A little-known pharmaceutical company that made billions selling opioids 'escapes' billions in fines and IRS payments

Endo began in 1920 as "Intravenous Products of America." Its website does not mention opioids;
instead it highlights the company's "past successes and history of expertise." (Endo photo)

A lesser-known pharmaceutical company named Endo made billions of dollars during the U.S. prescription opioid crisis by marketing its flagship opioid, Opana ER, as safe and non-addictive.

Despite whistleblower suits from Endo employees, the U.S. Department of Justice failed to pursue Endo, even as it vigorously prosecuted Purdue Pharma for its part in the opioid crisis, report Bob Fernandez of ProPublica and Craig R. McCoy of The Philadelphia Inquirer. The DOJ's investigative delay and the company's clever bankruptcy exit strategy allowed Endo to "escape $1.5 billion in fines and forfeitures" it owed and billions more "officials said it owed the U.S. government."

When the DOJ finally moved to prosecute Endo for its part in the opioid crisis, the company was bankrupt. "In what amounted to a liability fire sale by the Justice Department, the company’s woes with the federal government would all be resolved by a $200 million payment," Fernandez and McCoy explain. "In sentencing Endo in federal court Judge Linda Parker wondered how the amount paid to the U.S. could be so low. Parker said, 'I just don’t understand how it went from $1 billion to $200 million.' Federal prosecutor Benjamin Cornfeld explained: Endo was broke."

While Endo's 2024 financial troubles were real, a deeper look at the DOJ's delay after winning a criminal case against Endo in 2014, revealed how in those intervening years allowed Endo "vastly expanded its narcotic-pill empire before executing a corporate escape plan," Fernandez and McCoy write. "The plan allowed Endo to restructure its debt to retain control of the company and hand out $95 million in executive bonuses before seeking protection in bankruptcy."

DOJ's settlement with Endo concluded some of the company's financial troubles and "also mostly erased claims of another $1.5 billion for false health care billing and Medicare costs generated by the opioid crisis." In addition, "Endo paid a tiny fraction — three pennies on the dollar — of the $7 billion that officials said it owed the U.S. government, including $4 billion in taxes," Fernandez and McCoy explain. "Hundreds of lawyers, paralegals and financial advisers litigated Endo’s bankruptcy, billing more than $350 million. . . . Individual opioid victims didn’t fare as well. They got just $40 million from Endo — a sum that works out to about $1,000 per victim."

Southern timber owners could benefit from plan to create electricity and carbon credits by burning wood chips

The U.S. Pine Belt is filled with fast-growing Loblolly
pines. (Reddit map)

 

United Kingdom power producer Drax is scouting locations in America's Pine Belt to "build electricity generators fueled by burning wood chips," reports Ryan Dezember of The Wall Street Journal. "The plants’ exhaust will be piped underground instead of out of smokestacks, which generates lucrative carbon credits for which Drax is already lining up buyers." The company plans to sell its electricity to data center companies looking to fuel their artificial intelligence operations.

The plan could be an economic game changer for the U.S. South "where pulp and paper mills have closed and left timber growers without buyers for those trees unfit for making lumber or poles," Dezember explains. "Biomass power has long been dangled before Southern timberland owners as a potential solution to the glut of pine that has depressed prices and complicated harvests."

Drax's UK facility "burns pellets of compressed sawdust in a converted coal-fueled power plant," which fuels roughly 5% of the country's electricity. It already runs several U.S. pellet mills that fuel its UK operation, Dezember writes. The planned U.S. plant will be a BECCS, short for bioenergy with carbon capture and storage. The company plans to provide 24/7 renewable energy for AI data centers.

Drax is pinpointing locations that have all the elements it needs, which include a "confluence of carbon dioxide pipelines, pine plantations and a short wait to connect to the grid," Dezember reports. "It has options on properties and expects to announce a location for the first plant in 2025."

The company has sought timber managers who will manage forests without stressing their ecosystems, and it "plans to buy wood only from properties managed for timber production, not old-growth stands," Dezember explains. "Nor will the plants need the wood to be ground down to dust and pressed into pellets, which are made to facilitate ocean shipping. The U.S. power plants will only need the wood chipped into small pieces."

Understanding what pharmacy benefit managers are reveals flaws and solutions in U.S. drug pricing and selling system

Not all PBM savings are passed along to members.
(Adobe Stock photo)

Despite a deluge of news information discussing the unfair pricing practices of pharmacy benefit managers, what they are and what they do may still be a mystery. James B. Rebitzer, an economics professor at Boston University, provides some answers in his Q&A for The Conversation.

What are pharmacy benefit managers?
During the 1960s, PBMs "became essential middlemen [companies] between drugmakers and the many insurers, employers and government entities who purchase drugs on behalf of their members. . . . These companies negotiate price, affordability and access to prescription drugs. They do this by operating and designing formularies, which are lists of drugs that insurers cover.

Formularies assign drugs to different tiers that determine what patients must pay out of pocket to access the drug. . . . Tier placement determines how affordable a medication is to consumers and the effective drug price that insurers pay. . . .The price at which the PBM obtains the drug for its clients is the net price – the list price minus the drugmaker’s discount. . . . If a drugmaker increases its rebate, the net price falls, even if the publicly posted list prices remain high. This is why focusing on list prices to determine the cost of a drug can be misleading."

Are PBMs working to decrease their clients' costs or increase their profits?
Both. "If the contest for formulary placement works as it should, competition compels drugmakers to offer substantial discounts off the published list price. As a result, insurers and consumers benefit from a reduced net price for drugs. However, formulary competition can be undermined in various ways. . . . Competition within the formulary can also be distorted when drugmakers post very high list prices. This artificially inflates rebates for PBMs without lowering net prices for insurers and other parties."

How does market competition figure into PBM activity?
"The current regulatory environment in the U.S. tolerates overly large PBMs that engage in anticompetitive practices to accumulate excessive profits. Without strong competitors, dominant PBMs are free to charge their customers high fees and keep a larger portion of drugmaker rebates for themselves. . . . In theory, this problem should be self-correcting. . . . High profits should attract new competitors into the industry." But the chances for scrappy upstarts to survive are also limited by the industry's current PBMs' dominance.

Who are the villians?
The concentration of power is the problem. "If we didn’t have PBMs, we would need to invent them – or something like them – to obtain reasonable prices on patented drugs. But the concentration of market power among a few companies threatens to dissipate the value they create. A more competitive and transparent market for PBM services will help keep that contest fair and transparent – to the benefit of customers and society. . . . In that sense, PBMs aren’t the villain. Too much market power in too few hands is the problem, and that’s something more competition, sensible regulation and vocal consumers might fix."

Leaders and economists worry over what Trump's planned tariffs might do to business profits and consumer wallets

Businesses and U.S. economists are worried about how tariffs
could impact profits and American budgets. (Adobe Stock photo)

World leaders and CEOs are working to convince President-elect Donald Trump to reconsider his hard-line plans for tariffs against the country's biggest trade partners, which could "disrupt global trade and pummel profits," report Andrew Ross Sorkin, Ravi Mattu, Bernhard Warner, Sarah Kessler, Michael J. de la Merced, Lauren Hirsch and Tariq Panja of The New York Times. They "feel they’re making little headway in warning him of the consequences." Meanwhile, if Trump makes good on his threatened levies, U.S. consumers will likely pay higher prices.

Trump's first tariff announcements targeted Canada, Mexico and China. He said "he would impose 25% levies on Canada and Mexico, if they didn’t tighten their borders and stem the flow of illegal migration to the U.S.," The Times reports. "In subsequent social media posts, he went after BRICS countries," which include Brazil, Russia, India, China and South Africa, and other emerging markets.

Even though many Americans list high inflation, particularly on groceries and household staples, as a primary concern, "Trump conceded that he 'can’t guarantee tariffs won’t hit consumers hard," the Times reports. "That’s a concern among economists and big companies such as Walmart and Costco, who fear that levies could lead to price rises."

An estimate from The Budget Lab at Yale "found that the cost to consumers from Trump’s proposed tariffs could reach as much as $1,200 in lost purchasing power on average based on 2023 incomes, assuming retaliatory duties on U.S. exports are put into place," reports Rob Wile of NBC News. "While Trump has insisted other countries end up paying the cost of tariffs, most economists agree those costs wind up getting passed on to shoppers."

The National Retail Federation warned about "the impact of tariffs to everyday households," Wile writes. "Some Trump allies suggested the president-elect doesn’t actually plan to follow through with the proposed tariffs. . . . Rep. Dan Crenshaw, R-Texas, conceded, 'Tariffs will hurt the American consumer, that’s true. But they also make for good negotiation tools.'"

An Rx for American anger: Imagination, courageous peace-seeking and a collective will for something better for all

Graphic via MedPage

One look at social media posts or comments on newspaper stories, and it's easy to see why some Americans believe the mood of the country can be described as angry.

"This goes beyond malaise," writes psychiatrist Arthur Lazarus in his opinion for MedPage. This mood "signals something deeper. . . It isn't just dissatisfaction or unrest; it's a simmering anger, a wellspring of cynicism so powerful it spills over. . . . Our collective capacity for hope, patience, and even basic kindness seems to be eroding."

Why are Americans so angry? Lazarus writes, "At the heart of this phenomenon is a growing sense of betrayal -- by leaders, by institutions, by systems that promised stability, fairness, and opportunity. For decades, Americans have been sold visions of progress. . . But for many, these promises have proven illusory. . . . When a society feels full of "pervasive negativity," it's natural for humans to "armor up with cynicism" versus exposing feelings of hopelessness.

To make a way forward, we need to "go beyond anger," Lazarus explains. "Beneath the surface lies a yearning for something better -- a system that doesn't exploit, leaders who don't betray, and communities that support rather than divide. . . . Hope isn't naïve, nor is kindness. These qualities are necessary for the repair work ahead."

Reinvigorating courage and peace as American values can help change how we respond to adversity. Lazarus adds, "During the Civil Rights Movement, Martin Luther King Jr. championed peaceful protest and non-violent resistance as a form of courage. Sit-ins, marches, and boycotts challenged segregation and systemic racism without resorting to violence, even in the face of brutality."

Using current frustration as an energy to power change and innovation in U.S. health care models could also help. "Imagination in health care is often about seeing beyond immediate limitations to create systems that better serve humanity," Lazarus writes. "A compelling example is the transformation of Rwanda's health system."

A collective will to persevere together to make things better is an American ideal from the colonial period that can course-correct some of today's pessimism. Lazarus add, "In moments of crisis, it is tempting to retreat into cynicism or inaction. But previous challenges remind us that courage, imagination, and the will to rebuild are antidotes to despair."

Arthur Lazarus, MD is an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia. He is the author of several books on narrative medicine, including Medicine on Fire: A Narrative Travelogueopens and Story Treasures: Medical Essays and Insights in the Narrative Tradition.

Rural journalists can receive funding for computer-assisted reporting training

Journalists who work at smaller news organizations with a significant rural audience can apply for fellowships that cover much of the cost of attending an IRE training bootcamp for computer-assisted reporting. The goal of the fellowships is to help journalists at these organizations learn how to do important investigative stories that provide a public service for people in rural communities.

The deadline is Jan. 6 to apply for the March 24-28 bootcamp, which will be held at the University of Missouri’s School of Journalism in Columbia, Mo. That bootcamp is meant for beginners in data-driven journalism or journalists with minimal data experience.

According to IRE, a “Data Journalism Bootcamp equips journalists across all beats and media platforms with essential data skills. These weeklong, intensive sessions are designed to make data analysis accessible — even for beginners. If you’re new to data journalism, our March and August bootcamps are perfect, as they focus on Google Sheets.”

The deadline to apply for fellowships to attend the Aug. 4-8 bootcamp is May 6.

The Rural Computer-Assisted Reporting fellowships (R-CAR) are provided through a fund created by journalist Daniel Gilbert, who won the 2010 Pulitzer Prize for public service and a Scripps Howard Foundation National Journalism Award for community journalism for a series of stories about the mismanagement of natural gas royalties in southwest Virginia.

His donation of the $10,000 prize for the National Journalism Award was matched by the Scripps Howard Foundation and funds through a Kentucky state program. The funds are housed in an endowment as part of the Institute for Rural Journalism and Community Issues at the University of Kentucky.

The R-CAR fellowships cover registration costs for the bootcamp (up to $1,250 value), a one-year IRE membership or renewal, and a travel stipend of up to $500.

For more information or to apply, go to https://www.ire.org/training/fellowships-and-scholarships/r-car-fellowship/

AI news: Humans write the news only to have bots steal and repost it 'under stolen or assumed identities'

AI "reporters" plagiarize stories from real publications
written by humans. (Graphic by AI robot, Adobe Stock)

Artificial intelligence bots revived a closed small-town newspaper site using culled stories and stolen reporters' names. "The defunct Daily Tidings was alive and kicking, sending out fresh stories again," reports Danny Westneat of The Seattle Times. "The site’s masthead showed eight reporters — a ton for tiny Ashland, Oregon. . . . As Oregon Public Broadcasting revealed this past week in an investigation, the entire site now is reported and written by artificial intelligence bots, under stolen or assumed identities."

"One 'reporter' they tracked down actually lives in the United Kingdom and had no clue he was practicing journalism in southern Oregon," Westneat explains. "The site pumps out about five stories a day — most of them cribbed from real publications, such as Ashland News or The Oregonian, and rewritten by AI programs." The site boasts ads and videos from "big ad-streaming companies such as Google."

The Daily Tidings past owner "told OPB he looked into suing the AI operation — whoever or whatever it is," Westneat reports. "His lawyers though said it’s coming from outside the United States, likely China. It would be 'pursuing a phantom.'"

Ashland's robot news spot isn't unique. "Sites are popping up everywhere using AI bots to create the vague appearance of journalism, usually by rewriting or repurposing articles culled from the real local media," Westneat reports. "AI tools have been developed, such as one depressingly called Spin Rewriter, that can digest an article and convert it into 1,000 'human-quality' facsimile articles."

In Seattle, the "Hoodline" news site produces stories by bots. A former human Hoodline employee, who lost her job to AI, told Westneat, "Old-fashioned shoe-leather reporting has been replaced by fake people who’ve never set foot in any of the neighborhoods they write about — because they don’t have feet."

The editor of the Ashland News, Bert Etling, "says that in Ashland, the scam journalism has been mostly just annoying," Westneat reports. "It’s a plagiarism operation, so the real town news source, his Ashland News, isn’t at much risk of getting scooped. . . . But it isn’t helping that gnawing sense that nobody believes anything anymore."

Opinion: No American should go hungry. Supporting food banks and policy changes are part of the solution.

The U.S. exported 2.26 billion bushels of soybeans
in 2022. (Adobe Stock photo)

The United States is a top global producer of corn, wheat, soybeans, sugarcane, potatoes and rice. In terms of exports, it exceeds all other countries by trading more than 20% of what it grows. With all the food grown and exported, why do so many Americans live with food insecurity? They shouldn't, writes The New York Times editorial board.

One measure of how many Americans go hungry is the number of meals served by Feeding America in 2023: an astonishing 5.3 billion. "In a country of more than 330 million people, it is evidence of how widespread and persistent food insecurity remains," they write. "Food insecurity is defined by the Department of Agriculture as the lack of access to enough food for an active and healthy life. . . . In some of the poorest regions of America, mostly rural areas in the South, food insecurity among children is as high as 48%. But it is present in every county in the country."

Even as local, state and federal governments work to address how to feed everyone adequately, "Feeding America, a network of roughly 200 food banks and 60,000 food pantries and meal programs, is filling the void every day for tens of millions of Americans," they write. "Feeding America needs help to continue this essential frontline work. The average cost of a single meal may be only $3.99, but when that is multiplied by the millions of meals required, it adds up to $33 billion that families need and don’t have for groceries."

Hunger is more prevalent in minority communities. The editorial board reports, "Roughly one-quarter of Black Americans experience food insecurity, as compared with 10 percent of white non-Hispanic Americans, according to a report by Feeding America. In some parts of the rural American South, roughly two-thirds of Black people are experiencing food insecurity."

Meanwhile, U.S. policy changes could address ongoing food insecurity by allowing more Americans to qualify for the Supplemental Nutrition Assistance Program. The editorial board adds, "Most families of four that receive SNAP benefits have incomes below $40,560. Feeding America estimates that that leaves around 20 million people in a no man’s land, where they can neither afford sufficient food nor qualify for help to pay for it."

Rural communities struggle to find ways to communicate with growing non-native English-speaking population

Despite the ongoing growth of non-native English-speaking populations in rural communities, people in many counties and towns have failed to find effective ways to communicate with residents still learning English. The small town of Elko, Nevada, serves as an example. The town's "Hispanic or Latino population has grown to about 26%," reports Jazmin Orozco Rodriguez of KFF Health News. "The share of people age 5 or older who speak a language other than English at home increased to 18% as of 2022, while Spanish is the language spoken in nearly 15% of households."

With Elko's number of non-native English-speaking residents, the area needs translation support to ensure all residents understand vital information. Unfortunately, "state lawmakers in Nevada left out smaller counties from a recently enacted statewide language-access law," Rodriguez writes. "Not providing language access to people who need it is not only a violation of civil rights protected by Title VI of the Civil Rights Act, but it also can create public health and safety concerns said Jake Hofstetter, a policy analyst for the Migration Policy Institute, a think tank focused on immigration policy and research."

While much of rural America is white and English-speaking, its population has diversified, leaving smaller communities struggling to adapt to residents who aren't proficient in English. Rodriguez explains, "Implementing state and local language-access laws, however, is a challenge, researchers say, given standards can vary across state agencies and localities, making it difficult to ensure high-quality assistance is provided to speakers of various non-English languages."

The language-access challenges rural communities now face will continue to grow. "The number of white residents in rural parts of the nation decreased by about 2 million from 2010 to 2020, according to an analysis by the Carsey School of Public Policy at the University of New Hampshire," Rodriguez reports. "And the percentage of people who are members of a racial or ethnic minority living in rural areas increased from 20% in 2010 to 24% in 2020, with the largest share being Hispanic."

Language access services in metro and urban settings have grown; however, "Hofstetter said he doesn’t see many local policies that focus on the issue in rural areas," Rodriguez writes. "People living in rural areas may still benefit from a patchwork of resources through state agencies that provide services in their counties or local programs required to address language access because of federal funding."

Nonetheless, language barriers put non-native English speakers at a disadvantage. Rodriquez adds, "The degree to which local governments offer communications in languages other than English varies for several reasons, including enforcement of civil rights protections. That enforcement relies on civil rights complaints, which often must be filed by residents who may not know their rights related to language access."

Quick hits: He's not Santa, he's Belsnickel; 'phantom' towns; how music can reframe memories; going out for a walk

A local constabulary lends the town's Belsnickel
a hand. (Photo via Lancaster Farming)

Belsnickel may not be as famous as Santa (or as clean), but he gives Christmas gifts to children in Manheim, Pennsylvania. A Belsnickel is "a crotchety, fur-clad gift giver related to other companions of St. Nicholas in the folklore of southwestern Germany," reports Dan Sullivan of Lancaster Farming. A Belsnickel is tasked "to carry out duties somewhat similar to Santa, ferreting out the naughty and nice and dispensing just punishment or reward. Traditionally, Belsnickel carried a switch in one hand as corporal punishment for the bad kids and a pocketful of treats for the good ones."

When financial times are tight, not as many Americans buy new cars or repair the vehicles they have. "Pinched by inflation, higher interest rates, and supply-chain woes, Americans just haven’t been buying as many new vehicles lately," reports Spencer Jakob of The Wall Street Journal. U.S. consumers choosing to keep aging autos may sound "like great news for auto parts and repair companies. . . . [but] there are some surprising signs that Americans are choosing cheaper options or even deferring purchases of the goods and services that keep them running. . . . Skimping has rarely made less sense, though. . ."

Cartographic 'phantoms' are mapped towns where there isn't a town. (Illustration by Piper Olsen, L&S)

Most mapped towns exist but not all. "The Wisconsin state map is full of phantoms," reports Alli Watters of Letters & Science at the University of Wisconsin. Cartographer Howard Veregin spends his days scouting possible phantom towns, which includes exploring some of the state's most rural places. On one phantom sleuthing day, Veregin works to verify a mapped town called "Walker." He comes upon a friendly cranberry truck driver and this conversation ensues:

Truck driver: Good morning. Looking for something in particular?
Veregin: Well, I’m looking for cartographic phantoms.
Truck driver: What’s a cartographic phantom?
Veregin: It’s a community that is listed on a map, but it doesn’t exist on the ground.
Truck driver: This place exists.
Veregin: Sure, but it doesn’t really look like a community. What is it?
Truck driver: Well, this is our family cranberry farm. We’ve been farming cranberries here for 125 years. I’m a fifth-generation cranberry grower. Most of this area is private property. . .

"Veregin’s suspicions were confirmed. . . . He had found yet another cartographic phantom."

Beginning the new year a little wiser never hurts. In simplest terms, surviving 2025 is the first goal. Field & Stream experts "weighed in on four survival myths that could get you killed," reports Jim Baird. Many people think humans can live off nature's food and survive -- that's not true. "The myth here is that you can survive off them for an extended length of time. But the reality is if you are only eating 'survival foods,' you’ll start feeling sick and weak after a day or two." Another myth is if you kill large game "you're set" because you'll have all the protein you need. Not true, you can also get sick and die from eating too much protein without adequate fat. Read four debunked survival myths here.

Music may subtly shift emotional memories.
(Adobe Stock photo)

As a new year begins, people often reflect on how life has gone over the past year or years. Sometimes there are memories people wish they could change, and while history isn't alterable, music can help shift how people feel about past experiences. "Listening to music can change how you feel about what you remember – potentially offering new ways to help people cope with difficult memories, writes Yiren Ren, a cognitive brain science researcher at the Georgia Institute of Technology for The Conversation. "Our [research] results suggest that music acts as an emotional lure, becoming intertwined with memories and subtly altering their emotional tone. Memories may also be more flexible than previously thought and could be influenced by external auditory cues during recall."

Walking alone or with a buddy can be great exercise. 
(Adobe Stock photo)

Ernest Tubb twanged about "Walking the Floor over You." Johnny Cash confessed, "I Walk the Line." Aerosmith cranked the amps to "Walk this Way." Besides belting out catchy tracks, these musicians were onto something -- walking is an outstanding activity. "Walking can help meet the U.S. surgeon general’s recommendation that adults get at least 2 1/2 hours of moderate-intensity physical activity every week," reports Laura Ungar of The Associated Press. "This helps lower the risk of heart disease, high blood pressure, dementia, depression and many types of cancer. . . .While it’s not the only sort of exercise people should do, it’s a great first step toward a healthy life."

Kroger-Albertsons merger blocked by judge who sided with Federal Trade Commission's anti-trust argument

The merger would have 'nearly doubled Kroger's
store count.' (Kroger and Albertsons graphics)

The planned $20 billion merger between Kroger and Albertsons was blocked by a federal judge who "agreed with the Federal Trade Commission’s argument that Kroger would become the dominant player in traditional supermarkets if allowed to add nearly 2,000 stores by taking over Albertsons," report Dave Michaels and Patrick Thomas of The Wall Street Journal. U.S. District Judge Adrienne Nelson "rejected the companies’ counterargument that selling 579 stores to C&S Wholesale Grocers would replace the lost competition."

The ruling is a victory for FTC Chair Lina Khan, "who has waged legal battles to stop megadeals rather than accept companies’ proposed fixes to address competition concerns," Michaels and Thomas write. Kroger and Albertsons executives marketed the deal as a necessary move to compete with Walmart and Amazon.

Nelson's ruling cited the fierce "head-to-head competition" between Kroger and Albertsons, which the proposed merger "would have removed." Michaels and Thomas write, "An FTC spokesman said the ruling 'protects competition in the grocery market, which will prevent prices from rising even more.'"

If the deal had succeeded, Kroger's store count would have almost doubled, "exceeding the scale of Walmart’s 3,500 supercenters," Michaels and Thomas add. "Rodney McMullen, Kroger’s longtime chief executive, had pledged to eventually invest $1 billion annually in lowering prices at the acquired Albertsons stores. . . . FTC attorneys argued the deal would only give Kroger a reason to increase prices by removing a competitor." 

Earlier in the year, Albertsons CEO Vivek Sankaran told a federal court that "if Albertsons’s sale to Kroger was blocked, the supermarket chain would consider closing stores or laying off workers," the Journal reports. "He said that while the company’s business is sound for now, in the next two to three years it could need to find another buyer."

States promised opioid settlement spending transparency, but many have already strayed from commitment

When states and local governments anticipated billions in opioid settlement dollars, 12 states committed to 100% spending transparency, "promising annual reports 'specifying the activities and amounts,' they have funded," reports Aneri Pattani of KFF Health News. "But many of those reports remain difficult, if not impossible, for the average person to decipher."

Idaho settlement dollars are an example. The attorney general’s website hosts "more than 90 standardized spending reports from state and local entities. Sounds great. But in reality, it reads like this: 'In fiscal 2023, the city of Chubbuck spent about $39,000 on Section G, Subsection 9.' Cracking that code requires a separate document," Pattani explains. "The Idaho attorney general’s office, which oversees the state’s opioid settlement reports, did not respond to requests for comment."

New Hampshire has a different transparency problem. "The state government controls 85% of the state’s settlement funds and posts reports from grant recipients on its opioid abatement website," Pattani reports. "The reports explain the projects and populations served but lack a key detail: how much money each organization received."

Accessing dollars and cents details means searching through "the opioid abatement advisory commission’s meeting minutes, which date back several years" or other state government meetings and notes.

Graph by Aneri Pattani and Lydia Zuraw, KFF Health News and Christine Minhee, OpioidSettlementTracker.com

Idaho and New Hampshire aren't the only states falling short of their commitment. Other states have zero reporting, even though many residents are asking for the information. Pattani writes, "One of the loudest and most frequent questions from the public has been: Where are the dollars going? Victims of the crisis, along with their advocates and public policy experts, have repeatedly called on governments to transparently report how they’re using these funds, which many consider 'blood money.'"

Of the 12 states that promised spending accountability, seven have "reported 100% of their expenditures in a way that is easy for the public to find and understand," Pattani reports. "There are also states such as Indiana that didn’t originally promise 100% transparency but are now publishing detailed accounts of their expenditures."

Sharing settlement spending information not only helps the public hold state and local officials accountable for their spending choices, but it can also foster hope. Norman Litchfield, the director of addiction medicine at St. Luke’s Health System in Idaho, told Pattani, "A lot of people simply are just not aware that these funds exist and that these funds are currently being utilized in ways that are helping."

Ag round-up: Americans love butter and cheese; Brooke Rollins' nomination; toxic farm fertilizer; what to give a farmer?

Americans’ per capita consumption of dairy is up 3% over the past five years, 9% over the past
15 years, and 16% over the past 30 years. (Courtesy photo via Morning Ag Clips)

Even as U.S. milk and ice cream consumption dips, butter and cheese sales climb. "Butter and cheese consumption each surpassed all previous records, reaching all-time highs of 6.5 pounds (butter) and 42.3 pounds (cheese) per person, respectively, in 2023," reports Morning Ag Clips. "For context, a typical package of butter containing four sticks weighs 1 pound (16 ounces) and a standard bag of shredded cheese is half a pound (8 ounces)."

Synagro, a little-known company owned by Goldman Sachs, sells fertilizer made with sewage sludge to farmers who add it to crop soil. Unfortunately, Synagro's fertilizer may not be safe. It can contain biosolids, which often harbor 'forever chemicals' known as PFAS, which are linked to a range of "serious health problems including cancer and birth defects," reports Hiroko Tabuchi of The New York Times. "Farmers are starting to find the chemicals contaminating their land, water, crops and livestock." Synagro is leading a group of sludge-industry lobbyists "who argue they shouldn’t be held liable because the chemicals were already in the sludge before they received it and made it into fertilizer."

Fall and winter baking can increase
egg prices. (No Revisions photo)

The price of eggs is beginning to climb -- again. "The current spike coincides with shifts in shopping habits. Demand tends to rise in the fall and winter, says Brian Earnest, an animal protein economist with CoBank. Seasonal baking calls for increased egg use in home kitchens," reports Taryn Phaneuf of Nerdwallet. "Meanwhile, flocks of egg-laying hens are smaller because producers haven’t recovered from losses to bird flu over the past two years . . . The latest consumer price index shows that the price of eggs is up 37.5% from where it was a year ago."

When President-elect Donald Trump chose Brooke Rollins to head the Department of Agriculture, the nomination "blindsided" Robert F. Kennedy Jr., reports The Wall Street Journal. "Kennedy, the president-elect’s nominee to run the Health and Human Services Department, had been quietly compiling a shortlist of agriculture-secretary candidates in hopes of installing a like-minded disrupter in the post who would remake the food and farming sectors. . . . Brooke Rollins, a former White House aide with little prior relationship with Kennedy, wasn’t on the list."

2024 figures forecasted, USDA graph

As farmers plan for 2025 crops, many face lower profit margins for the second year in a row. "U.S. farm incomes are expected to fall again in 2024, and many farmers find themselves facing tighter budgets for next year," reports Kirk Maltais of The Wall Street Journal. "What hurt farmers the most was lower crop-cash receipts — the amount of money generated from selling crops. . . . Input costs, such as fertilizer and farm equipment, remain high. . . . Farmers are being squeezed, even after harvesting a record-size crop this year."

DaydreamsGirl photo via Lancaster Farming

If you want to know what to give a farmer, ask a farmer.

Crop farmer Tom Venesky’s has a few suggestions:

• A new tractor seat — Everyone has at least one tractor with a worn-out, busted-up seat
• Sunglasses, hearing protection or a tractor canopy
• A can of Freon — While being in a cab tractor shields us from the sun and noise, the glass can make it as hot as a greenhouse

Dairy farmer Taylor Pool shares some of her wish list:

• Muck boots — waterproof to keep your feet dry
• Hand warmers
• Duct tape
• Slippers
• Candles

And finally, cattleman Matthew Mitchell says livestock wranglers want:

• Waterproof snow pants or ski pants
• New socket set — since parts of old sets always magically go missing
• Utility knife/pocket knife

USDA orders testing of raw milk for bird flu to begin on Dec. 16. Testing is 'precautionary' and will aid virus containment

Mandatory milk testing will begin in six states
on Dec. 16. (Adobe Stock photo)

The Department of Agriculture has expanded its response to bird flu infections in U.S. dairy herds by ordering milk testing to begin on Dec. 16 -- "a step public health experts have clamored for following the detection of the H5N1 virus in U.S. dairy herds for the first time this spring," report Mark Johnson and Sabrina Malhiof The Washington Post. "The mandatory testing system is designed to identify which states and specific herds have been affected by the H5N1 virus." 

California, Colorado, Michigan, Mississippi, Oregon and Pennsylvania will be the first states to roll out mandated testing. The Post reports, "An industry representative in Pennsylvania, which ranks second in the nation for the number of dairy farms, said monitoring efforts are precautionary. No cases of H5N1 have been detected in the state’s dairy herds to date." So far, H5N1 infections have been reported in 720 herds in 15 states.

The mandate includes raw milk testing by "dairy farms, bulk milk transporters, milk transfer stations and dairy processing facilities," Johnson and Malhiof explain. "Herd owners whose cattle test positive for the virus must provide information for contact tracing and disease surveillance. Private laboratories and state veterinarians must report all milk that tests positive to the USDA."

Overall, dairy farmers and processors "have been reluctant to test animals or milk for the virus as they fear economic or other repercussions," reports Rachel Dobkin of Newsweek. However, as the virus spread, some farmer sentiments have changed. Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory, told Dobkin,"It's another step in the right direction. They're coming around that we need a better handle on it."

Health officials maintain that "the risk to people from bird flu remains low, and pasteurization kills the virus in milk, making it safe to drink," Dobkin adds. "Federal officials continue to warn against drinking raw milk."

Senate committee members and Postmaster General clash over postal changes; some could impact rural delivery

Sen. Josh Hawley, 'hates' Dejoy's
plan and vowed to try and 'kill it.'

Tempers flared as the U.S. Senate Homeland Security and Governmental Affairs Committee and Postmaster General Louis DeJoy wrangled over the U.S. Postal Service's lagging delivery, expenses and DeJoy's overall postal "optimization" plan, reports Eric Katz of Route Fifty. "DeJoy vehemently defended his efforts and said the senators standing in his way would bring about the end of the Postal Service."

The bipartisan pushback put DeJoy on the defensive and highlighted internal conflicts between DeJoy and Congress. "Sen. Josh Hawley, R-Mo., became angry with DeJoy when discussing his plan to slow down delivery for some mail, which is expected to disproportionately impact rural areas," Katz writes. "Hawley said, 'I hate this plan and I’m going to do everything I can to kill it.' The senator raised his voice and said he was no longer interested in being nice to DeJoy, was growing tired of his initiatives, and had 'waited and waited and waited' for improved performance."

After prickly exchanges about who or what would "go down with the ship," Sen. Gary Peters, D-Mich., who chairs the committee, "said he will follow up with the Postal Regulatory Commission on its review of DeJoy’s changes, which is due out in January," Katz explains. "Its findings are non-binding, and Peters said he will demand answers if postal management ignores the commission’s recommendations.

Several lawmakers criticized DeJoy's 'Regional Transportation Optimization' plan that "will require mail to sit overnight at post offices instead of being collected each evening for transportation to a processing center," Katz reports. "USPS paused those efforts in the run up to the election and its annual holiday busy season, but has vowed to resume them early next year."

Committee members zeroed in on USPS 2025 delivery targets, which were reduced, leaving next year's goals less robust than those from 2024. "For example, it expects to deliver regular cards and letters slated for two-day delivery on time just 87% of the time in fiscal 2025 compared to its goal of 93% in fiscal 2024," Katz adds. "The Postal Service also recently announced its intention to deliver some mail more slowly."

Jon Ossoff, D-Ga, asked "why Georgia is currently only seeing 75% of mail delivered on time, despite a promise this spring that USPS would be 'where we need to be' within 60 days," Katz reports. "DeJoy said the current performance level would remain as is for the foreseeable future. . . . Ossoff made clear he did not think DeJoy was doing enough and when the postmaster general said his attacks were becoming personal, the senator countered that he was reflecting the concerns of his constituents."

Mental Health Association launches hub dedicated to improving rural mental health access and education

Rural health includes mental health care.
(Mental Health Association photo)

The Mental Health Association launched a new hub with information and free resources to help rural residents access mental health treatment, reports Liz Carey of The Daily Yonder. The site also provides community members with tools for supporting mental health care in their area.

MHA built its hub to help address the drastic need for improved mental health treatment and education in smaller communities. Carey reports, "About 7.7 million rural adults, or about a quarter (23%) of all nonmetropolitan adults in the U.S., reported having mental illness in 2022, according to the Substance Abuse and Mental Health Services Administration. Additionally, about 1.6 million, or nearly 5%, of nonmetropolitan adults reported having serious thoughts of suicide that year."

While the hub contains many options, its conversational style and easy-to-use format make it approachable. The site's landing page features a "Get Help" drop-down list of information with links on managing a mental health crisis. The site features online mental health tests and surveys to help residents determine what kind of help might fit their situation.

America Paredes, MHA’s chief social impact officer, told Carey, "Based on an individual’s screening results, they have access to a self-guided platform that helps them navigate their mental health journey based on their experience and where they are in their journey."

Resources for communities working to help residents or families cope with mental illness are also available. Paredes told Carey, “We hope this hub serves as a first step for individuals who may feel alone in their experience and organizations looking to support these communities by providing them with free resources.”

Through the hub, MHA introduces rural residents to various care options, including telehealth, which can help them access care from mental health professionals they would otherwise have to drive long distances to see. Joy Jay, executive director of MHA-SC, told Carey, "The acceptance of telehealth has helped others in rural areas reach the help they might not have otherwise had access to."

Hospital monopoly in Appalachia doesn't meet benchmarks; some residents say they're scared to seek care

Ballad Health's Indian Path Community Hospital has an
average ER wait time of 43 minutes. (Ballad Health photo)

The lack of choices for hospitals in parts of northeastern Tennessee and southwestern Virginia has left some residents fearful of getting care at its facilities, but hospital officials deny many patient complaints and tie their quality of care troubles to Covid-19 and nursing shortages, reports Brett Kelman of KFF Health News. "Ballad Health is the only option for hospital care in a large swath of Appalachia. . . .Lawmakers in both states "waived federal antitrust laws so two rival health systems could merge," which made Ballad Health the "largest state-sanctioned hospital monopoly in the nation."

Six years ago, lawmakers allowed the merger to prevent more hospital closures. To than end, Ballad Health has kept most of its facilities open; however, the system has "fallen short of about three-fourths of the quality-of-care goals set by the states over the last three fiscal years," Kelman explains. Those shortcomings include "failing to meet state benchmarks on infections, mortality, emergency room speed, and patient satisfaction."

Ballad's lack of consistent care has left "residents wary, afraid, or unwilling to seek care at Ballad hospitals. . according to written complaints to the Tennessee government and state lawmakers, public hearing testimony, and KFF Health News interviews," Kelman reports. "Many of those who submitted complaints or were interviewed allege that paper-thin staffing at Ballad hospitals and ERs is the root cause of the monopoly’s quality-of-care woes."

Ballad Health CEO Alan Levine defended the system's record and "said the hospitals are rapidly recovering from a quality-of-care slump caused by Covid-19 and a subsequent rise in nursing turnover and staff shortages," Kelman adds. "These issues affected hospitals nationwide, Levine said, and were not related to the Ballad merger or the monopoly it created."

Local government officials from Tennessee joined Levine during his KFF Health News interview. "As Levine spoke in a boardroom at Ballad’s hilltop headquarters, he was flanked by three local mayors who voiced support for the hospitals and said complaints came from a vocal minority of their constituents," Kelman reports.

But not every government entity echoes that support. Kelman explains, "The Tennessee Department of Health, which has the most direct oversight over Ballad Health. . . has attempted to hold Ballad more accountable for its quality of care in closed-door negotiations." The TDH declined all of KFF's requests to discuss Ballad's record.

Given the system's long list of woes, some residents wish the merger had been rejected. "Joe Macione, who for years was on the board of Wellmont Health System, one of the rival companies that became Ballad, once publicly advocated for the merger. . . . Macione said state leaders should have admitted years ago that the monopoly was a mistake," Kelman reports. Macione told him, "It has not worked."

Flora & Fauna: Joyrides for rats; feral pigs forage through Hawaii; serviceberry tree history; a unique "comeback" bird

Rats learned to love driving and would opt to take longer routes to get to their destination.
(Photo by Kelly Lambert, CC BY-ND)

People aren't the only ones who love to go for a drive. Rats do, too. "I’m a neuroscientist who taught rats to drive − their joy suggests how anticipating fun can enrich human life," writes Kelly Lambert for The Conversation. "My colleagues and I found that rats could learn to drive forward by grasping a small wire that acted like a gas pedal. Before long, they were steering with surprising precision to reach a Froot Loop treat. . . . Unexpectedly, we found that the rats had an intense motivation for their driving training, often jumping into the car and revving the 'lever engine' before their vehicle hit the road. Why was that?" Read the research here.

In the lowlands of Hawaii, things are going to pigs. Feral pigs have invaded six of the state's islands with shocking efficiency and left a path of overwhelmed ecosystems in their wake. "Their impact is profound on Kaua‘i. Its mountains are home to 255 unique native plant species and 208 native birds, including 11 found nowhere else on Earth," reports Brendan Borrell of Hakai magazine. "Their wallows breed mosquitoes that spread avian malaria, contributing to 10 of Kaua‘i’s 16 native honeycreepers [birds] going extinct. . . . Despite the damage that feral pigs are causing, you can’t just shoot them on sight . . ."

Serviceberry trees are smaller trees native to North
America. (The Spruce graphic)

Like humans, a tree species has a history. The serviceberry tree was once common in the United States, particularly in colonial New England, where its bloom cycle indicated when the soil was soft enough to begin digging graves for the many settlers who didn't make it through the winter. "Preachers then went from settlement to settlement to perform funeral services," writes Jessica Damiano of The Associated Press. "Because it’s one of the earliest spring bloomers, the serviceberry is an important food source for bees, butterflies and other pollinators. Later, its berries sustain dozens of bird species and mammals. . . .There are more than 20 species of the North American native tree, which is sadly underused." Here are four favorites.

Whether it's that hefty frozen turkey, a delectable ham or ground lamb ready to be transformed into meatballs, the holidays can be a special time to be thankful for the meat on our tables. As an act of gratefulness for farm animals, a donation to an animal charity that works to make the lives of factory animals better may be in order. "Animal Charity Evaluators, a California-based nonprofit, puts out an annual guide for recommended animal charities," report Sigal Samuel and Kenny Torrella of Vox. "ACE researches and promotes the most high-impact, effective ways to help animals." Find this year's list here.

Red-cockaded woodpeckers nest in family units.
(Adobe Stock photo)

Americans love a comeback, especially when the returning member is cute, social and unique. "The red-cockaded woodpecker, an iconic bird in southeastern forests, has recovered enough of its population to be downlisted from an endangered species to a threatened one," reports Christina Larson of The Associated Press. Will Harlan of the nonprofit Center for Biological Diversity, told Larson, "It’s an amazing bird that has an unusual communal nesting structure. All nests usually cluster in the same tree, and the birds stick together as a family unit.”

Hazelnut trees are poised to flourish where they once died by the thousands. "Bullied by blight, the filbert has long failed to find a home on farms in the eastern U.S.," reports Ben Seal of Ambrook Research. "All across the eastern United States, hazelnuts had been cut down by Eastern filbert blight, or EFB, an endemic disease that chokes life from a tree. . . .But now, after nearly three decades of developing a way for farmers to overcome EFB. . . . A collection of four cultivars, [was] released in 2020, that can withstand even the intense pressure on [a] New Jersey research farm, where numerous strains of the blight are present."

AI is helping wolf trackers without using radio collars.
(Photo by ML, Unsplash)

New AI tracking technology is making it easier for wolves and ranchers near Yellowstone Park to coexist. "After 30 years of using traditional boots-on-the-ground observations, researchers are collecting wolf calls in hopes of honing population estimates, tracking wolves without using radio collars, and reducing conflict between the animals and ranchers," reports Devin Farmiloe of The Washington Post. "Learning more about how wolves communicate from a young age can shed light on pack dynamics that wildlife managers can use to better track and protect the species."

Vilsack says legacy of his 12 years at USDA is new revenue sources that will help smaller farmers and small towns

Rural voters strongly rejected President Biden, but his administration has started programs that are already reversing the decline of rural America, says Agriculture Secretary Tom Vilsack, a longtime politician who has given 12 years of his life to the job, more than anyone.

Vilsack summoned Jonathan Martin of Politico for an exit interview, and his frustration came through. “I think the challenge that we have in rural America is that we talk a lot about programs and not about vision,” he said when Martin asked what went wrong for Democrats in rural America.

“The vision is, you don’t have to get big or get out,” which has been a basis of federal agriculture policy since Richard Nixon was re-elected president in 1972, Vilsack said. “You can actually have diversity within your agriculture and in your national resource base in your rural economy and that can create enormous opportunity. And we’re investing in it.”

Vilsack cited “carbon market” payments for preventing greenhouse-gas emissions and other programs designed to help small and medium-sized farmers and boost local and regional food systems. But he said rural voters have yet to feel the impact of changes made under Biden.

“After 50 years of one approach, you can’t do this in a matter of a couple of years. You have to build the foundation. Now, the foundation has been built. The economic model is changed by virtue of the investments we’ve made in this administration. At least 10,000, probably more than that, investments have been made just in this department, in creating a different model so that small and mid-sized farming operations have an opportunity to stay in business.”

Vilsack served eight years under Barack Obama and four
under President Biden. (Associated Press photo by Carolyn Kaster)

Vilsack voiced frustration that the news media and others in Washington haven’t recognized the importance of those changes.

“Change is occurring,” he said. “It just hasn’t resonated with people like you. Or people in this city. You gotta understand the economics of this. You don’t. Nobody in your business understands it, which is the frustrating part for me. When you have a ‘get big or get out’ mentality, when you have an economy that is commodity-based, the big guys do really, really well,” but smaller producers may not.

He said 2022 was the best year ever for farm income, “but if you went out and talked to folks in rural places about that . . . that’s not how they would have seen it. It was a record year for a relatively small number of folks. So what happens, these folks are on knife’s edge, bad year comes, they have a hard time. Who is in a position to buy their farm? The larger farm or investment banks. . . . So you’ve got this model that we’ve had for 50 years that has slowly eroded economic opportunity in rural places.”

While debate about the Farm Bill is “all about reference prices” for crops, “The reference prices are about half a dozen commodities out of 100 some commodities,” Vilsack said. “We’ve created an opportunity in all 50 states, over 100 commodities. We’re paying farmers to do this. We’re giving premiums for what they’re growing and raising. It’s a brand-new concept. It’s really innovative. And it creates not only a better value for the farmer, it creates the ability to get that ecosystem market credit, to transform their waste into something more valuable.”

He added, “People out there are beginning to get it. I’ve had people come up and say, you know, for the first time, I see my kind of operation at USDA. For the first time, I see some change. I see some investment in small and mid-sized farming operations. You want to ask about legacy? That, to me, is the most important legacy.”

Vilsack said USDA “doesn’t get anywhere near the attention it deserves. Not for lack of trying, man. We tried.”

When Martin noted “the collapse of local and regional press, which would be a way to get your story out,” and cited a newspaper Vilsack knows well, the two-term Iowa governor interjected, “That’s bullshit. . . . The Des Moines Register is a shadow of what it was. But it doesn’t necessarily mean that it can’t cover what it should cover.”