EFTA02358536.pdf

From: Gregory Brown Sent: Sunday, April 16, 2017 8:22 AM To: undisclosed-recipients: Subject: Greg Brown's Weekend Reading and Other Things.. 04/16/2017 DEAR FRIEND <=div> Obesity's hefty price tag America's heaviest city grapples with costs from weight-loss surgery =o extra-wide hospital beds. <=r> <=p> =n a recent article in Politico Magazine by Beth Baker she=describes the operation above of a 30 year-old 330 pound female patient =E24140, considered "morbidly obese" 40=93 with two gaping hernias holes torn in the abdominal sac that holds the =ody's major organs, as "The belly wall is not designed to =old this much weight," said by her Baptist Memphis Hospital, surge=n George Woodman. By the operation's end, most of the patient*=804>s stomach was trimmed away, leaving a much smaller "gas=ric sleeve" that will allow her to feel full after eating =nly small amounts of food. Removing a portion of the stomach also suppress=s the hormones that stimulate hunger. The operation (known as a laparoscopic sleeve gastrectom=) is now the most common type of weight-loss surgery performed in=the U.S. Woodman has conducted 6,000 gastric sleeve operations, and =id three more that morning. Memphis is the heaviest metropolitan cit= in the country, with an adult obesity rate of about 36 percent — =pproaching the rate of more than 40 percent that researchers say we4i=99II reach by 2030, if current trends continue. "There is an unlimited number of patients," he sai=. EFTA_R1_01345793 EFTA02358536 Memphis may be the heaviest city in the country, but it isn't mu=h of an outlier. From the trimmest state, Colorado, to the most obese, Mis=issippi, the entire nation has been on a perilous—and costly*=94upward track when it comes to extreme weight gain. Severe obesity <=span>(a BMI of 40 or more) — the kind most harmful to individual well-being and expen=ive to society — is rising at an alarming rate and may affect 11 p=rcent of U.S. adults by 2030. Dieting and exercise are the prescription fo= most Americans who want to lose weight, but only a minority succeed.t>=A0 Woodman estimates that just 3 percent of his morbidly obese patients co=ld lose their excess weight on their own, so for most, bariatric surgery i= a last-resort option. With luck, this patient will lose about 75 percent =f her excess weight, putting her on track to a healthier future. 0=804fleople say that obesity is self-induced," Woodman said. 4k=A0"But it doesn't matter. We have to do something about it=" Every five days, Woodman holds a seminar for prospective patient=. On a recent Saturday, 60 people showed up. Perhaps one-third would=follow through with surgery. For some, Medicare, Medicaid, or private insu=ers will pay, calculating that the price of the surgery is less than the c=st of a lifetime of chronic disease. At Baptist Memphis, the operati=n costs $14,000 — the cost is often higher elsewhere, $25,000 or m=re. That may seem expensive, but it could be a bargain compared with=the estimated $200,000 in excess medical costs obese Americans can rack up=over their lifetimes. Memphis has the highest obesity rate among U.S. citi=s, and its appetite for unhealthy food is part of the reason. <1=> Pedestrians on Beale Street take in the sights, top,=including the day's menu at B.B. King's famous blues club, left.=C24, At right, spectators wait for the city's famous Mardi Gras parad= to pass by. As American waistbands continue t= expand, researchers and policymakers are trying to figure out just what t=e obesity epidemic is going to cost the nation. There are the direct=medical costs of treating obesity-related diseases including Type 2 diabet=s, heart disease and stroke, high blood pressure, arthritis, and related c=ncers, among others. And then there are the indirect costs: lost productiv=ty, more illness, extra infrastructure to handle heavier patients and resi=ents. These bills are already coming due in Memphis. Last year, extr= health care costs from obesity were $538 million — more than half=the budget of the city's public school system, according to Gallup=Healthways Well-Being Index. For the state of Tennessee, the annual =xcess health costs of obesity were $2.29 billion — equivalent to m=re than 6 percent of the entire state budget. No matter how many sur=eries Woodman conducts, he won't make a dent; many more Americans =re tipping the scales into the obese range each year. 2 EFTA_R1_01345794 EFTA02358537 Endocrinologist Ja= Cohen, who treats many patients with obesity-caused diabetes, estimates t=at the average diabetic patient costs the health care system triple what a=healthy person costs. Add in their lost productivity and the price t=g skyrockets. "It's politically imperative to reduce=the obesity rate," said Cohen. Nationally, "it costs literally tr=llions of dollars to treat these conditions." AS COSTLY AS the o=esity problem is now, its set to get worse. The baby boom generation=is the fattest on record, and they are just reaching the age where health =roblems begin to mount. Federal and state officials are growing incr=asingly worried about the steep price the country will pay for its weight =roblem. In West Virginia, one of the most obese states, public health comm=ssioner Rahul Gupta says the preventable direct medical costs of obesity a=e $1.4 billion to $1.8 billion a year, with an additional $5 billion in in=irect costs, such as lost productivity. Obese patients submit up to =even times the number of medical claims compared with normal-weight patien=s, he said. "At the state and federal levels, chronic diseas= burden is among the largest drivers of health care costs/4k=99 Gupta said, "and among chronic diseases it comes down to the conse=uences of obesity and tobacco." c=pan style="font-size:12ptline-height:17.12px;font-family:georgia,serif"= And then there are the national co=ts. Zhou Yang, a professor at Emory University who studies the impact of o=esity on the medical system, found that obese older males spent $190,657 m=re on lifetime health care expenses than their normal weight peers while o=der obese women spent $223,629 more. A 2016 meta-analysis by Univers=ty of Washington researchers found that annual medical spending attributed=to obesity nationally was nearly $150 billion — more than four tim=s the federal budget for foreign aid and nearly enough to fund the entire =.S. Department of Veterans Affair=. Other potential costs are harder to quantify but no less worrisome, for =atients, taxpayers and society at large. For example, researchers ar= discovering that vaccines may not be as effective in those who are obese.=C24> Studies have found that obese patients do not respond as well to the=HIV vaccine and the flu vaccine, leaving them more vulnerable to infection=— and to passing those diseases on to others. Over time, it4k=99s possible that a community's "herd immunity" co=ld suffer, creating the conditions for the return of diseases that were on=e controlled through immunization—and that could affect us all, ac=ording to an analyst at the Union of Concerned Scientists. Even the milita=y is affected, as recruiters struggle to find enough soldiers who meet fit=ess requirements. The percentage of overweight and obese young men doubled=over a 50-year period and tripled for young women. According to a st=dy by the National Bureau of Economic Research, Navy recruits who were ove=weight were more likely than their normal-weight peers to fail semiannual =hysical readiness tests. In all, overweight and obese active 3 EFTA_R1_01345795 EFTA02358538 duty mi=itary personnel cost the taxpayer $105 million a year in lost productivity= and $1 billion annually on treating obesity-related illness —more=than treating military tobacco and alcohol-related illness combined, NBER =stimated. Transportation costs, too, are rising, and not only for obese pa=sengers who must purchase two seats to fly. Researchers at the Unive=sity of Illinois estimated that 1 billion additional gallons of gasoline a=e consumed in the U.S. each year to ferry overweight and obese car passeng=rs from place to place. One study estimated that U.S. airlines purch=sed 350 million more gallons of jet fuel because of the number of heavier =assengers. Obesity also affects the bottom line of employers. Obesit= contributes to absenteeism and "presenteeism," whe= people show up but are less productive. Based on current trends, the cost=of obesity in lost economic productivity by 2030 will be between $390 bill=on and $520 billion annually. Obese employees may suffer financially as we=l. A 2010 study found that white women had 9 percent lower wag=s because of obesity, "equivalent in absolute value to the wage ef=ect of roughly 1.5 years of education or three years of work experience.=E2$4 A study in the Journal of Health Economics found that some =mployers pay lower wages to obese workers to cover higher insurance costs.=/span> c=pan style="font-size:12ptline-height:17.12pr,font-family:georgia,serif"=Even the cost of dying is higher for obese people. Companies like Go=iath Caskets specialize in funeral products for the obese — for a =rice. Everything from wider grave plots to specialized hearses with reinfa=ced chassis and heavy-duty lifting equipment must be used. Crematories are=widening furnace doors and chambers to accommodate very large bodies.4,=A0 A "supersize" funeral costs between $800 and $3,=oo more, notes U.S. Funerals Online. "The costs are not just rela=ed to health care," said Gupta. "There's a cost fo= people who can't reach their full potential in terms of education= employment, mobility, physical activity and productivity."=/p> AT BAPTIST MEMPHIS, case m=nagers Bonnie Jeter and Phyllis Lutz see the costly impact of obesity in t=e long-term acute care hospital, a special wing for critically ill patient=. When Jeter began as a case manager 27 years ago, obesity was rare.=C2.> Today, some 40 to 50 percent of the patients she sees are obese or =E204>super obese." Before opening this special win=, the rooms had to be retrofitted with hydraulic ceiling lifts and wider d=orways because of the large number of obese patients. On a tour of t=e unit, Jeter and Lutz led visitors to the bathing room. They cannot=lift their most obese patients into the extra-large tub, so these patients=must be given sponge baths. The large toilet is mounted on the floor= rather than the wall, to hold heavy patients. 4 EFTA_R1_01345796 EFTA02358539 "It can take three =eople to turn a super obese patient," said Lutz. Patients mu=t be turned every two hours to prevent pressure ulcers, in addition to bei=g moved for wound care, bed baths, and other needs. To make matters =orse, "We don't have any more staff [to handle obese patients]," sh= said. These patients face numerous complex medical problems. Q=9CThey take longer to get better," said Jeter. "Ther= are a lot of complications—diabetes, renal failure, terrible skin=wounds, circulatory issues, cellulitis, breathing difficulties." =C240Providing care is not incrementally more difficult, she said, 4>=9Cles a quantum leap." Not surprisingly, pati=nts often grow depressed and unmotivated. 'They're d=ing younger and younger," said Jeter. "It's horrif=c." To accommodate the many obese patients, Baptist Memphis Hospit=l has had to install extra-wide hospital doors. Bariatric surgeon Ge=rge Woodman, right, talks with patient Dana Brown one day after she receiv=d gastric sleeve surgery to shrink the size of her stomach. Then the=e's the discharge planning for patients ready for release. Nursing=homes and dialysis clinics can be hard to find. "Some [clinics] have a 350-po=nd size limit," said Jeter. She and Lutz must plan far ahead=to locate places to send the patients. =br> Usually, hospitals must eat the cos= for expensive bariatric equipment. A mechanical lift that can hold up to =00 pounds costs $6,000 — a bariatric lift, for up to 1,000 pounds,=$13,000. A standard hospital bed runs $8,000 compared with a large b=d for $45,000. Everything from larger blood pressure cuffs to wheelchairs,=stretchers, waiting room chairs and patient gowns must be on hand. Y=t health care providers cannot charge insurers for these costs. =p class="MsoNormal"> 4>=804,Obesity is one of the most urgent public health problems in our natio= today," said Jay Bhatt, chief medical officer of the American Hos=ital Association. In addition to equipment costs, he said, hospitals=pay for special safety training for workers. Nurse's aides r=nk 4th nationally in job injuries, behind police officers, jailers and fir=fighters, in part due to lifting heavy patients. Nursing homes face many o= the same challenges, said Cheryl Phillips, senior vice president for Publ=c Policy and Health Services for Leading Age, the trade association of non=rofit nursing homes. "We are arguing for better reimbursemen= that is risk-adjusted," said Phillips. "Medicaid do=sn't even meet the costs for much of the care —obesity is b=t one example." According to research by Yang, overweight an= obese baby boomers will spend 1.3 billion more days in long- term care tha= previous generations, costing Medicaid at least $68 billion. 5 EFTA_R1_01345797 EFTA02358540 At the end of a workday, she an= pediatrician-in-chief Jon McCullers sit in his office to reflect on the o=esity epidemic. McCullers was an infectious disease researcher until=five years ago, when he was recruited to Le Bonheur. "It was=obvious that my research wasn't what they needed," he said= High poverty levels in Memphis led to a host of urgent problems...A0 Topping the list was obesity. With an infusion of state and hospi=al funding, he launched the obesity program, which combines research, comm=nity outreach and a Healthy Lifestyle clinic. Most of the program*=8040s $3.5 million annual budget is not covered by patient insurance. Wha= is the goal? "Not to be the worst in the country," McCull=rs said wryly. The clinic has served 650 high-risk kids since opening in =ctober 2014, the majority African-American girls. For these children= a healthy lifestyle can be a new concept. Through surveys, Han.=8040s team found that two-thirds of the families they serve are considere= "food insecure," despite their obesity. "So=it's the types of foods they're eating — high in f=t, high in sugar," she said. As for exercise, Han, whose own=children go to Memphis public schools said gym class is held in the hallwa=s, if at all. Despite the immensity of the problem, Han and McCullers tr= to be hopeful. Nationally, the prevalence of obesity has remained s=able for children and teens, and the rate decreased significantly among pr=schoolers in 2013.2014, according to the Centers for Disease Control and P=evention. "We know we can make the obesity rate plateau4=804> said Han. "Now we need to make it reverse." Th= challenge is finding creative ways to connect with people where they live= "Most hospitals look at who is inside their walls,"=said McCullers. "You have to look outside your walls, and be=engaged with local and state governments and community groups." Ul=imately, they said, its clear obesity has stopped being a problem for only=those affected and is now a national crisis. The country literally c=nnot afford the impending costs. Shifting investments toward encoura=ing healthy environments and behaviors rather than paying for expensive, l=fe-threatening chronic disease is the only affordable — and humane=— response. "Obesity costs everybody,Q=9D said Yang. "Nobody can escape. Someone has to pa= the bill." =/p> So True The Reality of an American being Killed by an Illegal Immigrant 6 EFTA_R1_01345798 EFTA02358541 So Why are so many People T=rrified of Illegal Immigrants? Beca=se of Fear spread by Our Leaders Web Link: https://www.facebook.com/marnita.schroedl/posts/1021169359211=912 <https:=/www.facebook.com/marnita.schroedl/posts/10211693592115912> aspan> Please see the video via the above web link Stupid Money =p class="MsoNormal" align="center">Throwing more money at the military won't make it stronger</=pan> <=r> I called this piece stupid money aft=r reading reports that President Trump is proposing a $54 billion increase=for the Defense Department, which he then claimed would be offset by large=cuts in the State Department, foreign aid and other civilian agencies.Q=A0 Trump says he wants to do this so that "nobody will dare questi=n our military might again." But no one does. The U.S. milit=ry remains in a league of its o None of the difficulties the United States=has faced over the past 25 years has been in any way because its military =as too small or weak. As then-Secretary of Defense Robert Gates note= in a 2007 lecture, "One of the most important lessons of the wars=in Iraq and Afghanistan is that military success is not sufficient to win.=E244 To achieve "long-term success," he e=plained, requires "economic development, institution-building ...E2440. [and] good governance." =herefore, he called for "a dramatic increas= in spending on the civilian instruments of national security," in=luding "diplomacy" and "foreign assistan=e."win. The U.S. defense budget in 2015 was nine times the siz= of Russia's and three times that of China's. 7 EFTA_R1_01345799 EFTA02358542 More =mportantly President Trump is proposing dramatically increasing our nuclea= arsenal, as if this will somehow dissuade ISIS and other terrorist. =Also Trump is stuck in the 20th Century advocating large m=litary programs like aircraft carriers who are useless against a group of =ad guys with a dirty bomb or an adversary intent to poison our water suppl= or hack into banking system or election. But then that has already =appened with the President claiming that it was nothing to do with nothing= 4,=A0 Currently the United States spends almost $600 b=llion yearly on its military which is almost 40% of all of the money spent=globally, more than the next eight countries and 54% of all of the discret=onary spending in the country. And to give you more prospective, the=$54 billion that President Trump is proposing is almost as much as the ent=re military budget in China. Yet we are no safer than Indonesia, Bra=il, Spain, Australia or South Africa which are not in the top 10 of milita=y expenditures. Just to understand the wastefulness of wars you only have =o look at what US military in Iraq, Just in 2011 after our politicians had=declared victory and the media have largely moved on because it didni>=99t mean we wasn't going to spend almost $50 billion on thos= "non-combat troops" which remain, however. What else could we d= with that kind of scratch if we just brought them home? NPP tells us it w=uld buy: • 4,0=A0 24.3 million children rece=ving low-income health care for one year, OR aspan>726,044 elementary school teachers for one year, OR =C2.829,946 firefighters for one year, OR =C2$6.2 million Head Start slots for children for one yea=, OR * Q=A0 10.7 million households with ren=wable electricity -- solar photovoltaic for one year, OR =C*28.6 million households with renewable electricity-wi=d power for one year, OR =C2* =C* 6.1 milli=n military veterans receiving VA medical care for one year, OR 8 EFTA_R1_01345800 EFTA02358543  class="m_4977142885636407934m_-8127405716069441209m_-656486635394792824=_- 7961857543440115057gmail-m_2316529243473243556gmail-m_-24096286104043321=6m_- 2898380243958664293gmail-m_8032535085150903781gmail-m_7364578844834348=9m_7214502630609316032m_- 5955632774661111741m_-5561663390226941878gmail-m_=834175173281053053gmail- m_5591870416997806566m_-1350999846084077074m_-9189=60299443654177m_5611129322921874124gmail-m_- 4086174604780320648gmail-m_836=756590749716069m_-6847088887303417562m_2161194578616005294gmail- m_-7951578=9410294533gmail-m_3295320845838717775m_7691678573900696207gmail-m_- 9105161=75940617595m_5088034489175806744m_- 152171658728096921m_8507011639608972109=_6485943662441037371m_-2752056732855592506m_- 2401410245102402219m_-9198154=54671371128gmail-m_8659269584857187632m_-4444973350004102843gmail- m_734764=540094762350gmail-m_-7200549396638611718gmail-m_-5728695526232697474m_- 127=894677891184586gmail-m_-754538969383427232m_9164956893038593270m_221097336=126603280gmail- m_2918525785759295066m_7253808749210003129gmail-MsoUstPararraphCxSpMiddle" style="margin-left:lin">• =C2* 9.8 million people receiving low-income health =are for one year, OR *=B7 4>=A0 718,208 police=or sheriff's patrol officers for one year, OR 6.0 million scholarships for university students for one year,=OR * =C24> 8.5 million students receiving Pell=grants of $5,550 It's a tragic iron= that so much of the discussion surrounding the public debt centers on 40=8040entitlements" like Social Security (which hasn't a=ded a penny to the national debt) when we're still paying for Korea an= Vietnam and Grenada and Panama and the first Gulf War and Somalia and the=Balkans and on and on. Estimates of just how much of our national de=t payments are from past military spending vary wildly. In 2007, economist=Robert Higgs calculated it like this: I added up all past deficits (minus surpluses) since 1916 (whe= the debt was nearly zero), prorated according to each year's ratio of=narrowly defined national security spending--military, veterans, and inter=ational affairs--to total federal spending, expressing everything in dolla=s of constant purchasing power. This sum is equal to 91.2 percent of the v=Iue of the national debt held by the public at the end of 2006. Therefore,=l attribute that same percentage of the government's net interest outl=ys in that year to past debt-financed defense spending. When Higgs did tha= analysis four years later, he came up with a figure of $206.7 billion jus= in interest payments on our past military adventures. And most peop=e see this number as extremely conservative. Fareed Zakaria tells a story =hat he was surprise by the answer that General David Petraeus told him dur=ng the early days of the Iraq War and things were not going well. Wh=n asked whether he wished he had more troops. Petraeus was too polit=cally savvy to criticize the Donald Rumsfeld "light footprint*=8* strategy, so he deflected the question, answering it a different way= "I wish we had more Foreign Service officers, aid professionals a=d other kinds of non- military specialists," he said. The heart of =he problem the United States was facing in Iraq, he noted presciently, was=a deep sectarian divide between Shiite and Sunni, Arab and Kurd. "=e need help on those issues. Otherwise, we're relying 9 EFTA_R1_01345801 EFTA02358544 on 22-year-o=d sergeants to handle them. Now, they are great kids, but they really don=E2Q4H know the history, the language, the politics." I understand the need fo= a strong national defense but when you are already spending more than the=combined military budgets of the next largest countries, it is difficult t= believe that our military spending is bloated and more importantly full w=th wasteful boondoggles that suck the resources that we better use non-mil=tary specialists, foreign aid and diplomacy. As I use to say during =he Vietnam War, "if we had given the Viet Cong televisions instead=of dropping bombs the war would have ended years earlier." A= such throwing more money in an already bloated military is not only waste=ul it is dereliction to the fiduciary responsibility that our government o=es its citizens. Someone Has Got To Be Kidding? <=pan style="font-size:12ptline-height:107%;font-family:georgia,serif"> It is often =aid that Wall Street (the=financial markets) is a casino, but after this week I would label it the ultimate Ponzi Scheme (named after Charles Ponzi who=e company, Securities Exchange Company, in 1919 promised returns of 50% in 45 days or =00% in 90 days out of monies from newer investors) — after hearin= that Tesla Corporation surpassed Ford Motor Company in value. But how can =his be possible? One company is an automotive titan that has built more that 350 million vehicles over the past 115 years with 201,000 employees, sales of 6.6 million vehicles, annual revenues $152 billion and profits of $10.4 billion last year. And the other is only 15 years old, with 30,000 employees, sales of 76,000 vehicles, revenues of $7 billion, pre-tax loss of $746 million and has neve= made a profit. Yet the 15 year-old Tesla is now valued more than Ford. =br> Someone is crazy. =/font> Even if one were=to believe that Tesla has a more promising future, numbers don't lie. And yet a 7% surge in the value of shares in electric car firm Tesla a week ago Monday s=w it zoom ahead of Ford Motor Company, in terms of its stock market value..=A0 As Wall Street closed for the day, Tesla, led by 45-year-old tycoon and futurist Elon Musk, was worth $49bn (E38bn), compared with a pal=ry $46bn for the empire built by Henry Ford. This astonishing overtaking maneuver says as much about the nature of stock mark=ts as it does about these two very different carmakers. The old 10 EFTA_R1_01345802 EFTA02358545 clichl>=A9 among stock market investors is that you should "buy on the rumor, sell on the fact" — the idea that investment is more ab=ut what you expect to happen in the future than the current state of play — obviously =his is the case with Tesla. While Tesla's investors believe that it is th= standard-bearer of a battery-powered future — and Ford is the archetypal mass-produ=tion legacy car business. That is the myth that CEO Elon Musk carefully crafted for thirty-something year old Wall Street analysists who can afford to buy a $100,000 car. But as someone who j=st leased a Chevy Bolt, I did so because it was half the price of an entry level Tesla, even though=it is fully loaded and gets the same mileage. And I leased because in three years every major automaker from Mercedes to Renault will be offering electric vehicles that get more than 250 miles =ith a single charge, so who knows what is going to be my next car. =nd in spite the setback of a fatal crash last year, when a Tesla on autopilot failed to tell the difference between =he side of a white lorry and a bright sky, the company continues to make strid=s towards a fully driverless car but so is Uber, Google and the other big aut=makers. I understand that Tesla also has a potentially lucrat=ve sideline in storage batteries for the home. The Powerwall is intended=to allow homes to store solar power, and Tesla is also due to start installing its first sola= roof tiles this year. I appreciate that Tesla's has set a goal of building 500,000 cars in 2018 and Musk ha= even raised the prospect of doubling that to lm by 2020— except that th=se production targets are unprecedented in the automotive industry and as Sams=ng last year's debacle with its Galaxy Note 7 cellphone catching fire =E2.4) pushing production delivery prior an exhausted testing has shown that a single defe=tive part from a supplier can kill sales and stock prices faster than E.coli at Chipotle. And just like McDonald's, Burger King, KFC which also had E.coli outbreaks but fared better than thei= smaller fast-food rival, should both Ford and Tesla suffer a similar misfor=une, I would bet on Ford coming through quicker. Yes, Tesla's new Model 3 is slated to start p=oduction this year and is intended to offer a more affordable version of previous models,=with a price tag around $35,000. If successful, the Model 3 could supercharge Tesla's growth by musclin= in on the territory of mass market rivals. But Tesla's model X crossover, while although sexy is currently not burning down the ho=se with sales. It's important to remember that despite the massive hype surrounding Tesla, the gigafactory currently nearing construction in Nevada will only allow the company to make 500,000 =nits a year by 2020. That would be fine if Tesla only wanted to sell cars to rich people, but CEO Elon Musk has been c=ear that the company's mission is to bring sustainable electric transport t= the mass market. To do that, an automaker needs scale. And to get scale, =esla will need to sell millions of vehicles a year and to increase production from its current lev=l to 1million cars is truly wishful thinking. Therefore to sell more vehicles and more batteries fo= its storage business called Tesla Energy, Tesla needs more gigafactories. =Gigafactories currently go for about $5 billion. Elon got supplier partners to pay for about 60% of this one, but w= can't assume that will always be true. Tesla has incredible growth potential with vehicles and energy storage, but peopl= forget that this growth isn't free. On the positive side, if Tesla can continue to reduce its battery costs, it ha= the potential for a cost advantage that could never be overcome by internal-combustion manufacturers. Except again, like with vehicles, there are many other people here and abroad trying to come up with the next 11 EFTA_R1_01345803 EFTA02358546 generation of battery technology Q=80Q ask Motorola which pioneered the cell phone, revolutionized again with its flip-phone an= today is no longer in the business. T=day Tesla gross margin profit is more than $20,000 per vehicle but when you add up R&D and oth=r things it actually loses $19,000 for every car sold, while Ford made more t=an $1500 on each vehicle it sold. With the cost of expansion, which is going to be in the many billions of dollars, Te=la is years away from making money. I know that this doesn't mean much in the rarefied air in Silicon Valley a=d Wall Street, as Amazon didn't generate profits for its first two decades=and today has a $440 billion market cap, $906 share price with less than $5 billion i= net revenues. But somewhere on Wall Street there has to be other people saying something is wrong when the company tha= loss $746 million is worth more than a company in the same business made $1=.2 billion. If this doesn't sound fishy, I have a great deal on a bridge for you in the middle of the Sahara Desert.</=pan> What Was Accomplished? Like many I was not surprised when I heard a week ago Thursda= evening that the US military launched 59 tomahawk missiles against a Syrian airfield to punish Syria's President Bashar Assad for allegedly usi=g chemical weapons to attack his own citizens. This act was a dramatic reversal from Trump's pledges to limit U.S. invo=vement in Syria and to focus on America First, leaving Syria's neighbors and =he Europeans to sort out the mess. For years President Obama had resisted growing calls to intervene militarily against the Assad regime. President Barack Obama's decision to refrain from engagement in 2013 was crit=cized as feckless at the time and is cited now as one of the reasons that Trump was forced to act. =span style="font-size:12pt;line-height:107%;font-family:georgia,serif"><=span> But as Neal Gable= wrote this week in Moyers & Company: It is pretty amazing how quickly the media and suck-up politicians can transform a mendacious, hypocritical, amateurish, ignorant, incoherent, bigoted buffoon who is way,=way out of his depth into a man of courage, which is what they did to President Trump this past weekend. All it takes is some saber rattling and launching a few dozen missiles. Granted, the =rump brand is already so tarnished that he didn't get the bounce or the adulation that the B=shes, pere and fils, got when they began their wars. According to one poll, only=51 percent of Americans approved of Trump's action, but given that Trump'= favorability rating has hovered around or even south of 40 percent, this is an improveme=t. =br> 12 EFTA_R1_01345804 EFTA02358547 Not to be in=elicate here, but atrocities happen in the world all the time (and have happened on an even larger scale before in Syria). Humans are c=pable of unimaginable cruelty. Sometimes the victims die quickly and are made visible by media for the wor=d to see. Other times, they die in slow motion, out of sight and out of mind. Sometimes banned weapons are used; Sometimes conventional weapons; Sometime=, neglect, isolation and starvation. And sometimes it is just plain old genocide. And the world in=general, and America in particular, has a way of being wishy-washy about which atrocities deserve responses and which one= don't. These decisions can be capricious at best and calculated camouflages for ulterior motives at worst. Indred, the motivations for military action needn't be singular at all, but are often multiple, tucked one insi=e the other like nesting dolls. Acts of war can themselves be used as political weapons. They can distract attention, quell acrimony, increase appetite for military spending and give a boost to sagging approval ratings. This =E2.4>rally--around--the--flag" (or "rally=E2$4.) effect is well documented over the centuries. And please realize that President =rump's decision to launch the cruise missile strike is being applauded=by the same foreign policy traditionalist of both parties — the establishment figur=s who gave us the disastrous war in Iraq — as=a show of U.S. "strength" and "resolve."= This should worry us all. Red lines and symbolic displays of f=rce do not constitute a plan or a strategy. First of all, Syria is truly a Major 'Cluster-F@$K'<=i> Cr> Web Link: http=://youtu.beilFpanWNgtQY <https://youtu.be/JFpanWNgfQY> Syria=E2.4>s war is a mess because after six years because the conflict is divided between four sides with each side with having foreign backers — who don't even agree with each other on who they are =ighting — or who they are fighting against. And up until this past Friday, the United States was only focused on fighting ISIS= So to understand the crisscrossing interventions and battle lines in Syria today and how it got that way you h=ve to go back to the beginning of the conflict and examine how it unfolded.40=A0 =/span> The first=shots in the war were fired in March 2011 by its President, Bashar Assad, against peaceful Arab Spring demonstrators. =y July the protesters started shooting back with some Syrian troops defecting from the Syrian army to 13 EFTA_R1_01345805 EFTA02358548 join them and cal=ing themselves The Free Syrian Army — the uprising becomes a civil war =E244 with extremist from across the region and around the world traveling to Syria to join The Rebels. Assad actually encourages this by releasing jihadists' prisoners to taint the rebellion with extremism, with the hope of making it harder for foreign backers to support them. In January 2012 Al Qaeda forms = new branch in Syria calling themselves — Jabhat al-Nusra. AIs= around that time, Syrian Kurdish groups take up arms and informally secede from Assad's rule in the North. 4)=A0 =br> And that sum=er is when Syria became a proxy war with Iran interceding on Assad's behalf, sending daily cargo flights and hund=eds of ground officers. This causes several oil-rich Arab states in the region to start sending money and weapons to Th= Rebels, to counter Iran's influence. Please click on the web link above to see why Syria is such a mess with no easy answers. What troubles me is how cavalier both Congressional Republicans and Democrats with their accolades, including Senator Lindsey Graham comparing Trump to the most beloved Republican President in the mode=n era, the one and only Ronald Reagan. As pundits used the phrases of 4>=9Cstrong message" and "new sheriff in town=E24,40 few asked what actually was accomplished. Think about it, the US military did not target President Assad's Sarin gas stoc=pile. And since President Trump warned the Russians an hour in advanced that he was attacking Shayrat air field, one then has t= believe that they alerted their ally President Assad. Finally, most p=oportionate military responses are really only made to make the aggressors feel better when they don't have a strategy. Talal al-Barazi, the governor of Homs province that includ=s the air base, said at least 13 people were killed in the missile strikes, including five soldiers on the base and eight civilians in areas surroundin= the facility. The figures could not be independently confirmed, but are said to include several children, which if true will provide another photo opt for both the Syrian Regime, as well as terrorist around the world showing the innocent civilians killed by America= aggression. Q=A0 Although the Pentagon's initial assessment was that the strike severely damaged or destroyed Syrian aircraft and support infrastructure an= equipment at the airfield. But within hours of the missile attack, Syrian warplanes had taken off from that same =irfield and launched airstrikes against Khan Sheikhoun, the same town where at leas= 86 people had been killed in the sarin attack and dropped new conventional bom=s. As Comedian/Satirist John Oliver pointed out during his show on HBO this week, "while it is natural to take some=kind of action in response, it has to come in the context in a larger strategy or i= is close to worthless. And though the strikes seem to make certain people feel better... What did the= actually achieve?" John Oliver Explains Why Trump's Syria Strike Should Make Us All 4>=9CVery, Very Worried." 14 EFTA_R1_01345806 EFTA02358549 <=b> Web Link: https://youtu.be/Sjb7yvWWII0 <https://youtu.be/Sjb7yvWW=I0> =/b> As John Oliver asked, what was actually achieved? President Assad=E24>4>s chemical weapons weren't destroyed. Neither was the airfield. And since he was able to launch an aircraft attack later in the day, obviously whatever aircraft were destroyed did not really affect the Syrian governmen= from launching future chemical attacks whenever they want. Finally, w=ether Assad uses chemical weapons or conventional bombs to kill his adversaries and innocent civilians, does =t really matter? Because a child killed by a cluster bomb or Sarin gas ends with the same result. Ugly and unnecessary=death. In recen= days, the administration has offered conflicting statements on key questions, including whether Assad can remain in power un=er any sort of negotiated peace settlement. "They seem to be cel=brating the strike almost as accomplishment in itself rather than as a tool to achieve any particular strategy," said Jeffrey Prescott, who served as director for Iran, =raq, Syria and the Gulf States at the National Security Council under Obama from 2015 =c, 2017. "Even days later, they are basking in the glow, but we do not=have a clear sense of why this strike and to what particular end."</=pan> Furthermore, launching missiles against any natio= that hasn't attacked you is an Act of War, no matter how well intentioned. And to do so, without being in any danger and not having a clear cut strategy is definitely an unnecessary Act of War. Even the President's mo=t ardent supporters admit that the President doesn't have a strategy or a plan to end t=e conflict in Syria. Consequently, we are destine to enter another phase of Mission Creep, with the pointless killing of more and more people and costing billions mor= of US taxpayers' dollars. It is estimated =hat this latest tomahawk attack cost US taxpayers' more than $100 million dollars. And the only thing that was accomplished is that the President's supporters can claim that there is a new sheriff in town, as even the Trump Administration admits that overthrowing Assad most likely will make matters even worse. Therefore if this is true, then the only solution has to be a diplomatic one, which starts with negotiation not missiles. To put it briefly, blowing shit up does not make a President, Mr. President....=C24, So again, what was accomplished? President Assad4k=99s chemical weapons weren't destroyed. Neither was the airfield. And since he was able to launch an aircraft attack later in the day, obviously whatever aircraft were destroyed did not really affect the Syrian governmen= from launching future chemical attacks whenever they want. Finally, 15 EFTA_R1_01345807 EFTA02358550 w=ether Assad uses chemical weapons or conventional bombs to kill his adversaries and innocent civilians, does =t really matter? Because a child killed by a cluster bomb or Sarin gas ends with the same result. Ugly and unnecessary death. </=pan> In recent days, th= administration has offered conflicting statements on key questions, including whether Assad can remain in power un=er any sort of negotiated peace settlement. "They seem to be cel=brating the strike almost as accomplishment in itself rather than as a tool to achieve any particular strategy," said Jeffrey Prescott, who served as director for Iran, =raq, Syria and the Gulf States at the National Security Council under Obama from 2015 =o 2017. "Even days later, they are basking in the glow, but we do not=have a clear sense of why this strike and to what particular end."<hpan> =/p> Furthermore, lau=ching missiles against any nation that hasn't attacked you is an Act of War, no matter how well intentioned. And to do so, without being in any danger and not having a clear cut strategy is definitely an unnecessary Act of War. Even the President's mo=t ardent supporters admit that the President doesn't have a strategy or a plan to end t=e conflict in Syria. Consequently, we are destine to enter another phase of Mission Creep, with the pointless killing of more and more people and costing billions mor= of US taxpayers' dollars. As Charles Blow wrote in the New York Times: It's ea=y to sell the heroism of a humanitarian mission or the fear of terror or the two in tandem, as Trump attempted in this case. =The temptation to unleash America's massive war machine is seductive and also addictive. Put that power in the ha=ds of a man like Trump, who operates more on impulse and intuition than intellect, =nd the world should shiver. <=span> As righteous as =e may feel about punishing Assad, Syria is a hornet's nest of forces hostile to America: Assad, Russia, and Iran=on one flank and ISIS on another. You can't afflict one faction without assisting the other. In this way, Syria i= a nearly unwinnable state. We've been down this road before. Just over the horizon is a hill: Steep and greased with =olitical motives, military ambitions, American blood and squandered treasury. =eing weary here isn't a sign of weakness; to the contrary, it's a display of hard won wisdom. Neal Gabler again: Many of us during the campaign noted how Trump's reality TV experience a=fected and even defined that campaign, but far less attention has been paid to how it would affect his presidency. The narcissism, the imperial demeanor, the preening, the necessity of hyping the drama — these are now the hal=marks of his early administration. 16 EFTA_R1_01345808 EFTA02358551 It makes for good TV and lousy governance. The impulsiveness for which Trump is famous was built into reality TV too, whic= lurches mindlessly from one scene to another. Indeed, you could accurately describe reality TV as plot without content, which, not at all incidentally= is also a way to describe the Trump presidency. So, whether it was the right thing to do to st=ike Assad, it was, by reality show standards, certainly the best thing to do. It go= a huge audience. It made Trump look like a man of action. It won him plaudits on cable TV, which likes nothing better than some military action to boost ratings, just as William Randolph Hearst practically starte= the Spanish- American War to push newspaper circulation. And, not leas= of all, it did what entertainment is practically designed to do: It provided a distraction from the mess Trum= is making of the country. You don't usually think of warfare as a distraction; warfar= is what you usually get distracted from. But Trump grasped that launc=ing missiles would knock everything else off the front pages at a time when he needed it= And in the short term, he seems to have been right. Talking about Syria means we aren't talking about the Russian hacking of the election or the fai=ure of health care reform or the Keystone Cops White House staff or the trashing o= regulations or the myriad of other disasters in this ongoing reality show t=at stars the "Not Ready for Prime Time Players."<=span> It is precisely because this new interventionism has h=d the desired result that we should all begin to worry. If a few missiles i= Syria won him hosannas, what about some action against North Korea for the next reality show episod=? And what other improvised adventures could our new action hero president embark upon to keep us preoccupied and him winnin= praise? War may be the force that gives us meaning. But it is also the force that keeps us entertained and di=tracted. With an entertainer-in-chief in the White House, someone fo= whom the presidency is a great vanity, that should scare us. That should scare=us a lot. To su=marize: It is estimated that this latest tomahawk attack cost US taxpayers' as much as $100=million dollars, if not more. And the only thing that was accomplished is that the President's supporters can claim that ther= is a new sheriff in town, as even the Trump Administration admits that