Trump attacks everyone but Russia:

Trump attacks everyone but Russia:

The president continues his barrage of tweets after the Mueller indictments.

President Donald Trump railed against the investigations into Russian interference in the 2016 election Saturday night into Sunday, sending off a stream of tweets attacking the FBI, CNN, the Democratic Party, his own national security adviser, former President Barack Obama and the top Democrat on the House Intelligence Committee.

He did not criticize Russia, or voice concern over Vladimir Putin’s attempts to undermine U.S. elections.

“If it was the GOAL of Russia to create discord, disruption and chaos within the U.S. then, with all of the Committee Hearings, Investigations and Party hatred, they have succeeded beyond their wildest dreams. They are laughing their asses off in Moscow. Get smart America!” Trump wrote on Twitter on Sunday morning.

The tweets came after special counsel Robert Mueller indicted 13 Russians on Friday for their efforts to interfere in the 2016 election and aid Trump’s campaign. The Twitter broadsides attracted bipartisan pushback as Republicans and Democrats expressed frustration that Trump is not taking the Russian threat seriously.

The White House has sought to frame the indictments as vindication, since they do not allege collusion with the Trump campaign, but senior aides have voiced concern that Trump would lash out at the FBI.

Trump confirmed those fears on Saturday night.

“Very sad that the FBI missed all of the many signals sent out by the Florida school shooter. This is not acceptable. They are spending too much time trying to prove Russian collusion with the Trump campaign — there is no collusion. Get back to the basics and make us all proud!” Trump wrote on Twitter.

That statement stirred bipartisan ire.

“I think it’s an absurd statement. Absurd,” said Gov. John Kasich (R-Ohio) on CNN.

Others reacted to that tweet, and the rest, with something of an eye-roll.

“Maybe it was a bad idea for him to stay off the golf course,” quipped one senior GOP Hill aide in response to a query from POLITICO.

Trump also went after his national security adviser, H.R. McMaster, who said the evidence of Russian meddling was “incontrovertible.”

“General McMaster forgot to say that the results of the 2016 election were not impacted or changed by the Russians and that the only Collusion was between Russia and Crooked H, the DNC and the Dems. Remember the Dirty Dossier, Uranium, Speeches, Emails and the Podesta Company!” Trump wrote.

By Sunday morning, he was on to attacking Obama for the nuclear deal with Iran.

“Never gotten over the fact that Obama was able to send $1.7 Billion Dollars in CASH to Iran and nobody in Congress, the FBI or Justice called for an investigation!” Trump wrote.

Then, he moved on to the top Democrat on the House Intelligence Committee, Rep. Adam Schiff of California.

“Finally, Liddle’ Adam Schiff, the leakin’ monster of no control, is now blaming the Obama administration for Russian meddling in the 2016 Election. He is finally right about something. Obama was President, knew of the threat, and did nothing. Thank you Adam!” Trump wrote.

He later added: “Now that Adam Schiff is starting to blame President Obama for Russian meddling in the election, he is probably doing so as yet another excuse that the Democrats, lead [sic] by their fearless leader, Crooked Hillary Clinton, lost the 2016 election. But wasn’t I a great candidate?”

Trump also took a moment to defend his past statements that seemed to shed doubt on Russia’s role in election-meddling, writing: “I never said Russia did not meddle in the election, I said ‘it may be Russia, or China or another country or group, or it may be a 400 pound genius sitting in bed and playing with his computer.’ The Russian ‘hoax’ was that the Trump campaign colluded with Russia — it never did!”

Trump has repeatedly sought to downplay the evidence of Russian interference, and he said in November that he believed Putin’s denials of meddling.

“Every time he sees me he says, ‘I didn’t do that,’ and I really believe that when he tells me that, he means it,” Trump said at the time. “I think he is very insulted by it, which is not a good thing for our country.”

The Twitter tirade was notably absent of any calls to action in addressing Russian interference. That absence drew swift criticism, as did Trump’s seeming inability to focus on the meaning of the allegations beyond himself and his own campaign.

“Above all this rhetoric here, we begin losing sight of what is it we’re going to do about the threat of the Russians,” former Director of National Intelligence James Clapper said in an interview on CNN. “He never talks about that. It’s all about himself.”

“This is a president who claims vindication anytime someone sneezes,” Schiff told CNN, and he went on to question why the White House has refused to implement sanctions that Congress passed by huge majorities to punish Russia.

“It is inexplicable that the president of the United States continues to sit on sanctions that Congress passed, that Congress wants enforced against Russia over this interference,” Schiff said on “State of the Union.”

Under the law, sanctions were to be imposed by Jan. 30, but the White House demurred at that time, saying the threat of sanctions was “serving as a deterrent.”

Sen. James Lankford (R-Okla.), a member of the Senate Intelligence Committee, also expressed frustration about Trump’s unwillingness to confront Russia over the meddling.

“Russia’s clearly tried to advance their agenda into the United States,” Lankford told NBC.

Sen. Bernie Sanders (I-Vt.) called Trump’s unwillingness to address Russian interference going forward “one of the weirdest things in modern American history.”

“How do we have the president of the United States not saying what everybody knows to be true?” the 2016 Democratic presidential candidate continued in an interview on NBC’s “Meet the Press.” “Russia interfered in ’16, and they’re going to interfere in 2018. … This is a huge deal, and that we don’t have a president speaking out on this issue is a horror show.”

 

 

Updated 

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Twain publishes The Adventures of Huckleberry Finn:

Twain publishes The Adventures of Huckleberry Finn:

huck

On this day in 1885, Mark Twain publishes his famous–and famously controversial–novel The Adventures of Huckleberry Finn.

Twain (the pen name of Samuel Clemens) first introduced Huck Finn as the best friend of Tom Sawyer, hero of his tremendously successful novel The Adventures of Tom Sawyer (1876). Though Twain saw Huck’s story as a kind of sequel to his earlier book, the new novel was far more serious, focusing on the institution of slavery and other aspects of life in the antebellum South.

At the book’s heart is the journey of Huck and his friend Jim, a runaway slave, down the Mississippi River on a raft. Jim runs away because he is about to be sold and separated from his wife and children, and Huck goes with him to help him get to Ohio and freedom. Huck narrates the story in his distinctive voice, offering colorful descriptions of the people and places they encounter along the way. The most striking part of the book is its satirical look at racism, religion and other social attitudes of the time. While Jim is strong, brave, generous and wise, many of the white characters are portrayed as violent, stupid or simply selfish, and the naive Huck ends up questioning the hypocritical, unjust nature of society in general.

Even in 1885, two decades after the Emancipation Proclamation and the end of the Civil War, The Adventures of Huckleberry Finn landed with a splash. A month after its publication, a Concord, Massachusetts, library banned the book, calling its subject matter “tawdry” and its narrative voice “coarse” and “ignorant.” Other libraries followed suit, beginning a controversy that continued long after Twain’s death in 1910. In the 1950s, the book came under fire from African-American groups for being racist in its portrayal of black characters, despite the fact that it was seen by many as a strong criticism of racism and slavery. As recently as 1998, an Arizona parent sued her school district, claiming that making Twain’s novel required high school reading made already existing racial tensions even worse.

Aside from its controversial nature and its continuing popularity with young readers, The Adventures of Huckleberry Finn has been hailed by many serious literary critics as a masterpiece. No less a judge than Ernest Hemingway famously declared that the book marked the beginning of American literature: “There was nothing before. There has been nothing as good since.”

An Out-Of-Network Lab, An Elaborate Urine Test And Then A Surprise Bill:

An Out-Of-Network Lab, An Elaborate Urine Test And Then A Surprise Bill:

After Elizabeth Moreno had back surgery in late 2015, her surgeon prescribed an opioid painkiller and a follow-up drug test that seemed routine — until the lab slapped her with a bill for $17,850.

A Houston lab had tested her urine sample for a constellation of legal and illicit drugs, many of which Moreno says she had never heard of, let alone taken.

“I was totally confused. I didn’t know how I was going to pay this,” said Moreno, 30, who is finishing a degree in education at Texas State University in San Marcos, and is pregnant with twins.

Her bill shows that Sunset Labs LLC charged $4,675 to check her urine for a slew of different types of opioids: $2,975 for benzodiazepines, a class of drugs for treating anxiety, and $1,700 more for amphetamines. Tests to detect cocaine, marijuana and phencyclidine, an illegal hallucinogenic drug also known as PCP or angel dust, added $1,275 more.

The lab also billed $850 to test for buprenorphine, a drug used to treat opioid addiction, and tacked on an $850 fee for two tests to verify that nobody had tampered with her urine specimen.

Total bill: $17,850 for lab tests that her insurer, Blue Cross and Blue Shield of Texas, refused to cover, apparently because the lab was not in her insurance network. The insurer sent Moreno an “explanation of benefits” that says it would have valued the work at just $100.92.

Moreno’s father, in a complaint to the Texas attorney general’s office about the bill, identified the Houston surgeon who ordered the costly test as Dr. Stephen Esses. His office told Kaiser Health News the surgeon would have no comment.

Sunset Labs is part of a network of pain clinics and other medical businesses founded by Houston anesthesiologist Phillip C. Phan, according to Texas secretary of state filings and court records. Court records say Phan’s companies also own the facility where Moreno had her operation.

Three experts contacted by KHN said the lab grossly overcharged; they also doubted the need for the test.

“This just blows my mind,” said Jennifer Bolen, a former federal prosecutor and lab and pain management consultant. “It’s very high and incredibly out of the norm.”

Dan Bowerman, a medical fraud expert, called the lab bill “outrageous” and “unconscionable” and said it should have prompted an investigation.

“Sounds real fishy,” added Charles Root, a veteran industry adviser. He wondered if the lab had “misplaced the decimal point,” because such a test should cost a few hundred dollars, tops.

The lab disagrees.

Sunset’s billings “are in line with the charges of competing out-of-network labs in the geographical area,” lab attorney Justo Mendez said in an emailed statement.

Mendez said pain doctors agree that extensive urine testing is “the best course of action” and that a lab “is not in the position” to question tests ordered by a doctor.

Testing Booms As Opioid Epidemic Rages

Urine testing for patients with chronic pain has grown explosively over the past decade amid a rising death toll from opioid abuse. Pain doctors say drug testing helps them make sure patients are taking the drugs as prescribed and not mixing them with illegal substances.

Yet the testing boom costs billions of dollars annually and has raised concerns that some labs and doctors run urine tests needlessly — or charge exorbitant rates — to boost profits.

Some insurers have refused to pay, which can leave patients like Moreno threatened with ruinously high bills they had no idea they had incurred.

“Surprise bills larded with unexpected expenses and little explanation inflict sticker shock on vulnerable patients,” said James Quiggle, communications director of the Coalition Against Insurance Fraud, whose members include insurers, consumer groups and government agencies. Quiggle said many “puffed-up bills straddle a fine line between abuse and outright fraud.”

Moreno said her insurance covered the disc removal surgery in December 2015. She said the operation went well and she weaned herself off the hydrocodone pain pills. To her surprise, during a second appointment return about a month later, the surgeon’s office asked her to leave a urine sample.

“I didn’t think anything of it,” Moreno said of the test. “I said fine, whatever.”

More than a year later, she said, the lab phoned while she was driving and asked her to pay the $17,850 bill. The lab then sent her an invoice, dated March 10, 2017, which states: “based upon information from your health plan, you owe the amount shown.”

Luckily, her father, Dr. Paul Davis, was visiting her in Texas at the time. Davis, 66, is a retired family practice doctor from Findlay, Ohio.

Davis doubted the need for the test, not to mention what he thought was a sky-high price. He said the University of Findlay, where he helped train physician assistants, gave applicants a basic drug test at a cost of $174, while the local juvenile courts in Ohio paid $10 for a simple drug screen.

Fearing the bill would ruin his daughter’s credit scores, Davis said, he called Sunset and settled it in April 2017 by paying $5,000, which he said he now regrets. The lab sent Moreno a receipt that said it discounted her bill because of “financial need/hardship.”

Asked for comment, Blue Cross spokesman James Campbell said he couldn’t discuss a specific case but noted:

“We are disappointed as well as concerned about transparency whenever [any] member is surprised by an excessive charge for a seemingly routine service or received services that may not have been medically necessary.”

Campbell also said the lab was out-of-network and “we do not control how much they charge for services rendered.” The insurer encourages patients to confirm that all medical care they seek comes from medical providers in the Blue Cross network, he added.

Prices for urine tests can vary widely depending upon complexity and the technology used. Some doctors’ offices use a simple cup test, which can detect several classes of drugs on the spot. These tests rarely cost more than $200, and typically much less.

Bills climb higher when labs check for levels of multiple drugs and bill for each one, a practice insurers argue is seldom medically justified. But even labs sued by insurers alleging wildly excessive testing typically have billed $9,000 or less, court records show. One insurer sued a lab for charging $1,845 for a drug test, for instance.

Davis said Sunset Labs ignored his requests for a full explanation of the charges. In May, he filed a written complaint about the bill with the Texas attorney general’s office that included a copy of the bill and accused the lab of “price gouging of staggering proportions.”

“Young people just starting out, such as my daughter, may not have the ability to pay and this could result in damaged credit ratings or even bankruptcy,” he wrote.

Davis got a letter back from Attorney General Ken Paxton, who said the office would “review the information.” A spokesperson for Paxton told KHN: “We have received complaints about that business, but we can’t comment on anything else.” Sunset attorney Mendez said the lab is “not aware” of any such complaints.

In an interview, Davis also questioned the need for his daughter’s urine test because she received opioids only for a short period and the results would have had no impact on her treatment. In his complaint to the attorney general, Davis said the surgeon told him he ordered the tests because he feared possible retribution from the state medical licensing board for not testing patients who had been prescribed an opioid. The Texas Medical Board doesn’t require urine tests for patients receiving opioids for short-term pain, said spokesman Jarrett Schneider. That’s a “question of independent medical judgment as to whether the physician believes a drug test should be required,” he said.

Negative Reviews

Sunset Labs has an “F” rating with the Houston Better Business Bureau, which on its website posts an August 2017 complaint from a patient charged $16,150 for a urine test.

“This is not covered under my health insurance so I am expected to pay this excessive bill,” the complaint reads.

A second website that publishes government billing numbers of doctors and medical businesses includes a comment section with more than a dozen negative “reviews,” mostly complaints that the lab slammed patients with thousands of dollars in fees their insurers balked at paying.

In a pair of lawsuits filed in 2015, three doctors seeking to quit working at pain clinics operated by Phan accused the facilities of improper billing practices, including unnecessary urine testing. The doctors said they feared losing their medical licenses unless they severed their ties.

In one suit, Drs. Purvi Patel and Lance LaFleur also alleged that the pain clinics “pressured” doctors to overprescribe medical gear and genetic tests to insured patients “regardless of medical necessity.” The case did not go forward because the doctors did not pursue it. Neither doctor would comment.

In the second legal case, pain specialist Dr. Baominh Vinh said he resigned in April 2015 “based on certain questionable business practices … that are inconsistent with my ethical boundaries.” Vinh also alleged urine testing was overused. In a countersuit against Vinh, the pain clinics called his allegations a “falsehood” to justify violation of his employment contract.

The parties settled in March of last year. Terms are confidential, but a lawyer for the pain clinics said Vinh paid money to the company “and not vice versa.”

BY: FRED SCHULTE

February 16, 20185:15 AM ET