Latest news with #HarryTruman
4 days ago
- General
German Event Marks 80 Years since Truman Ordered A-Bomb Attacks
News from Japan Culture World Jul 26, 2025 18:00 (JST) Potsdam, Germany, July 25 (Jiji Press)--A memorial ceremony for victims of the 1945 U.S. atomic bombings of Hiroshima and Nagasaki in the closing days of World War II was held in the eastern German city of Potsdam on Friday, the 80th anniversary of then U.S. President Harry Truman ordering the atomic bomb attacks. The ceremony took place in the Hiroshima-Nagasaki square, located in front of the residence where Truman was staying when he issued the order. During the ceremony, a thousand paper cranes made by locals were placed at a cenotaph, and participants laid flowers and observed a moment of silence for the victims. Uwe Froehlich, 61-year-old head of the ceremony's organizer, said that participants had a firm resolve for nuclear disarmament. The ceremony also featured a reading of a German translation of an account of the atomic bomb experience of the late Hideto Sotobayashi, who came to Germany after experiencing the atomic bombing of Hiroshima at the age of 16 and participated in the construction of the cenotaph. [Copyright The Jiji Press, Ltd.] Jiji Press
NHK
5 days ago
- Politics
- NHK
Ceremony in Potsdam marks 1945 atomic bombings of Hiroshima, Nagasaki
The victims of the atomic bombings of Hiroshima and Nagasaki have been remembered at a ceremony in the German city of Potsdam, near Berlin. In 1945, then-US President Harry Truman is said to have given the go-ahead for the bombings while attending the Potsdam conference on the post-war treatment of Germany and conditions for Japan's surrender. The order to drop the bombs was issued by the military on July 25. The memorial ceremony took place on Friday, the 80th anniversary of the issuance of the order. It was held at the Hiroshima-Nagasaki square, located in front of the building where Truman stayed while attending the conference. Participants laid flowers and origami cranes in front of a monument made using a streetcar flagstone from Hiroshima and a stone from a temple in Nagasaki. They then observed a moment of silence. One participant said the monument is a place where he can explain to his son what happened and remind him that they have to make sure that something like this never happens again. Fukumoto Masao, a member of a civic group that organized the event, said he hopes the monument will prompt people to think about nuclear weapons.
Medscape
5 days ago
- Health
- Medscape
Medicare at 60: Good for Doctors, Patients?
Sixty years ago, Congress passed legislation that created Medicare . In 1966, its first year of implementation, there were 19.1 million enrollees. Almost a decade later, enrollment had grown to 22.5 million. Today, 68.8 million Americans have Medicare coverage, with about half enrolled in Advantage plans. The original idea for this insurance program was even bigger, with President Harry Truman endorsing universal coverage in 1945. As Medicare turns 60, Medscape convened an expert panel to discuss the successes — and shortcomings — of this landmark insurance program. Jen Brull, MD: For everyone on the panel, how might Medicare use AI (artificial intelligence) more generally over the next 50 years? Jonathan Gruber, PhD: As with many things, there's a right level of prior authorization, and we need to let data inform that. We need to be collecting a lot of data on who's using prior authorization, how it's being used, and how productive it is. And we need to recognize that the right answer is not "zero" or "every single visit." It's somewhere in between. We need to be putting more resources into studying that and figuring out what the right level is. I want to take a slightly more optimistic view of AI in two senses. One is, I think that right now a fundamental problem in healthcare is that not all people are practicing at the top of their professional abilities. We have doctors taking blood pressure in some places; doctors should never take a blood pressure. We have nurses who are unable to give pills in some places, and nurses should be perfectly qualified to give pills. I think AI can give us more confidence in allowing people to practice at the very top of their professional abilities. The other is long-term care. Elder loneliness is a huge problem in our country; proper long-term care is a huge problem. The attacks on immigration in this country — and there are attacks — are going to make the problems worse, because many of the caregivers in the United States are immigrants. My hope is that AI can play a productive role in helping provide care for our nation's elderly and disabled. So I have a slightly optimistic view of how AI can maybe make our healthcare system better. Improving Diagnosis Norman Ornstein, PhD: Let me give a slightly optimistic view. I have regularly read in the health and science sections in the Washington Post and The New York Times these stories about people who have horrendous health issues that go on for years that are undiagnosed or misdiagnosed until somebody realizes it's some rare thing that they had never encountered before, or you find a physician who'd encountered it once and they managed to deal with it and cure it. You can imagine AI being an enormous boon to physicians, allowing them to put in symptoms that somebody's having and a little bit of history and end up finding things that siloed physicians otherwise would not see. On the other hand, you can see AI being used, and sometimes misused, by insurance companies for billing purposes or to try to find ways to save money, but also to substitute for physicians — whether that will be a good thing or a bad thing. Claudia M. Fegan, MD: I think Jon made some very important points, that there are opportunities to use AI to assist physicians in diagnostic approaches. It also would be very beneficial in terms of identifying patients. We have a lot of patients who we are not touching, and there are preventive measures that we could take. Given a certain family history, given the vital signs, their weight and their background, you could anticipate certain problems that are not addressed. And I think that can push us to make better, data-driven decisions. It's an advantage that AI can provide, and we can easily put it in the hands of clinicians who are on the front line to make good decisions about patients going forward. But I think the threat here is insurance companies who may misuse it for other purposes, whether to deny coverage to people or to try to avoid expensive treatments that might be appropriate. Brull: Certainly, as one of the two primary care specialists in this group, I would say I'm very optimistic about AI and I see that it could be a team member. I also often say that I've never seen a chatbot give a hug to a patient. And as far as I know, patients don't just come to the doctor to plug their finger in and find out what's wrong. They come to partner, and so I think all of us see optimistic futures let's start with our two nonphysicians on the panel for this question. A Public Good Do you think Medicare has been good to the American people financially? Doctors complain all the time about reimbursement rates, but do you think those rates are reasonable? Let's start with you, Dr Ornstein. Ornstein: I think physicians in many instances have found ways around the lower reimbursement rates, which has often led to many unnecessary tests or other procedures so that they can get compensated adequately. I am very fearful, going back to a point that I made earlier, if these sequesters, this is the statutory Pay-As-You-Go plan that requires big cuts in Medicare because of the deficits being run up in the reconciliation bill, they limit them to 4% a year. But you know, that could even cut reimbursement rates more, and that will create a big problem. It may mean more physicians who decline to take Medicare, and that is going to create a burden for an awful lot of people along the way. Gruber: In terms of your specific question, what has it meant for the financial health of Americans, it has unambiguously been incredible. Amazing studies show that the introduction of Medicare led to massive reductions in the financial uncertainty facing elderly Americans with their medical spending. Has it been good for doctors? Unambiguously. It has been a huge boon to their business. One thing we know from every health economic study is, if you lower prices, more people use more medical care. Medicare did that. They lowered prices and people use more medical care. It's been a huge boon to the medical industry. I think the big question going forward is how to set the rates and in a way that balances our fiscal needs against the needs to have qualified physicians participate in Medicare. Quite frankly, it seems like the direction of that is clear: Medicare overpays subspecialists and underpays primary care doctors. And that's because the panel that set Medicare rates has been politically captured by the subspecialists. I find it hard to believe that if orthopedists made $700,000 instead of $1 million per year, they'd quit Medicare. But it is plausible that a primary care physician making $150,000 or $250,000 might actually quit Medicare. These are people who could go into other lucrative professions. I want to second Claudia's call for more data. We need to really understand how physicians will respond to reimbursements, and we need to set reimbursements in a way which balances these two needs. Ornstein: Let me add one thing. Just do a thought experiment. What if we'd never had Medicare? What if we didn't have any program with government support for a population of older Americans? The number of people who would've died prematurely, the number who would've used up every portion of their assets trying to cover just basic medical care, would've been enormously high. Society would've been so much poorer overall if there had been no Medicare. And if we see assaults on these programs, we're going to go back to having bankruptcies and people who won't get the care because they can't afford it. Brull: Dr Fegan, as a physician, what are your thoughts? Fegan: I think Medicare has made a tremendous difference. And if you just want to look at the data on life expectancy for Americans compared to other wealthy nations: If you look at the top 17 wealthiest countries in the world, we are really near the bottom up until age 65. And the dramatic change that occurs after 65 in terms of life expectancy in the United States, compared to other wealthy nations, is that we shoot to the top. And this is because Medicare has provided access to care for people who didn't have access to care. For physicians, and it really depends on the population of physicians you're talking about, it guaranteed that they were going to be compensated for patients that they may have been taking care of without appropriate compensation. The majority of hospitals in this country would not survive without Medicare. The majority of patients in hospitals in the United States are Medicare recipients. I would say that prior to the Affordable Care Act, 80% of our outpatients were unfunded and 56% of our inpatients were unfunded. Now we bounce between 60% and 65% of all our patients being funded, which made a tremendous difference for us. Medicare has made being a primary care physician feasible, whereas previously it was a financially precarious situation for many of them, in terms of being compensated for the services that they were providing. They might provide services for a chicken or for a free meal, as opposed to knowing that they would be paid at the end of the day, and they would know the rate they were going be paid. The challenge with Medicare is that it pays different rates within the city. I live in Chicago, and if you have an office downtown, the rate you receive is different from if you're on the South Side or West Side. We have to look at how we make those kinds of decisions. What We Pay Our Doctors Brull: Dr Ornstein, legislation in 1993 set targets for spending growth in physician services but did not account for inflation in practice costs. Why can't Congress seem to take care of the so-called doc fix? Ornstein: I think there are two reasons. One is obviously money. It means a lot more money, and they have been at least cognizant of the problems with the solvency of the program, looking at the long run. The second is that doctors have really not been a very effective lobby. To circle back to Medicare Advantage, I'd say the prime reason reimbursement rates are 130% or whatever, when they were supposed to be 90%, is because of the effectiveness of the insurance lobby with Congress. Congress could have stepped in and done something about that. If you look even, for example, at the Affordable Care Act, it was actually then-Senator Al Franken [D-Minn.] who said, 'If you're providing coverage under the Affordable Care Act, 85% of the money that you take in has to go back to patients.' There are ways for Congress to deal with this, but they respond to the lobbying that they get and the effectiveness that they've seen. And frankly, physicians have not been very effective. The physician community was extremely effective in keeping Medicare from being enacted for decades when the [American Medical Association] was an extraordinarily powerful lobby, until the Great Society and these enormous numbers of Democrats coming into Congress in 1964 enabled it to happen. But, if we're looking at weakness in lobbying efforts, physicians are in the top 10. More Pay Cuts Brull: Another one for you, Dr Ornstein. The recently passed budget reconciliation bill includes cuts in government spending. The Congressional Budget Office projected that this will include about $500 billion in mandatory reductions in Medicare spending between 2026 and 2034, or about a 4% reduction in payments to hospitals and physicians. Congress could act to block the cuts. Do you project that they will do so? And if they do not, what may be the effect on physicians and the program over the next decade? Ornstein: It's kind of interesting. We've had these so-called pay-go rules — pay-as-you-go — in one form or another since 1990 and the budget agreement that then-President George Herbert Walker Bush enacted with Congress, which was highly controversial because it violated the 'Read my lips: no new taxes" pledge. It has worked reasonably effectively, at least at different times. But in the past, when we have seen pay-go implemented, Medicare is one of the prime elements that gets these cutbacks or sequesters. Whenever it's happened, Congress has then stepped in and ameliorated it because they saw that it was going to have a bad effect. I'm not 100% sure it's going to happen this time. And the fundamental reason is that we know Republicans, certainly going back at least to the Newt Gingrich era in the House, have wanted to take over the Medicare program. Medicare as we know it would not exist if they had had their way. It would be in some other form. The sequesters don't allow cuts in Medicaid, but they have these big cuts in Medicare, and I think it's a dicey proposition. But let's just note, Jen, that if we do see these cuts, they will hit the reimbursement rates for hospitals and for physicians. Just start with hospitals for a minute, where we know the Medicaid cuts are going to have a devastating effect, especially on rural hospitals that have already been reeling even without these cuts. What we know is that if any hospital closes, it puts enormous pressure on other hospitals, and the other hospitals are not going to get the money. They're going to cut back on services. We've seen in Atlanta, for example, where an urban hospital had to close, and every other hospital found that their emergency room services were suddenly just completely overloaded. This system looks like it's separate parts private care, Medicare, Medicaid, but they're all interrelated, and it's like a set of dominoes. If one begins to fall, the others are affected by it. These cuts would be catastrophic if they are allowed to take place, and whether enough Republicans will join with Democrats to ameliorate that, which of course then means bigger deficits, we don't know for sure.
Medscape
5 days ago
- Health
- Medscape
Medicare at 60: Successes, Failures
Sixty years ago, Congress passed legislation that created Medicare . In 1966, its first year of implementation, there were 19.1 million enrollees. Almost a decade later, enrollment had grown to 22.5 million. Today, 68.8 million Americans have Medicare coverage, with about half enrolled in Advantage plans. The original idea for this insurance program was even bigger, with President Harry Truman endorsing universal coverage in 1945. As Medicare turns 60, Medscape convened an expert panel to discuss the successes — and shortcomings — of this landmark insurance program. Jen Brull, MD: What do you all think the impact will be of the coming Medicaid cuts in the budget bill? For people who are dual eligible, who need help with shared costs, how do you think physicians might be affected if those patients lose access to Medicaid copays? Claudia M. Fegan, MD: The problem is that a lot of people think Medicaid cuts don't really affect me; I have private insurance. But as Norm alluded, there are going to be a lot of hospitals that close, especially rural hospitals. And as he said, when hospitals close, it puts stress on all the other hospitals that remain. And whether it's emergency room services or just services in general — women not having places to deliver babies — all of these things are going to have a tremendous impact. As for the dual-eligible patients, they are not the sharp edge of the point, right? Dual-eligible patients will have some challenges because of the amount that they can't pay. That 20% of healthcare costs is a lot of money to come up with, and it is going to be a problem in terms of being able to access their routine care and everyday care. But I think the more dramatic impact is going to be on services that are available in communities. I think even some outpatient facilities will close as a result. It's going to have a greater impact on the healthcare of everyone because it's going to be an access issue. Nursing Home Care Norman Ornstein, PhD: We have an enormous misunderstanding of what Medicaid is. People think it's a program for poor people, but it's far more than that. The single largest component is nursing home care. You make these cuts and nursing homes, many of which are also struggling, what are they going to do? Some will close. Others are going to cut back on the number of people serving their patients, and they're going to cut the rates at which they pay people. We are going to have people making the minimum wage, and we are going to see more and more elderly with bed sores, with abuse, and with other problems. Or we are going to see not just the elderly who use up their assets and have Medicaid to allow them to go into nursing homes, but the nightmare that families are going to have when the nursing home isn't there, and they will have to take their elderly parents or grandparents into their own homes and can't be reimbursed for any of the costs that they have or the stresses that it puts on their lives. We have a lot of issues here: the hospitals, the nursing homes. Also, we were talking before about the problems in Medicare Advantage, with prior authorization for an awful lot of people. I think it's not quite the same, but it's a little bit like these work requirements in Medicaid. The number of able-bodied people who are sitting back, cracking open a beer, and watching TV and taking their Medicaid because it doesn't cost them anything is, at best, a trace element. The tiny number of people — 3% or so — able-bodied people who are not working are taking care of other family members, or they have big health issues of their own. These work requirements are designed not to get those people working, but to take people off the Medicaid rolls because they're so complicated that people can't fill them out. They don't know what to do about them. This is going to have a devastating impact on a large number of Americans, and not just the poor. Jonathan Gruber, PhD: Let me just confirm what's been said and emphasize that three-quarters of Medicaid spending is for the elderly and disabled. Republicans want to pitch it as a program for undeserving minorities. That's not true. Almost everyone who gets Medicaid deserves it. It's a program for our moms and dads and everyone we know. We need to recognize that when Medicaid gets cut, everyone suffers. Ornstein: I just want to add one other thing that I think is important. I recently saw a documentary about the advent of the Americans with Disabilities Act, which was one of the most significant pieces of legislation to help people in this country. And it is now under siege. Jon had said, and Claudia said, disabled people are going to be devastated by this. Just yesterday [July 14] , the Supreme Court bizarrely allowed the President to go forward and cut the heart out of the Department of Education, which provides almost all of the support for students with special needs in the country. The people who are going to suffer more than anybody else in the country, other than many of the immigrants, are the disabled. And that's a problem for humanity. It is basic decency here that is under assault. That's true with a lot of these cuts in Medicaid. It's true that there will be a broader assault on people who can't care for themselves. Medicare's Influence on Independent Practice Brull: Dr Gruber, a survey of doctors by the American Medical Association in 2022 found that roughly 46% were working in practices wholly owned by physicians. The figure had fallen from 60% a decade prior. Dr Fegan, you referenced this earlier. In what ways has Medicare affected physicians' ability to remain independently owned? Gruber: I'm not sure that's been the primary driver. At the end of the day, the primary driver has been essentially the rise of the profit motivation in medicine. There's more money to be made by consolidating doctors into larger groups and specializing. That's not obviously bad; there are pros and cons of that movement, but I wouldn't say Medicare's really been a primary driver. I think the primary driver's been the fact that there's money to be made to this consolidation. The one thing to which Medicare has contributed is what I said before, which is that Medicare probably overpays subspecialists and underpays primary care. By combining them into one group, you can take advantage of that mismatch to have a more profitable overall group. Financial Uncertainty Brull: Dr Ornstein, back in 1999, the American Enterprise Institute wrote that analysts projected Medicare would reach insolvency in the following two decades, which would be now. But you also said that the first estimation of this came in the 1970s. A more recent projection from the board of trustees is 2036, so we kicked the can down a little bit. What do you think of this, and do you think it'll actually happen in the next 60 years? Ornstein: This program is so popular, for all the reasons that we know, that I just do not see Medicare becoming insolvent unless there's a deliberate attempt by those in government who want to undermine it to force insolvency. Otherwise, the closer you get, the more we're going to see fixes to make sure that the program can continue. We have seen efforts to eliminate Medicare, but they haven't gotten anywhere because of the enormous popularity of the program, for all the right reasons. So, we have to worry about it, but I'm not worried about it in the foreseeable future. Brull: Which aspects of Medicare's original mission do you think have either succeeded or fallen short, and why? Let's start with you, Dr Ornstein. Ornstein: I think the main reality here is that Medicare has saved enormous numbers of lives. It has made this country better all the way across the board. If there were no Medicare, we would have a hellscape for a large number of people — not just the elderly, but their children and their grandchildren. I would say it's also managed to deliver care pretty damned efficiently, more efficiently in many instances than the private system of insurance. There are gaps here. I think we have seen, and we continue to see, fraud because we haven't put enough resources into dealing with it, mostly on the provider side. I will just give you one very quick story. My wife has gotten from Medicare several times now a claim for a device she had nothing to do with, from a company. She spent hours on the phone with Medicare and they said, 'We know this company, it's horrible, we're going to take care of it.' Then 3 months later, we get it again and we get it a third time. We need to find more efficiencies. Gruber: I think the pros could not have been stated better by Norm. I mean, basically we would have a significantly more financially insecure country and less healthy country if Medicare didn't exist. As for the con, I would say that Medicare has not done enough to take advantage of its position as the dominant payer. There's fascinating economic research which shows that private payers often just follow what Medicare does. Pushing Health and Private Insurers Forward Gruber: Everybody talks about how the private sector is innovating, but in fact, all the innovation in medical compensation over the past 50 years has been by Medicare, and the private sector just copies them and pays X% of Medicare. I feel like Medicare could be much more innovative. Like I said, the physician reimbursement system is largely broken. Medicare could have invested a lot more — and should invest a lot more — in thinking about answering some of the hard questions we've raised today about what is the appropriate use of prior authorization, what are the appropriate rates to pay? These are important topics that Medicare should be taking the lead on understanding, experimenting with through CMMI [the Center for Medicare and Medicaid Innovation], which can run pilots, and actually trying to be much more innovative in how it sets payment policy. Fegan: I agree with both of the previous speakers. Medicare has succeeded in providing access to care to a very vulnerable population and has succeeded in providing assured compensation for the providers who take care of that population. It's one of the reasons why I've spent the past 30 years advocating for a Medicare for All that we could afford, to take care of the entire population with the program, with some improvements that we've alluded to during the discussion today. But Medicare has been a success. What it set out to do, which was to offer care and ensure that care would provide compensation for the people who delivered it — I think that we are a better society because of that. We certainly spend enough on healthcare in this country; we just fail to provide care to everyone who needs it. We allow too many people who are not engaged in the delivery of care to take profit from it. There's a lot of opportunity to address the fraud and abuse, and we just fail to do so. Part of the problem is because we have three healthcare lobbyists for every single member of Congress. Congress tends to hear those lobbyists over the cries of the public, which would really benefit from a universal healthcare system. Brull: Thank you all for joining us today and for such a productive discussion. We appreciate your time and expertise.
Times
5 days ago
- Entertainment
- Times
The Times Daily Quiz: Friday July 18, 2025
1 Which fairytale character has trouble with a family of three bears? 2 I'm Just Wild About Harry was a 1948 campaign song of which US president? 3 The Channel 4 soap Hollyoaks is set in a fictional suburb of which Cheshire city? 4 The largest UK forest, Galloway Forest Park is in which Scottish council area? 5 Kensington Gardens features a memorial playground named after which princess of Wales? 6 Abolished in 1987, the final fee for which animal licence was 37 pence? 7 Elgar's ninth Enigma Variation is named after which 'mighty hunter' in the Bible? 8 In Welsh place names, which four-letter element indicates an estuary or river mouth? 9 Leopard, bearded, harbour, ringed and harp are species of which pinniped? 10 Which Victorian stage actor is played by Ralph Fiennes in David Hare's new play Grace Pervades? 11 In which Graham Greene novel do Brown, Smith and Jones travel to Haiti on the ship Medea? 12 The opening lines of which Bruce Springsteen song refer to the 1981 killing of gangster Philip Testa? 13 Produced by Jeremy Clarkson, what was named the best lager in England at the 2024 World Beer awards? 14 The Phil Taylor Trophy is awarded to the World Matchplay champion in which sport? 15 Guillotined in April 1794, which French revolutionary is pictured? Scroll down for answersAnswers1 Goldilocks 2 Harry Truman 3 Chester 4 Dumfries and Galloway 5 Princess Diana 6 Dog licence 7 Nimrod 8 Aber 9 Seal 10 Henry Irving 11 The Comedians 12 Atlantic City, as in 'Well, they blew up the chicken man in Philly last night' 13 Hawkstone Premium 14 Darts 15 Georges Danton
