The U.S. Senate is reportedly considering a healthcare bill, although few will admit to seeing it or knowing its contents. Rumors indicate it will not, as hoped, be a “kinder, gentler” version of the House bill. There’s been a great deal of criticism of the direct effects of the House bill including, but not limited to, tens of millions without insurance, astronomical cost increases for seniors and those with pre-existing conditions, inability to get coverage for preexisting conditions, watered-down coverage (with many standard situations not covered) and loss of support for those in nursing homes. However, I’ve heard little regarding the effects on those not included above.

Please note the following is not deeply researched, but largely the product of my own logical process and as such could be far from accurate. I’d love feedback from those more deeply-informed than I.

Let’s imagine an employed head of family with a spouse and two children. Insurance for this family is provided by his/her employer and deducted from his/her paycheck. In fact, both spouses enjoy this benefit, so if one loses his/her job, there’s a back-up plan. This happy family is probably laboring under the illusion that they have nothing to fear. I believe this is far from the truth!

The disappearance of billions of dollars from medical payments will impact clinics and hospitals. Personnel will be laid off and programs will be cut. Wait-time for all services will be longer and some “frills” will disappear. If you need a class on dealing with your child’s juvenile diabetes, for instance, it may no longer be offered as often or not at all. If it takes you a month to get an appointment with your doctor now, that wait may double. If you child falls off the playground equipment and breaks an arm, the emergency room visit may stretch to eight hours as opposed to four.


Ted Chan, founder of Care Dash, an online site for feedback on doctors, (yeah, I did some research!) was quoted in Becker’s Hospital Review on March 9, 2017, as saying: 

“Repealing the Affordable Care Act (ACA) without clear guidelines for replacing coverage will drive up costs across the board for patients, employers, and hospitals. Without requiring all to be insured, hospitals will be the insurers of last resort and will absorb the costs of uninsured patients seeking care. One recent study found that half of hospital bills go unpaid and that will only likely increase without an individual mandate….

When hospital bills go unpaid, taxpayers and local governments are often forced to pick up the tab. The question is not whether healthcare coverage should be paid for, it’s who pays.”


If you live in a rural area, the impact may be even greater, as rural medical services are economically tenuous. With fewer patients to serve and more low-income individuals, tight budgets are a constant. Under the ACA, there were supposed to be provisions to help rural medical programs, but many of these provisions were revised or never implemented.

Our happy fictional family may find their medical costs increase despite their insured status. When a family isn’t insured, that doesn’t mean they don’t get sick! They do, however, wait longer to seek treatment, present as sicker when they do go to the doctor, and their treatment is therefore more expensive. Since the bill is less likely to be paid, the hospital must recoup as much as possible in the form of increased costs for those WITH insurance. When insurance companies pay more, they’re going to raise the cost of their policies. Our fictional family will pay in increased insurance costs.

People who don’t have insurance are more costly employees. Since they can’t afford preventive care, they’re more likely to be sicker and miss additional time at work. (I’d prefer they NOT work, since someone coughing over my fast-food order is not something I relish!) I suspect this was one original motivation for employer-sponsored healthcare coverage.

Therefore, Fictional Family will be affected directly by the proposed healthcare bill. The medical services they need may well become harder to access, their health insurance costs increase, and their communities become a less pleasant and welcoming place to live.


Deborah G. Hankins is a retired “worker” who lives with her husband Milt and their little chihuahua Jose in Ashland, Kentucky. She is a leader in the local “Indivisible” group and is seriously concerned about our future under the present administration.  





I am old enough to remember pre-integration days in my hometown of Louisville, Kentucky. Segregation to me, as a young boy, seemed perfectly normal. It was dimply how things were done, how things were, and, since our neighborhood, Crescent Hill, was completely white, I seldom saw a “Negro” unless I rode the bus downtown or went through the black neighborhood in West Central Louisville. In my mind, “they” hardly existed.


Our schools were segregated, of course, but so were churches, theatres, restaurants, parks, amateur and professional sports, restrooms, trains, swimming pools, water fountains, neighborhoods: everything. When Negroes got on a city bus or trolley car, they automatically moved to the rear before taking a seat.

Such was true throughout the American South and in parts of the North, as well. As late as the early 1960s, for example, I visited a small town in Northern Indiana that had signs posted at the city limits warning Negroes that they had to be out-of-town by sunset — believe it or not!

                A SEGREGATED STREET

When I was a boy of about twelve, I was with my mother visiting her sister in Washington, D.C. As we were leaving D.C., we crossed over the Potomac into Arlington, Virginia on a Trailways bus, and the driver pulled into a small parking area. Now that we were entering “The South,” all the black riders who had been sitting near the front of the bus had to get up and move to the rear — while all the white riders who may have been sitting in the rear had to move closer to the front. Then the bus continued on further south.

It seems unbelievable to me today, but that is how it was. I guess that is one reason why I’m still a little surprised when someone who did not live back then tries to tell me that not much has changed since those pre-integration days.

Many racist attitudes are still in place, to be sure; but in a legal sense, the changes have been very great; indeed, and who would say the changes have not been for the better!





DID YOU KNOW that despite the president and his Press Secretary Sean Spicer’s assertions, Paul Manafort played a primary role in the Trump campaign and the Republican National Convention?


DID YOU KNOW that Paul Manafort lived in Trump Tower before he became Trump’s campaign manager? [The Daily Beast]

DID YOU KNOW that Paul Manafort “worked for a Russian billionaire with a plan to ‘greatly benefit the Putin Government?'” [Washington, Associated Press, March 23, 2017]

DID YOU KNOW that, according to the Associated Press, Paul Manafort received millions of dollars from Russia to influence American politics and businesses? He drew no salary for his Trump campaign work. 

DID YOU KNOW that Donald Trump said that Paul Manafort “had done a great job” the day after the Republican National Convention? Did Trump know that Manafort was working for a millionaire ally of Vladimir Putin? [Trump speech]


DID YOU KNOW that Roger Stone is “under investigation for what would be his dirtiest trick–colluding with the Russians to defeat Hillary Clinton and to put his friend in the White House?” [Maggie Haberman, The New York Times, March 21, 2017]

DID YOU KNOW that Carter Page, an American oil consultant and “an early foreign policy adviser to Donald J. Trump who was scrutinized by the F.B.I. on suspicion of private communications with senior Russian officials over the summer, was back in Moscow on Thursday.” [Moscow release to The New York Times, December, 2016]

DID YOU KNOW that Representative Devin Nunes (R, Calif), who is running the House Intelligence Committee on the Russian-Trump connection, was a member of President Trump’s transition team?

DID YOU KNOW that Representative Devin Nunes (R, Calif), who is running the House Intelligence Committee on the Russian influence in the 2016 election, told reporters he didn’t know who Roger Stone and Carter Page are? [Nunes interview]

DID YOU KNOW that Representative Adam Shiff, (D, Calif), a ranking member of the House Intelligence Committee’s investigation, has said publicly that “he has more than circumstantial evidence” that Trump associates colluded with Russia. [Lawrence O’Donnell program, MSNBC News, March 22, 2017]


DID YOU KNOW that Rex Tillerson, the current Secretary of State and General Mike Flynn, who served as Donald Trump’s National Security Advisor during the transition period and for a short period after President Trump took office, had close relationships with Vladimir Putin and the Russian oligarchs? [various news reports]


DID YOU KNOW that “the reclusive mastermind behind President Trump’s nationalist ideology and combative tactics, Stephen Bannon, made his public debut Thursday, delivering a fiery rebuke of the media and declaring that the new administration is in an unending battle for ‘deconstruction of the administrative state.’” [The Washington Post reporting on the Conservative Action Pac conference]

DID YOU KNOW that it is commonly known that Vladimir Putin despised Hillary Clinton and therefore wanted to influence the 2016 election to see that Ms Clinton lost the presidency to businessman Donald Trump? [MSNBC news release]

DID YOU KNOW that President Donald Trump is on record “assert[ing] his desire to draw Russia and the United States closer together as president–building on a long-established track record of Trump’s fondness for the autocratic Russian leader?” [CNN Politics article, “Donald Trump’s Praise for Vladimir Putin” by Jeremy Diamond, July 2016]

DID YOU KNOW that, while he was telling his followers that Hillary Clinton was under F.B.I. investigation,


Donald Trump [himself] was the subject of an F.B.I. investigation? [released during the House Intelligence Committee Investigation]

DID YOU KNOW that “The U.S. intelligence community concluded in a report released publicly on January 6th, 2017 that Russian President Vladimir Putin ordered a massive influence campaign to interfere in the presidential election in favor of Trump?” [MSN article, Max Greenwood in The Hill, March 22, 2017]

Now that you know these facts and assertions, can you connect the dots (the relationships)? Would you say that the Trump administration has some ‘splainin’ to do?

I would.



My parents restricted our television watching when I was young. I learned to tell time before kindergarten so I could turn on my program (Romper Room) at 11:30. I still rarely watch TV and been thinking we can let the cable access go without a problem. I watched only a few things in the past year and most of that was accessible online.

However, I know a lot of people have the television on just about all day. It’s background noise to some. For many, it is the focus of their activity. Perhaps, in time, it will be also for me. My mother-in-law, essentially bedridden in her last few years because of COPD, had no cable but still could watch local programs. She had public television on all day. Or at least when her local sports team was not being televised. The television brings the world to a lot of people, especially if they do not get out in to the world.

Back in 2000 I heard people talking about a new TV program, Survivor. They were excited about what the contestants of this reality show had to do. I actually watched one show; I think they had to eat bugs. It was an interesting concept but, to me, not worth the time. I had a six-year-old and my husband was dying of brain cancer. It was more important to me to spend time with them than spend an hour glued to what really seemed like the idiot box.

We were living in Huntington, West Virginia in 2010 when British Chef Jamie Oliver came to town to get people to change their bad eating habits. Part of the show was filmed at my son’s high school and he came home often with descriptions of what REALLY went on before the cameras started to roll. In addition, I spoke with one of the guys who was on the track team and had participated in the reality show. He described an incident where he informed an associate producer that he had a conflict and was told to tell Oliver. As he started to explain to the chef, Oliver struck his fingers in his ears and started singing “I can’t hear you.” Later, when the episode aired it showed Oliver having a fit because this guy had not had the courtesy to inform him that he would not be there.

So, it was very apparent to me that reality television shows are NOT about reality, but are staged as much as any scripted show. And it also became apparent to me that people watched these shows because they enjoyed seeing people lose. The excitement of the show very much included the idea that someone who is inferior would be kicked out. If the watcher voted for someone who got to stay, they “won.” This set people up, over these years, into a me versus the rest of them attitude.

Needless to say I had no interest in watching the Apprentice. I grew up in the New York City area and knew about Donald Trump’s ways to take advantage of people to get what he wanted. I did not need to give up my time watching him belittle people. However, it was a popular show. And many people voted for Trump based on that television persona. They did not realize it was fake. So, by accepting it as reality, guess what happened?

Now we have a new reality:

The head of the EPA went on national television and said carbon dioxide doesn’t drive climate change. This is a complete reversal of past EPA policy and a total rejection of all credible science and facts. This isn’t a joke–It’s the first step to killing all programs to combat climate change. Ask yourself WHY.

We have escalating fear that a transgender person will attack young girls in public restrooms although no such incident has happened. At the same time, young white men are getting slaps on the wrists for raping and sexually assaulting women, even when they are unconscious. Ask yourself WHY.

A member of the Congressional committee discussing the new healthcare plan does not want men to have to pay for pre-natal health care. Perhaps he is merely unaware how costs go down when the pool includes people who do NOT use a service, or maybe sees no reason for women to have health care costs as low as men. Ask yourself WHY.

The populations of more and more states are voting for legalized medical and recreational use of marijuana but the federal government is adamant that the risk to public health is equivalent to drugs like crack, meth, and heroin. So, the legal businesses have restrictions from federal banks and the government can continue to slap people into prison for sentences that are often longer than [sentences for] crimes against people. Ask yourself WHY.

While 17 intelligence agencies say they have proof that Trump and his cohorts had dealings with members of the Russian oligarchy, no one in Congress is willing to start an investigation but those same senators pounced all over the mismanagement of Hillary Clinton’s e-mails. Ask yourself WHY.

People throughout the country clamor that illegal aliens have stolen jobs from native-born Americans and support the deportation of all people who entered the country illegally. Farmers growing produce, restaurants, and the construction industry welcome people wanting jobs to come forward. Ask yourself WHY.

Trump promises a YUGE wall to protect us from “bad hombres” and also promises that he will get Mexico to pay for it. As the plans unfold, it appears that not only will we the people be paying for it with a surcharge on Mexican products but it is apparent that Trump’s plan to reduce the funding for the Coast Guard will offer a new door of entry to anyone wanting to come to stay. Ask yourself WHY.

Discussion about infrastructure construction includes giving the work to private companies who will get reimbursed by we the people with tolls on rebuilt highways and bridges. Ask yourself WHY.

And finally, because this list could go on and on….The new healthcare plan will be lowering costs not for we the people but for the government. The rest of us will have the option to pay more than we can afford for services unknown at this time, or die. Simple choice. Ask yourself WHY.

And the people are beginning to make some noise. Congressional town hall meetings in their home districts are having massive attendance. Some are calm as people ask questions and the representative or senator responds. Many districts, however, are not being visited or their meetings are cut short because the congressional representative or senator cannot adequately show that s/he is actually listening to his or her constituents.

But the majority of the people remain silent. Can you explain to me why?

One reader said I am asking too much of people to expect them to comment. Okay, here goes: don’t comment to me. Get involved. Turn off the television and go out into your community. Get involved. Only by your actions will you be known. If not you, who? If not now, when?



In May, the Food and Drug Administration will begin requiring restaurants that have more than 20 locations to post the calories of their foods in a conspicuous place.

Battle of the Bulge

Americans, who are becoming more obese by the year, need and deserve all the help they can in the battle of the bulge.

Some may say that this decision is “government interference” in our lives. Information is not interference. You don’t have to read what is posted. And even if you discover that your favorite dish is twice as calorie-laden as a healthy option, the “food police” are not in residence. It’s your call.

Two quotes apply to [this] column. The first, “No one changes until they are really uncomfortable,” is my favorite from four decades of psychology practice and three decades of raising kids. If you are only mildly uncomfortable, you’ll complain. If you are miserably uncomfortable, you may change. A high level of discomfort is the only thing that really promotes a different way of handling a problem situation.

The second is, “Knowledge is power,” which is attributed to a variety of sources including 10th-century Arabic, the Hebrew Bible, Persian poetry and Sir Francis Bacon. Take your pick, but almost all sources believe that one must know real facts in order to make good decisions.

Considering these two quotes, if we are concerned for the 35 to 40 percent of Americans who are now overweight, it makes perfect sense for eating establishments to let their customers know how many calories they are going to ingest. Posting food calories, which is the unit of measurement of energy from food, permits diners to make informed choices. Years ago, Maury and I had a few favorite beverages at Starbucks. One didn’t look particularly fattening–some coffee, a little milk, a little sugar and some flavoring. But it added up to almost 500 calories, and with our favorite small little coffee cake that had close to 400 calories, a little afternoon snack had more calories than a usual lunch.

Some may argue that calorie counting is not the only important aspect of food. That’s true. We also need proteins, carbohydrates, fats, minerals and vitamins. But, over the years, diet gurus have sold the American public on easy ways to lose weight. This is a $20 billion industry built on special diet foods, pills and other “quick fixes.” The truth is that there are no easy ways and counting calories requires information and it is tedious and boring. However, it works.

We Americans have change dour eating habits over the years, so that we now expect bigger portions and food that takes little time or energy to prepare. The fast-food industry fit in nicely with these preferences and have taught our nation that if it tastes good, the more the merrier.

But we’re getting sicker and sicker; diabetes and heart disease are linked to obesity. The Robert Wood Johnson Foundation found that health costs due to obesity in this country in 2015 were estimated between $147 billion and $210 billion.

Obesity is harmful and expensive for our nation. Not only are adults overweight, the Centers for Disease Control and Prevention reports that obesity in children and teens have quadrupled since 1980.


We need to make some changes. Two of those should include becoming better informed and more uncomfortable about our excess calorie consumption. A good start is for chain restaurants, and even independent ones, to post those calories counts in big, bold print where everyone can read them.

[Diane W. Mufson lives with her husband Maury in Huntington, West Virginia.  She is a retired psychologist.  This column first appeared in the Huntington, West Virginia Herald-Dispatch on Thursday, March 16, 2017.  It is reprinted with the permission of Ms Mufson.]





Purple has become more than just my favorite color. It is the color of obsession for me. It stirs raw emotion and almost a fight or flight mentality. Purple is the color of Alzheimer’s Advocacy Warriors.


I’m one of those warriors who treks to Washington D.C. a few times a year to voice my personal story and to advocate for the eventual cure plan for Alzheimer’s with the help of The National Institute of Health (NIH) and Congress. Now more than ever, the fight needs to be relentless as we learn of yet another clinical trial that has been halted due to poor outcomes. The picture is bleak. Two major pharmaceutical companies have had failed clinical trials this past year without a gaining a shred of new knowledge. In fact, the theory of Beta Amyloid plaques and Tangles present in the brain of people who have died of this insidious disease is on the chopping block for a cause. These are likely remnants of what is left behind in the ever-shrinking brain of an Alzheimer’s patient. This is the ONLY disease with NO CURE, NO SLOWDOWN and a sky-rocketing trajectory upwards!

I have become a tireless advocate for Alzheimer’s research funds and awareness to help combat this disease that robs of life, as they know it, so many people and their families. When something affects you personally, your outlook becomes very clear and very raw. It changed my life and the life of my entire family–forever. When you watch someone fade away slowly over a 12-year period, only to see them as a corpse of their former self, it hits you at your core. Especially, when it’s your beautiful mom.

The truth about this disease from a personal view:  This disease almost destroyed my life, but it also made me painfully aware of how much more attention that we as a nation need to be giving it. Again, there isn’t ANYTHING currently that can be done for someone afflicted with it. NOTHING. No cure, no medication slowdown, no nothing. NADA! Isn’t that crazy in this age of new-age technology, healthcare and pharmaceuticals? Literally, every other major disease process has medication assistance, cures and healthcare protocols. Not Alzheimer’s–it WILL BANKRUPT our already corroding, over-extended country in the next decade if we do not get a handle of  it at the very least. It makes me wonder. My thoughts get cynical and jaded, wondering if there is something going on behind the scenes, if you will. I digress. I obsess.

Some people might call my advocating a mission, a purpose or a calling, but I have come to realize that it was just the next “right” thing to do. I have been criticized for my obsession with advocating; I have even damaged my livelihood and my personal relationships with this obsession, but I have come to realize that this means that I AM doing the “right” thing! Using this obsession through my voice and my energy, especially working in senior healthcare, is definitely the next “right” thing for me to do.

TRUTH ABOUT THIS DISEASE:  The statistics are sobering (*AlzAssoc, 2016).

 *More than 5 million Americans are living with Alzheimer’s disease. Of these 5 million, most are aged 65 and older, but approximately 200,000 are under age 65. They have early-onset Alzheimer’s. My friend Tyler, a young advocate that I met in Washington, is a 23-year-old college student. He lost his mom last December at the age of 48 from Early Onset Alzheimer’s Disease. He has also lost his grandparents and his aunt and uncle to Alzheimer’s. He has been living with this disease since he was six-years-old. When he testifies, there isn’t a dry eye in the room. He is now in a clinical trial in which he will find out this summer if he will eventually contract Alzheimer’s. Did I mention that he is only 23!!! He has already seen and experienced this disease in many ways most of us cannot even fathom.

*Alzheimer’s is the sixth leading cause of death in the United States.

*1 in 3 seniors die with Alzheimer’s or another Dementia. *In 2015, more than 15-million caregivers provided an estimated 18.1 billion hours of unpaid care. Alzheimer’s costs caregivers more than their time. Family caregivers spend more than $5,000 a year caring for someone with Alzheimer’s. For some families, this means missing a vacation, but for others, it may mean going hungry.

*WOMEN are the epicenter of the Alzheimer’s crisis. Almost two-thirds of American senior living with Alzheimer’s disease are women…no one knows why. Women are also the main caregivers for others with Alzheimer’s disease.

*In 2016, Alzheimer’s and other dementias cost the nation approximately $236 billion!


*Alzheimer’s is the only disease among the top ten causes of death in America that cannot be prevented, cured or even slowed. Think about that one! The Walk to End Alzheimer’s is the only Fundraising “Walk” with absolutely NO SURVIVORS participating.

These are actual statistics that we use in Washington to advocate with on Capitol Hill and in front of Congress when testifying…Powerful, right? Here are some of the MOST powerful verbal advocating tools:

“Congressman XX–we need your help! Please endorse the new Hope for Alzheimer’s Act legislation so that people like my mom are cared for properly. My mom had her own “poop” under her fingernails because she forgot what toilet paper was and wouldn’t let anyone in the bathroom with her. My mom hit, slapped and punched my dad on more than a few occasions because she forgot ‘who this strange man was in her house, and her husband would not like it.’ My mom fell over the open dishwasher door onto her face because she had lost all spatial distance ability. My poor dad had no idea what to do with her and how serious the situation was because he was not aware of any resources available to him. IT’S NOT THE NOTEBOOK, CONGRESSMAN. My dad hid things from his own children because of the stigma. The STIGMA of this insidious disease is overwhelming to the everyday person. It is not a mental illness, Congressman, but a disease of the brain…the brain is actually DYING while the person is still living. This IS A DISEASE and this disease will bankrupt our country very soon if we don’t get your support.”


Congress and their staff are inundated by papers and all sorts of disease advocacy, so it’s my job to be a real as possible to shine the light on this disease and what it does in comparison to other diseases. I’ve seen their jaws drop and conversations shift from listening politely, to actually identifying with our advocacy. People still talk about this disease and how it has affected them personally from a place of shame and embarrassment. THIS is what needs to stop and, finally, that is changing through our advocacy.

I will tell you that since I have been advocating with others from around the country these last three years, we have had a historic $936 million approved for Alzheimer’s specific disease research through Congress to the NIH that was implemented in FY 2016. It’s working, and with the help of philanthropic organizations from around the country, we are bringing more awareness to what lies ahead if we don’t start paying more attention to Alzheimer’s disease. We are still hundreds of millions below what is currently being spent on cancer and heart disease research.

What does the future hold for our healthcare system and disease advocacy in our current political state? I cringe at the thought. We are in a very dangerous time for disease advocacy and healthcare futures for our citizens. Medicare hangs in the balance of our elected officials in Washington. I am not encouraged by what I am seeing on a daily basis coming out of our nation’s capital. WE MUST CONTINUE TO FIGHT! We must keep raising our voices to our political figures, to our healthcare providers and to our families and friends. We must resist at every turn! We cannot lose ground on what we have accomplish thus far.

Is advocating for everyone? No, probably not. It’s raw and usually is most effective when borne on, and from, personal experiences. It IS my comfort zone, however. It IS something that I can do to help slow the trajectory of this disease. It is personal and professional for me. Most importantly, it is the next “right” thing to do to make a difference. I will continue with my obsession.


[Maria Martini Deneau lives in Portage, Michigan, where she is a professional home healthcare specialist and a tireless crusader for those who suffer with Alzheimer’s and Dementia. Maria also serves as a determined, indefatigable volunteer and advocate serving as an ambassador for the Alzheimer’s Association.]