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- They Were Both Pregnant – Episode 046
  March 11, 2019Podcasts / Words of JenIn this episode, I read a piece of my writing that I wrote on July 28, 2015, on a Tumblr blog that no longer exists. The events in it took place decades ago, when I was in middle school. This is a story about what happens when teenage girls do not have access to birth control. It is based on my memory of actual events. I read “They Were Both Pregnant” on episode 046 of Words of Jen. If you enjoyed this episode please consider supporting me on PayPal.me. Thank you! https://media.blubrry.com/bookofjen/p/content.blubrry.com/bookofjen/woj046.mp3Podcast: Play in new window | DownloadSubscribe: Android | RSS...
- They Were Both Pregnant
  March 11, 2019Podcasts / Words of JenImage by Wokandapix on Pixabay I wrote this piece on July 28, 2015, on a Tumblr blog that no longer exists. The events in it took place decades ago, when I was in middle school. This is a story about what happens when teenage girls do not have access to birth control. It is based on my memory of actual events. I read “They Were Both Pregnant” on Episode 046 of Words of Jen. Middle school (or junior high, depending on where you lived) is pretty much hell for everyone. Kids who used to be nice and friendly in Elementary School suddenly develop hormones – and have no idea how to cope with them. It’s a period of adjustment, both physically and socially, that absolutely no one enjoys. Ask any 40 year old if they would want to be a kid again. The offer sounds tempting, until they remember what it was like to go through middle school. No, thanks! Nobody wants a “do-over” of middle school. One thing that many middle school students excel in is the ability to spread rumors about other people. Gossip is social currency, after all. Tell a juicy secret that some unfortunate friend shared with you, and won’t have any difficulty finding people to sit with at lunch. Or, such was the case “back in the day” before Facebook, smartphones, and the internet as we know it existed. My friends and I, like many middle school students, had difficulty discerning the rumors that were true from the ones that were flat-out lies. All these years later, I’ve forgotten about most of the rumors that spread like wildfire back then, except for one. The rumor was that those two girls, over at that other table, were both pregnant. I was twelve years old, in the eighth grade, and sitting with my friends at a table in the cafeteria. The place was noisy, and crowded, and the food was terrible. These friends were girls that I’d known from elementary school, and that I got along with well enough, but had little in common with. Even so, it was a great relief to know that someone was saving me a seat at “our table.” I’d seen what happens when a kid didn’t have any friends to sit with. “Sorry, all these seats are saved.” None of us had the social skills to have any clue what to do in that situation. We were young, and absolutely certain that everyone else was watching us all the time. That the zit on our forehead was, in fact, as large and red as a stop sign. Lunch period wasn’t about the food. It was about avoiding the fate of becoming the kid that the whole cafeteria laughed at. It was about spreading whatever gossip was going around that day. One day, I brought my tray of inedible pizza and a carton of milk that I wouldn’t drink any of, to the table with my friends. After we were all seated, one of the girls shared a secret rumor with is. “Those two girls over there, I don’t know their names, the sisters? Well, they’re both pregnant!” This revelation was met with skeptical silence. None of us could believe it. They were too young to be pregnant, right? And what were the odds that both of them were pregnant at the same time? This rumor had to be fake. I remember looking across the room at the two sisters who were sitting at another table. They sat there, by themselves, every lunch period. Three or four other kids sat at the same table as they did, with several empty seats between them, but nobody talked to each other (except for the two sisters). It was the “loser” table. No one, not even the kid who couldn’t find a seat that wasn’t saved, would dare sit there, for fear of the social consequences of doing so. The two sisters were identical twins, and weren’t from here. They spoke some English, but rarely talked to anyone but each other. They didn’t understand Spanish, and the Filipino kids couldn’t understand what those girls said when they spoke their native language. They were thin, tan, and pretty in ways that most middle schools girls were not (but desperately wished they could be.) The rumor had a lot of detail to it, which made it more believable. But, the biggest reason why the rumor eventually seemed credible was simple. No one had any reason to start a pregnancy rumor about two girls that no one cared about. Doing so wouldn’t help someone climb the social ladder and get invited to sit with “the cool kids”. Those two girls hadn’t made any enemies, so there was no reason to try and ruin their middle school lives with this sort of rumor. It just didn’t have the impact it would if the rumor were about the most popular girl in school – whoever that happened to be this week. It turned out that one of the girls had a boyfriend who was older than we were. He didn’t go to our school, and he wasn’t a middle schooler. “Is he a high schooler?”, one of my friends asked. Dating a high school boy, while you were still in middle school, was considered to be impressive. We were young, and the idea of dating an older boy – who might even be able to drive – sounded glamorous. “No!”, the rumor teller said, “ He’s not a high schooler. He’s 25!” This astounded even the most cynical of our small group. We talked over each other, asking questions in rapid fire. How did they even know a 25-year-old? Why would a 25-year-old want to date someone so young? Did their parents know they were dating a 25-year-old man? There weren’t any clear answers to those questions. The story was that the slightly older twin had been dating a 25 year old guy “for a long time”. They had sex, and she got pregnant. They broke up after she learned she was pregnant. The 25-year-old started dating her twin sister, and now, she was pregnant, too. I remember staring at those two girls, the ones no one knew much about. This was years before I’d heard the phrase “statutory rape”, but even then, I knew that what happened wasn’t ok. I tuned out my friend’s chatter, and the noise of the cafeteria and focused on the twin sisters. All of my friends, so far as I knew, were virgins. Most had never had a boyfriend, had never kissed anyone, and had not been brave enough to dance with a boy at the most recent school dance. Over there, were two girls who were our age and pregnant. It was surreal – like one of those horrible “After School Specials” come to life. While I was watching, one of the twins got up, slowly, and with difficulty. Her stomach was much rounder and fatter than I’d noticed before. Of course, I’d never paid much attention to her before, so I didn’t really have a good comparison. However, I was the oldest of four kids, and knew what a pregnant belly looked like. She walked/waddled directly to nearest bathroom. A minute later, her sister got up, with her own round belly, and followed her. It was true! They both were pregnant. I felt stunned, for reasons I couldn’t understand. I remember worrying about what would happen to them, even though they were strangers to me. How would they raise a baby when they were too young to have a job? Where was this man who was the father of both the babies? It didn’t occur to me, at the time, that the mother of the twin sisters would probably be the one to raise those babies. I wondered if one of the girls would have to marry the 25-year-old. If so, what would happen to her unmarried sister? About a month later, both the sisters disappeared. They were no longer sitting over there, at the “loser table”. People said that the twin sisters had both quit school. This rumor, unlike the previous one, was met with shrugs. No one cared anymore. Everyone forgot about the rumors, and the girls the rumors were about, as new rumors replaced the old ones. They Were Both Pregnant is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites....

Diablo III

- Galthrak The Unhinged
  February 4, 2019Diablo III / Diablo PetsThis is Galthrak the Unhinged. I got this pet from a Menagerist Goblin in between Season 11 and Season 12. The flavor text on Galthrak the Unhinged says: From the time he was a broodling, all he wanted was to be a Rift Guardian. He studied for many years, but was ultimately found wanting. Take him on a rift with you, and he’ll be happy. My Barbarian is chasing a Menagerist Goblin. It is the only type of goblin that has the potential to drop a pet. When a Menagerist Goblin drops a pet, it will look like a Legendary item. This one was named Galthrak the Unhinged. This particular Menagerist Goblin opened a portal to The Vault. Not all of them do that! So, I picked up Galthrak and jumped into The Vault to collect gold and gems. The Galthrak The Unhinged item says: A tiny, strange being. Here is Galthrak the Unhinged following my Barbarian around. Here’s another view of Galthrak following my Barbarian. Galthrak the Unhinged has plenty of teeth. I suppose it is possible that this “tiny, strange being” could be smiling at the idea of accompanying your character into a Rift. Galthrak The Unhinged is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...
- Highlights from Season 16 (Season of Grandeur)
  February 1, 2019Diablo III / Diablo SeasonsSeason 16 of Diablo III was called Season of Grandeur because players benefited from the legendary power of the Ring of Royal Grandeur. This ring reduces the number of items needed for set bonuses by 1 (to a minimum of 2). In short, it “unlocked” the set bonuses of every set, for every class, earlier than typical. Players did not need to actually have a Ring of Royal Grandeur in order to benefit from this buff. In Season 16, most of (but not all of) the sets – for nearly every class – had been improved. That made it difficult for me to decide which class to play. My solution to this problem was simple. I put all the character classes in alphabetical order and rolled an 8-sided die. My first roll was an 8, so I rolled again. I got a 6 on my second attempt, which means I would play a Witch Doctor in Season 16. The Challenge Rift that was available to do at the start of Season 16 was difficult for me. I wasn’t really expecting that because I watched an informative video made by Leviathan that showed me exactly where to find the big monsters. The problem was that I have rheumatoid arthritis in my hands, and it slowed me down. My fingers wanted to lock up, and that severely reduced my dexterity and button-hitting speed. Fortunately, Sixtee (from the Shattered Soulstone clan) helped me out. We finished the Monk Challenge Rift at 6:20.033. Season 16 started in January, which meant that The Darkening of Tristram event was happening. Just for fun, I decided to run my new Witch Doctor through it. She was at Level 20 when I started, and ended at Level 34 The next time I played was when I went into the game specifically to allow someone to join the Shattered Soulstone Clan. I decided to stick around and pick off some of the “leftover” Chapter I objectives that I needed to finish. I was asked, by the people on the Shattered Soulstone Discord, if I wanted to join a group. I declined because my hands weren’t quite ready for that at the time. Instead, I hung out in the Discord chat and talked with people while playing solo. My Witch Doctor, the Templar, and a bunch of minions killed Belial on Hard difficulty and completed the “Two Minds” objective. Another Chapter I objective required me to kill Ghom. I did this on Hard difficulty. This gave me just enough XP (experience points) to hit Level 35. Ghom just so happened to be a part of a Bounty, which was convenient. Here’s what my Witch Doctor was wearing when she was Level 41. In the video above, I worked on completing the last Objective in Chapter I. My Witch Doctor was at Level 48, and needed to hit Level 50. I moved the difficulty up to Expert. I decided to be efficient and get XP from Bounties. (The Bounties are required for upcoming Chapters). My goal while streaming that day was to hit Level 50. It was the last thing I needed to do to finish Chapter I of the Season Journey. My next goal was to work on Chapter II of the Season Journey. There are a total of eleven Objectives, and I only had one of them completed. It was the Friends With Benefits Objective, which players earn when they fully equip one of their followers. Expert: Complete a Nephalem Rift on Expert difficulty or higher. Here is what my Witch Doctor was wearing at Level 51. A friend that I play Dungeons & Dragons with (Synrgy) was ready to play some Diablo III, and wanted to help me level up. We had been trying to find time to play D3 together for a long time, and finally made that work. The first thing I needed to do was leave my game (which was on Expert difficulty) and change the difficulty to as high as the game would let me go. That limit turned out to be Torment IV. We completed a Nephalem Rift on Torment IV. Doing so put me at Level 56, and allowed me to complete the Master Objective (which is part of Chapter III.) Master: Complete a Nephalem Rift on Master difficulty or higher. In the video above, Synrgy and I went to The Ruins of Sescheron so I could get Kanai’s Cube and complete at Chapter II Objective. I hit Level 57 shortly after we began running through Sesecheron. By the time we found Kanai’s Cube, I was Level 63. This went very quickly! We did another Nephalem Rift, and I hit Level 66 when we turned it in. I hit Level 68 in the next Nephalem Rift, after Synrgy killed the Rift Boss. After that, we stayed in the Rift and he killed random monsters until I hit Level 70. It went much faster than if I had played solo. I got my first set piece in the last level of the Nephalem Rift that we explored. It was Zunimasa’s Cloth. The “free set” in Season 16 (for Witch Doctors) is the Arachyr’s set. Having pieces of Zunimasa’s set is useful, though, if I decided to do more than one Set Dungeon. By the time we decided we were done with this Nephalem Rift, my Witch Doctor was at Level 70 and had 4 Paragon points. Towards the end of the video above, we ended up with a full party. Synrgy and I were joined by theartguy (who I also play Dungeons & Dragons with) and someone else who was new to me. We ran a Nephalem Rift together. I hit Paragon 5 the instant I jumped into the Rift. When we turned it in, I hit Paragon 24. My Witch Doctor got a Carnevil Voodoo Mask in that Nephalem Rift. The last Nephalem Rift we completed put me at Paragon 35. In the video above, my friend theartguy and I ran some Greater Rifts. We completed Greater Rift 24 in 6:38.883. This, despite me dying several times (mostly because I was making some rather dumb choices about which monsters to attack, and from “standing in the bad”.) After turning in the Greater Rift, I was at Paragon 42. Making progress! We decided to do another Greater Rift 24, since the first one worked out really well. The second time was successful, but took a but longer than the first one we did. This time, we finished Greater Rift 24 at 7:26.083. I ended up at Paragon 48. At this point, the majority of what I needed to do in order to complete Chapter II involved crafting. I worked on it while hanging out in the Shattered Soulstone Discord and talking with people. Maximum Efficiency: Raise the Blacksmith, Jeweler, and Mystic to level 12. The Little Things That Count: Craft a level 70 item at the Jeweler. Hot Anvil Strong Steel & the Real Deal: Craft a level 70 item at the Blacksmith. Penchant for Enchants: Replace a property on an item with Enchanting at the Mystic. Enchanting is very useful for replacing an unwanted primary affix on a near-perfect item. Change Clothes: Transmogrify an item at the Mystic Pay No Mind: Kill Queen Araneae at Level 60 or higher on Hard difficulty. With some help, I was able to complete Chapter II in Season 16. Completing Chapter II gave me the Helm and Gloves of the Arachyr’s set. It is the “free” set for Witch Doctors in Season 16. Last time I played a Witch Doctor, I used the Zunimassa’s set, and have never tried Arachyr’s. My Witch Doctor is holding a two-handed mace called The Furnace. It isn’t specifically a Witch Doctor weapon, but was better than anything else I had at the time. I like the way it looks. Now seemed like a good time to start using the giant spider minion. The next step was to work on Chapter III of the Season Journey. I had a head start on this one because I completed several objectives already. They were: Tristram’s Most Wanted: Obtain an Act I bounty cacheCaldeum’s Most Wanted: Obtain an Act II bounty cacheArreat’s Most Wanted: Obtain an Act III bounty cacheHey There Kadala: Spend Blood Shards at Kadala. Kadala has a 10% chance to give you a Legendary.Master: Complete a Nephalem Rift on Master difficulty or higher Chapter III has 11 objectives. I had already completed five of them. It was a good start, but there was more work to be done. The Rock: Craft a Gem of Imperial or greater quality at the Jeweler. Socketing an Emerald into your weapon increases your Critical Hit Damage and is a big damage boost. Westmarch’s Most Wanted: Obtain an Act V bounty cache Level 1 Seasonal Cubist: Extract a Legendary power using Kanai’s Cube Deadgreed helped me kill Zoltun Kulle on Torment XIII. Deadgreed also helped me kill Rakanoth on Torment XIII. The objectives only require this to be done on Master difficulty – but count if you do it on higher difficulties. We completed a Greater Rift Level 70 at 8:25.116. When we were done, I had 149 Paragon points. The last thing I needed to do for Chapter III was complete a set of Act IV bounties. I got help with that from Deadgreed and Ritzey. In past Seasons, I usually finished Bounties solo. I don’t mind doing them, but it seems like a lot of people hate Bounties. I learned that if you get into a group, it goes a lot faster. For example, in a four person group, each player picks a Bounty to complete by themselves. Everyone helps on the remaining Bounty. Everyone completes the Seasonal objective for that Act’s Bounty and gets a cache. In this case, however, I was being “carried”. The guys were a lot higher Paragon than I was, and we were playing on Torment XIII. The most I could do was try not to die. I appreciate the help! Heaven’s Most Wanted: Obtain an Act IV bounty cache. I completed Chapter III at Paragon Level 153 – thanks to help from friends. Players that complete Chapter III receive two more pieces of the “freebie set”. What you get depends on what character class opened Haedrig’s Gift. I’m playing a Witch Doctor, so I got more Arachyr’s set pieces. Chapter IV requires players to kill all four Keywardens on Torment IV (or higher). My Witch Doctor wasn’t quite ready for that on her own. Fortunately, Deadgreed and Ritzey helped me out. They also helped me kill The Skeleton King and Clydaea. Players had to kill them on Torment VII or higher. At some point, I completed a Torment I Nephalem Rift – probably with help. Most of what was left for me to do in Chapter IV involved crafting. Exquisiteness: Reforge a weapon property to a socket at the MysticLet’s Get Started: Learn 5 Blacksmith RecipesJust Look At You!: Learn 5 Jewelcrafting Recipes…Is Another Man’s Treasure: Use Kanai’s Cube to upgrade a rare item to legendary quality The last thing I needed to do to complete Chapter IV, and earn the Wings of Lempo, was to complete a Greater Rift 20 solo. In the video above, I ran a Nephalem Rift in order to get a Greater Rift key. Then, I ran a Greater Rift 20, even though I wasn’t quite sure my Witch Doctor was geared up enough for that. To my surprise, it only took one try to finish a Greater Rift 20! I have now, officially, completed Chapter IV of the Season Journey. I completed Greater Rift Level 20 at 9:33.399. My goal for Season 16 was to get the Wings of Lempo. I like the contrast between the orange wings and the blue Araychr’s set. What’s next? My new goal is to complete enough of the Season Journey to earn more Stash space. If I achieve that, I’ll put the highlights into another blog post. Highlights from Season 16 (Season of Grandeur) is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...

Book Reviews

- Spook – by Mary Roach
  December 26, 2018Book Reviews / non fictionMary Roach is the author of Stiff – the Curious Lives of Human Cadavers. After writing about what happens to the human body after the person dies, it seems appropriate to write a book about what happens to the human soul after the body dies. Spook – Science Tackles the Afterlife was written in 2005. In my opinion, the best way to read Spook is to set aside whatever religious ideas you may have about the afterlife. Go into this book with an open mind and you will definitely learn something about human nature. This is not the book for people who have strong religious beliefs about the afterlife and who are looking for something that confirms what their religion tells them. It is the book for people who wonder what science can tell us about the soul, where it lives, and where it might go. In Spook, Mary Roach asks plenty of interesting questions, and follows up by finding out what science had to say regarding the afterlife. She does not provide the reader with a definitive answer about what, exactly, one should expect from the afterlife. Readers are free to take in whatever they find to be thought-provoking. The very first chapter delves into reincarnation. Mary Roach traveled through India with Dr. Kurti S, Rawat, director of the International Centre for Survival. He seeks out children who claim to have been reincarnated and gathers up as much information as he can from the child and the child’s family. Mary Roach appears to have experienced culture shock while in India, and I found her observations to be fascinating. There are parts of India where people believe in reincarnation. As such, when a very young child starts talking about people that the child’s parents do not know – the assumption is that reincarnation has occurred. The parents will ask the child questions, in an effort to learn more about who they were in a past life. In the United States, claims of reincarnation are very rare. The process Dr. Rawat uses goes like this: he learns of a child who claims to have been reincarnated. He travels to where that child lives and interviews the child and their family members. Dr. Rawat writes down all the details and studies it later. The best data comes from parents who immediately started writing down what the child told them about his or her former self, the names of that person’s loved ones, and the manner in which the person died. For some reason, people who have been reincarnated tend to have died a quick, unexpected, and very violent death. In short, the best outcome is when the child’s family, and the living relatives of the person who has been reincarnated into the child, meet and become like extended family. The worst outcome is when a scammer picks a target (usually someone rich), learns about their deceased relative, and coaches the child to pretend to be that person. Part of Spook includes details about a variety of ideas regarding where in the human body the soul “lives”. The specific part of the body that was believed to house the soul changed over time. Potential parts have included: sperm, ova, the pineal gland, the nerves (and/or the nervous system), a bone on the end of the spine called the luz, the coccyx, and one of the four chambers of the brain. A controversial study (which had many ethical issues) was done in an effort to find out how much the soul weighs. It was done in 1854 at a Consumptives Home, a charity that cared for people who were slowly dying of tuberculosis. A surgeon and physician named Duncan Macdougall placed a bed on a large, industrial, scale. A person who appeared to be about to die of consumption was placed on the bed. Macdougall, and other doctors, watched and waited for the person to die. At that moment, they checked the scale to see if the total weight had changed. The scale often showed that the person (and the bed they were lying on) weighed a tiny bit less immediately after the person died. The study was controversial for many reasons, the biggest of which was the question of whether a person who was about to die of consumption could truly give consent to being in the study. Despite this, other doctors attempted to replicate the study (using animals instead of people). The animals were not dying of consumption. They were euthanized after being placed on the industrial scale. The results of these studies contradicted each other and were inconclusive. From here, things move away from the realm of science (wonky and questionable as it was) and into the realm of seances (which were run by women who intended to scam people). I found this part of the book to be extremely entertaining, and I’ll leave you to read it for yourself. In short, seances became a popular thing for people to experience. Many people came to the seance already believing that they would encounter a spirit. They were easy marks. Another interesting thing I learned from Spook is that people have been using whatever the most modern technology was at the time to attempt to record the voices of spirits (or ghosts). Some of the earliest recordings were of mediums who claimed to be channeling a spirit – who had a lot of things to say. Sometimes, people heard crackles over the radio and interpreted them to be voices from the beyond. It often turned out to be the person’s imagination – with the exception of a situation where the people lived really close to where the radio waves were being transmitted. Those people were actually hearing radio transmissions from local stations that were somehow picked up by things like – for example – their oven. More recently, people began using tape recorders to capture the voices of the spirits. I presume people have started using there smartphones for this purpose. The common theme here is that people have a tendency to want to believe that the newest, hottest, piece of technology that can record something is definitely going to pick up the voices of spirits. Spook is a truly bizarre book that mixes scientific study (such as it was) with religion and the cultural beliefs of a population in a specific location at different points in history. When it comes to the afterlife, these concepts blend together and influence not only what a person believes about the human soul, but also what the afterlife is like. Spook – by Mary Roach is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...
- Stiff – by Mary Roach
  December 19, 2018Book Reviews / non fictionStiff – The Curious Lives of Human Cadavers is an exploration of what happens to the human body after the person dies. It is not a book for people who are squeamish, or who are mourning a loved one. I would definitely recommend Stiff to writers of mystery or crime novels, who need a good source of information about the timeline in which a cadaver decays. There are some things that people probably shouldn’t Google. Mary Roach does an excellent job of presenting factual information about a difficult topic to consider, while injecting just the right amount of what might be considered gallows humor. She does this without ever disrespecting the deceased. Stiff was published in 2003, so it is possible that some of the information in the book might be outdated. I suspect that the majority of it is still valid (but did not take the time to look up things to see what may have changed.) There’s a chance that the medical stuff could have been updated with new techniques between when the book was written and today. The first chapter of the book is about Mary Roach’s observations as she watches a group of doctors who are practicing face lifting techniques on cadaver heads. Some of the doctors are respectful of the person whose donated head they are working on. Others are less so. Mary Roach wonders who has the job of removing the cadaver heads from the rest of the cadaver – and she finds the answer to that question. Another chapter goes into the history of body snatchers. For a long time, it was illegal to dissect a dead human body. Anatomists had to resort to not-quite-legal means of obtaining bodies from which to learn about human anatomy. In some cases, the bodies were supplied by “resurrection men” who unearthed the recently deceased, put the body into a sack, and discretely delivered it to the doctor. It was apparently a good way to earn some money. It is also the reason that religious people – who believed the body needed to be entirely intact in order for the person to get into heaven – invested in Mortsafes. In that same chapter, there is an interesting (and disturbing) story about William Burke and William Hare, two “resurrectionists” who got into trouble. A man died in Hare’s boarding house before paying his fare. Hare and Burke took the body to an anatomist. After learning that bringing dead bodies to anatomists resulted in a nice payment, Hare and Burke started murdering people (and bringing the very recently dead to the anatomists). I’ll leave you to read the chapter to see how this obviously illegal situation was resolved. There is a chapter about the University of Tennessee’s Anthropological Research Facility – which is a large area of land in which cadavers are placed for the purpose of allowing researchers to study the timeline of decay. Part of the purpose is to assist those who investigate crime scenes. Other chapters cover a wide range of subjects, including information on whether or not cadavers are used for automobile crash tests. There is a chapter about the ethical issues involved in using cadavers (or cadaver legs) to determine which shoes provide the best protection for a living person who has stepped on a land mine. One of the chapters that I found especially interesting involved extremely religious Christians, who were alive, and who volunteered to be “crucified”. They weren’t actually nailed to a cross. It was a safely done approximation of crucifixion that involved people being secured to a huge cross by leather straps. The purpose of the experiment was to debunk previous hypotheses about what Jesus may have experienced. The purpose was to determine whether or not the volunteers had difficulty breathing while on the cross, and to figure out where the nails would have to be placed in order to prevent them from ripping out. Other oddities found in Stiff include details about an incredibly disturbing experiment where a researcher removed the head of an anesthetized monkey and attached it to the body of an entirely different monkey. There is also an amusing story in which Mary Roach goes to China in an effort to confirm, or debunk, an urban legend about human cadaver parts being used in the dumplings served in a restaurant. I found Stiff to be interesting, and strange, and filled with historical context that I might not have learned about if I had not read this book. There is definitely a tendency for people who work with cadavers (or parts of human bodies) to think of the cadaver as a person – and not a person – at the same time. Medical students, who must take a course that involves dissection of human cadavers, end up with a mix of emotions. They must, at times, distance themselves from considering the cadaver as a person. At the same time, many students form emotional attachments to the cadaver. This results in the university holding a mass funeral for the cadavers at the end of the semester. Students eulogize about the cadaver they worked on. It is a way of letting go, and thanking the person who donated their body to science, at the same time. Stiff – by Mary Roach is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...

World of Warcraft

- The Dwarves Explore Western Plaguelands – Part 1
  August 20, 2018The Dwarves / World of WarcraftThe Dwarves are Hansbrix the Hunter (and his pet bear, Fridge) and Bradanna the Priest. My husband and I had been playing these two characters together, completing parts of Azeroth zone by zone. There are things that we missed out on the first time we played (other characters) through some of the Cataclysm content. In this blog, I will feature the most interesting parts of The Dwarves trip through Western Plaguelands. The screenshots you see in this blog were taken on May 25, June 6, June 7, June 9, and June 10, 2015. The Dwarves began their exploration of Western Plaguelands by falling directly into the water, somewhere near Sorrow Hill. They were still in the water when they officially discovered Western Plaguelands. The Dwarves probably didn’t take the path they were supposed to take – but they managed to get to the right place anyway. Upon arriving in Andorhal, The Dwarves met two NPCs (Non-Player Characters). The first was Thassarian (level 85). The Dwarves had a quest to turn in to him. Hero’s Call: Western Plaguelands!: There is much to be done here. Both of our enemies are relentless and would slaughter us without mercy the moment we sheathe our blades. Thassarian gave The Dwarves a new quest to work on. Scourge First…Horde Later: Darkmaster Gandling of the Cult of the Damned leads the Scourge offensive here in Andorhal. My old counterpart, Koltira, leads the Forsaken forces. If we’re to win Andorhal, we’ll have to defeat both, but we will certainly fail if we have to take on both at once. I know Koltira well enough to know that he will focus on the Scourge first. We will do the same. Take out the weaker, desiccated Scourge to reduce their numbers. The Forsaken will have to wait to taste our wrath. The NPC standing next to Thassarian is named Lurid. He is a skeleton who is wearing armor. War Machines: Dried up Scourge… weak. Abominations… strong. We defeat strong abominations… we win war. Thassarian and Lurid appear to be mostly on the same page. They both want The Dwarves to kill off a lot of Scourge (and ignore the Forsaken for the time being). The difference is that Thassarian thinks it best to kill the weaker desiccated Scourge first, while Lurid wants The Dwarves to attack the stronger abominations. By this point in their adventure, The Dwarves have figured out that going after a specific enemy often brings in other enemies. With luck, The Dwarves can finish off these two quests in one battle. Before jumping into battle, The Dwarves drove over to see what Lang Loosegrip needed them to do. The Endless Flow: Araj the Summoner is bolstering the Scourge defenses with simple skeletons… an army of weaklings that will overwhelm you before it overpowers you. He has assembled animi within Andorhal’s northern towers that spew these skeletons out at an alarming rate. But I’ve got the solution! <Lang passes you a handful of grenades.> Their function is simple. Throwing these grenades at a bone animus … or, for that matter, a mob of skeletons… will reduce them to splinters. I didn’t know it at the time, but Lang Loosegrip had just given me a quest that would turn out to be one of my favorites. The Dwarves learned that it is very important to take the time to say hello to the local Flight Master. Bradanna noticed that she had mail to retrieve. There are no mailboxes on Andorhal. (Or, at least, none that The Dwarves could find.) They drove off in search of one. A good friend sent Bradanna an adorable Argi pet! Argi is super cute. Bradanna immediately picked him up and cuddled him. Argi didn’t seem to mind the trip back to Andorhal. The Dwarves were now ready to fight! They started attacking the Scourge. In this screenshot, they are fighting a Desiccated Magus. Bradanna and Hansbrix (and Fridge) fought a Desiccated Spearman while one of Thassarian’s army watched over Argi. The Dwarves eventually were able to take down some of the Opengut Behemoths that were wandering through Andorhal. Behemoths are big! (Dwarf for scale) Time to take out a mob of skeletons! The quests that involved jumping into a mob of skeletons, and slaying them all, were the most fun of all the Andorhal quests. Skeletons have long been my favorite monster to fight, and these kinds of battles remind me of playing the Diablo video games. So many skeletons! They just keep respawning. You can fight them forever…. or, until you turn in the quest. Thassarian: You may not act quickly, but at least you do not fail me. Very well. I will have a more important task for you, Bradanna, when the time is right. It sounds like Thassarian was not pleased that The Dwarves accepted his quest and then dashed off to get a pet out of a mailbox. That being said, he’s more pleased with The Dwarves than with…. whoever “failed” him before The Dwarves showed up. Lurid, on the other hand, didn’t seem to have much to say. He’s a man…um, skeleton… of few words. Lurid: Abominations…strong. Bradanna…stronger. Thassarian: With the death of the Lich King, all I have left is my duty. There is no family. There are no friends… there is only this. War. Hansbrix and Bradanna might have a vague awareness of the Lich King and the war against him. But, this is the first time they have encountered someone who was involved in that fight at the time it happened. Thassarian has lost everything that mattered to him. Thassarian: The Scholomance is one of the few Scourge holdouts remaining west of the Thondroril. The headmaster of Scholomance, a cultist by the name of Darkmaster Gandling, has made an appearance on the battlefield. This will be his last mistake. You will find Gandling in a square near the southern end of town. I want you to fight and weaken Gandling. I will join you to help finish him off. Thassarian: Gandling is strong, but do not worry. I will join you shortly after you begin to fight him. The Dwarves were a bit confused by these instructions. If Gandling is strong… then, shouldn’t Thassarian be coming along to the battle right from the start? Was he waiting for an invite to their party? Before either Hansbrix or Bradanna could ask Thassarian to accompany them… he gave them another quest. Thassarian: Gandling has brought his lieutenant, Rattlegore, with him. This clattering horror is far more dangerous than any of the other Scourge you will find upon the battlefield… even the abominations. You will find Rattlegore within an old town-hall building, near the center of town. I recommend caution before fighting him, Bradanna. He will not be a pushover. Rattlegore put up a decent fight. The Dwarves were able to defeat him without Thassarian’s help. It wasn’t clear if The Dwarves were supposed to have gone through Scholomance before arriving at Andorhal. I can’t quite make the story work out. If The Dwarves had decided to do Scholomance before Andorhal, they would have already killed Rattlegore and Darkmaster Gandling. If they took that route, it would mean The Dwarves would be fighting Rattlegore and Darkmaster Gandling a second time after arriving in Andorhal. The Dwarves are asked to kill these two “bad guys” here… and will undoubtedly meet them again whenever they get around to doing the Scholomance dungeon. Bradanna found a Blighthawk sitting by the lamppost outside the town-hall building. There was no time for pet battles, though. The Dwarves needed to find, and slay, Darkmaster Gandling. Bradanna was surprised to find that part of Andorhal was on fire. Hansbrix and Fridge had already run past the flames, in search of the next battle. Bradanna rushed to catch up to them. Hansbrix quickly got surrounded by skeletons! Fridge was nowhere in sight. Bradanna was, once again, glad that she had decided to become a healer. A view of Andorhal from the tower. Bradanna got overwhelmed by the respawning skeletons at the bottom of the tower, and tried to run. She ended up with a conga-line of skeletons that followed her directly into a Behemoth. Not ideal! The Dwarves found Darkmaster Gandling, and Fridge ran right over to fight him. We were still using Fridge as our “tank”. As such, the first threat Darkmaster Gandling made was “Prepare to die, Fridge!” Something in World of Warcraft assumes that the first one to attack the “bad guy” must be a player character. It never ceases to be amusing! The Dwarves entered combat. When would Thassarian show up? Darkmaster Gandling: Your life is forfeit. The Dwarves watched, helplessly, a Fridge got stuck in a bubble and lifted high into the air. This dire moment was exactly when Thassarian decided to arrive. Koltira Deathweaver joined the battle, too. Thassarian: For the Alliance! Koltira Deathweaver: For the Horde! The battle continues! Darkmaster Gandling: Enough of this. The Cult of the Damned doesn’t need Andorhal. This worthless city is yours to fight over. After his snarky remark, Darkmaster Gandling leaves Andorhal. We didn’t kill him. He presumably went back to Scholomance. Someday, if Bradanna and Hansbrix (and Fridge) decide to do the Scholomance dungeon – it would make sense to find Darkmaster Gandling in there – and fight him a second time. If Rattlebone is also in Scholomance…. then I’m going to assume that Darkmaster Gandling figured out how to rebuild him. Thassarian: Koltira! I had heard rumors that you were here in Lordaeron. Koltira: You heard correctly, Thassarian. I wanted to give you a chance to kill me again. Thassarian laughs. Hansbrix and Fridge wander away. Thassarian: It looks like it may have to come to that. Koltira: Yes, it may…but not today. With the Scourge out of the way, I plan to pull my troops back and regroup. Thassarian: I see. Then I will do the same. Thassarian: But you must be aware, Koltira: we are brothers no longer. You are a member of the Horde now, and I of the Alliance. Thassarian: Eventually, we will fight this battle for Andorhal, and only one of us can walk off of this battlefield victorious. Koltira: Yes, I know. And don’t think I’ll go easy on you. Thassarian laughs. Thassarian: Very well. I look forward to it. Koltira and Thassarian teleport away. Thassarian whispers: You are not to speak to ANYONE about the agreement that was made today, Bradanna. Consider this an order from your direct superior. This puts The Dwarves in the awkward position of having to turn in quests to Thassarian while pretending they didn’t see and hear the conversation he had with Koltira. Thassarian is just going to stand there, next to Lurid, as though nothing at all happened. Thassarian: Excellently done, Bradanna. And now, with the leader of the Scourge forces eliminated from Ahdorhal, we bide our time. Bradanna selected Gandling’s Gloves from the reward choice. It was the only item she could use. Lang Loosegrip: These grenades are all explosives, nothing more. I may not be a goblin engineer…but I still understand the value of being able to just explode things every once in a while. Lang Loosegrip: With the animus destroyed, the next logical step is tot take out Araj himself and to take a shard of his phylactery. You’ve probably already seen him, lurking at the fountain in the center of town. Take my grenades with you. They won’t do anything to Araj, but if he decides to summon any of those skeletons, you can use them to blow them away. Again. Before jumping into another battle, Bradanna, Hansbrix,and Fridge decided to take a short rest. They joined a happy looking, drunken, skeleton. He didn’t seem to mind. Lang Loosegrip was exactly right about where to find Araj the Summoner. The Dwarves didn’t have too difficult a time fighting this “big bad”. Shortly before dying, Araj the Summoner unleaded a mob of well-choreographed skeletons. They ran right for Bradanna. The Dwarves needed to pick up Araj’s Phylactery Shard in order to complete the quest. Hansbrix had no trouble smashing it! Thassarian: Araj dead… this is good. That gnome has done his part in winning this war. As have you, Bradanna. This was the first time I noticed how awesome Lurid’s axe was! I also noticed that Lurid appears to be wearing a decapitated Dwarf head, complete with braided beard, as a loincloth. What, exactly, was Lurid doing before he arrived at Andorhal? There must be a story there that hasn’t been told. Thassarian: The Alliance are victorious, and our forces are still strong. Military strategy dictates the we attack the Forsaken now, while they are recovering and unaware. I made a deal, however… We will wait. We attack Koltira and his troops when the time is right. In the meantime, speak with Ginny Goodwin and take a flight to the Chillwind Camp, to our south. Commander Ashlam Valorfist will give you your next assignment. You will hear from me when you are needed again in Andorhal. Ok, hold on there, Thassarian. First, you had a talk with Koltira, in the middle of town, about a secret truce. Then, you told us NOT to tell anyone about that secret truce. Now, you’re openly talking about that – apparently classified – truce again, out here where anyone nearby can hear you. If your goal was to baffle us into silence… well, you’ve succeeded. Next stop – Chillwind Camp! Commander Ashlam Valorfist: Welcome to the front lines, priest. The Kingdom of Stormwind, with the aid of its allies, has sent me here to counter the growing threat of the Scourge. Here at Chillwind Camp, we fight for our continued survival on a daily basis. If you’ve come here looking for a chance to prove yourself as a hero, then you’ll find plenty of opportunities to do so… especially as we push towards Andorhal and whatever malign force that controls the Scourge there. Commander Ashlam Valorfist: Word arrived shortly before you did, Bradanna. With the Scourge ejected from Andorhal, we are one step closer to retaking Lordaeron. Commander Ashlam Valorfist: We must always be prepared for battle, Bradanna. Whether that battle is against the Forsaken in Andorhal, against the Scourge in the east, or against some yet-unknown foe is unknown. What is known, is that we must be ready. We are low on arrows. I can obtain the shafts and heads, but I still need feathers. The birds that circle to the northwest typically molt this time of year. Would you mind traveling out into the field and gathering some of these feathers for our camp? The Dwarves were willing to go gather up some molted feathers. It’s nice that Commander Ashlam Valorfist, who sounds very focused on being ready for war, didn’t ask The Dwarves to kill the birds. Collecting the feathers the birds have already dropped will get the job done. Commander Ashlam realized that the birds were not his enemy. Thurman Grant has a sad story to tell. Thurman Grant: I hail from Westfall, far to the south…as do these men that travel with me. We are farmers, and nothing more. I had been told that Lordaeron had been healed, and that it was ready for tilling. However, this “Commander” now tells me that it’s too dangerous to proceed. He says that there’s a war going on, and that the plague lands still aren’t healed. Before anything else, I need to get some food in my men’s stomachs. Anything will do. Bear meat seems to be plentiful. Hansbrix, of course, took offense at Thurman Grant’s suggestion that he allow Fridge to be turned into dinner! Thurman Grant assured Hansbrix that wasn’t what he meant at all. He pointed toward the trees and asked The Dwarves to hunt some Shaggy Black Bears. Argent Officer Pureheart, of The Argent Crusade, was informative, but didn’t have a quest for The Dwarves. Argent Officer Pureheart: Well met, friend. I am Officer Pureheart, and I am a proud member of a world-wide organization known as the Argent Crusade. Our cause is simple – fight swiftly and mercilessly against any element of evil that surfaces in Azeroth. We are not a political body, nor do we ever wish to become one. To that end, we call both the Alliance and the Horde both as friends – friends in the cause of stamping out evil! For the Light, my sister! Bradanna nodded her head and listened to Argent Office Pureheart, and then walked away. There was something odd about this human, who felt the need to insist that her organization was not part of a political group, after proudly telling Bradanna that her organization likes to “fight swiftly and mercilessly against any element of evil that surfaces in Azeroth”. Bradanna wasn’t quite sure if this was a cult, and worried that Argent Officer Pureheart was about to ask her to make a donation. Hansbrix sent Fridge off to “tank”, while he and Bradanna fired at the Shaggy Black Bears from a distance. In between fighting Shaggy Black Bears, The Dwarves remembered to gather the Brownfeather Quills that were on the ground. Ok, back to fighting bears! Ready to turn in the bear meat and feather quests Thurman Grant: You hunt like a true priest…Even if we can’t set up homesteads… at least we can still eat. This time, Thurman Grant decided to insult Bradanna. Whatcha mean “you hunt like a true priest?” Bradanna felt mocked. She realized, however, that Thurman Grant probably didn’t mean it that way. He was just a rather awkward human. Ding! Bradanna hit Level 39! Commander Ashlam Valorfist: I will have my fletchers get to work on these. I am glad to see you being useful right away, Bradanna. Perhaps later I will have some more exciting tasks for you. It did not take Commander Ashlam Valorfist long to assign The Dwarves a “more exciting” task. True to his word, this quest proved to be more interesting than the one where he had them gathering feathers. Commander Ashlam Valorfist: These farmers from the south wish to take these farms, but I can’t let them enter the plaguelands unprepared. Even with the Scourge gone, danger still looms in the form of the Forsaken. No, we must be ready to fight…and that includes our new visitors. Before doing anything else, however, I would recommend that you travel to Uther’s Tomb, to the east, and place this tribute before his statue to ask for his blessing. Speak with the priest that tends to the tomb when you are finished. It appears that the majority of the people at Chillwind Camp take a while to get used to strangers. Very few wanted to talk with The Dwarves when they first arrived. All of a sudden, they got very chatty. Argent Officer Pureheart: I saw the strangest commotion coming through town the other day. A horse-drawn cart, loaded with crates and chests. A worgen woman at the reins, a blood elf by her side, and a dwarven paladin running behind, yelling some of the most creative obscenities I’ve heard in quite some time. They looked like they were headed to Eastern Plaguelands, though I’d imagine they can’t be far past the Thondroril River by now. I wonder what they were up to? Bradanna did not expect to see an Orc standing there. She wondered what happened to the Dwarf who was there before. High Priestess MacDonnell: Sorrow Hill, up the road to the northeast, was one of the first places that the Argent Crusaders and Cenarion Circle were able to heal. The area is now freed of the Scourge. However, there are still many specters of the past that, for some reason, have not passed on into the next world. They may be mourning, or they may have unfinished business… or they may just be lost. Take my thurible and use it to douse them with holy incense. One way or another, we will help them move onto the next plane. Alexia Ironknife: Greetings, priest. Don’t have too much time to talk — I’m just using Chillwind as a camp to get some rest before heading to Hearthglen. I’ve heard word that before they went crazy, the Scarlet Crusade had a mage working for them who was trying to create powerful bows and guns for their soldiers. I’m not sure if he succeeded or not… the Crusade killed him before any of his finished product made it out… or maybe they distrust the arcane that much. Alchemist Arbington: This job is definitely not worth sixteen-five a year. The Dwarves drove out to Sorrow Hill. Fridge ran along beside them. He’s pretty fast for a bear! Withdrawn Soul: Get away from here! Bradanna, Hansbrix, and Fridge battled some spirits at Sorrow Hill. The spirits started out being very unfriendly towards The Dwarves. Fortunately, their attitudes changed after the fight was over. Withdrawn Soul: I must be going now… Withdrawn Soul: I’ve waited here for too long. Time to say goodbye. Withdrawn Soul: I…I think I’m ready to leave now. Sorrow Hill is a good name for this area. There is something deeply depressing about encountering all these lingering souls, who haven’t left yet. They eventually find peace, and decide to move on. That too, is sad. After wandering around Sorrow Hill for a while, The Dwarves discovered the Path of Uther. The Dwarves found a statue in the Sorrow Hill graveyard. There was no marker to tell them who the statue was of. They decided to take a “tourist photo” anyway, figuring they might someday run into someone who could tell them about the statue. Fridge, as usual, photobombed what would otherwise have been a very somber image. Lovely yellow flowers line the Path of Uther. The Dwarves discovered Uther’s Tomb, and met High Priest Thel’danis (who seems to be the caretaker.) There, at the end of the tomb, was a magnificent statute of Uther the Lightbringer, surrounded by the Light. Here lies Uther the Lightbringer First Paladin – Founder of the Order of the Silver Hand Uther lived and died to defend the kingdom of Lordaeron. Though he was betrayed by his most beloved student, we believe that his spirit lives on. He continues to watch over us, even as the shadows close in around our ruined land. His light is the light of all humanity – and so long as we honor his example, it shall never fade. ???????? – Anonymous One by one, The Dwarves received Uther’s Blessing. High Priest Thel’danis: You and the humans at Chillwind Camp wish to re-take Andorhal? I wish you luck. Bradanna wasn’t quite sure if High Priest Thel’danis was giving The Dwarves a blessing, or if this was a polite way of saying that he expected us to fail. High Priest Thel’danis: If you truly intend to move forward in this battle for Andorhal… well, perhaps I can help. To the east lies a large crypt. The bottom level of the crypt was once used for storage of weapons and armor… until the Scourge came. Now that the undead have left, the weapons are free for the taking. Most of the weapons are probably rusted and rotten by now, but they will serve better than tunics and pitchforks. High Priest Thel’danis pointed out where to go, and The Dwarves chose to take the quest he offered them. He had a point. The farmers back at Chillwind Camp were going to need more than pitchforks if they were going to fight the Scourge. The Dwarves climbed a large hill and discovered Sorrow Hill Crypt before they could see it. Fridge pointed towards it and growled. He could smell whatever was over there, and didn’t like it one bit. Bradanna hesitated as she looked down upon Sorrow Hill Crypt. It looked so peaceful from here. She knew, however, that things were not always as they appeared to be Western Plaguelands. She raced down the hill to catch up with Hansbrix and Fridge. They had entered the Crypt without her, which she felt was a bad decision. Once again, she was glad she decided to become a healer, and hurried towards Hansbrix and Fridge as fast as she could. Despite what High Priest Thel’danis said, the crypt appeared to be empty. There were no weapons or armor pieces to be found. Fridge started growling at something The Dwarves couldn’t see. Bradanna quickly moved and prepared react to whatever was about to happen. That was when Foulmane lurched into view. The battle began! Foulmane pushed The Dwarves back to the stairs – but they did not give up. The Dwarves prevailed! After taking a moment to catch their breath, they noticed a glowing object on the other side of the room. It looked important. It turned out to be nothing more than a broken weapons crate. That was disappointing! Scattered all over the bottom level of the crypt, you find shattered crates that once held weapons and armor. It appears that somebody got here before you did. The Dwarves figured Foulmane was the one who smashed the crates. But, he wasn’t wearing armor or using any weapons. They wondered what happened to the old weapons and armor – but were interrupted. Ambushed! As you turn around, you see the silhouettes of shambling skeletons on the stairs. The undead aren’t gone from this crypt. They were lying in wait! Furthermore, they appear to be armed with the weapons that you came looking for. You’ll have to escape from the crypt. On your way out, you should gather as many pieces of equipment as you can. Skeletal Flayers and Skeletal Sorcerers appeared! It was now obvious who took the weapons and armor. The Dwarves and Fridge had to fight their way out of the crypt, and pick up random armor and weapons while the battle was going on. The battle continued after The Dwarves left the crypt. There were well armored skeletons outside. And then, it was over! The peace only lasted a few moments, before The Dwarves had to fight their way past more skeletons. Eventually, The Dwarves realized that their best option was to drive past the skeletons and return to Chillwind Camp. The Dwarves encountered Marlene Redpath just outside of Sorrow Hill. She wasn’t all there, and didn’t have anything to say. The Dwarves realized that they could see right through her. She didn’t look anything like the angry spirits in Sorrow Hill did. Was she a ghost? Did Marlene Redpath die in the house she now stands in front of? Whatever her story is…. has been lost. The Dwarves informed High Priestess MacDonnell that they released the spirits at Sorrow Hill. She was obviously greatly relieved to hear that. Bradanna handed High Priestess MacDonnell back her thurible. High Priestess MacDonnell: Hopefully, most of them passed on peacefully. I thank you, Bradanna. Commander Ashlam Valorfist: What happened at Uther’s Tomb, Bradanna? Commander Ashlam Valorfist: Attacked by ghosts? Strange. I suppose the crypt wasn’t fully healed after all. You just missed Thurman Grant…you remember, that oaf of a farmer that was here earlier. He took his men with him and traveled to the nearest farm…against my orders. Commander Ashlam Valorfist: The farmers traveled to the Writhing Haunt, an old farm to the northeast, across the river. Someone needs to keep an eye on them. Bring them those rusty weapons and armor you found. We can’t them fighting with pitchforks. Argent Officer Pureheart: These men and women here at Chillwind Camp have noble goals, but their ultimate purpose is war. I would like to offer you an opportunity to pursue more peaceful goals. At the Menders’ Stead, beyond war-torn Andorhal to the north, the Argent Crusade has joined forces with the Cenarion Circle. Together, we work on healing this land from the plague that used to reign here. Are you interested in joining our cause, priest? Bradanna and Hansbrix looked at each other and shrugged. The accepted Argent Officer Pureheart’s quest but did not necessarily agree to join. Instead, The Dwarves figured that offering the Cenerian Circle some help would be ok. Hansbrix, Bradanna, and Fridge discovered The Writing Haunt. The Dwarves found Thurman Grant inside a small, and nicely decorated, house at The Writhing Haunt. Thurman Grant: Did Valorfist send you? He doesn’t know when to let up, does he? Thurman Grant: Well, now that you’re here, we’ll gladly take that armor off your hands. You can keep the weapons, though. These men wouldn’t know which end to hold. The Dwarves happily handed over the armor. The farmers won’t have to know much, other than how to put it on properly, in order to make use of it. As for the weapons… it appears that Commander Ashram Valorfist didn’t bother to ask the farmers if they knew how to use the weapons The Dwarves were sent collect, or if the farmers wanted to learn how to use them. Bradanna wondered how the farmers were going to survive all the way out here, far from Chillwind Camp, and without anyone who knows how to use simple weapons to defend themselves with. Thurman Grant provided an answer. Thurman Grant: I told Commander Valorfist that we could hold our own, and we intend to. I had a little conversation with the death knight general, Thassarian, on my way over here. We farmers plan to help in our own way. We will take control of this farm, begin to cultivate the land…and then when the battle for Andorhal commences, we will attack the Forsaken from the rear. They’ll never expect it. First, we need to get rid of these Forsaken outriders. Kill some, then return to me. The Dwarves set out to kill some Forsaken Outriders. The farmers joined in. Thurman Grant was right – it does seem the farmers can “hold their own” here. They were out here killing Forsaken Outriders before The Dwarves got there. The farmers had even found the time to cultivate the land (in between fighting Forsaken Outriders). The Dwarves didn’t know anything about these plants, other than they grew much taller than Dwarves. The Dwarves returned to Thurman Grant to let him know they killed some Forsaken Outriders, as he had asked. Thurman Grant praised The Dwarves fighting skills. “My men could stand to learn a few moves from experienced fighters like you,” Thurman Grant said. Thurman Grant: In fact, you might still be able to help train some of my men. You probably noticed the abomination outside. We initially tried to fight him, but he didn’t want to fight back. He seems to want to help out on the farm. Take a group of four settlers and challenge this abomination to combat. He seems to be pretty tough, but with one of him and five of you, I think you’ll have a chance at beating him. Together, The Dwarves gathered up a total of eight of Thurman Grant’s Provincial Minutemen. They grabbed their pitchforks and followed The Dwarves toward the abomination. Fridge ran along with them, as usual. None of the farmers seemed to care that one member of their party was a bear. Bradanna figured that these farmers had seen worse things, and Fridge was showing no interest in attacking the farmers. It turned out Thurman Grant’s suspicion was right. The abomination introduced himself. His name is Gory, and he wants to help out on the farm. Gory: Gory wants to help out on farm. Gory already has his own scythe! One of the farmers yelled out: If you really want to help out, you can help me and my friends with some combat practice. The Dwarves looked at each other, alarmed what had just happened. This was a fight that didn’t need to happen. On the other hand, the farmers had reason to not want to welcome an abomination on their farm. The sight of Gory was unnerving! Gory: You want to fight? Alright, Gory fight. Gory: Gory give up! You farmers fight more good! Gory stopped fighting and just stood there. The farmers quickly realized that the battle was over, and started walking away from the abomination. This was a strange situation. Bradanna wondered if Gory needed healing. She felt bad for him. All he wanted to do was help on the farm – and he got attacked by eight human farmers, two Dwarves, and a bear. At the same time, Bradanna thought Gory was repulsive. She reluctantly decided it just wasn’t a good idea to try and heal an abomination. The Dwarves and all of the farmers/Provincial Minutemen went together to let Thurman Grant know what happened. Bradanna wasn’t sure he would believe their story. An abomination who doesn’t want to fight? It seemed unrealistic. Fortunately, the room full of witnesses to what occurred were enough to convince any reasonable person. Thurman Grant: We can handle things from here. I thank you for your help, Bradanna. I assume that when we next meet, it will be in battle. Take care of yourself until then. We’ll need all the help we can get. As a player, I found it interesting that the quest text was written as if a single player did the quests. Bradanna and Hansbrix were in a group, so they each got individuated responses that included their name. I guess this was the easiest way to make the quest text, since it could make sense for both single players and groups. It still felt a little weird, though. Thurman Grant had nothing more for The Dwarves to help with, and the farmers needed to get back to working on the farm. Before they left, The Dwarves wanted to check on Gory. The Dwarves carefully walked up to Gory. He was still standing in the same place. It was clear that Gory wasn’t the smartest of creatures, and Bradanna wondered if the farmers would continue to fight him. They might choose to ignore him, which didn’t quite feel right either. “Gory… are you doing all right?” Bradanna asked. Gory: Gory just happy to be in the sun. Bradanna reconsidered her assumption. Gory clearly wasn’t very smart, but he still had wisdom to share. She wished that everyone on Azeroth could be made happy simply by being in the sun for a while. Bradanna wanted to remember Gory’s words when tough times returned. After waiving goodbye to Gory, The Dwarves drove to The Mender’s Stead. The Dwarves met Field Agent Kaartish at The Menders’ Stead. Field Agent Kaartish: Welcome, priest. As you can see, our camp is a joint expedition between Argent Crusade members and Cenarion Circle druids, but we welcome all who wish to help heal the land. Field Agent Kaartish: No longer does the Scourge hold this area. We, the living, are retaking Lordaeron. We have taken great strides already, as you have already seen. The earth flowers, the trees grow tall and green, and the wildlife is beginning to return. Yet a few remnants of undeath remain. While the trees and grass prosper, the animals are struggling. Something is preventing them from healing, and I intend to find out what. Bring me samples from the plagued wildlife so that I may study them more closely. Next, The Dwarves spoke with Adrine Towhide, who also needed their help. Or, to be more accurate, she needed The Dwarves to help someone else. Adrine Towhide: I am Adrine Towhide, a druid of the Cenarion Circle. You can thank us for healing this land, where once there was only death. We accept all who choose to follow the druidic path, regardless of race, faction or talent. Occasionally, that means we enlist a druid who needs more help than others. I’d like you to meet Zen’Kiki. He’s pretty new, and he’s still learning his craft. Would you mind taking him out with you for a while? You can practice combat on the plagued animals that roam nearby. Zen’Kiki: Ready to go, mon! Selyria Groenveld: Dwarf! I’m glad someone’s here to help me out. We Cenarion druids have re-cultivated Daison’s Farm, immediately behind me. The land has flourished and our crops have been successful… mostly. A few plants seem to still be infected by the plague that ran through this land. Perhaps their roots were too deep, perhaps the seeds were weak… I cannot say. All I can say is that I need an able priest like you to help me remove the bad plants from the good ones. Before heading out, The Dwarves talked with Durnt Brightfalcon, a fellow Dwarf. Durnt Brightfalcon: Word is in from Andorhal, Bradanna. The battle has resumed. It has become somewhat well-known among the Alliance forces that you’re a hero of the first battle of Andorhal. Thassarian has requested your presence immediately. The Dwarves, Fridge, and Zen’Kiki were ready to leave The Menders’ Stead and get to work. This screenshot shows Zen’Kiki standing near Bradanna. What I couldn’t see was that Hansbrix had his own Zen’Kiki. The Dwarves fought a hulking plaguebear. Zen’Kiki tried to help. Zen’Kiki: Shapeshift! Zen’Kiki’s ready to pounce! Zen’Kiki: This isn’t right. Bradanna wasn’t sure what kind of creature Zen’Kiki turned himself into. She was pretty sure it wasn’t one that belonged on land. Zen’Kiki: Shapeshift! Here comes de moonfire! Zen’Kiki: It burns like the moon! Zen’Kiki hit himself with his moonfire. Bradanna was unimpressed. She considered healing him… but then figured maybe this was a good learning experience for a new druid. The Dwarves killed some really big spiders. They needed to collect samples from them for Field Agent Kaartish. The Dwarves ran through The Writhing Haunt to collect the last of the samples. Zen’Kiki tried his best, but he really wasn’t much help. Bradanna believed he meant well, though. The Dwarves returned to The Mender’s Stead to speak with the people who had asked for their help. Field Agent Kaartish: Once the animals are healed, our duties here will be nearly complete. Field Agent Kaartish: I will need some time to study these samples, Bradanna. I will speak to you again when I have completed my analysis. Field Agent Kaartish: We are not the only Argent Crusaders here in the plague lands. Our headquarters, Hearthglen, lies to the north. Even nearer to the north is a small lumber mill which we also control. Nathaniel Dumah is my main contact at the lumber mill. I encourage you to speak with him, should you find yourself in that part of the woods. Next, The Dwarves spoke with Adrine Towhide. She wanted to know details about how Zen’Kiki did. The Dwarves were extremely honest with their assessment of Zen’Kiki’s abilities as a druid. Adrine Towhide: It looks like Zen’Kiki is still having a little bit of trouble with his shapeshifting. Adrine Towhide: Among other things, Zen’Kiki needs to work on his spell accuracy. I could see his wrath spells spirling out of control even from here! In fact, I used them as a marker to follow your progress through the woods. Perhaps we can use Zen’Kiki another way. Take him up to the top of the all just to our east. The diseased hawks that circle above that hill must be destroyed. Ask Zen’Kiki to shoot at these hawks. Even if he can’t hit them, he will distract them so you can finish them off. Zen’Kiki: Ready to go, mon! Hansbrix took Fridge and went to do some necessary shopping before they headed out to complete their latest tasks. Bradanna kept her eye on Zen’Kiki. She wasn’t impressed with him at all, and felt like he would quickly get himself into trouble if no one was watching. As Zen’Kiki wandered around The Mender’s Stead, Bradanna moved just close enough to be in range in case he suddenly became in bad need of healing. Zen’Kiki: You just let Zen’Kiki know when you’re ready! I’ll bring one of these birds down for ya! Zen’Kiki: Here comes Zen’Kiki! Zen’Kiki was still having trouble with shapeshifting. He didn’t seem to know which way to face, and the Diseased Hawk was about to attack him. Fridge stepped in to tank, while Bradanna and Hansbrix shot the Diseased Hawk from a distance. Zen’Kiki: I seem to be… stuck… After The Dwarves killed the required number of diseased birds, they returned Zen’Kiki to Adrine Towhide. Adrine Towhide: Now we’re getting somewhere. How may birds did Zen’Kiki end up killing? None? You killed them all yourself? Alright, I suppose we’ll have to find another use for him then. I will let you know when the time is right. Next, The Dwarves headed over to Dalson’s Farm. It wasn’t very far away, so they decided just to run over there. The fought, and killed, some Thrashing Pumpkins. They also removed some unhealthy-looking pumpkins. Next, they went to remove rotten apples from the orchard. This is where The Dwarves ran into some Pome Wraths who attacked them. When this Pome Wrath was out of the way, The Dwarves continued their task. It’s always a good idea to remove the rotten apples before they spoil the bunch. Other Pome Wraths interrupted them, and were just as quickly dispatched. The last bit of agricultural work The Dwarves needed to do was to remove bad corn. It sounded easy, until the Corn Stalkers attacked. The Dwarves were well prepared to defeat these enemies. The Dwarves reported back to Selyria Groenveld, and told her about the rotten things that were at Dalson’s Farm. Selyria Groenveld: Thank you for your help, Bradanna. I know that picking vegetables isn’t the most heroic task imaginable, but even the humblest tasks have their rewards. Bradanna hit Level 40! Hanxbrix had already hit Level 40. He was always a bit ahead of Bradanna. The last thing to do was return to Andorhal and speak with Thassarian again. The Dwarves were right back where they started from, shortly after entering Western Plaguelands. Thassarian: Word has it that you helped those farmers arm themselves. Well, now they’ve initiated the attack without my order! They’ve forced my hand. The battle has resumed. This time, we fight the Forsaken… and I fight Koltira, my old brother of the Ebon Blade. Bradanna shook her head. Technically, The Dwarves armored the farmers. They never gave them arms, because Thurman Grant said that the farmers wouldn’t know which end to hold. It felt to her like Thassarian was using the situation as an excuse to start a fight with his “frenemy”. Thassarian: To the east, deep within Forsaken-held Andorhal, you will find their commanders. They do not fight, but call out orders from horseback. Hunt down and slay these commanders, Bradanna. The Forsaken won’t stand a chance. Lang Loosegrip had some advice for the The Dwarves. The advice was a bit vague, but he probably meant well. Lang Loosegrip: I’m no military expert, but this battle looks to be in our favor. Our defenders are equally matched with their death guards, but the farmers’ militia has taken them by surprise from the rear. For the Alliance! Still, we should all do what we can to make sure that we win. Travel east into Andorhal and slay the Forsaken death guards that are fighting with our men. The sooner they die, the quicker we can re-take Andorhal! The Dwarves, and Fridge, took on the Forsaken Deathguards, one at a time. Thassarian: Well done. With them out of the way, I have no more excuses. Soon, I must battle Koltira, for honor and for Andorhal. Thassarian: We are winning this battle, Bradanna. As long as those farmers keep chipping away at the Forsaken’s flanks, we will overtake them. And just like that, Thassarian changed his mind about the farmers, the moment he saw how useful they were. The Dwarves let Lang Loosegrip know that they completed the task he sent them on to kill the Deathguards. Lang Loosegrip: You fight well, Bradanna. I wish I had your ability… and your bravery. The Dwarves went back to talk with Thassarian, figuring he would have some plan worked out for the battle ahead. Thassarian: We nearly have this battle won, Bradanna. I can taste victory. The Forsaken never stood a… What the hell is that!? The Dwarves turned around to see what Thassarian was looking at. Thassarian: Is that a… val’kyr? Bradanna squinted her eyes… and could just barely see the form of something flying toward them. The Dwarves had never seen anything like this before! Val’kyr: Kneel, Alliance! Kneel before the might of the Forsaken! With that, this beautiful, horrible, creature, and the ones it brought with it, began an attack. Thassarian: Val’Kyr? Koltira brought val’kyr to this fight? Has he gone mad? No, this is not Koltira’s work. This was Sylvanas. Thassarian: The val’kyr were one of the Scourge’s primary weapons. Not only were they skilled in battle, but they could be used to convert corpses into Scourge minions. To think that Sylvanas is stooping to such levels for the sake of the Forsaken… We need to stop the val’kyr before they wipe us out and turn our army against us. Slay as many as you can find. And bring some of these minutemen with you. If they’ve survived this long, then they must have some battle skill. The Dwarves could hardly believe the situation they had gotten into. They were about to fight lesser Val’kyr with a bunch of militiamen who were armed with pitchforks. Thurman Grant: Our militia has been nearly wiped out. Only I and these few farmers remain. Those winged creatures… they took the bodies of our men and… and turned them into walking, undead corpses! With every one of our men they took, they bolstered their own ranks. It pains me to admit it, but you will ned to fight them too, along with the deathguards and val’kyr. As they did in life, they hunt in packs, so take some of my minutemen with you. The Dwarves, and Fridge, led the remaining militia into battle. They fought against Forsaken Troopers. Bradanna found these battles to be tough. It wasn’t because they were not up to the task. She worried about the militia who had to, once again, fight against their (now undead) brothers. She and Hansbrix led the militia past the fallen body of the one they just killed. The corpse lay on the road in Andorhal, ignored out of necessity. The battle continued to wage around them, and there simply was no time for anyone to mourn for their lost friends. The moment The Dwarves, and their band of militiamen, killed a val’kyr – another one began to attack. This was the kind of battle where one wrong move could turn out to be completely disastrous. Victorious! Thurman Grant: You fought valiantly, but we’re getting nowhere. Every body that falls just fuels their forces. Thassarian: For every val’kyr you slay, you save dozens of our men… and prevent the Forsaken forces from growing. Still, they press on. We may not will this battle after all. Thassarian: I spoke too quickly, Bradanna. Even with your support, things are looking grim for our forces out there. Thassarian: Our last hope of victory lies in defeating the val’kyr. You’ve done well up until now… but you’re only one woman and there are literally dozens of them raining destruction on the battlefield. One enormous val’kyr sits atop the tower to our south… you can see her from here. Perhaps if we eliminate her, the remaining val’kyr will dissipate. This is our only hope. Bring some of Grant’s men with you. You’ll need their protection for this battle. The Dwarves took a moment to make a plan with the militiamen, as Aradne watched while floating above the tower. Thassarian seemed to think that maybe Bradanna and her militiamen could take on Aradne by themselves, but didn’t seem hopeful about the outcome. Bradanna was undaunted, though. With Hansbrix and Fridge by her side, along with Hansbrix’s militiamen – this seemed like a battle they just might win. The first thing to do was climb to the top of the tower. The battle was intense, but went very quickly. Here lies the corpse of the Val’kyr Aradne. Thassarian: I watched your victory from below. Well-fought, but ultimately, it was for naught. The val’kyr and the Forsaken press on: soon they will overtake us. We have lost Andorhal. Thassarian: Head south, to Chillwind Camp. Tell Commander Ashlam Valorfist everything that happened here. Me? I’m going west, into Tirisfal. My battle’s not over yet. I’ve got an appointment with that harpy that calls herself a Banshee Queen…and I’m finding out what she did to Koltira. The Dwarves returned to Chillwind Camp to give Commander Ashlam Valorfist the news about Andorhal. Commander Ashlam Valorfist: Lost? No…next, they’ll be coming for Chillwind, I suppose. This was a major strategic blow to the Alliance’s plans for Lordaeron. Very well. I will report the results of this battle to King Wrynn. I don’t expect him to be happy. The Dwarves were right back where they started from. This was not the end of their adventure through Western Plaguelands, though. There was more to explore. The Dwarves Explore Western Plaguelands – Part 1 is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...
- World of Warcraft: Battle for Azeroth – Alliance Side
  June 9, 2018World of Warcraft / World of Warcraft BetasAfter completing the Battle for Lordaeron (and several of the quests that followed) on the Horde side of the World of Warcraft: – Battle for Azeroth Beta, I decided it was time to see what the Alliance side of that battle was like. This required me to roll a new character (which will disappear when the Beta ends). I chose to play a Dark Iron Dwarf, which is an Alliance Allied Race. Thelgarn (whose name came from a random Dwarf name generator I found online) is a Warrior. This blog contains screenshots, Twitch videos, and commentary about the Alliance side of the Battle for Azeroth Beta. There are some spoilers ahead. Watch World of Warcraft Battle for Azeroth Beta – Battle of Lordaeron Alliance Side from Queenofhaiku on www.twitch.tv Here is an example of the strange, red lines that I mentioned in the video. I found them disturbing, but cannot fully explain why. They just felt wrong. I kept getting distracted by these red lines hovering over the landscape while I was playing through the Battle for Lordaeron. It is pretty obvious that those lines are not supposed to be here. I’ve reported it as a bug, and figure that other players have, too. Hopefully, these bizarre red lines will be removed before this expansion launches. High Overlord Saurfang is somewhere in the middle of that mob. I’ll leave you to watch the video above to see what happens with him. Without giving too much away, I will say that part of his story continues for Horde players. Saurfang pops up in the Stormwind Stockade, and has something to say. As far as I can tell, only Horde players will get that part of the story (because it comes up during a series of quests that follow the Battle for Lordaeron on the Horde side). Watch World of Warcraft Battle for Azeroth Beta – Kul Tiras from Queenofhaiku on www.twitch.tv This lovely mount is called a Swift Red Gryphon. I had one of these on my Horde character during the Battle for Azeroth beta. This mount flies in Stormwind, but would not fly in some of the new areas of the Horde side. This does not surprise me. I figure there are probably new flying skills to purchase before characters can fly in new Battle for Azeroth zones. Shortly after this point in the Beta, I decided to try and get to Silithus so I could work on some quests that required me to travel to that zone. The flight master could not send me there – because I was on the wrong continent. So, I flew across Stormwind, got on a boat – and discovered a bug. Later, I learned that I had selected the wrong boat. Thelgarn the Warrior ended up in Kul Tiras – which clearly was not the right place. It wasn’t even the right continent. He quickly found some dinner, and then started exploring. I’d already been through some of this when during the Battle for Azeroth Alpha. New things had been added since then. Eventually, Thelgarn decided he had enough of Kul Tiras. He tried to find the boat that brought him here, but it left before he could get on. This gave him some time to look all official by sitting at this desk. Watch World of Warcraft Battle for Azeroth Beta – Killing Goblins for Mysterious Ore from Queenofhaiku on www.twitch.tv In this video, after waiting around for a boat that was taking a long time to arrive, Thelgarn remembered he could just hearth back to Stormwind and start over. A group of players was fighting a Target Dummy, who appears to be throwing Rubik’s Cubes. I’m guessing that the cube is a temporary stand in for something else that, for whatever reason, was not added to the Battle for Azeroth Beta. It turned out that Thelgarn was supposed to take this portal to Darnassus. I assumed that the boat all the way at the end of the row was the one that went to Kalimdor. It appears that is not so in the Battle for Azeroth Beta. Thelgarn ended up standing on a rock near the shoreline, which felt kind of random. But, I guess a portal can be set to pretty much anywhere in Azeroth. So… whatever. My biggest frustration with the Alliance side of the Battle for Azeroth is that the quest chains do not flow. Start in Stormwind – queue for Battle for Lorderon. Hang around until it suddenly becomes your turn to participate. Finish the battle, and end up back in Stormwind. Find a quest giver (or two) who want you to go to Silithus. But, before you can do that, you are supposed to speak with King Anduin. This involves watching a cinematic of the King giving a speech and talking with two (important) NPCs while the player…. waits and watches. I had some confusion about how to get to Kalimdor, but that could be my own fault. It is reasonable to assume that players would just understand that they were supposed to use the portal. Arrive in Darnassas, standing on a rock. Take what feels like a very long flight from the nearest Flight Trainer to Silithus. This is kind of a fuzzy screenshot, in part because my character was in flight, and also because the whole area is a strange, pink, tone. The disturbing red line in the sky is back. I reported it as a bug. I’ve no idea why I see these red lines on the Alliance side, but didn’t see any of them on the Horde side. The red lines in the air became purple lines in the air somewhere around Ashenvale. Pick up a few more quests in Silitus. Complete some, turn them in, get a few more. One of the quests involves killing goblins to obtain Mysterious Ore, and another asks the player to put explosives on some Shredders. These quests were fun, and fairly easy to do. Watch World of Warcraft Battle for Azeroth Beta – Meeting Magni from Queenofhaiku on www.twitch.tv Oh, wait! I was supposed to speak with Magni who just so happens to be on the other side of the same area I’m working on quests in. Speak with Magni, and you take a … I’m gonna call it a “waypoint”… to somewhere. Once there, you watch a cinematic that explains how Azeroth got wounded. To me, it felt like players must do this to complete that part of a quest. Talk to Magni, do a little quest, and get the super important amulet. Magni says to take the … waypoint… back. I assume this means back outside this special chamber. But, no. Thelgarn suddenly found himself back in Stormwind, with a quest to go see King Anduin. I had two quests in Silithus that I hadn’t started yet, and will now have to take the long flight back out there in order to complete them. It just doesn’t flow. This is disappointing because the Horde side of the Battle for Azeroth Beta flows really well. Obviously, things can change between now, and when the Battle for Azeroth expansion is released. I’m doing my part and reporting all the bugs that I find in the Beta (as I did in the Alpha). Overall, I think I will enjoy this new expansion, but might be focusing on my Horde characters a bit more than my Alliance ones for the Battle for Azeroth content. World of Warcraft: Battle for Azeroth – Alliance Side is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Patreon or at PayPal.me. Thank you!...

Out of Spoons (Chronic Illness)

- America Needs Universal Health Care
  February 5, 2019Out of Spoons / Public HealthPhoto by Miguel Á. Padriñán from Pexels It has been called “Single-Payer Health Care”, “Medicare For All”, “Medicaid For All”, and “Universal Health Care”. Australia, Canada, France, Germany, Singapore, Switzerland, and the United Kingdom all have Universal Health Plans. America Needs Universal Health Care. This blog post has a timeline of information about the Universal Health Care in the United States of America. It includes studies that show it can work better than our insurance-based system, ideas for implementing it, and how it would help people. May 31, 2017: The Sacramento Bee posted an article titled: “Higher taxes on cars and dining to pay for California health care? Nurses have a proposal”. It was written by Angela Hart. From the article: …A report by economists at the University of Massachusetts Amherst, released Wednesday, found that overall health care spending in California would fall 18 percent under the proposal from state Sent. Ricardo Lara, D-Bell Gardens, and Toni Atkins, D-San Diego.Accounting for savings achieved with their Senate Bill 562, it would cost $331 billion per year to run a universal coverage system in which state government, with taxpayer dollars, pays for medical service and procedures – down from more than $404 billion in spending under today’s system, according to the economic analysis. It was paid for by the California Nurses Association, the bill’s lead sponsor, which also endorsed Lara in his 2018 run for state insurance commissioner.The report proposes a complete overhaul of the state’s current health care system. People would no longer have to purchase insurance through Kaiser or Anthem Blue Cross, for example. Instead, health care payments would be reorganized under a single state-run system funded, in part, by new taxes on consumer purchases like new cars and dining out at restaurants, and business revenue.There would be no insurance premiums. No out-of-pocket costs for prescription drugs. No more deductibles.To make the universal health care proposal work, however, existing state and federal funding that subsidizes health care for low-income people, seniors, and people with disabilities would have to remain in place. That could be a challenge under President Donald Trump and the Republican-controlled Congress. Of the $331 billion needed to run the system, $225 billion would come from state and federal sources, a portion of which is currently spent on MediCal and Medicare.Cost savings would come through reductions in executive salaries and administrative costs for health care billing, as well as unnecessary or inefficient medical services. The state could also negotiate with pharmaceutical companies for lower drug prices and restructure reimbursement rates paid to providers – the current fee structure pays based on the quantity and complexity of medical services provided.Providing universal access to care would also lower costs by allowing people to see the doctor when they need to instead of delaying doctor visits because they can’t pay, the report found……Business groups, including the California Chamber of Commerce, and health insurers like Kaiser oppose the proposal… September 13, 2017: Senator Bernie Sanders introduced S.1804 – Medicare for All Act of 2017 to the Senate. It was read twice and referred to the Committee on Finance. Cosponsors of the bill included: Tammy Baldwin (Democrat – Wisconsin), Richard Blumenthal (D-Connecticut), Cory Booker (D-New Jersey), Al Franken (D-Minnesota), Kirsten Gillibrand (D-New York), Kamala Harris (D-California), Martin Heinrich (D-New Mexico), Mazie Hirono (D-Hawaii), Patrick Leahy (D-Vermont), Ed Markey (D-Massachusetts), Jeff Merkley (D-Oregon), Brian Schatz (D-Hawaii), Jeanne Shaheen (D-New Hampshire), Tom Udall (D-New Mexico), Elizabeth Warren (D-Massachusetts), and Sheldon Whitehouse (D-Rhode Island). The purpose of the bill was to establish a Medicare-for-all national health insurance program. Here are some key points of the bill: Every individual who is a resident of the United States is entitled to benefits for health care services under this Act. No person shall, on the basis of race, color, national origin, age, disability, or sex, including sex stereotyping, gender identity, sexual orientation, and pregnancy and related medical conditions (including termination of pregnancy), be excluded from participation in, or be denied the benefits of, or be subjected to discrimination by any participating provider… or entity conducting, administering, or funding a health program or activity, including contracts of insurance.Covered benefits include: hospital services, including inpatient and outpatient hospital care, including 24-hour-a-day emergency services and inpatient prescription drugs; ambulatory patient services; primary and preventative services, including chronic disease management; prescription drugs, medical devices, biological products, including outpatient prescription drugs, medical devices, and biological products; mental health and substance abuse treatment services, including inpatient care; laboratory and diagnostic services; comprehensive reproductive, maternity, and newborn care; pediatrics; oral health, audiology, and vision services; short-term rehabilitative and habilitation services and devicesNo cost-sharingBy not later than September 1 of each year, beginning with the year prior to the date on which benefits first become available…the Secretary [of Health and Human Services] shall establish a national health budget, which specifies the total expenditures to be made for covered health care services under this Act.An Office of Primary Health Care will be established within the Agency for Healthcare Research and Quality. Its main function is to be the hub that coordinates everything.Medicare for All will be paid for by a Universal Medicare Trust Fund. The money comes from taxes. It also comes from funding for Medicare, Medicaid, the Federal Employees Health Care Benefits program, TRICARE, and the maternal and child health program. All of those would become part of Medicare for All.The bill includes a Transitional Medicare Buy-In Option and Transitional Public Option, and establishes the Medicare Transition Plan. Transitional Medicare Reforms protect against high out-of-pocket expenditures for fee-for-service benefits and elimination of Parts A and B deductibles. July 19, 2018: Representative Pramila Jayapal (Democrat – Washington) posted a press release on her official website titled: “Rep. Jayapal, Rep. Ellison, Rep. Dingell, and Members of Congress Launch Medicare For All Congressional Caucus”. From the press release: …The Medicare for All Congressional Caucus will help build the evidence base for Medicare for All. It will sponsor briefings on topics ranging from the basics of Medicare for All to financing universal health care systems around the world. In development is also a clearinghouse of resources for members of Congress and their staff. Additionally, the caucus will provide an opportunity for members and their staff to interact with partners and providers across the country to gain a practical understanding of how a Medicare for All system would work.Support for Medicare for All is growing, not only among movement-builders, but within Congress. At its launch, an unprecedented 70 members had joined the caucus… July 30, 2018: The Intercept posted an article titled: “Koch-Backed Think Tank Finds “Medicare For All” Would Cut Health Care Spending And Raise Wages. Whoops.”. It was written by Ryan Grum and Zaid Jilani. From the article: A new study from the Mercatus Center at George Mason University is making headlines for projecting that Independent Vermont Sen. Bernie Sanders’s “Medicare for All” bill is estimated to cost $32.6 trillion – a number that’s entirely in line with 2016 projections, and is literally old news. But what the Associated Press headline fails to announce is a much more sanguine update: The report, by Senior Research Strategist Charles Blahous, found that under Sanders’s plan, overall health costs would go down and wages would go up.The study, which came out of the Koch-funded research center, was initially provided to the AP with a cost estimate that exceeded previous ones by an incredible $3 trillion – a massive error that was found and corrected by Sanders’s staff when approached by AP for comment……Blahous’s paper, titled “The Costs of a National Single-Payer Healthcare System,” estimates total national health expenditures. Even though his cost-saving estimates are more conservative than others, he acknowledges that Sanders’s “Medicare for All” plan would yield a $482 billion reduction in health care spending, and over $1.5 trillion in administrative savings, for a total of $2 trillion less in overall health care expenditures between 2022 and 2031, compared to current spending.In order to arrive at his number, Blahous looked at how “Medicare for All” could loser administrative costs and provide savings in areas like drug spending. He concluded that by empowering the secretary of Health and Human Services to negotiate for lower drug prices, Sanders’s plan would add “846 billion in additional savings over the 2022-2031” period. These savings, and others, are offset by certain other costs, like those which come from higher “utilization”, or the increased amount health care services used once everyone is insured.Blahous’s report also acknowledges some substantial benefits to eliminating employer-sponsored insurance. He writes that these changes, “should increase worker wage net of employer-provided health benefits,” while also “relieving individuals, families, and employers of the substantial health expenditures they would experience under current law.” The report even admits that the Sanders bill would serve as a boon to states, freeing them from most Medicaid obligations… You can read the Mercatus Report on its website. July 30, 2018: People’s Policy Project posted an article titled: “Mercatus Study Finds Medicare for All Saves $2 Trillion”. It was written by Matt Bruenig. From the article: The US could insure 30 million more Americans and virtually eliminate out-of-pocket health care expenses while saving $2 trillion in the process, according to a new report about Medicare for All released by the libertarian Mercatus Center……The report’s method are pretty straightforward. Blahous starts with current projections about how much the country will spend on health care between 2022 and 2031. From there, he adds the costs associated with higher utilization of medical services and then subtracts the savings from lower administrative costs, lower reimbursements for medical services, and lower drug prices. After this bit of arithmetic, Blahous finds that health expenditures would be lower for every year during the first decade of implementation. The net change across the whole 10-year period is a savings of $2.054 trillion……But even if you take the report’s headline figures at face value, the picture it pavings is the of an enormous bargain. We get to insure every single person in the country, virtually eliminate cost-sharing, and save everyone from the hell of constantly changing health insurance all while saving money. You would have to be a fool to pass that up. August 5, 2018: The Washington Post posted an article titled: “Tossing aside skepticism, Democratic candidates for governor push for state-based universal health care”. It was written by David Weigel. From the article: Wherever he takes his campaign for governor, Abdul El-Sayed is followed by activists handing out information about “Medicare for all.” When he grabs the microphone, El-Sayed makes a promise: He’ll bring universal health care to Michigan……El-Sayed, who campaigned this weekend with Sen. Bernie Sanders (I-Vt.) before Tuesday’s primary, is one of at least a dozen of Democrats running for governor this year on a pledge to do what no state has ever done: give basic health insurance to everyone, no matter the costs.The single-payer Democrats are on the ballot in red and blue states and from California, where Lt. Gov. Gavin Newsom is the heavy favorite to win in November, to Massachusetts, where Democrat Jay Gonzalez believes the issue will give him an opening against a popular Republican governor……Yet while Democrats running for the House and Senate talk about Medicare for all in aspirational terms, as a post-Trump national goal, liberal candidates for governor suggest that their states could quickly become laboratories for universal coverage. After years of bristling at questions about higher taxes and “government-run health care,” they’re leading with their chins – and the proposals they invite voters to read on their websites……Gov. Jay Inslee (D-Wash.) the chair of the Democratic Governors Association, said that Republicans were losing on the health-care issue and that attacks on single-payer amounted to diversions……In Colorado, where voters soundly defeated a single-payer ballot measure in 2016, Rep. Jared Polis (D-Colo.) has said that states could band together to provide universal health care… August 10, 2018: The Hill posted an article titled: “Fearing ‘blue wave,’ drug, insurance companies build single-payer defense”. It was written by Peter Sullivan. From the article: …The formation of the Partnership for America’s Health Care Future is a sign of the health-care industry’s alarm over growing support for a single payer health-care law within the Democratic Party.Health insurance and drug companies, who are often at odds on policy issues, banded together to form the group, which lobbyists say could run advertisements against single-payer plans and promote studies to undermine the idea.Industry groups are worries that support for single-payer is quickly becoming the default position among Democrats, and they want to push back and strengthen ties to more centrists members of the party to promote alternatives……When Democrats controlled the White House and Congress at the outset of the Obama presidency, they stopped short of a single-payer system in creating ObamaCare, which the Trump administration and GOP-controlled Congress have worked to dismantle.But support for a single-payer system has since gained steam, and a wide range of potential 2020 Democratic political candidates have backed Sen. Bernie Sanders’s (I-VT) “Medicare for all” bill, including Sens. Kamala Harris (Calif.), Cory Booker (N.J.) and Elizabeth Warren (Mass).Sanders himself may make a second run for the White House, and he would be expected to put Medicare for all at the center of his campaign… August 16, 2018: The Week posted an opinion piece titled: “The medical lobby is already peddling lies about Medicare-for-all”. It was written by Ryan Cooper. From the opinion piece: …What’s more, Sanders’ Medicare-for-all program would be immensely superior to virtually all private insurance. The average family premium for an employer-sponsored plan has increased 55 percent since 2007, while average workers contributions have increased 77 percent. Some 81 percent of private plans now have a deductible (which must be paid before insurance kicks in for most care), at an average of $1,505. For primary care, 71 percent have co-pays (a flat fee) and 22 percent have co-insurance (a percentage charge), at $25 and 19 percent respectively. All those cost-sharing trends – and many others for speciality and emergency care, surgeries, and hospital admissions – have been getting steadily worse over time. Insurance networks are also narrowing over time, making it harder to find providers that will accept one’s coverage.By contrast, Sanders’ Medicare-for-all would cover nearly all areas of medical treatment (including vision, dental, and hearing, though not long-term care) with no cost-sharing except for prescription drugs. Even that limited cost-sharing would be limited to $250 per year. And it would certainly be accepted by virtually every provider in the country – with the entire population in the program, they would have little choice (indeed, over 90 percent of primary care physicians already accept existing Medicare due to its large enrollment base of 59 million, and that is only about 18 percent of Americans.) Worries about out-of-network coverage would vanish. Switching onto that plan would be cause for wild celebration for the vast majority of people, not some uncomfortable burden. September 5, 2018: Andrew Yang, tweeted: “I’m running for President on a platform of Universal Basic Income, Medicare for All, and evolution to a human-centered economy. Here’s my speech to 1,000 Democratic Activists in Iowa.” The tweet included a YouTube video of the speech. He has information about his Medicare for All plan on his website. It involves shifting to a new healthcare system where costs will be controlled by setting prices provided for medical services. It also involves paying physicians a salary, instead of a fee-for-service payment (like we have now). The Cleveland Clinic is a good example of how Medicare for All would work. October 10, 2018: The Washington Post posted a Fact-Checker titled: “Fact-checking President Trump’s USA Today op-ed on ‘Medicare-for-All'”. It was written by Glenn Kessler. From the Fact-Check: President Trump wrote an opinion article for USA Today on Oct. 10 regarding proposals to expand Medicare to all Americans – known as Medicare-for-All – in which almost every sentence contained a misleading statement or a falsehood…“Throughout the year, we have seen Democrats across the country uniting around a new legislative proposal that would end Medicare as we know it and take away benefits that seniors have paid for their entire lives”……Sanders says he would first improve Medicare for seniors and the disabled by eliminating deductibles and covering dental, vision, and hearing aids, which are not covered under current law. Then, over the course of four years, the eligibility age would be lowered in stages until every American was covered.On paper at least, the Sanders plan would improve benefits for seniors, not take them away……”I also made a solemn promise to our great seniors to protect Medicare. That is why I am fighting so hard against the Democrats’ plan that would eviscerate Medicare.”…Under Trump, the date for when the Medicare Hospital Insurance (Part A) trust fund will be depleted keeps advancing. The current projection is 2026, three years earlier than the projection a year earlier.Part A is financed mainly through payroll taxes of 1.45 percent on earnings paid by both workers and employers; self-employed people pay 2.9 percent. The money raised is then credited to a pay-as-you-go trust fund, which uses the revenue raised to pay the benefits of Medicare beneficiaries.With the baby-boom generation retiring at a rate of 10,000 people per day, that puts pressure on the long-term financing of the program because fewer workers will be supporting more retirees. If the trust fund is depleted, that means the government would not be able to cover 100 percent of estimated expenses. Yet because of Trump’s tax cut, the budget deficit is soaring even as the economy is booming, in contrast to previous periods of under 4-percent unemployment. That leaves the government less prepared to deal with the consequences of baby-boom retirements.“Democrats have already harmed seniors by slashing Medicare by more than $800 billion over 10 years to pay for Obamacare.” Trump resurrects a misleading Republican talking point from the 2012 election..…”Democrats will seek to slash budgets for seniors’ Medicare, Social Security, and defense.”Trump may have a point about defense spending, never a favorite among the left, but the president’s $1 trillion deficits will put pressure on all aspects of government, no matter who is in power. Democrats generally have pushed to expand Social Security benefits, not cut them… November 30, 2018: Common Dreams posted an article titled: “‘Easy to Pay for Something That Costs Less’: New Study Shows Medicare For All Would Save US $5.1 Trillion Over Ten Years”. It was written by Jake Johnson. From the article: Confronting the question most commonly asked of the growing number of Americans who support replacing America’s uniquely inefficient and immoral for-profit healthcare system with Medicare for All.- “How do we pay for it?” – a new paper released Friday by researchers at the Political Economy Research Institute (PERI) shows that financing a single-payer system would actually be quite simple, given that it would cost significantly less than the status quo.“It’s easy to pay for something that costs less,” Robert Pollin, economics professor at the University of Massachusetts Amherst and lead author of the new analysis, declared during a panel discussion at The Sanders Institute Gathering in Burlington, Vermont, where Pollin unveiled the paper.According to the 200 page analysis of Sen. Bernie Sanders’ (I-Vt.) Medicare for All Act of 2017, the researchers found that “based on 2017 US healthcare expenditure figures, the cumulative savings for the first decade operating under Medicare For All would be $5.1 trillion, equal to 2.1 percent of cumulative GDP, without accounting for broader macroeconomic benefits such as increased productivity, greater income equality, and net job creation through lower operating costs for small- and medium-sized businesses.”The most significant sources of savings from Medicare for All, the researchers found, would come in the areas of pharmaceutical drug costs and administration.. The new analysis by PERI is called “Economic Analysis of Medicare for All.” December 11, 2018: The Guardian posted an opinion piece titled: “Universal healthcare could save America trillions: what’s holding us back?” It was written by Adam Gaffney. From the opinion piece: If you can’t undercut a popular proposal as undesirable, make it sound impossible. That, in any event, has been the tack of opponents of single-payer healthcare, also called improved “Medicare-for-all”……Yet casting Medicare-for-all as an economic impossibility is becoming a Sisyphean pursuit: a slew of studies – including one released just the other week – are confirming that yes, we can afford real universal healthcare in America. But if that’s the case, why haven’t we already achieved it? Well, the real stumbling block is not that single payer advocates’ arithmetic is poor, it’s that American politics are dominated by the rich.Still, the number smatter. On 30 November, a team of economists with the Political Economy Research Institute (Peri) at the University of Amherst published a highly credible, nearly 200-page economic analysis of Senator Bernie Sanders’ single-payer bill. The Peri study received essentially none of the media coverage lathered on the last such analysis – a flawed piece of work published by the conservative Mercatus Center last summer. But here’s the funny thing: though these two analyses came from economists from opposite ends of the political spectrum, they shared a similar finding: single-payer would reduce our nation’s healthcare spending bill by trillions of dollars over a decade (around $2tn and $5tn, respectively)……Going back decades, studies have found that, at worst, these costs and savings will balance out under a Canadian-style single-payer reform. “In Canada, each provincial plan provides for universal insurance coverage with no deductibles or copayments, controls on provider reimbursement, and administration by a single, public payer,” the Unites States General Accounting Office noted in an analysis of a single-payer bill way back in 1992. “We found that if these features were applied in the United States, the administrative savings could offset the added costs.”……There is another benefit of this system, albeit one that helps explain why we haven’t achieved it yet. A more progressive system of healthcare financing can, over time, reduce inequality not only in health, but in wealth, helping to close our nation’s disastrous economic divide. It’s not surprising, then, that billionaires don’t like it much. Nor is it unexpected that the corporate behemoths the have the most to lose are already sharpening their swords, pouring cash into a new anti-single-payer lobbying group that, as the Intercept recently reported, is maneuvering to “influence Democratic party messaging and stymie the momentum toward achieving universal health care coverage.”… The 1992 analysis is titled: “Canadian Health Insurance: Estimating Costs and Savings for the United States“. It is on the U.S. Government Accountability Office (GAO) website. December 16, 2018: USA Today posted an opinion piece titled: “Pig-headed Republicans are pushing America toward government-run national health insurance”. The opinion piece was written by Will Marshall. From the opinion piece: ..Hang on, don’t Republicans stand foursquare against a government takeover of the entire U.S. health care system? So they say. But the GOP’s pig-headed opposition to less drastic ways to make sure everyone has coverage is stimulating Americans’ appetite for a bigger government role in health care – and it will only be fueled by a federal judge’s ruling Friday night that the Affordable Care Act is unconstitutional.In a recent poll commissioned by the Progressive Policy Institute, for example, voters by a margin of 54 to 46 percent, including nearly half of Republicans, favored changing “the current health system so everyone gets health care through Medicare instead of through people’s place of work or instead of buying it directly.” A more general “new government health care program” drew even more support, including 52 percent of Republicans… The poll from the Progressive Policy Institute is titled: “America’s Resilient Center and the Road to 202o Results from a New National Survey“. December 19, 2019: Representative Rosa DeLauro (D-Connecticut) posted a press release titled: “DeLauro, Schakowsky Introduce Medicare for America”. From the press release: Congresswoman Rosa DeLauro (CT-03) and Congressmanwoman Jan Schakowsky (IL-09) today introduced the Medicare for America Act, a new healthcare bill that would ensure universal, high-quality, affordable health coverage by making Medicare accessible to all Americans and expanding the program’s covered benefits and services. The Medicare for America plan includes coverage for prescription drugs, dental, vision, and hearing services, as well as long-term supports and services for seniors and Americans living with disabilities.Medicare for America achieves universal coverage while preserving quality employer-sponsored insurance for those who have it and are satisfied. Americans who are uninsured or do not have employer-sponsored insurance – including those on the individual market – would be auto-enrolled into Medicare for America……One of the largest drivers of healthcare costs in the United States is the cost of prescription drugs. Currently, the United States government is banned from negotiating prescription drug prices under Medicare, which keeps prices artificially high for millions of Americans. Medicare for America will finally remove that ban, and if negotiations fail, the Department of Health and Human Services (HHS) will use the prices paid by the Department of Veterans Affairs (VA) or the average price of these drugs in Organization for Economic Co-operation and Development (OECD) nations….Medicare for America offers a simple, transparent cost structure. Individuals will have a $350 deductible and $3,500 maximum out-of-pocket spending. For households, their deductible will be $500 and $5,000 maximum of out-of-pocket spending. Medicare for America also ensures coverage is affordable for all by capping individual and household premiums at 9.69 percent of their monthly income. Individuals or families making less than 200 percent of the Federal Individual Poverty Level will not pay a premium, have to meet a deductible, or have a maximum out-of-pocket spending. Individuals or families between 200 percent and 600 percent of the Federal Poverty Level will receive subsidies to lower their contribution to the premium….…Currently, there is incredibly limited access to long-term supports in Medicare and private insurance, leaving Medicaid to be the primary payer of these services and supports. With an emphasis on home and community-based settings, Medicare for America establishes and guarantees access to long-term support and services… There is a summary of the Medicare For America Act of 2018: The Medicare for America Act would establish the Medicare for America (MFA) health program to provide universal, comprehensive, and affordable health coverage to all Americans.Who Can Join? Medicare for America achieves universal coverage by enrolling the uninsured, those that purchase their health insurance on the individual market, and those currently on Medicare, Medicaid, and CHIP. Large employers can continue to provide employer-sponsors care, if it is gold-level coverage. Or, they can direct that contribution toward their employee’s MFA premiums. Or, employees will have the option to choose MFA over employer-sponsored coverage.What Does it Cover? Medicare for America improves on Medicare’s and Medicaid’s benefits: covering prescription drugs, dental, vision, and hearing services. And unlike Medicaid, your zip code does not determine your benefits.Medicare for America also comprehensively covers long-term supports and services for Americans living with disabilities and seniors, which Medicare and private insurance do not. And unlike Medicaid, MFA compensates family caregivers, who play a crucial role in resolving America’s long-term care crisis.What Does It Cost Me? Premiums, to be established by the Secretary, will be no more than 9.69% of individuals’ or households’ monthly income. Current Medicare beneficiaries will pay either Medicare’s premium (how it is presently calculated) or MFA’s whichever is cheaper. And, individuals and families between 200 and 600 percent of the Federal Poverty Level will receive subsidies. Those below 200 percent will have no premium (or deductible or out of pocket limit).Deductibles for an individual (including seniors and current Medicare beneficiaries) will be $350; $500 for a family (based on a sliding scale for individuals and families between 200 and 600 percent of the Federal Poverty Level). Maximum out of pocket costs for an individual (including seniors and Medicare beneficiaries) will be $3,500; $5,000 for families (based on a sliding ccale for individuals and families between 200 and 600 percent of the Federal Poverty Level). Premiums will vary by family composition, but no individual or family can pay more than 9.69% of monthly income towards their monthly premium……What Doctors Can I See? Doctors who specialize in current Medicare remain a participating provider under MFA. The Secretary would establish a process for adding more providers not yet participating in Medicare (e.g. pediatric specialties)……What About Skyrocketing Prescription Drug Prices? MFA would end the Big Pharma giveaway banning Medicare from negotiating drug prices. Under MFA, the Secretary would negotiate prescription drugs based on value assessments. If negotiations fail, the Secretary shall use prices paid by the Department of Veterans Affairs or the average price of these drugs in OECD nations. If drug manufacturers refuse to negotiate, MFA will not cover any of their products, with an exceptions process for drugs otherwise unavailable for individuals with chronic conditions. Additionally, MFA bans the use of prior authorization and step therapy in any type of health insurance: public or private….…How is Medicare For America Paid For? Medicare for America will be finances by sunsetting the Republican tax bill, imposing a 5% surtax on adjusted gross income (including on capital gains) above $500,000, and increasing the Medicare payroll tax and the net investment income tax. Medicare for America also increases excise taxes on all tobacco products, beer, wine, liquor, and sugar-sweetened drinks.States will also need to make maintenance of effort payments equal to the amounts they currently spend on Medicaid and CHIP. For states that did not expand Medicaid, these amounts would be inflated by the growth in domestic product (GDP) per person plus 0.7 percentage points. For states that did expand Medicaid, these amounts would be inflated by the growth of GDP per person 0.4 percentage points.After 10 years of payments, they would then increase the growth in GDP per person plus 0.7 percentage points for all states. This structure would ensure that no state spends more than they currently spend, while giving a temporary discount to states that expanded their Medicaid programs.If states refuse to make the maintenance of effort payments, they will no longer be eligible for funding under the Mental Health Services Block Grant program, Social Services Block grant program, the Substance Abuse Prevention and Treatment Block Grant program (Federal Health Centers Program), State Targeted Response to Opioid Crisis Grants, Community Services Block grants, Section 330 grants, and the Ryan White HIV/AIDS grant program. The full text of the Medicare for America health program is here. December 29, 2018: The New York Times posted an article titled “Kamala Harris: Everyone Gets Sick. And We Deserve Better. It was written by Senator Kamala Harris (Democrat – California). From the article: …I’m so grateful my mother hand Medicare and I will fight for it to be guaranteed to all. I was among the first senators to sign on to the Medicare For All bill when it was introduced last year. There should be nothing partisan about wanting a system where health coverage and care are based not on how much money you have or where you live. We need a system with the goal of good outcomes rather than the goal of high profits. It would save countless lives, and according to recent studies, could trim as much as $15 trillion in health care costs over 10 years.I believe that health care should be a right, but the reality is that it is still a privilege in this country. We need to change that. When someone gets sick, there is already so much else to deal with: the physical pain for the patient, the emotional pain for the family. There is often a sense of desperation – of helplessness -a s we grapple with the fear of the unknown. Medical procedures already have risks. Prescription drugs already have side effects. Financial anxiety should not be one of them… January 7, 2019: CNBC posted an article titled: “California Gov. Gavin Newsom rips Trump in his inaugural address, pledges ‘an alternative to the corruption and the incompetence in the White House'”. It was written by Jeff Daniels. From the article: …Newsom campaigned for governor with ambitious plans for everything from single-payer health care and affordable housing to childhood poverty and universal preschool. The promises raised cost concerns from some taxpayer groups even before Newsome took the reins Monday.After taking office Monday, Newsome signed a “first-in-the-nation order to create the largest single purchaser for prescription drugs,” according to a press release issued by his office. He also proposed for his first budget to move the state “closer to health care for all,” including providing coverage to young undocumented immigrants through MediCal… The press release is titled: “Governor Newsom’s Inaugural Address: “A California For All'”. It is on the State of California’s Office of Governor website. January 7, 2019: California Governor Gavin Newsom posted news on his official website titled: “In First Act as Governor, Gavin Newsom Takes on Cost of Prescription Drugs & Fights for Health Care for All” From the news: …In his first act as California’s 40th Governor, Governor Gavin Newsom announced a series of major, first-in-the-nation executive actions and budget proposals to lower prescription drug and health care costs for all California families and move California closer to the goal of health care for all……Today, Governor Newsom signed the first-in-the-nation executive order that creates the nation’s biggest single purchaser system for drugs and will allow all Californians – including private employers – to sit together at the bargaining table across from big drug companies when negotiating drug prices. In his first budget, he will propose expanding financial help that makes it cheaper for families and individuals to buy health coverage and reinforce the Affordable Care Act after recent federal attacks. Governor Newsom’s proposal would also bring the state closer to toward the goal of health care for all by making it the first state in history to expand Medi-Cal coverage to all eligible undocumented adults. He also signed an executive order to establish a California Surgeon General who will be tasked with addressing the root causes of California health challenges and inequalities… Here are some key points from Governor Newsom’s proposals: The negotiation for pricing and purchasing prescription drugs under Medi-Cal will now be conducted by the Department of Health Care Services on behalf of all 13 million Medi-Cal beneficiaries, as opposed to only 2 million currently. The prescription drug executive order directs state agencies to purchase prescription drugs together, as opposed to negotiating with drug companies one-by-one; and charts the path to enable all Californians, including private purchasers, to join forces with public purchasers.Two years ago, California started covering undocumented youth under the state’s Medi-Cal program. Governor Newsom proposes that California take another step toward universal coverage by extending Medi-Cal eligibility to undocumented young adults who otherwise meet the program’s eligibility requirements. California will be the first in the nation to cover undocumented adults through a state Medicaid program.Governor Newsom announced his first budget will reinforce the Affordable Care Act and expand subsides that help individuals and families to afford health care. His budget proposes increasing the size of the subsidies for families who already receive it, and it would make California the first state in the nation to make subsidies available to middle income families.California will be the first in the nation to offer subsidies to individuals and families with income between 400 and 600 percent of the federal poverty level. To pay for the increased financial help, the budget proposes reinstating the individual mandate at the state level.Governor Newsom sent a letter to President Trump and Congressional leaders calling on the federal government to lift limitations that prevent California to develop and enact a single-payer health system to achieve universal coverage, contain costs, and promote quality and affordability. January 7, 2019: California Governor Gavin Newsom sent a letter to President Trump, Speaker of the House Nancy Pelosi, Majority Leader of Mitch McConnell, Minority Leader Charles Schumer, and Minority Leader of the House Kevin McCarthy. From the letter: …Existing law permits only limited, piecemeal innovation – not the comprehensive reform necessary to address the myriad challenges that Californians face when navigating today’s health care system. California families continue to struggle with rising health care costs. For example, this year alone, some families are expected to see an average of 9 percent rise in health care costs, according to Covered California. We have taken action and will do more to make health care more affordable and available for all Californians.However, to address this ongoing cost crisis in health care in the most effective way, we must have the federal tools to support California’s ability to provide quality healthcare for everyone, financed through a single-payer model like Medicare. We must have the tools to innovate and expand on the Affordable Care Act, even as we build toward a more comprehensive, universal system that works for patients, providers, and taxpayer alike.I ask that you amend federal law to enable States to apply for and receive Transformational Cost and Universal Coverage Waivers, empowering California to truly innovate and to begin transformative reforms that provide the path to a single-payer health care system. I am eager to take these challenges head-on and – together with my colleagues in the Legislature and with the benefit of federal policies that more fairly promote innovation, quality and cost-effectiveness – to create an affordable, easy-to-navigate health care system for all Californians….…The federal government has given States the flexibility to make innovative changes in health care through the use of waivers. However, the existing State Innovation Waiver is too limited to effectively design and implement comprehensive solutions. Congressional leaders have recognized this fact, proposing legislation last year to expand States’ waiver authority to promote universal coverage.In this spirit, the federal government should enact new law enabling States to apply for Transformational Cost and Universal Coverage Waivers to re-invest federal funding – combined with State funds – to increase coverage, contain costs, and drive improvements in health care quality. Employing such waivers, States could design and tailor their own solutions, and lay the groundwork for more comprehensive solutions, such as a single payer system. Under this approach, States would be able to apply to: Reallocate funds to best meet the needs of all the State’s population;Use public exchanges as a platform for potable benefits, leveraging funding from both employers and workers;Assure competition by making public plan options available in areas with limited health carriers;Support clear, continuous, and seamless coverage as residents move between individual coverage, employer-based insurance, Medicaid, and Medicare;Use tools such as all-payer pricing to address rising health care costs;Promote improvements to how care is delivered, supporting care coordination and payment systems that reward better quality;Integrate critical public health initiatives into the health care delivery system to address emerging and ongoing threats to health, such as conditions precipitated by climate change; andFinance locally anchored programs that close health disparities and address underlying social determinants of health January 7, 2019: Los Angeles Times posted an article titled: “Gov. Gavin Newsom proposes healthcare mandate, Medi-Cal expansion to more immigrants without legal status”. It was written by Melody Gutierrez. From the article: Gov. Gavin Newsom announced sweeping proposals to tackle the state’s healthcare needs shortly after taking office on Monday, outlining a dramatic Medi-Cal expansion that would cover young immigrant adults who are in the U.S. illegally, require that all consumers in the state carry health insurance and increase subsidies for middle-class families to help those who need it.The Day 1 announcement was as much a rebuke to the Trump administration as it was an attempt by Newsom to make good on his campaign promise to fix a fragmented healthcare system that leaves many priced out or underinsured. The governor also signed executive orders to consolidate the state’s prescription drug purchases into a state-run program and to create a new surgeon general position to look at health disparities before they manifest, as Newsom put it……Newsom campaigned on a universal healthcare platform and has said the issue would be among his top priorities. His announcement on Monday stopped short of the single-payer system demanded by activists that would cover all residents’ healthcare costs, but was characterized as the first step down that path.The new governor sent a letter to Congress and the White House asking for changes to federal laws so that the state can have the regulatory freedom to overhaul California’s healthcare system and move toward single payer……California would be the first state to cover immigrants without legal status who are younger than 26 through Medi-Cal, the state’s health program for people with low incomes. California already covers undocumented children until they turn 19, with Newsom’s plan increasing the age cut-off to mirror that of the Affordable Care Act, which allows young adults to stay on a parent’s health insurance plan until turning 26……A legislative proposal last year pegged the cost of extending Medi-Cal to undocumented immigrants under 26 at $250 million a year. That cost would fall solely to California, despite the mix of federal and state money that typically comprises Medi-Cal funding because the Affordable Care Act prohibits the use of federal dollars for covering immigrants who are in the U.S. illegally… January 7, 2019: Reuters posted an article titled: “New California governor tackles drug prices in first act”. It was written by Sharon Bernstein. From the article: Hours into his new job, California Governor Gavin Newsom signed an executive order on Monday that could dramatically reshape the way prescription drugs are paid for and acquired in the most populous U.S. state……In his executive order, Newsom directed state officials to set up what he said would ultimately be the nation’s largest single-purchaser system for prescription drugs.It directed California’s massive Medicaid system to negotiate prescription drug prices for all of its 13 million recipients, changing their benefits from a managed-care or HMO approach to one that allows the state to handle all purchases.Medicaid is the joint federal-state program that provides health insurance for the low income.The state would create a list of drugs to be purchased in bulk or targeted for price negotiations.The executive order also took the first steps to allow private companies and other governmental agencies to participate in the process of negotiating drug prices with pharmaceutical companies… January 9, 2019: Vox posted an article titled: “Bill de Blasio’s plan to guarantee health care for every New Yorker, explained”. It was written by Dylan Scott. From the article: New York Mayor Bill de Blasio has a plan to bring “universal health care” to America’s biggest city – and, though it’s not quite single payer, the initiative shows that Democratic politicians are getting more creative about what they can do to expand health care in the Trump era.De Blasio rolled out a new plan this week that he says would guarantee that every New Yorker, regardless of their ability to pay, the ability to visit a doctor and get affordable medical treatment in the city’s historic public hospitals system……For most New Yorkers, their insurance won’t change at all; they’ll get it through work, as well as Medicaid, Medicare, or the Affordable Care Act, like they always have. Instead, de Blasio’s wants to invest more money in the city’s safety net – an idea based on a successful predecessor in San Francisco – and it should help the people who don’t have insurance or a regular doctor to get medical care. It’s also a necessary, though limited, fix to a long-running crisis for the city’s public hospital network……Through a program called NYC Care, any uninsured New Yorker is able to visit one of the hospital system’s 70 clinics and see a primary care physician. They will be charged on a sliding scale designed to help keep health care affordable……The program targets the city’s 600,000 uninsured residents; about half of them are undocumented immigrants, the rest are eligible for coverage but they’re not enrolled for one reason or another. The city is providing $100 million every year to help the hospitals cover the cost of treating those people and then launching an outreach campaign to make sure the people know coverage is available to them……Another key component of this will be to boost enrollment for MetroPlus, the city health insurance plan that’s available through Medicare, Medicaid, and the Obamacare exchanges and offers the public hospital system – 70 clinics and 11 hospitals – as the plan’s provider network… January 10, 2019: Jacobin posted an article titled: “Medicare For All Isn’t Too Expensive”. It was written by Jon Walker. From the article: When opponents say Medicare for All is too pricey, they’re really saying they oppose any substantial effort to deliver universal quality care……The “big number problem” is the simple fact that the United States currently spends a lot of money on health care, some of which the CBO [Congressional Budget Office] considered part of the federal budget and the rest of which it treats as private spending. Redirecting or reclassifying that private spending as public spending would technically result in big increase in the federal budget……The CBO doesn’t follow the simple logic of only considering something part of the federal budget if the federal government directly pays for it. Nor does the CBO follow the basic logic of considering private activity part of the federal budget if federal law requires it, like an individual/employer mandate. Instead, the CBO considers health reform an “essentially government program” if it crosses some arbitrary line of regulation……In effect, the CBO believes the government forcing you to pay premiums to insurance companies doesn’t make those premiums a tax. But if the government also mandates that private health insurers meet a basic quality floor for their plans, then it would be……It is important to look at this in an international context. There is simply no industrialized country whose health care system wouldn’t be considered a government program under the CBO’s definition. Even countries that are widely regarded as government-private hybrid systems, or managed private insurance systems – such as Japan, Switzerland, the Netherlands, and Germany – have actuarial value requirements, plan standard rules and/or medical-loss ratio regulations that would cause the CBO to score the entire health insurance market as federal spending……What this means is that copying any of the private systems others point to as alternatives to Medicare for All would produce the same “big number problem” as Medicare for All. The ACA is basically as far as you can go while staying within the CBO’s idea of what is private – and it clearly is insufficient. Even just modest improvements to a few existing regulations in the ACA, such as requiring that a larger percentage of insurance payments go to actual medical care, would cross the CBO’s line and end up being scored as de facto nationalization.Strip away the complexities of budget scoring, and the upshot is clear: anyone who opposes Medicare for All because it will produce a big number from the CBO is effectively saying they are opposed to all significant health insurance reforms. January 16, 2019: The Hill posted an article titled: “Dem chairwoman plans hearing on Medicare for All proposals”. It was written by Peter Sullivan. From the article: The incoming chairwoman of a powerful health care subcommittee on Wednesday said that she intends to hold a hearing on several “Medicare for all” proposals, potentially giving the plans a chance to be considered by key lawmakers.“There are several Medicare for all bills that are out there, but they all have a different interpretation,” Rep. Anna Eshoo (D-Calif.), the new chairwoman of the Energy and Commerce health subcommittee, told reporters. “I think that it would be interesting to have the authors of these bills come to testify and explain what their bill does and have the members ask them questions.”..…Eshoo said a hearing would allow lawmakers a chance to ask questions like whether the Congressional Budget Office has done an analysis, “do you scrap the Affordable Care Act,” and what happens to people’s current insurance coverage……In 2017, Eshoo cosponsored the main Medicare for all bill in the House, which was led by then-Rep. John Conyers (D-Mich.)… January 18, 2019: Los Angeles Times posted an article titled: “Gov. Newsom’s healthcare initiatives will test what a single state can achieve on its own”. It was written by Michael Hiltzik. From the article: …Newsom’s proposals for near-term reforms would be funded entirely with state funds, assuming the Legislature assents. The expansion of Medi-Cal coverage for undocumented young adults would be financed from the general state fund, according to his budget message. The expanded subsidies would be paid for from penalties assessed from residents violating a state individual mandate requiring all Californians to carry health coverage, replacing the federal individual mandate penalty that the Republican Congress and Trump administration reduced to zero as of Jan 1. (State individual mandates are in place in Massachusetts, Vermont, New Jersey, and the District of Columbia.)State funding for these proposals can be a mixed bag. Budget constraints during a recession could prompt the Legislature to reconsider spending priorities. Paying for premium subsidies assessed on health coverage refuseniks makes theoretical sense, since the refusal of younger and healthier individuals to join the insurance poll drives up premiums in the pool. But it places the state in a policy bind, because if the mandate is successful, there will be less money for subsidies.Newsom says he’s confident that the expenditures he’s calling for will be sustainable even in an economic downturn. The funds for more early childhood services and developmental screening under Medi-Cal, as he proposed, would come from the tobacco tax increase enacted as Proposition 56 in 2016.More than $60 minion of the cost of expanding Medi-Cal to undocumented young adults would be covered by savings to county health centers that now have to absorb their treatment costs without reimbursement, Newsom says. And although it’s hoped that the individual mandate penalty will be a declining revenue source, he estimates the at least at first ti will bring in $500 million a year… January 22, 2019: The Seattle Times posted an article titled: “Inslee proposes ‘public option’ health-insurance plan for Washington”. It was written by Joseph O’Sullivan. From the article: Gov. Jay Inslee and Democratic lawmakers Tuesday announced proposed legislation for a new “public option” health-care plan under Washington’s health-insurance exchange.The proposal, which Inslee said is the first step toward universal health care, is geared in part to help stabilize the exchange, which has wrestled with double-digit premium increases and attempts by Republicans in Congress and President Donald Trump to dismantle the Affordable Care Act……Called the Cascade Care legislation, the plan would be offered in every county.The proposal would have the state Health Care Authority contract with at least one health-insurance carrier to offer qualified health coverage on the Washington Health Benefit Exchange, according to a summary of the proposal.The plan would be designed with transparent and consistent deductibles, copays and coinsurance, according to the summary, and would “compete on premium price, provider networks, customer services, and quality.”……Inslee’s proposed 2019-21 state operating budget would provide $500,000 to fund the initial work to set up the public option. After that, lawmakers and officials would have to determine how much ongoing money would be necessary……The legislation also proposes subsidies to help low-income families and individuals afford health insurance. It would require the state to develop a plan that would provide subsidies with the goal of having consumers spend 10 percent or less of their income on premiums.. January 25, 2019: WBUR News posted an audio segment titled: “Warren’s Tax Plan Would Aim At the Ultra-Wealthy” January 29, 2019: HuffPost posted an article titled: “Kamala Harris Backs Medicare For All And She Isn’t Messing Around”. It was written by Jonathan Cohn. From the article: Sen. Elizabeth Warren is pitching a wealth tax as she considers a run for president. She said Thursday night on MSNBC that under the plan, taxes would go up 2 percent for people who have more than $50 million, and 3 percent for people who have more than $1 billion… Two big questions for Democrats who support “Medicare for All” are whether they understand how such a system would actually work – and whether they really support what is arguably its most sweeping and controversial feature.When it comes to Kamala Harris, the answer to both questions appears to be yes.Harris, the Democratic senator from California who is now running for president, said during a CNN forum Monday evening that she believes health care is a right – and that creating a single, government-run insurance program modeled on Medicare is the best way to achieve that……But the Medicare for All Act of 2017, as the legislation is formally called, envisions some dramatic changes to the U.S. health care system – including a prohibition on private insurance, except for coverage of services outside the scope of the new government plan.The new plan would pay for just about every medically necessary service, so that wouldn’t leave much of a role, if any, for private coverage……The new interest in Medicare for All, which has become a top priority for progressive politicians and activists, is a byproduct of several factors – among them, frustration that the Affordable Care Act, which for all of its success at expanding access to care, has left so many Americans still struggling to pay their medical bills.Medicare for All holds out the promise of addressing this problem, and finally reaching the elusive goal of universal coverage, by automatically enrolling everybody in the government plan and then using regulation to set prices for doctors, hospitals and the rest of the health care industry. Typically, such proposals envision people paying for coverage entirely through taxes or income-related premiums, with little or not co-payments, deductibles, and other forms of cost-sharing.Such as system would likely be a lot easier for patients to use, as Harris suggested, and a lot more straightforward for the providers of health care, as well, because they wouldn’t have to worry about billing so many different insurers.. February 3, 2019: Politico posted an article titled: “Buttigieg: ‘Medicare for all’ wouldn’t end private insurance”. It was written by David Beavers. From the article: South Bend Mayor Pete Buttigieg, a declared 2020 presidential candidate, on Sunday said single-payer health care is “the right place for us to head as a country,” while saying a “Medicare for All” program doesn’t necessarily require doing away with private insurance……”If the framework we’re using is Medicare, a lot of people who have Medicare also have Medicare supplements, Medicare Advantage, something like that,” Buttigieg added. “So if we want to make Medicare available to everybody, whether as a public option to buy in or simply establishing that as how the payer structure works in this country that’s going to be the center of gravity.”… February 4, 2019: The Hill posted an article titled: “Medicare for All talk among 2020 Dems is a way to warm Americans to the idea, says pollster”. It was written by Julia Manchester. From the article: Pollster Robert Griffin said on Monday that talk among Democratic candidates about instituting a single payer “Medicare for all” health policy is a way to get American voters used to the idea of implementing it across the United States.“Some of this talk about phasing in over time is really just getting people used to the idea of if we wanted to do this as a country, this is how it might actually work,” Griffin, research director at the Democracy Fund Voter Study Group, told Hill.TV’s Jamal Simmons on “What America’s Thinking”… February 7, 2019: Modern Healthcare posted an article titled: “New Medicare For all draft bill sets a global budget model.” It was written by Susannah Luthi. From the article: A draft version of House Democrats’ upcoming Medicare for All bill proposes a national system that would pre-pay hospitals with lump sums while keeping a fee-for-service model for individual physicians.The 127-page draft, obtained by Modern Healthcare and dated Jan. 14, in many ways tracks with the system laid out in the 2017 bill from Sen. Bernie Sanders (I-Vt.) who brought Medicare for All to the forefront of progressive Democratic policy. But where the Sanders bill sidestepped the question of how the system would be funded by leaving it to the executive branch, the proposal from Rep. Pramila Jayapal (D-Wash.) lays out specific details of a nationalized global budget system.First, the bill would set up regional directors tasked with overseeing all hospitals, healthcare facilities and physicians in specific geographic areas. The HHS secretary would appoint those overseers.The regional directors would then negotiate each year with the facilities to set a lump sun, or global budget, that the government would pay out in advance to all institutional providers, These include hospitals, nursing homes, federally qualified health centers, home health agencies, and independent dialysis facilities……The existing prospective payment system would serve as the baseline rate to jump-start the global budget negotiations.Once the budget it set, hospitals and other institutions would need to stick to it for all outpatient and inpatient treatment. However, this budget would also be set up for review by the regional director four times a year……Some physicians, including those in certain group practices, could opt to receive a salary from a hospital or other provider subject to the global budget.Individual physicians, including those who belong to group practices, and who don’t opt for a salary, would be paid through fee-for-service according to a fee schedule set by the HHS secretary. Like the institutional providers, physicians wouldn’t be allowed to charge their patients anything for their care.The HHS secretary would need to update the fee schedule annually… February 7, 2019: Barron’s posted an article titled: “Understanding Elizabeth Warren’s Wealth Tax”. It was written by Matthew C. Klein. From the article: …Now, Sen. Elizabeth Warren (D.,-Mass.) – who is planning to run for president in 2020 – wants to add a new levy with its own distinct purpose: a yearly 2% tax on household net worth above $50 million, with a 3% rate on net worth above $1 billion.The tax would affect about 75,000 households, with fewer than 1,000 exposed to the 3% rate on net worth above $1 billion. The magnitude of the tax would not be large relative to the typical performance fee charged by managers of hedge funds and other alternative assets, many of whom fail to deliver net results superior to that of investments in index funds. Economists Emmanuel Saez and Gabriel Zucman of the University of California, Berkley, who helped design the Warren proposal, estimate it would confiscate about 1% of the gross domestic product each year. While there is some debate about the constitutionality of a federal wealth tax, there are many scholars who believe it would be legal.The basic argument for the tax is that it addresses an inequality in the existing system: the ultrarich pay lower effective tax rates than many other Americans because their income takes the form of rising asset values. The tax rate on capital gains is much lower than what the typical worker pays on his or her labor income, but those gains are taxed only when assets are sold, so many of the richest people minimize their tax burden even further by borrowing against their wealth.According to Zucman, the proposed tax would raise the total effective burden at the very top of the distribution from 3.2% to 4.3%. This tax obligation would still be lower than the average burden of 7.2% of net worth paid by most other Americans… February 11, 2019: Vox posted an article titled: “John Delaney has a plan for universal health care – but don’t call it “Medicare-for-all”. It was written by Dylan Scott. From the article: John Delaney has been running for president for nearly two years. Most people haven’t heard of him, and so far, he isn’t getting much traction in the polls.But the former Maryland Congress member has cooked up one of the more unique universal health care plans of anybody in the 2020 field. Delaney’s plan sticks out for two reasons: He is a former health care financier, so he brings an unusual amount of expertise to the issue, and while his plan is a path to universal coverage, he is going out of his way not to call it Medicare-for-all.Granted, there are a lot of details Delaney still needs to fill in, but the bones are pretty simple: * Every American under 65 would be enrolled in a new public plan that covers a certain set of medical services, comparable to the essential health services covered by Obamacare.* Employers and individuals could purchase supplemental insurance.* Medicare for people over 65 would be untouched.* The plan would be paid for mostly by maintaining the shared state-federal payments for Medicaid and by ending the unlimited tax break for employer health benefits… John Delaney posted information about his Universal Health Care Plan on his official website. From the information: Delaney’s health care proposal:* Create a new public health care plan for all Americans under the age of 65 while preserving traditional Medicare. The new plan would protect the reforms delivered by the Affordable Care Act, including guaranteed coverage of preexisting conditions and essential health benefits, and would make access truly universal. At 65, people would transition into Medicare. Medicaid would be absorbed by the new plan. The highly trusted Medicare provider network could be used for a new plan.* Guarantee universal coverage. Individuals would be automatically enrolled in the new public plan, with no complicated procedures to follow. People would be allowed to opt-out and receive a tax credit to buy their own insurance policy if they choose.* Keep private insurance options. Individuals and employers will be ablate purchase and negotiate supplemental coverage from private insurers to cover additional health needs. These supplementals could merge into the basic plan to make it easier for the user.* Employers would be encouraged to negotiate group rate supplemental plans that would merge with the basic governmental plan so that employees would be able to keep similar health care plans, many of which are popular and important to American families… Pay-fors (numbers are based on a 10-year projection):* The tax subsidy for employer-sponsored insurance costs the government more than $3.7 trillion and depresses wages for working Americans.* Allowing the government to negotiate drug prices would stop the transfer of wealth from working families to corporate executives and shareholders of pharmaceutical companies. This would save the government nearly $850 billion.* This plan would replace the ACA, and savings from ending the ACA’s tax subsidies would total $760 billion.* Current federal Medicaid spending is projected to be more than $4.8 trillion, which this plan would absorb.* States are projected to contribute more than $2.9 trillion to Medicaid. States would continue to pay their share for the current Medicaid population and the federal government would cover the cost of expanded coverage.* Implement cost sharing for higher-income individuals to fund an increase in reimbursement rates for primary care providers. February 19, 2019: Kaiser Health News posted an article titled: “For 2020 Dem Hopefuls, ‘Medicare-For-All’ Is A Defining Issue, However They Define It”. It was written by Shefali Luthra. From the article: …Isn’t Medicare-for-all what it sounds like? Medicare for everybody? Not quite. But also, kind of.Politicians talking about Medicare-for-All typically mean one of two things. It’s either a specific proposal in which every American is covered by the same, single health plan, or the general idea that anyone has the option together health care through Medicare.The first understanding is outlined in a bill from Sen. Bernie Sanders, (I-Vt.)……Sanders’ bill would outlaw private insurance where it competes with the public plan and change Medicare substantially by eliminating copays and other costs sharing, while expanding the program to cover long-term care, prescription drugs, dental care and vision. (As the bill is written, it’s hard to see what would be left for private plans to cover.)The program would phase in over four years and cover every American. And it’s worth noting that, though many countries run a single-payer system, none offers those “expanded” benefits because the expense could be enormous. Also, many single-payer programs do require a degree of cost sharing, involving small payments or deductibles.In other cases, the “Medicare-for-all” phrase has been repurposed.The midterms saw a wave of Democrats campaigning on it. But beyond the buzzards, what they were actually talking about was lowering Medicare’s eligibility age by giving people the option to buy in or join the program. This would leave the private insurance industry intact. It would also preserve Medicare Advantage, in which the government pays private companies to run Medicare plans……So what other options are Democrats talking about?Voters should get familiar with two other ideas: lowering Medicare’s eligibility age, and the “public option,” either through a Medicare or Medicaid buy-in.These concepts are decidedly not Medicare-for-all – think “Medicare for more” or “Medicaid for more.”Lowering the eligibility age loops more people into the current system and is seen by advocates as a potential step toward single-payer, says Alex Lawson, head of the left-leaning Social Security Works, who has been involved in drafting Medicare-for-all legislation.The public option lets people purchase coverage through Medicare or Medicaid. It has attracted criticism from Democrats aligned with the Sanders wing, who argue it’s settling for less… February 19, 2019: Politifact posted an fact-check titled: “Medicare for All: What it is, what it isn’t”. It was written by Jon Greenberg. From the fact-check: …What is Medicare for All?Sanders’ idea of Medicare for All would be a single, national health insurance program that would cover everyone who lives in the United States. In the bill, he introduced in 2017, it would pay for every medically necessary service, from routine doctor visits to surgery to mental health to prescription drugs. Dental and vision care are part of the package, too. The details on long-term health care might vary between the Senate and House versions, but broadly speaking, nursing home and related care would grow under both proposals.The government would set payment rates for services, drugs and medical equipment. Each year, the secretary of Health and Human Services would determine a national budget for all covered services and spending would be limited by that cap. For individuals, there would be no costs – no deductibles, no copays or coinsurance. The two exceptions would be for some prescription drugs – though that would be limited to $200 a year – and possibly for long-term care.It would replace all other insurance, with limited exceptions, such as cosmetic surgery. Employer-provided insurance, Medicaid and ultimately Medicare would all disappear.Would this proposal simply extend Medicare to everyone? Is it literally Medicare for All?No. Medicare for All is much more generous than the current Medicare program. Right now, the Medicare program is for Americans 65 and older; they receive care, but they’re also responsible for part of the costs. Unlike traditional Medicare, Sanders’ Medicare for All would cover medical bills completely, with no burden on the patient. There would be no Medigap insurance or Medicare Advantage.If Medicare for All sounds a lot like a single-payer health care system – where the government foots the bill for people’s health care – that’s because the two are largely the same. The new name seems intended to make the concept more popular… February 23, 2019: The New York Times posted an article titled: “Health Care and Insurance Industries Mobilize to Kill ‘Medicare for All'” It was written by Robert Pear. From the article: …Doctors, hospitals, drug companies and insurers are intent on strangling Medicare for all before it advances from an aspirational slogan to a legislative agenda item. They have hired a top lieutenant in Hillary Clinton’s 2016 presidential campaign to spearhead the effort. And their tactics will show Democrats what they are up against as the party drifts to the left on health care……The hospital federation and two powerful lobbies, America’s Health Insurance Plans and the Pharmaceutical Research and Manufacturers of America, created a coalition last June to pre-empt what they saw as an alarming groundswell of interest in proposals to expand the federal role in health care.In a daily fusillade of digital advertising, videos, and Twitter posts, the coalition, the Partnership for America’s Health Care Future, says that Medicare for all will require tax increases and give politicians and bureaucrats control of medical decisions now made by doctors and patients – arguments that echo those made to stop Medicare in the 1960’s, Mrs. Clinton’s health plan in 1993 and the Affordable Care Act a decade ago.The coalition will step up the tempo in the coming week as Democrats in the House and Senate plan to introduce bills to establish a single-payer system……The coalition has already picked up more than 25 members, including the American Medical Association, the American Hospital Association and the nation’s Blue Cross and Blue Shield plans……But the coalition does not speak for all health care providers.The American College of Physicians, the largest medical speciality organization in the country, has supported a Medicare buy-in for people 55-64… February 26, 2019: The Guardian posted an article titled: “Medicare for All: House Democrats unveil bill to expand healthcare nationwide”. It was written by Lauren Gambino. From the article: House Democrats have unveiled details of their ambitious plan to expand a popular, government-run healthcare program to all Americans. The measure marks a fresh sign of the party’s growing support for a once fringe idea the will play a defining role in the 2020 presidential campaign.The Medicare for All Act of 2019, to be formally introduced on Wednesday with 107 co-sponsors, would transform the American healthcare system from one in which millions of Americans are uninsured to one that provides universal coverage……The bill would establish a national health insurance program by gradually expanding Medicare – the federal health insurance program for people who are 65 or older – until it covered all Americans……The bill does not include details on how the government would pay for the new healthcare system, which some studies have estimated could cost tens of trillions of dollars over the next decade.[Congresswoman Pramila] Jayapal envisions major savings as a result of reducing administrative costs and inefficiencies in the current healthcare system. To pay for the plan, she suggested proposals such as taxing the rich at higher rates and mandated employer contributions……The plan has no chance of passing the Republican-controlled Senate. But the House speaker, Nancy Pelosi, has promised to allow hearings on the bill for the first time, giving progressives a prominent platform to make the case for a single-payer system……But as momentum grows, so, too, does the opposition. Private health insurers, doctors and hospitals are partnering to oppose single-payer proposals, which could significantly affect their bottom line.The Partnership for America’s Health Care Future has been mobilizing members to ramp up support for improving the Affordable Care Act, also known as Obamacare, as opposed to repealing it, as Republicans attempted to do, or replacing it with a new system……According to a summary of the legislation provided by Jayapal’s staff, the program would cover “primary care, hospital and outpatient services, prescription drugs, dental, vision, audiology, women’s reproductive health services, maternity and newborn care, long-term services and supports, prescription drugs, mental health and substance abuse treatment, laboratory and diagnostic services, ambulatory services, and more.”The transition to a Medicare for All system would happen over the course of two years… February 28, 2019: Congresswoman Pramila Jayapal posted on her official website a news article titled: “Jayapal, Dingell and more than 100 Co-Sponsors Introduce Medicare For All Act of 2019.” From the news article: Today, Representatives Debbie Dingell, Pramila Jayapal, other members of Congress and advocates introduced the Medicare For All Act of 2019. Today’s healthcare system fails to provide quality, affordable healthcare as a right to all people living in the United States, Nearly 30 million Americans are uninsured and at least 40 million more cannot afford the costs of their co-pays and deductibles.The quality of our healthcare is much worse than other industrialized countries – the life expectancy in the U.S. is lower than other nations, while our infant mortality rate is much higher. Yet the U.S. spends more money per capita on healthcare than any other industrialized nation. We waste hundred of billions of dollars every year on unnecessary administrative costs, while healthcare industry executives measure success in profits, instead of patient care.The current healthcare system in the United States is ineffective, inefficient and outrageously expensive. It is time to remove the profit motive in healthcare, to resolve the inefficiencies and to guarantee quality healthcare to every person living in the United States.The Medicare for All Act of 2019 improves and expands the overwhelmingly successful and popular Medicare program, so that every person living in the United States has guaranteed access to healthcare with comprehensive benefits… February 27, 2019: The Medicare for All Act of 2019, also called H.R. 1384, was posted on Congress.Gov. It was posted with very little information. This is typical of newly introduced bills. More information will be added later. The purpose of the H.R. 1384 is: “To establish an improved Medicare for All National health insurance program.” It was sponsored by Representative Pramila Jayapal (Democrat – Washington). The 106 co-sponsors are: Debbie Dingell (D-Michigan)Alma Adams (D-North Carolina)Nanette Barragan (D-California)Karen Bass (D-California)Joyce Beatty (D-Ohio)Donald Beyer (D-Ohio)Earl Blumenaur (D-Oregon)Brendan Boyle (D-Pennsylvania)Anthony Brown (D-Maryland)Andre Carson (D-Indiana)Matt Cartwright (D-Pennsylvania)Judy Chu (D-California)David Cicilline (D-Rhode Island)Katherine Clark (D-Massachusetts)Yvette Clark (D -New York)Wn. Lacy Clay (D- Missouri)Emanuel Cleaver (D-Missouri)Steve Cohen (D-Tennessee)Danny Davis (D-Illinois)Peter DeFazio (D-Oregon)Diana DeGette (D-Colorado)Mark DeSaulnier (D-California)Michael Doyle (D-Pennsylvania)Eliot Engel (D-New York)Veronica Escobar (D-Texas)Adriano Espaillat (D-New York)Lois Frankel (D-Florida)Marcia Fudge (D-Ohio)Tulsi Gabbard (D-Hawaii)Ruben Gallego (D-Arizona)Jesus Garcia (D-Illinois)Jared Golden (D-Maine)Jimmy Gomez (D-California)Vincente Gonzalez (D-Texas)Al Green (D-Texas)Raul Grijalva (D-Arizona)Debra Haaland (D-New Mexico)Josh Harder (D-California)Alcee Hastings (D-Florida)Jahana Hayes (D-Connecticut)Brian Higgins (D-New York)Katie Hill (D-California)Eleanor Holmes Norton (D-DC at Large)Jared Huffman (D-California)Shelia Jackson Lee (D-Texas)Henry C. “Hank” Johnson (D-Georgia)William R. Keating (D-Massachusetts)Robin Kelly (D-Illinois)Joseph P. Kennedy, III (D-Massachusetts)Ro Khanna (D-California)Ann Kirkpatrick (D-Arizona)James R. Langevin (D-Rhode Island)Brenda L. Lawrence (D-Michigan)Barbara Lee (D-California)Mike Levin (D-California)Andy Levin (D-Michigan)John Lewis (D-Georgia)Ted Lieu (D-California)Alan Lowenthal (D-California)Nita Lowey (D-New York)Carolyn B. Maloney (D-New York)James McGovern (D-Massachusetts)Jerry McNerney (D-California)Gregory W. Meeks (D-New York)Grace Meng (D-New York)Jerrold Nadler (D-New York)Grace F. Napolitino (D-California)Joe Neguse (D-Colorado)Alexandria Ocasio-Cortez (D-New York)Ilhan Omar (D-Minnesota)Jimmy Panetta (D-California)Donald M. Payne (D-New Jersey)Ed Perlmutter (D-Colorado)Chellie Pingree (D-Maine)Mark Pocan (D-Wisconsin)Katie Porter (D-California)Ayanna Pressley (D-Massachusetts)Jamie Raskin (D-Maryland)Lucille Roybal-Allard (D-California)Bobby L. Rush (D-Illinois)Tim Ryan (D-Ohio)Gregorio Killi Camacho Sablan (D-Northern Mariana Islands At Large)Linda T. Sanchez (D-California)John Sarbanes (D-Maryland)Janice Schakowsky (D-Illinois)Adam B. Schiff (D-California)Robert C. “Bobby” Scott (D-Virginia)Jose E. Serrano (D-New York)Adam Smith (D-Washington)Jackie Speier (D-California)Eric Swalwell (D-California)Mark Takano (D-California)Mike Thompson (D-California)Dina Titus (D-Nevada)Rashida Tlaib (D-Michigan)Paul Tonko (D-New York)Marc A. Veasey (D-Texas)Nydia M. Velazquez (D-New York)Peter J. Visclosky (D-Indiana)Maxine Waters (D-California)Bonnie Watson Coleman (D-New Jersey)Peter Welch (D-Vermont)Susan Wild (D-Pennsylvania)Frederica S. Wilson (D-Florida) The text of H.R. 1384, “To establish an improved Medicare for All national health insurance program” has been released. Here are some key points: Every individual who is a resident of the United States is entitled to benefits for health care services under this Act. The Secretary shall promulgate a rule that provides criteria for determining eligibility purposes under this Act.Any individual entitled to benefits under this Act may obtain health services from any institution, agency, or individual qualified to participate under this Act.No person shall, on the basis of race, color, national origin, age, disability, marital status, citizenship status, primary language use, genetic conditions, previous or existing medical conditions, religion, or sex, including sex stereotyping, gender identity, sexual orientation, and pregnancy related medical conditions (including termination of pregnancy), be excluded from participation in or be denied the benefits of the program established under this Act… or be subject to any reduction of benefits or other discrimination by any participating provider… or any entity conducting, administering, or funding a health program or activity, including contracts of insurance, pursuant to this Act.The Secretary shall provide a mechanism for the enrollment of individuals eligible for benefits under this Act. The mechanism shall include a process for the automatic enrollment of individuals at the time fo birth in the United States (or upon establishment of residency in the United States).The mechanism shall provide for the enrollment of all individuals who are eligible to be enrolled as of such dates…The mechanism shall include a process for the enrollment of individuals for health care services (under section 102(b)).Benefits shall first be available under this Act for items and services furnished 2 years after the date of the enactment of this Act.For any individual who – has not yet attained the age of 19 as of the date that is 1 year after the date of the enactment of this Act, or who has attained the age of 55 as of the date that is 1 year after the date of the enactment of this Act, benefits shall first be available under this Act for items and services furnished as of such date.Beginning on the effective date described… it shall be unlawful for a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; for an employer to provide benefits for an employee, former employee, or the dependents of an employee or former employee that duplicate the benefits provided under this Act.Nothing in this Act shall be construed as prohibiting the sale of health insurance coverage for any additional benefits not covered by this Act, including additional benefits that an employer may provide to employees or their dependents, or to former employees or their dependents. There is a section that describes the Comprehensive Benefits: Hospital services, including inpatient and outpatient hospital care, including 24-hour-a-day emergency services and inpatient prescription drugsAmbulatory patient servicesPrimary and preventative services, including chronic disease managementPrescription drugs and medical devices, including outpatient prescription drugs, medical devices, and biological productsMental health and substance abuse treatment services, including inpatient careLaboratory and diagnostic servicesComprehensive reproductive, maternity, and newborn carePediatricsOral health, audiology, and vision servicesEmergency services and transportationEarly periodic screening, diagnostic, and treatment services…Necessary transportation to receive health care services for persons with disabilities or low-income individuals (as determined by the Secretary)Long-term care services and support Here are more key points from the Act: The Secretary shall ensure that no cost-sharing, including deductibles, coinsurance, copayments, or similar charges, is imposed on an individual for any benefits provided under this ActThe Act excludes “treatment of experimental items and services and drugs”. There is a section about coverage of long-term care services. Individuals enrolled for benefits under this Act are entitled to the following long-term services and supports and to have payment made by the Secretary to an eligible provider for such services and supports if medically necessary and appropriate and in accordance with the standards established in this Act, for maintenance of health or for care, services diagnosis, treatment, or rehabilitation that is related to a medically determinable condition, whether physical or mental, of health, injury, or age that – Causes a functional limitation in performing one or more activities of daily living orRequires a similar need of assistance in reforming instrumental activities of daily living due to cognitive or other impairment. Long-term supports under this section shall be tailored to an individual’s needs, as determined through assessment and shall be defined by the Secretary to – Include any long-term nursing services for the enrollee, whether provided by an institution or in a home and community-based settingProvide coverage for a broad spectrum of long-term services and supports, including for home and community-based services and other care provided through non-institutional settingsProvide coverage that meets the physical, mental, and social needs of recipients while allowing recipients their maximum possible autonomy and their maximum possible civic, social, and economic participationPrioritize delivery of long-term services and supports through home and community-based services over institutionalizationUnless an individual elects otherwise, ensure that recipients will receive home and community based long-term services and supports … regardless of the individual’s type or level of disability, service need, or ageBe provided with the goal of enabling persons with disabilities to receive services in the least restrictive and most integrated setting appropriate to the individual’s needsBe provides in such a manner that allows persons with disabilities to maintain their independence, self-determination, and dignityProvide long-term services and supports that are of equal quality and equally accessible across geographic regionsEnsure that long-term services and supports provide recipient’s the option of self-direction fo services from either the recipient or care coordinators of the recipient’s choosing This Act sets up the Universal Medicare Trust Fund. If I am understanding this correctly, the money comes from taxes. It also appears to consolidate the funding for the Medicare, Medicaid, Federal Employees Health Benefits program, the TRICARE program and the Maternal and Child Health Program. There is a whole lot more in the Act that I have not described here. I recommend you read it over if you want the full information. March 4, 2019: Seattle Patch posted an article titled: “Jayapal’s Medicare For All Bill Was Born On Seattle’s Streets”. It was written by Neal McNamara. From the article: On a warm, sunny day last August, organizers with the local Democratic Socialists of American (DSA) were leading a panel discussion about Medicare For All in the basement of the Columbia City Library.It was a serious event. One member of the panel, a physician, reminded that “people are going to die” if the U.S. healthcare system continues as it is.But it was also an event that’s part of a long term strategy by Seattle DSA organizers (along with 120 other DSA chapters across the U.S.) to pressure lawmakers into supporting M4A.The movement scored a victory last week when U.S. Rep. Pramila Jayapal, D-Seattle, introduced a comprehensive Medicare-for-all bill in the House. It’s not the first M4A bill, but it is the result of a more recent movement tapping into frustration over private health insurance.On the streets of Seattle, DSA organizers have been door-knocking on M4A since spring 2018……DSA and a host of other progressive groups and labor unions have endorsed Jayapal’s bill. It hits all the points DSA has lobbied for: abolishing private insurance for a single healthcare provider; comprehensive coverage for any condition, including dental and vision; no payment at the point of service; coverage for everyone, including immigrants; and a jobs program for workers transitioning out of