Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.

Input: Consider Input: The first Democrat-only televised debate is Wednesday, a natural forum for the three candidates to tout their agendas to a broader audience after several weeks of unveiling fresh items. Gretchen Whitmer, Shri Thanedar and Abdul El-Sayed agree on many issues, like raising the minimum wage to $15 an hour, spending much more on roads and other infrastructure, shutting down twin oil pipelines in a waterway linking two of the Great Lakes and repealing the state’s emergency manager law. But there are some differences that are being emphasized more in the stretch to the Aug. 7 election. El-Sayed, Detroit’s former health director, has proposed a plan to provide all Michigan residents with government-financed “Michicare” until they reach Medicare age, including 600,000 who have no insurance. He hopes to make it a “wedge issue,” especially with Whitmer, who has not embraced the single-payer concept and whom he has criticized for accepting campaign donations from the political action committee of Blue Cross Blue Shield, the state’s dominant insurer. “Health care is a human right,” he said, contending that raising taxes to fund the Medicare-for-all-style system while eliminating premiums, deductibles and copays would save both residents and businesses overall. Whitmer is expected to announce her own health care plan before the primary and most recently has rolled out education and economic proposals while also focusing on her mantra to “fix the damn roads.” The former Senate minority leader frequently points to her role in the bipartisan expansion of Medicaid to more than 600,000 adults, including in a TV ad that is airing. “She’s the only candidate in the race who has actually expanded coverage for Michiganders,” said spokesman Zack Pohl. El-Sayed, who is courting the party’s liberal wing and in recent days outlined a plan to address high auto insurance premiums, proposes paying for Michicare with a 2 percent or 2.25 percent gross receipts tax on businesses, depending on their size, with the first $2 million exempt from taxation. He also would effectively raise the state’s 4.25 percent personal income tax to between 5 percent and 8 percent, via a graduated payroll tax. Thanedar, a multimillionaire businessman, also supports a universal, single-payer system but has not elaborated. He is recommending tax increases to fund signature facets of his economic plan — expanding child care subsidies to cover 345,000 additional low-income children, ten times more than now, and paying for 78,000 more 3- and 4-year-olds to attend preschool. He says the moves would allow thousands of women to re-enter the workforce and improve students’ educational outcomes. He wants to boost the 6 percent corporate income tax to 7.5 percent for businesses with at least $350,000 in gross receipts and assess a 10 percent tax on the portion of receipts exceeding $1 million. He also would assess an 8.85 percent personal income tax for individuals earning at least $200,000 and a 10 percent rate for millionaires. Households with less than $50,000 income would pay no income tax. “We are one big family. We need to chip in to make it helpful to the ones who need help,” Thanedar said during a recent joint Democratic-Republican debate on Mackinac Island. Both he and El-Sayed, if elected, would face steep obstacles, including a Republican-led Legislature — unless power shifts — and the constitutional requirement that voters approve a graduated income tax. Whitmer, with an eye toward the general election, has been more pragmatic — focusing on what her camp says is actually achievable in the current budget and political environment. While not ruling anything out, she has not called for changes to business or income taxes and has proposed repealing the taxation of retirement income that was enacted as part of a GOP-written tax overhaul. She pledges to work with lawmakers to fund an infrastructure bank to upgrade roads through user fees such as higher fuel taxes or, if that is unsuccessful, to ask voters to approve bonding. Thanedar wants to borrow money, while El-Sayed also proposes an infrastructure bank funded with increased fuel taxes and other revenue-raising mechanisms. The centerpiece of Whitmer’s jobs plan is providing a two-year maximum $3,040 annual scholarship to high school graduates who attend an in-state university, community college or receive technical training, as long as they do community service, maintain a certain grade point average and have a good attendance record. The estimated cost is $100 million a year. “It’s about creating a path for everyone in to a high-wage skill,” she said. ___ Online: Policy plans for — El-Sayed: https://abdulformichigan.com/issues — Thanedar: https://www.shri2018.com/ — Whitmer: https://www.gretchenwhitmer.com/issues/ ___ Follow David Eggert on Twitter at https://twitter.com/DavidEggert00 . His work can be found at https://apnews.com/search/David%20Eggert

Output: Democrats unveil new policies before gubernatorial primary.


Input: Consider Input: Clearly, the costs involved in cancer treatment already are high. By removing a layer of treatment from an estimated 40,000 patients, those costs would have to drop, but it is unclear from the story by how much. Also, it would have been worth mentioning whether this is likely to affect how insurance companies handle lymph node removals. The story did a good job providing some numbers on benefits, but we wish it had provided more and explained some things a bit more. It says, for example, “In 27 percent of the women who had additional nodes removed, those nodes were cancerous.” How many women had additional nodes removed and, of those, how many had cancerous nodes? A figure like 27% means 1 out of every 4 women had nodes that were, indeed, cancerous, which seems to conflict with other statements in the story about chemotherapy and radiation wiping out the cancer. The story discusses several harms from lymph node removal, and shows that the difference in survival for women who had nodes removed and those who did not was not significant. “Indeed, women in the study who had the nodes taken out were far more likely (70 percent versus 25 percent) to have complications like infections, abnormal sensations and fluid collecting in the armpit. They were also more likely to have lymphedema.” This is where the story really outperformed some of the competition covering the same news. It placed the study into the broader context of a movement in cancer care away from surgeries that don’t provide a clear benefit, and it also explained the study design and the limitations of the study in several ways. “The study, at 115 medical centers, included 891 patients. Their median age was in the mid-50s, and they were followed for a median of 6.3 years. … One potential weakness in the study is that there was not complete follow-up information on 166 women, about equal numbers from each group. The researchers said that did not affect the results. A statistician who was not part of the study said the missing information should have been discussed further, but probably did not have an important impact. It is not known whether the findings also apply to women who do not have radiation and chemotherapy, or to those who have only part of the breast irradiated. Nor is it known whether the findings could be applied to other types of cancer.” It was too bad that it did not mention limitations in terms of lack of enrollment. The targeted enrollment was 1900. There also was an imbalance in the randomization that should have been mentioned. The story is careful to explain to readers that the research findings only apply to a subset of women with breast cancer. “Now, researchers report that for women who meet certain criteria — about 20 percent of patients, or 40,000 women a year in the United States — taking out cancerous nodes has no advantage. It does not change the treatment plan, improve survival or make the cancer less likely to recur. And it can cause complications like infection and lymphedema, a chronic swelling in the arm that ranges from mild to disabling.” The Q&A that ran with the story provided more detail about the different types of cancers and cancer patients, noting, for example, “First of all, 20 percent (the estimate of the study’s lead author, Dr. Armando E. Giuliano) refers to 20 percent of all the newly diagnosed cases of invasive breast cancer each year. This does not include noninvasive breast cancer, or DCIS, ductal carcinoma in situ. The total is about 207,000, so 20 percent is roughly 40,000 women. That is about how many women would match those in the study, in terms of tumor status, affected lymph nodes and course of treatment.”  The story also says, “The results mean that women like those in the study will still have to have at least one lymph node removed, to look for cancer and decide whether they will need more treatment. But taking out just one or a few nodes should be enough.” Good quotes including from Dr. Monica Morrow, chief of the breast service at Sloan-Kettering and an author of the study, but also a few fromindependent experts toward the end. Dr. Grant W. Carlson, a professor of surgery at the Winship Cancer Institute at Emory University, and the author of an editorial accompanying the study, provides some soul-searching context by saying that, in taking out so many lymph nodes, “I have a feeling we’ve been doing a lot of harm.” Dr. Elisa R. Port, the chief of breast surgery at Mount Sinai Medical Center in Manhattan, said, “It’s definitely practice-changing.” And Dr. Alison Estabrook, the chief of the comprehensive breast center at St. Luke’s-Roosevelt hospital in New York said, “In the past, surgeons thought our role was to get out all the cancer. … Now he’s saying we don’t really have to do that.” The story does a great job explaining the history of this form of treatment and how it has evolved over time. “But doctors have continued to think that even microscopic disease in the lymph nodes should be cut out to improve the odds of survival. And until recently, they counted cancerous lymph nodes to gauge the severity of the disease and choose chemotherapy. But now the number is not so often used to determine drug treatment, doctors say. What matters more is whether the disease has reached any nodes at all. If any are positive, the disease could become deadly. Chemotherapy is recommended, and the drugs are the same, no matter how many nodes are involved.” The story goes on to do something that stories like this rarely do, it compares compares the harms from different forms of treatment, saying “After armpit surgery, 20 percent to 30 percent of women develop lymphedema, Dr. Port said, and radiation may increase the rate to 40 percent to 50 percent. Physical therapy can help, but there is no cure.” The story makes it clear that removing all under-arm lymph nodes is the standard of care for women with breast cancer and that feelings about that standard are entrenched. The story establishes that a change in treatment protocol away from removing all the lymph nodes under the arms of women with breast cancer would be novel. There is some nuance, here, though that could be missed by a casual reader. Women who have one to two positive lymph nodes would avoid having additional lymph node surgery. The overall tone of the story may make it appear to some readers that women get to avoid lymph node surgery altogether, but they don’t. The story goes well beyond any news release.

Output: Lymph Node Study Shakes Pillar of Breast Cancer Care


Input: Consider Input: "Newly minted Senate Minority Leader Chuck Schumer, D-N.Y., blasted the incoming administration for already abandoning campaign pledges in an interview on MSNBC. For example, he pointed to Rep. Tom Price of Georgia, an orthopedic surgeon and President-elect Donald Trump’s nominee to lead the Department of Health and Human Services. ""Price, the guy from HHS, Donald Trump said when he campaigned he wouldn't cut Medicare and Social Security, but he turns around nominates as his HHS secretary, guy who made his career on cutting Medicare and Medicaid,"" Schumer said on Jan. 3’s Rachel Maddow Show (around the 14:10 mark). ""We’re going to slam him on these things."" Trump certainly promised to keep health care programs for seniors (Medicare) and the poor (Medicaid) intact and to protect Social Security (which doesn’t fall under HHS’ jurisdiction). But what about Schumer’s characterization of Price’s record on the health care programs? Price has supported reducing the government’s role in Medicare and Medicaid and reducing spending on the programs. That would be a major change of course from how the programs ran under the Obama administration. Trump’s pledges Throughout the course of the 2016 election, Trump largely promised to protect or save Social Security and Medicare and instead to crack down on waste and fraud, with a few detours. Trump tweeted that he would leave all three safety nets intact in May 2015, a month before he made his official presidential announcement (in which he said the same thing). During the election, Trump continued to promise to protect Social Security and Medicare during debates, numerous campaign events, multiple interviews and campaign ads. He even seemed to suggest expanding Medicare or Medicaid in some instances and (falsely) accused Hillary Clinton of wanting to cut them. Post-election, Trump’s incoming chief of staff said Trump intends to keep those promises. Trump’s health care plan, released in March 2016, proposed to turn Medicaid into a ""block grant"" program but didn’t specify what that would look like. (Typically, block grants set a cap on the amount of federal funding to states for Medicaid instead of the current structure of the federal government matching state spending.) Price’s career A doctor and staunchly conservative policy wonk, Price has made health care one of his legislative priorities in his 20-year stint as a public servant. Price, who had his own orthopedic clinic in northern Atlanta, first ran for state office in 1996. During his time in the Georgia State Senate from 1997 to 2005, he sponsored legislation ""to increase patient choice, enact Medical Savings Accounts, and reform the Medicaid system,"" according to his Georgia legislature biography. In 2006, he ran for and won former Republican House Speaker Newt Gingrich’s old seat, spurred at least in part from outrage over the rising cost of malpractice insurance (tort reform is another pet issue of Price’s). Price has focused on reducing government oversight of health care and shifting to more private insurance. The first piece of legislation he introduced was a resolution ""recognizing the need to move the nation's current health care delivery system toward a defined contribution system,"" which would be a move away from employer-provided coverage as it exists today. He also sponsored bills to increase Medicare payments to doctors, allow doctors to enter into private contracts with Medicare beneficiaries and charge the program for their services,  and called for implementing cost-saving measures in Medicare and Medicaid. After Obama’s election, Price emerged as one of the leading opponents of the president’s signature Affordable Care Act. ""While the stated goal (of health care reform) remains noble, as a physician, I can attest that nothing has had a greater negative effect on the delivery of health care than the federal government’s intrusion into medicine through Medicare,"" Price wrote in a 2009 column in Politico that advocated for ""a third way that puts patients in charge."" He has introduced a plan to repeal and replace Obamacare every legislative session since 2009. Price’s Empowering Patients First Act instead provides tax credits to help pay for private insurance plans and expands health savings accounts. The Price plan also allows for people to opt out of Medicare and Medicaid (and other government-run health programs) and choose the tax credits to purchase private plans instead. It folds in his previous advocacy of private contracting between Medicare beneficiaries and doctors. Beyond his own proposals, Price supported Paul Ryan’s 2011 budget plan, which would have eventually moved Medicare toward private insurance by giving people under 55 voucher-like tax credits to purchase plans. This is also called premium support. When he became chairman of the House budget committee, Price was the primary author of a budget for fiscal year 2016  that included $900 billion in spending reductions to Medicaid (through block granting) and $148 billion to Medicare (by leaving the Obama administration’s cost-saving measures intact), according to the nonpartisan Committee for a Responsible Federal Budget. Price’s budget for fiscal year 2017 similarly sought: $1 trillion from Medicaid and $449 billion from Medicare. After Trump’s election, Price expressed optimism that lawmakers could overhaul Medicare in 2017. Did Price cut Medicare, Medicaid? For all of Price’s efforts to change Medicare and Medicaid and reduce spending, nothing actually came to fruition. Whether Price’s supported policies amount to ""cutting"" the health program or making it more market-oriented is a matter of debate, though he clearly wants to reduce the government’s role in Medicare. Schumer’s office pointed to Price’s comment on Medicare being government intrusion and his support for Medicare overhaul as evidence for Schumer’s claim. But a Trump transition team spokesman told us Price ""has long been a champion for strengthening Medicare for both current and future beneficiaries"" and believes that ""Medicaid provides a crucial safety-net for millions of Americans."" Experts, meanwhile, were divided over whether Price’s proposals amounted to ""cutting"" Medicare and Medicaid. The Center for Medicare Advocacy, a nonpartisan health care advocacy group, typically doesn’t weigh in on cabinet appointments but opposes Price’s nomination precisely because of his position on Medicare, said David Lipschutz, the group’s senior policy attorney. ""The policies he has advocated would significantly cut and alter Medicare,"" Lipschutz told us, listing Price’s support for a premium support model, opposition to allowing Medicare to negotiate prescription drug prices and advocating for private contracting between Medicare beneficiaries with physicians with Medicare footing the bill. Gail Wilensky, the former director at the Centers for Medicare and Medicaid under President George H.W. Bush, called Price’s comment on Medicare as government intrusion a ""gross exaggeration."" But Wilensky preferred to characterize Price as a supporter of Medicare reform. She added that like Price, she supports premium support as a model for Medicare reform, as do prominent Democrats Alice Rivlin, a health care policy expert who served under President Bill Clinton, and Bob Reischauer, a fellow at the left-leaning Urban Institute. Our ruling Schumer said, ""Donald Trump said when he campaigned he wouldn't cut Medicare and Social Security"" but his nominee for the Secretary of Health and Human Services ""made his career on cutting Medicare and Medicaid."" Price, Trump’s HHS pick, has supported reducing the government’s role in Medicare and block granting Medicaid, which would amount to spending reductions to both programs. While it’s clear these proposals would reduce federal spending on the health safety nets, experts say it’s not the same thing as gutting the programs entirely. Trump did pledge to leave Medicare and Social Security alone, and Price’s positions seem at odds with that. (It’s worth noting that Social Security isn’t administered by HHS)."


Output: "Charles Schumer Says Donald Trump campaigned on not cutting Medicare and Social Security, but his nominee for the Secretary of Health and Human Services, Tom Price, ""made his career on cutting Medicare and Medicaid."