Congress Must Focus On Public Health To Avoid Another Crisis

How to reduce the impact of coronavirus on our lives - The Washington PostSource: Las Vegas Sun, by Christina Madison

Our country is on the verge of another health care crisis, and families across Nevada will pay the price if Congress fails to protect our access to affordable care and coverage.

I am a clinical pharmacist specializing in public health with a focus on communicable diseases. My nearly two-decade career has been spent working in communities counseling patients on how to treat and prevent the spread of infectious diseases. For the past two years, that work kicked into overdrive. I set up COVID testing sites and vaccine clinics, where I facilitated the administration of more than 11,000 vaccine doses in Southern Nevada.

My work over the years — and especially during the pandemic — has put a spotlight on the need to focus on our health. We need Congress to focus on our health, too, and extend the tax credits included in the American Rescue Plan. Last year, a record number of Americans signed up for marketplace coverage, including more than 101,000 Nevadans. Ninety-percent of those who enrolled in health insurance coverage through the Silver State Health Insurance Exchange received premium subsidies to make their coverage more affordable.

These provisions delivered big for Nevada families. I hear it all the time from the patients I see at the two clinical practices I maintain — having extra layer of financial security and less stress from having to choose between affording health care or paying rent, cooling their homes, and keeping food on the table was a godsend. In fact, the average family saved $2,400 a year on their health care because of these affordable plans.

But unfortunately, the expanded tax credits that powered those savings will expire at the end of the year, and millions of Americans could see their premiums increase in 2023.

Fortunately, our Democratic representatives in Washington, D.C., are working to keep premiums low and further reduce health care costs. Last November, Reps. Dina Titus, Susie Lee, and Steven Horsford voted to extend the health care premium reductions in the American Rescue Plan to prevent our premiums from skyrocketing at the end of this year. Our senators, Catherine Cortez Masto and Jacky Rosen, are on board to extend the premium tax credits for working families, too. Other Democrats in the Senate should follow their lead. If Senate Democrats fail to get the bill passed, 9 million Americans will face increased health care costs and 3 million will lose coverage altogether.

The American Rescue Plan helped give millions of American families the resources to focus on their health when we needed it most. For many families, this has not only helped make ends meet during the pandemic but allowed them to access essential care for the first time in years.

We cannot go backwards. Lawmakers need to listen to Nevadans and not let the health care premium reductions in the American Rescue Plan expire. If they do, millions will see dramatic increases in their 2023 health insurance premiums, and many will no longer be able to afford insurance at all. But the saving grace is that this is entirely preventable. Senate Democrats must act now to ensure families can continue to afford the health care they need.

Citing a Mental Health Crisis Among Young People, California Lawmakers Target Social Media

Citing a mental health crisis among young people, California lawmakers  target social media

Source: Kaiser Health News, by ZInnia Finn

Karla Garcia said her son’s social media addiction started in fourth grade, when he got his own computer for virtual learning and logged on to YouTube. Now, two years later, the video-sharing site has replaced both schoolwork and the activities he used to love — like composing music or serenading his friends on the piano, she said.

“He just has to have his YouTube,” said Garcia, 56, of West Los Angeles.

Alessandro Greco, now 11 and a soon-to-be sixth grader, watches videos even when he tells his mom that he is starting homework, making his bed, or practicing his instrument. When she confronts him, she said, he gets frustrated and says he hates himself because he feels like watching YouTube isn’t a choice.

Alessandro tells her he just can’t pull himself away, that he is addicted.

“It’s vicious — they’ve taken away my parenting ability,” Garcia said. “I can’t beat this.”

Some California lawmakers want to help Garcia and other parents protect their children’s mental health by targeting website elements they say were designed to hook kids — such as personalized posts that grab and hold viewers on a specific page, frequent push notifications that pull users back to their devices, and autoplay functions that provide a continuous stream of video content.

Two complementary bills in the state legislature would require websites, social media platforms, or online products that children use — or could use — to eliminate features that can addict them, harvest their personal information, and promote harmful content. Those that don’t comply could face lawsuits and hefty fines. One of the measures would impose penalties of up to $7,500 per affected child in California — which could amount to millions of dollars.

Federal lawmakers are making a similar push with bills that would tighten children’s privacy protections and target features that foster addiction. One would require online platforms to provide tools to help parents track and control their children’s internet use. The measures were approved by a U.S. Senate committee July 27.

“We have to protect kids and their developing brains,” said California Assembly member Jordan Cunningham (R-San Luis Obispo), a lead author of both bills and a father of four children, at a committee hearing in June. “We need to end Big Tech’s era of unfettered social experimentation on children.”

But Big Tech remains a formidable foe, and privacy advocates say they are concerned one of the California measures could increase data intrusions for everyone. Both bills have cleared the state Assembly, but whether they will survive the state Senate is unclear.

Tech companies, which wield immense power in Sacramento, say they already prioritize users’ mental health and are making efforts to strengthen age verification mechanisms. They are also rolling out parental controls and prohibiting messaging between minors and adults they don’t know.

But these bills could violate companies’ free speech rights and require changes to websites that can’t realistically be engineered, said Dylan Hoffman, executive director of TechNet for California and the Southwest. TechNet — a trade association for tech companies, including Meta (the parent company of Facebook and Instagram) and Snap Inc. (which owns Snapchat) — opposes the measures.

“It’s an oversimplified solution to a complex problem, and there isn’t anything we can propose that will alleviate our concerns,” Hoffman said about one of the bills that specifically targets social media.

Last year, the U.S. surgeon general, Dr. Vivek Murthy, highlighted the nation’s youth mental health crisis and pointed to social media use as a potential contributor. Murthy said social media use in teenagers had been linked to anxiety and depression — even before the stress of covid-19. Then during the pandemic, he said, the average amount of teenagers’ non-academic screen time leaped from almost four hours a day to nearly eight.

“What we’re trying to do, really, is just keep our kids safe,” Assembly member Buffy Wicks (D-Oakland), another lead author of the California bills and a mother of two children, said at the June committee hearing.

One of Cunningham and Wicks’ bills, AB 2273, would require all online services “likely to be accessed by a child” — which could include most websites — to minimize the collection and use of personal data for users younger than 18. This includes setting default privacy settings to the maximum level unless users prove they are 18 or older, and providing terms and service agreements in language a child can understand.

Modeled after a law passed in the United Kingdom, the measure also says companies should “consider the best interests of children when designing, developing, and providing that service, product, or feature.” That broad phrasing could allow prosecutors to target companies for features that are detrimental to children. This could include incessant notifications that demand children’s attention or suggestion pages based on a child’s activity history that could lead to harmful content. If the state attorney general determines a company has violated the law, it could face a fine of up to $7,500 per affected child in California.

The other California bill, AB 2408, would allow prosecutors to sue social media companies that knowingly addict minors, which could result in fines of up to $250,000 per violation. The original version would also have allowed parents to sue social media companies, but lawmakers removed that provision in June in the face of opposition from Big Tech.

Together, the two California proposals attempt to impose some order on the largely unregulated landscape of the internet. If successful, they could improve kids’ health and safety, said Dr. Jenny Radesky, an assistant professor of pediatrics at the University of Michigan Medical School and a member of the American Academy of Pediatrics, a group that supports the data protection bill.

“If we were going to a playground, you’d want a place that had been designed to let a child explore safely,” Radesky said. “Yet in the digital playground, there’s a lot less attention to how a child might play there.”

Radesky said she has witnessed the effects of these addictive elements firsthand. One night, as her then-11-year-old son was getting ready for bed, he asked her what a serial killer was, she said. He told her he had learned the term online when videos about unsolved murder mysteries were automatically recommended to him after he watched Pokémon videos on YouTube.

Adam Leventhal, director of the University of Southern California Institute for Addiction Science, said YouTube recommendations, and other tools that mine users’ online history to personalize their experiences, contribute to social media addiction by trying to keep people online as long as possible. Because developing brains favor exploration and pleasurable experiences over impulse control, kids are especially susceptible to many of social media’s tricks, he said.

“What social media offers is a highly stimulating, very fast feedback,” Leventhal said. “Any time that there is an activity where you can get a pleasurable effect and get it fast and get it when you want it, that increases the likelihood that an activity could be addictive.”

Rachel Holland, a spokesperson for Meta, explained in a statement that the company has worked alongside parents and teens to prioritize kids’ well-being and mitigate the potential negative effects of its platforms. She pointed to a variety of company initiatives: In December 2021, for example, it added supervision tools on Instagram that allow parents to view and limit kids’ screen time. And in June, it started testing new age verification tactics on Instagram, including asking some users to upload a video selfie.

Snap spokesperson Pete Boogaard said in a statement that the company is protecting teens through steps that include banning public accounts for minors and turning location-sharing off by default.

Meta and Snap declined to say whether they support or oppose the California bills. YouTube and TikTok did not respond to multiple requests for comment.

Privacy groups are raising red flags about the measures.

Eric Null, director of the privacy and data project at the Center for Democracy and Technology, said the provision in the data protection bill that requires privacy agreements to be written in age-appropriate language would be nearly impossible to implement. “How do you write a privacy policy for a 7-year-old? It seems like a particularly difficult thing to do when the child can barely read,” Null said.

And because the bill would limit the collection of children’s personal information — but still require platforms that children may access to gather enough details to verify a user’s age — it could increase data intrusions for all users, he said. “This is going to further incentivize all online companies to verify the age of all of their users, which is somewhat counterintuitive,” Null said. “You’re trying to protect privacy, but actually you’re now requiring a lot more data collection about every user you have.”

But Karla Garcia is desperate for action.

Thankfully, she said, her son doesn’t watch violent videos. Alessandro prefers clips from “America’s Got Talent” and “Britain’s Got Talent” and videos of one-hit wonders. But the addiction is real, she said.

Garcia hopes legislators will curtail the tech companies’ ability to continually send her son content he can’t turn away from.

“If they can help, then help,” Garcia said. “Put some sort of regulations on and stop the algorithm, stop hunting my child.”

Small Business Owners Predict a Retirement Crisis

An overwhelming majority of small-business owners say that the country is in the midst of a retirement crisis. The online study, commissioned by Nationwide and conducted by Harris Poll, found that 84% of small business owners say American workers are facing a retirement readiness crisis. However, 60% of small-business owners say that their own employees are on track to retire. Sixty-three percent of small business owners say it’s important for a business owner to provide retirement benefits, but only 34% offer these benefits to their employees.

Small businesses play an outsized role in helping workers prepare for retirement. According to the U.S. Small Business Administration, small businesses make up 99.7% of all employers, employ 49% of all private-sector workers, and create 63% of the new private-sector jobs in the country.

Joe Frustaglio of Nationwide said, “We’ve reached a point in this country where people are starting to pay attention to the fact that a retirement savings problem exists. Employers need to provide access and education, and workers need to take advantage of what’s available to them.”

Sixty-seven percent of small-business owners who offer retirement benefits, including 401(k)s, plan to increase their contribution to employees’ 401(k) plan. Thirty percent of small-business owners who don’t offer retirement benefits plan to offer these benefits in the future. If that happens, 54% of small-business owners will offer their employees retirement benefits.

Half of small-business owners who plan to start offering retirement benefits say they will do so because they expect sales or revenue to increase in the next 12 to 24 months, and 32% say the U.S. economy will improve in the same timeframe. Small business owners who offer 401(k) plans and say they will increase contributions have an even more positive outlook: 56% expect company sales or revenue to increase in the next 12 to 24 months, and 53% say the U.S. economy will improve in that same period.

“In spite of recent market volatility, economic indicators are pointing toward continued growth for the U.S. economy in 2016. Small business owners should see Main Street benefit from the economic stability that we’ve enjoyed during the last few years,” said David Berson, senior vice president and chief economist at Nationwide.

Twenty-five percent of small-business owners who plan to offer retirement benefits in the future say the ACA has made health benefits less attractive to employees, and 18% say the ACA has decreased company health care costs. Thirty-three percent of small-business owners who offer retirement benefits and plan to increase company contributions to their employees’ 401(k) plans say the ACA has made health care benefits less attractive to employees, and 30% say the ACA has decreased the company’s health care costs. “Lower health care costs means small business owners have the option of contributing more to their employees’ retirement.

As the ACA makes health care benefits less relevant to small business employees, business owners have to find a new way to recruit and retain employees. There is mounting evidence that 401(k) plans are filling that role,” said Frustaglio.

Fifty-nine percent disagree that retirement benefits are not important for attracting and retaining employees. Forty-two percent of those who plan to increase contributions say that their company’s 401(k) plan is now more important for attracting and retaining employees as a result of the ACA. Twenty-four percent of small business owners who will offer retirement benefits in the future say their company’s 401(k) plan is now more important for attracting and retaining employees because of the ACA.

“As the health care insurance marketplace becomes more commoditized, employers are looking for new tools to attract and retain key employees, Employers who are using 401(k) plans as a recruitment tool are ahead of the game because we’re seeing more company owners asking how they can do this,” said Frustaglio.

He adds that small business owners who are not offering a 401(k) plan to their employees should talk to a financial advisor about finding a plan that’s right for their employees and business. Eighty percent of small business owners say they cannot compete with a Fortune 500 company’s benefits, and 48% say they could afford a customized 401(k) plan to meet their small business needs.

Frustaglio said, “Small companies not being competitive with large corporations in terms of employee benefits is just not true in today’s world. No matter the size of the business, from one with 33,000 associates like Nationwide to the corner grocery store, today’s 401(k) plans allow for customization and access to the same options with the same tools for all employees.”

Frustaglio recommends that small business owners who offer retirement benefits to their employees do a plan review every year with their advisor. The review should include an analysis of the plan’s components and investment options for their employees.

Last Updated 08/10/2022

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