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7 Global Food Conglomerates Partner on Water Stewardship Commitments

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Last week, seven global food and beverage companies made commitments to work with thousands of farmers in their global supply chains to reduce water use and pollution impacts.

The firms in question are Diageo, General Mills, Hain Celestial, Hormel Foods, Kellogg, PepsiCo and WhiteWave Foods, and they are participating in the AgWater Challenge: a collaborative initiative organized by Ceres and the World Wildlife Fund (WWF).

The companies submitted detailed sustainable sourcing and water stewardship plans. A progress report on their commitments will be published in a year.

Such a collaboration is vital because a third of the world’s food is grown in areas of high water stress or competition. Agriculture also consumes a massive amount of water and is a leading cause of global water pollution. The food sector uses 70 percent of global freshwater supplies, mainly to grow crops.

“Without an adequate supply of water, food companies have no business,” Eliza Roberts, manager of the Water Program at Ceres, told TriplePundit. Three factors are “depleting freshwater resources around the world,” she told us: climate change, population growth and water pollution. “Global food companies are already facing materials risks, including disruption of operation, higher operating costs, and constraints to growth.”

Every business needs water to operate. However, consumers generally don’t realize just how much water is needed to produce the food they eat. “When consumers think about the role of water in business, they think about the water that a company uses within its own four walls or as a direct ingredient in a beverage,” Roberts pointed out. “But the reality is that the bulk of water in the food sector is used to grow the food that we eat.”

The AgWater Challenge includes five categories: setting time-bound goal for completing a water risk assessment across the companies' supply chains; setting sustainable sourcing goals; setting time-bound goals to reduce the water impacts of key crops; support farmers to steward water resources; and collaboration at the watershed level to protect resources in high-risk areas. All companies committed to completing a water risk assessment by 2017.

Three of the seven companies -- Diageo, General Mills and Kellogg -- were recognized as AgWater Stewards for their actions across all five categories. These three firms already have water stewardship commitments on the books. Diageo defines its approach to water stewardship through the Diageo Water Blueprint. It is based on four core areas: raw materials sourcing, operations, the communities where it operates, and local and global advocacy for best practices in water stewardship. Diago also committed to establish partnerships with farmers to develop sustainable agricultural supplies of six raw materials by 2020. By the same year, the company will ensure sustainable water stewardship on 100 percent of owned agricultural land.

General Mills committed to champion the development of water stewardship plans by 2025 for the most material and at-risk watersheds in its global value chain. The global food company committed to sustainably source its top 10 ingredients (palm oil, fiber packaging, wheat, oats, sugar beets, vanilla, cocoa, dairy, corn and sugarcane) by 2020.

Kellogg Co. committed to responsibly source by 2020 its global 10 priority ingredients by measuring continuously improvement for row crops through metrics focused on several factors, including water and fertilizer use. It also committed to support 17,000 agricultural suppliers, millers and farmers in 22 countries to optimize water use and improve watershed quality.

New commitments by the other four companies include:


  • The Hain Celestial Group will complete a water risk assessment across its entire supply chain by the end of 2017. The company will use this assessment to implement a watershed-by-watershed strategy to reduce water use and pollution risks linked to agricultural production.

  • Hormel Foods will develop a sustainable agriculture policy over the next three months, requiring all direct suppliers, contract animal and feed grain farmers to meet best environmental practices for reducing water pollution risks.

  • PepsiCo plans to improve the water-use efficiency of its direct agricultural supply chain (citrus, corn, oats and potatoes) by 15 percent in high water risk sourcing areas.

  • WhiteWave Foods will develop a time-bound roadmap for agricultural water stewardship by 2018. The roadmap will address the watershed challenges of dairy, soy, almond and produce in areas of greatest water risk, including California.
These seven brands collectively represent $123 billion in annual revenues and are “some of the biggest commodities buyers in the world,” Roberts told us. Those brands “have a fiduciary duty to address sustainability risks like water, which can directly threaten their future profitability." By participating in the AgWater Challenge, these firms are helping to meet that fiduciary duty -- and hopefully their competitors take notice.

Image credit: Flickr/USFWS Mountain Prairie

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Extended Stay America Offers Shelter to Cancer Patients

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Everyone has a cancer story. If you or someone in your immediate family hasn’t had cancer, chances are you know someone who has.

More and more people are being diagnosed each year. The Centers for Disease Control and Prevention (CDC) estimates that new cancer cases will increase by more than 20 percent from 2010 to 2020. As Olympic gold medal winner and cancer survivor Shannon Miller says, “Cancer doesn’t care who you are.”

When everything changes


As we sat together at the American Cancer Society Hope Lodge in New York City, it was obvious that she is right: Among us were an Olympian, a special education coordinator, a municipal manager, a special needs adult caregiver, an independent business owner, a firefighter and a TriplePundit writer. And we were a group of cancer warriors (a word many cancer patients like better than “survivor”). Each of our diagnoses was different, but one aspect of our stories was exactly the same. One day, it’s life as usual. Then a doctor says, “it’s cancer,” and everything changes.

Everyone in the room said the same thing. So many things go through your mind as doctors clinically lay out your options. You are not only a cancer patient, but you also need to research doctors and insurance policies, deal with family and work, and try to understand treatment options, among other things. In the midst of getting shocking news, you have to make serious decisions. Quickly.

Most of us want to trust that our doctor knows everything and will propose the best treatment. That we will survive. But what if you live in a small town with a hospital that isn’t equipped to deal with your illness? What if your doctors think there isn’t anything to be done? What if the treatment they recommend seriously cripples your quality of life, if you even survive it? What if you had to travel far away from home to get the treatment that you needed?

Where to find help


Founded in 1913, the American Cancer Society (ACS) operates 38 Hope Lodges around the U.S. for patients who need to travel for treatment. At Hope Lodge, patients stay free and can get transportation between the lodge and the treatment center. But unfortunately, 38 locations aren’t nearly enough to help the growing number of cancer patients.

When Extended Stay America employees overwhelmingly voted that they wanted the company to throw its philanthropic muscle behind helping cancer patients, company executives weren’t sure how they could help. But ACS knew exactly how: donated hotel rooms for cancer patients.

And Hotel Keys of Hope was born.

Extended Stay America operates 630 locations across the U.S. and Canada (more than 69,000 rooms). In its first year, the company donated more than 50,000 hotel stays (both free and deeply discounted) that helped more than 6,700 cancer patients and their families afford to travel to get the treatment they needed.

“Transportation and lodging costs are a huge issue for patients,” said Shari Henning, executive vice president of the American Cancer Society. “Extended Stay America became a secondary Hope Lodge for saving people’s lives. When Hope Lodge was full, ESA allowed us to continue to say yes to people that contacted us."

By July 2017, Hotel Keys of Hope will have contributed 150,000 rooms (equal to $5 million in lodging cost savings) to more than 15,000 cancer patients since the start of the program.

I hadn't heard of Hotel Keys for Hope, and neither had any of the 40+ women in my young cancer survivors support group. But ACS is a familiar resource, especially when it comes to help with lodging. A few years ago, my friend Grace had to go to Chicago for treatment on the same weekend as the Chicago Marathon -- when the majority of hotel rooms are booked months in advance. And although there were no rooms available at Hope Lodge, ACS got her a room at the Sheraton right downtown near her appointment.

"The American Cancer Society worked so hard to find me a room. I couldn't believe that they found one in the middle of all that was going on -- for a discounted rate. ACS gets things done right away. They also think of things like special cleaning for cancer patients [fewer germs]. And after all that, the Sheraton donated swag bags [to be handed out to new cancer patients]," she said.

A home away when patients need it most

For these cancer warriors gathered around the room in New York, Hotel Keys of Hope played a big part in their treatment journey.

Nikki** was diagnosed with breast cancer at 18. In the more than 10 years since, she had several recurrences (when the cancer comes back). The most recent recurrence in 2012 showed that the cancer had metastasized to her brain (stage four). In 2015, it reached her liver and left lung. Her Philadelphia doctor told her there was nothing to be done, and that she should go home, contact hospice and prepare to die.

But the young mother of two small children, foster mother to a now-thriving teenage daughter, EMT and first woman (and woman of color) to be accepted into the Hamilton, New Jersey Fire Department was not ready to give up.

When she got another medical opinion, she found out that the treatment she needed was available in New York City at Sloan Kettering Baskin Ridge. It was much too far to commute daily. Sloan Kettering knew about ACS and Hope Lodge and sent Nikki their way. Through Extended Stay America, Nikki and Jon-Arthur were able to stay from December 2015 to February 2016. When we met in the summer of 2016, she was still working, taking care of her kids and living life.

"Without Hotel Keys of Hope, we couldn't have gotten it done. It really took the stress off of us," Nikki said. A special perk of ESA? It is pet-friendly. Nikki was able to bring her dog, who was a real comfort when she was recovering from treatment.

When Greg was diagnosed with stage three bladder cancer in 2013, the “gold standard” course of treatment that his doctor in Pennsylvania recommended involved removing his bladder and wearing an apparatus for the rest of his life, impacting his quality of life and mobility. So, he had to make a decision about whether to accept his doctor’s recommendation or find another way, all the while having an aggressive cancer that was continuing to grow.

“You only have one chance to pick the right [course of action], and you are running out of time,” Greg said.

So, he did some research and found that the two most renowned programs for his type of cancer were in Texas and at Massachusetts General in Boston. Texas was too far, but Boston was only eight hours from his home. Mass General sent Greg to ACS and ESA for help with lodging. He is now two years out from treatment, with no apparatus in sight.

"Hotel rooms in Boston were around $300 a night," he said. He and his wife, Jalee, couldn't see how they could afford a long-term stay. Hotel Keys of Hope rates begin at 25 percent off the regular room rate (which as of this writing averaged $150/night in the Boston area). The program also offers rooms for $19 a night or completely free.

Bonnie was diagnosed with stage three Hodgkins lymphoma. She lived in upstate New York, but needed a complicated treatment regimen involving chemo and a stem cell transplant, so she was referred to Sloan Kettering. Hope Lodge was booked for more than a month, but her treatment could not be delayed, so she moved into ESA in 2014. Now she is planning her wedding to Jermaine.

Tosha had Hodgkin's Lymphoma at 17 and was diagnosed with breast cancer in 2014. Due to her cancer history, she was referred to Mass General in Boston for a specific type of radiation treatment, but that meant she needed to travel from her Connecticut home. She also found out about ACS and ESA through Mass General.

"You are researching so many things, and there are so many cancer organizations out there. When a recommendation comes from your doctor's office, it means more," Tosha said.

Seeing the effects up close


ESA employees overwhelmingly voted for the company to get involved in the cancer fight, and they are in a position to see the people they are helping up close. Nikki and Jon-Arthur, for example, developed a great relationship with the manager of their hotel during their lengthy stay.

Gary is an Extended Stay America manager in Portland, Maine. He wanted to join ESA largely because of the Hotel Keys program. He had a brother that was diagnosed with cancer at age 13 (who later passed away).

"My whole interview was about the program," Gary recalled. "I really wanted to be involved."

And as a manager, he is. Gary talked about how it felt to become close to patients who stayed for weeks. He grew to know their treatment schedule and tried to anticipate needs they might have after seeing other long-term cancer patients go through it. And, sometimes, he would get a call from a patient's family that they would not be returning because their treatment did not work and they passed away. Those days are tough, he said.

Since ACS has relationships with other hotels, why is this partnership with ESA so important?

Because ESA has features that regular hotels don't. The suites are large, so when patients are feeling terrible after treatment, they can rest in the bedroom with the door closed and their family can stay in the living room. The kitchen with a full-sized refrigerator and dishes is useful because many cancer patients have specific foods they can or can't eat. Eating out every meal for weeks won't work. One woman in the group brought her own blender to make smoothies because they were the only thing she wanted to eat. And remember Nikki's dog? Extended Stay America is a cross between a hotel and an apartment that works out very well for patients undergoing treatment.

Help by spreading the word


When I told my group about the Hotel Keys program, one organizer said that every social worker in every cancer treatment center should know about it, so more people can take advantage of better treatment options even if they are a long way from home.

Another friend, Jori, has stage four breast cancer. So, she has traveled frequently to other cancer centers far from home for appointments, tests and treatment, but she never knew about Hotel Keys for Hope or received any travel assistance. When I told her about the program, she said she could see the benefits but only if people know about it.

"I feel like we are at the mercy of a good social worker to inform us and stay involved. When you need to get a second opinion, it is pretty urgent usually," she said. "Also, it seems like a lot of programs have forms to fill out and doctor's signatures, so the mental capacity to do that [in the midst of crisis] isn't always there. I think ways to spread the word would probably be most effective by social media and through cancer centers."

Last month was my second October (breast cancer awareness month) since I completed treatment. I am reminded of my weeks and months of treatment more during this time of year and sad to see our group grow larger as more women get new diagnoses. I know that people want to help, so instead of buying something pink, spread the word about Hotel Keys for Hope. It helps patients with any cancer diagnosis. Tell the person with cancer in your life, that family friend, or friend of a friend. It could encourage them to look further for treatment, and that could make all the difference.

If you stay at Extended Stay America, drop your key in the donation box. For every key dropped in the box, ESA will donate $1 of hotel room value (up to $1 million dollars) so that even more cancer patients can benefit.

To request an ESA Hope Lodge room, cancer patients or their caregivers should call the American Cancer Society at 1-800-ACS-2345.

Unless otherwise specified, images are credited to Andrea Newell.

**Participants in the group readily shared their experiences, but one member requested that 3p not use last names, so cancer patients are only referred to by first names.

Author note: Extended Stay America paid for my trip to New York, but my opinions and experiences are my own.

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Pulp and Paper Industry, U.N. Partner on Clean Water in Southeast Asia

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Despite Southeast Asia's tropical climate and overall abundant rainfall, UNESCO, the U.N. Organization for Education, Science and Culture, identified this region as one that will become highly susceptible to water stress during the 21st century.  And according to the NGO Water.org, Indonesia -- Southeast Asia’s largest economy -- is falling far short of meeting the water needs of many of its citizens. An estimated 102 million Indonesians lack access to decent sanitation facilities, and 37 million do not have reliable access to safe drinking water. The results not only pose a huge risk to public health, but will also impede future economic development in a nation where per-capita income is below $3,500 annually.

The reality for Indonesia, as well as for its Southeast Asian neighbors, is that the private sector will have to step up in order to develop the infrastructure necessary to provide safe, clean and potable water to its citizens, as many governments in this region are either lacking capacity or are just too corrupt to take on the task.

To that end, UNESCO is partnering with several organizations, including Habitat for Humanity Indonesia and Asia Pulp and Paper (APP), on a project that aims to improve the quality and safety of drinking water in this country of 250 million people.

The project is located on Pari Island, which is in Kepulauan Seribu, or the Thousand Islands, an archipelago of over 1,000 islands located north of the island of Java and Indonesia’s capital, Jakarta. Pari Island is one of only 13 islands within this chain that is fully developed as a tourist destination. But its sparkling white sand beaches contrasted with the surrounding stellar water belie the fact that much of the available water on Pari Island is highly saline and unfit for human consumption.

To that end, UNESCO launched a project on this island that falls under the United Nations Global Compact’s (UNGC) Water Mandate. The Mandate’s core elements are supply chain and watershed management, collective action, public policy, education and community engagement ,and transparency. The Pari Island Project addresses the Mandate’s focus on collective action and community engagement and also supports what APP says is its commitment to addressing Indonesia’s water challenge beyond the areas in which the company operates.

According to APP, UNESCO asked the company to assess the underlying problems involving water in Pari Island. The company found that the challenges on this island are similar to some of the communities in which APP conducts business, including the lack of awareness of effective hygienic practices and an overall substandard water quality.

Throughout the project, APP worked with its partners to introduce what it insists are the two best approaches to help address the water challenges the island faces: first, to raise awareness on the importance of effective hygienic practices within the island’s communities; and in addition, APP and its partners tasked themselves with introducing new technologies, such as updated methods for saline water treatment and biopore holes, in order to improve the water quality from its existing water sources.

APP said it is still evaluating these new programs to determine how they can be replicated in other communities within and beyond the areas in which it operates. "Our ultimate hope is that, through this project, we’ll find a way to introduce technology to communities that encourage sustainable application even after the project is completed," explained Librian Angraeni, APP’s sustainability manager and a chair of the Indonesia Water Mandate Working Group (IWMWG).

Over the past several years, APP also launched other water stewardship programs across its home base of Indonesia, Ms. Angraeni said. In 2012, the company partnered with the Indonesian Institute of Sciences (LIPI) to install water purification devices in Giam Siak Kecil-Bukit Biosphere Reserve. And the company is no stranger to Habitat for Humanity Indonesia: Past projects include their work together to refurbish six water sources for the rural community of Soran in Central Java Province, as well as the construction of sanitation facilities in the West Java province of Serang.

In addition to this community work, APP says it has conducted water footprint assessment within all of its major operations. The water assessment was completed between 2012 and 2015, and the result was a detailed water mapping of all of its operations and revealed areas of potential water savings.

So, what is in it for APP to work on these water projects? After all, the challenge the company faces in its water conservation efforts is that the cost of this resource in Indonesia is relatively low; hence these water-saving projects do not generally save APP a substantial amount of money. However, the company says that tackling these projects makes good business sense by linking water saving to other aspects including like energy and fiber, which will lead to greater cost savings and water-saving benefits in the long term.

At the company’s Indah Kiat Perawang plant, for example, data resulting from a water footprint analysis helped the mill identify more than 60 improvement opportunities across its operations, from raw water treatment to the overall efficiency of the pulp and paper factory’s equipment. The end result is that the mill is now able to reduce its consumption by 50,000 cubic meters of water daily. When compared to the amount of water this mill consumed five years ago, it has since reduced its water intensity by 21 percent for pulp production and 8 percent for paper production.

In recent years, the U.N. touted its Sustainable Development Goals, or SDGs, as the way forward if the world is going to alleviate poverty while preparing for a growing population that could top 9 billion people by 2050. One of these most important goals is No. 17, which enlists partnerships to further the SDG goals.

There is no way the U.N. and national governments can come close to achieving these efforts without enlisting the private sector. The work of companies such as APP gives these businesses the opportunity to share their capacity and expertise in order to prepare for a more crowded world, while also offering them the chance to look inward and find ways to make their own operations and supply chains far more sustainable, responsible and efficient.

Image credit: Asia Pulp and Paper

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NASA and the Evolution Climate Change Research

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"Distance lends enchantment to the view." -- Mark Twain

Back when America was young and farmers outnumbered city folk, planning next year’s crop typically included a quick look to the Farmers’ Almanac for advice. Filled with seasonal forecasts, planting charts, tide tables and astronomical charts, the Farmers’ Almanac was cutting edge technology for long-range forecasting when it was first published in 1792.

Still going strong today, the Almanac reflects our abiding dependence on the cycles of nature, the give-and-take of the seasons, and a stable, predictable climate within which we may thrive. As the human footprint expanded across the globe, so too did the necessity of understanding the Earth and our place in it.

This point was never brought home more poignantly than in December 1968, when Apollo 8 transmitted the first images ever seen of Earth from space, as witnessed by three lonely space travelers. If a picture can write a thousand words, that one image wrote a book.

NASA’s manned space flight missions to the moon grabbed attention and glory for the agency in the '60s, but Earthrise was the seed that germinated NASA’s most important mission: looking back on ourselves and understanding how the world works.

Budget priorities


In the 50 years since Bill Anders snapped the “unscheduled” photo of Earth rising over the moon’s surface (above), the human population doubled, grain yields tripled, and economic output grew seven times over. In the process, the atmospheric concentration of carbon dioxide rose from 323 parts per-million to over 400 ppm, up nearly 25 percent in a geologic glint of time. According to NASA Earth Science, “Over a third of the U.S. economy -- $3 trillion annually -- is influenced by climate, weather and natural hazards, providing economic incentive to study the Earth.”

The economic growth of the past half century hasn’t necessarily translated into growth of NASA’s budget. NASA receives 0.40 percent of the federal government’s $4.147 trillion budget. Contrast that to the 12.6 percent allocated to defense spending. The $523.9 billion budgeted to the DoD would pay for all of NASA's activities 29 times over.

Climate research is particularly vulnerable given the current political climate in Washington. Rep. Lamar Smith of Texas chairs the U.S. House Committee on Science, Space and Technology. Often characterized as a climate denier with hostility toward climate change research, Smith counters that he’s a “not a denier, but a skeptic.” The committee authorized extreme cuts of as much as 25 percent of NASA's earth sciences budget in 2015 over concerns that the earth sciences team studies climate change. The budget remains under attack. 

How does NASA continue to refine and improve its Earth science and climate research in spite of a disinterested Congress constantly looking to defund research?

Research priorities


In the beginning, NASA had no official role in Earth science. When Congress chartered NASA in 1958 with the National Aeronautics and Space Act, the mission was developing technologies for space observation and "research into the problems of flight within and outside the earth’s atmosphere." Early NASA administrators integrated the agency's technology development with an Earth Observations program at the Goddard Space Flight Center in Greenbelt, Maryland. At first, this was an "applications program" with the Weather Bureau and the U.S. Geological Survey. The agreement between the three agencies specified the Weather Bureau (which later became the National Oceanic and Atmospheric Administration-NOAA) and USGS to conduct scientific research with NASA providing "observational technology." 

The agreement between the three agencies specified the Weather Bureau (which later became the National Oceanic and Atmospheric Administration-NOAA) and USGS to conduct scientific research with NASA providing "observational technology." This cooperative arrangement produced the Nimbus series of experimental weather satellites and the Landsat series of land resources satellites.

An economic downturn and extended period of inflation in the 1970s scuttled this inter-agency arrangement. Congress set to work cutting the budgets of all three agencies. NOAA and the USGS were unable to fund their part of the program. Budget cuts squeezed NASA as well, but in 1976, Congress revised the 1958 space act, authorizing NASA to conduct stratospheric ozone research. NASA now had a fundamental role in Earth science.

NASA's early planetary missions to Venus and Mars helped pique Congress' interest in Earth science. Astronomers expected these "Earth-like" planets to have surfaces conditions able to support life. Instead, they found Venus with a CO2-choked atmosphere and surface temperatures hot enough to melt lead; a "runaway" greenhouse effect. On Mars, they found an atmosphere only 1 percent as dense as Earth's, a frozen surface, and no water. But Mars also hinted to a distant past when liquid water may have flowed freely on its surface.

These unexpected initial findings from our planetary neighbors focused attention on our own planet. As for planetary exploration beyond Earth, Congress soon lost interest. In 1977, Congress made sharp cutbacks in planetary exploration. President Ronald Reagan threatened to eliminate the program entirely.

In the late '70s and early '80s, NASA moved into low Earth orbit.

Earth observatory

With the glory of Apollo long gone, massive cuts in spending for planetary research, and the start of the Space Shuttle program, NASA turned its attention even more to planet Earth. A growing awareness of the potential for climate disruption in the '70s and '80s, an expanding ozone hole over the Antarctic, and increasing stress on global ecosystems set in motion a new mission for NASA.

In 1982 NASA started an Earth science program called Global Habitability, which later became Mission to Planet Earth. In 1984, Congress once again revised the original Space Act, granting authority for the "expansion of human knowledge of the Earth." Interagency research efforts once again took shape, leading to the Global Change Research Program.

In the fiscal year 1991, Congress appropriated funds for the Earth Observing System. A network of coordinated polar-orbiting and low inclination satellites, the EOS provides long-term observation of land surface, oceans, biosphere, and atmosphere. It is the Farmers' Almanac writ large. EOS is the foundation of space-based Earth sciences, bringing its ongoing observations to both the global research community and the general public.

In all, NASA currently has 19 operating Earth climate science missions monitoring a host of Earth processes. Just a few among them include:


  • The Atmospheric Carbon and Transport-America monitors the terrestrial carbon cycle.

  • Aqua collects data on evaporation, precipitation and cycling of water over land and sea.

  • COral provides a global-scale picture of the condition of coral reefs.

  • DSCOVR Deep Space Climate Observatory launched in February 2015. DSCOVR orbits in deep space at the Lagrange Point between Earth and the Sun. It provides and early warning of severe solar storms and also measures aerosols, ozone, and changes in Earth's radiation.

  • The twin GRACE (Gravity Recovery and Climate Experiment) satellites in polar orbit map Earth gravitational waves. The project monitors shifting deepwater ocean currents, runoff and groundwater storage, and exchanges between ice sheets and oceans.

  • Jason 3 measures ocean surface height

The Blue Marble

Despite the vagaries of Congress and the politics of climate change, NASA has developed a long-term, integrated system for observing Earth and measuring global change. NASA's role in climate and research is embedded in the effort to understand the complex, interdependent systems that eventually bore life in a lonely corner of a vast universe.

I suggest that there is no part of the human endeavor that is not ultimately impacted by the health of our planet. The image of Earth, hovering like a blue and white jewel against the stark backdrop of space, jarred humanity into a new realization of our place in the universe and the sheer beauty of our Blue Marble.

The race to the moon called us home.

Earthrise Image enhancement credit: Marc Van Nordon, courtesy Flickr

Mission chart courtesy of NASA

Blue Marble image editing credit: NASA Goddard Space Flight Center, courtesy Flickr

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The Past and Future City: Historical Preservation is Essential for Green Building

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Editor's note: The following is an excerpt from "The Past and Future City" by Stephanie Meeks with Kevin C. Murphy. Copyright © 2016 National Trust for Historic Preservation. Reproduced by permission of Island Press, Washington, D.C.

By Stephanie Meeks and Kevin C. Murphy

Although climate change has added additional urgency to our efforts, the idea that older buildings have a key role to play in forging greener, more sustainable communities has been around for a while. In 1980, when President Jimmy Carter first made energy efficiency a national focus, the National Trust had a poster that showed a building in the shape of a gasoline can. It read: “It takes energy to construct a new building — it saves energy to preserve an old one.” That, in a sentence, is why preservation is so fundamentally important to our future health and well-being.

According to the U.S. Department of Energy, building operations account for 41 percent of the nation’s energy consumption, 72 percent of its electricity consumption, and 38 percent of its carbon dioxide emissions. In urban areas, these numbers are even higher. Commercial buildings are estimated to be responsible for 70 percent of Chicago’s total carbon emissions and 80 percent of New York’s. Given these statistics, there is no way to feasibly address the climate crisis without changing how we manage our urban landscape.

At the same time, roughly one billion square feet of buildings are demolished and replaced every year in the United States. According to an analysis by the Brookings Institution, the country is in the midst of demolishing and replacing 82 billion square feet of existing space — nearly a quarter of the existing building stock — by 2030.

That is an astonishing amount of waste. In fact, the energy used to demolish and rebuild that much space could power the entire state of California for a decade! According to a formula produced for the Advisory Council on Historic Preservation, about 80 billion British thermal units (Btus) of energy are embodied in a typical 50,000-square-foot commercial building.

As my predecessor Richard Moe pointed out in 2008, that’s “the equivalent of 640,000 gallons of gasoline. And if you tear the building down, all the energy that went into creating the building is wasted. Demolishing that same 50,000-square-foot building also creates nearly 4,000 tons of waste. That’s enough debris to fill 26 railroad boxcars — a train nearly a quarter of a mile long, headed for a landfill that is already almost full.”

It simply does not make sense to recycle cans and newspapers to save energy and not recycle buildings. As architect and green advocate Carl Elefante wrote in a 2009 essay, “Taking into account the massive investment of materials and energy in existing buildings, it is both obvious and profound that extending the useful service of life of the building stock is common sense, good business, and sound resource management.” Put simply, he said, “The Greenest Building is the one that’s already built.”

This holds particularly true when you consider that it takes decades for even most of the new efficient buildings to recover the carbon that is expended in their construction. In short, we cannot build our way to sustainability. In a perfect world, every new building going forward would be net zero — meaning it produces as much as energy as it consumes.

But even if that were the case, it would have the same effect over a full year as cutting energy use of all existing buildings by just 1 percent. “Seeking salvation through green building,” wrote Elefante, “fails to account for the overwhelming vastness of the existing building stock. [That] is the elephant in the room: Ignoring it, we risk being trampled by it. We cannot build our way to sustainability; we must conserve our way to it.”

That is why what we do with our existing fabric is so important. In our rush to embrace green construction, we cannot lose sight of the tremendous value of saving and reusing buildings that have already been built.

In January 2012, a few years before conducting the Older, Smaller, Better research cited throughout this book, the National Trust’s Preservation Green Lab published its first major report, entitled “The Greenest Building: Quantifying the Environmental Value of Building Reuse," on this nexus of preservation and sustainability. The Green Lab first looked at the full life-cycle — from the extraction and transportation of the raw materials used in construction through decades of use—of different types of buildings, such as single-family and multifamily homes, schools, warehouses, and offices.

To ensure that their data accounted for different climates and a variable mix of energy sources, Green Lab researchers surveyed buildings in four U.S. cities: Chicago, Atlanta, Phoenix and Portland, Oregon. Using this life-cycle analysis methodology, they then compared the relative environmental impacts of building reuse and renovation versus demolition and new construction over the course of a seventy-five-year life span.

In almost all cases, when they compared buildings of similar size and functionality, they found that building reuse yields fewer environmental impacts than new construction. In fact, depending on the type of structure, it takes between 10 and 80 years for a new “green” building that is 30 percent more energy efficient than the existing one to make up for the amount of carbon unleashed through its construction. These findings accord with other studies on the subject. For example, a report by Britain’s Empty Homes Agency found that it takes 35 to 50 years for a new, green home to recover the initially expended carbon as well.

The range of environmental savings varies based on building type, location, and presumed level of energy efficiency, but when comparing buildings with the same energy performance level, the environmental savings from reuse are between 4 and 46 percent over new construction. The one exception is when industrial warehouses are converted into multifamily residential units, which resulted in a 1 to 6 percent greater environmental impact. Foremost among the reasons for this difference are the amount and type of materials used for rehab, which can significantly mitigate or even cancel out the energy savings from recycling buildings.

So, it is important to use the right materials — and minimize the amount of new materials — in renovation projects. If done correctly, however, the impact reductions of reusing old buildings can be substantial, particularly when taken to scale.

To take just one example, if the city of Portland, Oregon, were to retrofit and reuse the single-family homes and commercial office buildings that it is otherwise likely to demolish over the next 10 years, based on its demolition rates from 2003 to 2011, the potential impact reduction would total approximately 231,000 metric tons of carbon dioxide. This figure is about 15 percent of Portland’s stated carbon reduction target over the next decade. The city could save 15 percent immediately just by conserving and reusing its already existing buildings.

What is true in Portland can be true all over the United States. In 2014, as part of the United Nations Climate Summit, 451 cities around the world — including 122 in the United States—pledged to reduce their carbon emissions and begin preparing for climate change. Similarly, in 2015, a number of U.S. and Chinese cities agreed to deep cuts in carbon emissions as part of a bipartisan climate summit in Los Angeles — a city that, like New York, has pledged to cut its emissions by 80 percent by 2050. As noted earlier, Seattle has gone a step even further and declared that it will be completely carbon neutral by 2050. All these cities can get a leg up on reaching these necessary emissions cuts by stopping demolition and working with their existing building fabric.

Ultimately, we can’t build our way out of the global warming crisis. We have to save our way out. That means we have to make better, wiser use of what we’ve already built.

“Original green”


There’s another factor to consider here as well, what author and architect Stephen Mouzon has called “original green” in a book and blog by that name. “Originally, before the Thermostat Age,” Mouzon wrote: “The places . . . and buildings we built had no choice but to be green, otherwise people would freeze to death in the winter, die of heat strokes by summer, starve to death, or other really bad things would happen.”

Put another way, many older buildings are inherently green by design through features like thick walls, high ceilings, use of daylight, operable windows, awnings, generous eaves, and porches. They reflect the wisdom — wisdom that has sometimes been lost — of earlier generations.

Stephanie Meeks and Kevin C. Murphy are the authors of "The Past and Future City."

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Clif Bar Proves That Corporate Social Responsibility Can Win Customers

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307
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Year after year, Clif Bar proves that corporate social responsibility wins customers. The company is growing at a 17 percent annual compounded rate. That is exceptional in an economy struggling to achieve 3 percent growth. Further so, Clif Bar achieves 17 percent compounded annual growth by running its business to achieve five aspirations for profits, brand, people, community and the environment.

Corporate social responsibility is not a business function like finance or operations at Clif Bar. Being purposeful is at the core of the company and how it measures performance. It is Clif Bar's secret sauce for winning customers in the highly competitive food market segment.

Clif Bar links purpose and business growth


Today's business environment can be characterized as a race to the bottom on price. In this business model, people and products are commodities. Only high-volume, low-cost competitors win.

But money is not the sole consumer issue. Market research documents that consumers seek purpose and values in what they buy and who they buy from. Here are three examples of how the consumer search for purpose is reshaping our economy and creating business opportunities:


  1. Our national weight crisis is very real to moms and millennials. These key consumers are searching for foods that taste good, are affordable and have authentic health benefits.

  2. The vast majority of Americans believe global warming is real and manmade. Americans seek to buy from businesses that are part of the solution and not part of the problem. This trend has resulted in renewable energy now representing 50 percent or more of our new power generating capacity. Voters support growth of renewable energy over the growth of fossil energy by a 4 to 1 margin.

  3. How a business treats its customers, work associates and the disadvantaged is a major consumer concern. Consumers do not want to buy seafood connected to slave labor. They do not want to buy clothes made by children. And the millennial generation, the most diverse in U.S. history, will not tolerate a company that discriminates.

Clif Bar demonstrates the business case that a company can achieve superior financial results by meeting these types of consumer expectations. Clif Bar is not alone in demonstrating that purposefulness sells.

Many of our volume retailers are now Green Giants selling over a billion dollars worth of green products annually. For example, Costco is now the largest organic food retailer selling $4 billion annually. Target’s Made to Matter product line generates $1 billion annually, and products that satisfy Walmart's Sustainability Index now generate $1.5 billion in annual sales.

Clif Bar’s CEO Kevin Cleary on how to be purposeful and profitable


Here's how Clif Bar's CEO Kevin Cleary explains the company's success:

“Our culture is our competitive advantage!”

Cleary defines culture as how people work together. His anchoring leadership goal is to connect people to what matters. Connecting people to what matters drives product design. It drives the design of the work environment. It exemplifies their brand equity. Ultimately, it is the link between the company's purpose and profits.

You see this in Cleary’s execution of Clif Bar’s five aspirations. Under his leadership, Clif Bar built one of our country’s first LEED Platinum corporate headquarters. This building aligns with the company’s environmental aspiration. But it is also is an example of Cleary’s leadership in embracing best practices that improve employee productivity, such as Biophilic Design. Under Cleary’s leadership, Clif Bar also doubled its business size. But this business result was achieved while only increasing the number of employees by about 50 percent.

Cleary and his team also use the company’s five aspirations in determining how to invest in the business. The company just launched its first bakery, a $90 million investment. It did not qualify potential locations in the traditional economic development process that is heavily focused on least cost. Instead the company applied all five aspirations of business, brand, people, community and environment in assessing where to locate.

On that basis, Clif Bar choose Twin Falls, Idaho. Tellingly, this town’s motto is, “People serving people.” Doesn’t that sound like Clif Bar? And of course, the company built its bakery using Biophilic Design to make sure employees stay connected to the beauty of Twin Falls while on the job.

If your business is in search of double-digit growth, this video interview with Clif Bar CEO Kevin Cleary conducted at Sustainable Brands 2016 is a must-watch. In it, Cleary speaks to how he is growing the business. He explains in more detail how the company is realizing increased worker productivity. He shares how the company’s supply chain has engaged in collaborative learning to lower costs and emissions. Most importantly, Cleary outlines how Clif Bar has successfully linked purpose and profits.

https://www.youtube.com/embed/Aybxk2hz6gU

Image courtesy of Clif Bar (press use only)

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Preparing for Organizational Change

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100
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By Tom Chapman

Organizational change is a daunting subject, but it may be a necessity if your business isn't performing as you’d hoped. In many cases, companies are held back by their reluctance to alter anything, whether it’s through fear of getting it wrong or just plain laziness.

Instead of falling behind and potentially causing long-term damage, see the idea of change as another opportunity to get things right. The key is to go in with confidence, and to know exactly what needs to happen.

With that in mind, below are some tips to help you prepare, and to get the results you expect.

Be completely honest


Sticking with that opening point, don’t procrastinate: The first step to successful organizational change is to admit that something actually needs changing. Be honest about the things that aren’t right at present, and openly discuss the ideal situation. Where would you like to be in a year’s time? How about five years? Which processes frustrate you? Is everybody in their best possible role?

The fear of being accused of failure leads so many companies ignore the truth, but this is counterproductive. Be realistic not only about what’s wrong right now, but also about what you’re capable of doing to change it. Bite off more than you can chew and your effort will likely go to waste.

Involve everyone


Secrecy is a dangerous thing in business – your workforce won’t take kindly to being left completely out of the loop, and they certainly won’t be as open to change if they’re not sure of the reasoning behind it.

Instead of assuming your answers are the right ones, keep an open conversation with your workforce and take their concerns and suggestions seriously. This change might be your idea but they’re the ones who will be affected most on a day-to-day basis, and they’ll need to be on your side for it all to go smoothly.

Map out the process


When you know what you want to achieve and have an idea of how you’re going to get there, start mapping out the plan in a way that makes it clear to everyone involved. It’s not enough to have an idea, send out an email and expect everyone to make it happen – the process must be organized from the start.

Use this map as an opportunity to pinpoint the areas in which employees will be affected when things start to change. Regardless of whether it’s a shuffle of team structure or just the introduction of a new IT system, your employees will be much more cooperative if they know what’s happening in advance.

Don’t be afraid to learn


Leading organizational change requires knowledge and skill, so think about how you might be able to acquire more of both. You may well have gone through similar projects in the past, in which case take what you can from these experiences, but also look at opportunities to learn from other experts.

There are plenty of courses out there designed to help you become a better business leader, and many focus on subjects like growth and transition. Below are some examples:

University of East Anglia (UEA) -  MSc Management

Wherever you are in your business journey, this course at UEA promises to improve your knowledge and understanding of finance, corporate governance, marketing and organizational behavior.

University of Birmingham – Online MBA (Masters in Business Administration)

This wholly online course is the first of its kind to be accredited by the Association of MBAs, and is designed for professionals with at least three years of management experience. It provides key insights into effective modern business practices, covering everything from marketing to accountancy.

Ashridge Executive Education – Masters in Organizational Change

As the name suggests, this course focuses specifically on organizational change, making it the perfect choice for your preparation. Over a period of 18 months, it’ll look at a range of proven, research-backed approaches, giving you skills to apply almost immediately.

University of Portsmouth – Executive MBA

This internationally recognized business management degree aims to develop your leadership skills using a range of expert-led masterclasses and effective group projects. Regular guest lectures are another benefit of the course.

Be ambitious and prepare!


Success comes with achieving the objectives you set for yourself and your business. And if you’re not quite on track with those goals, change may be the only option. With all of the above in mind, take the time to prepare properly, otherwise you risk wasting your time and everybody else’s.

Image credit: Pixabay

Tom Chapman is a content specialist for Vertical Leap – A search marketing agency based in Portsmouth and London, UK – He has excellent knowledge of marketing as well as technical matters such as the Internet of Things.

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Ignoring Scientific Evidence, Consumers use Alternative Medicines at Their Own Risk

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367
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Consumers are often critical, and even distrusting, of the pharmaceutical industry and the medical profession at large. In turn, they sometimes gravitate toward alternative medicines such as herbal remedies, essential oils and homeopathic remedies. These trends continue despite the fact that the overwhelming body of scientific evidence suggests this $34 billion American industry not only offers few, if any, health solutions, but can even harm consumers.

The complete lack of scientific evidence substantiating any health benefits is especially true of the homeopathic medicine industry. The sector itself suggests that its annual revenues range anywhere from $3 billion to $6 billion annually. Backed by powerful forces, including a congressional Dietary Supplement Caucus in Washington, D.C., this industry continues to reap profits at the expense of public health.

Companies marketing homeopathic remedies have been particularly successful in landing shelf space at drugstores and big-box chains across the U.S., despite the overwhelming evidence that these products often do not work, lack any stringent oversight, are often untested by regulators or the industry and, in fact, have even been proven to endanger the health and lives of young children.

The popularity of homeopathic remedies endures, even as overall interest in the sciences surges -- evident in the popularity of social media channels such as the “I f---ing love science” Facebook page, which has over 25 million “likes.” But are there instances when these remedies can work? And are there cases when the treatment of ailments at home is a viable alternative to the purchase of conventional over-the-counter medicines, or even visiting a physician?

A quick background on homeopathic remedies

TriplePundit spoke with Jann Bellamy, who helped established and is now on the board of the nonprofit Society for Science-Based Medicine, by telephone from her office in Tallahassee, Florida, to gain insight on this discussion.

Credible medical researchers have long dismissed homeopathic medicine as pseudo-science. First conceptualized by a German physician in 1796, it surged in popularity in the U.S. and Europe during the 19th century before falling out of favor due to relentless criticism by mainstream scientists. In the years before World War II, homeopathy enjoyed renewed interest in Nazi Germany and across the Atlantic in the U.S. When New York Sen. Royal Copeland, a homeopathic physician, authored the 1938 Federal Food, Drug and Cosmetic Act, he included special protections for homeopathic remedies. By the 1970s, the homeopathic remedy industry increased tenfold, largely due to the New Age movement which emphasized healing and spirituality when the time came to treat health ailments.

For almost 80 years, the Food and Drug Administration had jurisdiction over homeopathic remedies, but the agency let the industry grow with almost no oversight. “Unfortunately, the FDA just never has caught up with the times,” Bellamy told us. “It has the authority to regulate, but it has pretty much defaulted to the homeopathic industry and allowed it to regulate itself.”

Should the homeopathic industry be allowed to regulate itself?

Homeopathic remedy companies such as Hyland’s say their remedies are regulated by the FDA, but Bellamy argues that the FDA has eschewed its responsibility to monitor this sector. “Yes, one could argue that technically the FDA regulates this industry. But, in addition to requiring good manufacturing practices, all FDA has really done in terms of regulating is the issuance of a compliance guide, which is only a manual on how to label products,” she explained.

These same companies often point to a body of research and a 200-year history that demonstrates these remedies are effective. But Bellamy urged strong caution.

“There are no well-conducted trials of homeopathy that proves it works,” Bellamy insisted. She pointed to an extensive Australian government review that came out last year, which concluded: “There are no health conditions for which there is reliable evidence that homeopathy is effective.” A report commissioned by the United Kingdom’s parliament several years ago gave a scathing assessment of homeopathy, concluded the practice is nothing more than treating patients with a placebo, and urged the nation’s National Health Service to stop funding any such medical care.

“Really, in my view, we should not be able to sell these products,” Bellamy told 3p. “We know they don’t work. They don’t adhere to the basic principles of science. So, why should they be sold at all?”

She pointed to the fundamental rules of homeopathy, such as “like cures like,” which posits that a substance which causes illness symptoms in healthy people would remediate similar symptoms in sick people. Furthermore, Bellamy explained that the concept of “potentiation,” or homeopathic dilution, in which ingredients are diluted and vigorously shaken (or, as the industry says, “succussed”) to the point that no molecules of the original substance even exist in the solution,  is contrary to the basic principles of chemistry and physics.

How should pharmacists handle homeopathy?

Nevertheless, these remedies are readily available in neighborhood drugstores and, of course, through online retailers such as Amazon. On that point, Bellamy argued that retail companies are placing their pharmacists’ professional reputations at risk.

“Pharmacists, back in the day, used to own the pharmacy, but they don’t anymore as they are now an employee of a Walgreen’s or RiteAid,” Bellamy explained. The result is that their relationship with their employers puts them in an unfair dilemma as these companies stock their stores’ shelves with alternative remedies in order to meet consumer demand.

“We need a framework in place so that a pharmacist is bound to say, if asked, ‘Look, this product just does not work.’ But the fact is: These products are profitable for these retailers, bottom line.”

Retailers in turn look to the FDA to provide safety guidance. For example, CVS was quick to pull Hyland's teething tablets from shelves when the FDA issued a warning.

What should the FDA do?

Bellamy does not see the situation changing much unless the FDA steps up and takes its mandate to regulate these remedies seriously. “I think it’s not going to be resolved as long as the current regulatory system is in place,” she said. But she inferred that if the regulatory agency summarized the scientific evidence governing how these remedies work, you would see an immediate impact.

“If you had to put on a bottle’s label, ‘this doesn’t work for anything,’ that would obviously cut into these companies’ sales. They’d be finally telling the truth, as in fact, they should not be able to imply that what are in these bottles is going to do consumers any good.”

Another problem is that the FDA does not have sole authority over homeopathic and other alternative medicines. While the FDA is tasked with regulating how these medicines are made and labeled, the Federal Trade Commission (FTC) regulates how they are advertised.

“The FTC, in fact, has expressed concern to the FDA over its lack of regulation, which is indeed confusing to people,” Bellamy said. “The FTC, rightfully so, has told the FDA to do its job."

The FTC issued a policy that health claims for any product must be substantiated by evidence; yet the FDA’s current regulatory framework causes confusion. Many homeopathic remedy advertisers mistakenly believe that if their products comply with the FDA guidelines on homeopathy, then they do not have to comply with the FTC’s substantiation requirements. Last year, the FTC condemned the FDA for not taking stronger action on these remedies:

“The staff comment notes that the FDA’s regulatory framework for homeopathic drugs, set forth in a 1988 Compliance Policy Guide, does not require that over-the-counter (OTC) homeopathic drugs be approved by FDA as safe and effective if they satisfy certain conditions, including that the product’s label contains an indication for use. Yet the policy guide does not require sellers to have competent and reliable scientific evidence to support the indication for use.”

The stubborn fact is that the unregulated sale of homeopathic remedies is a scandal perpetuated by companies that care more about profit than healing, without being held accountable to accept the basic fundamentals of science. Most damning is these companies’ claims that their products, which are largely made of water and sugar, are effective because they contain the “memory” of these substances even if not a single molecule exists.

By that logic, drinking water in much of the U.S. -- which is largely reclaimed and recycled as it passes through sanitation systems and eventually back into municipal supplies -- would still be toxic from contaminants, giving the phrase "toilet to tap" a scary new meaning.

Image credit: Wellcome Images/Wiki Commons

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Obamacare Rate Increases Aren't the Federal Government's Problem

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If you are one of the 13 million Americans who get their health insurance through the healthcare exchange (via the Affordable Care Act, aka Obamacare), you probably already heard the bad news: Some premiums are due to go up next year.

And if you are one of the 22 million Americans who are self-employed, don't have employees and rely on the national program (also called Obamacare) for your healthcare, this could seem like big news. Prior to Obamacare, many self-employed individuals either obtained insurance through private associations like the National Association for the Self Employed (NASE) or through a second job. Or they were unable to afford health insurance, period.

Of course, one of the reasons this announcement was such a headline-grabber is that most of the media coverage neglected to remind us that rate increases were a mandatory requirement by insurance companies when they agreed to lower their rates for the first year of ACA. That by no means should be a criticism of the Obama administration's efforts: Any experienced business owner knows that it takes time to build up revenue and clientele when starting out. Why would it be any different for the businesses benefiting from the country's first national healthcare plan?

And premium increases are far from new under this healthcare exchange. In a 2012 decision, the Supreme Court determined that states could legally oversee their own healthcare exchange. And this contributed to big premium spikes in 2016. That's right -- spikes may be states' fault for failing to regulate insurance companies when they choose to separate from the feds.

Although YourHealthIdaho.org projected across-the-board increases of around 25 percent for 2016,  some residents in North Idaho received as much as a 400 percent markup last year that the site described as a "premium increase. " (Disclosure: This writer was one of them.) According to one insurance carrier, it wasn't the lack of enrollees that forced companies to raise rates. In fact, it was the popularity of the healthcare marketplace and cost of providing health and wellness checkups that caused rates to spike. Of course, these are the very issues that insurance carriers claim should lower costs for both the insurance company and the patient.

But with all this water under the bridge, premium increases may not be the real issue of concern. According to U.S. Department of Health and Human Services Secretary Sylvia Mathews Burwell, the rising costs aren't just due to the fact that carriers are still "trying to adapt" to the national mandate or that they are forced to compete "according to price and quality." "Efforts to undermine the ACA, such as certain states’ decisions not to expand Medicaid and Congressional actions to block funding for the law, contribute to higher premiums as well," Burwell said.

I wonder if Burwell shouldn't have added to that many of the states that did not expand Medicaid have some of the greatest problems in making sure insurance premiums remained stable or affordable. Idaho Health is careful to tell prospective enrollees, "The Idaho Department of Insurance does not have the authority to disapprove or establish insurance rates." It can negotiate with insurance companies, and it can say whether it feels rate increases are justified in its view. But in the end, the insurance carrier has the final say about what it charges.

And as consumers discovered in Arizona -- where rates are expected to rise 116 percent next year, including in areas served by only one or two carriers -- affordability once again is dependent upon state oversight and advocacy on the part of the consumer.

It is consumers' right to expect health coverage won't discriminate against certain age groups that may be more vulnerable to health issues. This includes states that historically fought to keep the ACA from being enacted. In 2010 Arizona joined forces with 25 other states to sue the newly established Act. The states argued, among other things, that Congress was exceeding its authority under the Federal Commerce Clause. The eventual outcome was more say for states in regulating their own healthcare marketplaces. But did it help consumers ensure they could afford health care? Apparently not.

On the eve of one of the most contentious elections in history, consumers are left wondering why the healthcare provisions that were designed to keep insurance affordable are being undermined by rate increases. Maybe it's not the federal government that needs to step up to address consumers' expectations, but the states that will once again be forced to absorb greater overhead if consumers can't afford to buy adequate health insurance.

Image: Flickr/Philippe Put

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