instruction:
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.
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"Mitt Romney came to coal country on Aug. 14, standing before a crowd of miners in eastern Ohio and pledging to fight for their jobs. You could be forgiven if you thought this was much ado about 3,150 jobs -- the number employed directly by coal operations in Ohio, at least before two mines announced layoffs recently. But Romney’s greater point was about how coal fires so many power plants in Ohio and the region, and how, he says, environmental regulation from President Barack Obama’s administration threatens jobs at those plants, too. This could drive up the cost of electricity for every Ohioan, Romney said. This debate -- over the cost of electricity, the shift among power plants to natural gas, the environmental and health risks, the role the government should or shouldn’t play -- has been building for years. And after the event, the Obama campaign had a response, saying that Romney’s position on coal has changed substantially since he was governor of Massachusetts. ""Immediately after becoming governor, Romney condemned coal-fired plants, saying they kill people,"" said an Obama campaign news release. The claim was similar to one the Obama team made in a radio ad, and Obama reelection aides backed it with specific quotes Romney made in February, 2003, when Romney was the freshly elected governor of Massachusetts. The quotes: The Obama campaign also highlighted a Romney quote that had no lethal references but was just as strong. It came from a state of Massachusetts news releasein which Romney said:  ""If the choice is between dirty power plants or protecting the health of the people of Massachusetts, there is no choice in my mind. I will always come down on the side of public health."" Romney made each of these statements during a Feb. 6, 2003, showdown over the future of the controversial, coal-burning Salem Harbor Power Station. In 2001, Massachusetts passed new rules to reduce power plant emissions of nitrogen oxide, sulfur dioxide, carbon dioxide and mercury, to be phased in over several years. The mercury standard would not be finalized until 2004. Romney supported the rules, as he made clear repeatedly. Massachusetts singled out its most egregious polluters as the ""Filthy Five"" plants, including Salem Harbor. Public health and environmental scientists at Harvard studied the emissions from two of the plants in 2000 and concluded that Salem Harbor was responsible for 53 deaths, 570 emergency room visits, 14,400 asthma attacks and 99,000 incidents of upper respiratory symptoms -- all per year. As occurs with similar studies that health authorities cite, local residents and others who wanted to keep the Salem Harbor plant open (for jobs and tax revenue) disputed those figures, saying they resulted from unproven modeling. It turned out that the Harvard scientists had revised their figures in 2002, putting premature deaths from Salem Harbor’s pollution at 30 per year and reducing the number of emergency room visits to 400 and the asthma attacks at 2,000, according to the Boston Globe and the Boston Herald. But the scientists stood by the broader conclusion -- that emissions from dirty power plants can be deadly. The Harvard methodology has now been widely replicated and is respected by health scientists, according to several environmental authorities we spoke with. Romney appeared to accept their findings, too. In the above-mentioned news release, the commonwealth of Massachusetts quoted Romney in the third person on the danger factor:  ""Romney said that the Salem Harbor plant is responsible for 53 premature deaths, 570 emergency room visits and 14,400 asthma attacks each year. He also pointed out that coal and oil fired plants contribute significantly more air pollution than their gas fired counterparts, exacerbating acid rain and global warming."" This was in a news release issued by the governor’s aides, not some radical outside instigator. It was issued under the name of Romney, Lt. Gov. Kerry Healey and Romney’s development chief, Douglas Foy. According to the Boston Globe, Romney hired Foy from the  Conservation Law Foundation, or CLF, a leading environmental advocacy group in Massachusetts. The spat with Salem Harbor turned into a testy exchange that February day after Salem Harbor’s then-owner, Pacific Gas and Electric, sought an extension until 2006 to comply with Massachusetts’ emissions rules -- and plant supporters showed up to to demand that the governor back off. Romney was adamant that the company comply by 2004. His statements that day show how he felt: ""That plant kills people."" And to those including city officials who argued that this would cost jobs: ""I will not create jobs that kill people."" Based on some of the quotes, it might appear that Romney was speaking only about that single plant (which a new owner, Dominion, is phasing out, after which a subsequent third owner will build a natural gas plant there). That’s what we thought when we began looking into this. It is also what the Romney campaign told us in email. So was it accurate for the Obama campaign to imply that Romney’s words characterized his broader attitude toward coal emissions when he was governor? We kept looking, because people in the environmental community told us it was a valid claim. And the news release under Romney’s name suggested it as well. Romney spoke of plants, not just a single one, when he pointed out that coal and oil fired plants contribute significantly more air pollution than their gas fired counterparts, exacerbating acid rain and global warming. Still, to give him the benefit of doubt, what if he really just meant the Salem Harbor plant? Wasn’t that plant particularly egregious when compared with coal-fired plants under attack by federal regulators today? No, say environmentalists who include authorities from the CLF. Their claims are supported by U.S. EPA emissions data we verified independently. ""When he said that ‘this plant kills people,’ he was talking about a plant that produced pollution comparable to the emissions of plants in the Midwest,"" said Seth Kaplan, vice president for policy and climate advocacy at the conservation foundation. Jonathan Peress, an environmental and regulatory attorney who works for the CLF and was recently chairman of the American Bar Association’s air quality committee, added in a separate interview with PolitiFact Ohio that Romney promoted Massachusetts air standards that were almost identical to those the U.S. EPA wants to enforce -- and that Romney now criticizes. ""The levels of emissions that he was talking about were levels that were virtually identical to what the EPA has proposed,"" Kaplan agreed. ""He was steadfastly standing behind emissions reductions that are the same as those currently attacked."" To see if this was accurate -- that the emissions Romney decried were similar to or even weaker than those under current attack now by the EPA (whose rules Romney now attacks) -- we examined the emissions cuts that Massachusetts wanted and data on the level of sulfur dioxide and nitrogen oxides emissions at Salem Harbor and in the Midwest. The U.S. EPA keeps the information in its extensive Clean Air Markets database. Nitrogen oxides react with sunlight to create ozone and smog. Sulfur dioxide is tied to particulate matter and is considered particularly dangerous to health, said Jonathan Walke, a senior attorney with the Natural Resources Defense Council Action Fund. The level of both these substances was multiple times lower at Salem Harbor, even when Romney was trying to force the plant to reduce emissions, than at Eastlake in Northeast Ohio and several other Ohio plants we checked. Our comparisons included multiple years, including Salem Harbor in 2003 with Ohio plants in 2011. To compensate for differences in electricity output, number of boilers and hours of operation at different power plants, we checked the data for emissions per megawatt-hour. The pattern held. ""It’s all the same pollution, albeit in higher quantities in Ohio,"" Walke said. You might ask why we looked at Eastlake. It’s because FirstEnergy Corp. plans to shut down two of that plant’s boilers rather than spend heavily on scrubbers to comply with EPA rules. This is one of several coal-burning plants at the heart of the current jobs-versus-pollution debate, although Romney did not mention it specifically. It’s important to note that the rules on nitrogen and sulfur are not what is prompting the FirstEnergy shutdowns. New EPA rules on mercury and toxic metals are the cause of planned closures in Eastlake. The tougher limits won’t take effect until 2014. The EPA aims to cut mercury emissions by 79 percent. But as the Massachusetts governor, Romney supported mercury reductions in his state, too. In 2004, he signed off on a rule aiming to reduce mercury emissions by 95 percent by 2012. With Romney’s name on the letterhead, Massachusetts in May, 2004, issued a lengthy set of justifications for the mercury rule. Among them:  ""First, [new research] confirms and extends our understanding of mercury's harmful effects on learning, attention and other critical cognitive skills in children. Recent studies have found that children exposed to mercury levels may show signs of attention deficit disorder, impaired visual-spatial skills and poor coordination."" Romney was ""a champion"" of those mercury regulations, said Shanna Cleveland, a staff attorney with the Conservation Law Foundation. ""He was one of the reasons we got them through."" Time to clean up: Romney was discussing a specific power plant, Salem Harbor, when he said,  ""That plant kills people."" But the public record shows that his comments were part of a broad emissions-cutting program he embraced. And the power plant that he considered deadly had emissions that were no worse, and in many cases lower, than at Midwest plants that he would now wants left alone, citing the use of affordable and abundant coal. If one were to have supported the regulations Romney wanted in 2003, it’s fairly safe to assume that ""one would also support such things nationally,"" said Jonathan Levy, an environmental scientist at  Boston University and Harvard and co-author of the now heavily replicated study on the correlation between coal-burning power plants and respiratory health. The Obama campaign claimed that as governor, Romney condemned coal plants as killers. He spoke at times of a single plant, but at other times made clear that other plants also needed to cut emissions for the sake of public health. This even included new rules for mercury reductions -- the same substance from coal plants that now is prompting closures in Ohio. The debate over coal involves calculations of costs, the abundance or scarcity of natural resources, health and environmental risks, and attitudes about government regulation. It is not our role to say Romney was right or wrong at one time. But with additional information from emissions data, interviews and the public record of his governorship,  the Obama campaign claim about Romney’s coal position of nine years ago is nearly as clear as a haze-free day. On the Truth-O-Meter, it rates ."
answer:
"Barack Obama Says that as Massachusetts governor, Mitt Romney ""condemned coal-fired plants, saying they kill people."


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- Frustration over limited time spent with patients. - Inordinate amounts of time inputting required data. - Side effects including high levels of stress. The patient? Herself. The remedy? “I did the research and found direct primary care,” said Anderson-Elder of Windsor. And in June she joined Dr. Frank Morgan at Balance Health in Greeley, a direct primary care clinic he founded four years ago in Greeley. Leaving her family practice at UCHealth Medical Clinic in Windsor after seven years wasn’t an easy decision, she said, but it was the right decision for her. Many physicians — from all specialties — share Anderson-Elder’s frustration and levels of stress incurred while working in insurance-based health care systems. In the 2018 Medscape National Physician and Depression Report, 42 percent of family physicians admitted to having burnout or depression, listing “too many bureaucratic tasks (charting, paperwork)” and “too many hours at work” as the leading factors in burnout. Although direct primary care has been around for some time, it is just now gaining a toehold with both physicians contemplating the switch to a different way of providing care and patients willing to give it a shot, so to speak. In 2017, there were more than 600 direct primary care clinics in the U.S., 10 percent of those in Colorado, according to the Colorado Independent. Anderson-Elder said in her research she found 1,000 out of the 80,000 family doctors practicing in the U.S. have gone the direct primary care route. DIRECT PRIMARY CARE What is direct primary care? And why the interest? First and foremost, the major difference is that direct primary care does not accept insurance. Patients instead pay a monthly membership fee that includes unlimited visits, calls and emails, along with many routine services and access to prescriptions and lab work at a reduced cost. For the physician, it means quality time spent with patients and no more time filling out paperwork to satisfy health insurance company regulations. What the monthly fee is varies from clinic to clinic. At Balance Health, it is $99 for adults, $180 for couples and $30 for children. Those who sign up for direct primary care are asked to sign an annual contract but can be released from it with 30 days’ notice, Anderson-Elder said. “We want to be accessible to our patients. We don’t want them to go to urgent care or ER if they don’t have to,” she said. And yes, that includes calls at 3 a.m., but if it can wait till morning, the patient is worked into that day’s schedule. Anderson-Elder typically sees eight to 17 patients per day, depending on whether it’s cold and flu season. And she spends as much time as needed with them. At her previous practice, she was limited to spending 15 to 20 minutes per patient. “People service their cars,” she said. “They should do the same thing with their bodies. You should be looked at and tuned up.” While most people think of going to the doctor only when they don’t feel well or need a physical for work or school, Anderson-Elder said she likes to see patients even when they feel healthy so she can check in on their well-being and talk about proper nutrition. “Oftentimes patients think they’re healthy, but then we do an exam and sometimes find things,” she said. Direct primary care works best when combined with a high-deductible health plan, Anderson-Elder said, for those times when unexpected surgeries are scheduled and for patients who suffer from chronic illnesses. But she said about one-third of her patients have no health insurance at all. She also noted direct primary care should not be confused with concierge medicine, which also provides direct access to providers for a flat fee but still bills insurance companies for services provided. Another key distinction between the two is direct primary care is mentioned in the Affordable Care Act as an acceptable option for receiving medical care without insurance, while concierge medicine is not, according to the American Academy of Family Physicians. And last year, Colorado Gov. John Hickenlooper signed Colorado HB17-1115, which establishes that direct primary health care can operate without regulation of the division of insurance. Windsor Republican Rep. Perry Buck was a primary sponsor of the bill. Patients at Balance Health also can tap into other healthy-living services for additional fees. Dr. Dana Morgan, a family care physician, specializes in bioidentical hormone replacement therapy. Balance Health also has a small fitness gym replete with trainers and classes. Wellness coaching also is offered. Leaving her practice in Windsor, though a hard decision, has been the right prescription for her, she said. “I no longer take paperwork home,” she said. “I’m happier and less stressed.” ___ Information from: The Tribune of Greeley, Co, http://greeleytribune.com
answer:
Windsor doctor joining direct primary care movement.


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Under the agreement, Emergent BioSolutions will no longer enforce a contract that had allowed it to be the only company to develop a nasal spray version of the drug nalmefene for use as an antidote in a nasal spray. The attorney general’s office said the new agreement came after it found that Adapt Pharma, which has since been bought by Rockville, Maryland-based Emergent, had the exclusive rights to sell the drug using Aptar Pharma’s nasal spray technology. The drug is still in the pipeline and is not on the market, though. “Given the tragic, devastating effects of the opioid crisis, and the urgent need for additional drugs for the emergency treatment of opioid overdoses, my office will do whatever possible to ensure that there are no unnecessary impediments to the development of additional life-saving opioid overdose reversal drugs,” Attorney General Letitia James said in a written statement. The agreement with James’s office does not affect Narcan, a spray version of the drug naloxone now sold by Emergent. That from is popular for police, firefighters and others to use to try to revive people who are overdosing. It is not subject to an exclusivity agreement on the spray technology. Narcan retails for about $140 for two doses, but the company sells that amount to first responders for $75. More than 400,000 deaths in the U.S. since 2000 have been linked to opioids, a class of drugs that includes heroin, fentanyl, and prescription painkillers such as Vicodin and OxyContin. Companies would still need Food and Drug Administration approval before their products could be on the market. There is at least one effort to introduce a generic version of a naloxone nasal spray. Purdue Pharma, the maker of OxyContin, announced a grant in 2018 for a nonprofit drug company to develop one. ___ This story has been updated to correct that the drug at the center of the agreement is a spray version of nalmefene that is under development, not naloxone. It also clarifies that Narcan is sold to first responders for a lower-than-retail price.
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Deal will let more companies make an overdose antidote spray.