his wife, who lives in Industrial-street, Horbury, how he received his injuries, Private Tolson says that he was engaged in an attack on a German reserve trench, when a shell burst near him, and he received a bullet through the right leg. 'I lay where I was until I came round and found my leg had been hit. Three Germans then came out of a trench and gave themselves up to me. I motioned for them to come on, and they picked me up and carried me to our nearest stretcher bearers. I had my leg dressed and was then left in a shell-hole. The enemy then started sending heavy shells over, and I thought it wisest to try and crawl out of danger.' With the aid of two sticks he had picked up, he managed to hobble for three hours and a half, when he reached a dug-out, where several other wounded men were resting. 'We had been there about a quarter of an hour' he continues 'when two shells dropped on top and knocked it in, but I was lucky in not getting a scratch. I scrambled out, and carried on, plastered from head to foot, until I reached our trenches.' He added that he was mending nicely and expected to be sent to 'Blighty' in a few days."
1. Personal recollection of Levi Tolson's grand-niece, Nancy Dransfield as related to Alan Howe in August 2014.


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Category Archives: King-Anderson bill
Congress Finally Doing Something: Bundled Billing Won't Solve Surprise Billing and More About Medicare, Is it Actually Lowering Costs?
I stated and I believe that the answer to our healthcare problem has to be a bipartisan solution. Last week Senate health committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) introduced S.1895, the Lower Health Care Costs Act of 2019 — bipartisan legislation to deliver better health care at a lower cost. Chairman Alexander and Ranking Member Murray announced that the committee would vote on the legislation on June 26, 2019.
"The single issue I hear most about from Tennesseans is, 'What are you going to do about the health care costs I pay for out of my own pocket?' Well, we've got an answer," said Chairman Alexander. "This legislation will reduce what Americans pay out of their pockets for health care in three major ways: First, it ends surprise billing; second, it creates more transparency — you can't lower your health care costs until you know what your health care actually costs. And third, it increases prescription drug competition to help bring lower cost generic and biosimilar drugs to patients. I look forward to working with my colleagues in the Senate health committee to mark up this legislation next week before sending it to the full Senate for consideration."
"People across the country have been facing impossible decisions to afford the care they need and are counting on us to act. So I'm glad my Republican colleagues decided to listen to families and join Democrats at the negotiating table to work on these bipartisan steps to help lower health care costs, end surprise billing, respond to issues like the maternal mortality crisis, vaccine hesitancy, and obesity, and more," said Senator Murray. "But this must be a first step, not a last one. I hope Republicans will build on this momentum by joining us at the table on bigger health care issues too—like repairing the damage from President Trump's health care sabotage and protecting people with pre-existing conditions."
Since last Congress, the Senate health committee has held five hearings on ways to reduce health care costs and four hearings on the cost of prescription drugs. In May, Alexander and Murray released a draft of this legislation for discussion, receiving over 400 comments. The Lower Health Care Costs Act of 2019 is composed of nearly three dozen specific provisions from at least 16 Republican senators and 14 Democrat senators.
Congress is fully engaged in trying to solve "surprise" medical bills and the conversation has exploded into a full-fledged debate on the best way to rein in bad actors while ensuring that physicians receive fair reimbursement for their services. The bipartisan U.S. Senate Working Group on Transparency dropped a new bill in 2019 that aims to address surprise billing. This Working Group, led by Sen. Bill Cassidy, MD (R-LA), has engaged in the most thoughtful discussion on the issue, meeting with stakeholders since summer 2018.
It is no surprise that in May the White House turned to Sen. Cassidy for advice on how to address this issue through legislation. During these discussions, a proposal emerged that would utilize hospital bundled billing to curb unanticipated medical bills. In a letter to the bipartisan Working Group, ASPS and other stakeholders urged the Working Group to consider the full scope of bundling and its ripple effect on patients. This practice would negatively affect patients in rural communities, as bundling could lead to further financial strains on rural and underserved hospitals. Patients may face reduced access to specialty care if hospitals and other facilities are forced to close. The letter highlighted that the use of hospital bundled billing to address this issue is untested and could be highly disruptive to the healthcare delivery system.
Medicare program aimed at lowering costs, improving care may not be working as well as thought
Kara Gavin reported that as the Medicare system seeks to improve the care of older adults while also keeping costs from growing too fast, a new University of Michigan study suggests that one major effort may not be having as much of an impact as hoped.
A new analysis of data from the Medicare Shared Savings Program finds that high-cost physicians and high-cost patients dropping out of the program accounted for much of the savings reported from 2008 to 2014.
After the effects of those departures were taken into account, the Accountable Care Organizations taking part in the MSSP had the same costs as physicians in their area who weren't taking part in ACOs but also took care of other patients with traditional Medicare coverage.
The study also compares ACO and non-ACO providers on measures of health care quality, finding that patients in an MSSP ACO were not more likely to get four proven tests for common health problems than similar patients with the same kind of Medicare coverage who weren't part of an ACO.
The study is published in the Annals of Internal Medicine. The authors note that the results have greater implications for providers who voluntarily join an ACO, rather than physicians employed by large group practices that have engaged in Medicare cost and quality efforts for many years—such as those at Michigan Medicine, U-M's academic medical center.
The findings suggest that as the federal government continues its effort to "bend the cost curve" for Medicare through voluntary reforms, it should take into consideration year-to-year shifts in which providers and patients are taking part in ACOs. Otherwise, the researchers say, "selection bias" could skew the interpretation of the program's effects.
ACOs can earn extra dollars from Medicare based on their overall costs and quality averaged across all their providers' patients or can lose money if they don't meet cost or quality goals. The Centers for Medicare and Medicaid Services has set a goal of increasing the disincentives or "risk" that ACOs face, so accurate measurement of actual cost and quality performance will increase in importance, the researchers say.
"Our results suggest that there is less reason for optimism about the MSSP's effects to date that might have been suggested by other studies," said Andy Ryan, senior author of the new study and a professor at the U-M School of Public Health. "We hope CMS will consider the implications as it moves forward with evaluating programs aimed at improving the long-term sustainability of the Medicare system."
Ryan worked with Adam Markovitz, who led the analysis as part of his doctoral degree in public health and is now completing his medical degree at the U-M Medical School as part of the Medical Scientist Training Program.
"At the project's outset, we hypothesized that early savings in this voluntary ACO program were driven by the disproportionate entry of high-performing "early adopter" clinicians into ACOs," Markovitz said. "To our surprise, we found that ACO savings may be driven by the disproportionate exit of higher-spending clinicians out of ACOs."
In all, the ACO providers whose overall costs were in the top 1% of all providers studied were more than twice as likely to leave an MSSP ACO as providers whose costs fell into the middle level of spending.
Whether these providers were encouraged to leave the ACO because of their costs, or whether they left voluntarily because they were unable or unwilling to reduce the growth in the cost of their patients' care, can't be determined through the current study.
MSSP ACO administrators are able to see the costs attributed to each of the providers taking part in their ACO, so "gaming" of which providers to include could be happening, say Ryan and Markovitz.
"We would hope that if a provider shows a trend toward low-value care, the ACO would work with them to remedy the situation," Ryan said.
Markovitz, Ryan, and colleagues published a study in Health Affairs earlier this year, showing that high-cost patients were slightly more likely to leave ACOs than lower-cost ones. They noted in that study that the MSSP program does not adjust ACOs' payments depending on how much more ill their participating patients have become over time—the payment is based on how sick each patient was when their provider first joined the ACO.
While this has apparently kept ACOs from "up-coding" patients to game the system, it also means that ACOs may have an incentive to drop providers whose patients become more severely ill—and therefore more costly.
That study and the new study have implications for the changes being proposed for MSSP and other value-based payment programs in Medicare.
"There need to be more safeguards against the selective attrition of patients and providers from ACOs that we've observed in our studies," Ryan said. "As CMS encourages more provider risk-taking, it should design its systems to support what's working best to improve care and efficiency."
Markovitz also notes that CMS could design more future Medicare innovations as true experiments—for instance, with randomization (as in Medicare's bundled payment plan for joint replacement surgery) or a phased roll-out that allows researchers to evaluate more readily whether a program truly saved money or improved quality.
CVS just laid out a big reason why health companies are worried about Amazon
Kyle Walsh of CNBC noted that when word spread that Amazon would move into health care in 2017, health-care executives had a ready answer: We are not afraid.
"I honestly don't believe that Amazon will be interested in the near future in the next few years in this market," Walgreens' CEO Stefano Pessina told investors in an earnings call in July 2017.
"I think we have a lot of capabilities and a value proposition that can compete effectively in the market," CVS CEO Larry Merlo said back in August.
But recent legal actions tell a different story.
In April, CVS filed a lawsuit against John Lavin, a former senior vice president in charge of CVS Caremark's retail pharmacy network, after Lavin told the company he was leaving to take a job at Amazon's pharmacy arm, PillPack. The judge this week ruled in CVS' favor, preventing Lavin from taking immediate employment at PillPack.
That follows another case from January of this year, where insurance giant UnitedHealth sued one of its employees for attempting to join a different Amazon initiative. That was Haven, Amazon's joint employer health venture with Berkshire Hathaway and J.P. Morgan.
These lawsuits suggest incumbents are more concerned than they're letting on in public.
The underlying concern: Amazon going directly to insurers
Amazon has said almost nothing in public about its health-care strategy.
But Amazon could disrupt the space dramatically by negotiating directly with insurance companies on drug pricing, cutting out the existing pharmacy benefits managers, or PBMs. All of that could potentially lower health-care costs for consumers.
Among other functions, PBMs help insurance companies negotiate lower drug costs. Manufacturers arrange discounts, called rebates, with the benefits managers so they can fix a spot for their products on a PBM's list of preferred drugs. It's a huge business — CVS' PBM business represented approximately 60% of its overall revenues in 2018, or around $116 billion, according to a person familiar with CVS' business.
Amazon PillPack CEO TJ Parker, in a deposition in the Lavin case, admitted to the court that the company had "explored a number of different things."
But he said the company had "no immediate plans" to compete with CVS Caremark's core offering, its PBM.
CVS certainly seems to think differently, according to the lawsuit to prevent Lavin from working for PillPack.
"Given its robust infrastructure, operational capacity, and distribution reach, Amazon-PillPack is uniquely positioned to negotiate directly with payers (insurers) and displace CVS Caremark's email-based services," CVS argued in support of its motion for a preliminary injunction.
In other words, CVS worries that Amazon is hiring Lavin to approach its clients — insurance plans — for deals that could undercut its PBM.
In particular, CVS said PillPack is already approaching Blue Cross Blue Shield. (CNBC reported talks between PillPack and the insurance network in May.)
"Most recently, Amazon-PillPack engaged in direct discussions with Blue Cross Blue Shield, a federation of 36 health insurance plans that cover more than 100 million Americans, to provide its members with prescription home delivery," CVS' motion reads.
Lavin, who has an extensive background working with payers, would be well positioned if Amazon PillPack did decide to take that step toward direct contracting over time.
According to Jefferies' analyst Brian Tanquilut, who also reviewed the legal documents, there's a real threat that Amazon could chip away at CVS Caremark's business over time by going directly to insurers. "The lawsuit shows that pharmacy benefits managers are now also at risk of being dis-intermediated," he wrote.
To that assertion, a PillPack spokesperson responded: "It is important to keep in mind that what's being reported here is another company's speculation about our business strategy for a lawsuit to which neither Amazon nor PillPack is a party."
However, other drug supply chain experts agree that the PBMs have reason to worry, especially as the health industry consolidates and policymakers are pushing PBMs to be more transparent about their practices.
"PBMs are going to be more protective of their mail pharmacy business than ever and less welcoming to outsiders like PillPack," said Stephen Buck, a drug supply chain expert who previously worked at McKesson.
For his part, Lavin said in communications to his former employer that he would not be competing head-on with them but would be negotiating from the opposite side of the table.
"I'll be … handling [PillPack's] negotiations with PBMs … in other words, it'll be the opposite of what I did for CVS," he noted in an email to CVS' human resources department that was disclosed during the case.
The judge disagreed and granted CVS' motion to enforce the non-compete agreement and block Lavin from working for PillPack for 18 months.
In his ruling, Judge John J. McConnell wrote, "Mr. Lavin will also negotiate and build relationships with private Payers and public Payers, both of whom are current CVS clients." McConnell wrote, "It also appears that PillPack will be looking to negotiate directly with the insurers and others on the Payer level."
CVS, in a statement to CNBC, denied any claim that it is working to block competition and said that it will continue to work with new players.
"We remain focused on delivering innovative solutions to transform the health care experience, but there is always room for new players in health care, as competition can help lower overall costs for payers and patients," said a spokesperson for CVS Caremark.
If you remember our discussion last week, last we noted was that Wilbur Mills the Chairman of the Ways and Means Committee hit upon the idea of combining the most ambitious components of three of the bills that all of the various groups arguing for a health care solution for the senior population. His idea was quickly embraced by the Administration because they all regarded it as insurance against any Republican attack. On Marci 23, 1965, the Ways and Means Committee voted to substitute the Mill's bill for the King-Anderson bill and on the following day, it was introduced on the House floor. After only one day of floor debate, the Mill's bill was passed without amendment by a vote of 313 to 115.
The features of the new bill was incorporated into two amendments to the Social Security Act, which provided in Title 18 for a universal hospital insurance program for the elderly and for optional coverage of physicians' services while Title 19 (known as Medicaid) expanded the Kerr-Mills program of medical coverage for the needed.
When the Mills bill was referred to the Senate, months of debate and discussion proceeded and then was referred out of committee having been amended no less than seventy-five times. The full Senate considered further 250 amendments, passed the bill as amended. It was then sent to a Senate-House conference committee with the task to resolve the over 500 differences between the two chambers.
In July the House passed the finally revised bill to be officially part of the Social Security Amendments of 1965 and the next day after the House passed it the Senate approved the measure. Finally, on July 30, 1965, President Johnson flew into Independence Missouri to sign the Medicare bill into law in the presence of former President Truman. Success finally!!
What were the provisions of the legislation?
Title XVIII, Part A: Hospital Insurance provided that all persons over the age of sixty-five otherwise entitled to benefit under the Social Security or Railroad Retirement Act were eligible and were automatically covered. The benefits were measured in sixty-day periods following discharge from a hospital or extended-care facility. During each benefit period, they were entitled to up to ninety days in a hospital, one hundred days in an extended care facility, and home-care benefits for up to one year after the most recent discharge from either a hospital or extended care facility.
Care in either a psychiatric or tuberculosis hospital was limited to a lifetime amount of 190 days, provided that a physician as being "reasonably expected to improve" certified the patient. Subscribers were required to pay a "front-end deductible" for each hospital stay of up to ninety days. This deductible started at $40 but has risen to more than $760 for the first sixty days and an additional $190 for days 61-90. No front-end deductibles were imposed for the use of extended care facilities for the first twenty days but after that point, a daily copayment was levied.
The program was financed by earmarked payroll taxes levied on employers and employees and disbursements were made from the fund either directly to providers or through an intermediary insurance company who then reimbursed the providers based or what was and still is known as "reasonable costs."
Because there is a lot more to the bill I will further breakdown the other provisions of the Medicare bill. But as seen in the eventual design and passing of the Medicare bill it took cooperation and bipartisanship to get the job done.
Listen up Congress, no matter which party you belong to!!
This entry was posted in Adam Markovitz, Amazon, Amazon Pillpack, Bernie Sanders, Chairman Lamar Alexander, CVS, Democrats, Federal taxes, Health Care, healthcare delivery, Insurance, John F. Kennedy, King-Anderson bill, Lower Health Care Costs Act of 2019, Lyndon Johnson, Medicaid, Medicare, Physicians, President Truman, Republicans, Senator Patty Murray, Social Security Act, Social Security Administration, Trump, Uncategorized on June 25, 2019 by raaorsini.
Rural healthcare a Top Issue Among Voters for 2020 and Such Bad Patients Here in the U.S. More Important-Happy Father's Day!!
Voters want 2020 candidates to start talking about access to healthcare in rural America — in fact, most say it would swing their vote, according to a poll conducted by survey research firm Morning Consult and the Bipartisan Policy Center.
The poll hit on a rare area of bipartisan agreement in the healthcare debate: 93 percent of Republicans and 92 percent of Democrats said making it easier to access healthcare in rural communities is important to them. The issue was also consistent across rural and nonrural voters: 91 percent of nonrural voters and 95 percent of rural voters said this was an important issue.
Three in 5 voters said they would be more likely to vote for a candidate who includes expanding rural healthcare access as part of their platform.
Unsurprisingly, rural voters said they had less access to healthcare in all its forms: primary care physicians, hospitals, specialists, pharmacies and urgent care.
The poll is based on survey responses from 1,995 voters across the country, in addition to 200 rural voters from Iowa, 200 rural voters from North Carolina and 200 rural voters from Texas. It was conducted in May.
Who are the Worst Patients in the World?
Americans are hypochondriacs, yet we skip our checkups. We demand drugs we don't need and fail to take the ones we do. No wonder the U.S. leads the world in health spending.
David H. Freedman noted that he was standing two feet away when his 74-year-old father slugged an emergency-room doctor who was trying to get a blood-pressure cuff around his arm. I wasn't totally surprised: An accomplished scientist who was sharp as a tack right to the end, my father had nothing but disdain for the entire U.S. health-care system, which he believed piled on tests and treatments intended to benefit its bottom line rather than his health. He typically limited himself to berating or rolling his eyes at the unlucky clinicians tasked with ministering to him, but more than once I could tell he was itching to escalate.
My father was what the medical literature traditionally labeled a "hateful patient," a term since softened to "difficult patient." Such patients are a small minority, but they consume a grossly disproportionate share of clinician attention. Nevertheless, most doctors and nurses learn to put up with them. The doctor my dad struck later apologized to me for not having shown more sensitivity in his cuff placement.
When he wasn't in the hospital, my dad blew off checkups and ignored signs of sickness, only to reenter the health-care system via the emergency department. Once home again, he enthusiastically undermined whatever his doctors had tried to do for him, practically using the list of prohibited foods as a menu. He chain-smoked cigars (for good measure, he inhaled rather than puffed). He took his pills if and when he felt like it. By his late 60s, he'd been rewarded with an impressive rack of life-threatening ailments, including failing kidneys, emphysema, severe arrhythmia, and a series of chronic infections. Various high-tech feats by some of Boston's best hospitals nevertheless kept him alive to the age of 76.
It was in his self-neglect, rather than his hostility, that my father found common cause with the tens of millions of American patients who collectively hobble our health-care system.
For years, the United States' high health-care costs and poor outcomes have provoked hand-wringing, and rightly so: Every other high-income country in the world spends less than America does as a share of GDP, and surpasses us in most key health outcomes.
Recriminations tend to focus on how Americans pay for health care, and on our hospitals and physicians. Surely if we could just import Singapore's or Switzerland's health-care system to our nation, the logic goes, we'd get those countries' lower costs and better results. Surely, some might add, a program like Medicare for All would help by discouraging high-cost, ineffective treatments.
But lost in these discussions is, well, us. We ought to consider the possibility that if we exported Americans to those other countries, their systems might end up with our costs and outcomes. That although Americans (rightly, in my opinion) love the idea of Medicare for All, they would rebel at its reality. In other words, we need to ask: Could the problem with the American health-care system lie not only with the American system but with American patients?
One hint that patient behavior matters a lot is the tremendous variation in health outcomes among American states and even counties, despite the fact that they are all part of the same health-care system. A 2017 study published in JAMA Internal Medicine reported that 74 percent of the variation in life expectancy across counties is explained by health-related lifestyle factors such as inactivity and smoking, and by conditions associated with them, such as obesity and diabetes—which is to say, by patients themselves. If this is true across counties, it should be true across countries too. And indeed, many experts estimate that what providers do accounts for only 10 to 25 percent of life-expectancy improvements in a given country. What patients do seems to matter much more.
Somava Saha, a Boston-area physician who for more than 15 years practiced primary-care medicine and is now a vice president at the nonprofit Institute for Healthcare Improvement, told me that several unhealthy behaviors common among Americans (for example, a sedentary lifestyle) are partly rooted in cultural norms. Having worked on health-care projects around the world, she has concluded that a key motivator for healthy behavior is feeling integrated into a community where that behavior is commonplace. And sure enough, healthy community norms are particularly evident in certain places with strong outcome-to-cost ratios, like Sweden. Americans, with our relatively weak sense of community, are harder to influence. "We tend to see health as something that policymaking or health-care systems ought to do for us," she explained. To address the problem, Saha fostered health-boosting relationships within patient communities. She notes that patients in groups like these have been shown to have significantly better outcomes for an array of conditions, including diabetes and depression than similar patients not in groups.
The absence of healthy community norms goes a long way toward explaining poor health outcomes, but it doesn't fully account for the extent of American spending. To understand that, we must consider Americans' fairly unusual belief that, when it comes to medical care, money is no object. A recent survey of 10,000 patients found that only 31 percent consider cost very important when making a health-care decision—versus 85 percent who feel this way about a doctor's "compassion." That's one big reason the push for "value-based care," which rewards providers who keep costs down while achieving good outcomes, is not going well: Attempts to cut back on expensive treatments are met with patient indignation.
For example, one cost-reduction measure used around the world is to exclude an expensive treatment from health coverage if it hasn't been solidly proved effective, or is only slightly more effective than cheaper alternatives. But when American insurance companies try this approach, they invariably run into a buzz saw of public outrage. "Any patient here would object to not getting the best possible treatment, even if the benefit is measured not in extra years of life but in months," says Gilberto Lopes, the associate director for global oncology at the University of Miami's cancer center. Lopes has also practiced in Singapore, where his very first patient shocked him by refusing the moderately expensive but effective treatment he prescribed for her cancer—a choice that turns out to be common among patients in Singapore, who like to pass the money in their government-mandated health-care savings accounts on to their children.
Most experts agree that American patients are frequently overtreated, especially with regard to expensive tests that aren't strictly needed. The standard explanation for this is that doctors and hospitals promote these tests to keep their income high. This notion likely contains some truth. But another big factor is the patient preference. A study out of Johns Hopkins's medical school found doctors' two most common explanations for overtreatment to be patient demand and fear of malpractice suits—another particularly American concern.
In countless situations, such as blood tests that are mildly out of the normal range, the standard of care is "watchful waiting." But compared with patients elsewhere, American patients are more likely to push their doctors to treat rather than watch and wait. A study published in the Journal of the American Board of Family Medicine suggested that American men with low-risk prostate cancer—the sort that usually doesn't cause much trouble if left alone—tend to push for treatments that may have serious side effects while failing to improve outcomes. In most other countries, leaving such cancers alone is not the exception but the rule.
American patients similarly don't like to be told that unexplained symptoms aren't ominous enough to merit tests. Robert Joseph, a longtime ob‑gyn at three Boston-area hospital systems who last year became a medical director at a firm that runs clinical trials, says some of his patients used to come in demanding laparoscopic surgery to investigate abdominal pain that would almost certainly have gone away on its own. "I told them about the risks of the surgery, but I couldn't talk them out of it, and if I refused, my liability was huge," he says. Hospitals might question non-indicated and expensive surgeries, he adds, but saying the patient insisted is sometimes enough to close the case. Joseph, like many American doctors, also worried about getting a bad review from a patient who didn't want to hear "no." Such frustrations were a big reason he stopped practicing, he says.
In most of the world, what the doctor says still goes. "Doctors are more deified in other countries; patients follow orders," says Josef Woodman, the CEO of Patients Beyond Borders, a consulting firm that researches international health care. He contrasts this with the attitude of his grown children in the U.S.: "They don't trust doctors as far as they can throw them." (For what it's worth, patients in China may be even worse than American patients in this regard. According to one report, they spend an average of eight hours a week finding and sharing information online about their medical conditions and health-care experiences. Various observers have told me that Chinese patients wield that information like a club, bullying doctors into providing as many prescriptions as possible.)
American patients' flagrant disregard for routine care is another problem. Take the failure to stick to prescribed drugs, one more bad behavior in which American patients lead the world. The estimated per capita cost of drug noncompliance is up to three times as high in the U.S. as in the European Union. And when Americans go to the doctor, they are more likely than people in other countries to head to expensive specialists. A British Medical Journal study found that U.S. patients end up with specialty referrals at more than twice the rate of U.K. patients. They also end up in the ER more often, at enormous cost. According to another study, this one of chronic migraine sufferers, 42 percent of U.S. respondents had visited an emergency department for their headaches, versus 14 percent of U.K. respondents.
Finally, the U.S. stands out as a place where death, even for the very aged, tends to be fought tooth and nail, and not cheaply. "In the U.K., Canada, and many other countries, death is seen as inevitable," Somava Saha said. "In the U.S., death is seen as optional. When [people] become sick near the end of their lives, they have faith in what a heroic health-care system will accomplish for them."
It makes sense that a wealthy nation with unhealthy lifestyles, little interest in preventive medicine, and expectations of limitless, top-notch specialist care would empower its health-care system to accommodate these preferences. It also makes sense that a health-care system that has thrived by throwing over-the-top care at patients has little incentive to push those same patients to embrace care that's less flashy but may do more good. Medicare for All could provide that incentive by refusing to pay for unnecessarily expensive care, as Medicare does now—but can it prepare patients to start hearing "no" from their physicians?
Marveling at what other systems around the world do differently, without considering who they're doing it for, is madness. The American health-care system has problems, yes, but those problems don't merely harm Americans—they are caused by Americans. And more importantly, what do we do about it to contribute to improving our health care system?? Any suggestions??
More on the History of Medicare and Other Healthcare Reforms
Remember last week's conversation as we realized that with the assignation of President Kennedy that Congressional support swelled. President Lyndon Johnson pushed for enactment of a host of reform measures, among them Medicare and in one of his earliest speeches to Congress referred to Medicare as "one of his top priorities".
Back and forth it went between committees and candidates and then the November election proved decisive in the history of Medicare. President Johnson's campaign underscored the importance of extending social security benefits to cover health care costs, but his challenger, Barry Goldwater was adamantly opposed to the plan.
Again, we had many congressional supported the measure, while at the same time organized medicine devoted great sums of money in their attempt to defeat Medicare's chief defenders. This was an interesting election which proved to be a win for the Democrats, who gained thirty-eight seats in the House and the pro-Medicare majority increased by forty-four seats. Also, interesting was that of the fourteen physicians who ran for Congress in the election eleven lost, and of those three that won one was a Medicare supported.
It seemed obvious that the electoral outcome was due in a large part to the strong support given the pro-Medicare candidates by the older voters. The prominence given the prospective passage of a Medicare bill during the campaign led to its being given "pride-of-place in the 89thCongress. Next, the King-Anderson bill was the first bill introduced into each chamber (H.R. 1 and S.1) when Congress convened on January 4, 1965. President Johnson 3 days later, in a Special Message to Congress, urged the swift passage of the bill.
It was interesting that the bill was only a hospital insurance scheme only and did not cover physicians' services. The AMA was faced with a choice of whether to support the bill or help design a modified bill to Organized medicine's liking. The AMA then proposed an alternative called the "Eldercare" bill, that would have expanded the Medical Assistance (MAA) for the Aged program, which was established under the Kerr-Mills Act. Then two members of the Ways and Means Committee introduced legislation along the lines of Eldercare, which provided more sweeping coverage than the King-Anderson bill.
The AMA's campaign seemed to strike a sympathetic chord among the electorate and a survey by the AMA found that 72% of the respondents agreed that any government health insurance plan should cover physicians' services. The Congressional backers of a government health insurance plan were delighted with the poll, which signaled wide support for an extension of coverage offered by the King-Anderson bill.
Here we go again, the Republicans were worried of being deprived of not getting any credit for a health insurance plan and so a third bill was introduced in the Ways and Means Committee by its ranking Republican member, John Byrnes of Wisconsin. This plan was an extension of a private health insurance plan offered by the Aetna Life Insurance Company to federal employees. This plan called for the creation of a government-administered insurance plan for the elderly that covered both hospital expenses but also physicians' services as well as the costs of drugs and permitted older Americans to either opt out of the plan or not, their choice.
It gets more complicated but Wilbur Mills the Committee Chairman thought that combining the most ambitious components of all three bills into a new proposal would be best.
More to come next week!
This Sunday being Father's Day, I decided to write a blog post on the word "father."
While that may seem like an obvious idea, there's a deeper meaning to that word for me personally—since 2017, the word "father" has been my life word.
You see, for years—decades, really—I have prayed for and selected a word that would lead me to live intentionally throughout the calendar year. I've chosen words or phrases that would spur my thinking and my actions to be in alignment with the kind of life I want to live.
Some years the word was intensely personal, usually because I had a lot of growing to do in a specific area. Other years, the word was more about others and how I needed to add value to people in new ways.
But "father" is different.
I thought it would be a one-year word, a gentle reminder to see and connect with people with even greater care and wisdom. But one year turned into two, and I began to understand that some people don't need care and wisdom—they need a dose of reality to get them moving!
Then, two years became three.
This is my third year with the word "father" as the central piece of my thinking and reflection, and I've become more convinced it may be my word for the rest of my life.
Part of that sense comes from the work I'm doing with my team. We're experiencing a season of significance unlike anything I've ever seen—the culmination of their tireless work over the years and miles of this leadership journey. We are collectively seeing a harvest on seeds we've sown at times and in places when we weren't sure there'd ever be a return.
The joy and fulfilment of reaping those rewards with the many wonderful people I've worked and coached alongside is deeper and richer than I could've dreamed. Fatherhood, in this instance, is fun.
But there's also the flipside of being a "father" to many, and I'm reminded of it whenever I visit places where people are desperate for training in values and leadership. More and more, people are asking for help in transforming themselves and their communities, and more and more I find my heart and my passion drawn to help them.
I want to be a guide; be a friend; be a teacher; be a mentor.
But what I really want to be is a "father".
"Father" is about adding value differently, which means I am constantly stretching myself in new ways. Just like when my kids were growing up, and I had to change tactics or reset my thinking, I'm finding that being a "father" to many means constantly adjusting how I approach life.
My thinking is deeper, bigger, more inclusive, more defined; as a result, my dreams are larger and more significant than I ever imagined because they are dreams for other people.
That's what it means to be a "father". That's what my dad did for me—he dreamed big dreams on my behalf and then loaned me his belief to chase dreams of my own. I am blessed that he's still with me; this will be our 72ndFather's Day together, and every year reminds me of how wonderful it is to have my father's love and investment.
It also reminds me to pay that kind of love forward.
In that way, the biggest gift of a "father" is to pour into others what is valuable and good and helpful and challenge them to repeat the process with others. The influence of a father can either build or destroy, and our world needs more of the former. We have more than enough of the latter.
My challenge to you this Father's Day is to add value to someone else. Invest in them, encourage them, challenge them; loan them your belief in their potential, and then equip them to do something amazing with it.
I've seen firsthand how that kind of intentional investment changes families, as well as changes the world.
Happy Father's Day to you, wherever you are. Whether you're celebrating or being celebrated, make it a day to remember—make it a day that you choose to add value to others and make a difference to those around you.
This entry was posted in American Medical Association, American Medical Political Action Committee, Barry Goldwater, Democrats, Eldercare, GOP health care plan, Health Care, John F. Kennedy, King-Anderson bill, Lyndon Johnson, Medicaid, Medicare, Medicare for All, Physicians, Republicans, Rural America, Rural Hospitals, Social Security Administration, The Worst Patients, Uncategorized on June 18, 2019 by raaorsini.

redpajama_set_name: RedPajamaCommonCrawl


I talk to so many people who are looking into to tiny living as a way to reduce their expenses and change their relationship with money.
I am, by no means, an expert when it comes to financial planning but I did quit my 15 year career to pursue something I love and the tiny house is what gave me the opportunity to do just that.
I jumped without a safety net.
I didn't have much in the way of additional savings before quitting my job. I just knew that if I didn't do it right then I may never have the courage to try again.
The first step to financial independence is to reduce your debt. While we lived in our large suburban home I knew this was not going to be possible. My income and my monthly expenses were not compatible. We put our house on the market and with a combination of a great realtor and the right buyer we were able to sell it quickly.
I think it is important to note that during this time I did not have a car payment or student loans. My debt was lower than that of many Americans, and yet it weighed heavily on me. I felt that I needed to keep working to pay them off but the more money I earned the more money I would feel compelled to spend. It was a vicious cycle.
Our apartment decorated for the Holidays.
We lived in our apartment for two years while we finished building our tiny house and during that time I paid off my debts completely. This gave me the courage to begin building freelance business before I quit my job. I established a budget that would help me keep my spending in check. I knew it would do me little good to quit my job only to end up with more debt.
Moving in to the tiny house, especially without utility bills, gave me an opportunity to lower my expenses. I do not have rent. I do not pay for electricity, gas, or water. I do not have a car payment. (In fact, when my 10 year old car decides to give up the ghost we don't plan on replacing it and will only have one car.) My only expenses are my phone and Internet, groceries, health insurance and prescriptions, my quarterly taxes, and whatever fun plans we have each week. We don't hermit in our tiny house; we love being out in the community enjoying the beer and restaurant scene.
One day my book will be finished, I promise!
By doing those three things I was able to leave a comfortable, good paying job that didn't make me happy to being able to do something I absolutely love. Still, a year and a half later, I am happy with what I have accomplished. I make enough money to keep up with my expenses and business continues to grow. I could have taken the easy road and stayed with my job but I knew that I couldn't live that way. And don't think this is the naivete of youth, I'm not as young as you think I am. This was necessary for me and I believe that it is necessary for many people. Deliberate living can lead you to a place where it becomes possible.
What do you want to accomplish? How can you reduce your expenses to change your life?
I am looking into doing this, but in a slightly bigger place. I want a more permanent solution in regards to being able to place this on my own land, having a septic system, electricity, plumbing and such. Also, i would like to be in compliance with the state and towns. What state is the perfect place to have one of these homes? I am on a retirement pension.
South Alabama right on the Florida line makes for a great location to the Gulf. Any direction within 1 1/2 hours you have all kinds of things to do. Costs of living is low and land is as well. Escambia County Alabama. Easy permitting!
Check out the upper peninsula of Michigan.
I couldn't agree more with you.So much of our precious time here on earth is spent working for all the stuff we are led to believe we can't live without.I recently said goodbye to the rented apartment,stashed my must-haves in a small storage unit(still can't say goodbye to some things),and bought an older 5th wheel.I have dear friends that enjoy having me as a neighbor and I pay them for the kindness to park on their property.I now am debt free and starting to see my dream of a tiny house in the horizon.Thank you for your post.
I think you forgot about your car insurance, registrations, gasoline, auto maintenance and repair costs, homeowner's insurance (if you have any), laundry expenses as well as whatever it costs to heat your home. This isn't a criticism, just a note that your expenses are more than what you listed.
You're right - there are always a few more expenses. I hadn't calculated these in because, in the grand scheme of things, they are minimal. Laundry is the only other reoccurring cost and since our laundromat is also a bar we put that cost in our entertainment fund.
My car is old so my cost of registration is minimal and only once a year. My insurance is also not expensive and my car has cost very little to maintain. For a 10 year old car it has never needed more than general maintenance and the occasional tiny tweak. No critical systems have been repairs and, as I mentioned, when one does go we will simply become a 1 car couple. We live in the south so heat is not much of a cost consideration and we also travel to visit family throughout much of the winter holiday season. Thank you for pointing this out.
I AM ALSO CONSIDERING A SIMPLER LIFE. MORE MONEY TO SPEND IN THE RIGHT PLACES AND MORE TO SAVE. I HAVE BEEN INTERERSTED NOW FOR SOME TIME. ALL THESE ARTICLES GIVE ME THE BOOST I NEED. SO THANK YOU AND KEEP ON KEEPING ON.
my question is... how are you living rent free? where is your house? is it a barter agreement? you do work on the land for free rent/utilities? just curious.
Thanks for your question. We own the land where our house is built so there is no rent or mortgage. Our house is off the grid and our powe is solar so there are no utility bills.
Thanks for sharing! Are there places to live where the land is free, what do you do for water and electricity? Is there any land taxes? I live in IN and may live again in IL....where can you build these that is affordable?? Please e-mail the answer to : hisownlamb8@yahoo.com Thanks!!
Thank you for sharing! I have a few ?s 1. Where in Indiana or Illinois would I be able to build one with affordable cost. 2. Do you have land taxes, electric hook up or water expenses? 3. Does you dwelling have to have septic, etc.? 4. How would I research the costs and options?
if you have land in indiana somebody will be taxed. actually you don't have to have a septic system. there are people that put i port-a-jons. there is one we drive by that is doing that. they have been there 2/3 years. pap disappeared and martha wondered where it went. my guess is that the homeowners got rid of it. the county dose not have time to watch. the usual mo here is to build a nice fence around it. we are master plumbers and we know what a septic system job looks like. they aren't putting them in.
i don't know if you need a license to install your own system but i'm sure you will have to have it inspected. so don't get a permit. each county has a board of health with a sanitarian. each county has their own rules. call the sanitarian in what ever county you are looking at and ask the rules.
if you are permitting you will need a soil scientist then a septic contractor. the septic cons will probably know the "best" soil scientist because the septic cons want to install the system. if you go it yourself with permit then do yourself a favor and have the soil scientist do the layout.
just call them all up and act dumb. i'm not saying you are. just pump then for info. write it allll down. get all printouts that are available. read and digest this for a few days and call them back with you new questions. do this until you run out of questions.
my advise is to buy a woodlot in a rural area and just do as you please. where to find your home well the most successful people just drive out and around here to look. our sanitarian covers fulton and marshall counties. actually fulton county subs from marshall. i'm no tea beggar fan but when they cuts the fat they cuts the inspectors. lol. breid44atlive.
This is what I want when our kids leave home. I wish I could do it now!
My children are young teens (13/15) and I decided not to wait. My kids are actually excited about or new tiny house which I am currently building by hand. We each have our own private loft and even a reading nook that doubles as a guest bed.
A couple years ago I had a health scare (series of mini-strokes) that were a blessing in disguise and helped me realize that life is short and you need to realize your dreams today. There is course a planning period and building time but I began living my dream realization opposed to waiting years then beginning the process.
Money. The topic we all hate to discuss but love to fuss about. Thanks for sharing your story, Laura.
I have been whittling away at debt and reducing my expenses since starting my own small business a couple of years ago. Like most entrepreneurs, I started the business on a shoestring and times were very tough for a good year as I built my client base. This period forced me to be more frugal.
After one and a half years working on the coalface with the business I decided to step down, manage it, and hire my first staff member. Reason for this was that I got offered a well-paying position working on a project with a former manager of mine. From a financial perspective it was too good an opportunity. It would allow me to pay down my debt, pump more money into the business, buy land and build my dream. I am currently half way through the project and have paid down most of the debts - save one which I am continuing to pay off over time as the interest rate is low and I wish to preserve cash flow for now in case I find the perfect block of land. I should be debt free in the next couple of months.
As the expenses to build my dream begin to grow - as I learn more about what is required to buy land and build a house on it - I am becoming more and more frugal, even though I am earning more and more. I can't wait until the end point - where I can leave this job that I am doing for all the wrong reasons and I can start to realise the dream.
pavel. no no no you are doing it for the RIGHT reasons. you are contract labor. you are a subcontractor. this has an end and it ain't your grave. take the money and run. i had one real job out of high school i got out of there in 1965 and haven't looked back. i'm 68 and will not work anything that last more than 2 days. we are paid off. we call it living by your wits.
i turn down very few 2 day jobs. if we are not in the mood we just charge more, lots more. we are the most expensive around. martha answers the phone and i do the work.
when you have to much work raise your rates. never assume that your customers don't have more money than you. they do. they hired you. there is an old saying that you can work 40 hrs @ $15.00 or 20 hrs @ $30.00 or 10 hrs @ $60.00. i moved right to plan c. i like to work 10 hours and take the rest of the week off with pay. lol.
I love this deliberate living series. I'm trying to be more mindful about how I spend my time and money. Your posts have been thought provoking and motivating. Thanks!
No, it's a great question. We do happen to have separate finances and Matt is much better at money than I have ever been. He is also not in debt. We split our expences for the household and anything that is personal we are responsible for our own - like my health insurance. I don't think this would work as well if we weren't not on the same page whether or not our money was together or separate.


text:
Mental and physical health
Information for healthcare service providers
Benefit Provisions and Payment Requirements for Treatment Benefits
These Requirements apply to Providers of treatment benefits pursuant to the Veterans Health Care Regulations in consideration for payment under the Health Care Benefits Program - Treatment Benefits as administered by Medavie Blue Cross under contract with Veterans Affairs Canada (VAC).
This publication is available upon request in alternate formats.
For the purposes herein:
"Benefit" under the treatment benefits refers to any product or service provided under Program of Choice (POC) 1 to 14 and, to be eligible as a VAC benefit, may require a prescription whether or not required by law (Benefit Grids should be referenced).
"Client" means a person who is eligible to receive treatment benefits pursuant to the Veterans Health Care Regulations.
"Blue Cross" means Medavie Blue Cross and its agents in Canada.
"Program of Choice" (POC) refers to the treatment benefits, available to a client, within a specific group as identified in the Veterans Program Policy Manual, and is subject to the prescriber, recommender and pre-authorization requirements, frequency limits and Maximum Allowable Cost provisions set out in the Benefit Grid related thereto.
The 14 POCs are:
Ambulance / Medical Travel Services
Audio (Hearing) Services
Oxygen Therapy (Respiratory)
Prosthetics and Orthotics
Related Health Services
Vision (Eye) Care
"Prescription" means, when authorizing benefits under the Oxygen Therapy program (POC 9) or the Prescription Drug program (POC 10), a written or verbal order that prescribes the treatment benefits recommended in relation to the client's health needs. If the prescription is written, it must be dated and signed by the required prescriber who is licensed or authorized by the province for that purpose. If the prescription is verbal see section 13 herein.
For benefits that do not require a prescription by law, but are required by VAC policies, a prescription is a written document that prescribes the treatment benefits recommended in relation to the client's health needs. The prescription must be dated and signed by the health professional who is recommending the benefit.
"Dispensing Fee" is a fee paid to a qualified provider when a prescription is required by law or as stipulated on the VAC Benefit Grid or individual drug criteria. The prescription must not only be required but also must be presented by the client or their representative to the provider and retained by the provider. A dispensing fee will not be paid unless a prescription is required.
"Provider" means a health professional or other person who provides treatment benefits to a client and who submits a claim to Blue Cross for payment under the Treatment Benefits Program.
"Service Date" means the date on which the treatment benefits are supplied to, received and accepted by a client.
"VAC Health Identification Card" means the card issued by Blue Cross, on behalf of VAC, that identifies a client and the Programs of Choice for which the client is eligible.
"Veterans Health Care Regulations" means the Regulations, as amended from time to time, pursuant to the Department of Veterans Affairs Act 1985, R.S.C., chapter V-1.
"Recovery" means a recouping of funds by VAC's third party payer (Medavie Blue Cross), on behalf of Veterans Affairs Canada, from any Provider for failure to comply with the payment Requirements set out herein and within the respective Benefit Grids. Compliance to these Requirements is determined through the retrospective audit process as outlined under the section titled, "Claim Audits."
"Training" means certain treatment benefits require training in their use. This training must be supplied by the provider and included as a condition of the purchase, rental or lease-to-buy agreement.
Treatment Benefit Providers
VAC recognizes the authority and responsibility of provincial licensing bodies, pursuant to provincial enactments, to determine the eligibility of a Provider to practice a profession in a province.
A Provider must conform to the registration, licensing or certification required pursuant to provincial enactments to be eligible to provide treatment benefits. If no such criteria exist, the Provider must meet the requirements established by VAC policy including the Benefit Grid.
Any provider submitting a health care benefit claim for payment of the cost of a treatment benefit provided to a client will:
submit a claim only after the service date.
submit the claim to Blue Cross using the appropriate claim form or electronic format required by the POC which applies to that treatment benefit.
claim to VAC no more than the amount equal to the rate payable to the Provider by a non-Veteran who purchases the treatment benefit for cash.
be paid, by VAC, at no more than the rate established for the treatment benefit pursuant to the Veterans Health Care Regulations and any guidelines, policies, benefit grids or fee schedules established thereunder. Such payment by VAC at that rate is considered to be full and total payment of the claim by VAC as follows:
Where a treatment benefit is also a fully insured service of the province in which the benefit is provided, the rate that VAC pays is the rate established by the province for that service and costs.
For clients receiving benefits for their pensioned/awarded condition(s), VAC pays the full amount described in 4 (d). All other VAC clients must first access their provincial health care system.
Where the treatment benefits are not a fully insured service of a province in which they are received but an association of health professionals, in respect of that province, has adopted a fee schedule for treatment benefits and costs, the Minister may approve a rate that is based on that fee schedule.
In any other case, the rate normally paid for those treatment benefits and costs in the community in which the treatment benefits are provided (usual and customary).
The rates established under the Veterans Health Care Regulations apply only to treatment benefits provided to Veterans Affairs Canada clients. Canadian Forces and Royal Canadian Mounted Police members are administered under their own legislation and regulations.
confirm that the claim is true and accurate to the best of their knowledge and belief.
confirm that the claim does not include any amount in respect of a treatment benefit provided to a client, for which the Provider has otherwise been reimbursed or will be reimbursed by a third party such as a provincial health care system, private insurance company, etc.
confirm that the Provider has complied with the prescription stipulations described in this Requirements document.
not claim for any charge above the VAC maximum allowable cost;
not request client signatures on claim forms in advance of the provision of benefits.
by the act of submitting a claim for payment accept all the terms and conditions set forth in this document.
With the exception of an electronic claim form, a treatment benefit claim form submitted by a Provider must be signed by the client or a client's representative. If the client's representative signs the claim form, on behalf of the client, the representative must provide an explanation as to why the client was unable to sign. This section does not apply to an individual who has Power of Attorney (POA) for the client. Note: The Provider of the service cannot sign for the client.
Claim forms must be signed by the Provider. Electronic Claim Submissions will be exempt from this process.
A Provider will not submit a claim for a treatment benefit in circumstances where the client has cancelled the request for the treatment benefit or the client refuses to accept delivery thereof.
Veterans Affairs Canada is not permitted, under the authority of the Financial Administration Act, to pay for missed appointments.
For those benefits which require pre-authorization, claims for benefits that have not been authorized or that exceed the number of authorized occurrences are not eligible for payment.
Prescription Requirements (General)
The following terms apply when the POC Benefit Grid requires that a client have a prescription to establish entitlement to a treatment benefit:
the Provider must obtain and have possession of the prescription before the treatment benefit is provided to the client. A claim will not be eligible for payment if the Provider obtains the prescription after the service date. Any amounts previously paid with respect to such a claim are recoverable from the Provider;
unless otherwise indicated on the respective Benefit Grid, prescriptions are required for both the initial and subsequent purchases of benefits. A prescription may authorize refills in conformity with the Benefit Grid and the Provider may provide a treatment benefit in accordance with the number of refills designated on the prescription. A refill, not designated in the prescription, will not be eligible for payment and any amounts previously paid with respect to such a claim are recoverable from the Provider;
prescription which is not dated will be deemed invalid and a claim for a treatment benefit provided by a Provider on the authority of an undated prescription will not be eligible for payment and any amounts previously paid with respect to such a claim are recoverable from the Provider; and
a prescription, including all designated refills, will be valid for only one year from the date it is written and a claim for a treatment benefit provided by a Provider on the authority of an expired or invalid prescription will not be eligible for payment and any amounts previously paid with respect to such a claim are recoverable from the Provider.
POC 10 (Prescription Drugs) treatment benefits must be prescribed by an authorized physician, dentist, optometrist or any other person authorized, by the province, to prescribe drugs in that province or jurisdiction.
Treatment Benefits for the POCs must be prescribed by a physician or other health professional in accordance with the Benefit Grids as follows:
If a prescription for any Prescription Drugs program (POC 10) benefit is communicated verbally (i.e. called into a pharmacy by the authorized prescriber), the Provider may provide the benefit to the client subject to the federal and provincial / territorial laws of the jurisdiction in which the verbal order is issued. In addition, the Provider will fulfill the following VAC requirements at the time the prescriber verbally communicates the prescription details to the treatment benefits Provider.
The person to whom the prescription is communicated by the prescriber must convert the prescription to a written format and must include the following details:
the name and address of the client;
the date the prescription was verbally communicated;
the prescriber's name;
the name of the benefit prescribed;
the quantity of the benefit prescribed;
the strength of the benefit prescribed;
the directions for use;
number of refills authorized;
a handwritten indication that the prescription is a verbal order;
the handwritten initials or signature of the pharmacist who received the prescription;
the handwritten initials of the pharmacist who dispensed the benefit.
If the verbal prescription is a renewal, it is acceptable to use an electronically generated label or hardcopy from the previous prescription to identify that there are no changes. In this case, the following is required:
the written date;
an indication that the prescription is a verbal order;
the pharmacist's handwritten initials or signature on the prescription.
Electronically generated labels / hardcopies without the above information will not be accepted.
The validity period for a verbal prescription will be no longer than one year from the date the prescription was transcribed. The provider must keep the prescription on file for a period of no less than one year.
Generic Substitution
Veterans Affairs Canada only pays for the generic form of a formulation. If a prescribing physician wishes to prescribe the brand name product, the patient must be trialed on the generic formulation for at least three months. If at the end of the trial period, the brand name is still considered to be the most appropriate form of treatment, the prescribing physician must write in their own handwriting "No substitution".
Frequent Dispensing
For certain "high risk" chronically used drugs, where safety and compliance are of concern, a less than 28-day supply will be compensated. The request for a reduced supply may originate with either the pharmacist or the prescriber. The drug categories for which less than a 28-day supply will be compensated are:
antidepressants;
anti-psychotics;
opioids;
benzodiazepines;
certain high-cost cancer drugs.
Through provider audit, special attention will be given to these drug categories to ensure the appropriateness of short-term dispensing in all cases. VAC will audit and recover where inappropriate quantity reduction occurs.
Payment of Claim
Blue Cross will process a claim within the standards specified from the contract with a Provider and, subject to the following exceptions, pay the Provider at the appropriate rate:
a claim submitted which does not follow the conditions outlined in the preceding sections 1 through 13 of this document, will not be processed;
a claim submitted at a date later than eighteen (18) months (12 months if the benefit is received under the Rehabilitation program) from the service date is not eligible for payment;
a claim that does not otherwise conform to the Requirements is not eligible for payment.
Claim Audits
Blue Cross may audit a claim to determine if the claim conforms to this document. In cases where Blue Cross determines that the requirements are not met, the claim will be ruled ineligible for payment or if payment was made to the Provider, that payment will constitute a debt subject to recovery by Blue Cross.
Where, as the result of an audit, Blue Cross has identified a prescription is missing or invalid, the Provider may not submit prescriptions that the prescriber reissues or duplicates after the service date to support the claim of the Provider.
Where, as a result of an audit, Blue Cross has identified records are missing or invalid, the Provider may not submit reissued or duplicate records, including but not limited to time sheets, invoices, case notes, or treatment plans after the audit date to support claims of the Provider.
Blue Cross has the right to audit any claim submitted by a Provider, regardless whether the claim was paid or is outstanding for payment and including claims for which pre-authorization was obtained from VAC Head Office, VAC Area offices or Treatment Authorization Centres.
Blue Cross has the right to access and copy any records and information relevant to the Provider's claim including, but not limited to, any manufacturers' invoices and account statements (where the records form part of the basis for the amount billed), claim forms and prescriptions.
Blue Cross will, at the conclusion of an audit, notify the Provider in writing of the Audit Decision and what amount of a claim, if any, has been identified for payment or recovery.
Audit Redress Procedure
A Provider may, within fifteen (15) working days from the date of receipt of the Audit Decision, request that Blue Cross conduct a Review of that decision. The Provider must direct the request for a Review in writing to:
National Investigative Unit
Moncton NB E1C 8L3
For the purpose of a Review, the Provider may, within sixty (60) days of the written notification of the audit results, submit new or additional information or reasons why all or a portion of the claim is eligible for payment. The information submitted will be considered by Blue Cross and, within thirty (30) days (longer if extenuating circumstances prevail causing a delay) a Review Decision will be rendered with respect to the eligibility of the claim for payment. Blue Cross will notify the Provider in writing of the Review Decision.
A Provider may, within fifteen (15) working days from the date of receipt of a Review Decision, request that VAC conduct a reconsideration of the Review Decision. The Provider must direct the request for reconsideration in writing to:
Attn: Director Health Care, Rehabilitation and Income Support Programs
Charlottetown PE C1A 8M9
For the purpose of a Reconsideration, the Provider may submit, within thirty (30) days of a written notification from Blue Cross, new or additional information or reasons why all, or a portion of the claim is eligible for payment. The information submitted will be considered by VAC and a reconsideration decision rendered with respect to the eligibility of the claim for payment. VAC will notify the Provider in writing of the reconsideration decision.
The VAC reconsideration decision will be a final and binding disposition of the claim, subject to any other legal remedies available to the Provider.
At the date of an Audit, Review or Reconsideration Decision (or the result of any other legal remedy available to the Provider) and in conformity with the Decision concerning the issues in dispute between Blue Cross and the Provider with respect to a claim:
any amount payable by one party (payer) to the other party (payee) will be payable forthwith, provided that the amount exceeds the minimum recovery payment established either by VAC policy or the treatment benefits program; and
the Provider may not resubmit a claim that was determined to be ineligible for payment and Blue Cross will not be obligated to pay any such claim.
Client Retention of Treatment Benefits
Providers will not:
unless authorized by VAC, request that a client return a treatment benefit for which the Provider submitted a claim, unless authorized by VAC;
request that a client either pay for or return a treatment benefit, in circumstances where the Provider's claim is ruled ineligible for payment or the claim amount previously paid is recovered by Blue Cross pursuant to an audit.
Privacy and Ownership of Information
It is the providers' responsibility to adhere to all applicable legislation in relation to the protection of personal information in their possession.
VAC reserves the right to determine who may register or be approved as a Provider. VAC may refuse, suspend or revoke the status of a Provider for reasons including, but not limited to, the following:
refusing Blue Cross access to the records and information incidental to the conduct of an audit or otherwise fails to cooperate in the conduct of the audit;
publishing or distributing any advertising material for treatment benefits, which makes reference to VAC in any way other than the following statement: "VAC Health Identification Cards Accepted";
either in writing or orally, making any claim that VAC endorses the treatment benefits available from that Provider over those of any other Provider;
specifically directing advertising for treatment benefits to clients in order to solicit business, unless that advertising is part of a general distribution to all clients and other persons;
specifically targeting VAC clients by telephone or any other means for purposes of soliciting business;
the unsatisfactory provision of treatment benefits;
failing to adhere to the requirements outlined in the POC Benefit Grid;
no longer meeting registration criteria as established by VAC;
fraud;
not submitting an invoice within the past 24 months.
VAC may take any of the following actions based on the conclusion of an audit:
cancel a Provider's status;
suspend a Provider's status;
re-instate a Provider's status;
criminal prosecution;
civil litigation;
recover an overpayment by direct cash settlement, by deducting the amount from subsequent payments for eligible claims or other negotiated repayment options;
refer a matter to an appropriate licensing authority for investigation; and
no further action
VAC retains sole authority to establish the policy, guidelines and rules with respect to eligibility for treatment benefits and the Treatment Benefit Program.
If any provision of the Benefit Provisions and Payment Requirements or its application to any part or circumstances is restricted, prohibited or unenforceable, such provision will be ineffective only to the extent of such restriction, prohibition or unenforceability without invalidating the remaining provisions hereof without effecting the validity or enforceability of such provision or its application to other parties or circumstances.
Help Combat Healthcare Fraud and Abuse
The Medavie Blue Cross National Investigative Unit conducts the audit function on behalf of Veterans Affairs Canada (VAC). The mandate of this Unit is to protect the financial integrity of VAC's Health Care Benefits Program – Treatment Benefits. The Unit is accountable to deter, detect, investigate, and prosecute cases of health care fraud and abuse committed by both participating health care providers and cardholders. Fraud is becoming a major concern within the insurance industry. Not only is insurance fraud a criminal offence in Canada, it also negatively impacts the cost of insurance for everyone.
If you become aware of fraudulent and / or abusive activity relating to any of VAC's Health Care Programs, please contact the National Investigative Unit's Fraud Hotline at 1-866-485-5500 or by e-mail at BC_FAPInvestigations@medavie.bluecross.ca.


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Drugmaker Valeant Pharmaceuticals International Inc.'s CEO, J. Michael Pearson
Michael Christensen · January 3, 2016
Shares of Valeant Pharmaceuticals International, Inc. rose by 3.22% in the last five trading days and 24.31% for the last 4 weeks. Valeant has been making headlines since August 2015 for reasons like price hike of specialty drugs, erroneous financial reporting, and termination of contracts with Philidor Rx Services. CIBC reissued a sector perform rating and set a $90.00 price target on shares of Valeant Pharmaceuticals Intl in a research report on Friday, December 18th.
Laurie Little, spokeswoman of the company, said that their blessings are with Mr. Pearson and they wish him speedy recovery. "Out of respect for Mike's family and their privacy, we will only provide updates when appropriate", Little said in an e-mail.
The company shares have dropped -19.39% from its 1 Year high price.
The report about his hospitalization was first published by the New York Times.
The head of troubled pharmaceutical company Valeant Pharmaceuticals International Inc. has been hospitalized. The CEO promised to provide further transparency regarding the business to the shareholders. However, rather than being apologetic, his tone was bold and defiant while discussing the business strategies of the company that invited scrutiny from federal agencies and investors.
Pearson, who had to be taken to the hospital with pneumonia on Christmas, has been trying to get investors back on board after everyone started jumping ship when the recent scandals broke.
Earlier this month, Valeant announced a drug distribution deal with pharmacy giant Walgreens that will lower prices of many medications by 10 per cent in the United States. Valeant raised prices by 66 percent this year, far beyond any other peer in the market and attracting the attention of Congress. Bill Ackman's Pershing Square Capital Management, one of the largest holders of the stock, was down more than 17 percent in 2015 through November.
Valeant denied Left's allegations, saying they were only supposed to drive down the company's stock price.
Mr. Pearson, a former consultant from McKinsey & Co., was appointed CEO of Valeant in 2008, and he steered the company through a phase of rapid growth and meteoric rise in the price of the company's stocks.
Zacks Investment Research downgraded Valeant Pharmaceuticals Intl from a hold rating to a sell rating in a research report on Monday.
In October Valeant severed ties with a mail-order pharmacy that used aggressive practices to secure reimbursement for pricey skin drugs.
KickassTPB Meta Torrent Search Engine Taking Over The Torrent World
Investor Carl Icahn Sweetens Offer for Pep Boys


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Анастасия Александровна Лагина (род. 11 августа 1995 года, Ярославль) — российская гандболистка, вратарь клуба «Ростов-Дон» и сборной России. Мастер спорта России. Бронзовый призёр чемпионата мира 2019 года.

Биография
В секцию гандбола Анастасия пришла в возрасте 9-ти лет. Первым тренером является Рафаэль Арменакович Калашян. Кандидат в мастера спорта России. Обучалась в Тольяттинском государственном университете.

С 2011 по 2016 годы играла в составе ГК «Звезда» (Звенигород). с 2016 по 2017 годы — в ГК «Луч» (Москва). С июля 2017 года игрок тольяттинской Лады. Победительница чемпионата России среди дублирующих составов 2013 года в составе «Звезды-2». Серебряный призёр чемпионата России 2018 и 2019 годов, серебряный призёр Кубка России 2019 года в составе «Лады».

В мае 2021 года перешла в клуб «Ростов-Дон».

Карьера в сборной
Была вызвана в национальную сборную на чемпионат мира 2019 года. Бронзовый призёр чемпионата мира 2019 года, который проходил в Японии.

Примечания

Ссылки
 Анастасия Лагина на сайте Европейской гандбольной федерации

Гандболистки России
Игроки женской сборной России по гандболу
Игроки ГК «Звезда»
Игроки ГК «Луч»
Игроки ГК «Лада»
Игроки ГК «Ростов-Дон»
Выпускники Тольяттинского государственного университета

redpajama_set_name: RedPajamaWikipedia


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JEITA HARISSA BYBLOS
BAALBEK ZAHLE KSARA
CEDARS GIBRAN KOZHAYA
TRIPOLI BATROUN
LEBANON WINERY TOUR
BEIRUT CITY TOUR
WALK BEIRUT TOUR
FARAYA MASSAYA
CREATE YOUR OWN TOUR
Bayrock
Beirut Down Town
Saifi Village
Beirut Souks
Gemmayze Street
Hotel pick up & drop off
Private air-conditioned vehicle
Entrance fees to attractions
Snacks and other personal items
This experience can be hosted in Arabic, English, French
We will explore Beirut known as "The Paris of the Middle East" thanks to its French influences and vibrant cultural and intellectual life. We will discover the most beautiful streets and sightseeing the city has to offer. We will enjoy a guided tour from the Bayrock (Rawche) to Down Town, Saifi Village, Blue Mosque, The Egg Cinema, The Roman Baths, The Big Sarai, Parliament square, Beirut Souks, Zaitouna Bay, Gemmayze street, St. Nicolas stairs, Sursock Museum, Mar Mikhael street.
At the end of the tour, we will enjoy Lebanese food for lunch.
TOUR AVAILIBITY
Operating all year round
From 9:00am to 1:00pm
125 USD – 1 person
180 USD – 2 people
BAYROCK (RAWCHE ROCKS)
Located at Beirut's westernmost tip, the two huge rock formations, which stand like gigantic sentinels, are a popular destination for locals and visitors alike.
Raouché also is claimed to be the remains of a sea monster the Greek hero Perseus killed to save Andromeda. The stone is rock as Perseus used Medusa's head on the monster to turn it into stone. Some historians believe that the word "raouché" derives from the Aramaic word rosh or Arabic word Ras, both meaning head. Other historians argue that it is a French word roche (rocher), meaning rock.
The Beirut Central District or Centre Ville is the name given to Beirut's historical and geographical core, the "vibrant financial, commercial, and administrative hub of the country.
Saifi Village is an example of a New Urbanist-style neighbourhood with cobblestone streets, apartment buildings, town houses, and shops.
A major commercial district in Beirut Central District. Beirut's largest and most diverse shopping and leisure area. Beirut Souks also features piazzas and public space.
The souks have historically been at the commercial heart of Beirut. They sustained severe damage during the Lebanese Civil War and were rebuilt by Solidere according to the ancient Greek street grid, maintaining the historic landmarks and pre-war street names.
GEMMAYZE STREET One of Beirut's bohemian quarters, the district is full of narrow streets and historic buildings from the French era. The neighborhood is well known today for its trendy bars and pubs, cafes, restaurants and lounges, most of which are directly located on Rue Gouraud.
Rue Gouraud is known especially for its culinary scene that is popular with Beirut's fashionistas
Copyright © 2019-2022 Pub Crawl Beirut, all rights reserved. No part of this web page may be reproduced in any way, or by any means, without prior written permission of Pub Crawl Beirut.
© 2023 Pub Crawl Beirut. Proudly powered by Sydney


Australian native, Mark Webb, is an aromatic educator, scientist, cosmetic & formulations chemist, an aromatherapist, and food & beverage formulator and I have invited him to Rochester NY to share his knowledge about CO2 extracts. I went to Atlanta in October to take an Aromatic Medicine course with Mark. It was four intensive days of learning followed by homework and another four days coming up in March (plus more homework) to graduate from the course. I was impressed by the depth of knowledge that Mark conveyed to the class with a healthy dose of humor and a focus on safety. After the Aromatic Medicine Class, Mark flew to Boulder Colorado where he gave his CO2 class for the first time ever. Not being small enough to fit in his suitcase and follow him there, I decided instead to ask him to come to the East coast to give the same workshop here. Many aromatherapy classes occur in Boulder or on the West coast and so I'm happy to give a closer option to folks on the other side of the country.
CO2 extracts are becoming more widely used than ever before and their uses are still being discovered. Mark has spent over a decade getting to understand them so that others can experience the vast benefits of this extraction method. Many essential oils are steam distilled and some constituents are lost in this process. CO2 extraction uses the same plant material as steam distillation to start, but instead of using steam, the constituents are extracted by using CO2 at varying temperatures and pressures. Once the plant material is extracted, the CO2 returns to its gaseous state and what's left over is the CO2 extract which is often much richer than its essential oil counterpart.
Why is this so exciting? Well, because with more of the plant material in the extract, there can be added healing properties and an entirely new "medicine" than what comes from the essential oil, carrier oil, or hydrosol. CO2 extracts are used in aromatherapy as well as in the cosmetic and food industries.
Who might benefit from this class?
I hope you will join us in learning about this exciting and underexplored aspect of aromatherapy!
In this 2 day workshop Mark will delve deeply into the world of CO2 Extracts, looking firstly at the history and the production technology and how this affects the end product. He will compare and contrast a range of volatile and non-volatile, Liquid, Select and Total CO2 extracts with their essential and fixed oil counterparts and oleoresins, discussing safe and effective usage within topical and internal formulations.
Mark has over a decade of experience formulating with CO2 extracts making him well placed to discuss their uses within the fields of cosmeceutical and aromatic therapy applications. His knowledge about how to incorporate these extracts in food and beverages for both therapeutic and non-therapeutic use enables him to provide a broad range of practical and day-to-day examples. If you have been curious about using CO2 Extracts, this is the workshop to answer your questions.
Discover what CO2 extracts are and how they compare to essential oils, expressed oils, absolutes and oleoresins.
Find out how CO2 extracts are made and the differences between Liquid, Select, Total, volatile and non-volatile extracts.
Discuss the various applications of CO2 extracts across a variety of dose forms & application techniques.
Learn safe use and handling of CO2 extracts, recognizing which extracts to watch for and the importance of dilution within formulating.
Accommodations: Get the group rate of $109 per night for any available room or suite with a special discount code available to students at East Avenue Inn & Suites. Just a short walk from the classroom with shuttle service also available. Rates are good only as long as there are rooms available, so BOOK EARLY!
Course Prerequisite: None. This course is available for anyone wanting to learn about CO2 extracts!
Mark Webb's class on CO2's is very informative, to say the least. At every turn Mark exhibits his wide range of knowledge on a great many subjects of interest to the aromatic and herb student. His acerbic wit will keep you on your toes while you exercise your brain to take in all the nuances of his humor, as well as the great information he imparts. Enjoy and keep your pencils sharpened!
Mark Webb's CO2 class will awaken if not enlighten you to the wonder that is the CO2 extract. I know of no other teacher with the knowledge base nor captivating presence you will experience in this 2 day class or any of his classes. Come empty and leave full.
CO2s are becoming more available to Aromatherapists without the knowledge to go with them. This class explores the therapeutics on so many of the extracts that I couldn't wait to run out and start using them with confidence.
It's your turn to take Mark's CO2 class and see how much fun you'll have learning with him! Don't forget the early bird registration deadline is January 6, 2017. What a great holiday gift for your wishlist to either ask for or to fulfill for yourself.


This year, I've done something I thought about doing in years previous, and never had the motivation to do. I've signed up for Passion Color Joy's 30 Paintings in 30 Days. I'm borrowing a theme from my friends at Maker's Movement, and am using this as a time to explore "Home". As a painter working primarily with landscapes and botanicals/flowers, I'm settling in to my new environment by painting it daily. The Pacific North West has always had a place in my heart, and I feel that my work is in a rhythm right now that just works.
Have you read or listened to the 2009 interview with Ira Glass (you may know it from Saar Oz who used this interview to create "Nobody Tells This to Beginners")? For most of my time painting post-grad, I've felt like I've been living in the gap where what I made didn't quite live up to the idea, the taste, and the high level of expectation I set for myself. Now that the dust has settled and we are starting to find our way in calling Washington home, I feel that gap closing.
I am excited for the ways I will grow during this 30 day project, and am looking forward to updating you along the way. Currently, my plan is to work in watercolor in small pieces. My assumption is that all pieces in these 30 days will be 5x7 on 140lb or 300lb watercolor paper (I've been switching between the those two weights).
If you're interested in reserving one of these daily pieces along the way for purchase, send me an email at kait@larkspurandlaurel.com.


Torre de Ona is a relatively young winery – founded in 1987 – and is situated on a stunningly beautiful 100 acre property in the Rioja Alavesa region of the Rioja. This single estate is unique within the winemaking landscape of the Rioja, where it is more common for wineries to purchase the grapes they need, rather than grow them. The Rioja Alavesa presents harsh surroundings, namely in the form of highly inorganic and stony soils that retain little water here in these high altitude vineyards, situated some 600+ meters above sea level.
The climate is similar to the Rioja Alta, but the resulting wines at Torre de Ona tend to be more structured and concentrated than their neighbouring counterparts. The Rioja Reserva and Crianza "Finca San Martin" from Torre de Ona are delicious values consistently rated at the top of the food chain in the Rioja Alavesa by leading wine critics.
Torre de Ona is owned by the legendary Rioja house La Rioja Alta S.A. – also owners of the celebrated Ribera del Duero producer Bodegas Aster and the masterful Albarino producer Lagar de Cervera in Rias Baixas.


For Vanderbilt senior Ariel Helms from Oklahoma, twists and turns in her past, including a long-kept family secret, led to her passion for discovery in a Vanderbilt lab.
This course covers probability distributions for classical and quantum systems. Topics include: Microcanonical, canonical, and grand canonical partition-functions and associated thermodynamic potentials. Also discussed are conditions of thermodynamic equilibrium for homogenous and heterogenous systems. The course follows 8.044, Statistical Physics I, and is second in this series of undergraduate Statistical Physics courses.


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Kwara APC squelches rumours of Abdulrazaq's withdrawal
March 9, 2019 News, Politics, Project
APC's Abdulrahman Abdulrazak: I have not withdrawn from the race
Mr Abdulrahman Abdulrazaq, the All Progressives Congress governorship candidate in Kwara has not withdrawn from the race and is still in the run.
Mr Abdulraheem Olawuyi, a member of the House of Representatives from Kwara, debunked the rumours circulating on Friday and urged supporters of APC to ignore it.
Olawuyi told the News Agency of Nigeria (NAN) in Ilorin on Saturday that the purported withdrawal of the APC candidate was the handiwork of the opposition.
The candidate himself in a tweet also debunked the rumour:
"I have NOT withdrawn from the Kwara gubernatorial race. Beware of fake news. Kindly call in to tell your friends and family in Kwara to go out and VOTE APC. There's no going back from this, Kwara State must be freed from the dynasty. Help spread this message with your RT", Abdulrazaq wrote.
According to the statement being circulated, Abdulrasaq was said to have stepped down due to an allegation, now in court, that he forged his School certificate.
"We regret to announce that our candidate Abdulrahaman Abdulraq stepped down due to WAEC scandal in court; we direct our supporters to go for Accord Party. O to ge," the statement read.
Olawuyi said that the message was borne out of frustration and panic that the APC would emerge victorious in the governorship and state house of assembly elections.
He called on APC supporters not to be distracted by the news of the withdrawal, saying that such distractions were normal in a democratic contest.
Olawuyi called on the people of Kwara to discountenance the message and go out en-masse to vote for the APC.
Culled from: Source
#TrackNigeria
INEC News
Nigeria Decides 2019
Vote-buying, threat to democracy – CNPP
The Conference of Nigerian Political Parties (CNPP) on Thursday decried the recent incidence of vote-buying in the country, saying the practice is a threat to the growth of democracy. Mr Gboyega Adeniji, the Secretary-General of […]
Gbenga Daniel, three others withdraw from PDP chairmanship race
December 9, 2017 News
Chief Gbenga Daniel, a former Governor of Ogun and an aspirant to the Peoples Democratic Party (PDP) national chairmanship position has stepped down from the race. Daniel at the convention ground on Saturday in Abuja, […]
INEC commits to conduct flawless rerun polls in 9 Ibeju-Lekki polling units
March 21, 2019 Politics, Project
By Yemi Adeleye #TrackNigeria: The Independent National Electoral Commission (INEC) in Lagos State says it has concluded arrangement to conduct a flawless supplementary election in nine polling units of Ibeju-Lekki state constituency I. Mr Sam […]