Brent Staton, a primary care physician in Cookeville, heads an organization called Cumberland Center for Healthcare Innovation, a network of affiliated, independent doctors in small towns and rural counties around the state. But what it is, is a band of primary care doctors in about 50 counties across Tennessee who want to collaborate as a way to sustain their independence in changing the health care system — and as a path to making their patients, and communities, healthier. It’s an operational umbrella that provides lots — and lots — of data, contracting support and ideas on how to comply with increasingly complex quality standards facing physicians. It’s doctor-run, which is part of the appeal to insurers who are trying to control costs, as well as to patients who are looking for a doctor-patient relationship. It’s also one of the reasons why the organization has a shot at being successful at a model that others have struggled to make work.
"This is the New Deal" saud Sheila Allgood, a manager of Bolt, the broadband subsidiary of the Northeast Oklahoma Electric Cooeprative. "Now we are doing what cable and telecom companies don't want to do, just like we did for electricity when the big private power companies didn't want to come here."
Colorado's rural areas can't escape higher health insurance costs because it costs more to deliver health care. That's the conclusion Monday from the state Division of Insurance, which was ordered to study the problem of higher insurance prices on the Western Slope and in other rural areas. The Division looked at Colorado's nine geographic rating areas for health insurance. State lawmakers from rural areas have said it's unfair that folks along the Front Range have lower costs for health insurance. They wanted to see Colorado adopt a single price for health coverage in all parts of the state.
The Christian Science Monitor describes a “a new class divide,” this one in rural America. Patrick Jonsson tells us that a new class of “super farms” is concentrating income in fewer hands. “The widening gulf between the haves and have nots is not limited to the Rust Belt’s cast-off manufacturing workers, working class suburbanites, or inner-city poor working on a stagnant minimum wage,” Jonsson writes. “The same trends have taken hold in farm country, though in different forms. The farms that once generated wealth for entire communities are now creating a new class of superfarmers.” At least one rural academic doesn’t hold out much hope that either party will address this rural issue. That will be up to us. “Communities that are waiting for either [Donald] Trump or [Hillary] Clinton to come into office and solve all their issues are being unrealistic,” says David Peters, a rural sociologist who studies heartland inequality at Iowa State University in Ames. “Residents and community leaders do, however, have this power to build up trust in the community … [in order] to marshal investment and resources. Yes, it’s difficult. But it’s within their power to change.”
We’re now approaching the Everest level in our march to the total narcissistic society: Thirty-somethings are writing their memoirs.
I’m not kidding. J.D. Vance has done a Sir Edmund Hillary in his newly released “Hillbilly Elegy: A Memoir of a Family and Culture in Crisis.” This lad with ancestral roots in “Bloody Breathitt” County, deep in the Cumberland Mountains of Eastern Kentucky, is a mere 31 years old. Actually, he discloses in the book that his birthday is August 2, 1984, so he’ll be 32 when you read this. The book, a best seller on Amazon, is being especially celebrated by conservatives and libertarians because they believe it explains the phenomenon of the decline of the poor white working class in the US. New York Times conservative columnist David Brooks, who fears that disaffected white Americans are going to elect a tyrant named Donald Trump, calls it “essential reading for this moment in history.” The executive editor of The National Review is even more effusive: “To understand the rage and disaffection of America’s working class whites, look to Greater Appalachia. (Vance) gives voice to this forgotten corner of our country, and to the millions of white Americans who feel powerless as their way of life is devastated. Never before have I read a memoir so powerful, and so necessary.” No book about Appalachia has gotten this much attention since Harry Caudill’s “Night Comes to the Cumberlands” was published in 1963 and led President Kennedy to lay the groundwork for LBJ’s eventual War on Poverty. Caudill eloquently described the rape of a region and a people by colonialist coal barons allied with governments and called on the conscience of the nation for remedies. Vance begs to differ: “These problems were not created by government or corporations or anyone else. We created them, and only we can fix them….we hillbillies must wake the hell up.”
Excavators breached a dike Monday that for more than a century had protected farmland, furthering a state and federal plan to convert thousands of acres of agricultural fields into salmon habitat in the Skagit Delta. Excavators started digging a gap in the 12-foot-high dike in the morning. By late afternoon, Puget Sound’s high tide was spreading saltwater over 131 acres that previously grew crops such as broccoli, red potatoes and vegetable seeds. Tiny fish were swimming at the toe of new dike farther inland on Fir Island, between the Skagit River’s south and north forks, which empty into Puget Sound. The head of a farm group accepted the conversion of cropland into a fish-rearing estuary as a regulatory necessity, but he wasn’t rejoicing. “It’s not a celebratory time,” said Brandon Roozen, director of the Western Washington Agricultural Association. “There’s been blood, sweat and tears spent on that land to keep it fertile.” The agricultural association represents a dozen diking, drainage and irrigation districts that serve farmers over 54,000 acres.
Carfentanil a drug used to sedate elephants and other large animals which is 100 times as potent as the fentanyl have been found to be mixed with or passed off as heroin. The appearance of carfentanil, one of the most potent opioids known to investigators, has added another angle to cases of drug overdoses, heroin and abuse of fentanyl. Carfentanil is so powerful that zoo veterinarians typically wear face shields, gloves and other protective gear — "just a little bit short of a hazmat suit" — when preparing the medicine to sedate animals because even one drop splattered into a person's eye or nose could be fatal, said Dr. Rob Hilsenroth, executive director of the American Association of Zoo Veterinarians
's a toothy giant that can grow longer than a horse and heavier than a refrigerator, a fearsome-looking prehistoric fish that plied U.S. waters from the Gulf of Mexico to Illinois until it disappeared from many states half a century ago. Persecuted by anglers and deprived of places to spawn, the alligator gar — with a head that resembles an alligator and two rows of needle-like teeth — survived mainly in Southern states in the tributaries of the Mississippi River and Gulf of Mexico after being declared extinct in several states farther north. To many, it was a freak, a "trash fish" that threatened sport fish, something to be exterminated. But the once-reviled predator is now being seen as a valuable fish in its own right, and as a potential weapon against a more threatening intruder: the invasive Asian carp, which have swum almost unchecked toward the Great Lakes, with little more than an electric barrier to keep them at bay. Efforts are underway to reintroduce the alligator gar to the northern part of its former range.
Alongside the dog, horse, and livestock shows, as well as other a competition featuring the Beaver State's best home-brewers of beer, the cannabis competition will award the three traditional ribbons (blue, purple, yellow) in three categories of marijuana plant (sativa, indica, hybrid). The inclusion of marijuana in a state fair speaks to its suddenly booming reputation as a cash crop and its growers as the future farmers of America, at least in Oregon, Washington, Colorado, Alaska, and Washington, D.C., where, since 2012, voters have approved legal recreational use of marijuana. It remains illegal in the eyes of the federal government.
Emails obtained through public-records requests by a conservation group show that State Toxicologist Ken Rudo forcefully resisted the McCrory administration last year as it moved to alter the do-not-drink letters sent to hundreds of well owners near coal-ash pits owned by Duke Energy. In March 2015, after Rudo had drafted the letters advising well owners — many of whom had elevated levels of the carcinogen hexavalent chromium — against using their water for drinking or cooking, department administrators pushed Duke Energy’s position that the water would generally be considered safe to drink under the federal Safe Drinking Water Act. According to Rudo, one of the most experienced health experts in the N.C. Department of Health and Human Services, that claim is just not true.