The newest version of 'Trumpcare' may have some alarming implications for the opioid crisis

Donald Trump Paul Ryan

The Congressional Budget Office on Wednesday released an updated analysis of the American Health Care Act, the House GOP healthcare bill, that economists and advocates said contained some alarming takeaways for the future of the fight against the opioid crisis.

While the nonpartisan CBO projected that 23 million more Americans would be uninsured by 2026 under the AHCA compared with projections under the current healthcare system, two other issues are contained within those numbers.

The first: The newly amended AHCA keeps largely in place the more than $800 billion in cuts to federal Medicaid spending over the next decade from the original version of the bill.

It does so by rolling back the Medicaid expansion established under the Affordable Care Act as well as other changes under the law. The CBO estimates that, under the AHCA, approximately 14 million people would come off the Medicaid rolls by 2026.

The second issue, and one not present in the previous version of the AHCA, is the so-called MacArthur Amendment, which would allow states to apply for permission to rescind some of the Affordable Care Act’s regulations if they introduce policies designed to lower insurance premiums.

The CBO found that about one-third of the US population lives in states that would most likely make “moderate changes” to regulations under the MacArthur Amendment and about one-sixth lives in states that would make more extensive changes.

Christine Eibner, a health economist for the Rand Corporation, said that while there was a lot of uncertainty about how states would change regulations, it was reasonable to think state legislators would be under a lot of pressure to cut back on so-called essential health benefits, or certain conditions that insurers are required to cover, if other states are able to show that doing so brings down premiums. If that happens, substance-abuse treatment is viewed as the benefit “most at risk” to be cut, Eibner told Business Insider.

Approximately 1.84 million people in the US are receiving treatment for substance-use disorders or mental illnesses through the Medicaid expansion or the ACA’s individual insurance marketplace, according to research conducted by Richard Frank, a professor of health economics at Harvard Medical School, and Sherry Glied, a dean at New York University. All of those people would be at risk of losing the approximately $5.5 billion paid out for treatment through those two avenues of insurance.

A 2017 Health and Human Services report found that approximately 34% of individual-market insurance plans did not cover substance-abuse treatment before the Affordable Care Act. Under the AHCA, a similar number would most likely either not cover treatment or begin underwriting substance-use disorder as a preexisting condition for thousands of dollars in premium surcharges, making insurance prohibitively expensive, Frank told Business Insider.

Eibner said the individual market wasn’t the only place where treatment coverage would be affected. While she said employer-sponsored insurance would most likely continue to cover treatment, she expected Medicaid programs in states rolling back regulations related to the essential health benefits to cut substance-abuse treatment coverage as well.

Amendments to the AHCA allocate $15 billion over nine years and $8 billion over five years, respectively, to offset some of the costs to consumers if states waive benefits like substance-abuse treatment coverage and coverage for Americans with preexisting conditions. Frank found in his preliminary calculations, however, that those funds would be exhausted many times over in just a few short years just to pay for treatment for opioid-use disorder and serious mental-health conditions, leaving aside the myriad other conditions those funds are supposed to help cover.

BI Graphics_Drug OverdosesGary Mendell, the CEO of Shatterproof, a national nonprofit working to end the opioid crisis, has come out fervently against the bill.

“It’s unbelievable that in the middle of a crisis our legislators would even consider reducing access to insurance for those needing treatment for substance-use disorder,” Mendell told Business Insider.

While Mendell said he had engaged with the Trump administration over its ongoing commission dedicated to tackling the opioid crisis, he said that if the AHCA were signed into law, the administration and Republicans would have “zero credibility” in trying to fix the crisis because of how many people would be likely to lose access to treatment.

An analysis conducted by Eibner and Christopher Whaley, a policy researcher at Rand, found that in places that waive substance-treatment benefits, the out-of-pocket cost for consumers who use those benefits could rise by $1,333 a year. For “high-need” consumers, like those who need an in-patient stay at a treatment facility, out-of-pocket costs could rise to $12,261 a year.

“This assumes people still continue to use treatment,” Eibner said. “Some may not seek it at all if it becomes too expensive.”

Mendell said the AHCA would make substance-abuse treatment prohibitively expensive and, in particular, medication-assisted treatment, or MAT.

Considered by many experts to be the “gold standard” for overcoming opioid addiction, MAT uses prescription medications like buprenorphine or methadone to reduce cravings, allowing patients to work on the underlying issues leading to their substance use without the constant pressure of withdrawal.

Because of its promising results, MAT has gained bipartisan support in statehouses and on Capitol Hill, but it’s expensive and remains difficult to access.

Health and Human Services Secretary Tom Price said in West Virginia earlier this month that MAT amounted to “substituting one opioid for another,” a claim almost universally rejected by scientific, medical, and treatment communities. Mendell went so far as to call Price’s statement a “dangerous comment that perpetuates misinformation.”

SEE ALSO: Trump’s proposed trillion-dollar cuts to Medicaid are a stunning reversal from one of his biggest campaign promises

DON’T MISS: GOP healthcare bill would leave 23 million more uninsured, undermine protections for people with preexisting conditions

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Google had an incredible reason for not giving gender pay data to the government: It's too expensive (GOOG, GOOGL)

Larry Page

Google officials were in federal court on Friday to defend its pay practices, pushing back against government allegations that it underpays its women employees.

But if the tech giant hoped to prove its fairness to the world, it didn’t exactly win many fans with one of its major lines of reasoning.

According to a report by The Guardian’s Sam Levin, Google’s budget-minded lawyers argued in court that the government was being unreasonable in demanding that Google collect and turn over internal compensation data.


The money.

Complying with a request by the US Department of Labor  would be too expensive and too logistically difficult, Google’s lawyers reportedly argued.  The job would apparently require 500 hours of work and cost $100,000.

Note that Google is the world’s No.1 internet search engine, with $92 billion in cash and short-term securities on the balance sheet of its parent company, Alphabet. 

And given that Alphabet made $6.8 billion in profit before taxes in just the first quarter of 2017, according to Google Finance, the DoL attorney at Friday’s court hearing couldn’t resist a snarky response, saying “Google would be able to absorb the cost as easy as a dry kitchen sponge could absorb a single drop of water,” Levin reports.

The US Department of Labor (DoL) has previously accused Google of “systemic compensation disparities.” The DoL has filed a lawsuit to compel Google to turn over its internal compensation data. Because Google is a federal contractor, it is required by law to submit employment data to the government as part of routine compliance procedures to prove it is not violating equal employment laws, the DoL says.

Occupational segregation

Google has consistently denied the accusations that it underpays women and it even tweeted in April that it “closed the gender pay gap globally” meaning it pays women and men equally for equal work worldwide, it says.

Its HR site also released a guide that instructs others how they can do the same, including the step called “run a pay analysis.” Presumably, this means that Google already has loads of salary data in a form that allows it to be analyzed, at least internally.

After the suit went public, job hunting site Glassdoor released its own analysis of Google’s pay based on the self-reported salaries submitted by employees. For what it’s worth, Glassdoor sided with Google, finding no evidence that Google underpays for equal work.

However, Glassdoor also found that women overall at Google are still paid 16% less than the men. That’s because, of the women who work at Google, fewer of them have roles within the highest paying jobs at Google. It’s a situation called “occupational segregation,” and it’s a common reason why women earn less than men across the economy, not just at Google, Glassdoor’s Chief Economist, Dr. Andrew Chamberlain told Business Insider.

In any case, folks on Twitter are not buying the argument that Google can’t afford to dig up the salary data that the government is requesting.



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Here's how Trump's salary compares to other leaders in countries with the biggest economies

Being a world leader isn’t merely about having a powerful military arsenal at your disposal or inspiring a generation of youth to become productive members of society.

It’s also about the delicate balancing act between progressing one’s country and defending the fundamental principles of its social or moral code — and with so much responsibility, you can be sure to expect a democratically elected president or even a monarch to be amply compensated for their services.

Of course, the buck doesn’t stop there: After the end of one’s term, there’s always the lucrative speaking engagement circuit or book deal they could sign on to — Hillary and Bill Clinton reportedly earned over $10 million from mostly speaking fees and royalties in 2015.

Regardless, the base pay for our world leaders isn’t something to be scoffed at.

Here are the paychecks for presidents and prime ministers in the world’s biggest economies:

Trump's salary comparison_update

SEE ALSO: It’s costing a fortune to protect the Trump family

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2 people stabbed to death after confronting a man shouting 'hate speech' at Muslim women on train

Screen Shot 2017 05 26 at 8.25.41 PM

Two people were stabbed to death on a light-rail train in Portland, Oregon, on Friday afternoon, after trying to confront a man who was verbally abusing two Muslim women, according to police officials cited in The Oregonian.

One individual died at the scene and the other died at the hospital, the newspaper said.

The suspect was reportedly shouting “hate speech or biased language,” and focused on the Muslim women — one of whom was wearing a hijab, said Portland Police spokesman Sgt. Pete Simpson.

As passengers attempted to intervene, the suspect turned his attention toward them. A third passenger was also stabbed, but suffered no life-threatening wounds, according to Portland police officials.

“In the midst of his ranting and raving, some people approached him and appeared to try to intervene with his behavior and some of the people that he was yelling at,” Simpson said, according to The Oregonian. “They were attacked viciously.”

The suspect was was later taken into custody as he fled into a downtown neighborhood in Northeast Portland.

“These were folks just riding the train and unfortunately got caught up in this,” Simpson said.

SEE ALSO: Police officer stabbed and many wounded in apparent terror attack near UK Parliament

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Sears is in 'free-fall' and its rate of decline is 'very concerning' (SHLD)

Sears Pembroke Mall

Sears’ shares enjoyed a strong surge this week, soaring as much as 20% on Thursday after the company reported its first net profit in two years. 

But traders’ cheer quickly wore off and shares dipped again, as the grim reality behind the initially rosy headlines set in: Sears’ operational decline is in fact accelerating, and its odds of survival beyond 2017 remain uncertain, according to Evercore ISI analyst Greg Melich.

A closer look at Sears’ earnings show that the company’s sale of its Craftsman brand in March is responsible for its net income of $244 million in the first quarter. Excluding the sale, Sears’ losses deepened to $230 million from $199 million the prior year.

“Operating losses… show no sign of improvement” and “sales remain in a state of free-fall decline,” Melich wrote in a research note. 

Sears’ sales overall tumbled more than 20% to $4.3 billion in the first quarter, which the company blamed on store closures and declining sales at its stores open at least a year. Same-store sales plunged 12.4% at Sears stores and 11.2% at Kmart stores. 

SearsSears says it is “fighting like hell” to turn business around and has promised to cut costs by $1.25 billion. The company has announced more than 180 store closures so far this year and recently told investors that it has bids for $700 million in real estate sales, which would provide much-needed cash to help keep it afloat.

Assuming those sales occur and Sears can achieves success with its cost-cutting plan, “it should have sufficient liquidity to make it through holiday, although the cash burn and rate of sales decline are very concerning,” Melich wrote. 

But the company is still a very sick patient with little evidence of any sustainable forms of cash flow going forward, according to his note. 

“Improving the cash burn rate is imperative as the company shrinks, and Sears remain very far from sustainable levels of loss that does not require external liquidity,” Melich wrote. “Given the very weak store base, continued comp declines, anemic sales productivity, and continued share loss in most major categories, Sears does not appear well positioned for the rest of 2017.”

Moody’s vice president and senior analyst Christina Boni last month delivered a similar assessment on Sears’ survival, saying the real estate sales will help the company survive a little longer, but at the same time diminishes the company’s lifeline as it struggles turn business around.

“Sears’ financial performance remains extremely weak,” Boni said. “Its effort to sell real estate which has produced over $700 million of bids currently will enhance liquidity, but accelerates the timeline required to stem operating losses as it asset base diminishes.” 

Sears CEO Eddie Lampert addressed bankruptcy concerns recently and said the company has “as much time as our vendors and our lenders and our shareholders are willing to give us.”

“The reality needs to be better than it is for us to really demonstrate to people that the transition is starting to take hold,” he said in an interview with the Chicago Tribune.

SEE ALSO: This is what Sears stores could look like in the future

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Going Against the Conventional Wisdom

No I in Team Business Cartoon

I hate hate hate the old “there’s no ‘I’ in team” adage. It’s not that I’m not a team player. It’s just that the phrase went from lame to tired to trite to maddening and back to lame, and it just will not go away!

Anyway, one day my wife came home from work talking about a team-building exercise they’d done in a meeting and this idea popped into my head.

It’s not like you can get revenge on an idiom, but I’d like to think that if it was possible, this cartoon might help.

This article, “Going Against the Conventional Wisdom” was first published on Small Business Trends

Snapchat maker, Snap, acquired a tiny drone company as its pushes further into hardware (SNAP)


Snap spent less than $1 million to acquire a tiny drone startup in Venice, according to a new report from BuzzFeed

It’s not the first time the company has flirted with acquiring a drone startup, but the deal to acquire Ctrl Me Robotics means the company is furthering its push into hardware.

As part of the deal, Snap brought on Ctrl Me Robotics founder, Simon Saito Nielsen, and acquired some of its assets and equipment, according to Buzzfeed’s report.

The drone company was already winding down when the founder approached Snap about the possible acquisition, per the report. The company’s website no longer works, and its social media pages stopped posting in October, likely around the time of the acquisition. Snap declined to comment. 

Snap’s already been rumored to be working on a drone or other types of hardware following the launch of its smart sunglasses, Spectacles.

While Snap’s smart sunglasses might not be ubiquitous, it’s turned into a million-dollar “modest” business for the self-described camera company. 

During its earnings call, Snap said that it had brought in $8 million from the sale of Spectacles and that it is continuing to explore new technologies.

“It’s been really exciting to see people capture memories from their perspective,” CEO Evan Spiegel said at the time. 

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Sergey Brin's secret blimp will be a luxury 'air yacht' and be used to deliver humanitarian aid, report says

Sergey Brin

More details are leaking about Google co-founder Sergey Brin’s secret quest to build a giant airship.

Bloomberg broke the news last month that Brin was working on a secret blimp project at Moffett Field. Business Insider subsequently reported that Brin’s company was called LTA Research & Exploration and that it has been leasing space from Google parent company Alphabet. 

Now anonymous sources tell The Guardian that the ship is being personally funded by Brin at an estimated cost of over $100 million. The blimp is expected to be massive in both scale and grandeur — something like 200 meters long. That’s not as big as the famously unfortunate Hindenburg, which was 245 meters. But some say it would be among the biggest aircraft flying the skies today, and possibly the biggest.

These sources expect that Brin plans to use it to bring humanitarian food and supplies to the far corners of the world. And they also expect him to use it as luxurious “air yacht” for the billionaire and his family and friends to enjoy, according to the report.

Brin declined common on the original Bloomberg story, nor did he comment on the Guardian story and Alphabet declined comment to Business Insider as well.

raytheon jlens blimp securityBrin is said to be fascinated with air travel. The unit he oversees at Google’s parent company Alphabet is working on all kinds of aircraft, including balloon type crafts. Brin is the executive champion of the unit formerly called Google X, now calling itself simply X.

Earlier this week, the unit gave updates on several of its projects including Project Loon, which delivers internet connectivity to remote regions using balloons. Loon is being used by tens of thousands of people in flood-affected zones in Peru, X says. That’s the first time that balloon-powered internet has been used to connect so many people.

X also has a project called Makani that’s trying to generate electricity from an energy kite. Earlier this month, it had a successful prototype test of the kite, which X says is the largest ever of its kind at 600 kilowatts. 

And then there’s Project Wing, the unit’s drone delivery project. Although we’ve reported on this project’s troubles and set-backs, it was also called out as a project to watch by Alphabet CEO Larry Page in his annual letter to shareholders in April.

As we previously reported, Brin is actively involved at X and even has his own desk installed in some of the projects, like Wing. So, when it comes to objects that fly, Brin just can’t seem to get enough.

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SEE ALSO: Despite setbacks and job cuts, Google is promising a big update in its race against Amazon’s delivery drones

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What Small Businesses Should Know About Neural Machine Translation

What Small Businesses Should Know About Neural Machine Translation

Among the list of technologies that have radically changed our economy in the last year is a handful that did not receive the same level of attention as artificial intelligence or self-driving cars. One, in particular, is called Neural Machine Translation (NMT), a major breakthrough in language technology that some believe is a turning point in how business gets done.

The Internet and the connectivity it facilitates is primarily responsible for what we now call the global economy. Emails, web pages, and mobile applications have created a marketplace for ideas and products, as well as empowered organizations to collaborate instantly from thousands of miles away. But for as small as the world is today, it can get smaller, and language is a major part of that.

What is Neural Machine Translation Used For?

NMT, a deep learning technology, appears to have achieved a breakthrough in fluency that will have far ranging impacts throughout the business world. “Linguistic technology that works at fluent or near-fluent levels would be enormously impactful for business of all sizes,” says Denish Gachot, CEO of Systran Group, a leading company in the language tech industry. “Language barriers are still regularly identified as one of the primary obstacles to getting deals done, to reaching new markets, and impeding the efficiency of business operations.”

If you are not already familiar with NMT, here are three things you need to know.

It Is Powerful

The last few years have seen huge leaps in machine translation abilities. Most anyone who has used the Internet has interfaced with a translation tool at some point – be it on Facebook or the Google translation feature – and likely experienced extreme disappointment. What makes NMT different from its predecessors is its soft-alignment, or its ability to translate entire sentences based on context and language patterns, rather than just going word by word.

Systran’s version of NMT, known as Pure Neural Machine Translation (PNMT), was one of the first to reach the market. It is currently capable of translating between more than 100 different languages. And because of the almost human intuition of soft-alignment processing, this open-network frame allows the system to provide more reliable, accurate translations than have ever been available before.

Small businesses can benefit from this technology in a number of ways. Addressing client concerns, marketing to a new area, or answering questions from foreign investors? Any written communication, particularly of a technical nature, can be translated by NMT quickly, accurately, and into multiple target languages.

It Is Improving

Machine learning technology is not new, but it is finding new ways to make an impact. When we hear about machine learning, we think applications like facial recognition or self-driving cars. In a surprisingly short period of time, these programs have learned how to distinguish minute human facial features and navigate traffic with minimal human training. Instead of painstakingly programming every piece of information, the machine is taught how to learn and then set loose on a quest to become an expert.

“Neural Machine Translation…considers the entire input sentence as a unit—like you would comprehend a whole image rather than its individual pixels—taking into account the nuances of speech and meaning,” writes Stephanie Mlot for PC Magazine.

Translations are not made one word or phrase at a time. NMT can look at the body of work being translated as a whole. Interestingly, this is not done by comparing the text to a large data set of other translations, but rather is “understood” in a neural sense. The developers of this technology are not even entirely certain what mathematical calculations are being made inside the “mind” of the translation machine.

Pair that neural capacity with its deep learning function and the technology can become highly adept at industry-specific translation requirements, no matter how technical. That can help small businesses that would like to work internationally but cannot afford a team of translators.

It Is Accessible

All of this is important for small businesses because it is available technology. Emerging technology trends like this are not meant to be kept in the hands of large corporations. They are intended to trickle down, improving all the way, until they are wielded by none other than the every-day companies that make the world go round.

“The applications for this technology are not limited to the governments, law firms and international corporations that already operate all over the globe,” says Gachot. “Small businesses can just as easily leverage NMT for any number of applications. It will even become available to small freelancers who use online marketplaces to share their goods and services as those markets integrate the technology into their platforms.”

Translating documents and business communication, even simple ones like advertisements or product descriptions is a costly process that requires time and manpower, which is why many companies are limited in what they can do internationally. NMT changes that.

For small businesses, the world just got a little smaller.

Brain Photo via Shutterstock

This article, “What Small Businesses Should Know About Neural Machine Translation” was first published on Small Business Trends

How to Manage the Scarcity of Time, Talent, Energy for Success

How to Manage the Scarcity of Time, Talent, Energy for SuccessTime, Talent, Energy: Overcome Organizational Drag and Unleash Your Team’s Productive Power addresses how successful companies like Netflix, Google, Apple, and other powerful brands are able to maintain their success in a world where competition is brutally fierce and customer loyalty is fleeting.

The book argues that the continued success of these companies doesn’t depend on their capital as many would assume. It depends on how they manage scarcity, particularly three scarce resources: time, talent and energy. Any business that can leverage these three resources, the book says, will have a massive competitive advantage over every other business in its industry.

What is Time, Talent, Energy About?

In Time, Talent, Energy, the key to becoming a profitable and successful company isn’t getting more money so you can invest in more resources. (In fact, the authors argue that the business world has an overabundance of capital!) Money helps, but it isn’t the only factor. It’s how you use the resources a business already has — time, energy and talent. This is what distinguishes an excellent company from an average one. Companies able to attract the right talent, cultivate that talent and direct its energy will create a decisive competitive advantage that builds each year rather than declines.

The book contends that businesses, in their quest to grow, sabotage their efforts with red tape, complexity, ineffective leadership and a lack of engagement with their workforce. Businesses don’t do this on purpose, but it happens. As businesses start to mature, culture develops and policies develop. More meetings are scheduled and more departments are created. Decisions take longer to get approved as more layers of management get involved. Leadership focuses on maintaining the status quo instead of developing and cultivating talent. Slowly, the once successful company becomes a fossilized version of its own success.

Time, Talent, Energy suggests it doesn’t have to happen this way. Businesses, especially mature ones, can adopt the book’s strategies to cultivate an efficient, loyal and engaged workforce. Once a business takes the steps to create that workforce, those employees begin creating a cycle of success on their own. In attracting and retaining good talent, a business becomes more productive. In becoming more productive, it can afford to hire even greater talent for even better results.

Author Michael Mankins is a strategy expert, speaker, regular contributor to Harvard Business Review and partner at management consulting firm Bain & Company (San Francisco office). He is also a board member of the Children’s Creativity Museum and the National Association of Urban Debate Leagues.

Co-author Eric Garton is also a partner of Bain & Company (Chicago office), a frequent contributor to Forbes, an expert in organizational transformation and part of the leadership team that develops best practices for consumer and industrial goods.

What Was Best About Time, Talent, Energy?

The best part of Time, Talent, Energy is the book’s core message and the recommendations that build on that core message. The book argues that every company can improve its productivity by paying attention to just three resources: time, talent, and energy. In a cash-strapped world still reeling from a recession, this is empowering news. Every business has the same amount of time. Time, Talent, Energy shows how to optimize that time so you can leverage the talent and energy every business possesses to reach a higher level of performance.

What Could Have Been Done Differently?

One area of Time, Talent, Energy that could use more attention is the spotlight on small and medium-sized businesses (referred to as “everyday businesses” in the book.) While the book promises to demonstrate how an “everyday business” can utilize the strategies of Time, Talent, Energy, it doesn’t develop that promise into a fully fleshed-out example. More attention here (specifically a case study or case studies with a small business that utilized the book’s examples) might help small or medium-sized business owners who aren’t sure if the book’s strategies can be implemented on a smaller scale for big results.

Why Read Time, Talent, Energy?

Time, Talent, and Energy is a very important book because it redirects the conversation about internal growth with specific, actionable recommendations on how to optimize it in simple ways. Many business advice books focus on the paradox of success experienced by companies like Kodak and Blockbuster. As companies grow, they tend to reinforce their internal growth. That reinforcement includes policies, aspects of culture, assumptions and leadership styles that can become so ingrained in a business that it gets in the way of future growth. In other words, these businesses get so successful that they lose the qualities that make them so successful over the long run. Time, Talent, Energy was written to remedy that. By regularly focusing on the three scarce resources involved with growth, it is hoped, business owners can prevent their businesses from falling into the paradox of success.

This article, “How to Manage the Scarcity of Time, Talent, Energy for Success” was first published on Small Business Trends


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