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Marvin Mallek, a doctor who treats covid patients from both sides of the river at Springfield Hospital in Vermont, said New Hampshire covid patients are now facing business as usual from insurers, suffering the same sort of financial stress that routinely affects patients with cancer, heart disease and other serious ailments.

“The inhumanity of our health-care system and the tragedies it creates will now resume and will now cover this one group that was exempted,'' he said. “The U.S. health-care system is sort of like a game of musical chairs where there are not enough chairs, and some people are going to get hurt and devastated financially.”

Hospitals also are in the position of having to resume billings and collections for individuals who may have been laid off because of the pandemic or been too sick to work, experts said.

“These waivers ended in January as we all had gained a better understanding of the virus, and people and communities became more familiar with best practices and protocols for limiting COVID-19 exposure and spread,” the company said in a statement. “Also, at this time vaccines, which are proven to be the safest and most effective way to protect oneself from COVID-19, were starting to become readily available.”Anthem took in $4.6 billion in profits in 2020, compared to $4.8 billion in 2019.

The reintroduction of cost-sharing mainly affects people with private or employer-based insurance. Patients with no insurance can have 100 percent of their expenses covered by the federal government, under a special program set up by the government for the pandemic, with hospitals reimbursed for care at Medicare rates.

Covid patients with Medicaid, the government plan for lower-income people that is paid for by states and the federal government, continue to be protected from cost-sharing, insurance specialists said

Patients on Medicare, the federal plan for the elderly, could face out-of-pocket costs if they do not have supplemental insurance.

Last year, according to the Kaiser Family Foundation, 88 percent of people covered by private insurance had their co-pays and deductibles for covid treatment waived. By August 2021, only 28 percent of the two largest plans in each state and D.C. still had the waivers in place, and another 10 percent planned to phase them out by the end of October,

general, a person with Azar’s type of plan would have an in-network deductible of $1,500 and an in-network out-of-pocket maximum of $4,000,

“We still don’t know where the numbers will land because the system makes the family wait for the bills,” s

Bills related to her stay at the out-of-network rehab hospital in Tennessee could climb as high as $10,000 more, her relatives have estimated, but they acknowledged they were uncertain this month what exactly to expect, even after asking UnitedHealthcare and the providers.

In 2020, as the pandemic took hold, U.S. health insurance companies declared they would cover 100 percent of the costs for covid treatment, waiving co-pays and expensive deductibles for hospital stays that frequently range into the hundreds of thousands of dollars.But this year, most insurers have reinstated co-pays and deductibles for covid patients, in many cases even before vaccines became widely available.

Looking forward the most worrying issue for the Kremlin is the isolation of the country’s economy. Since the start of the war the Russian stock market has closed, interest rates have doubled, inflation has shot up, and the value of the rouble has plummeted. One recent estimate suggests that Russia faces a drop of from 7 to 15% in GDP in 2022. It risks defaulting on it’s debts.

it is hard to see how Russia is going to have much spare capacity to compensate Ukraine for the damage it has inflicted upon it, even in the unlikely event it was prepared to offer to do so as part of an agreement.  

Second, given what has happened over the past few weeks to the population of these territories, those remaining will be more hostile to Russia and will likely resist an imposed government.

At the very least Moscow will want the provinces of Donetsk and Luhansk in their entirety, and not just the previous separatist enclaves, to be annexed or given some independent status. This was, after all, the demand with which Russia entered the war.  

It is, however, by no means straightforward even from a Russian perspective.  

First, if Ukraine has not otherwise been defeated and so “demilitarised” then this will be a frontier that will require defending for the indefinite future.

There is a further issue here even if there is no agreement. The cities and towns that have suffered the worst as a result of Putin’s war are those that were once claimed to be pro-Russian and so required “liberation” from Ukrainian “genocide”.

So the cost of occupying even this limited part of the country will be considerable and that is before even thinking about the expense required to render those horribly damaged towns and cities at all habitable, with effective infrastructure and accommodation.

Their economies were in decline before 2014 and that process has since accelerated. They are now poorer than other parts of Ukraine and prone to criminality.

The capital Grozny was rebuilt but the economy functioned thereafter at barely a fraction of pre-war levels. Despite efforts to make the economy more productive, in 2017 it was estimated that Chechnya required 80% of the government budget to be subsidised.

The other implication is that while economic sanctions have not yet given the West much leverage over Putin’s war strategy they do offer it leverage over his peace strategy.

Attempts to turn the situation around have not been helped by Chechnya’s rampant corruption. So this relatively small territory is already costing Moscow close to $3 billion a year. Crimea, annexed in 2014, may be costing a similar amount.  

Or take Syria. Here Russian air power was also used in a  brutal way, this time against rebel populations and in support of the Assad regime. That campaign succeeded in keeping Assad in power but Russia lacks the resources to reconstruct Syria

“Now moving into its eleventh year, the conflict in Syria has inflicted an almost unimaginable degree of devastation and loss on the Syrian people and their economy. Over 350,000 verifiable deaths have been directly attributed to the conflict so far, but the number of unaccounted lethal and non-lethal casualties is almost certainly far higher

More than half the country’s pre-conflict population (of almost 21 million) has been displaced—one of the largest displacements of people since World War II—and, partly as a result, by 2019, economic activity in Syria had shrunk by more than 50% compared to what it had been in 2010.”   

Syria was a far cheaper war for Russia to wage, probably in the low billions of dollars, in fuel, ordnance, and personnel cost. Far less has gone into economic assistance and much of that has been returned to Russia as arms sales and gas and infrastructure contracts

The strains on the Russian war effort are already evident, from the army’s hesitation about trying to fight their way into cities and the recruitment of mercenaries, to the reported appeal to China for help with supplies of military equipment and Putin’s fury with his intelligence agencies for misleading assessments and wasting roubles on Ukrainian agents who turned out to be useless

He is now having to choose between a range of poor outcomes, which the US suggests may include escalation to chemical use (which would be both militarily pointless and test further Western determination not to get directly involved).

War is rarely a good investment. Putin has acted for reasons of political and not economic opportunism. The prospects for any territory “liberated” by Russia is bleak. They will not prosper and will remain cut off from the international economy. To the extent that people stay they will have to be subsidised for all their needs while there will be little economic activity.  

Because of the destruction the short-term prospects will be bleak even if these territories are fully returned to Ukraine. But over the longer-term they will be much better off because of the amount of economic assistance Ukraine will receive and its integration into the international economy.

as Germany and Japan showed after 1945 even shattered economies can be rebuilt to even greater levels of efficiency with sufficient resilience and resources. That is another reason why Western financial assistance and investment will be especially vital - Ukraine’s full recovery will serve as a testament to Putin’s failure.

 it is worth keeping this analysis in mind when considering prospective peace deals. The Russians may have underestimated the costs of conquest from the start but their approach to war has raised those costs considerably, especially in those parts of Ukraine close to Russia.

Third, these territories will be economically wrecked and with no prospect of recovery so long as they are separated from Ukraine. 

The question of the future of sanctions and how they might be unwound is not one to be discussed separately from any peace talks. They are a vital part of the negotiations. As there can be no Western-led peace talks without Ukraine, it should be made clear to Moscow that for now this is a card for Zelensky to play.

The future of the Russian economy can then be in his hands. Should a moment come to start to ease sanctions, some leverage will be required to ensure that any agreement is being honoured. There could be a link  to reparations for the terrible damage caused.

As his original war plans failed Putin has insisted his forces follow a disruptive and cruel strategy that has put his original aims even more out of reach and Ukraine with a say over the future of the Russian economy.

In Britain, where gas accounts for roughly 40 percent of electricity generation but has a disproportionate effect on its cost

if the price of beer had risen as much that of natural gas over the last year, a pint in a pub would cost £25, or about $30.

“How can you adapt to a rise like this?” said Tewdos Gebreysus, a 35-year-old Uber driver in London, who said he was now paying four times as much on his energy bills as he was at the beginning of the year.

Johnson has left it for his successor to devise a response to the skyrocketing energy costs.

She and her opponent, Rishi Sunak, reject more sweeping measures, like using state subsidies to freeze the energy price cap for two years.

at a campaign gathering with Mr. Sunak on Thursday, she said the solution to the crisis was not to throw more money carelessly at consumers. Mr. Sunak, who has proposed cutting value-added tax on energy bills, warned that without drastic action, “there’s a high risk that millions of people will fall into destitution.

Britain is far less dependent on Russian gas than Germany or other European countries. But the structure of its energy market makes it extremely sensitive to fluctuations in the market price of natural gas.

The Bank of England has predicted that inflation will peak at 13 percent in October as the new energy prices turn up in household bills. Other estimates are higher; analysts at Citibank have said the rate could reach as high as 18 percent early next year.

Britain’s opposition Labour Party recently proposed to freeze energy tariffs where they are now, paying part of the £29 billion cost by increasing the so-called windfall taxes that the Conservative government imposed this year on oil and gas giants operating in the North Sea

The leadership contest has been dominated by Ms. Truss’s promise to cut taxes, which is popular with the rank-and-file Conservative Party members who will vote for the next prime minister. But economists say it would do little to protect the most vulnerable people from the ravages of soaring energy bills.

With another hefty price increase looming in October, the public outcry over energy costs is likely to haunt the next prime minister. Unless the government develops an effective response, some analysts said, the issue could cripple the government and tilt the next election to the Labour Party.

“We have a sort of worst-of-both-worlds system,” said Jonathan Portes, a professor of a professor of economics and public policy at Kings College London. “Household prices are related to the spot market, and we sort of save up price increases and dump them on households all at once.”

Beyond the mechanics of the system, critics said Britain had lagged Germany and other European countries in urging people to reduce energy consumption and increase the efficiency of their homes and offices.

“This is the poverty of our politics,” said Tom Burke, the chairman of E3G, an environmental think tank, and a former government adviser. “You’ve got to do some financial work to address the costs in the short term, and then you’ve got to really drive forward on demand reduction in the long run.”

The Fast Start plan will require extensive coordination between city, state and federal officials,  Weaver said. She was joined Tuesday by retired National Guard Brig. Gen. Michael McDaniel, who said he thinks the project can be done within a year by 32 crews.

McDaniel — who is assisting in coordinating activities between the city, the Lansing Board of Water and Light, state and federal agencies, and other stakeholders -- said the project could begin within the next month. But McDaniel reiterated the plan is still in its early phases and much of it is based on "assumptions."

The preliminary project scope developed by the BWL shows that up to 15,000 lead pipes could be removed in one year "under optimal conditions," Weaver said.McDaniel noted that while it took the BWL 10 years to remove 13,500 pipes, he thinks they can move quicker in Flint because they've perfected the process. McDaniel and Weaver said Flint crews would also be involved in the project.

The project would be done in two phases, with the first targeting high-risk households of children under the age of 6, children with elevated blood-lead levels, pregnant women, senior citizens, residential day care facilities, people with compromised immune systems and households where water tests indicate high levels of lead at the tap.

The project will not immediately address schools, businesses and other locations in Flint, according to a document released by the city detailing the plan. The city said most large facilities are served by "high-capacity cast iron water services," and not the typical lines found in residential water services.

the document states. "For institutional entities like schools and businesses, bottled water can continue to provide for their short-term needs."

Phase two of the program would ramp up to a "full-scale operation" that would bring in 32 crews and a "robust administration and logistics support team to meet the one-year goal," Weaver said.

McDaniel said the costs in the projected $55-million effort could fluctuate because of  the architecture and condition of the water distribution system. The estimated cost per line is $3,670, according to a city document. Of the $55 million, about $1.5 million will go toward administration and logistics, according to the city, which said personnel costs are estimated at $900,000 and operations costs are projected to be $600,000. According to the city, the bulk of the cost — $36 million — will go toward the labor and about $9.7 million will go toward the materials.

According to the city, the Fast Start program will remove and replace the lines at no cost to the homeowner. However, homeowners will be required to sign an agreement that authorizes Flint to remove and replace the portions of the lines on their private property and allow access to the meter inside the home.Lead lines will be replaced with new copper lines and a water filter will be installed at the kitchen tap for three months as a precaution, city officials said.

Flint's drinking water became contaminated with lead in April 2014 after the city, while under the control of a state-appointed emergency manager, switched its source to the Flint River as a temporary cost-cutting move and the state Department of Environmental Quality failed to require the addition of needed corrosion-control chemicals. As a result, corrosive water caused lead to leach from pipes, joints and fixtures, causing many citizens to receive water with unsafe lead levels. The state has told residents not to drink the water without filtering and says it is treating all Flint children as having been exposed to unsafe levels of lead

The FBI is now investigating the contamination of Flint’s drinking water amid a growing public outcry. U.S. Rep. Candice Miller, R-Harrison Township, proposed an emergency $1-billion grant to be authorized through the Environmental Protection Agency, and two Democratic U.S. senators and U.S. Rep. Dan Kildee, D-Flint Township, proposed up to $400 million in dollar-for-dollar matching funds from the state to do much the same thing.

The U.S. Attorney's Office announced Jan. 5 that it was assisting the EPA in the investigation

Several lawsuits have been filed in connection with the crisis.

When asked at the news conference whether she thinks Snyder will support the plan, Weaver said the city can no longer afford to wait."We’re putting forward our plan and we cannot wait for that," Weaver said. "We don’t trust that and we deserve new pipes. That’s the only way this community is going to be confident and people will stay here and people will come. I cannot imagine that he would not support this plan. If he doesn’t, shame on him."

The U.S. government is lending its support to SMR development. In September, the Nuclear Regulatory Commission for the first time issued a final safety evaluation report on a SMR—a critical step before a design can be approved—to NuScale

is developing its first commercial SMR for utilities in Utah and promising power by the end of the decade.

the Energy Department awarded $210 million to 10 projects to develop technologies for SMRs and beyond, as part of its Advanced Reactor Demonstration Program. The agency had already awarded $400 million to various projects since 2014 “to accelerate the development and deployment of SMRs,

. Potential buyers range from U.S. utilities trying to phase out coal-fired generators to Eastern European countries seeking energy independence.

GE’s second offering, a system now in development with nuclear startup TerraPower LLC, replaces water with molten salt, similar to what’s used in some advanced solar-power arrays. Dubbed Natrium, the system runs hotter than water-cooled reactors but at lower pressure and with passive cooling, which eliminates piping and electrical systems while improving safety, according to TerraPower CEO Chris Levesque.

“When you have a really elegant design, you can get multiple benefits working together,” Mr. Levesque says. TerraPower, established by investors including Bill Gates, received $80 million of the Energy Department funding for Natrium in October.

Greenpeace, the Union of Concerned Scientists and other advocacy groups argue that nuclear power remains a dangerous technological dead-end that causes as many problems as it solves.

Traditional reactors grew over time to achieve greater efficiencies of scale and lower cost per kilowatt-hour because power output rose faster than construction and operating costs. “There’s no reason that’s changed,” he says, dismissing SMR makers’ promises of lower costs and increased safety

Many proposed SMR expense reductions, such as less shielding, could ultimately increase their danger, while the combined use of several modules could create new safety risks like radioactive contamination that negate gains in individual modules, he says.

Mr. Ramana also says that the technological advances like 3-D printing and digital manufacturing that make SMRs possible are doing even more to improve green renewables. “It’s a kind of treadmill race, where one treadmill is going much faster.”

although SMRs have lower upfront capital cost per unit, their economic competitiveness is still to be proven.”

For many patients and their families, hospital fees are already complicated, opaque and stressful. The Kingsburys show just how little control consumers have.

None of this has been clear to consumers—until this year. Hospitals and insurers have long set prices through confidential negotiations. Starting Jan. 1, hospitals were required to make their prices public under a Trump administration policy that sought to expose the sector’s pricing to greater market pressure.

Compliance with the rule has been spotty, but the available data show that prices vary widely among the plans that negotiate contracts with hospitals. While the data remains difficult for consumers to use, knowing the full range of rates could ultimately help patients negotiate their bills.

Healthcare economists note that prices in other sectors, such as airlines, can also vary for the same service, but hospitals’ steep prices mean the dollar difference between the highest and lowest rates can amount to tens of thousands of dollars. “The order of magnitude of healthcare costs is different,”

Even within an insurance plan, prices aren’t consistently low or high. A plan’s prices for one service can be among the lowest a hospital negotiates, but among the highest for another,

A person insured by Minnesota-based HealthPartners would have received the most favorable price for a hospital stay because of back problems, but the cost of an emergency room visit with the same insurance was among the highest, according to the Journal’s analysis of the data.

When insurance didn’t cover some treatments, the Journal found, Avera McKennan Hospital set its own prices that ranked among the highest anywhere in the U.S. in the Journal’s analysis.

The LifeShield price of about $780 amounted to a discount of 53% off the hospital’s charge. Ms. Kingsbury paid all of it because her plan’s benefits didn’t cover the rest of the bill. The insurance was exempt from some federal rules that protect healthcare consumers. LifeShield didn’t respond to requests for comment.

Ms. Kingsbury earned roughly $17,700 last year, tax records reviewed by the Journal show. Her husband, who is retired, received about $22,800 in yearly income from Social Security. They bought insurance in 2019 from LifeShield National Insurance Co.

The range of prices is the product of a complex interplay of multiple payers and hospitals, and a lack of competitive pressure to hold down costs, economists said. Rates have been determined by trade-offs at the bargaining table between hospitals and insurers—such as an offer of cheaper prices in return for more business—and by market power, with higher prices where hospitals dominate.

Hospitals and insurers ultimately bargain for prices to meet financial targets for revenue and profit, said David Dillon, a healthcare actuary with the consulting firm Lewis & Ellis Inc. “It is kind of as simple as both sides of the table have their revenue requirements,” he said.

“The market for healthcare just doesn’t look at all like the market for tomatoes because somebody else is literally negotiating and purchasing on your behalf,” Mr. Cooper said.

The cost for the scan under LifeShield was $1,497, almost half the price charged under Avera. However, Ms. Kingsbury’s plan at LifeShield was exempt from Affordable Care Act rules to prevent gaps in coverage. LifeShield didn’t cover this scan. So Avera charged Ms. Kingsbury the price it sets for patients not covered by insurance, at $8,451, one of the highest prices in the Journal’s analysis of publicly available rates nationwide.

“Healthcare is a service and it can be an expensive service, especially for a serious condition. That’s why health insurance exists,” said Avera spokeswoman Ms. Meyers. “It is important for consumers to understand what they are buying and the coverage it provides.”

The Journal compared Avera McKennan’s 2019 PET CT price for Ms. Kingsbury with the price Medicare would pay, as calculated by price-comparison startup Turquoise Health Co. The hospital’s cash price for Ms. Kingsbury in 2019 was 5.7 times the Medicare rate, according to the Journal’s analysis using newly public data collected by Turquoise. That’s one of the highest multiples of any of the more than 1,200 U.S. hospitals in the analysis.

lower costs are going to be about finding ways to get people to take more responsibility for their health — for losing weight, for example, or bringing their blood pressure down.

there are other concerns, such as whether an all-encompassing system like Kaiser’s can really be replicated and whether the limits it places on where patients can seek care will be accepted by enough people to make a difference.

Or whether, as the nation’s flirtation with health maintenance organizations, or H.M.O.’s, in the 1990s showed — people will balk at the concept of not being able to go to any doctor or hospital of their choice.

its integrated model is in favor again. Hospitals across the country are buying physician practices or partnering with doctors and health insurers to form accountable care organizations, or A. C.O.’s, as a way of controlling more aspects of patient care. Doctors are also creating so-called medical homes, where patient care is better coordinated.

The days when doctors, hospitals and other providers are paid separately for each procedure will disappear eventually, health experts say. Instead, providers will have financial incentives to encourage them to keep people healthy, including lump sums to care for patients or provide comprehensive care for a specific condition. “All of care is going to move down this path, and it has to,” Mr. Halvorson said. “Medical homes are doing it; the very best A. C.O’s are going to figure out how to do it.”

there are downsides to the creation of large health care systems that may be motivated by the desire to increase their clout in the market, making it easier to fill beds and charge the insurers more for care. “They become these huge local monopolies,”

“We have all the pieces,” said Philip Fasano, Kaiser’s chief information officer. “Anything a patient needs you get in the four walls of our offices,

its plans are typically at least 10 percent less expensive than others, especially where they control all the providers

Kaiser has also been using the information to identify those doctors or clinics that excel in certain areas, as well as those in need of improvement. The organization has also used the records to change how it delivers care, identifying patients at risk for developing bed sores in the hospital and then sending electronic alerts every two hours to remind the nurses to turn the patients. The percentage of patients with serious pressure ulcers, or bed sores, dropped to well under 1 percent from 3.5 percent.

 The committee's model calculations, while exploratory and highly uncertain, indicate that the benefits of making the transition, i.e. energy cost savings, improved vehicle technologies, and reductions in petroleum use and greenhouse gas emissions, exceed the additional costs of the transition over and above what the market is willing to do voluntarily."

Improving the efficiency of conventional vehicles is, up to a point, the most economical and easiest-to-implement approach to saving fuel and lowering emissions, the report says.  This approach includes reducing work the engine must perform -- reducing vehicle weight, aerodynamic resistance, rolling resistance, and accessories -- plus improving the efficiency of the internal combustion engine powertrain.

Improved efficiency alone will not meet the 2050 goals, however.  The average fuel economy of vehicles on the road would have to exceed 180 mpg, which, the report says, is extremely unlikely with current technologies.  Therefore, the study committee also considered other alternatives for vehicles and fuels, including:

Although driving costs per mile will be lower, especially for vehicles powered by natural gas or electricity, the high initial purchase cost is likely to be a significant barrier to widespread consumer acceptance

Wide consumer acceptance is essential, however, and large numbers of alternative vehicles must be purchased long before 2050 if the on-road fleet is to meet desired performance goals.  Strong policies and technology advances are critical in overcoming this challenge.

While corn-grain ethanol and biodiesel are the only biofuels to have been produced in commercial quantities in the U.S. to date, the study committee found much greater potential in biofuels made from lignocellulosic biomass -- which includes crop residues like wheat straw, switchgrass, whole trees, and wood waste.  This "drop-in" fuel is designed to be a direct replacement for gasoline and could lead to large reductions in both petroleum use and greenhouse gas emissions; it can also be introduced without major changes in fuel delivery infrastructure or vehicles.  The report finds that sufficient lignocellulosic biomass could be produced by 2050 to meet the goal of an 80 percent reduction in petroleum use when combined with highly efficient vehicles

Strangely, though nonprofits are increasingly expected to perform like businesses, they do not get the same leeway in funding that government-contracted businesses do. They don’t have nearly the bargaining power of big corporations, or the ability to raise costs for their products and services, because of tight controls on grant funding. “D.C. is full of millionaires who contract with government in the defense field, and they make a killing, and yet if you’re a nonprofit, chances are you aren’t getting the full amount of funding to cover the cost of the services required,” Iliff said. “Can you imagine Lockheed Martin or Boeing putting up with a government contract that didn’t allow for overhead?”

When faced with dwindling funding, one response would be to cut a program or reduce the number of people an organization serves. But nonprofit leaders have shown themselves very reluctant to do that. Instead, many meet financial challenges by squeezing more work out of their staffs without a proportional increase in their pay:

nonprofits like PIRG, for example, have a tradition of forcing employees to work long, unpaid hours—especially their youngest staff. “There’s a culture that says, ‘Young people are paying their dues. It’s okay for them to be paid for fewer hours than they’re actually working because it’s in the effort of helping them grow up and contribute to something greater than they are,’” Boris says.

These nonprofit employees are saying that their operations depend on large numbers of their lowest-paid staff working unpaid overtime hours. One way to get  to that point would be to face a series of choices between increased productivity on the one hand and reduced hours, increased pay, or more hiring on the other, and to choose more productivity every time. That some nonprofits have done this speaks to a culture that can put the needs of staff behind mission-driven ambitions.

In the 1970s, 62 percent of full-time, salaried workers qualified for mandatory overtime pay when they worked more than 40 hours in a week. Today, because the overtime rules have not had a major update since then (until this one), only 7 percent of workers are covered, whether they work in the nonprofit sector or elsewhere. In other words, U.S. organizations—nonprofit or otherwise—have been given the gift of a large pool of laborers who, as long as they clear a relatively low earnings threshold and do tasks that meet certain criteria, do not have to be paid overtime.

Unsurprisingly, many nonprofits have taken advantage of that pool of free work. (For-profit companies have too, but they also have the benefit of being more in control of their revenue streams.) B

“There is this feeling that the mission is so important that nothing should get in the way of it,”

“Too often, I have seen the passion for social change turned into a weapon against the very people who do much—if not most—of the hard work, and put in most of the hours,” Hastings recently wrote on her blog. “Because they are highly motivated by passion, the reasoning goes, they don’t need to be motivated by decent salaries or sustainable work hours or overtime pay.”

A 2011 survey of more than 2,000 nonprofit employees by Opportunity Knocks, a human-resources organization that specializes in nonprofits, in partnership with Jessica Word, an associate professor of public administration at the University of Nevada, Las Vegas, found that half of employees in the nonprofit sector may be burned out or in danger of burnout.

. “These are highly emotional and difficult jobs,” she said, adding, “These organizations often have very high rates of employee turnover, which results from a combination of burnout and low compensation.” Despite the dearth of research, Word’s findings don’t appear to be unusual: A more recent study of nonprofits in the U.S. and Canada found that turnover, one possible indicator of burnout, is higher in nonprofits than in the overall labor market.

for all their hours and emotional labor, nonprofit employees generally don’t make much money. A 2014 study by Third Sector New England, a resource center for nonprofits, found that 43 percent of nonprofit employees in New England were making less than $28,000 per year—far less than a living wage for families with children in most cities in the United States, and well below the national median income of between $40,000 and $50,000 per year.

Why would nonprofit workers be willing to stay in jobs where they are underpaid, or, in some cases, accept working conditions that violate the spirit of the labor laws that protect them? One plausible reason is that they are just as committed to the cause as their superiors

But it also might be that some nonprofits exploit gray areas in the law to cut costs. For instance, only workers who are labelled as managers are supposed to be exempt from overtime, but many employers stretch the definition of “manager” far beyond its original intent.

even regardless of these designations, the emotionally demanding work at many nonprofits is sometimes difficult to shoehorn into a tidy 40-hours-a-week schedule. Consider Elle Roberts, who was considered exempt from overtime restrictions and was told not to work more than 40 hours a week when, as a young college grad, she worked at a domestic-violence shelter in northwest Indiana. Doing everything from home visits to intake at the shelter, Roberts still ignored her employer’s dictates and regularly worked well more than 40 hours a week providing relief for women in crisis. Yet she was not paid for that extra time.

“The unspoken expectation is that you do whatever it takes to get whatever it is done for the people that you’re serving,” she says. “And anything less than that, you’re not quite doing enough.

In the late Clinton administration we had an arrangement with North Korea in which they had shuttered their nuclear weapons program in exchange for regular shipments of fuel oil, assistance with nuclear energy technology which could not be used for nuclear weapons and various other inducements. This arguably also involved a continuous cat and mouse game with the North Koreans, periodic shakedowns for more assistance, various care and feeding, etc. The incoming Bush administration viewed this deal as appeasement and an example of American weakness and set about a cycle of confrontation that eventually cratered the deal. North Korean quickly proceeded to become a nuclear state. What was termed the 'Agreed Framework' was unlovely and unsatisfactory in a number of ways; the alternative we got was considerably worse.

The key was that the Bush administration saw the Agreed Framework as appeasement but they were not - though they sometimes suggested they would be - willing to adopt the likely alternative of military confrontation. (We could soon see a similar set of events unfolded with Iran.) Thus the Bush White House was able to stand strong against appeasement (with all the psychological self-affirmation and self-satisfaction that entails) at the cost of allowing North Korea to become a nuclear state, which it has now been for more than a decade.

It is not as though any of this emerges against a backdrop of harmonious US relations with China. In addition to the long-simmering friction over trade, the US and China are currently engaged in a complex and increasingly perilous struggle over which country will be the dominant power in the maritime waterways of East Asia, through which a huge amount of the world's trade flows.

The key predicate to wise action is understanding the range of potential outcomes and costs of different choices and whether you are ready and able to sustain them. One of the things I noticed early with the hawks in the Bush administration was a frequent willingness to commit leaders to future costs they may not fully understand secure in the knowledge that once the actions are taken the leader will have to pay those costs whether they like it or not.

Some people think Trump has no actual foreign policy. This is not true. He is extremely ignorant. But he has an instinctive and longstanding way of thinking about and approaching foreign policy questions which goes back decades before he ran for President

It is one that sees international relations in zero-sum terms (for me to win, you have to lose), sees the US as being taken advantage of by allies (either through advantageous trade deals or expenditures on defense). This is why you see economic nationalism going back decades with Trump and either skepticism or hostility toward international treaty organizations like NATO.

What you also have in Trump is someone who is impulsive and aggressive by nature - you see these qualities in primary colors in everything he does. These are highly dangerous qualities in a President.

They become magnified when such a person is being advised by people who provide an ideological purpose and justification to such impulsiveness and aggression.

That is where I fear and believe we are with Trump. Not everything in foreign policy is sacred. But here we have an impulsive and ignorant man whose comfort zone is aggression surrounded by advisors with dangerous ideas

Even President Bush had a coterie of more Realist-minded and cautious advisors to balance out the hotheads. They lost most of the key debates - especially in the first term. But they provided a restraining counter-balance in numerous debates. At present there is no one like that around Trump at all.

At the end of the day, having a white roof cannot hurt. It does keep buildings cooler which translates into lower energy costs

white roofs aren’t always practical, especially because many people have ordinary shingle roofs and while shingles come in very light colors, I’ve never seen any that are white. That, and as has been mentioned, keeping them clean!

white roofs may reduce cooling costs. What about 75 percent of the US where there are more heating degree days (HDD) than cooling degree days (CDD) and a dark colored roof actually provides more benefits by reducing the heating costs…

We have found that white roofs do provide a low-cost solution that can help buildings reduce energy costs, in a wide variety of climates, as well as cool the atmosphere regionally and globally. We have also found disadvantages. The reflective roofs may cause unwanted glare, for example, and may modestly increase heating costs in winter. But answers to these issues are exactly the ones we’re working hard to find.

In our opinion, all of these arguments and studies suggest that selective use of white and other reflective roofs makes sense as part of an integrated strategy

n an urban environment you also have thermal mass to take into account, I don`t have the mathematics to put here, however a simple analogy would be if you painted a piece of concrete black and put it in the sun and had another identical piece painted white, the black piece would still be radiating heat longer after the sun has gone down.

Most urban environment are made of high thermal mass products, Concrete, Bitumen Steel, these all will heat up more if they are darker colors and radiate back into the local environment after dark. Where as if they radiated heat back into the air instead of absorbing it all day, there might be a better chance of a cool down before the sun comes up the next day.

half a dozen consumer advocates told me they are concerned that the problem will get worse, since the uninsured rate is going up, and more people are signing up for cheaper but skimpier health-insurance plans introduced by the Trump administration. More Americans are also now on high-deductible health plans, many of which require patients to pay thousands before insurance kicks in. Networks of doctors have grown narrower, meaning more providers are likely to be out of network.

Emergency-room visits and planned surgical procedures are the most common causes of large medical bills that patients simply can’t afford to pay

Often, a hospital might be covered by a person’s insurance network, but the individual doctors who work there and the ambulance company that services it aren’t

some patients do wind up with medical debt, which discourages them from seeking medical care, because they fear they will incur even more debt if they go to the doctor again

The debt can also worsen people’s credit, which can make it hard for them to live healthier lives by, say, moving to better neighborhoods. In the end, they get sicker, and risk plunging even further into debt.

“The reality is that medical costs are not objective, real costs,” says Berneta L. Haynes, the director of equity and access at Georgia Watch. One day, an MRI can cost $19,000. The next, it can cost nothing.

The United States currently has the lowest minimum wage, as a proportion of its average wage, of any advanced economy,

The argument against increasing the minimum wage often relies on what I call “economism”—the misleading application of basic lessons from Economics 101 to real-world problems, creating the illusion of consensus and reducing a complex topic to a simple, open-and-shut case.

The minimum wage has been a hobgoblin of economism since its origins

Think tanks including Cato, Heritage, and the Manhattan Institute have reliably attacked the minimum wage for decades, all the while emphasizing the key lesson from Economics 101: Higher wages cause employers to cut jobs.

In today’s environment of increasing economic inequality, the minimum wage is a centerpiece of political debate

The real impact of the minimum wage, however, is much less clear than these talking points might indicate.

In 1994, David Card and Alan Krueger evaluated an increase in New Jersey’s minimum wage by comparing fast-food restaurants on both sides of the New Jersey-Pennsylvania border. They concluded, “Contrary to the central prediction of the textbook model ... we find no evidence that the rise in New Jersey’s minimum wage reduced employment at fast-food restaurants in the state.”

Card and Krueger’s findings have been vigorously contested across dozens of empirical studies. Today, people on both sides of the debate can cite papers supporting their position, and reviews of the academic research disagree on what conclusions to draw.

economists who have long argued against the minimum wage, reviewed more than one hundred empirical papers in 2006. Although the studies had a wide range of results, they concluded that the “preponderance of the evidence” indicated that a higher minimum wage does increase unemployment.

On the other hand, two recent meta-studies (which pool together the results of multiple analyses) have found that increasing the minimum wage does not have a significant impact on employment.

The profession as a whole is divided on the topic: When the University of Chicago Booth School of Business asked a panel of prominent economists in 2013 whether increasing the minimum wage to $9 would “make it noticeably harder for low-skilled workers to find employment,” the responses were split down the middle.

The idea that a higher minimum wage might not increase unemployment runs directly counter to the lessons of Economics 101

there are several reasons why the real world does not behave so predictably.

Although the standard model predicts that employers will replace workers with machines if wages increase, additional labor-saving technologies are not available to every company at a reasonable cost

At the other extreme, very large employers may have enough market power that the usual supply-and-demand model doesn’t apply to them. They can reduce the wage level by hiring fewer workers

In the above examples, a higher minimum wage will raise labor costs. But many companies can recoup cost increases in the form of higher prices; because most of their customers are not poor, the net effect is to transfer money from higher-income to lower-income families.

In addition, companies that pay more often benefit from higher employee productivity, offsetting the growth in labor costs.

why higher wages boost productivity: They motivate people to work harder, they attract higher-skilled workers, and they reduce employee turnover, lowering hiring and training costs, among other things

If fewer people quit their jobs, that also reduces the number of people who are out of work at any one time because they’re looking for something better. A higher minimum wage motivates more people to enter the labor force, raising both employment and output

Finally, higher pay increases workers’ buying power. Because poor people spend a relatively large proportion of their income, a higher minimum wage can boost overall economic activity and stimulate economic growth

Even if a higher minimum wage does cause some people to lose their jobs, that cost has to be balanced against the benefit of greater earnings for other low-income workers.

In short, whether the minimum wage should be increased (or eliminated) is a complicated question. The economic research is difficult to parse, and arguments often turn on sophisticated econometric details. Any change in the minimum wage would have different effects on different groups of peop

Nevertheless, when the topic reaches the national stage, it is economism’s facile punch line that gets delivered, along with its all-purpose dismissal: people who want a higher minimum wage just don’t understand economics (although, by that standard, several Nobel Prize winners don’t understand economics

This conviction that the minimum wage hurts the poor is an example of economism in action

one particular result of one particular model is presented as an unassailable economic theorem.

A recent study by researchers at the Cornell School of Hotel Administration, however, found that higher minimum wages have not affected either the number of restaurants or the number of people that they employ, contrary to the industry’s dire predictions, while they have modestly increased workers’ pay.

The fact that this is the debate already demonstrates the historical influence of economism

Low- and middle-income workers’ reduced bargaining power is a major reason why their wages have not kept pace with the overall growth of the economy. According to an analysis by the sociologists Bruce Western and Jake Rosenfeld, one-fifth to one-third of the increase in inequality between 1973 and 2007 results from the decline of unions.

With unions only a distant memory for many people, federal minimum-wage legislation has become the best hope for propping up wages for low-income workers. And again, the worldview of economism comes to the aid of employers by abstracting away from the reality of low-wage work to a pristine world ruled by the “law” of supply and demand.

“Pricing carbon correctly is a concrete and cost-effective way to slow climate change. We are wasting an opportunity to steer our economics along a low-carbon growth path and losing precious time with every day that passes.”

An abundance of carbon credits and exemptions for major emitters has plagued emission-trading systems in Europe and California, making credits cheap and hindering their effectiveness

A series of recent developments, though, have provided a glimmer of hope for would-be carbon taxes. The United Kingdom’s adoption of a carbon tax in the power sector produced a 58 percent drop in emissions from 2012 to 2016.

The biggest development of all may be in China, the world’s largest greenhouse gas emitter, which has taken steps toward its own emissions trading program. China’s move has the potential to narrow the gap between global carbon prices and climate costs to 63 percent in the early 2020s, OECD found.

The OECD report compared effective carbon rates—taxes on fossil fuels, carbon taxes and emission-trading credits—against estimated climate costs, which it projected at €30 ($35) per ton of carbon. The result is a carbon pricing gap, the difference between actual carbon rates and climate costs.

The organization found that countries with larger carbon pricing gaps tend to have more energy-intensive economies. Russia and China, for instance, have gaps of 100 percent and 90 percent, respectively, OECD found.

Less energy-intensive economies, by contrast, have less ground to make up. OECD measured the gap in Spain at 51 percent, Ireland at 42 percent and France at 41 percent

The carbon pricing gap in the United States, the world’s second-largest emitter, was 75 percent.

U.S. utility industry representatives expressed skepticism regarding the efficacy and viability of the Energiewende, reflected in the following issues and questions raised during the meeting:

Cost Impact on Households. Would rising household rates evidenced in Germany be acceptable in the United States?

mplications for the Economy and Industrial Competitiveness. How do the costs of renewable energy policy affect long-term economic growth and competitiveness? 

Impact on utilities. Will traditional utilities be driven out of business? Or are new business models emerging

Fairness and equity. Would a policy in which one sector (households) bears most of the costs be politically or socially viable in the United States? 

Technical barriers. How is Germany overcoming technical challenges in integrating large shares of variable renewable energy, including impacts on neighboring countries? 

we can see that Germany’s Energiewende provides several useful lessons for the U.S. as it thinks strategically about the future of its electricity industry.

“With the Renewable Energy Act that we created in 2000, we financed a learning curve that was expensive. But the good news is that we have learned in only 13 years to produce electricity with wind power and solar facilities at the same price as if we were to build new coal or gas power stations.”

In spite of high costs, and despite the realization that elements of the Energiewende need to be reworked, Germany has rolled out a sweeping and effective suite of policies and legislation successfully, supported by a remarkable political and social consensus.

Gaining a consensus on a clear policy direction is critically important and should precede and inform debates about which specific policy mechanisms to implement and how

Monitoring and course corrections are required, with solutions tailored to local conditions. Policymakers should be prepared not only to monitor continually the effectiveness of policy, but also to alter the policy as technology and market conditions change. Importantly, fine-tuning policy or market design should not be viewed as a failure.

Setting objectives and developing national policy are important. If a country can agree politically on fundamental objectives, designing and implementing effective policy mechanisms is easier

electricity consumption of the average American household is significantly greater than the average German family of four which uses about 3,500 kWh/year, while the U.S. average is 10,800 kWh/year,

making a U.S. ratepayer much more sensitive to price increases.

despite the Energiewende’s costs, German households and politicians remain ideologically committed to the goal of emissions reduction and highly tolerant of the associated costs

The fact that alarm over climate change and its impacts have not penetrated American politics or society in the same way may be the most significant cultural difference between the two countries and may explain American disbelief that Germans could remain supportive of an increasingly costly policy.

Germany has demonstrated that high levels of renewable energy penetration are possible, with limited to no impact on reliability and system stability

For electric cars, lower maintenance costs and the lower costs of charging compared with gasoline prices tend to offset the higher upfront price over time. (Battery-electric engines have fewer moving parts that can break compared with gas-powered engines and they don’t require oil changes. Electric vehicles also use regenerative braking, which reduces wear and tear.)

The cars are greener over time, too, despite the more emissions-intensive battery manufacturing process. Dr. Trancik estimates that an electric vehicle’s production emissions would be offset in anywhere from six to 18 months, depending on how clean the energy grid is where the car is charging.

The new data showed hybrid cars, which run on a combination of fuel and battery power, and can sometimes be plugged in, had more mixed results for both emissions and costs. Some hybrids were cheaper and spewed less planet-warming carbon dioxide than regular cars, but others were in the same emissions and cost range as gas-only vehicles.

The average cost of an employer health plan for an individual for 2021 was $7,739, also up about 4% from last year.

No one, not entrepreneurs nor Whitehall officials, can predict the state of the energy sector in 30 years’ time.

But discussions over the cost are almost irrelevant because centralising all these decisions will shut down the market discovery process, meaning we’ll never know if cheaper, better routes were available.

We still don’t have a clear estimate from the government on the cost of reaching net zero by 2050, though the Office for Budget Responsibility put the total cost at £1.4 trillion in July. The Treasury this week warned UK households and businesses face the prospect of new taxes in the coming years to help meet the targe

Rather than gazing into a crystal ball, his officials would abandon their obsession with specific choices or sectors.

opportunity costs affect economic activity in unseen ways. Money spent on pumps today is money that cannot be spent on hydrogen boilers tomorrow, which may be a better solution. Jobs filled in green sectors are jobs unfilled elsewhere.

Perhaps Johnson should come down on the side of a border-adjusted carbon tax. It arguably offers the most cost-effective lever to reduce carbon emissions at the speed and scale necessary.

there’s no indication so far that anything this reasonable will replace current decision-making.

Support may soon give way to hostility if government remains stubbornly committed to its current approach.

The idea that, if we are to halt climate change then we need to start doing things differently, is no longer a fringe view.

Households in all five boroughs needed to be pulling in at least $100,000 to afford housing, food and transportation, and to have a shot at being able to plan for the future

In southern Manhattan, home to some of the most expensive ZIP codes in the country, families with two adults and two children needed to make at least $150,000 combined

The actual median household income in the city was hovering around $70,000

a considerable majority of households that could not keep up with the cost of living — 80 percent — had at least one working adult, and more than half of New Yorkers who could not make ends meet had a college degree or some college credit, if not a graduate degree.

The affordability crisis is particularly urgent for nonwhite New Yorkers, the study found. Latino, Black and immigrant New Yorkers were bearing the brunt of the affordability crisis, and residents of the central Bronx had the highest rates of economic instability.

And more than 85 percent of households where single mothers were taking care of young children were unable to keep up with the cost of living

the broader economic and cultural landscape is so different now than it was just a few years ago that public investments of even this somewhat smaller scale appear poised to make an enormous difference.

That’s because those public investments are being made not against dirty-energy headwinds but with the support of much broader tailwinds

Thanks to technological change and the plunging cost of renewables, a growing political and cultural focus on decarbonization and increasing awareness of the public health costs of pollution and market trends for things like electric vehicles and heat pumps, it’s genuinely a whole new world out there. Not that long ago, the upfront cost of a green transition looked almost incalculably large. Today it seems plausible that quite dramatic emissions gains can be achieved for just, say, $369 billion

For 90 percent of the world, clean energy is now cheaper than dirty alternatives, and while countries like Spain are boasting about more than tripling solar power capacity by 2030, in Texas, solar output has grown 39-fold in just six years. Globally, renewable output has grown fourfold in the past decade

Ten years ago, when the United States endeavored to tackle the problem of climate change, it tried to do so largely by punishing the cost of dirty energy with a cap-and-trade system. This time, it’s giving a kick-start, or a boost of momentum, to an already ongoing green transition.

this strategic choice of carrots rather than sticks has received some deserved praise: It’s better and more popular to subsidize cheap, clean energy than it is to make the bad stuff more expensive

A “fair share” analysis suggests the United States — today the world’s second largest emitter, and historically the largest by far — should be moving faster than any nation in the world.

The models may ultimately prove optimistic, given the complications of infrastructure build-out

it is fair to wonder about the uncertain economics of some of the bill’s technological bets, like carbon capture and storage, which could allow emissions from industry and power generation to be trapped and sequestered, and which some climate activists and environmental justice advocates distrust

Jesse Jenkins, who leads the REPEAT Project, says he believes that the tech problems of C.C.S. have been solved and that, with tax credits, the bill will address its cost problem, leading to a dramatic scale-up in use. Julio Friedmann, a former Obama-era Energy Department official turned carbon removal advocate, says that a rapid scale-up of C.C.S. would be, while miraculous, also plausible.

the fact that this much climate progress appears even remotely possible for less than the annualized budget of the State Department, as Ben Dreyfuss recently put it, is a remarkable reflection of the state of green energy today, even without the new law. When it comes to emissions, we are no longer fighting an uphill battle, at least in the United States and many other countries like it. We are deciding how quickly to race downhill.

at the risk of playing Pollyanna, I think it is also possible to see the size of the bill — its relative smallness — as at least a mark of good news

The headline projection of the I.R.A. impact appears, if inadequate by the standards of the Paris agreement, nevertheless impressive: a 40 percent reduction in just eight years

already today the United States has reduced emissions 20 percent from 2005 levels, and was projected to reduce them further even without the benefit of the I.R.A. As recently as a few weeks ago, before the bill was revived, it might have felt like the United States was permanently stalled on climate action, but in fact the country was already moving to decarbonize, if not fast enough.

peed really matters; as the writer and activist Bill McKibben put it, when it comes to warming, “winning slowly is the same as losing.” Simply moving in the right direction isn’t enough, and too much time has been squandered — within the United States and globally — to avoid what was once described as a catastrophic climate future.

If the United States achieves that 40 percent reduction, that’s still well short of the country’s target of a 50-52 percent reduction by 2030. The gap may seem relatively small, but it represents more than half a billion tons of carbon each year. That’s a lot.

the I.R.A. is a compromise, obviously and outwardly, tying new leases for wind power development to new ones for oil and gas, only moderately reducing the country’s demand for oil and gas over the next decade and investing less in environmental justice measures than Biden himself promised not too long ago

But its basic bet — that many of these markets and technologies are close enough to tipping points that relatively small public support can get them racing toward inevitability — also means the ultimate impacts could be larger and far-reaching.

The effects on prices and markets could make state and local action cheaper and easier, and even federal regulation more palatable

the bill includes some unheralded provisions to help retire coal power more quickly, as Keane Bhatt, the policy director for the Progressive Caucus, has pointed out, as well as an under-discussed “stick” in the form of a fee for methane

The impact of its “green bank” and Energy Department loans could be quite large — some estimates have suggested they could run into the hundreds of billions, and the $27 billion handed to the Green Bank could catalyze ten times as much private capital

because much of the I.R.A.’s top-line “investment” comes in the form of tax credits, its outlays — and impacts — could ultimately grow substantially if certain sectors (wind, solar and C.C.S., for instance) really do take off.

This might not ultimately be just a $369 billion package, in other words, but something quite a bit bigger. Enough to get us to 50 percent by 2030? “I think we have a pretty good chance,” Jenkins says.

it is striking that, given where we were not that long ago, such a proposition seems credible at all. Here’s hoping.

The provisions tying future auctions for wind power to leases for oil and gas development have been called “poison pills,” because they appear to lock in future emissions. But the ultimate impact is likely to be quite small. (Energy Innovation estimates at most 50 million tons of additional annual carbon emissions, compared with a billion in reductions from other measures in the bill.)