Friday, January 03, 2014

People are happy. Leave them alone. Just leave them alone.

By Mark Joseph Stern
This New Year's Eve (click here) was an especially celebratory one for Colorado: When the clock hit midnight (Mountain Time), the state's first legal marijuana sale took place:  Washington state and Uruguay have joined Colorado in legalizing the substance, but Colorado was first to create and implement a regulatory framework....

People have been through enough. No matter how many have made obscene money and believe they are happy, they didn't get a hoot about the great people of this nation. People have suffered for over a decade now. They have suffered economically, they have lost their homes, they have been abandoned when they wanted to work, they have gone hungry when food stamps were removed from within their grasp, they have watched their education costs escalate to hideous amounts of repayment, the American Dream has been robbed from this nation.

This is a new economy. These folks have fought and demanded and aided the infirmed and solved problems in chronic pain as well as saw cancer victims eat and gain weight. They are heroes unto themselves and others. They have now made a stride in legalization that can help their state pay it's bills and begin to rebuild. They are heroes. They are happy being RESPONSIBLE heroes, exhibiting the maturity that brings.

This is a new economy and they aren't going to abandon it.  They are happy and they are making others happy. Leave them alone. They have done something for themselves and others that Wall Street abandoned. I just hope they continue to be their own heroes without the selling out to Wall Street because the quality will be ruined and the responsibility for safe practice will disappear with exploitative corporate profits.

Leave them alone. They are hurting no one and there is every measure they are helping many.

President Obama needs to talk about how he is fixing the National Budget and how it relates to the National Debt.

Rick Hohensee of Washington carries a "Fire Congress" sign near the House steps on Capitol Hill in Washington in October. Americans enter 2014 with a profoundly negative view of their government, expressing little hope that elected officials can or will solve the nation's biggest problems, a new poll finds. Associated Press 

Posted: Thursday, January 2, 2014 6:17 pm
...Americans, (click here) who have a reputation for optimism, have a sharply pessimistic take on their government after years of disappointment in Washington.
The percentage of Americans saying the nation is heading in the right direction hasn’t topped 50 in about a decade. In the new poll, 70 percent lack confidence in the government’s ability “to make progress on the important problems and issues facing the country in 2014.”
The poll comes about two months after partisan gridlock prompted the first government shutdown in 17 years....
...Local and state governments inspire more faith than the federal government, according to the poll, with 45 percent at least moderately confident in their state government and 54 percent expressing that much confidence in their local government....

The US House said it won't put the unemployment extension on it's January calendar. The US House is living to play with the Debt Ceiling. They will practice brinkmanship until the last minute AGAIN. President Obama needs to address these issues when he speaks about the reason why it is in the best interest of the nation to extend unemployment benefits. 

As it stands right now, the US House is going to grand stand on the fact the US Senate is spending AGAIN rather than working on the National Debt and the Debt Ceiling. President Obama has to speak to the nation to have them understand that progress has been made on the nation's budget and that progress translate into reducing the Nation's Debt and how that will end the continual rising Debt Ceiling. If the President doesn't address this in a way to empower Americans to take a stand and resolve their anxiety over the fiscal condition of the country today and in their children's future; the US House Republicans will play politics that say, "Democrats are nothing but tax and spend."

While most Americans understand that unemployment benefits continue to support the USA economy, it is still spending and seems counter intuitive to the nation's best fiscal outcomes.

The two year budget agreement appears to be more of an appeasement to Ryan than a real accomplishment by Murray. The Democrats need to remind Americans while the controversial aspects of the budget seems to be a win for the US House, in actuality SSI, Medicare and Medicaid were maintained while the task remains to raise the cap on the program. They need to remind the nation that simply raising the cap on the programs will solve the fiscal challenges and the sooner that is completed the better the outcome for the Seniors and Poor. Democrats need to remind the nation, the US House isn't interested in solving the problems of these programs, but, only interested in ending them and the Dems prevented that from happening.

posted on 
WASHINGTON — As Congress returns to session next week, (click here) House Democrats and Republicans are still nowhere near an agreement to extend the Emergency Unemployment Compensation Program.
On Monday, Sen. Harry Reid is scheduled to bring a three-month extension of the program without a way to offset the cost up for a vote. It’s unclear whether it has enough support to pass, but even if it does, House Republicans say they won’t agree to any extension, for any length of time, without a cost offsetting provision.
“It’s hard for me to know if the Democrats are sincere about this. I must say I have my doubts,” Rep. Tom Cole told BuzzFeed. “There’s no way there’ll be an extension of extraordinary unemployment without a pay-for.”
House Speaker John Boehner has said he won’t support an extension without a cost offsetting measure as well....

The problem is 'sea ice extent' because of global warming. NASA reported about this, but, no one paid attention.

Published time: January 03, 2014 18:56

This photo provided by Fairfax Media Pool and released by the Australian Antarctic Division on January 2, 2014 shows the Chinese Antarctic vessel Xue Long (C) from the bridge of the Aurora Australis ship off Antarctica, both in the frozen waters to help rescue a nearby Russian research ship (not pictured). (AFP Photo / Jessica Fitzpatrick)

The Chinese icebreaker Xue Long, (click here) which helped rescue 52 passengers from the stranded Russian ship Akademik Shokalskiy, is feared to be stuck in the Antarctic sea ice. An Australian icebreaker is now on standby for a potential second rescue mission.
The Xue Long, or Snow Dragon, had helped ferry stranded passengers from the Akademik Shokalskiy to an Australian icebreaker the Aurora Australis, but is now concerned about its own ability to move through the heavy sea ice, the Australian Maritime Safety Authority (AMSA) said....

All the news media services globally dependent and favoring the petroleum industry goes around ignoring valuable information from NASA because it doesn't fit into their political ranting and raving.

Everyone wants to sensationalize this mess with the tilt that favors their political outcome and no one reports the truth.

Let's all just play with fire because human beings are the smartest creatures on Earth and we can put out any fire once we get it started. Right? Arrogance? Yes? Absolutely.

Earth is just the place to drill and frack and punch holes in it for oil and gas and coal and minerals for profits so profiteers don't have to worry about their future. The more money in their Pots of Gold the better, heck, they can jump on a space ship to nowhere then and live forever.

Well, lookey thar. NASA has been doing their jobs after all.

I'll be hog tied and hornswoggled, they even fixed up a graph for our better understanding. It isn't a Wall Street graph, but, it is interesting one. Right?

See this graph is a plot of ALL the advances and retreat of Antarctica Sea Ice since 1980. I'll be darn those scientists at NASA have plotted a trend in sea ice advance that predicted exactly what is happening in the CIRCUMPOLAR CURRENTS today. There are two circumpolar currents. Indeed.

To the right is about the simplest picture I could find regarding the two currents that circulate at the bottom of the world. The one nearest the ice continent is East Wind Drift and then outside the East Wind Drift is the West Wind Drift. They lie next to each other and flow in opposite directions.

Interesting thing happens at their convergence point, there is OCEAN UPWELLING caused by the two current rubbing against each other. The same phenomena occurs at the Equator. When there is upwelling there are phytoplankton exposed from below the surface to the top of the ocean waters. It provides incredible feeding opportunities for marine mammals like whales. The whales migrate. They migrate like birds, they go to either polar regions to feed and they go to the tropical areas to breed and give birth. Smart aren't they? They know their young calves can have adverse outcomes when born in frigid temperatures. I am wondering long about now how much upwelling is occurring and how much open water there is for them to feed. This is the only season they can feed in Antarctica. I suppose there will be yet another scientific expedition to check on them soon.

Now about this map and that graph. This is an evaluation NASA does annually. They conduct these surveys to account for changes in polar ice masses and to realize where there are ice bergs and what kind of havoc the bergs will cause in shipping lanes. Well, here it is and guess what, the sea ice is causing problems in ship traffic.
October 1, 2013
In late September 2013, (click here) the ice surrounding Antarctica reached its annual winter maximum and set a new record. Sea ice extended over 19.47 million square kilometers (7.51 million square miles) of the Southern Ocean. The previous record of 19.44 million square kilometers was set in September 2012....

Remember that year 2012. I'll be referring to it soon. I just love the way NASA scientists minimize their own measurements. "Oh, it only is adding 22 miles to the sea ice?" Are these scientists ever required to get their heads out of their satellites and actually ride in a ship to understand what 22 miles of sea ice will do?

...Sea ice extent is defined as the total area in which the ice concentration is at least 15 percent.
“For the second year in a row, we set a record high winter maximum,” said Walt Meier, a glaciologist at NASA’s Goddard Space Flight Center. “But even though it is a record high, it is only 3.6 percent above the 1981-2010 average maximum. That means the difference between this year and an average year is that the ice edge extended an average of only about 35 kilometers (22 miles) farther this year.”...

The truth is they minimize their measurements so Senator Inhofe doesn't demand their firing for being honest in a way that is damaging to his reputation as a Climate Denier. NASA scientists worry about whistle blowing because Russia already has their own scientists and they would profoundly be out of work even if they fled the country from Inhofe.

Keep in mind the 'wind chill' factor when thinking about the growth of sea ice. Also realize when water moves it does not readily freeze. So, when water and wind reach the East Wind Drift it becomes more stagnant and moves with water that is already frigid. Now what happens when water and cold is added to an established ocean current? 

I'll wait a minute on that one. Most people can figure this one out. I have confidence most anyone reading this can establish an understanding of what occurs here. So I'll wait a minute or two.

June 13, 2013
PASADENA, Calif. -- Ocean waters (click here) melting the undersides of Antarctic ice shelves are responsible for most of the continent's ice shelf mass loss, a new study by NASA and university researchers has found. 

Scientists have studied the rates of basal melt, or the melting of the ice shelves from underneath, of individual ice shelves, the floating extensions of glaciers that empty into the sea. But this is the first comprehensive survey of all Antarctic ice shelves. The study found basal melt accounted for 55 percent of all Antarctic ice shelf mass loss from 2003 to 2008, an amount much higher than previously thought....

I'll be darn NASA scientists have plenty of guts to go with their smarts. So, I have to conclude it is the media that is scared to death to report what exactly the truth is, because scientists already know and are not in denial.

This study by NASA was conducted because there were large amounts of 'something' entering the ocean currents from under the ice sheets. All the satellites knew is that it was happening, but, the satellites can't state it is melting ice. So, now the assessments are complete WE KNOW that Antarctica is losing vast amounts of it's ice structures. 

There is a similarity between this map of Antarctica and that of the Arctic Circle map I posted earlier. The colors and methodology in reporting is the same. So between the two maps it is clearly DOCUMENTED that Earth is losing it's ice caps and we losing them where Continental and Oceanic ice meets warmer ocean waters. 

So, what is all this sea ice mess about and why does it indicate global warming? There is 2012 again.

November 12, 2012
NASA and British Antarctic Survey scientists (click here) have reported the first direct evidence that marked changes to Antarctic sea ice drift caused by changing winds are responsible for observed increases in Antarctic sea ice cover in the past two decades. The results help explain why, unlike the dramatic sea ice losses being reported in the Arctic, Antarctic sea ice cover has increased under the effects of climate change....
..."We now know that these regional changes are caused by changes in the winds, which, in turn, affect the ice cover through changes in both ice drift and air temperature," he continued. "The changes in ice drift also suggest large changes in the ocean surrounding Antarctica, which is very sensitive to the cold and salty water produced by sea ice growth."... 

When continental ice melts it is adding H2O to the ocean currents. The salinity drops in the East Wind Drift first.

Remember when I first started this blog how I recorded daily from information familiar to consumers, the daily changes in wind and temperature of Antarctica and places like Barrow, Alaska? 


Yeah. See, there was a reason for all that and it wasn't to scare people into 'believing' in the Climate Crisis. It was to demonstrate with solid scientific principles how serious Earth's deterioration is to all people in all areas of the world. I did that successfully. It was those that were receiving the information that didn't want to valid what I knew, even back then, was occurring. NASA eventually was moved to FINISH the work they were already doing to a conclusion regarding the warming of Earth.

The drastic loss of ice in particular ways that alarmed observers; they had to account for it. So, they did.

Why the larger extent of 'sea ice' as opposed to 'continental ice?' The oceans are warming so there is more ice melt entering waters. That ice melt are really cold, so when the water finally stops moving in the East Wind Drift and adds to the coldness of that current it starts to solidify again. Add to that the high winds with really low temperatures causing a wind chill and contributing to the fall in temperature of surface water in the East Wind Drift and the water solidifies. Add to that the East Wind Drift and West Wind Drift interact at their convergence zone and then the West Wind Drift starts to become effected in the same way as the East Wind Drift.

Just because the wind blows cold doesn't mean that Earth is in a cooling cycle. Because if Earth was in a cooling cycle the ice at the poles where they meet with ocean waters would not be melting.

It is all there. It is all documented by the best scientists in many nations and their data concurs. It is very difficult to deny that the poles are losing their ice and sea ice extent is increasing due to the loss of that ice from the continent. If anyone denies it; they are lying.
I posted this about a week or so ago. 

The Arctic continued to shift to a warmer, greener state in 2013. (click here)

So, because of the higher winds and arrival of Arctic temperatures to the lower 48 makes this mute? Or maybe folks just, "don't get it?"

Okay. maybe folks just don't get it in the face of a ship being stuck in the sea ice around Antarctica. I'll be back later to dig into what this counter intuitive effect of wind is all about. Okay? Later then.

The wind brings temperature change in double digits and the wind also dries the land.

January 3, 2014
1200 GMT
The Weather Channel Departure from Normal Low Temperatures in degrees Fahrenheit

Odd, isn't it? So much of the country is far colder while there are areas up to ten degrees warmer.

So, one would expect the lows to be very low based on what people are experiencing, but, a departure this profound in high temperatures? The departure from high temperatures in the areas where it is frigid maintain that level, but, the areas with warmer departures are still far higher.

Additionally, there is snow cover, but, not in all areas of the frigid map. Why is that important, because, the less snowfall in many areas of the country the greater the drought come Spring and Summer.

Then there is the amount of snowfall and the quality of the snow. Will the snow continue to exist throughout the winter or will it melt or partially melt and then return with the next storm?

How much of the snow becomes ice?

And dig this, the wind chill factor actually increases temperature in some areas of the country by single digits up to 39 degrees Fahrenheit.

The small map below is the current temperatures across the nation.

Where the wind chill increased normal temperatures that continues to be indicated in actual temperatures. Where the wind chill decreased normal temperatures the same exists in actual temperatures. What does that mean? It means the temperatures are weather dependent and episodic.

It is not a general cooling of the climate. The dominating factor is the wind and not normal storms. If the winds are coming from the Pacific the land is warmer. If the winds are coming off the Arctic Circle the land is colder. This is not a lasting cold. It is episodic. 

January 3, 2014
UNISYS Water Vapor Satellite of North and West Hemisphere (click here for 12 hour loop - thank you)

This should be a somewhat familiar dynamic to this hemisphere. The moisture delivering the snow is from equatorial water vapor to the point the ICZ (Intertropical Convergence Zone) is nearly absent of water vapor. Off the west coast is an Arctic Oscillation.

Idaho drought monitor map shows ‘Severe’ and ‘Extreme’ drought (click here)
The Idaho Drought Monitor Map shows around half of the state is under a “severe” or “extreme” drought.
About 5 percent of the state, in the southwest, is under the extreme drought, while another 40 percent is under the severe drought.
Much of the rest of the state is under a “moderate” drought (25 percent), or “abnormally dry” (8 percent), according to the map.
The top part of the state, which is significantly more narrow than the rest of the state, is not under any type of adverse weather. This is about 22 percent of the state.
This is worse than January 1, 2013, when 45 percent of the state was under no drought conditions.
The surrounding states, including Nevada, Washington, and Oregon, are also experiencing a lack of rain.
Publication date: 1/3/2014

January 1, 2013
By Tina Volpe
Posted by Life Channel
California has seen its share of drought, (click here) anyone who is a long-time resident can attest to water rationing and restrictions – and it appears it might be dealing with water shortages again in 2014.
Although winter is a strange time of year to announce a drought – with three-fourths of the country under ice and snow, but California has not had its usual rain or snowfall. A city like Santa Cruz usually gets at least 30 inches of rain every year, but this year – only about five inches fell – from July to June.
As of December 24th, 85 percent of the state was experiencing severe or extreme drought conditions. Reservoirs are at below normal levels, and people are starting to worry....

The US Drought Monitor 
December 31, 2013

Where are the temperatures higher due to wind and where is the drought?

At least one farmer is taking the recommendations about planting varieties of wheat with deep roots. Thank you Land Institute.

This picture is from the article about California in this entry. The pathway shows the droughted land, but, the wheat shows a crop of wheat. The plants have deep roots and are able to tap enough water to continue to grow. That is an amazing picture. The trees in the background have deep roots by the age of the trees alone. They are not young trees. So, there is a healthy water table underneath this crop, it is just finding the right wheat to plant. 

This picture makes an excellent argument to plant perennial grain crops. The roots should not be disturbed. This crop can be harvested. Wheat is a grass. In a similar species family as anyone's yard grass. Yard grass can 'go to seed' if it is not mowed regularly, right? That is what this is. That wheat can be harvested and the roots will continue to grown a wheat crop. It is important to monitor the 'yellowing' of any perennial crop as to the nutritional status of the crop. Liquid fertilizer can be added as necessary.

A broken axle is irrelevant until the investigation is complete. A broken axle could be a symptom and not a cause.

Regardless, the safety margin for any such disaster is not enough. Rail safety is lacking. The fact there are three derailments, at least one fatal is more than suspicious. I don't buy the fact three derailments are caused by increased use of rail services. That is an excuse. There is no excuse for this level of negligence or worse.

I'll talk about the Climate Crisis later. This reality of frigid temperatures and severe weather, even really bad snow storms, VALIDATES the FACT Earth is warming at an incredible rate and indeed it is important for the USA to find solutions to their Greenhouse Gas Pollution. Yes, even the boats stuck in the Antarctica Sea Ice is due to the Climate Crisis. As a matter of fact it was predictable they were going to stuck in that sea ice.

This topic is not one entry with a short paragraph.

Later today. It is already after 2 AM.

I hate to burst everyone's bubble, but, this study is about benefits offered before The Patient Protection and Affordable Care Act was instituted.

This paragraph is from CBS. It is very deceiving intending to bring political debate without complete facts.

AP January 2, 2014, 4: 05 PM
SALEM, Ore. -- A new study (click here) has found that people enrolled recently in Medicaid went to the emergency room 40 percent more frequently than others, often seeking help for conditions that could be treated less expensively in a doctor's office or an urgent care clinic....

The study was recently published in "Science," but, the Medicaid expansion occurred in 2008. It was offered in Oregon before The Patient Protection and Affordable Care Act was even law.

...The study by Sarah Taubman (click here) of the National Bureau of Economic Research and colleagues is the third in a series detailing results from an Oregon-based experiment begun in 2008, in which low-income adults were randomly given Medicaid coverage. The adults were later surveyed to gauge the effects of the coverage on their health and well-being.

Called the Oregon Health Insurance Experiment, it was designed to shed light on the effects of guaranteeing Medicaid coverage for low-income, uninsured adults, an important topic in the United States since insurance for the poor is a big component of the 2010 Affordable Care Act....

There were federal monies involved to sponsor this study? This was suppose establish the effects of the law on a control population? Is that right? Because that is not what Oregon says.

The Oregon Health Insurance Experiment (click here) is a landmark, randomized study of the effect of expanding public health insurance on the health care use, health outcomes, financial strain, and well-being of low-income adults. It represents the first use of a randomized controlled design to evaluate the impact of Medicaid in the United States. Although randomized controlled trials are the gold standard in medical and scientific studies, they are rarely possible in social policy research. In 2008, the state of Oregon drew names by lottery for its Medicaid program for low-income, uninsured adults, generating just such a randomized controlled design. This ongoing study represents a collaborative effort between researchers and the state of Oregon to use this opportunity to learn about the costs and benefits of this expansion of public health insurance.

"Probably of Hospital Admission"


You know what this means to me? It means those of low income cannot necessarily discern whether they are sick enough to be hospitalized. That is all that means to me.

      Use of health care
    • Medicaid increased the likelihood of being admitted to the hospital by 30 percent, driven by hospital admissions not originating in the emergency department.
    • The Poor have been sicker than the average American and until they receive quality care they remain under or uneducated to what appropriate health care provides to improve their health status.
    • Medicaid increased the likelihood of using outpatient care by 35 percent, using prescription drugs by 15 percent, but did not seem to have an effect on use of emergency departments.
    • Financial hardship
    • Medicaid decreased the probability of having an unpaid medical bill sent to a collection agency by 25 percent – which also benefits health care providers since the vast majority of such debts are never paid.
    • Self-reported health and well-being
    • Medicaid increased the probability that people report themselves in good to excellent health (compared with fair or poor health) by 25 percent.
    • Medicaid increased the probability of not screening positive for depression by 10 percent.
    • Emergency department visits overall
    • Medicaid increased the number of emergency department visits over the 18-month period by about 40 percent (0.41 visits, relative to a base of 1.02).
    • This is the part the media is presenting as controversial adding to the cost of health care by the use of emergency rooms. The study was conducted 2 years after the Medicaid expansion lottery was conducted, so that places the information in 2010. Basically, the program is excellent. The visits were not frivolous and conducted by the patients on a whim, the visits were all purposeful. There were approximate 40% increase in emergency room use by Medicaid Expansion recipients. The demographics didn't change as to types of visits. However, the 40% also included, "We found no statistically significant increase in emergency department visits that did result in hospital admissions." That means the SAME STATISTICAL RESULT for hospital admissions were the same. That statistical result was 40% more. The reason there is a neutral calculation is because with 40% more visits it included the same number hospitalized.
    • I didn't see any speculation by the study that explains why the ER was a venue of choice. Were there no Medicaid Primary Physicians in the patients of the lottery? Was this the community's habit? Was there misinformation given the recipients by a Social Worker. Was there NOT a Primary Physician assigned to them and if assigned to a Primary Physician did they not like that physician? There are many reasons why this would occur and it is missing from the study.
    • Types of visits and subpopulations
    • Medicaid coverage increases use of the emergency department across the broad range of types of visits and subgroups. Moreover, we did not find statistically significant decreases in emergency department use in any of the subpopulations we examine.
    • Medicaid increased visits occurring during standard hours (weekdays 7am-8pm) and visits outside of standard hours (weekends and evenings). Both types of visits increased by over 40 percent (0.23 visits relative to a base of 0.57, and 0.21 visits relative to a base of 0.46, respectively.
    • Medicaid increased use for visits classified as "non-emergent," "primary care treatable," and "emergent, preventable." We found no statistically significant change in the use of visits classified as "emergent, non-preventable."
    • Medicaid increased outpatient emergency department visits (visits that did not result in a hospital admission). We found no statistically significant increase in emergency department visits that did result in hospital admissions.
I am really surprised at the level of malice by the Press with this population of Americans.

By Jordan Rau
May 10, 2013
study of Oregonians (click here) who won Medicaid benefits in a 2008 state lottery has sparked an intense debate about the value of expanding health care to the poor -- and the value of health benefits in general.

I have a problem with that paragraph. The idea that health care benefits are or are not valuable to a person's life is bizarre. Everyone deserves health care and if it lifts their depression that is valuable.

Mary Carson is, in a way, at the center of that debate. The 55-year-old Oregon woman was accepted into the Oregon Health Plan, the state Medicaid program, in 2011. She and her partner live with her three children. They earn about $1,000 a month by making and selling replicas of historic battle knives used in the Civil War and the two World Wars, doing odd jobs and providing respite care for people with cancer.

"It took me 6 months to change my level of co-operation with my doctor, and she said I was faster than many," Carson recently recounted in blog comments that recently drew media attention. "Most people got into the groove about their 2nd physical. Then we had year-to-year values for blood tests and weight and blood pressure. Those numbers getting better helped."
This population has been chronically neglected for decades, which raises the question, what kind of value is the American society looking for when approaching health care with this population? There won't be miracles. They aren't going to change overnight if they have a Medicaid card. Much of their health care will have to be learned. They are used to avoiding care except for serious problems. Having Medicaid opens the door of opportunity for removing that strategy. 
This population will have more visits after they have Medicaid, simply because they have neglected their health for a long time and are finally catching up. The hospitals will receive monies for their visits where they never received any before. The fact this population of Americans need to adjust to having health care insurance and the best approach to use it should be a surprise to no one.
The researchers in the New England Journal of Medicine looked at patients much like Carson. In results published last week, they found that those who gained Medicaid coverage used more health services than low-income residents who had not been accepted into the program. But the Medicaid enrollees did not show significantly better blood pressure, cholesterol and blood sugar levels than the other group, although they had lower rates of depression....
No clue. The folks without Medicaid AVOID health care because they can't afford it. Why spend monies on a physician visit if one cannot afford the medication?

The lack of improvement of blood pressure, cholesterol and blood sugar are all issues of DIET as well as medication. If a person has high blood pressure they need medication but they also have to improve their diet by minimizing salt content. If a person has high cholesterol they have to minimize fats in their diet. If a person's blood sugar doesn't change it is because they have to limit carbohydrates in their diet.

These folks receive Food Stamps/SNAP. Every dollar of food assistance has to go a long way from month to month. That does not lend itself to seek out high end grocery stores.

Additionally, those three medical conditions like , hypertension, hypercholesterolemia and diabetes requires weight loss and
exercise in order to improve outcomes. There is a chance that can happen with
those eligible to Medicaid, but, what do we know by the statements of this participant? These Americans are slow to change. Their 'range' of opportunity to change is limited, so they need strategies they have never been equipped with before. Does that mean they don't deserve health care because it doesn't carry the same value as other Americans? No, it means we have more work to do to bring them up to speed and seek the best strategy for their medical compliance.

A family of five living on $1000 per month is profound poverty and there are families in the USA living on less. So, when they are presented with changing their habits to improve their health and well being, it isn't easy. They have to change within a very tight budget. This population of Americans are difficult to change in their outcomes. It isn't because they don't want health care, it is because they are not equipped to carry out COMPLIANCE in the same why as other Americans with higher incomes. This population is a challenge, but, they are not a challenge we can or should ignore nor a challenge to far.

We live in the world's wealthiest nation. (click here) Yet 14.5 percent of U.S. households—nearly 49 million Americans, including 15.9 million children—struggle to put food on the table.
In the United States, hunger is not caused by a scarcity of food, but rather the continued prevalence of poverty. Both issues must be addressed in our continued efforts to help those Jesus called "the least of these" (Matthew 25:45)....
Who thought this nation would ever be looking at a poverty rate of 14.5 percent? Yet we are. As more and more Americans fall into poverty the demand for our attention as a nation is vital. No person is disposable simply because their socio-economic condition is lousy.
Who ever thought Bernie Madoff would ruin lives? Who ever thought Americans would lose their 401Ks. Who ever thought Americans would lose their homes because Wall Street was greedy and stupid and needed a bailout. Who ever thought Wall Street would take their monies and run without providing loans vital to businesses in the USA to return jobs to the people of the country?
Those forced into poverty after 2008 were not your usual worries. Those folks were usually the ones worrying about those in poverty and now the tables were turned and they were the needy.
That reality tells me every American needs to pay attention to those in need because tomorrow has proven to be unpredictable in ways no one could imagine. 
I have to laugh at Republicans. They say things like, "That is September 10th thinking," but, they never say, "That is Pre-2008 thinking."
There should be a clear understanding by every American that policies effecting the Poor are important, especially because of 2008.
There is no going back. We are not going to do that. We need to get on with this and begin the 'fit' we need to assist the most challenging health care issues including the lethargy of the Poor to grasp change and incorporate it into their lives.