Today's most important story comes from Dr. Deborah Birx, the doctor advising the White House on the coronavirus. She warns that we are entering a “new phase” of the pandemic, when the virus is everywhere and is spreading at such a pace that we could see more than 300,000 deaths by the end of the year. On Saturday, the national daily death toll from Covid-19 reached 1,198, exceeding 1000 for the sixth day in a row.........Continue reading

I see the scissors
in front of thee,
yet you ask
for them incessantly.
I try to tell you
where they are,
while you grab them
both near and far.
"Are these them?"
is what you ask.
Now I understand
you know not too
what objects are
in front of you.

My head is a blender,
whirling words all about.
I tread lightly so my anger
doesn't appear and come out.

Perhaps this life will have to do.
I am certain I won't find another you.
A friend in this long, long life,
The special person, my beloved wife.
We have been through thick and thin,
Now fighting a battle we can't win.

There is so much futility;
You don't have the ability
Nor the tool for tranquility
And all become a liability,
Charging to an old utility,
Bringing you back to reality,
Resulting in the end. Finality

Anesthesiologist Claire Rezba started tracking lost health workers almost instinctively. Researchers and industry professionals say the lack of good official data on these deaths is “scandalous” and is putting lives in danger........Read More

NASA Astronomy Picture of the Day:

How different does sunset appear from Mars than from Earth? For comparison, two images of our common star were taken at sunset, one from Earth and one from Mars. These images were scaled to have same angular width and featured here side-by-side. A quick inspection will reveal that the Sun appears slightly smaller from Mars than from Earth. This makes sense since Mars is 50% further from the Sun than Earth. More striking, perhaps, is that the Martian sunset is noticeably bluer near the Sun than the typically orange colors near the setting Sun from Earth. The reason for the blue hues from Mars is not fully understood, but thought to be related to forward scattering properties of Martian dust. The terrestrial sunset was taken in 2012 March from Marseille, France, while the Martian sunset was captured in 2015 by NASA's robotic Curiosity rover from Gale crater on Mars. Last week a new rover and a helicopter -- onboard Mars 2020 -- launched for Mars.

Photo by Damia Bouic Right Image Credit: NASA, JPL-Caltech, MSSS; Digital processing: Damia Bouic

Shared by Heather Cox Richardson from Letters from an American with this message:

 "There are many things I would like to write about, but they will have to wait. There were too many nights lately that ended up as mornings, and I cannot hold my eyes open.
I will leave you with a photo that Buddy took this week while my day was ending and his starting. I love what I do, but there is no doubt that he has the nicer office.

Judy Garland (1922 - 1969) American actress, singer, and dancer

What is there to say?
What is there to do,
For each and every day
I lose more of you.

I fear not of death on this day,
for it would mean I've gone away.
I would no longer miss my friends
nor hear the words and Amen.

It is almost five am.
What is wrong with me?
I have been up,
since half past three.
Words pop into my brain,
falling like Summer rain.
If I don't write them down,
they will no longer be found,
for they disappear like raindrops do
and then I can't share them with you.

Who is to blame?
Only time will tell
if you now have
a space reserved in Hell.

It appears you have succeeded
to isolate this Country from the World,
when the citizens are not welcome
to travel to other countries.
Nice plan.

If I couldn't hear.
If I couldn't see,
Would I understand
What is wrong with thee?

NASA Astronomy Picture of the Day:

Like an illustration in a galactic Just So Story, the Elephant's Trunk Nebula winds through the emission nebula and young star cluster complex IC 1396, in the high and far off constellation of Cepheus. Also known as vdB 142, the cosmic elephant's trunk is over 20 light-years long. This detailed close-up view was recorded through narrow band filters that transmit the light from ionized hydrogen and oxygen atoms in the region. The resulting composite highlights the bright swept-back ridges that outline pockets of cool interstellar dust and gas. Such embedded, dark, tendril-shaped clouds contain the raw material for star formation and hide protostars within. Nearly 3,000 light-years distant, the relatively faint IC 1396 complex covers a large region on the sky, spanning over 5 degrees. This dramatic scene spans a 1 degree wide field of view though, about the size of 2 Full Moons. Mars 2020 Launch: photos from planet Earth

Photo by Chad Leader

When COVID-19 smacked the United States in March and April, health plans feared medical costs could skyrocket, jacking up premiums drastically in 2021, when millions of the newly unemployed might still be out of work.

But something else happened: Non-COVID care collapsed as hospitals emptied beds and shut down operating rooms to prepare for an expected onslaught of patients sickened by the coronavirus, while fear of contracting it kept people away from ERs, doctors’ offices and outpatient clinics. In many regions of the country, the onslaught did not come, and the billions of dollars lost by hospitals and physicians constituted huge savings for health plans, fattening their bottom lines.

But that doesn’t mean consumers will see lower premiums next year.

Numerous insurers across the country have announced plans to hike rates next year, though some have proposed cuts.

Peter Lee, executive director of Covered California, appeared skeptical about premium reductions in the state’s Affordable Care Act exchange, which is likely to announce 2021 health plan rates next week.

“Would we like zero increases? Absolutely. Would we like them negative? Yeah — but not if that means you’re going to increase premiums in a year by 20%,” Lee said in an interview with California Healthline this week. “We’ve been leaning on them to do what we always lean on them to do, and this is to have the lowest possible rates where you won’t be on a rate roller coaster. We want health plans to price right — not to price artificially low or artificially high.”

Covered California provides coverage for about 1.5 million residents who buy their own insurance.

If the insurance exchanges in other states offer any guidance for Covered California, it is in the direction of moderate premium increases for 2021, though there is wide variation.

A KFF analysis last week of proposed 2021 rates in the exchanges of 10 states and the District of Columbia showed a median increase of 2.4%, with changes ranging from a hike of 31.8% by a health plan in New Mexico to a cut of 12% in Maryland. (Kaiser Health News, which produces California Healthline, is an editorially independent program of KFF.)

Among the roughly one-third of filings that stated how much COVID-19 added to premiums, the median was 2%, with estimates ranging from minus 1.2% at a plan in Maine to 8.6% at one in Michigan.

The proposed premiums for ACA marketplace plans do not affect job-based coverage, but they may indicate how the pandemic is affecting premiums generally.

The consensus among industry experts is that COVID-19 has generated little pressure for rate rises, and health plans should err on the side of moderation. But some fear that many insurers will hold onto the reserves they’ve built up, citing the possibility of widespread vaccinations and concerns that the care forgone in 2020 could rebound with a vengeance next year.

“The tendency of health plans, when they are faced with any degree of uncertainty, is to be very conservative and price for the worst-case scenario,” said Michael Johnson, an industry observer and critic who worked as an executive at Blue Shield of California from 2003 to 2015. “Actuaries are less likely to get fired if the plan prices too high than if the plan prices too low. But I think regulators really need to push back hard on that.”

Lee said all 11 insurers participating in the exchange this year will remain in 2021, and no new ones will be added to the mix, though some of the current carriers will extend their coverage geographically. Ninety percent of consumers who buy their own health insurance get subsidies from the federal government or the state to help pay their premiums.

In January, California became the first state to offer subsidies to middle-income people who make too much money to qualify for federal subsidies. The lion’s share of the state subsidies is earmarked for those who earn between 400% and 600% of the federal poverty level, or $51,040 to $76,560 a year for an individual and $104,800 to $157,200 for a family of four.

The rate proposals expected to be unveiled next week will be subject to scrutiny by state regulators before they are finalized. Sign-ups for the plans start Nov. 1 and run through Jan. 31. This year, the average Covered California rate increase statewide was 0.8%, the lowest since the exchange started providing coverage in 2014.

The benefits reaped by health plans so far in the pandemic can be seen in strong second-quarter earnings and reduced spending on care. UnitedHealth Group, the nation’s largest health insurer, announced earlier this month that its net profit in the April-June quarter nearly doubled from the same period a year earlier. Its medical spending plummeted from 83.1% of premium revenue to 70.2% over that period.

Anthem, the parent company of Blue Cross of California, reported Wednesday that its net profit in the second quarter doubled from the same period in 2019, also on the back of plunging medical expenses.

Anthem said it offered one-month premium credits ranging from 10% to 50% to enrollees in individual, employer and group dental policies — including its Blue Cross plans in California.

UnitedHealth said it has provided $1.5 billion worth of financial support to consumers so far, including premium credits and cost-sharing waivers, and expects to pay out $1 billion in rebates.

But UnitedHealth, which does not participate in Covered California, is seeking a rate increase of 13.8% in the New York exchange. Anthem, which covers about 80,000 people in Covered California, is planning rate hikes of 16.6% in Kentucky and 9.9% in Connecticut.

On the other hand, Kaiser Permanente, which covers more than one-third of Covered California enrollees, plans rate cuts in other states, ranging from 1% in Hawaii to 11% in Maryland. (Kaiser Health News, which produces California Healthline, is not affiliated with Kaiser Permanente.)

Lee downplayed the notion of a financial boon for California health plans, saying that, partly because of the use of telehealth, primary care has rebounded and the plans are paying for it. “So we don’t see this as being at this point a bonanza year for health plans,” he said. “Rather, it’s a year in which there are lessons learned for how we can deliver care in a pandemic.”

Still, the health plans are in a far stronger position than they had feared earlier this year.

In March, Covered California released a study showing that COVID-19’s impact on 2021 premiums for individuals and employers could range from an increase of 4% to more than 40%. But less than three months later, projections commissioned by the industry’s national advocacy group, America’s Health Insurance Plans, showed that even in the worst-case scenario of a 60% COVID infection rate — far above where it stands now — the pandemic would increase medical costs in 2020 and 2021 by 6% at most, and could even decrease them.

That moderate effect is largely attributable to what Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation, called “a kind of yin and yang: If you have a lot of COVID, you don’t have a lot of other health care spending.”

Independent of the course the pandemic takes, emergency room and outpatient visits still lag behind pre-COVID levels and will probably continue to do so next year, to the continued benefit of insurers, predicted Glenn Melnick, a professor of health care finance at the University of Southern California’s Sol Price School of Public Policy. That could be good news for consumers, he said, potentially leading to lower premium increases or even reductions next year.

On the other hand, hospitals and doctors have lost money, and the ones whose contracts with health plans are up for renewal will be looking to make up those losses, Melnick said.

“Providers could be asking for 20-25% increases next year,” he said, “and if they’ve got market power, they can make it stick.”

July 31, 2020

Mr. President, you talk big right now but you must know that the overwhelming majority of the citizens of our country, believe you have failed us in so many many ways that sometimes we think it is nothing but a bad dream.  You continue to do all you can to divide us and to create turmoil. For most of us now, it is not about politics anymore, it is about the survival of our country, our freedoms, the well being of our families, and the future of our children and future generations.

As I see it. the time has come for you to consider one of these three alternatives:

 - Resign now. Make up a story, you are good at that. About 40% of the people may believe it

 - Declare that you will not seek or accept another term (see making up a story above) 

 - Run for another term and get ready to be defeated by a landslide “the likes of which has never been seen before”

  You get to decide Mr. President.  I hope you make the right decision for our country.

NASA Astronomy Picture of the Day:

On Thursday this snapshot from a small plane 5,000 feet above Florida's Space Coast caught a rocket's trail rising into the blue morning sky. It was July's third launch of a mission from planet Earth bound for Mars. The Atlas V rocket left Cape Canaveral Air Force Station from Space Launch Complex 41 at 7:50am EDT carrying NASA's Mars 2020 Perseverance Rover. The car-sized Perseverance is headed for a landing at Jezero Crater on the Red Planet in February 2021. On board the sophisticated rover is the Ingenuity Mars Helicopter. Mars 2020 Launch: photos from planet Earth

Photo by John Kraus

Quick, easy and healthy, mango salsa. Great with chips best friend! - Click the image below to read Marta Rivera's recipe at Simply Recipes