health and wellness mod 7

Medicaid is a

similar program for low income households

in 2012

the US on average spent 48,745 per person on healthcare. other rich countries like Switzerland and Norway spend a little over $6,00 and countries like Germany, France, the UK, and japan spent in the 3-5,000 range

insurance premium

the amount you pay to the insurance company each month so that you can keep your coverage

experience rating

used in the us -where different groups that have higher or lower risks pay difference prices

columbia university's state of the planet

"(The process of producing plastics) emit pollutants such as nitrogen oxides, sulfur dioxide and particulate matter, as well as benzene, which is carcinogenic, and volatile organic compounds that can react with sunlight to form ground-level ozone ... (The agency) warns that the greenhouse gas emissions from plastic jeopardize our ability to keep the global temperature rise below 1.5˚C. If plastic production stays on its current trajectory, by 2030, greenhouse gas emissions from plastic could reach 1.34 billion tons per year (Links to an external site.), equivalent to the emissions produced by 300 new 500MW coal-fired power plants. This is because more than 99 percent of plastics are made from fossil fuels, both natural gas and crude oil—and because plastic results in greenhouse gas emissions at every stage of its lifecycle."

ocean acidification

rise of acidity in the ocean's chemistry as a direct effect from carbon dioxide in the atmosphere reacting to salt water

uk has a _____ healthcare system

socialized

Medicare is a

taxpayer funded public insurer that pays providers to care for seniors

private and public sectors

supply insurance and care to most Americans -in the private sectors, 56% of patients pay for their health care with insurance that they get primarily from their employer

Benefits of Recylcing

-Reduces the amount of waste sent to landfills and incinerators -Conserves natural resources such as timber, water and minerals -Increases economic security by tapping a domestic source of materials -Prevents pollution by reducing the need to collect new raw materials -Saves energy -Supports American manufacturing and conserves valuable resources -Helps create jobs in the recycling and manufacturing industries in the United States

access

entry into, or use of, the health care system

recycling is a complicated system dictated by

market demand, price determinations, local regulations, the success of which is contingent upon everyone, from the product-designer, to the trash-thrower, to the waste collector, to the recycling factory worker. We consumers play a much more critical role than we might imagine-- depending on how we use our products and in what shape we throw them away, determines their value and quality post-use....

when if ever, should the government get involved to help

markets achieve the most effective, efficient, and far outcome?

third party payer system

medical costs are paid through a third party (commercial insurance company)

environmental justice explained

parts that are whiter and wealthier tend to have green spaces, grocery stores with nutritious organic food, the money to buy it - often far away from pollution emitting freeways poorer and more diverse -tend to have industrial sites, heavy duty diesel polluted ports, highways, and hazardous waste -every thing the city relys on but that heavily pollute the air and water -this segreation can be traced back to race based zoning and housing policies -poor land planning -plant more trees to suck up more carbon -start a cap and trade program -benefits the communities that are already doing fine -communities still hurting from pollution are still hurting -race, ethnicity, or wealth and income brackets cause them to experience wildly different quality of air, water, and life -can experience different deaths

deductible

portion of the health care costs that you're responsible for yourself before your insurance kicks in

health care is split into different sectors

private public voluntary sectors

2 not all plastic is created equal

-#1 (PET), ex: water bottles — highest recycling value; keep out of the sun to prevent toxins leaking into the container (no bueno for your health). -#7 (OTHER) is the catch-all category. It includes non-recyclables and corn-based plastics (PLA). (As a consumer, you can't tell the difference.) 1. HEALTH EFFECTS: plastic has been linked to disrupting hormonal growth and carcinogens. While its use is also associated with public hygiene and preventing bacteria contamination (many Taiwanese, for example, use plastic straws to drink everything from beer to milk out of fear of a contaminated supply chain), consumers should be wary of chemicals leaching into food or drink products. According to the Science History Institute, "[c]urrent health concerns focus on additives (such as bisphenol A [BPA] and a class of chemicals called phthalates) that go into plastics during the manufacturing process, making them more flexible, durable, and transparent." Most experts agree that you should stay away from #3 PVC (often found in pipes) and #6 PS (Styrofoam, often used as food/drink containers). 2. HOW IT'S MADE: Did you know that most plastics originate from crude oil? Only plastics labeled PLA are made from the sugars in corn or other plant-starches like cassava. 3. RECYCLABILITY: Oftentimes we just throw things away into the recycling bin with the full faith that they will be recycled just because the label says its recyclable. But that's not always the case. Moreover, there are 2 types of plastics: thermoset vs. thermoplastics. Thermoplastics are plastics that can be re-melted and re-molded into new products, and therefore, recycled. However, thermoset plastics "contain polymers that cross-link to form an irreversible chemical bond," meaning that no matter how much heat you apply, they cannot be remelted into new material and hence, non-recyclable.

example for a broken leg

-$7,500 for x ray, cast, physical therapy paying each month

3 coffee cups can't actually be recycled

-Because there are two different materials, the cups cannot be recycled unless the materials are separated, which is impossible to do by hand and requires a special machine. -That's why the easiest items to recycle are the products made from a single material. Water bottles (100% PET plastic) are a prime example of this. -Coffee cups are similar to the packaging enclosing snacks like health bars. Both are multi-layered, with each layer serving a particular purpose, e.g. wax layer for the label, or the aluminum layer to prevent external heat from altering the chemical composition of the item before you purchase it. -This kind of design, however, makes recycling the product super difficult, especially since the layers are often very thin and stacked tightly on top of one another. It's just not cost-effective and far too time-consuming for a recycling factory to separate and recycle each piece.

ideas on how to reduce and reuse

-Buy used. You can find everything from clothes to building materials at specialized reuse centers and consignment shops. Often, used items are less expensive and just as good as new. -Look for products that use less packaging. When manufacturers make their products with less packaging, they use less raw material. This reduces waste and costs. These extra savings can be passed along to the consumer. Buying in bulk, for example, can reduce packaging and save money. -Buy reusable over disposable items. Look for items that can be reused; the little things can add up. For example, you can bring your own silverware and cup to work, rather than using disposable items. -Maintain and repair products, like clothing, tires and appliances, so that they won't have to be thrown out and replaced as frequently. -Borrow, rent or share items that are used infrequently, like party decorations, tools or furniture.

how people are fighting for change

-Curbside recycling "was started with a really good intention; I used to feel so proud," said Wenzlau. Now, after learning of the effects the nation's exports are having overseas, he said, "my heart aches, because the system is doing harm". -Even in San Francisco, long hailed for the high percentage of waste it is able to recycle, the head of the city's waste disposal provider has said that the system is failing. -"The simple fact is, there is just too much plastic - and too many different types of plastics - being produced; and there exist few, if any, viable end markets for the material," Michael J Sangiacomo of Recology recently wrote in an op-ed. -america generates 34.5 tons of plastic waste each year, enough to fill the houston astrodome 1,000 times -The impact of the shift in plastic trade to south-east Asian countries has been staggering - contaminated water supplies, crop death, respiratory illness from exposure to burning plastic, and the rise of organized crime abound in areas most exposed to the flood of new imports," the report found. -In the first 10 months of 2018, the US exported 192,000 metric tons of plastic waste to Malaysia for recycling. Some of the factories had licenses to process foreign waste. Some only had licenses to deal with Malaysian plastic waste but secretly processed foreign waste. Often, such "processing" actually meant illegally burning plastic, with the toxic fumes inhaled by Malaysians living near unlicensed factories and dump sites. -On the outskirts of Jenjarom, a town in the district of Kuala Langat, where local authorities shut down 34 illegal factories last July, a land manager struggled to get rid of 10ft-high piles of plastic left under a corrugated roof by illegal importers of foreign waste. Nearby, a huge field of foreign plastic had been abandoned by the former renters: Chinese illegal factory owners, who left without warning following the crackdown.

5 recycling plastic downgrades its quality

-First, it's important to know that plastics are simply polymers, long chains of atoms "arranged in repeating units often much longer than those found in nature." -According to the Science History Institute, the "length of these chains, and the patterns in which they are arranged, are what make polymers strong, lightweight, and flexible. In other words, it's what makes them so plastic." =every time plastic is recycled, the polymer chain grows shorter, so its quality decreases -The same piece of plastic can only be recycled about 2-3 times before its quality decreases to the point where it can no longer be used. -Additionally, each time plastic is recycled, additional virgin material is added to help "upgrade" its quality, so that the recycled product has a fighting chance in the market against new, durable and fresh goods. So when you read the label "recycled material," think twice about what the word "recycled" actually means in that context.

4 you can't recycle dirty plastic

-Got a little pizza sauce and cheesy goodness left on that pizza box? Now it can't be recycled (you can still compost it though!). -Any plastic material with food residues on (or in) it CANNOT be recycled. In order for plastics to be transformed into recycled goods, they must be of decent quality. So what to do? =WASH FIRST, THEN RECYCLE.WASH YOUR PLASTICS AFTER EVERY USE, SO THEY HAVE THE CHANCE TO BE RECYCLED INTO NEW MATERIAL. -Remember, recycled materials (i.e. your trash) must compete with virgin materials in the market, so quality matters. -In Taiwan, there are several groups of people who sort trash, remove food remnants from bento boxes, and then send the containers to the recycling factories (since the outside material is generally paper). -Some recycling factories then take these goods and wash them multiple times before they are cut, reheated and transformed. -But most of the time, a "dirty" recyclable thrown into a public trash/recycling bin doesn't even have the chance to end up at the recycling factory; it's determined useless (meaning either too troublesome, to clean, or not capable of generating income from) and lumped with all the other trash that ends up in landfill or the incinerator. = rinse out and wash your plastics before you recycle them. clear all food residuals to guarantee they have a shot of making it to the recycling factor

how plastic waste fuels a global business

-Plastic's first stop on its months-long journey is a recycling facility where it is sorted into bales based on its type - soda bottles, milk jugs and clamshell-style containers, for instance, are all made of subtly different kinds - and readied for sale. -Waste plastic is a commodity, and recycling brokers search across the US and abroad for buyers who will want to melt the plastic down, turn it into pellets, and make those pellets into something new. -ong's problem is hardly a lack of supply. Each month the equivalent of thousands of shipping containers worth of recyclable plastics, which used to be exported, are piling up all over the United States. Nor is his worry a shortage of demand for plastic. It is desperately needed by factories in China for manufacturing into myriad new products - from toys and picture frames to garden gazebos. -What is nearly killing his business is the fact that many countries have soured on the recycling industry, after unscrupulous operators set up shop, operating as cheaply as possible, with no regard for the environment or local residents. -"In our industry, if you do it properly, you save the environment," Wong said. "If you do it improperly, you destroy the environment." -Wong said he might spend $150 to buy a ton of plastic scrap from a US recycler. Once it is shipped abroad, sold to a processor, turned into pellets and then again shipped to a manufacturer, the seller might ask as much as $800 per ton. -Yet the cost of similar virgin plastic, which is often higher quality, is just $900 to $1,000 a ton. -At one reseller - a corrugated-metal warehouse piled floor-to-ceiling with plastic that included shimmery sheaths of wrapping from US retail stores - Wong wanted to test the quality of the supply. He filled a baggie with ground-up flakes of black plastic from picking crates, then took a cigarette lighter and lit one of the flakes on fire. He carefully sniffed the smoke to get a sense of what variety of plastic it was. At Wong's next stop, an existing Monterrey recycling processor, you could get a sense of the work the new factory might do. -A rudimentary plastic processing machine stretched 40ft across the bare dirt of the warehouse floor. The processor takes rejected car parts and grinds them up into confetti-sized flakes. Workers feed these flakes into a flume that channels them past a heater to melt them. The melted plastic is pressed into long, white strings, which are stretched across the room and allowed to harden. At that point, they are chopped into pellets a little bigger than rice grains. -Wong said he would like to build more modern factories with up-to-date systems for eliminating toxic releases to the air and water. But he said he was sure that many of his less scrupulous competitors would keep exporting on the cheap. He suggested that even in countries that had banned plastic imports, the material continued to be smuggled in. -"Recyclers have set up factories in all these countries, but they don't have enough supply. So, even though it is smuggling, even though it is not legal, they still have to do what it takes to get the plastic." -shipping containers worth of US plastic sent to countries that mismanaged 70% of their own plastic, 68,000 lbs -In the Philippines, about 120 shipping containers a month are arriving in Manila and an industrial zone in the former US military base at Subic Bay. Records indicate they were filled with plastic scrap shipped from such places as Los Angeles, Georgia and the Port of New York-Newark. From the Manila port, shipping records and Philippines customs documents show, some of the US plastic was transported to Valenzuela City. The area, on the outskirts of the Philippine capital, is known as "Plastic City" and residents are increasingly concerned about the number of processing factories sprouting in their midst. -"You smell that?" said a shopkeeper, Helen Lota, 47, as she stood in front of her neighborhood convenience store at noon one day last month. "That's nothing. It's worse towards evening. It gets suffocating," -"There are times it's really hard to breathe. Many of us here are getting sick," said Lota. "I had my daughter's cough checked in the hospital. But the X-ray is clear. The coughing must be caused by the smell." -Noticing Lota complaining about the plastic problem, passersby stopped to chime in. "My mother's cough won't go away, probably because of the smell," said Renante Bito, 38. -recycling is also one of the area's biggest income sources. -Turkey takes in from abroad has soared, from 159,000 to 439,000 tons in two years. -about 10 ships pull into the ports of Istanbul and Adana, carrying about 2,000 tons of cheap US scrap plastic that is no longer wanted by China. Most of it comes from the ports of Georgia, Charleston, Baltimore and New York -"There are 500,000 street collectors in Turkey, working almost like ants to collect the waste,"

benefits of reducing and reusing

-Prevents pollution caused by reducing the need to harvest new raw materials -Saves energy Reduces greenhouse gas emissions that contribute to global climate change -Helps sustain the environment for future generations -Saves money -Reduces the amount of waste that will need to be recycled or sent to landfills and incinerators -Allows products to be used to their fullest extent

benefits of donation

-Prevents usable goods from going into landfills -Helps your community and those in need -Tax benefits may be available

benefits of reducing wasted food

-Saves money from buying less food. -Reduces methane emissions from landfills and lowers your carbon footprint. -Conserves energy and resources, preventing pollution involved in the growing, manufacturing, transporting, and selling food (not to mention hauling the food waste and then landfilling it). -Supports your community by providing donated untouched food that would have otherwise gone to waste to those who might not have a steady food supply.

climate change is central to california's wildfires

-Their opinion pieces represent a dangerous form of climate denialism, one that recognizes the value of climate adaptation—adapting to life under a changing climate—but purposefully misdirects by refusing to acknowledge the critical importance of limiting the amount of future climate change. -The science is clear. Climate change plays an undeniable role in the unprecedented wildfires of recent years. More than half of the acres burned each year in the western United States can be attributed to climate change. The number of dry, warm, and windy autumn days—perfect wildfire weather—in California has more than doubled since the 1980s. -Without aggressive reduction of greenhouse gasses, forests in Northern California, Oregon and Washington could experience an increase of more than 78 percent in area burned by 2050. Governor Gavin Newsom correctly characterized recent wildfires as a "climate damn emergency." It's almost unfathomable to imagine a situation in which the 2020 wildfire season becomes a regular occurrence or even a mild year, but that's exactly what could happen in our future. -We must dramatically reduce our greenhouse gas emissions. Otherwise, in a few decades, we might recall the more than four million acres of California burned so far this year—that have already shattered the prior record, set in 2018—as a relatively light wildfire season. That prospect, rooted in science and devastating to life and property, is unacceptable. -Fuel treatments reduce the buildup of vegetation that has resulted from nearly a century of fire suppression and from the criminalization of traditional Indigenous controlled burning. Twenty million acres of forests across California could now benefit from fuel treatments like prescribed burns, purposely-set fires intended to safely reduce fuel overgrowth. However, inadequate funding, limited prescribed burn crews, and dangerous weather conditions remain barriers to conducting prescribed burns. -As the owner of 57 percent of forests in California, the federal government has an enormous role to play. The U.S. Forest Service aspires to treat 500,000 acres per year, but is unlikely to reach that target given limited funding from Congress. However, new legislation could help: a new bill from Ron Wyden (D-Ore.) could guarantee $600 million each year for prescribed burns across federal, state and private lands. -Last year, Governor Newsom also declared a state of emergency to fast-track 35 fuel-reduction projects that would protect 200 at-risk communities. -In the September 29 debate, two years after recommending that Californians rake the forest, President Trump deflected on commenting on the role of climate change in recent wildfires. Instead, he told us, "Every year I get the call: 'California is burning! California is burning!" If that was cleaned, if you had good forest management, you wouldn't be getting those calls." -Ignoring climate change won't prevent climate disasters. From California wildfires to Gulf Coast floods, we already experience their effects. Arguments that purposefully misconstrue the impacts of climate change on our ecosystems and communities increase our peril.

6 glass and metal can be recycled infinitely

-There's no need to add additional virgin material in the recycling process- recycling glass and metal is the ultimate form of circular economy, the process of using and then reusing materials without generating any waste. (Spring Pool Glass Co. Ltd., a glass recycling and innovation company based in Taiwan, is an excellent example of this.) -So then why did we make the switch to plastic? Dasdy Lin, Sustainability Consultant at the Plastics Industry Development -center PIDC 3 reasons Global transportation shipping costs Safety - consistency and stability of products without risk of breaking Profit "Say for example, I ship 100 bottles and in the end, I only receive 98 because 2 broke. That's capital loss. But plastic rarely breaks. Plus, if we are looking at life-cycle assessment, it will probably take more energy to ship the glass bottles than the plastic ones because glass is heavier. The weight difference will result in the consumption of more fuel during transportation. So the negative effect on the environment is more fuel-burning, which results in more pollution."

5 health care A's

1 availability (does the person live where the health services they need are readily available?) 2 accessibility (refers to a person's literal ability to get to facilities and keep appointments) 3 accommodation (are the ways that services are organized to accept clients, like the hours that they're open or the ways that they communicate with patients) 4 acceptability (based on whether a doctor meets the patient's preferences)- both in terms of their professional abilities and in their personal traits, like gender, race, and age 5 affordability (how people pay for health care in the US, and more importantly if people can pay for health care, is closely linked to how we financially structure the health care system

in 2014,

10.4% of American's didn't have health insurance coverage, down from 13.3% in 2013. two third of Americans had health insurance through a private insurer. the vast majority got coverage through their employer and the rest bought individual plans

the affordable care act got passed in 2010

2 laws in one -insurance reform: more people and better coverage more people: cover them under Medicaid expansion, exchanges, guaranteed issue, community rating (created a pool of coverage, high premiums), individual mandate, kids <26 better coverage: prevention benefits, rx drug benefits, insurance company requirements (limited spending cost on insurance companies, had to tell people about premiums being raised way in advanced 16 million people are covered now if only sick people had coverage the pool would be too expensive 138% of poverty 19 states did not expand Medicaid didn't have to expand, it was difficult to damage 20 million people got coverage Law 2: delivery Reform -integrated care: (population based care was more team based), ACOs bundles, dual eligible, care transitions quality focus: transparency and data sharing, value based payment, fraud and abuse innovation: CMMI, prevention fund (prevention illnesses and diseases), pricing reforms, FQHCs changes of the ACA -fewer people will be covered by Medicaid -exchanges are gone -community rating: doesn't provide the mandate, sicker people will stay and the others will flee -people are not going to have benefits anymore -insurance company requirements: fewer people get Medicaid, fewer policy exchanges, 23 million people are going to lose coverage -?ACOs bundles, prevention funds -if the expansion happened, where would the money come from? it would come from savings from the federal government, new taxes, 840 million is saved by getting rid of exchanges

the us has a single payer system for those over ____ and those below the ______ line

65, poverty

1 Not all plastic is recyclable

=Plastic bags- Not recyclable. =Straws- Not recyclable. =Coffee Cups- you need a special machine; without it, no. Keyboards- maybe, if you get it to the right person. =recycling is determined by the market and city government =If there's a demand in the market, then recyclers and companies will pay for your post-consumer recyclables. -But without a market demand, those recyclables are almost useless; placing them in the recycling bin won't make a difference if you can't make money off of them. If the demand isn't there, or the quality of the materials post-use is incurably dirty, they end up in landfill or incinerators. -Your local government also plays an essential role. Government regulations create market opportunities for companies to recycle legally-mandated products. But every municipality is different. Before you throw something away, check what your city actually recycles. -Public investment in recycling systems, moreover, is integral to their long-term sustainability and success. While the price of purchasing a new piece of plastic is far cheaper than paying someone's salary to manage and sort recyclables, the environmental cost is substantially greater. Subsidies, investments and public support go a long way.

terms

ACO vs. HMO vs. PPO. There are a number of important similarities and differences between ACOs, HMOs (Health Maintenance Organizations), and PPOs (Preferred Provider Organizations): An ACO is generally based on a self-defined network of providers, whereas in most HMOs and PPOs, the network is defined by a health plan. In the Medicare Shared Savings Program and most commercial ACOs that are part of PPO health plans, an ACO cannot limit a patient's ability to use providers that are not part of the ACO, whereas the primary care providers in an HMO typically have the ability to limit which services a patient can receive and from which providers they can receive approved services. In the Medicare Shared Savings Program, a Medicare beneficiary remains able to use any Medicare provider, and in most commercial ACO programs, a commercially-insured patient can continue to use any provider in the network of providers that is under contract to the payer. In an ACO that is paid through shared saving programs, there is no change to the underlying fee-for-service payment structure for the providers in the ACO. In contrast, in many HMOs, a provider group receives a capitation payment that it can use to pay its physicians and other providers in different ways. Bundled Payment vs. Fee for Service Payment. Contrary to popular belief, bundled payments are not a radical change from fee-for-service payments. In fact, many payments in typical fee-for-service systems are already bundled to some extent. For example, the payment that is typically made for a physician office visit (an "evaluation and management" service) is intended to cover multiple tasks the physician performs before the visit and after the visit as well as what is done during the visit, and the time during the visit is intended to cover multiple activities. The fee-for-service payment made to surgeons for surgery is typically a "global fee" which bundles together the surgery itself and the separate visits the surgeon has with the patient before and after the surgery. If the surgeon accepts the global fee, the surgeon is not permitted to bill separately for office visits with the patients to follow up on the surgery and therefore does not get paid differently based on how many post-surgical visits he or she has with the patient

thriftiness tips

Be mindful of old ingredients and leftovers you need to use up. You'll waste less and may even find a new favorite dish. -Shop in your refrigerator first! Cook or eat what you already have at home before buying more. -Have produce that's past its prime? It may still be fine for cooking. Think soups, casseroles, stir fries, sauces, baked goods, pancakes or smoothies. -If safe and healthy, use the edible parts of food that you normally do not eat. For example, stale bread can be used to make croutons, beet tops can be sautéed for a delicious side dish, and vegetable scraps can be made into stock. -Learn the difference between "sell-by," "use-by," "best-by," and expiration dates. -Are you likely to have leftovers from any of your meals? Plan an "eat the leftovers" night each week. -Casseroles, stir-fries, frittatas, soups, and smoothies are great ways to use leftovers too. Search for websites that provide suggestions for using leftover ingredients. -At restaurants, order only what you can finish by asking about portion sizes and be aware of side dishes included with entrees. Take home the leftovers and keep them for or to make your next meal. -At all-you-can-eat buffets, take only what you can eat.

planning tips

By simply making a list with weekly meals in mind, you can save money and time and eat healthier food. If you buy no more than what you expect to use, you will be more likely to keep it fresh and use it all. -Keep a running list of meals and their ingredients that your household already enjoys. That way, you can easily choose, shop for and prepare meals. -Make your shopping list based on how many meals you'll eat at home. Will you eat out this week? How often? -Plan your meals for the week before you go shopping and buy only the things needed for those meals. -Include quantities on your shopping list noting how many meals you'll make with each item to avoid overbuying. For example: salad greens - enough for two lunches. -Look in your refrigerator and cupboards first to avoid buying food you already have, make a list each week of what needs to be used up and plan upcoming meals around it. -Buy only what you need and will use. Buying in bulk only saves money if you are able to use the food before it spoils.

recycling creates jobs

EPA released significant findings on the economic benefits of the recycling industry with an update to the national Recycling Economic Information (REI) Study in 2016. This study analyzes the numbers of jobs, wages and tax revenues attributed to recycling. The study found that in a single year, recycling and reuse activities in the United States accounted for: 681,000 jobs $37.8 billion in wages; and $5.5 billion in tax revenues. This equates to 1.17 jobs per 1,000 tons of materials recycled and $65.23 in wages and $9.42 in tax revenue for every ton of materials recycled.

we live in a plastic era

From the clothes we wear to the food we eat, plastic has become a household staple for families and communities around the world. Given its prominence, and the fact that scientists estimate it takes somewhere between 450 -1,000 years to decompose (some argue it will never decompose), it is essential for us to understand this material. -only powered by knowledge can we take the necessary actions to transform our relationship with plastic and protect our families, communities and the environment

storage tips

It is easy to overbuy or forget about fresh fruits and vegetables. Store fruits and vegetables for maximum freshness; they'll taste better and last longer, helping you to eat more of them. -Find out how to store fruits and vegetables so they stay fresh longer inside or outside your refrigerator. -Freeze, preserve, or can surplus fruits and vegetables - especially abundant seasonal produce. -Many fruits give off natural gases as they ripen, making other nearby produce spoil faster. Store bananas, apples, and tomatoes by themselves, and store fruits and vegetables in different bins. -Wait to wash berries until you want to eat them to prevent mold. -If you like to eat fruit at room temperature, but it should be stored in the refrigerator for maximum freshness, take what you'll eat for the day out of the refrigerator in the morning.

reducing wasted food at home

Most people don't realize how much food they throw away every day — from uneaten leftovers to spoiled produce. EPA estimates that in 2018, about 68 percent of the wasted food we generated—or about 42.8 million tons-- ended up in landfills or combustion facilities. By managing food sustainably and reducing waste, we can help businesses and consumers save money, provide a bridge in our communities for those who do not have enough to eat, and conserve resources for future generations.

donation

One person's trash is another person's treasure. Instead of discarding unwanted appliances, tools or clothes, try selling or donating them. Not only will you be reducing waste, you'll be helping others. Local churches, community centers, thrift stores, schools and nonprofit organizations may accept a variety of donated items, including used books, working electronics and unneeded furniture.

prep tips

Prepare perishable foods soon after shopping. It will be easier to whip up meals or snacks later in the week, saving time, effort, and money. -When you get home from the store, take the time to wash, dry, chop, dice, slice, and place your fresh food items in clear storage containers for snacks and easy cooking. -Befriend your freezer and visit it often. For example, -Freeze food such as bread, sliced fruit, or meat that you know you won't be able to eat in time. -Cut your time in the kitchen by preparing and freezing meals ahead of time. -Prepare and cook perishable items, then freeze them for use throughout the month. -For example, bake and freeze chicken breasts or fry and freeze taco meat.

recycling basics

Recycling is the process of collecting and processing materials that would otherwise be thrown away as trash and turning them into new products. Recycling can benefit your community and the environment.

risk pool

a group of individuals who are covered under one insurance plan

steps to recycling materials

Step 1: Collection and Processing There are several methods for collecting recyclables, including curbside collection, drop-off centers, and deposit or refund programs. Visit How do I recycle... Common Recyclables After collection, recyclables are sent to a recovery facility to be sorted, cleaned and processed into materials that can be used in manufacturing. Recyclables are bought and sold just like raw materials would be, and prices go up and down depending on supply and demand in the United States and the world. Step 2: Manufacturing More and more of today's products are being manufactured with recycled content. Common household items that contain recycled materials include the following: Newspapers and paper towels Aluminum, plastic, and glass soft drink containers Steel cans Plastic laundry detergent bottles Recycled materials are also used in new ways such as recovered glass in asphalt to pave roads or recovered plastic in carpeting and park benches. Step 3: Purchasing New Products Made from Recycled Materials You help close the recycling loop by buying new products made from recycled materials. There are thousands of products that contain recycled content. When you go shopping, look for the following: Products that can be easily recycled Products that contain recycled content Below are some of the terms used: Recycled-content product - The product was manufactured with recycled materials either collected from a recycling program or from waste recovered during the normal manufacturing process. The label will sometimes include how much of the content was from recycled materials. Post-consumer content - Very similar to recycled content, but the material comes only from recyclables collected from consumers or businesses through a recycling program. Recyclable product - Products that can be collected, processed and manufactured into new products after they have been used. These products do not necessarily contain recycled materials. Remember not all kinds of recyclables may be collected in your community so be sure to check with your local recycling program before you buy. Some of the common products you can find that can be made with recycled content include the following: Aluminum cans Car bumpers Carpeting Cereal boxes Comic books Egg cartons Glass containers Laundry detergent bottles Motor oil Nails Newspapers Paper towels Steel products Trash bags

U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes?

The U.S. spends more on health care as a share of the economy — nearly twice as much as the average OECD country — yet has the lowest life expectancy and highest suicide rates among the 11 nations. The U.S. has the highest chronic disease burden and an obesity rate that is two times higher than the OECD average. Americans had fewer physician visits than peers in most countries, which may be related to a low supply of physicians in the U.S. Americans use some expensive technologies, such as MRIs, and specialized procedures, such as hip replacements, more often than our peers. The U.S. outperforms its peers in terms of preventive measures — it has the one of the highest rates of breast cancer screening among women ages 50 to 69 and the second-highest rate (after the U.K.) of flu vaccinations among people age 65 and older. Compared to peer nations, the U.S. has among the highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths. Per capita health spending in the U.S. exceeded $10,000, more than two times higher than in Australia, France, Canada, New Zealand, and the U.K. Public spending, including governmental spending, social health insurance, and compulsory private insurance, is comparable in the U.S. and many of the other nations and constitutes the largest source of health care spending. In the U.S., per-capita spending from private sources, for instance, voluntary spending on private health insurance premiums, including employer-sponsored health insurance coverage, is higher than in any of the countries compared here. At $4,092 per capita, U.S. private spending is more than five times higher than Canada, the second-highest spender. In Sweden and Norway, private spending made up less than $100 per capita. As a share of total spending, private spending is much larger in the U.S. (40%) than in any other country (0.3%-15%). The average U.S. resident paid $1,122 out-of-pocket for health care, which includes expenses like copayments for doctor's visits and prescription drugs or health insurance deductibles. Only the Swiss pay more; residents of France and New Zealand pay less than half of what Americans spend. Despite the highest spending, Americans experience worse health outcomes than their international peers. For example, life expectancy at birth in the U.S. was 78.6 years in 2017 — more than two years lower than the OECD average and five years lower than Switzerland, which has the longest lifespan. In the U.S., life expectancy masks racial and ethnic disparities. Average life expectancy among non-Hispanic black Americans (75.3 years) is 3.5 years lower than for non-Hispanic whites (78.8 years).4 Life expectancy for Hispanic Americans (81.8 years) is higher than for whites, and similar to that in Netherlands, New Zealand and Canada. Reflecting shorter life expectancy, the U.S. has the highest suicide rate of these countries, with France a close second. Meanwhile, the U.K. has the lowest rate — half that of the U.S. Elevated suicide rates may indicate a high burden of mental illness; socioeconomic variables are also a factor.5 The U.S. has seen an uptick in "deaths of despair" in recent years, which include suicides and deaths related to substance use, including overdoses. Worse health outcomes and shorter life expectancy appear related to risk factors and disease burden. More than one-quarter of U.S. adults report they have ever been diagnosed with two or more chronic conditions such as asthma, diabetes, heart disease, or hypertension during their lifetime compared to 22 percent or less in all other countries. This rate is twice as high as in the Netherlands and the U.K. Obesity is a key risk factor for chronic conditions such as diabetes, hypertension and other cardiovascular diseases, and cancer. The U.S. has the highest obesity rate among the countries studied — two times higher than the OECD average and approximately four times higher than in Switzerland and Norway. Overall, obesity rates were highest in English-speaking countries, all with rates of one-quarter or more of the total population. Issues that contribute to obesity include unhealthy living environments, less-regulated food and agriculture industries, and socioeconomic and behavioral factors. Despite having the highest level of health care spending, Americans had fewer physician visits than their peers in most countries. At four visits per capita per year, Americans visit the doctor at half the rate as do Germans and the Dutch. The U.S. rate was comparable to that in New Zealand, Switzerland, and Norway, but higher than in Sweden. Less-frequent physician visits may be related to the low supply of physicians in the U.S. compared with the other countries. The U.S. has slightly more than half as many physicians as Norway, which has the highest supply. The average length of a hospital stay in the U.S. in 2017 was 5.5 days, far lower than the OECD average and comparable to that in Sweden, Switzerland, and France. Canadians and Germans had the longest lengths of stay, while Australians had the shortest. U.S. utilization for specialized scans is higher than in most countries, nearly twice as high as the OECD average but comparable to France. Germany had an even higher magnetic resonance imaging (MRI) rate, while New Zealand's was low. Previous analyses suggest that countries with a high supply of MRI scanners also tend to have higher rates of scan utilization The U.S. performs some elective surgeries at a higher rate than other countries. The U.S. rate of hip replacements per 1,000 persons age 65 and older was higher than the OECD average but similar to the rate in Norway and Switzerland. Canada, the U.K., and New Zealand had the lowest rates, with rates close to the OECD average. The U.S. outperforms peer nations in terms of preventive measures. In the U.S., more than two-thirds of adults 65 and older had a flu vaccine in 2016, considerably more than in the average OECD country. Only the U.K. had a higher rate than the U.S. At the lower end of the spectrum, one-third of older adults in Germany and Norway received the vaccine. The U.S. also had one of the highest rates of women ages 50 to 69 being screened for breast cancer. The U.S. rate is considerably higher than the OECD average. In contrast, in Switzerland, France, and Germany, only half of women this age had been screened. The five-year survival rate for breast cancer is the highest in the U.S. among the 11 countries — it is more than 5 percentage points higher than the OECD average. Breast cancer survival rates in all 11 countries compared here are higher than the OECD average. This is not true for other types of cancer. For example, five-year survival for cervical cancer among U.S. women is lower than in the 10 other countries and below the OECD average. Hospitalizations for diabetes and hypertension — which are considered ambulatory care-sensitive conditions, meaning they are considered preventable with access to better primary care9 — were approximately 50 percent higher in the U.S. than the OECD average. Only Germany had higher rates for both conditions. The U.S. rate of hypertension-related hospitalizations was more than eightfold higher than the best-performing countries, the Netherlands, the U.K., and Canada. For diabetes hospitalizations, the U.S. rate (204/100,000) was more than threefold higher than the Netherlands, the best-performing country. Premature deaths from conditions that are considered preventable with timely access to effective and quality health care,10 including diabetes, hypertensive diseases, and certain cancers, are termed "mortality amenable to health care." This indicator is used by several countries to measure health system performance.11 The U.S. has the highest rates of amenable mortality among the 11 countries with 112 deaths for every 100,000. It is notable that the amenable mortality rate has dropped considerably since 2000 for every country in our analysis, though less proportionately in the U.S. The U.S. rate was two times higher than in Switzerland, France, Norway, and Australia. This poor performance suggests the U.S. has worse access to primary care, prevention, and chronic disease management compared to peer nations. Conclusions and Policy Implications While the United States spends more on health care than any other country, we are not achieving comparable performance. We have poor health outcomes, including low life expectancy and high suicide rates, compared to our peer nations. A relatively higher chronic disease burden and incidence of obesity contribute to the problem, but the U.S. health care system is also not doing its part. Our analysis shows that the U.S. has the highest rates of avoidable mortality because of people not receiving timely, high-quality care. The findings from this analysis point to key policy implications, as well as opportunities to learn from other countries. First, greater attention should be placed on reducing health care costs. The U.S. could look to approaches taken by other industrialized nations to contain costs,12 including budgeting practices and using value-based pricing of new medical technologies. Approaches that aim to lower health care prices are likely to have the greatest impact, since previous research has indicated that higher prices are the primary reason why the U.S. spends more on health care than any other country.13 Second, our findings call for addressing risk factors for, and better management of, chronic conditions. We can start by strengthening access to care and primary care systems. Our findings show that the U.S. has a relatively lower rate of physician visits compared to other nations. This is surprising given U.S. adults' seemingly greater health needs. We do know from previous Commonwealth Fund surveys that adults in the U.S. experience greater affordability barriers to accessing physician visits, tests, and treatments.14 Increasing access to affordable health care and strengthening primary care systems are two of the most important challenges for the U.S. health care system.15 Third, the U.S. should promote incentives to use effective care and disincentives to discourage less-effective care. For example, a recent analysis estimated that as much as one-quarter of total health care spending in the U.S. — between $760 billion and $935 billion annually — is wasteful.16 Overtreatment or low-value care — medications, tests, treatments, and procedures that provide no or minimal benefit or potential harm — accounts for approximately one-tenth of this spending. The U.S. can learn from other countries; for example, our comparably high use of MRI scans and surgeries for hip replacement suggests we should assess when these interventions bring the greatest value. The global Choosing Wisely campaign promotes conversations around evidence-based care between physicians and their patients to help evaluate which tests and treatments are truly necessary and free from harm.17 In sum, the U.S. health care system is the most expensive in the world, but Americans continue to live relatively unhealthier and shorter lives than peers in other high-income countries. Efforts to rein in costs, improve affordability and access to needed care, coupled with greater efforts to address risk factors, are required to alleviate the problem.

7 the everything else category

The next time you use a plastic product, flip it over and check the bottom. If you see #7 in the center of a three-arrowed triangle, you have no way of knowing for certain whether its recyclable or non-recyclable (even plastics industry people and recyclers can't tell sometimes). -Polylactic acid (PLA), for example, is a #7 plastic. It is made from plant-starch instead of petroleum, and therefore, marketed as "biodegradable." (For your reference, most synthetic plastics come from crude oil.) -I use quotations here because it's important to know that current biodegradable products can only decompose if they are sent to a special factory, where the temperature and humidity is specially controlled, and lumped together with other compostable plastics. (If those plastics are thrown into landfill and mixed in with other trash, it doesn't matter if they're compostable or not. They're not going back into nature if they're stuck in between layers of other waste.) -Another example of a #7 plastic is melamine, a non-recyclable plastic used often in food containers like bowls. Its claim to fame: its durability and being dish-washer safe. In Taiwan, melamine can be spotted in night markets (beware pink bowls the next time you want to try some pork over rice(lu rou fan). According to Dasdy Lin, you can't recycle melamine because it is a thermoset plastic: "it won't melt again- the only way is to incinerate it."

climate change

a long term change in the earth's overall temperature with massive and permanent ramifications

fee for service health care system

Where services are unbundled and paid for separately (x ray, lab test, and doctors time will all be separated)

growing population is

a problem -the rate of the human population is slowing down -as women and girls get better educated, they have fewer kids and the kids they do have have more resources, so they are better taken care of and they are more successful -it is estimated that the world is going to go to 9 billion humans, maybe 10 -we want renewable energy, access to internet, clean water

where does your plastic go? global investigation reveals america's dirty secret--- article

after you drop a piece of plastic into a recycling bin, it is whisked off to a factory where it is seamlessly transformed into something new. -This is not the experience of Nguyễn Thị Hồng Thắm, a 60-year-old Vietnamese mother of seven, living amid piles of grimy American plastic on the outskirts of Hanoi. Outside her home, the sun beats down on a Cheetos bag; aisle markers from a Walmart store; and a plastic bag from ShopRite, a chain of supermarkets in New Jersey, bearing a message urging people to recycle it. Tham is paid the equivalent of $6.50 a day to strip off the non-recyclable elements and sort what remains: translucent plastic in one pile, opaque in another. A Guardian investigation has found that hundreds of thousands of tons of US plastic are being shipped every year to poorly regulated developing countries around the globe for the dirty, labor-intensive process of recycling. The consequences for public health and the environment are grim. a team of guardian reporters in 11 countries has found: -Last year, the equivalent of 68,000 shipping containers of American plastic recycling were exported from the US to developing countries that mismanage more than 70% of their own plastic waste. -The newest hotspots for handling US plastic recycling are some of the world's poorest countries, including Bangladesh, Laos, Ethiopia and Senegal, offering cheap labor and limited environmental regulation. -In some places, like Turkey, a surge in foreign waste shipments is disrupting efforts to handle locally generated plastics. -With these nations overwhelmed, thousands of tons of waste plastic are stranded at home in the US, as we reveal in our story later this week. -America alone generates 34.5m tons of plastic waste each year, enough to fill Houston's Astrodome stadium 1,000 times. -Of the 9% of America's plastic that the Environmental Protection Agency estimated was recycled in 2015, China and Hong Kong handled more than half: about 1.6m tons of our plastic recycling every year. They developed a vast industry of harvesting and reusing the most valuable plastics to make products that could be sold back to the western world. -But much of what America sent was contaminated with food or dirt, or it was non-recyclable and simply had to be landfilled in China. Amid growing environmental and health fears, China shut its doors to all but the cleanest plastics in late 2017. -america sends 1 million tons of plastic waste overseas every year -malaysia mismanaged their own plastic by 55% -indonesia and vietnam improperly managed 81% and 86% -Take Vietnam. Minh Khai, a village on a river delta near Hanoi, is the center of a waste management cottage industry. Rubbish from across the world, inscribed in languages from Arabic to French, lines almost every street in this community of about 1,000 households. Workers in makeshift workshops churn out recycled pellets amid toxic fumes and foul stench from the truckloads of scrap that are transported there every day. Even Minh Khai's welcome arch, adorned with bright red flags, is flanked by plastic waste on both sides. -In 2018, the US sent 83,000 tons of plastic recycling to Vietnam. On the ground, America's footprint is clear: a bag of York Peppermint Patties from Hershey, with US labeling, and an empty bag from a chemical coatings manufacturer in Ohio. -the toxic fumes resulting from the burning of plastics or plastic processing can cause respiratory illness. -hundreds of toxic substances, including hydrochloric acid, sulfur dioxide, dioxins and heavy metals, the effects of which can include developmental disorders, endocrine disruption, and cancer. -April, more than 23,400 shipping containers of scrap remain held up in customs. But business continues to boom in Minh Khai. Tham said that scrap is still arriving from Haiphong, northern Vietnam's largest port, and other parts of the country every day, and records show a significant rebound in imports. -As countries like Vietnam, Malaysia and Thailand banned imports, records show the plastic waste fanning out to a host of new countries. Shipments began making their way to Cambodia, Laos, Ghana, Ethiopia, Kenya and Senegal, which had previously handled virtually no US plastic. -Experts estimate that 20% to 70% of plastic entering recycling facilities around the globe is discarded because it is unusable - so any plastic being recycled at Sihanoukville would inevitably result in more waste there.

smokers are

at higher risk for heart disease and lung cancer an insurer might charge you higher premiums if you smoke

US providers are

being paid 3x more than other countries treatments are more expensive

iron triangle

congress (want to get re elected -bureaucrats (want to protect their funding and jobs) -lobbyists (want to advance the interests of their clients all work towards policies -passed obamacare

obama care

did not set up a UK style system where hospitals are public property and doctors are public employees -tries to increase health coverage by requiring private health insurers to insure everyone who applies, charge the same premiums to people of the same age, and cover pre existing conditions -reflects people attitudes towards healthcare

community rating

everyone in the risk pool is charged the same price to buy into the insurance plan

an insurance company decides

how to set their premiums and deductibles based on how likely the 'risk' is that they'll have to pay out an insurance benefit

climate change is caused by

human activity rise of 1.2f to 1.4f excess of greenhouse gases increased demand for burning fossil fuels #1 victim oceans oceans regulate the earth temperature by 50% of earths oxygen ocean has increased by .3F since 1969 -ocean acidification is hurting ocean animals -increased by 30% -clams, shellfish, and corals are at risk -1 billion people rely on the ocean for their source of protein -the sea level has risen 6.6inces since 1870 -when the ocean gets warmer, it swells -glaciers are melting -since 1995 the earth has lost 400,000,000 tons of ice how we can help -recycle -walk or use pubic transportation -turn off electronics when you are not using them -eat less meat -eat more local produce

most french providers

including hospitals are private businesses

according to the kaiser family foundation

the US has higher rates of hospital admissions for preventable conditions, and it has high rates of medical, medication and lab errors

single payer system

where you have to pay for prescriptions, dental, and glasses