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Editorials from around New England

December 21, 2018

Editorials from around New England:

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CONNECTICUT

The Connecticut Post

Dec. 21

State Comptroller Kevin Lembo can sound methodical in his strategy for reducing the cost of prescription medications.

“They negotiate pricing with the pharmaceutical company that manufactures the drug and they negotiate pricing with the pharmacy that dispenses the drug. They’re in the middle of all that.”

He can also sound a cop in a 1970s melodrama trying to bust up a drug ring in the streets, diagnosing the problem as “They buy a drug for X, they sell it for Y, I reimburse them for part of that, and they keep the difference.”

It will take both attitudes to bring cheaper prices to the people who get prescriptions from doctors but have less negotiating power than someone buying illicit street drugs.

Even scalpers hawking tickets at concerts have more transparency about profit margins, as original prices are printed on tickets.

Lembo’s office is in the process of exposing profit margins hidden by so-called pharmacy benefit managers. He refers to the repugnant bookkeeping tactic as “hidden wealth exchanges.”

His methodical plan is to do so through his office’s request for proposal for Connecticut’s new pharmacy benefits agreement.

But the street fight version is that he is trying to bust up the drug monopoly by fighting money with money.

Lembo’s office is too large a customer to be ignored, as they spend nearly $2 billion annually on health care.

That’s just Connecticut, and Lembo claims his office is the first to take the approach of demanding an RFP that ensures the middleman is not pocketing extra cash.

If the change saves coin for consumers, expect other states to follow Connecticut’s lead. But Lembo — and we — are hopeful it can be even more influential by convincing other employers to call for the same mandates.

“It’s the first of its kind in the nation. We are pushing this in a very serious way.” Lembo said.

The state is trying to protect consumers in other ways. First-time prescriptions would be limited to 30-day fills, a response to data that suggests less than one-third of 90-day first-time fills are not refilled.

The initiative has the potential to reform the industry quickly but is the result of Lembo’s patient resolve as well as legislation crafted to make drug companies more transparent about their pricing. The measure sailed through the General Assembly during the most recent session.

The state’s current pharmacy benefit management company is CVS Caremark. The new contractor is not expected to be chosen until the end of February. Once the new system starts, Lembo — along with the state’s 200,000 employees and their dependents — can start following the money.

Connecticut’s future pharmacy benefit manager will also have to provide access for prescribers to compare the actual cost of medications with alternatives, turning state employees into their own watchdogs.

Lembo is no doctor but may have found a cure for this ailing system.

Online: https://bit.ly/2BxA4on

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MASSACHUSETTS

The Boston Globe

Dec. 17

Another day, another report — two this time — on how badly Americans have been duped by Russian trolls and turned against each other in a social media cyberwar that the United States continues to lose. The question remains: What are we as a nation going to do about it?

The findings of one report by the Senate Intelligence Committee have already appeared in The Washington Post. A companion report, commissioned by the committee and written by New Knowledge, a cybersecurity firm, was released Monday.

Both deal with the depth and breadth of Russian interference in the 2016 presidential election through the use of social media. But more than that, the reports expose a shocking level of American naivete about what constitutes “news,” a disturbing but not so shocking level of racial animus in this country, and the extent to which our own tribalism can be exploited. It also turns over the rock of this nation’s social media giants and explores the extent to which they will dissemble to control their empires and market share.

The reports focused on the work of the St. Petersburg-based Internet Research Agency, already indicted by special counsel Robert Mueller’s team for interfering in the 2016 election. The Senate report found that, between 2015 and 2017, some 30 million users of Facebook and Instagram shared IRA-generated posts. Facebook posts were shared 31 million times and generated 39 million “likes.”

The New Knowledge report found that while the IRA also made use of Twitter and YouTube, its eventual weapon of choice became Instagram, where its troll accounts generated 187 million hits. About 40 percent of the agency’s Instagram accounts had at least 10,000 followers. “The most prolific IRA efforts on Facebook and Instagram specifically targeted Black American communities and appear to have been focused on developing Black audiences and recruiting Black Americans as assets,” the New Knowledge report found.

Police-involved shootings in particular provided ample fodder for disinformation campaigns. It went from there to direct voter suppression. “NOT VOTING is a way to exercise our rights,” said one Facebook post, on Nov. 3, 2016. “NO LIVES MATTER TO HILLARY CLINTON. ONLY VOTES MATTER TO HILLARY CLINTON,” read another, posted on Oct. 29 of that year.

The Russian effort remains ongoing — rather like a cybergame of whack-a-mole. A social media site goes dormant for a time, then reappears. “Over the past five years, disinformation has evolved from a nuisance into high-stakes information war,” the authors wrote.

And for all of our techno-smarts, this nation remains at a disadvantage. “It is precisely our commitment to democratic principles that puts us at an asymmetric disadvantage against an adversary who enthusiastically engages in censorship, manipulation, and suppression internally,” the report noted.

Still there are things that can be done. A better-informed and more social media savvy public is, of course, critical. But just as crucial is a collaborative effort between government and the new techno-giants.

The heads of some of the platforms involved — the report is particularly critical of executives of Facebook and Google — need to be more forthcoming with data than they have been to date. The authors also promote a “multi-stakeholder model,” writing, “The United States government has departments with decades of experience managing foreign propaganda and espionage. . . . Robust collaboration between government agencies, platforms, and private companies is key to combatting the threat.”

There are no fewer than 17 intelligence agencies from which to choose — from the FBI and CIA to the State Department Bureau of Intelligence and Research. Many have cybersecurity in their portfolios as well.

The report’s suggestion calls to mind the post-9/11 pleas for intelligence agencies to work together to “connect the dots.” Today, some of those “dots” are private entities that must be brought to the table. The future of this democracy may depend on it.

Online: https://bit.ly/2CtSwA1

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RHODE ISLAND

The Providence Journal

Dec. 21

Will we someday be able to leave Earth as easily as we fly from point to point on its surface? It seems we are one step closer, following the successful flight and landing of Richard Branson’s Virgin Galactic spacecraft, which soared more than 51 miles above the California desert in a test flight this month.

Fifty one miles above the surface. Think of it: The typical domestic flight might reach an altitude of 30,000 feet, or between five and six miles high. Virgin Galactic flew 10 times higher, at an altitude where the planet below can clearly be seen to be a cloud-strewn globe, spinning through the darkness beyond.

It wasn’t the highest a privately crewed craft has flown — that distinction belongs a predecessor craft, SpaceShipOne, whose pilot took it nearly 70 miles above the same desert in 2004. But the private space race had stalled since, until Mr. Branson’s Virgin began racing fellow billionaires Elon Musk and Jeff Bezos to reboot the dream of commercial space tourism.

We might also quibble about where space begins, and whether Virgin Galactic really reached it. At 51 miles, it surpassed the rather arbitrary boundary set by NASA’s predecessor agency, which noted that above 50 miles, atmospheric pressure dropped below one pound per square foot, a point at which aircraft control surfaces were no longer effective.

But if you define space as the point at which satellites can fly in a sustainable orbit, that’s about 100 miles high. If you’re counting the distance to space in atmospheric layers, Virgin Galactic reached the bottom of the second-highest layer, known as the thermosphere. It flew through a sublayer known as the ionosphere, where charged particles create such otherworldly phenomena as the aurora borealis.

And yet, space flight is poetry as well as physics. Virgin Galactic soared successfully beyond recent ventures and reignited the dream of space flight for the rest of us. We have reached the point where a person with no astronaut training might plausibly board a spacecraft and reach space by lunchtime. The idea fires the imagination, inspiring us again to contemplate the mystery of our own antlike lives, conducted atop a planet spinning through the Great Deep.

Consider the Spitfire piloted in 1941 by Royal Canadian Airman John Gillespie Magee reached just 33,000 feet, yet he was inspired to write the poem “High Flight,” in which he spoke of “slipping the surly bonds of Earth” and “touching the face of God.”

We humans are curious and adventurous by nature. We seek to explore the oceans, climb the next hill, and soar above the clouds. It is refreshing, in fact, that space travel is becoming democratized by international partnerships and private ventures like Virgin Galactic. Space exploration is too grand an enterprise to be the province only of government agencies with billion-dollar budgets.

Congratulations to the team behind Virgin Galactic — and thank you for reawakening in us the wonder of space travel.

Online: https://bit.ly/2LvOY35

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VERMONT

Rutland Herald

Dec. 20

A coalition of nine Northeast states, including Vermont and the District of Columbia, has announced an agreement to work to impose regional limits on carbon emissions from transportation sources.

The goal of the landmark agreement, announced this week, is to create “a regional low-carbon transportation policy proposal that would cap and reduce carbon emissions from the combustion of transportation fuels through a cap-and-invest program.”

The group said emissions from transportation sources account for the largest portion of the region’s carbon pollution.

The states will work to draft a more detailed plan within a year. At that time, each state will decide whether to formally adopt the policy. Proceeds from the program would go toward developing low-carbon and more resilient transportation infrastructure — from bike lanes to public transit to zero-emission vehicles.

This is a step in the right direction. There is cause for concern.

The report makes the following conclusions:

— Climate change is already causing problems to which Americans are already responding, from flooding in the coast, to pests in the heartland, fires out west, thawing permafrost in Alaska, and more.

— Human activities are causing the climate to change faster than it has at any point in this history of modern civilization.

— Evidence of human causation is undeniable and growing.

— Climate change is already a threat to American health and wealth, as high summer temperatures increase the risk of illness and death and the heat wave season has already increased by over 40 days since the 1960s in some cities.

— The warming in high emissions scenario is expected to cost $160 billion in lost wages; 2 billion labor hours lost annually by 2090 due to temperature extremes.

— The most vulnerable populations face the highest risk as lower-income and marginalized communities face additional barriers for coping with extreme weather and other climate-related events.

— Sea level rise is already forcing people to abandon coastal communities, and a wider coastal retreat will be “unavoidable” in some areas in all but the most optimistic sea level rise expectations.

A University of Vermont geology professor, Lesley-Ann L. Dupigny-Giroux, has authored a section of the National Climate Assessment that pertains to our corner of the world. It was released earlier this year and dismissed by climate deniers and the Trump administration.

In it, Dupigny-Giroux, Vermont’s climatologist, details significant changes to our natural world.

In her role, Dupigny-Giroux has been able to facilitate dialogue among meteorology, climatology, emergency management, agriculture, forestry and GIS users across the state. According to her UVM bio, “She continues to work closely with colleagues at these and other state agencies to better quantify the causal dynamic and impacts of floods, droughts and severe weather on Vermont’s physical landscape.”

It is affecting us here at home.

According to the National Climate Assessment, “The seasonal climate, natural systems, and accessibility of certain types of recreation are threatened by declining snow and ice, rising sea levels, and rising temperatures. By 2035, and under both lower and higher scenarios, the Northeast is projected to be more than 3.6 F (2 C) warmer on average than during the pre-industrial era. This would be the largest increase in the contiguous United States and would occur as much as two decades before global average temperatures reach a similar milestone.”

We cannot deny that climate change is already making some extreme weather more common and more intense. Climate change links have been found in heat waves, droughts, fires, floods, storms and hurricanes. Without question, climate change is affecting biodiversity, causing large-scale shifts in species and altering ecosystems, but aiding in the spread of invasive species, including a noticeable increase in ticks and the emergence of emerald ash borer, among many others.

We are moving in the right direction, but we have so much more to do. It starts with being aware, understanding the facts, and each of us doing our part to make the difference.

Online: https://bit.ly/2EHJW27

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MAINE

Portland Press Herald

Dec. 21

The Trump administration this week told more than 700,000 poor Americans that they’d better enjoy the holidays - there are lean times ahead.

Denied its wish to strengthen work requirements for food stamps through the recently passed farm bill, the administration is taking similar steps through rulemaking, which does not require congressional approval. Sixty days after the new rules are published, waivers for work requirements now available in areas of high unemployment will be waived themselves - and hundreds of thousands of Americans will lose benefits under the Supplemental Nutrition Assistance Program.

It could have been worse. House Republicans, with input from Rep. Bruce Poliquin of Maine’s 2nd District, proposed in the farm bill a number of SNAP changes, including stricter work requirements, that could have reduced benefits for 2 million Americans and deprived 265,000 low-income children of free school meals. President Trump threw his support behind the proposal, but it was stricken from the final bill.

The administration says work requirements encourage those on food stamps to find a job and thus pull themselves out of poverty. Sonny Perdue, secretary of agriculture, said they restore the “dignity of work.”

But if that is truly the goal, there are far better ways to accomplish it than taking away food from a person who is struggling. No, this isn’t about giving a hand up - it’s about an ideological effort to slice public benefits, justified by the fiction they tell about poor Americans.

SNAP requires that most adults without dependents work. States can apply for waivers in areas where employment lags, and almost all states - including Maine - have used them.

With the country nationally at nearly full employment, the Trump administration says people should have no trouble finding jobs. If they aren’t working, the argument goes, it’s because they’re lazy, and the threat of losing assistance is necessary to nudge them in the right direction.

But the argument doesn’t hold up.

Most food-stamp recipients who can work do, at least periodically. Anyway, there is no large group of freeloaders out there, just a lot of people working low-paying jobs with unstable hours for whom the $1.40 per meal SNAP assistance is a crucial lifeline.

The few who don’t work and don’t have dependents - about 2.8 million out of the 40 million Americans on SNAP - are not sitting at home living off the government; benefits commonly referred to as “welfare” just aren’t that generous. Instead, most of them are struggling to get by.

And they don’t fit into any neat box. Called “able-bodied,” they often have chronic illness and mental health problems. Said to be without dependents, they are often involved in caregiving. Portrayed as shirking work, they often don’t have skills that fit the jobs available.

The barriers facing these Americans are real, and taking away food assistance doesn’t do anything to help overcome them. In fact, experience shows that work requirements don’t lead to stable employment. And they don’t reduce hunger.

The requirements, however, do reduce SNAP rolls, and that’s the point - to save a little money, no matter the consequence.

A better plan would be to increase the federal minimum wage, which would provide more money to the majority of SNAP recipients who work, and who are working for less every year that the minimum wage stays flat. In fact, a $12-per-hour wage would save SNAP $53 billion over the next decade, because workers would no longer qualify.

But that plan would mean letting go of the trope of the poor layabout, and further cutting public benefits requires poor Americans to be held in contempt, whatever the reality.

Online: https://bit.ly/2T2C9Q7

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NEW HAMPSHIRE

Portsmouth Press Herald

Dec. 20

A 45-year-old Rochester mother is shot, allegedly by her 47-year-old husband, who then shoots and kills himself.

A 43-year-old Hampton woman allegedly stabs her husband with a tanto blade four times in the back and once in the neck. Then he shows up in court, saying he is there to support her and sad to see her charged and put in jail.

Ongoing coverage of these recent incidents are top headlines on our websites and in our newspapers. They are newsworthy events the community needs to know about, and they are also disturbing and potentially traumatizing for some readers.

Now is an important time to talk about domestic violence. It’s common, it’s complicated and everyone needs to know there are resources to help.

“These crimes impact an entire community,” said Madison Lightfoot, communications specialist for the New Hampshire Coalition Against Domestic and Sexual Violence. “Anytime domestic violence or sexual assault is featured in the media can be difficult for survivors and loved ones.”

This message is important to hear, especially now as Christmas and the New Year’s holidays approach.

“Oftentimes crisis centers see an increase in calls around the holidays as it can be a difficult time of year for survivors,” Lightfoot said. “But it’s important to know support is available anytime.”

Haven is the violence prevention and support services crisis center for domestic violence, sexual assault and stalking, serving southeastern New Hampshire. Its 24-hour hotline is (603) 994-SAFE (7233) and walk-in services are offered weekdays 9 a.m. to 5 p.m. at 20 International Drive, Suite 300 in Portsmouth and 9 a.m. to 4:30 p.m. at 150 Wakefield St. in Rochester.

The statewide 24-7 confidential hotline is 1-866-644-3574.

“It’s important for victims and families to know you do not need to be in crisis to call,” Lightfoot said.

The support available by calling or visiting the crisis centers is open to friends and loved ones of the survivors or people at risk, too.

“We can all play a role in preventing these devastating actions of violence by educating ourselves on the warning signs of abuse, learning more about local support services in our area, and believing and supporting the survivors in our lives,” Lightfoot said. “We can help to create safer communities. We encourage everyone to reach out to local crisis center to speak with an advocate to learn more about how they can support a loved one and learn more about how they can safely intervene when they recognize an unhealthy situation.”

Lightfoot was asked about the New Hampshire Coalition Against Domestic and Sexual Violence’s role and concerns in cases where both the husband and wife have been charged with violent crimes.

“Our law in New Hampshire mandates that the law enforcement officer determines who the primary aggressor is in a domestic violence situation,” she said. “This can be challenging. It’s critical law enforcement has the training and support they need to be able to make these determinations. The other piece of that is we know abuse to be a pattern of coercion and control and it’s critical these factors are what law enforcement are looking for when they look into these cases.”

She said victims of abuse need understanding about how they handle their individual situations.

“Victims understand their environment better than anyone and they make decisions daily on how they can make themselves and their children safe,” Lightfoot said. “Sometimes victims know moving forward in the criminal justice system can put themselves and their children in more danger. It’s our role at the coalition is to make sure the system is treating victims safely and with respect.”

Online: https://bit.ly/2Bxts9h

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