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January 7, 2018 E-Newsletter

Publication 2018 Issue 01 Published in house by the RI ARA

As U.S. budget fight looms, Republicans flip their fiscal script The head of a conservative Republican faction in the U.S. Congress, who voted this month for a huge expansion of the national debt to pay for tax cuts, called himself a "fiscal conservative" on Sunday and urged budget restraint in 2018. In keeping with a sharp pivot under way among Republicans, U.S. Representative Mark Meadows, speaking on CBS' "Face the Nation," drew a hard line on federal spending, which lawmakers are bracing to do battle over in January. When they return from the holidays on Wednesday, lawmakers will begin trying to pass a federal budget in a fight likely to be linked to other issues, such as immigration policy, even as the November congressional election campaigns approach in which Republicans will seek to keep control of Congress. President Donald Trump and his Republicans want a big budget increase in military spending, while Democrats also want proportional increases for non-defense "discretionary" spending on programs that support education, scientific research, infrastructure, public health and environmental protection. "The (Trump) administration has already been willing to say: 'We're going to increase non-defense discretionary spending ... by about 7 percent,'" Meadows, chairman of the small but influential House Freedom Caucus, said on the program. "Now, Democrats are saying that's not enough, we need to give the government a pay raise of 10 to 11 percent. For a fiscal conservative, I don't see where the rationale is. ... Eventually you run out of other people's money," he said. Meadows was among Republicans who voted in late December for their party's debt-financed tax overhaul, which is expected to balloon the federal budget

deficit and add about $1.5 trillion over 10 years to the $20 trillion national debt. "It's interesting to hear Mark talk about fiscal responsibility," Democratic U.S. Representative Joseph Crowley said on CBS. Crowley said the Republican tax bill would require the United States to borrow $1.5 trillion, to be paid off by future generations, to finance tax cuts for corporations and the rich. "This is one of the least ... fiscally responsible bills we've ever seen passed in the history of the House of Representatives. I think we're going to be paying for this for many, many years to come," Crowley said. Republicans insist the tax package, the biggest U.S. tax overhaul in more than 30 years, will boost the economy and job growth. 'ENTITLEMENT REFORM' House Speaker Paul Ryan, who also supported the tax bill, recently went further than Meadows, making clear in a radio interview that welfare or "entitlement reform," as the party often calls it, would be a top Republican priority in 2018. In Republican parlance, "entitlement" programs mean food stamps, housing assistance, Medicare and Medicaid health insurance for the elderly, poor and disabled, as well as other programs created by Washington to assist the needy. Democrats seized on Ryan's early December remarks, saying they showed Republicans would try to pay for their tax overhaul by seeking spending cuts for social programs. But the goals of House Republicans may have to take a back seat to the Senate, where the votes of some Democrats will be needed to approve a budget and prevent a government shutdown. Democrats will use their leverage in the Senate, which Republicans narrowly control, to defend both discretionary non-

defense programs and social spending, while tackling the issue of the "Dreamers," people brought illegally to the country as children. Trump in September put a March 2018 expiration date on the Deferred Action for Childhood Arrivals, or DACA, program, which protects the young immigrants from deportation and provides them with work permits. The president has said in recent Twitter messages he wants funding for his proposed Mexican border wall and other immigration law changes in exchange for agreeing to help the Dreamers. Representative Debbie Dingell told CBS she did not favor linking that issue to other policy objectives, such as wall funding. "We need to do DACA clean," she said. On Wednesday, Trump aides will meet with congressional leaders to discuss those issues. That will be followed by a weekend of strategy sessions for Trump and Republican leaders on Jan. 6 and 7, the White House said. Trump was also scheduled to meet on Sunday with Florida Republican Governor Rick Scott, who wants more emergency aid. The House has passed an $81 billion aid package after hurricanes in Florida, Texas and Puerto Rico, and wildfires in California. The package far exceeded the $44 billion requested by the Trump administration. The Senate has not yet voted on the aid.

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President Trump has made 1,950 false or misleading claims over 347 days With just 18 days before President Trump completes his first year as president, he is now on track to exceed 2,000 false or misleading claims, according to our database that analyzes, categorizes and tracks every suspect statement uttered by the president. As of Monday, the total stood at 1,950 claims in 347 days, or an average of 5.6 claims a day. (Our full interactive graphic can be found here.) As regular readers know, the president has a tendency to repeat himself — often. There are now more than 60 claims that he has repeated three or more times. The president’s impromptu 30-minute interview with the New York Times over the

holidays, in which he made at least 24 false or misleading claims, included many statements that we have previously fact-checked. We currently have a tie for Trump’s most repeated claims, both made 61 times. Both of these claims date from the start of Trump’s presidency and to a large extent have faded as talking points. One of these claims was some variation of the statement that the Affordable Care Act is dying and “essentially dead.” The Congressional Budget Office has said that the Obamacare exchanges, despite welldocumented issues, are not imploding and are expected to remain stable for the foreseeable future. Indeed, healthy enrollment for the coming year has

surprised health-care experts. Trump used to say this a lot, but he’s quieted down since his efforts to repeal the law flopped. Trump also repeatedly takes credit for events or business decisions that happened before he took the oath of office — or had even been elected. Sixty-one times, he has touted that he secured business investments and job announcements that had been previously announced and could easily be found with a Google search… With the successful push in Congress to pass a tax plan, two of Trump’s favorite talking points about taxes — that the tax plan will be the biggest tax cut in U.S. history and that the United States is one of the highest-taxed nations — have rapidly moved up the list..Read More

Report: The American Public Spent $43 Million Last Year So Trump Could Play Golf The American public spent at least $43 million in order to support President Donald Trump‘s consider able golf habit in 2017. Reports on presidential golf expenses are not itemized under official U.S. government statistics or written into the outlays for the U.S. governmental financial year. Rather, the $43 million total is a low-end estimate provided by (A similar tracker took note of President Barack Obama‘s similar ly publicized proclivity for the track.) Trump’s golf count is mostly based on confirmed news reports of presidential golf outings published by The Washington Post. Additional sources include White House Public Press Pool postings about golf and a handful of additional stories regarding Trump’s frequent golf forays issued by various media. The pool report statistics are culled from press pool RSS feeds

mentioning “any of the following words or phrases: vacation, palm beach, golf, golfing, golfed, Trump International, Trump National, Bedminster, [and/or] Sterling.” Bedminster, New Jersey is the home of the Trump National Golf Course. Sterling, Virginia is the home of the Trump National Golf Club. The entire methodology employed by is explained in two lengthy sections of the website here and here. In sum, President Trump made a confirmed 88 visits to various golf courses in 2017. Some caution, however, as a confirmed visit to a golf club doesn’t necessarily equate to a confirmed game of golf. That list is available in full here. To break down the numbers a bit, taxpayers shelled out just shy of $20 million for airfare on Trump’s golf outings to Mar-a-Lago alone. An additional $8.5

million was spent on flights to Trump’s Bedminister club. The site also features a side-by-side comparison between Presidents Obama and Trump–both maligned by their respective political opposition for spending an inordinate amount of time out on the links. When the 44th and 45th presidents faceoff over the dubious honor, however, Trump beats Obama hands-down. In fact, it’s not even close: After the first year of each man’s presidency, Obama had only played golf 28 times; Trump definitely played at least 43 times in that same timespan–and likely played around 76 games of golf–at a cost of roughly $1 million per game–all on the dime of the American people.

Rubio: GOP Tax Bill ‘Probably Went Too Far’ On Helping Corporations Sen. Marco Rubio (R-FL) said Friday that he believes the recently passed GOP tax bill did too much to help the bottom line of America’s largest corporations. “I thought we probably went too far on [helping] corporations,” the Florida Republican told the Fort Myers-based News-Press. “By and large, you’re going to see a lot of these multinationals buy back shares to

drive up the price,” Rubio continued. “Some of them will be forced, because they’re sitting on historic levels of cash, to pay out dividends to shareholders. That isn’t going to create dramatic economic growth.” The bill passed by the Republicancontrolled Congress and signed into law by President Donald Trump last week slashed the corporate tax rate from 35 to 21 percent. It also includes a number of provisions that benefit the country’s wealthiest residents rather than the middleclass Americans the GOP has insisted will

benefit from the plan, including a cut to the top income tax rate and for pass-through businesses. The bill will go into effect on Jan. 1, 2018. Rubio told the News-Press he was unconcerned about polls showing that most Americans disapprove of the legislation, saying the media has unfairly influenced peoples’ opinions and that ultimate perception of the bill will be based on “what their paycheck is telling them.”

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Here's how your tax bracket will change in 2018 President Donald Trump signed the Republican tax bill into law at the end of December. The new legislation makes sweeping changes to the tax code for businesses and, on average, American taxpayers. Here's how this new tax plan will change federal income tax brackets in 2018 compared with those in 2017.

      

First, for single filers: 10%: $0 to $9,525 of taxable income for an individual 12%: $9,526 to $38,700 22%: $38,701 to $82,500 24%: $82,501 to $157,500 32%: $157,501 to $200,000 35%: $200,001 to $500,000 37%: over $500,001

And second, for joint filers:

 10%: $0 to $19,050 for married joint filers  12%: $19,051 to $77,400  22%: $77,401 to $165,000  24%: $165,001 to $315,000  32%: $315,001 to $400,000  35%: $400,001 to $600,000  37%: Over $600,000 There are still seven federal income tax brackets — but at slightly lower rates and adjusted income ranges. About 70% of Americans claim the standard deduction when filing their taxes, and their paychecks will almost certainly increase — albeit slightly. In 2017, the standard deduction for a single taxpayer is $6,350, plus one personal exemption of $4,050.

The new law combines those into one larger standard deduction for 2018: $12,000 for single filers and $24,000 for joint filers.

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

RI ARA HealthLink Wellness News


Terrifying Brush With Death Drives Doctor To Fight For Patients The searing abdominal pain came on suddenly while Dr. Rana Awdish was having dinner with a friend. Soon she was lying in the back seat of the car racing to Henry Ford Hospital in Detroit, where Awdish was completing a fellowship in critical care. On that night nearly a decade ago, a benign tumor in Awdish’s liver burst, causing a cascade of medical catastrophes that nearly killed her. She nearly bled to death. She was seven months pregnant at the time, and the baby did not survive. She had a stroke and, over the days and weeks to come, suffered multiple organ failures. She required several surgeries and months of rehabilitation to learn to walk and speak again. Helpless, lying on a gurney in the hospital’s labor and delivery area that first

night, Awdish willed the medical staff to see her as a person rather than an interesting case of what she termed “Abdominal Pain and Fetal Demise.” But their medical training to remain clinically detached worked against her. Later, in the intensive care unit, she overheard her case being discussed by the surgical resident during morning rounds. “She’s been trying to die on us,” he said. It made her angry, she said, because she was trying desperately not to die. “I felt he was positing me as an adversary. If my care team didn’t believe in me, what possible hope did I have?” Awdish survived and returned to her work at Henry Ford Hospital, but her perspective was indelibly altered. In her recently published book, “In Shock,” she describes her through-the-looking-glass experience as a critically ill patient. The ordeal opened her eyes to communication lapses,

uncoordinated care and at times a total lack of empathy at an institution that says on its home page that health care there “should be built around just one person: you.” The health system has embraced many of her suggestions for change. Today, she splits her time working as a critical care physician and as the medical director of care experience for the Henry Ford Health System. In the past five years, she and three colleagues have developed a program to improve empathy and communication with patients, called Clear Conversations. At retr eats that typically last two days, Henry Ford Hospital staff practice having difficult conversations with improvisational actors who act as their patients. The program also trains providers in fundamental patient communications skills and offers real-time physician “shadowing” to provide feedback. ...Read More

Mild cognitive impairment 'treatable' with regular exercise, say experts The American Academy of Neurology have updated their clinical practice guidelines for the care of people with mild cognitive impairment to recommend that they take regular exercise. The guidelines were updated after a systematic review of published scientific evidence on mild cognitive impairment (MCI) by an American Academy of Neurology (AAN) expert panel. In reporting their recent findings in the journal Neurology, the AAN panel say that while there is no "high-quality evidence" that supports the treatment of MCI using drugs, regular exercise training may improve "cognitive measures."

The risk of developing MCI, a medical conditionassociated with problems with memory and thinking, rises with age. MCI often precedes dementia There is strong evidence to suggest that MCI can progress to dementia, though not everyone who has MCI will go on to develop dementia. The AAN say that people aged 65 and over who have MCI have a 7.5 percent risk of developing dementia during the first year after diagnosis. By the third year, the total risk rises to about 20 percent. Those with MCI have a milder form of some symptoms seen in people with dementia. For instance, they may struggle to

finish complex tasks and fully grasp information that they have read. By contrast, people with dementia struggle with tasks that are key to independent living, such as eating, bathing, and getting dressed. The updated AAN guideline — which is endorsed by the Alzheimer's Association — states that, as long as the condition "is not linked to a disease of the brain cells that gets worse over time," MCI can be treatable….Read More

Could measuring blood caffeine catch Parkinson's early? A new study looks to blood caffeine levels in search of a better means to diagnose Parkinson's disease before the first clear symptoms start to show. Parkinson's disease is a neurodegenerative disorder that is characterized by tremor of the limbs, difficulties with maintaining balance and coordination, and slowness of movement. The disease tends to develop in adults

over 60 years of age, and its symptoms are known to worsen over time. Parkinson's disease affects more than 4 millionpeople globally, and in the United States, around 60,000 new cases are diagnosed yearly, according to data from the National Institutes of Health (NIH). Previous research has revealed that early diagnosis of Parkinson's disease can lead to improved health outcomes, decelerated symptoms, and preserved neuromotor abilities.

But so far, it has been difficult to diagnose the condition in its early stages, due to the fact that the most obvious symptoms — which are related to motor impairment — become more visible only in the later stages of the disease. Now, scientists from the Juntendo University School of Medicine in Tokyo, Japan, are investigating the potential of blood caffeine level tests in diagnosing Parkinson's early on….Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Parkinson's stages: Signs and symptoms Parkinson's disease is a brain disorder that causes coordination issues, including tremors and speech impediments. A person may have all or only some of the symptoms associated with Parkinson's. While everyone with Parkinson's experiences the disease differently, it is broken down into several stages depending on the symptoms. In this article, we look at the signs and symptoms that are typically present at each stage of the disease. What are the stages of Parkinson's? Parkinson's disease is broken into five stages. Each stage presents changing or new symptoms that a person is likely to encounter. Dividing the disease into stages helps doctors and caregivers understand and address some of the challenges a person is experiencing as the disease progresses. Stage 1 The five stages of Parkinson's measure the severity of symptoms. During the initial stages of Parkinson's disease, the symptoms are typically not severe. A person can perform everyday tasks with minimal issues, so many of the signs and symptoms of stage 1 can be missed. Some signs and symptoms of this stage include changes in:

 posture  facial expressions  walking In addition, a person may experience mild tremors on one side of the body. A doctor might prescribe medication at this stage that will help control the symptoms. Stage 2 Tremors, trembling, and stiffness affect both sides of the body in stage 2 of the disease and are much more noticeable. The increased stiffness is often enough to delay tasks. A person may find it difficult to maintain independent living, according to their age and other factors. Walking, speech, and posture problems are often more noticeable in stage 2 of Parkinson's. Stage 3 Stage 3 or mid-stage Parkinson's disease is characterized by an increase in symptoms. A person will experience most or all of the symptoms of stage 2, plus:  problems with balance  slow movements  slow reflexes A person with stage 3 Parkinson's must be aware of the increased likelihood of falling due to coordination issues. Dressing and other self-care tasks may become more difficult. Treatment at this stage often involves both medication and occupational or physical therapy. Some people respond favorably to treatment, while others may not

experience much improvement. Stage 4 During stage 4 Parkinson's, daily activities may be challenging or even impossible. It is likely that a person will require some form of daily care, as independent living is not usually possible. People at this stage may be able to stand on their own but may need a walker or other assistive device to walk. Stage 5 Stage 5 is the last and most debilitating stage of Parkinson's disease. A person will not be able to stand or move around due to stiffness. Depending on their age and health, they may be bedridden or use a wheelchair for mobility. Unlike earlier stages, a person will need constant nursing aides. Aides will help the person do daily activities and prevent dangerous situations or accidents from occuring. In stage 5, a person may also experience:  hallucinations  delusions  dementia  poor response to medication  Confusion Read More: Signs and symptoms Rating scales How does Parkinson's progress? Outlook

Head and neck cancer: Acid reflux may raise risk in seniors New research investigates whether the common acid reflux is a risk factor for head and neck cancer in elderly people. Dr. Edward D. McCoul, at the Tulane University School of Medicine in New Orleans, LA, and colleagues led the new study. Their findings were published in JAMA Otolaryngology: Head & Neck Surgery. As they say, cancers of the upper aerodigestive tract (UADT) include malignancies of the larynx, tonsils, and sinuses, among others. Worldwide, these cancers account for more than 800,000 yearly diagnoses of cancer and more than 360,000 yearly deaths. In the United States, it is estimated that 62,000 people develop head and neck cancers every year, which include oral

cavity and larynx malignancies. There are several factors that are potentially accountable for these cancers, write Dr. McCoul and colleagues, including the use of alcohol and tobacco, viral infections, and chronic inflammation of the upper airways. But existing studies that have examined the link between the gastroesophageal reflux disease — commonly known as acid reflux or heartburn — and UADT cancers have yielded mixed results. Additionally, this association has not yet been studied in the elderly U.S. population. So, Dr. McCoul and colleagues set out to examine it. In the U.S., it is estimated that acid reflux affects as much as 20 percent of the population. Adults with obesity and the

elderly are particularly prone to the condition, studies show. “These data suggest " that elderly patients with [acid reflux] in the United States are 3.47, 3.23, 2.88, and 2.37 times as likely as those without [acid reflux] to be diagnosed with laryngeal, hypopharyngeal, oropharyngeal, and tonsillar cancers, respectively." Read More: Acid reflux may raise laryngeal cancer risk Strengths and limitations of the study

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •


RI ARA January 7, 2018 E-Newsletter


RI ARA January 7, 2018 E-Newsletter