Category: Kim Bellard

Trade Ya Subsidies For a Government

Oct 13, 2025

By KIM BELLARD

As you may have heard, the federal government is currently shut down, although for many federal workers – those deemed “essential” – that just means they keep on working but don’t get paid (and, in fact, some might never get paid). The cause is the now-standard failure of Congress to pass a budget. As it often does in these instances, the House did pass a continuing resolution (CR) to keep the government open (for seven weeks), and Senate Republicans are willing to go along, but Senate Democrats are balking. Even though they’re usually the ones who advocate “clean’ CRs, this time they’re holding out to include some other legislative fixes. Their key demand: continuing the expanded ACA premium tax credits.

I am a little puzzled why this is the hill upon which they’re willing to keep the government shut down.

Let’s back up. When ACA was passed in 2010, a crucial component was subsidies to help low- income people afford ACA coverage (along with subsidies for cost-sharing features like deductibles). Subsidies were, and are, crucial for the ACA marketplace to survive. These subsidies came in the form of premium tax credits.

If you recall the dismal individual health insurance marketplace pre-ACA, individuals couldn’t get coverage unless they passed medical underwriting, and, even then, preexisting conditions exclusions applied. As a result, few qualified and everyone complained. ACA did away with medical underwriting and pre-existing conditions exclusions, but the only way to ensure that enough healthy people would join the risk pool was to generously subsidize their coverage, much as employers do with employment-based health insurance. Thus the premium tax credits.

The trade-off worked for almost ten years. About ten million people got coverage through the exchanges. Then the pandemic hit. People needed coverage more than ever, yet many people’s incomes crashed. So in 2021 Congress passed “enhanced” premium tax credits as part of the American Rescue plan Act. They increased the amounts of the credits and made them available to some higher income families. Those expanded credits were extended to the end of 2025 as part of the Inflation Reduction Act.

It is those expanded premium tax credits that are expiring. The original credits would remain. Things would go back to the way they were pre-pandemic (although, of course, premiums are now higher due to inflation). It’d be more of a setback than a catastrophe.

The expanded tax credits did have a dramatic impact. Enrollment went from about ten million to over 24 million – 22 million of whom had the expanded credits. So it certainly is a non-trivial matter if they expire. KFF estimates that average premiums would double in 2026.

Still, though, CBO estimates loss of the expanded credits would result in about 3.8 million people losing coverage, which is a far cry from the 14 million whom gained coverage since they were implemented.

I’m not sure if the CBO is being overly optimistic, or if ACA has taught people to appreciate their coverage.

Everyone in Congress knew, or should have known, that these tax credits were expiring this year.

And Yet It Moves

Sep 24, 2025

By KIM BELLARD

Science buffs will recognize the title as the (possibly apocryphal) quote Galileo muttered after he was forced by the Catholic Church to recant his assertion that the earth moved around the sun, contrary to church dogma. We’re in an era where it is the Trump Administration, not the church, forcing people and organizations to accede to things they don’t really believe in, whether they are law firms, universities, media companies, or big corporations, to name a few.

That’s why I was so pleased when last week the National Academies of Sciences, Engineering, and Medicine (NAS) not only didn’t take a knee about the Trump Administration’s dogma about climate change being a hoax, they also didn’t just mutter their objections. They issued a lengthy report outlining how climate change is very real, is largely due to human contributions, and is extremely bad for us and the planet.

And yet it moves indeed.

The NAS was spurred into action by an EPA announcement proposing to rescind an Endangerment Finding issued in 2009 by the Obama EPA. “With this proposal, the Trump EPA is proposing to end sixteen years of uncertainty for automakers and American consumers,” EPA Administrator Zeldin said.“In our work so far, many stakeholders have told me that the Obama and Biden EPAs twisted the law, ignored precedent, and warped science to achieve their preferred ends and stick American families with hundreds of billions of dollars in hidden taxes every single year.” He was practically giddy.

Not so fast, the NAS report says. Its overarching conclusion: “EPA’s 2009 finding that the human-caused emissions of greenhouse gases threaten human health and welfare was accurate, has stood the test of time, and is now reinforced by even stronger evidence.”

The report lists five key conclusions:

Emissions of greenhouse gases (GHGs) from human activities are increasing the concentration of these gases in the atmosphere.
Improved observations confirm unequivocally that greenhouse gas emissions are warming Earth’s surface and changing Earth’s climate.
Human-caused emissions of greenhouse gases and resulting climate change harm the health of people in the United States.
Changes in climate resulting from human-caused emissions of greenhouse gases harm the welfare of people in the United States.
Continued emissions of greenhouse gases from human activities will lead to more climate changes in the United States, with the severity of expected change increasing with every ton of greenhouse gases emitted.

Pulling no punches, it says:

In summary, the committee concludes that the evidence for current and future harm to human health and welfare created by human-caused GHGs is beyond scientific dispute. Much of the understanding of climate change that was uncertain or tentative in 2009 is now resolved and new threats have been identified. These new threats and the areas of remaining uncertainty are under intensive investigation by the scientific community. The United States faces a future in which climate-induced harm continues to worsen and today’s extremes become tomorrow’s norms.

i.e., “And yet we are endangering ourselves, and the planet.”

Shirley Tilghman, professor of molecular biology and public affairs, emeritus, and former president, Princeton University, and chair of the committee that wrote the report, was more diplomatic: “This study was undertaken with the ultimate aim of informing the EPA, following its call for public comments, as it considers the status of the endangerment finding. We are hopeful that the evidence summarized here shows the strong base of scientific evidence available to inform sound decision-making.”

That’s More Like It

Sep 12, 2025

By KIM BELLARD

I’m always on the lookout for advances in healthcare that seem more like 22^st century medicine than what we still experience in 2025. Way too much of it seems less advanced than we should be expecting in a world of AI, genetic engineering, nanobots, and the like. I often think of the scene in Star Trek IV where Dr. McCoy finds himself in a 20^th century hospital and is appalled:

So I’m pleased to report on a couple of developments that seem like the future.

Transcranial ultrasound stimulation (aka “ultrasound helmet): You may not have ever heard of deep brain stimulation, unless you know someone who has advanced Parkinson’s, dystonia, essential tremors, or epilepsy. It turns out that electrical impulses to certain parts of the brain can help reduce the involuntary motions these conditions can result in.

The drawback is that deep brain stimulation is delivered by electrodes implanted deep in the brain. While this may not be quite as daunting as it sounds, people are still, you know, drilling holes in your head and pushing electrodes into your brain. You can imagine Dr. McCloy’s reaction.

Enter transcranial ultrasound stimulation. A new paper in Nature from researchers at University College London (UCL) and Oxford describes using a 256 element helmet to precisely aim ultrasound waves to accomplish the same results.

Our findings reveal this system’s potential to non-invasively modulate deep brain circuits with unprecedented precision and specificity, offering new avenues for studying brain function and developing targeted therapies for neurological and psychiatric disorders, with transformative potential for both research and clinical applications.

Professor Bradley Treeby, senior author of the study from UCL Medical Physics and Biomedical Engineering, said:

Clinically, this new technology could transform treatment of neurological and psychiatric disorders like Parkinson’s disease, depression, and essential tremor, offering unprecedented precision in targeting specific brain circuits that play key roles in these conditions.

The ability to precisely modulate deep brain structures without surgery represents a paradigm shift in neuroscience, offering a safe, reversible, and repeatable method for both understanding brain function and developing targeted therapies.

Have Some Water – While You Can

Jul 30, 2025

By KIM BELLARD

We live on a water world (despite its name being “Earth”). We, like all life on earth, are water creatures, basically just sacks of water. We drink it, in its various forms (plain, sparking, carbonated, sweetened, flavored, even transformed by a mammal into milk). We use it to grow our crops, to flush our toilets, to water our lawns, to frack our oil, to name a few uses. Yet 97% of Earth’s water is salt water, which we can’t drink without expensive desalination efforts, and most of the 3% that is freshwater is locked up – in icebergs, glaciers, the ground and the atmosphere, etc. Our civilization survives on that sliver of freshwater that remains available to us.

Unfortunately, we’re rapidly diminishing even that sliver. And that has even worse implications than you probably realize.

A new study, published in Science Advances, utilizes satellite images (NASA GRACE/GRACE-FO) to map what’s been happening to the freshwater in the “terrestrial water storage” or TWS we blithely use. Their critical finding: “the continents have undergone unprecedented TWS loss since 2002.”

Indeed: “Areas experiencing drying increased by twice the size of California annually, creating “mega-drying” regions across the Northern Hemisphere…75% of the population lives in 101 countries that have been losing freshwater water.” The dry parts of the world are getting drier faster than the wet parts are getting wetter.

“It is striking how much nonrenewable water we are losing,” said Hrishikesh A. Chandanpurkar, lead author of the study and a research scientist for Arizona State University. “Glaciers and deep groundwater are sort of ancient trust funds. Instead of using them only in times of need, such as a prolonged drought, we are taking them for granted. Also, we are not trying to replenish the groundwater systems during wet years and thus edging towards an imminent freshwater bankruptcy.”

As much as we worry about shrinking glaciers, the study found that 68% of the loss of TWS came from groundwater, and – this is the part you probably didn’t realize – this loss contributes more to rising sea levels than the melting of glaciers and ice caps.

This is not a blip. This is not a fluke. This is a long-term, accelerating trend. The paper concludes: “Combined, they [the findings] send perhaps the direst message on the impact of climate change to date. The continents are drying, freshwater availability is shrinking, and sea level rise is accelerating.”

Yikes.

“These findings send perhaps the most alarming message yet about the impact of climate change on our water resources,” said Jay Famiglietti, the study’s principal investigator and a professor with the ASU School of Sustainability.

We’ve known for a long time that we were depleting our aquifers, and either ignored the problem or waved off the problem to future generations. The researchers have grim news: “In many places where groundwater is being depleted, it will not be replenished on human timescales.” Once they’re gone, we won’t see them replenished in our lifetimes, our children’s lifetimes, or our grandchildren’s lifetimes.

Professor Famiglietti is frank: “The consequences of continued groundwater overuse could undermine food and water security for billions of people around the world. This is an ‘all-hands-on-deck’ moment — we need immediate action on global water security.”

If all this still seems abstract to you, I’ll point out that much of Iran is facing severe water shortages, and may be forced to relocate its capital. Kabul is in similar straits. Mexico City almost ran out of water a year ago and remains in crisis. Water scarcity is a problem for as much as a third of the EU, such as in Spain and Greece. And the ongoing drought in America’s Southwest isn’t going any anytime soon.

Gen Z Should Give Health Care a Stare

Jul 28, 2025

By KIM BELLARD

Last I knew, Gen Z showed its disdain for older generations with a dismissive “OK Boomer.” But that was a few years ago, and now, it appears, Gen Z doesn’t even bother with that; instead, there is what has become known as the “Gen Z stare.” You’ve probably seen it, and may have even experienced it. TikTok influence Janaye defines it thusly: “The Gen Z stare is specifically when somebody does not respond or just doesn’t have any reaction in a situation where a response is either required or just reasonable.”

It’s been blowing up on social media and the media over the last few days, so it apparently has tapped into the social zeitgeist. It’s often been attributed to customer service interactions, either as a worker receiving an inane request or as a customer facing an undue burden.

You can already see why I link it to healthcare.

It’s off-putting because, as Michael Poulin, an associate psychology professor at the University at Buffalo, told Vox: “People interpret it as social rejection. There is nothing that, as social beings, humans hate more. There’s nothing that stings more than rejection.”

Many attribute the Gen Z stare to Gen Z’s lack of social experience caused by isolation during the pandemic, exacerbated by too much screen time generally. Jess Rauchberg, an assistant professor of communication technologies at Seton Hall University, would tend to agree, telling NBC News: “I think we are starting to really see the long-term effects of constant digital media use, right?”

Similarly, Tara Well, a professor at Bernard College, told Vox: “It’s sort of almost as though they’re looking at me as though they’re watching a TV show… We don’t see them as dynamic people who are interacting with us, who are full of thoughts and emotions and living, breathing people. If you see people as just ideas or images, you look at them like you’re paging through an old magazine or scrolling on your phone.”

Millennial Jarrod Benson told The Washington Post: “It’s like they’re always watching a video, and they don’t feel like the need to respond. Small talk is painful. We know this. But we do it because it’s socially acceptable and almost socially required, right? But they won’t do it.” Zoomer (as those of Gen Z are known) Jordan MacIsaac speculated to The New York Times: “It almost feels like a resurgence of stranger danger. Like, people just don’t know how to make small talk or interact with people they don’t know.”

On the other hand, TikTok creator Dametrius “Jet” Latham claims: “I don’t think it’s a lack of social skills. I just think we don’t care,” which might be more to the point.

ABC News cited some customer service examples that deserved a Gen Z stare: “I’ve been asked to make somebody’s iced tea less cold. I’ve been asked to give them a cheeseburger without the cheese, but keep the pepper jack of it all.” As Zoomer Efe Ahworegba put it: “The Gen Z stare is basically us saying the customer is not always right.”

Ms. Ahworegba doesn’t think a Gen Z stare doesn’t reflect Gen Z’s lack of social skills, but rather: “They just didn’t want to communicate with someone who’s not using their own brain cells.” As some Zoomers say, it is “the look they give people who are being stupid while waiting for them to realize they are being stupid.”

Still, as one commenter on TikTok wrote: “I think it’s hilarious that Gen Z thinks they’re the first generation to ever deal with stupidity or difficult customers, and that’s how they justify the fact that they just disassociate and mindlessly stare into space whenever they are confronted with a difficult or confusing situation, instead of immediately engaging in the situation like every other generation has ever done before them lol.”

Or perhaps this is much ado about nothing. Professor Poulin noted: “To some degree, it’s a comforting myth that all of us who are adults — who’ve gotten beyond the teens and 20s — that we tell ourselves that we were surely better than that.” When it comes to displaying socially acceptable behavior, he says: “This isn’t the first generation to fail.”

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Interestingly, Gen Z is already skeptical of our traditional healthcare system, as well they might be.