PRIMARY CARE WOES --- Will We Solve Rhode Island's Problem?

Bureaucracy versus medicine

By Dr. Steven Fera for Save Our Health Care 

To the rescue?

Primary care in this country is at a critical juncture. The causes are multiple, but government reforms, demands of private payers and corporate employers, the burden of pre-authorization, and the introduction of electronic medical record (EMR) systems are all important contributing factors.

In the 1990s, managed-care plans emerged which greatly increased insurance company profits at the expense of the physician. Hospital executives and entrepreneurs have capitalized by organizing physicians into groups called Accountable Care Organizations, collecting a substantial percentage of collected income. Nowadays, physicians are required to use electronic medical records, which has transformed daily workflow. 

In many cases, patient visits are dominated by time spent engaged in data entry, which requires searching for the correct medical diagnostic code (currently there are over 69,000) and billing code, along with including sufficient medical “information” to qualify for payment. The companies that developed them are reaping significant profits from hospitals and physician practices. Whether this enhances quality or simply undermines the doctor-patient relationship depends on who you ask.

Over the past decade or so, the costs of practice have outpaced increases in reimbursement. Moreover, administrative demands have steered a majority of physicians into employment models, where they have often found that “protocols” and “productivity” were more important metrics than “quality,” leading to both physician and patient dissatisfaction. A rewarding and successful doctor-patient interaction requires time, a luxury many practitioners can no longer afford within the constraints of shorter patient visits. 

Vance at the negotiating table

Next, carpet bomb the Vatican

Nearly 70 Acres Conserved for Recreational Use in Richmond

More than open space

The Rhode Island Department of Environmental Management (DEM) has acquired the 68-acre Princess Pine Estate in Hopkinton on Wincheck Pond for public recreational use. The $1.66 million purchase was funded by   $800,000 from the US Fish & Wildlife Service (USFWS) through the Wildlife Restoration Program, $500,000 from the Rhode Island Chapter of The Nature Conservancy (TNC), and $361,000 in Open Space Bond funds.

“We are very pleased to work with our partners at USFWS and TNC to preserve this beautiful property. In completing this acquisition, we are conserving ecologically important habitat while at the same time, expanding public access to an exceptional site for outdoor recreation,” said DEM Director Terry Gray. “This is one of the most beautiful parts of Rhode Island and we hope that people come out and enjoy a hike or just visit and connect with nature. Working with our partners enables us to leverage state open space funds from the Green Bonds overwhelmingly approved by Rhode Island voters to secure open space resources for the good of our environment and the people of the state.”

A closer look at vaccine strength revealed a surprising link to brain health.

Stronger Flu Shot Linked to Nearly 55% Lower Alzheimer’s Risk, Study Finds

By University of Texas Health Science Center at Houston

A routine visit to a public health office led to an unexpected scientific insight, one that may reshape how researchers think about preventing Alzheimer’s disease.

A new study from UTHealth Houston reports that older adults who receive a higher dose of the influenza vaccine may have a significantly lower risk of developing Alzheimer’s disease compared to those who receive the standard dose.

The results were published in Neurology.

Alzheimer’s disease is the leading cause of dementia, affecting more than 7 million Americans age 65 and older as of 2025. That represents about 1 in 9 people in this age group, and the number is projected to more than double by 2050.

Earlier research from 2022, led by Paul Schulz, MD, a professor of neurology at McGovern Medical School at UTHealth Houston and director of the Neurocognitive Disorders Center, found that people age 65 and older had a lower risk of Alzheimer’s disease if they received a flu vaccine.

Now, three years later, Schulz and his team report that the reduction in risk is even greater among those who receive a higher dose of the vaccine.

Unions play key role in keeping direct care workers in the workforce

Unions help prevention worker turnover

By University of California, Los Angeles

Edited by Gaby Clark, reviewed by Robert Egan

Unionization and working for a public employer are associated with significantly lower turnover among direct care workers (DCW), a group that provides daily care for older adults and those who are disabled and unable to care for themselves, UCLA-led research suggests. 

The findings on the role of DCW unionization, published in the peer-reviewed JAMA Network Open, apply to both for-profit and nonprofit organizations, suggesting that unionization can play a significant role in keeping DCWs in the workforce—and save the health care system $1.5 billion a year in turnover costs. It can also lead to improvements in care quality due to increased job satisfaction and lower stress.

Why direct care worker turnover matters

"Direct care workers provide essential daily care for millions of older adults and people with disabilities, but very high levels of worker turnover make it increasingly difficult for people to receive the consistent care they need," said study lead Dr. Geoffrey Gusoff, assistant professor of family medicine at the David Geffen School of Medicine at UCLA. "Reducing turnover and retaining workers in the direct care workforce is essential for meeting the need for high-quality direct care services."

Environmental Council of RI seeks to protect Rhode Island's climate goals, expand conservation funding, decarbonize buildings, and save RIPTA

ECRI pushes green agenda

Steve Ahlquist 

The Environment Council of Rhode Island (ECRI), a coalition of more than 60 organizations “advocating for policies to protect and enhance the environment for all Rhode Islanders,” introduced its 2026 legislative priorities at a State House event on Tuesday. “These priorities were chosen by the membership of ECRI through a month-long democratic process and represent the diversity of the environmental community in Rhode Island,” said ECRI Executive Director Jordan Miller at the opening of the event.

Here’s the video: The Environment Council of RI 2026 Lobby Day; April 14, 2026

This year, ECRI announced four legislative priorities for the 2026 legislative session. As described by ECRI Vice President Tina Munter, “[T]hese priorities, in no particular order, include urging our legislators to oppose the rollback of state clean energy and energy efficiency programs that have been proposed in the governor’s FY2027 budget, the Green Bond plus crucial additional funding for conservation and open space measures, the Save RIPTA legislative package as put together by the Save RIPTA Coalition, and building decarbonization legislation, both building benchmarking and reporting and building performance standards.”

Accidentally true

Fortune Magazine confirms that WE pay Trump's tariffs, not foreign countries, despite Trump claims

Big win for Rhode Island voters

Trump DOJ loses again, now 0 for 5 on voter roll cases, as court rejects Rhode Island lawsuit

By Jim Saksa for the Democracy Docket

The Department of Justice (DOJ) lost again as a federal judge dismissed its lawsuit to force Rhode Island to provide unfettered access to its voter registration rolls, bringing the agency’s record among active cases to five defeats, zero wins and 25 cases still pending. 

In Donald Trump’s second term, the DOJ has demanded every state’s unredacted voter registration records — including sensitive private data like social security numbers and dates of birth — as part of the administration’s obsessive focus on immigration enforcement. While 17 Republican-led states have complied, the rest have refused, leading the DOJ to sue 29 states and Washington, D.C. for their voter rolls. 

Rhode Island is now the fifth state to secure a district court victory, joining California, Oregon, Michigan and Massachusetts.*

U.S. District Judge Mary S. McElroy, a Trump appointee, called the DOJ’s widespread voter roll demands a “fishing expedition.” The DOJ sought to use the 1960 Civil Rights Act (CRA) to order Rhode Island to turn over unredacted versions of its registration records, saying they were needed to ensure compliance with the National Voter Registration Act (NVRA) and Help America Vote Act (HAVA).

CDC Head Blocks Release of Findings Showing Strong COVID Vax Effectiveness

The report detailed how adults receiving COVID-19 vaccines saw hospitalization rates drop by 55 percent.

By Chris Walker

This article was originally published by Truthout

Acting Centers for Disease Control and Prevention (CDC) Director Jay Bhattacharya, who also leads the National Institutes of Health (NIH), is reportedly delaying the publication of new findings within the health agency showcasing the strong effectiveness of COVID-19 vaccines to prevent emergency room visits and hospitalizations. 

According to a report from The Washington Post, which cites two scientists with knowledge of Bhattacharya’s actions, the unpublished report examined adults who had been vaccinated between the months of September and December last year, and compared their health results to adults who didn’t get vaccinated. Among those who received vaccinations, ER and urgent care visits dropped by 50 percent, while hospitalizations overall saw a 55 percent decline. 

The report has cleared the CDC’s scientific-review process, but Bhattacharya is blocking its publication over supposed concerns over its methodology, the scientists said, demanding further scrutiny. However, the report used methods that are regularly utilized by the national health agency, and a report on flu vaccines, using the same methodology as this blocked report, was published just last week. 

The revelation of the delay of the report and the questionable rationale for delaying its release is raising concerns among members of the scientific community that the agency is shaping its policy due to the anti-vaccine attitudes of Bhattacharya and Department of Health and Human Services Secretary Robert F. Kennedy Jr.

The Government May Be Spying on Your Phone

The rapid erosion of privacy

By Don Bell

...And everything else

Our smart phones reveal a lot about us.

In order to function, they connect with communications networks and geolocation services, creating detailed maps of our daily lives. If you knew how to read them, you’d know someone’s favorite coffee shop, the person they’re dating, where they go to school or church, and more.

Would you want the government to have this information at its fingertips? Most of us wouldn’t — but that’s what’s happening. FBI Director Kash Patel recently admitted that the agency is buying up our personal information — including movement and location data — without a warrant.

If this concerns you, it should. It’s a clear violation of the Fourth Amendment. And it’s one reason why privacy and civil liberties advocates have been demanding Congress close a loophole that essentially allows the government to purchase our data without a warrant.

The Fourth Amendment exists to prevent the government from conducting unreasonable searches and seizures. So normally, if law enforcement officers want to access a person’s cell phone location data in the United States, they need a warrant. However, because Congress hasn’t updated laws to address technological advancements, government agencies can instead pay third party data brokers to access this data for them — no warrant needed.

Unfortunately, there’s nothing in the law that explicitly outlaws buying information from third parties. This loophole is the equivalent of the police handing your landlord an envelope of cash in order to enter your apartment without a warrant, with the police arguing that they didn’t technically break and enter.

He is Seriously, Frighteningly, Utterly, and Completely Losing His Mind

We are in great danger

Robert Reich

It’s a catastrophe on the way to becoming a cataclysm.

Trump is rapidly going stark-raving mad. He’s a clear and present danger to the United States and the world.

He lashed out at The New York Times after its chief White House correspondent questioned his mental health and stability and pointed to his “erratic behavior and extreme comments.”

“HAVE THEY NO SHAME? HAVE THEY NO SENSE OF DECENCY?” Trump posted in CAPITAL LETTERS about the Times, inadvertently echoing the famous words of Joseph Welch when standing up to Joseph McCarthy during the Army-McCarthy hearings of 1954. Trump went on to take issue with the Times’s coverage of his war in Iran rather than his mental state, as if to prove the Times’s point.

He keeps saying he’s “won” the war with Iran, although he’s never said what “winning” means. At one moment his goal is to free Iran’s people. At another, it’s to end Iran’s capacity to produce a nuclear weapon. At another, to destroy Iran’s missiles. At another, to achieve “regime change.” At another, to open the Strait of Hormuz (which was open before Trump started his war). At another, he says he’ll know the U.S. military operation in Iran is over when he feels it "[in] my bones.”

He can’t even stay on the same subject for more than a few minutes. In the middle of a high-level Cabinet meeting about the war, he spends five minutes talking about his preference for Sharpie pens. He interrupts another Iran war update to praise the White House drapes.

He threatens that if Iran doesn’t reopen the strait, “a whole civilization will die tonight.” Then he says America doesn’t need the strait reopened. Then he says: “Open the Fuckin’ Strait, you crazy bastards, or you’ll be living in Hell - JUST WATCH! Praise be to Allah. President DONALD J. TRUMP.”

He calls the Pope “WEAK on Crime, and terrible for Foreign Policy” because the Pope wants peace. He posts an AI-generated picture of himself as Jesus, then says he was only depicting himself as a physician.

He won’t give up on his illegal and dangerous (for the economy) criminal investigation of Fed Chief Jerome Powell, claiming it’s not just about Powell’s renovations at the Fed but also a “probe on incompetence,” adding he’ll fire Powell if he doesn’t resign after his term as chair ends.

He claims that the United States “needs” Greenland. He confuses Greenland with Iceland. He says whales are being killed by windmills. He claims that he won all 50 states in 2020. That he defeated Barack Obama in 2016. He says the former chair of the Joint Chiefs of Staff should be executed. He goes on an eight-minute ramble about poisonous snakes in Peru. He boasts of ending a fictional war between Cambodia and Armenia.

After Robert Mueller’s death, he says, “Good, I’m glad he’s dead.” He blames the murders of Rob Reiner and his wife Michelle on “the anger [Rob Reiner] caused others through his massive, unyielding, and incurable affliction with a mind crippling disease known as TRUMP DERANGEMENT SYNDROME.” After Joe Biden is diagnosed with an aggressive form of Stage 4 prostate cancer, Trump says, “I’m surprised that the public wasn’t notified a long time ago because to get to Stage 9, that’s a long time” (there is no Stage 9 cancer).

He’s been losing it for a while now, but in the last few months it’s become far worse.

United States of Anxiety

Pick up Charlestown trash on Saturday