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For years, patients in the U.S. health care system have grown frustrated with a bureaucracy they don’t understand . Doctors are included in an insurer’s network one year but not the next. Getting someone on the phone to help can be next to impossible. Coverage of care and prescriptions is often unceremoniously denied. This week’s fatal shooting of UnitedHealthcare CEO Brian Thompson has unleashed a wave of public feeling — exasperation, anger, resentment, helplessness — from Americans sharing personal stories of interactions with insurance companies, often seen as faceless corporate giants. In particular, the words written on ammunition found at the shooting scene — “delay,” “deny” and “depose,” echoing a phrase used to describe how insurers dodge claim payouts — amplified voices that have long been critical of the industry. “All of a sudden, I am fired up again,” said Tim Anderson, describing how his wife, Mary, had to deal with UnitedHealthcare coverage denials before she died from Lou Gehrig’s disease, or amyotrophic lateral sclerosis, in 2022. Anderson said they couldn’t get coverage for machines to help his wife breathe or talk — toward the end, she communicated by blinking when he showed her pictures. The family had to rely on donations from a local ALS group, he said. “The business model for insurance is don’t pay,” said Anderson, 67, of Centerville, Ohio. “When Mary could still talk, she said to me to keep fighting this,” he added. “It needs to be exposed.” For Anderson and others, Thompson's death and the message left at the scene have created an opportunity to vent their frustrations. Conversations at dinner tables, office water coolers, social gatherings and on social media have pivoted to the topic, as police efforts to find the gunman keep the case in the news. Hans Maristela said he understands why the chatter is bubbling up. The 54-year-old caregiver in California was moved to comment on Facebook about UnitedHealthcare's reputation of denying coverage. As a Catholic, he said, he grieves Thompson's death and feels for his family, especially with the holidays around the corner. But he sees frustration with insurers even among his clients, most of them wealthy older people who've not been shielded from high out-of-pocket costs. “And then you know the CEO of this company you pay a lot of money to gets $10 million dollars a year, you won’t have a lot of sympathy for the guy," Maristela said, citing Thompson's compensation package that included base pay and stock options. “Health care is a business, I understand, but the obsession with share price, with profit, has to be reevaluated.” University of Pennsylvania researcher Michael Anne Kyle said she's not surprised by the growth of conversation around insurers. “People are often struggling with this by themselves, and when you see someone else talk about it, that may prompt you to join the conversation,” she said. Kyle studies how patients access care and said she's seen frustration with the system build for years. Costs are rising, and insurers are using more controls such as prior authorizations and doctor networks to manage them. Patients are often stuck in the middle of disputes between doctors and insurers. “Patients are already spending a lot of money on health care, and then they’re still facing problems with the service,” she said. Insurers often note that most of the money they bring in goes back out the door to pay claims, and that they try to corral soaring costs and the overuse of some care. In Ohio, Anderson said his initial reaction to the CEO shooting was to question whether it was connected to a coverage denial, like the ones he'd experienced with his wife. “I definitely do not condone killing people,” he said. “But I read it and said, 'I wonder if somebody had a spouse whose coverage was denied.’” It's something Will Flanary, a Portland-based ophthalmologist and comedian with a large social media following, saw online a lot in the shooting's immediate aftermath and found very telling. “It’s zero sympathy,” he said. “And the lesson to take away from that is not, ‘Let’s shame people for celebrating a murder.’ No, it’s: ‘Look at the amount of anger that people have toward this system that’s taken advantage of people and do something to try to fix that.’” Flanary's content, published under the name Dr. Glaucomflecken, started out as niche eye doctor jokes and a way to cope with his own experiences with two cancer diagnoses and a sudden cardiac arrest. But it has evolved, featuring character skits that call attention to and satirize the decisions of large health insurers, including UnitedHealthcare. He said he's never seen conversations around health insurance policy take off the way they did this week — and he hopes these new voices can help bring about change. “I’m always talking about how powerful social media can be with advocacy," he said, "because it really is the only way to put a significant amount of pressure on these corporations who are doing bad things for patients.” The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.The signs at Nippon Steel read: “The world through steel,” underlining why Japan’s top steelmaker is pursuing its $15 billion bid to acquire U.S. Steel. “We can’t expect demand in Japan to grow as the population is declining. We need to invest in production that leads to growth,” a company official, Masato Suzuki, said while giving reporters a look at a Nippon Steel plant in Ibaraki Prefecture, north of Tokyo. Nippon Steel Corp. has its eyes on India, Southeast Asia and the U.S., Suzuki said. About 70% of the plant's output is exported. The Tokyo-based company remains optimistic, although the deal is opposed by President-elect Donald Trump, President Joe Biden and American steelworkers. During the tour, slabs of steel, glowing hot-orange at more than 1,000 degrees Celsius, rolled through the cavernous plant to become giant spools of super-thin steel. Nippon Steel officials didn’t disclose details of the fine technology they said the planned acquisition would offer U.S. Steel. Under the proposed deal, first announced in 2023, U.S. Steel would keep its name and its headquarters in Pittsburgh, Pennsylvania, becoming a subsidiary of Nippon Steel. Nippon Steel already has manufacturing operations in the U.S. and Mexico, China and Southeast Asia. It supplies the world’s top automakers, including Toyota Motor Corp., and makes steel for railways, pipes, appliances and skyscrapers. The American steel industry has waned as Chinese steelmakers have grown to dominate the market. Japan wants to leverage the decades-old U.S.-Japan security and political alliance to seal the acquisition, but the outlook is uncertain. In September, an arbitration board jointly chosen by U.S. Steel and United Steelworkers decided the proposed acquisition could proceed. But United Steelworkers union, which has 1.2 million members, have objected, citing worries about job losses and contract terms. The union has questioned Nippon Steel’s plans to transfer production locations and concerns about national security and domestic supply chains. When asked for comment, it referred to a recent letter to its members. “As a union, our primary concern is the future of our jobs and the communities we live and work in — not just this year, but also for the foreseeable future. We’ve seen job losses in the past, and we must do everything we can to avoid it in the future,” said the letter, co-signed by Mike Millsap, chairman of the negotiating committee, and its international president, David McCall. “While Japan is a political ally, it is also an economic competitor, one that has proven time and again that it is willing to promote its steel industry at our expense,” the union said. Nippon Steel is promising to “preserve the legacy” of U.S. Steel and protect jobs, pensions and benefits, pledging that there will be no layoffs or plant closures. The deal is expected to produce an economic boost for the region equivalent to nearly $1 billion in the first two years, create up to 5,000 construction jobs and generate almost $40 million in state and local taxes, according to Nippon Steel. William W. Grimes, professor of international relations and political science at Boston University, said Nippon Steel's commitment to keeping the U.S. Steel factories running would help preserve U.S.-based production of specialty steels. Nippon Steel also has also promised investments to make the factories more competitive. There is no militarily sensitive technology Nippon Steel would be able to take from the U.S., and the U.S. relies on steel produced in allied countries, including Japan, Grimes said. “If Japanese companies do draw a lesson, it should be to engage unions and local politicians early in the process,” he said.jilicc com download 。

The intersection of faith and governance is not only a global phenomenon but also a deeply personal one for many of us in the vastness of 13 islands we call the Cook Islands. Let alone the 94 thousand living in Aotearoa or 21 thousand in Australia. Especially now as our government must consider our Christian nation status. It is vital we look at the broader context of religious restrictions and governments around the world and move beyond calls of hate or preference. A 2019 Pew Foundation report highlighted this dynamic with profound insights. With over a decade of tracking, the report revealed increasing global government preference toward specific religious groups, particularly in regions such as the Middle East and North Africa (MENA). In these areas, Islam is predominantly preferred, often enshrined in their state constitutions, laws, and societal norms. For instance, 19 of the 20 countries in the MENA region officially recognize Islam, with legal systems often deferring to Islamic law. In Egypt, for example family law is dictated by the religion of the spouses, defaulting to Islamic law when there is a disparity. Their governments have no problem declaring and enforcing Islam as their state religion and its flow into their laws and practices. Across Asia, Africa, and even Europe, governments have shown increasing preference toward dominant religious groups. In Thailand, constitutional amendments have elevated Theravada Buddhism, while in Europe, countries like Greece and Iceland maintain close ties between state and Christian denominations. Even in secular states such as Fiji, constitutional provisions ensure equality of religion while recognizing the predominant influence of Christianity on their cultural fabric. Watch a game of Rugby and hear them sing hymns before and after the game, giving thanks to God for their safety and participation. Closer to home, Pacific nations like Samoa and Tonga explicitly declare their Christian identities within their constitutions. Samoa, for instance, amended its constitution in 2017 to affirm itself as a Christian nation, while Tonga’s constitution upholds the sanctity of Sunday and requires its monarch to be Protestant. As we deliberate on the Cook Islands’ identity as a Christian nation, these global and regional precedents offer valuable lessons. They illustrate how nations both Islam, Buddhist or Christian have balanced their religious heritage with their self-determined principles of inclusion and freedom of religion if that is their choice. But each is free to determine that as they see fit. At its heart, this is not just a legal or constitutional question but a deeply spiritual, deeply moral and deeply cultural one. Christianity has been central to the Cook Islands’ identity since prophecies of its arrival by Taunga in Rarotonga and Enuamanu, and the arrival of its message and gospel. It shapes our values, our community spirit, and the very fabric of our society, our traditional leaders and government. It would be remiss of me to suggest that the God of the Bible is not singular in his desire for worship and honour, clearly stating there are no other Gods before him. Or that if Jesus is God, then he is not as Islam states merely a prophet of God. This distinction in each other’s scripture is more than just a difference of opinion, it is a crossroad that sends both faiths in opposing directions and on roads that never cross again. Ultimately, the question of the Cook Islands as a Christian nation and religious diversity is not just about constitutional amendments or legal frameworks. It is about what kind of society we aspire to be, our identity and our laws, our values and the basis of our internal and external moral code within the diversity of the world we now live in. A leader who knew diversity was King Solomon, who in the Hebrew book of proverbs inscribed, “Righteousness exalts a nation, but sin is a reproach to any people.” In this simple verse, a rule, or standard, composed of two alternatives, there is no middle ground, and there are two causes and each with its own effect. Therefore, we pray for our leaders the wisdom to discern, courage to choose and conviction to lead our nation.None

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A bipartisan Senate Intelligence Committee report released Friday slammed the CIA for its treatment of patients with a mysterious ailment known as “Havana syndrome,” determining that “many individuals faced obstacles to timely and sufficient care.” The report outlines 11 recommendations for the CIA to implement to address key concerns such as a lack of an “established clear and documented policies, guidance, and criteria for how it refers AHI (anomalous health incidents) reporters to facilitated treatment programs.” The recommendations also include developing written policies for medical care and benefit programs associated with AHIs, conducting a comprehensive organizational assessment of the CIA’s response to AHIs, and reestablishing a standard post-AHI evaluation to all AHI reporters who request one. Examples of insufficient care outlined in the report included patients who “experienced delayed, denied, or pre-conditioned care,” including “long wait times to access facilitated treatment options; were denied facilitated care by a CIA care adjudication board; perceived that their access to facilitated medical care was contingent on their willingness to participate in a NIH clinical research study.” A spokesperson for the CIA told CNN that during the periods covered in the report, the agency worked to both understand the problem and investigate the “possibility that foreign actors were harming US government personnel and their families.” “In that environment, supporting our officers and their families required us to dynamically adapt our programs and processes to changing needs and circumstances. Whether, in hindsight, we could have done better is for others to evaluate, but our commitment to ensuring that our officers and their families had access to the care they needed has never wavered,” the spokesperson said, emphasizing that the agency has “no greater responsibility than to care for the health and safety of our people.” The mysterious illness first emerged in late 2016, when a cluster of diplomats stationed in the Cuban capital of Havana began reporting symptoms consistent with head trauma, including dizziness and extreme headaches. In subsequent years, there have been cases reported around the world, including clusters of at least 60 incidents in Bogota, Colombia, and Vienna, Austria. There have been about 1,500 reported cases across the US government in 96 different counties, officials said last year, but the number of reported incidents has dropped significantly in recent years. One problem facing the medical community is that there is still not a clear definition of Havana syndrome, which the government refers to as “anomalous health incidents” (AHIs). These tests were done, in some cases, long after symptoms began, making it harder to understand what physically happened. The illness and its cause have remained frustratingly opaque to both the intelligence community and the medical community. Despite long-standing speculation that the illness could have been the result of a targeted campaign by an enemy of the US, the US intelligence community said last year that it cannot link any cases to a foreign adversary, ruling it unlikely that the unexplained illness was the result of a targeted campaign by an enemy of the US. The Senate report, however, recommends that the US intelligence community should continue research as “there remain many unanswered questions about these incidents given information and research gaps.” “The IC must remain objective and must continue to actively collect intelligence: conduct analysis and pursue information that could shed light on AHI reports in general and foreign adversary emerging technologies, to include directed energy weapons in particular.” “Moreover, U.S. adversaries are likely developing directed energy technologies that may plausibly explain some of the reported symptoms community associated with AHls,” the report states. The report also denounces the CIA for halting its collection of clinical research on Havana syndrome while the Pentagon’s research efforts continue. “CIA has halted its own internal clinical research efforts related to AHIs. Specifically, the Agency stopped promoting pre-AHI baseline medical assessments in December 2021 and stopped conducting post-AHI medical assessments in January 2022. As a result, CIA may be missing out on important clinical data that could advance its understanding of AHIs,” it says. The committee also warns about the risks posed by the CIA’s lack of preparedness to respond quickly. “The Committee nevertheless assesses that CIA may not be well postured to respond to future AHI reports and to facilitate quick, accessible, high-quality medical care for those who need it, particularly in the case of another AHI cluster.” Additionally, the report lays out three recommendations for Congress to consider, including codifying into law the two Federal Employees’ Compensation Act bulletins pertaining to AHI-related claims and amending the Expanded Care Program. The findings are “based largely off testimonial evidence provided by CIA officials, other USG (US government) officials, medical professionals who provided care to AHI reporters as part of a facilitated medical care program, and AHI reporters.”