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The Club PUBlication  08/27/2018

8/27/2018

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New gene-editing technique may revolutionize disease treatment​
​By GINA KOLATA New York Times

For the first time, scientists have found a way to efficiently and precisely remove genes from white blood cells of the immune system and to insert beneficial replacements, all in far less time than it normally takes to edit genes.

If the technique can be replicated in other labs, experts said, it may open up profound new possibilities for treating an array of diseases, including cancer, infections like HIV and autoimmune conditions like lupus and rheumatoid arthritis.

The work, published in the journal Nature, “is a major advance,” said Dr. John Wherry, director of the Institute of Immunology at the University of Pennsylvania, who was not involved in the study.

But because the technique is so new, no patients have yet been treated with white blood cells engineered with it.

“The proof will be when this technology is used to develop a new therapeutic product,” said Dr. Marcela Maus, director of cellular immunotherapy at Massachusetts General Hospital.

That test may not be far away. The researchers have already used the method in the laboratory to alter the abnormal immune cells of children with a rare genetic condition. They plan to return the altered cells to the children in an effort to cure them.

Currently, scientists attempting to edit the genome often must rely on modified viruses to slice open DNA in a cell and to deliver new genes into the cell. The method is time-consuming and difficult, limiting its use.

Despite the drawbacks, the virus method has had some success. Patients with a few rare blood cancers can be treated with engineered white blood cells — the immune system’s T-cells — that go directly to the tumors and kill them.

This type of treatment with engineered white cells, called immunotherapy, has been limited because of the difficulty of making viruses to carry the genetic material and the time needed to create them.

But researchers now say they have a found a way to use electrical fields, not viruses, to deliver both gene-editing tools and new genetic material into the cell. By speeding the process, in theory a treatment could be available to patients with almost any type of cancer.

“What takes months or even a year may now take a couple weeks using this new technology,” said Fred Ramsdell, vice president of research at the Parker Institute for Cancer Immunotherapy in San Francisco. “If you are a cancer patient, weeks versus months could make a huge difference.”

“I think it’s going to be a huge breakthrough,” he said.

The Parker Institute already is working with the authors of the new paper, led by Dr. Alexander Marson, scientific director of biomedicine at the Innovative Genomics Institute — a partnership between University of California, San Francisco and the University of California, Berkeley — to make engineered cells to treat a variety of cancers.

In the new study, Marson and his colleagues engineered T-cells to recognize human melanoma cells. In mice carrying the human cancer cells, the modified T-cells went right to the cancer, attacking it.

The idea of engineering T-cells without using a virus is not new, but the immune cells are fragile and hard to keep alive in the lab, and it has always been difficult to get genes into them.

Already the scientists are talking to the Food and Drug Administration about using the new method to precisely attack solid tumors, as well as blood cancers.

“Our intent is to try to apply this as quickly as possible,” Ramsdell said.
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The Club PUBlication 08/20/2018

8/20/2018

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         Spirit of the Rivers 
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Carol Wergin
An Invitation from Carol Wergin, SOTR project
​Dear Friends,

The day has arrived!  The Spirit of the Rivers is now gracing our lakefront! And, what a gorgeous sight it is!  Beautifully sculpted by R.T. Wallen, it quickly attracted attention from multitudes of people. 

The site is not yet complete.   Paving and landscaping will take place around the site for the next month or so.  If you visit the monument when workers are present please be careful and courteous, remembering that the work will soon be done and it will be there for generations to enjoy!

Plan to join us at the Dedication of the sculpture on Sunday, September 16th at 2:00.  You might want to bring a lawn chair and arrive early.  The Menominee Drumming Circle will welcome visitors to the site.  We'll hear from the artist, R.T. Wallen, Ken Meshigaud, the Chairman of the Hannahville Potawatomi Community and descendant of Chief Mishicott, as well as local officials and project organizers.  The monument is located at 4815 Memorial Drive, Two Rivers, across from Aurora Medical Clinic.

It is not too late to be part of history!  Engraved pavers can still be purchased by downloading a Paving Brick Form from spiritoftherivers.org.
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The Spirit of the Rivers committee invites you to enjoy the lakeshore and its new historic visitors!

Carol Wergin
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The Club PUBlication  08/13/2018

8/13/2018

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         Lee Schaefer
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  Star Tribune - Wed Aug 8, 2018
Are cheap, short-term health plans a good option?LEE SCHAFER@LEEASCHAFER

The Minnesota Council of Health Plans hasn't taken a position on a new policy initiative out of Washington, the permission to issue cheap, short-term medical insurance policies for up to three years.

It's a hot topic, but our main health plan trade group hasn't stated an opinion because its members apparently can't all agree on this one.

You can imagine the debate. On the one hand, there has to be a cheaper option for people who earn too much to qualify for a government subsidy for conventional plans that meet the rules but can't really afford them. So these short-term plans, however imperfect, are better than nothing.

Not so fast. These short-term medical policies will attract younger and healthier people, leaving only older and sicker people in the conventional market and maybe dragging it down. Plus a bunch of families won't realize how little insurance they have really bought until they find themselves denied coverage and then lose their house. So these short-term plans are a cure much worse than the disease.

Picking the right side in this conversation isn't a no-brainer.
That the Minnesotans in the industry can't seem to agree is at least a little newsworthy, because these kinds of plans sure aren't very popular here. The likelihood of what's effectively a three-year, bare-bones insurance product being approved by our state seems very low, at least the way that things stand now. Of course, there's an election coming.

Short-term medical insurance got its name in an obvious way, by generally being available for only 90 days. The new guidelines out of Washington effectively allow them for a year, with the ability to be extended for two more years. That means a skinnied-down health insurance policy originally designed as a stopgap can be used for up to three years.

There's not a much of a market for them now because there aren't that many circumstances in life where having a genuinely short-term plan makes a lot of sense, limited to situations like that of a person who is finishing school and not yet eligible for the group insurance plan at a new job.

For most everyone else, there's open enrollment every year, plus rules that allow people going through life events such as a divorce to get new insurance during the year.

"The devil in all these short-term plans is in the details," said Milt Edgren, a veteran insurance consultant and principal with Golden Valley-based Woodhill Financial, meaning all the ways listed in the contract that the insurance company won't pay.

Edgren isn't much of a fan, in part because they clearly remind him of the so-called junk insurance plans sold before the ACA took effect. In some states "insurance" plans for a whole family had cost just $100 a month. That's certainly cheap enough, but consumers later found out that all they really provided was some reimbursement for room and board during a hospital stay.


That expensive imaging exam? That's your problem. Same for the chemotherapy treatments keeping mom alive.
Getting rid of policies like this was one of the goals of the ACA, as far too many consumers made it through a health crisis only to find themselves in a financial crisis, even though they had faithfully paid their premiums.

The ACA made a lot of things essential that you would expect, such as emergency services and hospitalization. But the minimum standard also included coverage for prescription drugs, maternity and newborn care, treatment for mental health disorders and so on.


Pre-existing conditions
The ACA also banned the practice of denying coverage for a pre-existing health condition. This aspect of the ACA remains popular, and a recent poll by the California-based Kaiser Family Foundation found that maintaining protections for pre-existing conditions was the top health concern of voters this summer.

In a brochure for a short-term plan available here in Minnesota through Medica's website (but not issued by Medica), the second paragraph made it perfectly clear that a short-term medical insurance policy was for people waiting to get conventional coverage, not a substitute for a plan that met the standards of the ACA.

Further down it got to pre-existing conditions, explaining how the policy wouldn't cover anything that received treatment or even led to a consultation within the previous five years.
​
What wouldn't be covered turned out to be a much longer list than what was covered, and in smaller type. Slip off your ATV and get injured, and that's your problem. Same with racing a sailboat.

One exclusion was particularly eye-catching, just for the creepy way it got stated: "Suicide or attempted suicide or intentionally self-inflicted injury, while sane or insane."


So why would somebody allow consumers to buy policies like this that could last for years?
Proponents have a consumer in mind: a family that makes too much money to get subsidies for ACA-compliant plans but not nearly enough to easily pay for one. For a family of two, subsidies for private health plans fall away as household income approaches $65,000. Price-checking online for a "peak bronze" plan for a baby boomer husband and wife here in the Twin Cities turned up a cost of nearly $1,100 per month, with a $13,300 deductible.

That could be enough to drive people out of the regular insurance market. Of the options they have, a short-term plan to help with unexpected expenses may be the least bad.

Champions of insurance products like these short-term medical plans, however, seem to gloss over at least one detail when stumping for them. By calling it "much less expensive healthcare at a much lower price," the president masked the fact that there's going to be nothing different about the size of the bill for health care services. It's just a different way to try to pay for it.


   The real problem, of course, is not that health insurance costs so much.
                                        It's that health care does.
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The Club PUBlication  08/06/2018

8/6/2018

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​                The 
            National
​Deficit isn't a wakeup
                call
               
                Yet!


​​

For many local business leaders, other issues are more pressing.                                           
By JIM SPENCER 
[email protected]


WASHINGTON – In slightly more than a decade, the national debt of the United States will be more than the value of goods and services the country produces in a year, the Congressional Budget Office (CBO) projected in a recent report. The country spends more money in a year than it takes in, and the gap is growing, not shrinking, CBO said.

“CBO’s report is filled with sobering projections that should be an urgent wake-up call for the administration and Congress,” said Michael Peterson, head of the Peter G. Peterson Foundation, one of the country’s top federal budget think tanks. “Annual budget deficits are on track to eclipse $1 trillion in just two years, and continue growing.”

So why do so few people in the public and private sectors seem to care?

The short answer, according to sources interviewed by the Star Tribune, is that nothing really bad will happen for a few years.

V.V. Chari, an economics professor at the University of Minnesota and an adviser to the Federal Reserve Bank of Minneapolis, sees the lack of urgency on the part of politicians and others in leadership as irresponsible fiscal myopia.

“This is not a system that seems willing to take short-term sacrifices

At a time when economic recovery from the Great Recession is complete, unemployment is low and the country is not involved in a major military action, traditional strategy has been to bring the national debt down, Chari noted.

Instead, President Donald Trump and Republican majorities in the U.S. Senate and House are banking on economic growth to eventually make up for tax cuts to corporations and individuals that will increase the debt and deficit.
​

Some economists embrace that philosophy.

“To tax is to depress the economy,” said Edward Prescott, a Nobel Prize winner and adviser to the Minneapolis Fed. “The U.S. has the right amount of debt given the age of its population. I don’t see any big problems.”

At this point, Minnesota’s CEOs have different priorities than the country’s debt and deficit, said Charlie Weaver, director of the Minnesota Business Partnership, a group of the state’s major corporate executives.

“Frankly, I don’t hear a lot about [the federal debt and deficit],” Weaver noted. “It is not a lack of concern. It is that other issues are more pressing.”

Weaver’s members worry about a possible trade war prompted by Trump’s newly imposed tariffs on some Chinese imports and on imported aluminum and steel from Canada, Mexico and the European Union, as well as retaliation to them. They worry about Trump’s withdrawal of the U.S. from the Trans Pacific Partnership trade agreement with 11 Pacific rim countries. They worry that Trump’s immigration restrictions will limit workforce expansion the country needs to grow its way out of debt.

When debt and deficit “start to impact the ability of [individual] companies to grow,” Weaver said, “that’s when it will be a first topic of discussion. Until [companies] see a direct impact, you’re not going to see that. Right now, it’s not going to be in the top three.”

At the Leuthold Group, a financial-research firm based in Minneapolis, chief investment strategist Jim Paulsen looks not at U.S. government spending but at the spending decisions of hundreds of millions of individuals and businesses to judge the country’s economic health.

“On private-sector balance sheets, debt ratios look as good as they have in a number of years,” Paulsen said. “The level of corporate debt to profits is low. There’s tons of liquidity in corporations and households. If we have private sector health, it can take care of the public sector.”

Mark Wright, research director at the Minneapolis Fed, and Chari agree that the short-term risks to business are not serious for the next several years, but they say that without attention, future problems could abound.

“I don’t see a lot of appetite to increase immigration,” said Wright, who called workforce expansion one of the surest ways to stimulate economic growth. Cuts to legal immigration could actually reduce growth, he added.

Without nearly unprecedented sustained levels of growth, Chari and Wright said, taxes on everyone, including businesses, must eventually rise to meet the country’s financial obligations. Either that or deep cuts must be made in programs such as Medicare and Social Security.

Another risk to businesses is that as the U.S. borrows more to keep running, interest levied by America’s creditors will rise, Wright said. As the world’s biggest economy and one with a record of paying back what it borrows, America may always find takers for its IOU’s. But there will come a point where interest payments going up will drag the economy down.
“Private borrowing rates [for businesses and individuals] follow government rates,” Wright said.

“ It is not for the Fed to tell the government how to operate,” Wright said. But he stressed that when combining federal debt with state and local government debt — including pension and health care obligations — the country’s debt situation looks “much worse.” Wright rated Minnesota’s debt worries “middle of the pack.”

“We’re not out of the woods,” he said.

Using CBO’s revenue and spending projections, the Committee for a Responsible Federal Budget (CRFB), a think tank chaired in part by ex-Minnesota congressman Tim Penny, pointed to an ominous future: “By 2041, spending on Social Security, health care, and interest will exceed all revenue. That essentially means every dollar Congress appropriates — whether for defense, education, or basic research — will be financed with borrowed money.”

“Action,” CRFB concluded with a play on words, “needs to start yesterday.”
Jim Spencer • 202-662-7432

When debt and deficit “start to impact the ability of [individual] companies to grow, that’s when it will be a first topic of discussion. Until [companies] see a direct impact, you’re not going to see that. Right now, it’s not going to be in the top three.”

Charlie Weaver, director of the Minnesota Business Partnership
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