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Tencent gains approval to sell mutual funds to WeChat users
 Traditional finance houses now being seriously challenged in the wealth management market by emerging internet financial companies

Output: Tencent has been granted a licence from the China Securities Regulatory Commission to sell third-party mutual funds directly. The development will allow the company to make better use of its popular messaging app WeChat to sell investment products, analysts have noted. WeChat has close to one billion users. The firm will now have more control over wealth management services offered via WeChat, rather than relying on third-party partners, analysts added. It's also predicted Tencent could seek to turn its payment service, Tenpay, into a full financial service platform. The company previously obtained licences for mobile payments, insurance and micro-financing.


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India testing blockchains in education, health, corruption fight
 Niti Aayog explores blockchain usage in education, health and agriculture

The Indian government's policy think tank, Niti Aayog, is testing waters to employ blockchain technology in education, health and agriculture, several media reports stated.

The top government think tank is developing a proof of concept to take advantage of the new technology in key sectors, a senior government official told The Economic Times on condition of anonymity.

The think tank along with blockchain startup Proffer, which was founded by MIT and Harvard graduates, held a blockchain hackathon from 10 November to 13 November 2017 at IIT Delhi, a report in YourStory said in November last year.

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About 1,900 students from the IITs, MIT, Harvard University, UC Berkeley College of Engineering, and top engineering institutions around the world participated in the event. AgroChain, a blockchain-based marketplace that helps farmers and consumers through co-operative farming, bagged the first prize at the competition, the report added. The marketplace was developed by students from the Indian Institute of Information Technology and Management-Kerala (IIITM-K).

Niti Aayog has also been working on developing a country-wide blockchain network called IndiaChain which looks to reduce corruption and frauds, maximise transparency of transactions, report in November 2017 in technology news website Factor Daily had stated. The think tank is also expected to connect the blockchain infra to IndiaStack—the country's digital identification database, the report added.

Blockchain technology uses cryptographic tools to create an open and decentralised body of data, which can include banks transactions and the like. The data record can be verified by anyone involved in the transaction and information can be tracked via a secure network.

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Output: India is testing blockchain applications in education, health and agriculture, among other sectors of the economy, and is working on a proof-of-concept platform, according to an anonymous senior government official. Government think tank Niti Aayog co-hosted a blockchain hackathon alongside start-up Proffer in November. Reports the same month revealed the think tank was also developing a fraud-resistant transaction platform called IndiaChain, which is expected to be linked to national digital identification database IndiaStack.


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Higher living wage risks robot takeover of low-paid jobs: report
 Increases in minimum wage levels risk raising the pace of mechanisation in the workplace, according to the Institute for Fiscal Studies (IFS).

A report for the economic think tank urges "extremely careful" monitoring of wage rates over the coming years as statutory pay goes up and employers look to cut costs.

The National Living Wage, which applies to workers aged 25 and over, is set to rise to £7.83 per hour from April from a current rate of £7.50.

Current ambitions will see it hit 60% of median wages in 2020 - around £8.56 if forecasts prove accurate.

Please use Chrome browser for a more accessible video player 2:14 Could robots replace human workers?

The IFS said those set to be brought within the minimum wage net in 2020 are more than twice as likely to be in the 10% most "routine" occupations as those who were directly affected by the minimum wage in 2015.

It said that leaves roles such as retail cashiers and receptionists at the mercy of potential automation. However, the report admitted the future was "uncertain" and that the loss of some jobs to automation could open other opportunities.

The report was released after a separate study in the summer warned that 15 million UK jobs "could disappear due to technological disruption".

IFS research economist Agnes Norris Keiller, who wrote the study, said: "The fact that there seemed to be a negligible employment impact of a minimum at £6.70 per hour - the 2015 rate - does not mean that the same will be true of the rate of over £8.50 per hour that is set to apply in 2020.

"Beyond some point, a higher minimum must start affecting employment, and we do not know where that point is."

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She added: "Meanwhile even higher rates, as proposed for example by the Labour Party, would bring even more employees in more automatable jobs into the minimum wage net."

Shadow business secretary Rebecca Long Bailey said: "Technological change, if harnessed effectively, could bring about immense benefits - transforming jobs and workplaces and driving up productivity and living standards.

"All workers should be paid a full and fair wage, which is why Labour has pledged to introduce a Real Living Wage of at least £10 an hour by 2020, as well as support for smaller businesses to pay it.

"Labour will invest in our country's future, new technologies, our businesses, our infrastructure and people. Higher wages, good jobs, greater investment in skills and technology to boost productivity and high employment all goes

together. They are complements, not trade-offs."

A Government spokesman responded: "The National Living Wage is creating a stronger economy and a fairer society, having delivered the fastest pay rise for the lowest earners in 20 years.

"But we also want to create highly-skilled, well-paid jobs for the future, backing innovation and supporting the development of new skills through our Industrial Strategy.

"That's why the Government is working with industry to ensure the benefits of new technologies are felt across different sectors and regions."

Output: The UK Institute for Fiscal Studies has warned that a higher National Living Wage brings with it the possibility of more jobs being automated, as employers look to keep costs down. The current £7.50 ($10.18) hourly rate is set to rise to £7.83 in April and could rise to £8.56 by 2020. IFS research economist Agnes Norris Keiller said there was a "negligible impact on employment with the 2015 hourly rate of £6.70 and added: "beyond some point, a higher minimum must start affecting employment, and we do not know where that point is".


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Regus WeWork may seek stock-market flotation this year
 Depending on whom you ask, WeWork is either a brilliant company that is re-imagining office space and the modern workplace, or a glorified, overvalued real estate play with no sustainable competitive advantage.

One thing is clear: The start-up is making waves in the business world and real estate market as it now commands a valuation of $21 billion, up from $18 billion earlier last year, just eight years after its founding in 2010. It's received investments from the likes of Softbank, Fidelity Investments, and JPMorgan Chase along the way.

Last year was a big one for the co-working specialist as the company made a number of acquisitions, taking over Meetup, The Flatiron School, and Spacemob, among others, and making a splashy real estate play with its $850 million purchase of the Lord & Taylor flagship building on Manhattan's Fifth Avenue, which will become the company's new headquarters.

With WeWork's valuation north of $20 billion, revenue on track for over $1 billion last year, and a pedigree as a disruptor, it's not a surprise that investors would be anticipating the company's IPO (initial product offering). Co-founder Adam Neumann reiterated last summer that the company plans to go public.

Before we explore whether WeWork will debut on the market this year, let's take a look at how far the company has come.

What is WeWork?

Like Airbnb or Uber, WeWork is a company distinctly of the mobile and digital era. The internet has rewritten the norms of white-collar work, allowing those in industries like media, design, and tech to work from anywhere with an internet connection.

WeWork capitalized on this shift by creating workspaces that cater to freelancers, entrepreneurs, and small businesses looking for customizable office space and the community that a WeWork hub fosters. The company leases office space and redesigns it to attract millennials in the knowledge economy as well as others looking for office space.

Founders Neumann and Miguel McKelvey started a similar business in 2008 in Brooklyn called Green Desk, as an eco-friendly co-working space, which paved the way for WeWork after they sold Green Desk to their landlord in 2010. Making community the central focus, the pair opened the first WeWork in New York in April 2011. Today, WeWork is growing quickly, with its locations nearly tripling over the last year, and the company now has 275 locations across 59 cities around the world. WeWork is even experimenting with living spaces with WeLive, which has two locations, one in New York and one in Washington, D.C., and offers short- or long-term housing in community-focused microapartments based on the WeWork model.

Will 2018 be the year?

While the company has given no indication of when it would issue an IPO, there's good reason to think that WeWork could go public this year. The company said last year it would reach the key milestone of $1 billion in annual revenue, nearly doubling sales from a year ago. The stock market -- especially tech stocks -- is strong, as the Nasdaq jumped 28% last year and the valuation of the S&P 500 is as high as it's been since the tech bubble. Not all IPOs have been winners lately, as Snap Inc and Blue Apron were duds, but WeWork looks like the type of company -- the clear leader in a new industry and demonstrably profitable on a unit business -- that would generate excitement among investors. When it opens a new location, WeWork says it takes a loss for the first few months, but locations are generally profitable nine months after opening.

Having just scored a $4.4 billion investment from Softbank in August, WeWork may not necessarily need the cash that would come with an IPO, but the company has been expanding fast and spending money to boot with its $850 million purchase of the Lord & Taylor building and its $200 million acquisition of Meetup in November 2017. If the company seeks more such acquisitions, tapping the public markets may be its best option for a cash influx.

WeWork may also want to be mindful of the lesson in Uber's travails as a private company; the ride-hailing specialist may have waited too long to go public as it's now saddled with a slew of image problems after a number of scandals, not to mention regulatory challenges. WeWork's reputation in that area remains spotless for now, but it needs to avoid mistakes that would potentially damage that reputation.

With the market roaring, investors hungry for new tech IPOs, and a strong economy pushing WeWork's growth, 2018 could be a great year for WeWork stock to go public.

Output: Co-working start-up WeWork may go public this year after its valuation rose to $21bn from $18bn in 2017. WeWork acquired a number of smaller companies in the past year, including Meetup and Spacemob, and also bought the former Lord & Taylor building on New York's Fifth Avenue for $850m to serve as its headquarters. Co-founder Adam Neumann confirmed last year that the company intends to go public, and with the stock market performing well for tech companies, 2018 appears a good time.


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AMD poised to gain market share as Intel pounded by chip flaws
 AMD is big winner from chip flaw fiasco as more than $11 billion in Intel stock value is wiped out 11:43 AM ET Fri, 5 Jan 2018 | 00:43

Investors are piling into AMD shares and selling Intel stock after major chip security vulnerabilities were revealed earlier this week, and it totally makes sense.

Enterprises will likely diversify their chip security architecture risk for mission-critical applications by buying more AMD server chips. The company's "architecture differences" have proven immune to the more problematic one of the two disclosed vulnerabilities.

British tech website The Register reported Tuesday that some Intel processors have a "fundamental design flaw" and security issue, which spurred the company to confirm the problem later in the day.

AMD shares are up 10.4 percent in the two days through Thursday following the report, while Intel's stock declined 5.2 percent in the period, wiping out $11.3 billion of shareholder value.

One of the two vulnerabilities, called Meltdown, affects Intel processors. The other, named Spectre, could affect chips from Intel, AMD and Arm.

Intel said Wednesday that performance degradation after security updates for Meltdown "should not be significant" for the average user. But on a call with investors, the company admitted a decrease in performance of up to 30 percent was possible after fixes under some "synthetic workloads."

Bank of America Merrill Lynch told clients the big Intel performance hits were "likely for enterprise and server workloads."

On the flip side, AMD said any performance hits will be "negligible" after Spectre-related security software updates and there is "near zero risk of exploitation." The company also confirmed it is not affected by Meltdown due to processor "architecture differences."

Researchers and Apple said Spectre is more difficult to exploit.

Multiple Wall Street analysts predicted AMD will take advantage of the Intel's security issues.

AMD could use it as "a marketing edge given differing architectures and no vulnerability yet," Mizuho Securities analyst Vijay Rakesh wrote in a note to clients Wednesday.

Intel's high-profit data-center business, which sells server chips to cloud computing providers and enterprises, is the chipmaker's crown jewel.

Rakesh noted that Intel had 99 percent market share of the data-center market, representing a huge opportunity for AMD.

Analysts estimate that Intel's data-center group will generate $18.5 billion in sales and $7.4 billion in operating profit in 2017, according to FactSet.

"Longer-term customers could be more motivated to find alternatives at AMD and possibly ARM (CAVM benefits) to diversify the architectural risks," Bank of America Merrill Lynch analyst Vivek Arya wrote Thursday. "AMD appears poised to be the most direct beneficiary."

An AMD gain of significant market share in the server market is not unprecedented. The company hit 25 percent share in 2006. If AMD is able to reach 10 percent or 15 percent market share of the data-center business, it could add billions in revenue to the company's financial results.

Any increase will be a boon for AMD because the Wall Street consensus for the company's 2017 estimated sales is just $5.25 billion.

One leading tech industry analyst says the chipmaker will do just that.

"The news of Intel's processor security issue and the potential performance degradation to correct it comes at an inopportune time as Intel currently faces heavy competitive pressure from its long-time nemesis, AMD," Fred Hickey, editor of High Tech Strategist, wrote in an email Thursday. "AMD's new line of chips is a significant challenger for the first time in many years (since AMD's Opteron chip days)."

AMD launched new line Epyc data-center processors to much fanfare last June with design wins at cloud computing providers Microsoft Azure and Baidu.

"For Intel, it likely means loss of market share (lower revenues) as well as loss of pricing power (lower gross margins) as the advantage shifts to the buyers and away from Intel, which has totally dominated the PC/computer server processor market in recent years," Hickey said. "AMD's new processor chips already had momentum and that momentum will likely be propelled further by the recent security issue disclosures."

Output: Intel has seen more than $11bn wiped off its market value following a report by The Register of two vulnerabilities in its microprocessors that could lead malware to stored password data. In contrast, shares in rival Advanced Micro Devices (AMD) rose 10% after the company said there was a "near zero risk of exploitation" despite its chips being affected by one of the vulnerabilities. Computers using Intel chips from the past 10 years could be affected, including those running Microsoft Windows and Apple OS X. AMD now has a chance to eat into Intel's 99% share of the data-centre market.


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Demand for cyber coverage rises 50% in India
 MUMBAI: About 250 companies, including some of the top staterun banks , have bought cyber insurance cover, which is 50% more than what was sold in the past year. With rising attacks, insurers expect robust future demand for cyber risk insurance in India.Today, cyber risk is the most discussed risk topic-area in board rooms. Marsh India, a Mumbai-based insurance broking firm with a large share in the cyber segment, saw a 50% increase in companies buying cyber security cover in 2017 compared with 2016.Cyber liability insurance has been around in the international markets for more than a decade. However, Indian insurers have started writing this business for only three years now. It covers losses arising from a cyber attack or incident of data breach. Mostly banks and ecommerce companies have been buying large covers.The size of cyber insurance premium is Rs 200 crore. It is expected to grow to Rs 400 crore in the next couple of years. There is huge demand for cyber insurance policies after the telecom revolution and various initiatives have pushed increasing digitisation of the economy. “Cyber insurance is going through a similar phase of active dialogue which we saw for Directors’ and Officers’ liability insurance in India 15 years ago,” said Sanjay Kedia, country head, Marsh India.“One major difference though is that the cyber risk incident is on the rise at a much faster pace, and the nature of risk is far more dynamic and possibly explosive in many situations.” In 2017, public sector lender Union Bank of India was hacked and a whopping $171 million was debited from the bank’s account through Society for Worldwide Interbank Financial Telecommunication or SWIFT payments without the bank’s authorisation.The money was retrieved after the bank acted with the help of government agencies. In 2016, card data of 3.2 million customers was stolen from a network of Yes Bank ATMs managed by Hitachi Payment Services. Banks in India had to reissue cards and faced a combined loss of more than $2 million after hackers allegedly penetrated the system that carried out the processing of ATM transactions. There have been cases of mobile phone applications of banks being hacked by cyber-criminals. The pilferage of personal information and money in digital wallets has cost banks crores of rupees.

Output: Demand for cyber insurance among Indian companies has spiked by roughly 50%, with around 250 top companies opting for coverage. Indian underwriters reportedly began offering such policies only three years ago. Increased popularity of this type of insurance comes following a 2017 hack on public-sector lender Union Bank of India. The attack resulted in $171m being debited from the bank's account without authorisation.


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Terror insurance spending up four-fold in UK public sector
 None

Output: The UK's public sector has increased its spending on insurance against terrorist attacks four-fold over the past 12 months. Roughly £56m ($76m) of contracts included terrorism coverage were underwritten in 2017, up from £14m in 2016. Recent attacks are said to have caused less physical damage than previous incidents. Business interruption from these attacks, however, has been notable, with insurers criticised for failing to get payouts to businesses impacted by last year's attack at Borough Market, losses from which are estimated to have been £1.4m.


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Land values for logistics and data centre hubs doubled in 2017
 A worker pulls carts full of customer orders along the floor inside the million-square foot Amazon distribution warehouse that opened last fall in Fall River, MA.

Land fit for future fulfillment centers for the likes of Amazon and Walmart saw huge spikes in prices last year, according to real estate services firm CBRE.

In a trend largely stemming from the growth of e-commerce players across the U.S., some plots of land now cost twice the amount they did a year ago, the group found. This is especially true in major markets, including Atlanta and Houston.

In surveying 10 U.S. markets, CBRE found the average price for "large industrial parcels" (50 to 100 acres) now sits at more than $100,000 per acre, up from about $50,000 a year ago.

Industrial land plots of five to 10 acres, which typically house infill distribution centers for completing "last-mile" deliveries, watched their prices soar to more than $250,000 per acre by the end of 2017, up from roughly $200,000 a year ago, according to CBRE. Located in more bustling metropolitan settings, these warehouses must help retailers serve consumers closer to their homes.

To be sure, industry experts say that despite an uptick in construction of late, there's still a long way to go before supply aligns with demand.

Output: The average price for large industrial plots of land of between 50 and 100 acres doubled last year from $50,000 to $100,000 per acre, thanks to increased demand for data hubs and distribution centres, according to a survey by CBRE. In an examination of 10 US markets, plots of between five and 10 acres, suitable for "last-mile" depots, cost $250,000 per acre by the end of last year, an increase of $50,000 on 2016. David Egan, the global head of CBRE's Industrial & Logistics Research division, said that demand is not likely to drop in the near future.


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Regus Birmingham breaks 1 million sq ft office take-up for first time
 Office take up in quarter four, 2017 in the central Birmingham office market totalled 354,530 sq ft in 49 deals as scheduled in the table below, compiled by the Birmingham Office Market Forum.

When added to the 81 deals totalling 650,542 sq ft recorded in the first three quarters of the year, the 2017 year-end total take up amounts to 1,005,072 sq ft in 130 deals.

This compares with:

692,729 sq ft in 139 deals for 2016

970,458 sq ft in 132 deals for 2015

713,460 sq ft in 148 deals for 2014

664,147 sq ft in 128 deals for 2013

The 2017 outcome is a record take up year, beating the previous high seen in 2015.

Office take up was boosted by the emergence of HS2 related demand together with the Government committing to the largest prelet seen in the city for a decade. In addition, key larger transactions were concluded in the Professional Services and the Serviced Office sectors.

Breaking 1 million sq ft office take up for the first time is extremely positive for Birmingham during the current period of unprecedented development activity and further regeneration, visible across the BOMF area. It is also particularly encouraging bearing in mind the slow first half of the year following on from the dip seen in the previous year’s total.

For further information please contact the author of the report Jonathan Carmalt, Director, Office Agency, JLL on 0121 214 9935 or email [email protected]

Birmingham Office Market Forum was established in 2007 to present a co-ordinated voice to investors, developers and occupiers about Birmingham’s city centre office market.

The Forum brings together the city’s leading office agents and Business Birmingham.

For a list of member firms or further information visit their website

Output: Office take-up in Birmingham during 2017 broke the one million sq ft barrier for the first time, in spite of a slow first half to the year, according to data from the city's Office Market Forum. The year saw a total of 130 deals and beating the previous record of 970,458 sq ft in 2015. The figures were given a fillip by demand linked to the planned HS2 high-speed rail link, and the UK government committing to the city's biggest pre-let in 10 years.


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UK insurers may cover health claims based on chatbot diagnosis
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People use chatbots to find homes, interact with their favorite brands, and schedule appointments. Many consumers are onboard with using chatbots to gather instant, personalized information.

In many cases, chatbots are the first point of contact for individuals who feel unwell and need to decide whether to head to the doctor. As this technology becomes more prominent, people understandably begin to wonder if insurance companies will cover sessions with chatbot doctors. Given their innovative use of chatbots in the health care sector, it’s looking like insurers and health organizations in the U.K. could be the first to establish insurance coverage for health consultations with chatbots.

How do chatbot doctors work?

People who have yet to interact with a chatbot doctor might wonder how they work. Could a bot know as much as physicians who have completed years of medical school and relevant work experience?

Sometimes, the chatbot makes a preliminary assessment about a person’s health depending on the responses the individual gives to targeted questions. One such chatbot called Ada is available to residents in the United Kingdom. The assessment is free, and the bot avoids providing a set-in-stone diagnosis. Ada uses artificial intelligence to get continually smarter with ongoing use.

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The developers know Ada won’t replace doctors but hope the bot will help more patients understand what their symptoms might mean. However, a person can also supplement the assessment portion by talking to an actual doctor. That option is offered for a fee and includes receiving a prescription if needed.

Individuals frequently head to sites such as WebMD and end up with a questionable self-diagnosis. This is why it makes sense that insurers would be open to the idea of paying for patient interactions that begin with chatbots. A bot’s ability to personalize its conversations with patients could theoretically yield a smaller margin of error and be less likely to provide misleading information.

Reducing emergency room visits

The U.K.’s National Health Service (NHS) is also trying out a chatbot that asks people a series of questions when they dial the nationwide emergency number to indicate whether or not they need an ambulance. Representatives hope the service will reduce the number of people dispatchers send to emergency rooms.

When too many callers are sent to the emergency room, patients wait in hospitals for several hours or even longer before receiving treatment. Those in favor of chatbots say the technology could keep emergency room visits at more manageable levels. In contrast, critics assert that the NHS previously used a symptom checker app that made highly publicized and dangerous blunders when advising some patients, and they think the same problems could occur with the chatbot.

The NHS provides free health care to legal residents of the United Kingdom that covers most needs, including emergency care and visits with general practitioners. However, the NHS assists over 1 million patients in England every 36 hours. People who rely on the NHS for health care often deal with long waits. To compensate, those who can afford them often subscribe to private insurance plans.

It will be interesting to gauge the outcome of this NHS program, especially considering how many people rely on the NHS. If things go well, the positive result could prompt insurance companies to accept claims from customers who receive advice from chatbots regarding their well-being.

How much are chatbots worth?

It remains to be seen if insurance companies in the United Kingdom and elsewhere will cover chatbot doctors. The evidence to suggest their willingness — or lack thereof — to do so is not available yet because the technology is too new.

One reason insurers might balk at the idea of paying for this kind of coverage is the need to determine the fair market value of compensation for such services. In some areas, health facilities use telehealth providers to reduce the need for on-call personnel. However, the relevant valuators in those locations must remain aware of federal and state laws surrounding telemedicine. If they fail to do so, over- or undercompensation could occur during the billing and collection processes.

Some telemedicine laws have not been in place for very long. Not surprisingly, many locations have not even considered chatbots in the equation.

Helping people understand their coverage

Although insurance companies haven’t made it clear whether they’re completely onboard with covering chatbots, it seems promising that some are already using chatbots to help customers achieve a higher level of understanding about their coverage packages.

For example, Now Health International is a company that provides health insurance for expatriates. The headquarters is in Hong Kong, and the establishment has other branches in Asia and the United Kingdom.

This summer, the insurance provider launched a chatbot through Facebook Messenger. Regardless of whether users are existing customers or are only thinking about purchasing coverage packages, they can use the chatbot to find physicians in the Now Health International network or get questions answered about filing claims and receiving quotes.

The chatbot can also recognize keywords entered by a user into the chat window. When it picks up on those words, the technology automatically directs the person to the proper area of the website for further information.

The increasingly widespread use of chatbots for health — including those provided by insurance companies — indicates that some insurers are laying the necessary foundation for covering chatbots in the future. However, it’s likely that before that happens, we must pass legislation clarifying the valuation-related questions that could arise during claims, billing, and other aspects.

As consumers become more comfortable with using chatbots to ask questions about their health or insurance, the increased prevalence of the technology in the marketplace could push officials to iron out the details. That would pave the way for insurance companies to clearly mention they accept claims related to treatment that involves chatbot doctors on their websites or insurance documents. Insurers may also stipulate that they will not offer coverage to patients who did not speak to actual doctors during their chatbot-driven conversations and only used the chatbots for preliminary advice.

Chatbots could drastically change how people manage their health care needs. Similarly, they could alter how doctors treat patients and how insurers handle the claims. Since the technology is in its infancy, however, it’s only possible to perform research and make educated speculations.

Kayla Matthews is senior writer for MakeUseOf. Her work has also appeared on Vice, The Next Web, The Week, and TechnoBuffalo.

Output: Machine learning chatbots – such as Ada, which helps UK residents make preliminary assessments about their health – could lead to insurance companies offering coverage for virtual consultations. Industry insiders have suggested that a chatbot's ability to personalise consultations makes them less likely to make mistakes, leading to less risk for insurers. The country's National Health Service is using a chatbot assessment service in an attempt to reduce A&E patient numbers.


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ETF shop Reality Shares adds blockchain experts to advisory board
 California-based asset management firm Reality Share Advisors announced on Wednesday its advisory board now includes six blockchain and cryptocurrency executives. The members are the following:

Erik Voorhees: The founder of Coinapult and CEO of ShapeShift.

The founder of Coinapult and CEO of ShapeShift. Dr. Garrick Hileman: A research fellow at the University of Cambridge and researcher at the London School of Economics.

A research fellow at the University of Cambridge and researcher at the London School of Economics. Jeff Garzik: The co-founder and CEO of Bloq, a blockchain enterprise software company.

The co-founder and CEO of Bloq, a blockchain enterprise software company. Matthew Roszak: The founding partner of Tally Capital, a private investment firm focused on blockchain-enabled technology.

The founding partner of Tally Capital, a private investment firm focused on blockchain-enabled technology. Steve Beauregard: The founder and former CEO of leading blockchain payment processor GoCoin.

The founder and former CEO of leading blockchain payment processor GoCoin. Derin Cag: The founder of Richtopia and co-founder of Blockchain Age, a research center and digital data consultancy for blockchain technology.

While sharing more details about the board, Eric Ervin, CEO of Reality Shares, stated:

“In recognizing the tremendous growth potential for blockchain technology while still in its infancy, this advisory board seeks to infuse our investment products and decisions with the knowledge and research of credible thought leaders in the space.”

Ervin then added:

“Our newly-formed advisory board is comprised of well-regarded influencers at the forefront of blockchain innovation who are deeply entrenched in the disruptive technologies and ideas propelling the distributed ledger and cryptocurrency revolution.”

Founded in 2011, Reality Shares is described as an innovative asset management firm, ETF issuer, and index provider. The firm noted that its goal is democratize the world’s best investing ideas, using systematic quantitative methods to deliver products and solutions that support a range of investing objectives, such as diversification, lower correlation, risk mitigation, or unique market exposures.

Output: Asset management company Reality Shares Advisors has appointed six blockchain and cryptocurrency executives to its advisory board to "infuse its investment products and decisions with the knowledge and research of credible thought leaders", according to CEO Eric Ervin. The appointees include Jeff Garzik, the CEO of blockchain enterprise software company Bloq, Derin Cag, co-founder of research centre Blockchain Age, and Steve Beauregard, former CEO of payment processor GoCoin. Reality Shares Advisors focuses on ETF and index investments.


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General Motors sales surge in China as US registers declines
 General Motors sells 70% more cars in China than in the US.

China's auto market growth has outpaced the US in the last decade, but is slowing.

In China, General Motors is hot. In November, its 10 joint ventures and two wholly-owned foreign enterprises sold 418,225 new vehicles in China, up 13% from a year ago. It was the best November ever, GM said. SUV sales soared 73%.

By comparison, in the US, GM sold 245,387 new vehicles in November, it reported a few days ago, down nearly 3% from a year ago. In other words, in November, GM sold 70% more vehicles in China than in the US.

China became the world’s largest new vehicle market for the first time in 2009, when sales in the US plunged. For years, growth rates in the Chinese market blew the doors off the US market. But the hectic pace has recently subsided. For 2017, deliveries are expected to rise only 2%, and competition from local automakers is getting tougher.

Buick is still hot in China – though it’s just about moribund in the US, where deliveries fell 3.5% year-over-year in November to just 16,833 vehicles, accounting for only 7% of GM’s total sales in the US. Of them, 2,228 were the China-made compact SUVs, the Buick Envision.

In China, Buick is still the fourth largest auto brand with a market share of just under 5% so far this year, behind Volkswagen, Honda, and Toyota. In November, GM sold 112,738 Buicks, or 27% of its total sales. But for the month, Buick was already outsold by GM’s Baojun.

Baojun is the hottest brand GM has in China. Sales of the bargain-priced vehicles soared 52% in November to 113,711 units, accounting for over a quarter of GM’s total sales in China.

GM launched Baojun in 2010, after the “New GM” had emerged from Chapter 11 bankruptcy in the US in July 2009, with Debtor in Possession (DIP) financing and equity investments from the US taxpayer. This support helped GM go on an investment spree in China, and, along with its joint-venture partner SAIC, plow $2.4 billion in the Baojun factory in Liuzhou, even as many former GM plants in the US had been shuttered and were disposed of in bankruptcy.

But GM owns only 44% of Baojun. With technology transfer to SAIC being a big part of the deal, this is a risky proposition. The Wall Street Journal:

Other foreign auto makers “are consistently taken aback by GM’s apparently generous technology sharing” when it comes to Baojun, said Michael Dunne, a former GM executive and now president of Dunne Automotive, a consultancy. “The open approach has engendered considerable goodwill but it also leaves GM vulnerable to the whims of its powerful Chinese partner.”

GM was less proud of its brand Wuling. It sold 113,919 units. GM does not brag about the year-over-year change in deliveries, as it does with Baojun. In fact, in the press release, there is no mention of this year-over-year change. Turns out, a year ago, GM had reported 121,566 sales in November. In other words, Wuling sales dropped 6.3% year-over-year.

Nevertheless GM gushed, while purposefully leaving out Wuling: “GM’s performance was strong across its brands. Baojun deliveries reached an all-time monthly high, while Buick, Cadillac and Chevrolet set November sales records.”

China-sold Buicks, Cadillacs, and Chevrolets are built by a 50-50 GM-SAIC joint venture. These vehicles tend to be more upscale than GM’s Chinese brands.

For the first 11 months this year, GM sold 32% more vehicles in China than in the US, with 3,549,087 units in China, up 3.3% year-over-year, versus 2,691,493 units in the US, down 1.2%, according to Autodata. 2017 will be the sixth year in a row when GM’s vehicle sales in China exceeded those in the US.

But it’s complicated. These are joint ventures, margins in China are thin, and in terms of profits, GM’s China operations don’t contribute all that much. For the year 2016, GM booked global profits of $9.4 billion, of which GM attributed only $2 billion to “equity income” at its joint ventures in China despite all the massive in vestments in China. Most of the remainder of its global profits came from its sales in the US, and mostly from the fat profit margins on pickups and SUVs.

Then there’s Tesla, with a market capitalization not much behind GM’s despite minuscule vehicle sales. This is where hype goes to die.

Output: Surging sales of General Motors cars in China meant the company sold 70% more vehicles there than in the US in November. China sales rose 13.1% last month, YoY, to 491,702 vehicles, having jumped 13% in November. US sales fell 3.3% to 245,387 last month after a 3% decline in November. The most popular GM brand in China is the Baojun, sales of which rocketed 52% in November to 113,711. However, GM only owns 44% of Baojun, with China's SAIC holding a large part of the deal. The Wall Street Journal warns that this "leaves GM vulnerable to the whims of its powerful Chinese partner".


Instruction: create a high quality summary of the given input

Input:
Ocean dead zones have quadrupled in size since 1950
 Ocean dead zones with zero oxygen have quadrupled in size since 1950, scientists have warned, while the number of very low oxygen sites near coasts have multiplied tenfold. Most sea creatures cannot survive in these zones and current trends would lead to mass extinction in the long run, risking dire consequences for the hundreds of millions of people who depend on the sea.

Climate change caused by fossil fuel burning is the cause of the large-scale deoxygenation, as warmer waters hold less oxygen. The coastal dead zones result from fertiliser and sewage running off the land and into the seas.

The analysis, published in the journal Science, is the first comprehensive analysis of the areas and states: “Major extinction events in Earth’s history have been associated with warm climates and oxygen-deficient oceans.” Denise Breitburg, at the Smithsonian Environmental Research Center in the US and who led the analysis, said: “Under the current trajectory that is where we would be headed. But the consequences to humans of staying on that trajectory are so dire that it is hard to imagine we would go quite that far down that path.”

“This is a problem we can solve,” Breitburg said. “Halting climate change requires a global effort, but even local actions can help with nutrient-driven oxygen decline.” She pointed to recoveries in Chesapeake Bay in the US and the Thames river in the UK, where better farm and sewage practices led to dead zones disappearing.

However, Prof Robert Diaz at the Virginia Institute of Marine Science, who reviewed the new study, said: “Right now, the increasing expansion of coastal dead zones and decline in open ocean oxygen are not priority problems for governments around the world. Unfortunately, it will take severe and persistent mortality of fisheries for the seriousness of low oxygen to be realised.”

The oceans feed more than 500 million people, especially in poorer nations, and provide jobs for 350 million people. But at least 500 dead zones have now been reported near coasts, up from fewer than 50 in 1950. Lack of monitoring in many regions means the true number may be much higher.

The open ocean has natural low oxygen areas, usually off the west coast of continents due to the way the rotation of the Earth affects ocean currents. But these dead zones have expanded dramatically, increasing by millions of square kilometres since 1950, roughly equivalent to the area of the European Union.

Furthermore, the level of oxygen in all ocean waters is falling, with 2% – 77bn tonnes – being lost since 1950. This can reduce growth, impair reproduction and increase disease, the scientists warn. One irony is that warmer waters not only hold less oxygen but also mean marine organisms have to breathe faster, using up oxygen more quickly.

There are also dangerous feedback mechanisms. Microbes that proliferate at very low oxygen levels produce lots of nitrous oxide, a greenhouse gas that is 300 times more potent than carbon dioxide.

In coastal regions, fertiliser, manure and sewage pollution cause algal blooms and when the algae decompose oxygen is sucked out of the water. However, in some places, the algae can lead to more food for fish and increase catches around the dead zones. This may not be sustainable though, said Breitburg: “There is a lot of concern that we are really changing the way these systems function and that the overall resilience of these systems may be reduced.”

The new analysis was produced by an international working group created in 2016 by Unesco’s Intergovernmental Oceanographic Commission. The commission’s Kirsten Isensee said: “Ocean deoxygenation is taking place all over the world as a result of the human footprint, therefore we also need to address it globally.”

Lucia von Reusner, campaign director of the campaign group, Mighty Earth, which recently exposed a link between the dead zone in the Gulf of Mexico and large scale meat production, said: “These dead zones will continue to expand unless the major meat companies that dominate our global agricultural system start cleaning up their supply chains to keep pollution out of our waters.”

Diaz said the speed of ocean suffocation already seen was breathtaking: “No other variable of such ecological importance to coastal ecosystems has changed so drastically in such a short period of time from human activities as dissolved oxygen.”

He said the need for urgent action is best summarised by the motto of the American Lung Association: “If you can’t breathe, nothing else matters.”

Output: Ocean dead zones, which contain no oxygen, have become four times larger since 1950, while the number of areas with very low oxygen close to coasts has increased tenfold, according to the first comprehensive analysis of these areas. Most marine species cannot exist in such conditions, and the continuation of such trends would result in mass extinction, endangering the livelihood of millions of people. Large-scale deoxygenation is the result of climate change caused by burning fossil fuels; as waters warm, they contain less oxygen.


Instruction: create a high quality summary of the given input

Input:
US public divided on online abuse: Pew
 Pew Research Center surveys have found that online harassment is a common phenomenon in the digital lives of many Americans, and that a majority of Americans feel harassment online is a major problem. Even so, there is considerable debate over what online harassment actually means in practice.

In an effort to examine more deeply where people “draw the line” when it comes to online harassment, the Center conducted a survey in which respondents were presented with fictional scenarios depicting different types of escalating online interactions. The survey then asked them to indicate which specific elements of the story they considered to be harassment.

Their answers indicate that Americans broadly agree that certain behaviors are beyond the pale. For instance, in various contexts most agree that online harassment occurs when people make direct personal threats against others. At the same time, the public is much more divided over whether or not other behaviors – such as sending unkind messages or publicly sharing a private conversation – constitute online harassment.

In two vignettes, respondents were asked if and when the social media platforms where the incidents were occurring should have stepped in and addressed the unfolding events. Again, majorities agree that the platforms should step in to address behaviors such as threatening messages. But public views are more split when it comes to the responsibilities of the platforms at other points in these incidents.

Scenario 1: A private disagreement between friends that becomes public and escalates in severity

People’s perceptions of online harassment incidents can often depend on who is involved in the conflict, as well as whether that conflict plays out publicly or in private. The first scenario in the survey presented respondents with an example of a private disagreement between a fictional character named “David” and his friend over a sensitive political issue. The conversation begins in a private messaging thread but then becomes public and escalates in severity:

“David and his friend are messaging privately about a sensitive political issue on which they disagree. David says something that offends his friend, who forwards the conversation to some people they know. One of those people shares the conversation publicly on a social media account, and David receives unkind messages from strangers. The original conversation is then reposted on an account with thousands of followers, and David receives messages that are vulgar. Eventually someone posts David’s phone number and home address online, and David starts to receive threatening messages.”

The vast majority of Americans (89%) agree that David does experience online harassment at some point in this conflict. Just 4% feel that he does not experience online harassment at least somewhere during the episode, and 7% say they are not sure if he was harassed or not. Although there are some modest demographic differences on this question, sizable majorities of Americans across a wide range of groups agree that this scenario as a whole does in fact involve online harassment.

When asked to identify which specific elements of the scenario they consider online harassment, only a small share of Americans (5%) think the initial disagreement when David offends his friend qualifies. The public is more evenly divided on the next two elements of the scenario: 48% think it constitutes online harassment when David’s friend forwards their private conversation to other people, while 52% do not deem it harassment. Similarly, 54% say it counts as harassment when someone then shares the conversation publicly on social media, while 46% think it does not.

There is relatively broad consensus on the remaining elements of the scenario. Substantial shares of Americans think David experiences online harassment when he begins to receive unkind messages from strangers (72%), when those messages become vulgar (82%), when his personal information is posted online (85%), and when he starts to receive threatening messages (85%).

Views of this scenario differ little based on the gender of the main character

The gender of the scenario’s lead character has little impact on Americans’ perceptions of whether online harassment did or did not occur in this situation. A separate group of respondents was given an identical scenario to consider but with a woman as the lead character instead of a man. Some 91% of Americans feel that the scenario involving a female protagonist qualifies as online harassment, compared with 89% in the scenario involving a man. And their responses to the specific elements of the story are also nearly identical in each version.

Scenario 2: Harassment involving sexism

The second scenario in the survey used a story involving a character named Julie to explore how Americans view online harassment issues involving sexism and sexual harassment:

“Julie posts on her social media account, defending one side of a controversial political issue. A few people reply to her, with some supporting and some opposing her. As more people see her post, Julie receives unkind messages. Eventually her post is shared by a popular blogger with thousands of followers, and Julie receives vulgar messages that insult her looks and sexual behavior. She also notices people posting pictures of her that have been edited to include sexual images. Eventually, she receives threatening messages.”

As was true in the preceding scenario, the vast majority of Americans (89%) agree that Julie does indeed experience online harassment at some point in this scenario. Another 6% feel that Julie was not harassed at any point in the encounter, while 5% say they are unsure if this scenario involves harassment or not.

And as was the case in the preceding scenario, the public has differing views on which aspects of this story represent online harassment. A very small share of Americans (3%) think Julie’s initial disagreement with her friends counts as online harassment. Some 43% consider it harassment when she begins to receive unkind messages, while around one-in-five (17%) consider it harassment when her post is shared by the popular blogger with thousands of followers. Meanwhile, substantial majorities of Americans think Julie is being harassed when she receives vulgar messages about her looks and sexual behavior (85%), when her picture is edited to include sexual images (84%), and when she receives threatening messages (85%).

Along with asking respondents to identify which specific elements of this scenario count as online harassment, this scenario included a second set of questions about when – if it all – people think the social media service where this incident was occurring should have stepped in to address the behaviors in question. These findings indicate that the public has a somewhat different standard for behaviors that constitute online harassment, as opposed to behaviors that necessitate a response from online platforms.

For example, some 43% of Americans consider it to be online harassment when Julie receives unkind messages from the people reading her post – but just 20% think that the platform should have stepped in to address that behavior when it occurred. The public’s attitudes diverge in similar ways on some of the more severe behaviors in the scenario. Most prominently, 85% of Americans think that Julie experiences online harassment when she begins to receive vulgar messages about her looks and sexual behavior. But substantially fewer (although still a majority at 66%) think that the social media platform has an obligation to step in and address that behavior.

Women are more likely than men to view certain behaviors in this scenario as harassing

The vast majority of both men and women feel that Julie does in fact experience online harassment in this scenario. But at the same time, men and women respond somewhat differently to some of the specific elements of the scenario. Most notably, women are roughly three times as likely as men to consider it online harassment when Julie’s post is shared on social media by the blogger (24% vs. 9%), and they are also substantially more likely to consider it harassment when Julie first begins to receive unkind messages (50% vs. 35%). And although roughly eight-in-ten men consider it harassment when Julie receives vulgar messages, when she sees people editing her picture to include sexual imagery, and when she receives threatening messages, in each case that point of view is shared by roughly nine-in-ten women.

Scenario 3: Harassment involving racism

The final scenario in the survey used a story involving a character named John to explore how Americans view online harassment issues in the context of racially motivated content. This scenario is nearly identical to the preceding one involving “Julie” and sexual harassment but with racial rather than sexual overtones:

“John posts on his social media account, defending one side of a controversial political issue. A few people reply to him, with some supporting and some opposing him. As more people see his post, John receives unkind messages. Eventually his post is shared by a popular blogger with thousands of followers, and John receives vulgar messages that make racial insults and use a common racial slur. He also notices people posting pictures of him that have been edited to include racially insensitive images. Eventually, he receives threatening messages.”

In many ways, Americans’ views on this scenario mirror those in the previous scenario involving sexual harassment. Fully 85% of adults believe John experiences online harassment in this scenario, while 6% feel he does not face harassment, and 10% are unsure if this scenario involves online harassment or not.

They also respond in largely similar ways when asked which specific elements of the story constitute harassment. Very few Americans think that John’s initial social media argument constitutes online harassment, but sizable majorities agree that John experiences harassment when he receives vulgar messages with racially insulting language (82%), when his picture is edited to include racially insensitive images (80%), and when he receives personal threats (82%).

And as with the case of the scenario involving sexual content, Americans have a somewhat different threshold for behavior that constitutes online harassment as opposed to behavior that deserves a response by the social media platform hosting that behavior. For instance, 80% of Americans think it constitutes online harassment when people begin posting pictures of John that include racially insensitive imagery, but 57% think that the social media service should have stepped in to address that behavior.

Slightly larger share of the public thinks social media platforms should step in for behaviors involving sexual harassment than for behaviors involving racial harassment

The scenarios involving “John” and “Julie” are generally identical in content, with the former involving explicitly racial content and the latter involving sexual content. Overall, similar shares of Americans view these scenarios as involving online harassment at some point. But slightly larger shares of the public – although a majority of Americans in each instance – think the social media platform should have stepped in at various times during the scenario involving Julie, as opposed to the scenario involving John:

Output: The US public is divided over whether certain behaviours can be categorised as online harassment, according to a new survey by Pew. Although most respondents agreed that direct personal threats constituted harassment, opinion differed as to whether unkind messages, or the public sharing of a private conversation, met the requirements. The survey posed a series of fictional scenarios, asking those surveyed which actions depicted constituted harassment. The majority felt that social media platforms should intervene in the case of threats, though respondents were divided over the platforms’ responsibilities in other areas.


Instruction: create a high quality summary of the given input

Input:
Kremlin may investigate failings in Russia's space programme

Image by Kremlin.ru

A spat of recent failures in Russia’s space industry has caused the Kremlin to consider an official probe of problems in the sector. Kremlin spokesman, Dmitry Peskov, said this week that authorities warrant a thorough analysis of the situation in the space industry, reported Associated Press.

4GB – A Georgian Electronic Music Festival In Soviet Style: Watch

“A Russian weather satellite and nearly 20 micro-satellites from other nations were lost following a failed launch from Russia’s new cosmodrome in the Far East on Nov. 28. And in another blow to the Russian space industry, communications with a Russian-built communications satellite for Angola, the African nation’s first space vehicle, were lost following its launch on Tuesday,” wrote AP.

Russian Deputy Prime Minister Rogozin, who’s portfolio includes space operations, was critical of Russian space corporation, Roscosmos, declaring Roscosmos was “trying to prove that failures occur not because of mistakes in management but just due to some ‘circumstances.'”

SpaceX Says It Will Take 65% Of Global Commercial Launch Market

Tsarizm has previously reported that Russia has lost a large percentage of the commercial launch market in recent years due to the rise of SpaceX and other commercial operators in the West, and failures such as the Kremlin has seen recently which has damaged Russia’s once strong reputation in space.

The new Russian launch pad at Vostochny has been marred with delays and accusations of corruption. Russian President Vladimir Putin himself publicly called for those in charge of the project to be punished. The work horse for Moscow’s space efforts previously has been the Russia-leased Baikonur launch pad in Kazakhstan, where heavier launches still take place until Vostochny can be finished in 2021.

Russian Space Program Close To Collapse

The loss of market share in the commercial launch space has put a critical source of revenue and foreign currency in crisis.

Output: The Kremlin is considering an official inquiry into problems in Russia's space programme. A failed launch from the country's new facility in the Far East in November led to the loss of a Russian weather satellite and nearly 20 micro-satellites from other countries, while communication links with a Russian-built communications satellite launched on behalf of Angola have also been lost. Deputy Prime Minister Dmitry Rogozin, who has responsibility for the space industry, has been publicly critical of the country's space corporation, Roscosmos, and a Kremlin spokesman said the situation warrants a thorough analysis.


Instruction: create a high quality summary of the given input

Input:
Frail Patients Losing Access To Dental House Calls
 RANCHO CUCAMONGA, Calif. — Devon Rising shakes his head and tries to cover his face with his hands. It’s time to get his few remaining teeth cleaned, and he fusses for a bit.

Gita Aminloo, his dental hygienist, tries to calm him by singing “Itsy Bitsy Spider,” the classic children’s song.

Rising, 42, is mentally disabled and blind. He has cerebral palsy and suffers from seizures. It’s hard for him to get to a dentist’s office, so Aminloo brought her dental picks, brushes and other tools to him at the residential care facility he shares with several other people who have developmental disabilities.

Rising is among a vulnerable class of patients who are poor and so frail they can’t leave the nursing home or, in his case, the board-and-care home to visit dentists. Instead, they rely on specially trained dental hygienists like Aminloo, who come to them.

But this may be the last time Aminloo cleans Rising’s teeth. And it’s not because of his resistance.

Hygienists say some of their patients are no longer getting the critical dental care they need because of recent policy changes: The state dramatically slashed payment to providers and created a preauthorization process they call cumbersome.

In 2016, Denti-Cal, the publicly funded dental program for the poor, cut the rate for a common cleaning procedure for these fragile patients from $130 to $55. Hygienists say they can’t afford to continue treating many of them for that kind of money. They also claim that half of their requests to perform the cleanings are rejected — an assertion not supported by state data.

The Department of Health Care Services, which runs Denti-Cal, said it made the changes to bring the program’s reimbursement policy in line with other states and to reduce “unnecessary dental treatment.”

But Aminloo insists the new state regulations victimize the most vulnerable people, who she said are losing their access to routine dental care.

“If these patients don’t get preventive oral care, their overall health is going to suffer,” she warned.

Dental hygienists are generally allowed to practice without the direct supervision of a dentist in 40 states, including Nevada, Texas, Colorado, Michigan and Florida. But the type of patients they can see varies by state. So do reimbursement and preauthorization rules.

Washington state’s Medicaid program pays providers $46 for a similar cleaning procedure, said Anita Rodriguez, a member of the Washington State Dental Hygienists’ Association. Hygienists there don’t have to obtain preauthorization to perform cleanings, but they are required to explain why the cleaning was necessary when they bill Medicaid.

“Our state makes access for our independent hygienists relatively uncomplicated though, like other Medicaid providers, we make pennies on the dollar for our care,” she said.

Since California reduced payments for “maintenance” cleanings for these patients — usually performed every three months to treat gum disease — many hygienists have stopped seeing them. Eight hygienists, including Aminloo, filed a lawsuit in Los Angeles County Superior Court in 2016, arguing that the health care services department cut the reimbursement rate without first obtaining necessary federal approval.

At one point, it appeared as if the department had agreed to settle and cancel its rate change but then backed out, court documents show. The department said it will not comment on pending litigation.

At the time of the rate reduction, the state also started requiring dental hygienists to obtain prior authorization to treat gum disease in patients who live in special care facilities. Hygienists must submit X-rays along with their authorization requests. But they say it’s almost impossible to take decent X-rays of elderly or disabled patients who have a hard time controlling their head movements, or who refuse to open their mouths widely.

When hygienists do manage to get X-rays, their requests are often denied anyway, hygienists from across the state told California Healthline.

In a letter to the state legislature last year, the California Dental Hygienists’ Association wrote that more than half of their authorization requests had been denied since the change. “Denti-Cal’s sweeping new rules are destroying the lives of fragile patients and the women who own small businesses providing care at the bedside,” the letter said.

But state statistics show a much lower denial rate.

From the time the change took effect in July 2016 through June 2017, the health care services department approved 10,000 of nearly 13,000 deep cleanings requested by these dental hygienists to treat gum infections, according to the data. It also approved 31,300 of the nearly 33,000 requests for routine cleanings that follow a deep cleaning. The state said it paid more than $2.5 million to dental hygienists for these procedures.

Darla Dale, a hygienist in Eureka and a vice president of the hygienists association, said the department’s denial numbers don’t reflect what her organization is seeing.

“There’s no way that’s true,” Dale said. “We’re in contact with these hygienists. … Many have stopped working because we can’t spend our lives trying to get authorization.”

Darci Trill, a hygienist working in Alameda and Contra Costa counties, is among those who stopped seeing patients in nursing homes after denial letters piled up. “I lost about 70 percent of my Denti-Cal clients,” she said.

State health officials pointed to the American Academy of Periodontology, which considers the new authorization guidelines standard, including X-rays to diagnose gum disease.

An April 2016 report by the Little Hoover Commission, an independent state watchdog agency, said the state health services department found it “unusual” that nearly 88,000 out of 100,000 Denti-Cal-eligible patients in nursing homes had received deep cleanings during the 2013-14 fiscal year. This figure and other factors raised “questions about their necessity — and hence the new policy requiring X-ray documentation,” the report said.

In frail patients, advanced gum disease can cause not only tooth loss, but pneumonia and other respiratory issues, Trill said.

Maureen Titus, a hygienist in the San Luis Obispo area, said her clients rely entirely on caregivers for their dental hygiene, and that brushing and flossing is neither easy nor effective. “Most have bleeding gums, inflamed gums and tartar buildup,” she said.

Among patients who are attached to feeding tubes, tartar builds up quickly because they don’t chew their food, Aminloo said. “After two or three months, you can’t even see their teeth.”

The independent practice of dental hygienists in California dates to 1997, when the state legislature allowed them, with additional training and certification, to work without the direct supervision of dentists. Some started their own mobile businesses. This is the first time in the intervening 20 years that they’ve had to obtain preauthorization to perform dental cleanings, Trill said.

The California Dental Association, which represents dentists, said dentists have long been required to get prior approval for cleanings for patients in special care facilities.

“We supported the department’s decision to equalize requirements for periodontal services, regardless of whether a dentist or hygienist provides the service,” said Alicia Malaby, the association’s spokeswoman.

Dr. Leon Assael, the director of community-based education and practice at the University of California-San Francisco’s School of Dentistry, said preauthorization requirements in other states, including Minnesota and Kentucky, where he used to work, have also delayed or limited care for homebound patients.

The requirements have driven providers out of the system, he said, leaving patients behind.

“If this were toes being lost, this would be a scandal,” Assael said, “but with teeth, it’s been accepted.”

Output: Recent policy changes in California has endangered the dental care of a rising number of patients who are unable to receive dental care as they are too frail to leave their nursing homes. The state has slashed payments to dental care providers and hygienists and created a cumbersome preauthorization process which is hindering the delivery of dental care as part of Denti-Cal. Denti-Cal, the publicly funded program for the poor, reduced the rate for a simple cleaning procedure from $130 to $55 which has seen hygienists unable to continue treating their patients. The Department of Health Care Services maintains it made the changes to reduce unnecessary treatment, but the hygienists maintain that the new regulations victimize the most vulnerable patients. Whilst dental hygienists are allowed to practice without direct supervision in 40 states, rules governing patient choice, reimbursement and preauthorization rates vary. Since reducing payments for maintenance cleaning, many hygienists have stopped seeing their patients, and a lawsuit was filed, arguing that the decision was made without obtaining federal approval. At the same time as the reductions, requirements were also imposed for x-rays but this is an especially difficult process when working with disabled and elderly patients, should the requests even be granted. State data indicates a disparity between hygienists’ observations and state approval, which suggests that between July 2016 to July 2017, 10,000 of almost 13,000 requests were granted for deep cleaning, paying $2.5 million in the process. These figures are disputed by hygienists, one of whom claims that she lost 70 percent of her Denti-Cal patients because of the changes. This is the first time in 20 years, since dental hygienists were permitted to act independently that preauthorization has been required.


Instruction: create a high quality summary of the given input

Input:
One change to dental care that could save lives, money
 Tens of millions of Americans have decaying teeth, frequent toothaches and chronic dental pain. The result can be lost work productivity, missed school days and outright suffering. Many of those people — adults and children — lack access to the dental care that could help them.

Fortunately, states are beginning to embrace what The New York Times has called “a big idea” for social change: a new category of dental care providers that can mitigate many of these problems without burdening taxpayers or state budgets with bigger government or regulations.

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America lacks sufficient dental care providers. Some 63 million people live in places that the U.S. Department of Health and Human Services designates as dental shortage areas. People on Medicaid face even higher hurdles, since only 1 in 3 dentists accepts Medicaid patients. The American Dental Association acknowledges that high costs pose a significant barrier to dental care for many.

That’s why the two of us — on opposite sides of many issues, including the national health care law — have come together in support of a common sense policy that should spread to all states: allowing dentists to hire professionals known as dental therapists. Analogous to nurse practitioners and physicians’ assistants, dental therapists work as mid-level providers within a larger dental team, supplying preventive care and performing routine procedures, such as filling cavities.

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Voters across the political spectrum support the use of these new mid-level dental practitioners. In a national poll conducted in 2016 by Americans for Tax Reform 79 percent of all voters were in favor the idea. That included support from 77 percent of Republicans, 79 percent of independents and 80 percent of Democrats.

Allowing dental therapists to practice would remove an unnecessary government barrier to dental services and enable dentists, many of them small business owners, to treat more patients and expand their businesses if they so choose. It would utilize the free market at little cost to states.

In 2007, the tragic case of 12-year-old Deamonte Driver gained national attention when the Maryland boy died from an untreated tooth infection because his family couldn’t find a dentist who would treat him. Instead of an $80 procedure that could have prevented Deamonte’s death, his saga turned into a series of hospital visits that came too late, ending with the needless loss of his life, but also costing taxpayers tens of thousands of dollars through Medicaid. And yet, little has changed across the U.S. since then when it comes to dental care access. There has been a serious market failure, harming lives and raising costs. Fortunately, a market solution now exists, if only states will adopt it: dental therapists.

The lower salaries of dental therapists, compared with dentists’, reduce the cost of delivering care, making it more feasible for both nonprofit and private dental clinics to accept Medicaid payment rates for patients who depend on public programs, like Deamonte Driver did. This would allow states to do more with scarce Medicaid dollars — a win for both taxpayers and patients. Dental therapists also give entrepreneurial dentists more flexibility to expand practice hours, treat more patients, reduce costs and focus their own time on more complex procedures. That can produce more income for dentists’ practices and better health outcomes for patients.

Dental therapists give high-quality care. They are well-educated, thoroughly trained and carefully tested. The programs that prepare them must meet rigorous standards approved by the same body that oversees the training of dentists, the Commission on Dental Accreditation, which includes the American Dental Association as a member.

Dental therapists have practiced for nearly 100 years in more than 50 countries. In fact, America was late to the game. Alaska first introduced this type of practitioner to the United States in 2004. Since then, Minnesota, Maine and Vermont have passed legislation authorizing dental therapists, and Arizona, Massachusetts, Michigan, North Dakota and several other states are considering it.

Dental therapists would make a big difference in the lives of the many Americans who are struggling to find dental care. As the health care debate continues at the national level, allowing dental therapists to practice is a bipartisan solution that state legislators can adopt right now that benefits small businesses, helps patients and eases the burden of rising health care costs, including Medicaid. We are proud to stand together in support of this proven program.

Grover Norquist is president of Americans for Tax Reform. Don Berwick is former administrator of the Centers for Medicare and Medicaid Services and currently senior fellow at the Institute for Healthcare Improvement and lecturer at the Harvard Medical School.

Output: Poor dental health affects tens of millions of Americans with 63 million live in places described as dental shortage areas; suffering from decaying teeth, toothaches and chronic dental pains. Not only does this lead to general suffering, from an economic stance work productivity is damaged across all age ranges. Moreover, high medical costs mean only 1 in 3 dentists actually accept Medicaid patients. However, states are now attempting to overcome the issues that stop both adults and children receiving proper dental care at little cost to the taxpayer. Political advocates Grover Norquist and Don Berwick see a simple solution, one that received over a 75 percent backing from Democrats and Republicans alike. They want to allow dentists to hire a variety of professionals from dental therapists to nurse practitioners who can supply preventive care and perform routine procedures that do not require dentists. This would utilize the free market at little cost, allowing dental therapists to operate without unnecessary government barriers while being able to treat more patients, offering the potential opportunity for SME’s expansion. Tragic cases like Deamonte Driver, who lost his life after receiving poor dental treatment would be prevented if dental therapists were able to operate. Subsequently, dental therapists are far cheaper than dentists, they provide high-quality care, are well educated and readily available, having existed in more than 50 countries for over a century. Should states turn to dental therapists, it would provide a simple solution to help patients, businesses and combat rising health care costs.


Instruction: create a high quality summary of the given input

Input:
States Look To Create Own Individual Mandates In Wake Of GOP Tax Bill
 Updated Story Several Democratic-led states are looking to implement state-level individual mandates for insurance coverage in an effort to reduce the prominence of bare counties and failing risk pools due to the end of the Affordable Care Act’s individual mandate in 2019 and other instabilities surround the law. California, New York, Maryland, Connecticut, and Washington state are all considering pursuing state individual mandates for insurance coverage when their state legislatures come into session in early 2018 ,...

Output: Following on from the Republican tax bill, several Democratic-led states are looking to implement state-level individual mandates to overcome bare counties and the prospect of failing risk pools. California, Connecticut, New York, Maryland and Washington State, are all considering the move when their state legislatures come into session in early 2018. It is likely that the states will attempt to implement a model similar to that of RomneyCare, introduced in Massachusetts in 2006, and the ACA’s individual mandate. These states do not require federal approval for the move as the mandate penalty is a tax, and as a result, have the ability to implement their own version of the Obamacare mandate. It is unlikely that the move will extend beyond these states as there is far more likely to be partisan pushback as state legislatures often skew to the right. California, in particular, is looking at the possibility of a state individual mandate to overcome the uncertainty at federal level surrounding Obamacare. Maryland too would likely introduce an individual mandate, Massachusetts could fall back on its original proposition, with Washington State proving the most complicated.


Instruction: create a high quality summary of the given input

Input:
Scripps Health reorganization to include layoffs
 Scripps Mercy Hospital in Hillcrest is among the facilities affected by a reorganization plan underway at parent company Scripps Health.

Though it has billions in the bank, Scripps Health will pursue layoffs in 2018 as part of a reorganization strategy that emphasizes lower costs and greater reliance on caring for patients outside of its five hospitals.

In a recent memo to all of the health system’s 15,000 employees and 3,000 affiliated doctors, Chris Van Gorder, Scripps’ chief executive officer, says that cuts are necessary to remain competitive in a health care world where health insurance companies increasingly consider low prices as a main factor in contracting and patients are more often shopping around for services as deductibles increase.

Scripps missed its annual budget by $20 million last year for the first time in 15 years, Van Gorder said in an interview this week. It was a wake-up call, he said, that added urgency to the need to both cut costs and also re-think how the private not-for-profit health network does business.

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“We’ve got to shift our organizational structures around to be able to deal with the new world of health care delivery, find ways of lowering our costs significantly,” Van Gorder said. “If we don’t, we will not be able to compete.”

Scripps is far from the only large health care system to announce cost-cutting measures in recent months.

Advocate Health, Illinois’ largest health care provider with 12 hospitals and 35,000 employees, announced in May that it would try to cut more than $200 million in costs due to flat revenue projections. Tenet Health, the nation’s third-largest medical chain with 77 hospitals, announced in October that it will eliminate a middle layer of management after posting a $56 million loss after a 1.4 percent single-quarter revenue decline, according to industry news source Modern Healthcare.

Things haven’t gotten quite so bad yet at Scripps.

A look at Scripps’ bond industry financial filings make it clear that this is not a company teetering on the edge of insolvency. Far from it. Scripps, the audited financial statements for the 2017 budget year show, has banked about $2.6 billion in unrestricted cash and other investments.

However, Scripps has recently seen its operating margin, the percentage of revenue left over after all the bills are paid, shrink significantly from about 9 percent in 2012 to 2.3 percent in 2017. Financial statements show that Scripps’ bottom line was significantly bolstered this year by investment income. A roaring stock market helped significantly increase the value of its holdings, pushing total profitability up to $350 million for the year, a number that is 25 percent greater than last year.

How can an organization be making money, have a significant financial cushion and yet still be planning for layoffs in the coming year?

Van Gorder said the basic fact is that operation of the organization must continue to bring in more revenue than it spends and declining operating margins must be addressed even if revenue from the stock market is currently masking those declines.

“As strong as we are on the bottom, bottom line, the trends at the top end are changing, and we have to adjust to them,” Van Gorder said.

Still, with more than two billion in the bank, couldn’t Scripps afford to burn some savings and stave off layoffs?

Van Gorder said that it’s not responsible management to fix a recurring problem with savings. And, having a hefty balance sheet, he added, is necessary to get favorable interest rates from lenders as Scripps moves to execute a recently announced $2.6 billion building plan that will replace Scripps Mercy Hospital in Hillcrest, add a new patient tower at Scripps Memorial Hospital, La Jolla and upgrade facilities in Encinitas, Chula Vista and Torrey Pines.

These upgrades and replacements, the executive added, are made more urgent than they would otherwise be due to a state law that requires all hospitals to meet certain seismic requirements by 2030 or cease operation.

In addition to borrowing and revenue from philanthropy, Scripps plans to tap its savings to fund its building plan. That plan, Van Gorder said, will continue but will be undertaken with knowledge that insurance companies want to avoid paying the higher prices charged by hospitals whenever possible.

That means pulling back on the previous tendency to include plenty of space inside hospital complexes to patients whose medical needs don’t require them to be admitted for a overnight stay. Scripps has already started on this path with the purchase of Imaging Healthcare Specialists in 2015. The company operates stand-alone imaging centers that offer cheaper scans than are available in the outpatient centers attached to the region’s major hospitals.

“We’re seeing a huge shift in the ambulatory side,” Van Gorder said. “We’re now, for example, doing total joint replacement in ambulatory surgery centers. A year ago, that didn’t take place. The experts are telling me and others that you’re going to see a huge jump in that as technology continues to improve … that’s going to pull a whole lot of utilization away from hospitals and hospitals that haven’t prepared for that shift are going to be in deep trouble in the not-to-distant future. That’s why we’re trying to make this shift proactively.”

Scripps’ bond filings do show that it has seen a significant shift in its business over the last five years.

From 2011 to 2016, the most recent year for which aggregated patient data is available, Scripps reported that inpatient discharges, the total number of days that patients spent in its hospitals, and surgeries performed in hospitals all decreased slightly. Meanwhile, the number of surgeries performed at its outpatient surgery centers increased 69 percent. Visits to Scripps Clinic and Scripps Coastal Medical Group increased 14 percent and 19 percent respectively and emergency visits were up 21 percent.

Scripps’ first step in its reorganization plan to better address the shift from inpatient to outpatient is to collapse its ranks of hospital management. Instead of having a chief executive officer to manage operations at each of its five hospitals, the plan is to have two executives handle those duties, one for hospitals in La Jolla and Encinitas and another to oversee operations in San Diego and Chula Vista. A third executive will be in charge of all ancillary services, including operation of the medical offices, outpatient surgery centers and other facilities that Scripps owns or leases throughout the region.

This consolidation will not require any layoffs. Gary Fybel, currently the chief executive officer at Scripps Memorial Hospital La Jolla, and Robin Brown, chief executive officer at Scripps Green Hospital, will retire. The northern chief executive officer position has been awarded to Carl Etter, current chief executive officer of Scripps Memorial Hospital Encinitas. The south position will be handled by Tom Gammiere, who currently runs Scripps Mercy Hospital in Hillcrest. Lisa Thakur, currently corporate vice president of operating rooms, pharmacy and supply chain, will fill the ancillary services post, and her previous job will not be filled.

Van Gorder said further personnel cuts are coming and are intended to save $30 million during the current budget year ending Sept. 30, 2018. Cuts should save $40 million in subsequent years, he added. Most will be focused on administrative job classifications.

“There will be layoffs,” Van Gorder said. “I don’t like it, but it has to be done for me to protect the organization and our ability to take care of our community into the future.”

So far, he said, there are no specifics to share on which particular jobs are most at risk.

He added that, as the current reorganization effort takes shape, hiring is also anticipated. More workers will be needed to provide quicker service to patients.

“What I want to do at the point of service is support our nursing staff with more paid professional staff,” Van Gorder said.

Gerard Anderson, a professor of health policy and management at Johns Hopkins School of Medicine in Baltimore, said the current trend of cost-cutting at large health care systems does indeed appear to be driven by decreases in reimbursement by Medicare and private health insurance companies.

“In almost every single hospital they’re losing some amount of money in operating margin but making it up in spades when you add in their investment income,” Anderson said.

The researcher said he was a bit disturbed to see organizations flush with stock market earnings discuss cuts, especially if those cuts are to employees who directly care for patients.

“You’re seeing layoffs but I don’t necessarily understand why you need to lay someone off when your margin is something like 11 percent after non-operating income is added into the mix,” Anderson said.

But what about the need to shift business strategy and reduce administrative expenses as reimbursement falls? Anderson said he can see that point as long as it’s true.

“If they really are doing this in the non-patient-care area, I think that makes sense,” he said. “In general, we’ve seen more across-the-baord cuts than targeted specifically to areas of management and administration. The salaries in management have grown faster than they have for clinicians.”

Health Playlist × On Now Video: Leaders urge public to help extinguish hepatitis outbreak On Now San Diego starts cleansing sidewalks, streets to combat hepatitis A On Now Video: Scripps to shutter its hospice service On Now Video: Scripps La Jolla hospitals nab top local spot in annual hospital rankings On Now Video: Does a parent's Alzheimer's doom their children? On Now EpiPen recall expands On Now Kids can add years to your life

paul.sisson@sduniontribune.com

(619) 293-1850

Twitter: @paulsisson

Output: The San Diego-based non-profit health care system Scripps Health is set to pursue layoffs in a restructuring process in 2018. Scripps missed its annual budget by $20 million and intends to target lower costs and a greater dependence on caring for patients outside of its hospitals. The company’s CEO, Chris Van Gorder, revealed in a memo that the cuts are necessary with insurers and patients increasingly targeting lower prices as health costs rise. The announcement by Scripps follows in a cost-cutting trend amongst large health care organizations; both Advocate Health of Illinois and Tenet Health announced similar measures following disappointing results. Although Scripps maintains a $2.6 billion balance in cash and investments, with an increased profitability of $350 million, its operating margin has slimmed from 9 percent in 2012 to 2.3 percent in 2017. The firm believes that it would not be responsible management to turn the savings towards a recurring problem especially as it requires favorable interest rates from lenders on its $2.6 billion building project. Alongside the personnel cuts intended to save $30 million in the current budget year, there will be a consolidation of management positions.


Instruction: create a high quality summary of the given input

Input:
Millennials aspire to own homes despite pessimism over chances
 The return to work after Christmas is never easy. Unless you’re an estate agent: they love January. Following the pre-Christmas lull, families rush back into wanting to buy and sell their houses (helped in part by the traditional post-festivity spike in family breakdown). But for an increasing number of us, house hunting is becoming little more than an exercise in window shopping (or ‘property porn’ if you’d rather).

The share of the population owning a home has been falling since 2003, with particularly profound consequences for younger families. As the chart below shows, today’s 30 year olds (that is, the oldest members of the millennial generation born between 1981 and 2000) are only half as likely to own their house as their parents were at the same age.

Like so much of the Christmas TV schedule, this is a story that’s been on repeat for some time. Britons get that their country is no longer a nation of home owners. As research carried out by Ipsos MORI back in the summer for the Intergenerational Commission showed, 71 per cent of people (across all generations) think millennials face worse prospects than their parents in this regard. Just 7 per cent think young adults are better off. Indeed, of all of the questions asked in the survey, it was the one on which respondents were most pessimistic.

Yet, despite being pessimistic about the overall picture for millennials, new data shows that a significant share of the generation think they personally will manage to beat the gloom. The next chart takes data from the Bank of England’s latest NMG survey to show that more than half (52 per cent) of non-owning households headed by someone aged under-35 (roughly speaking, the millennial generation) expect to buy at some point in the future. And that proportion holds up even among lower income millennials.

If such expectations were borne out, around 75 per cent of millennial households would eventually own a home. That would put the generation on a par with the home ownership rates recorded among baby boomers. It would also be roughly 10 percentage points higher than the ‘optimistic’ scenario we set out in September (our ‘pessimistic’ scenario put the figure under 50 per cent). Short of a significant turnaround in housing trends, the implication is that many members of the younger generation will find their aspirations go unmet.

And, while the one-in-four (24 per cent) non-owning millennials who think they’ll never buy a home might have a more realistic outlook of the future, they’re just as likely to be unhappy with their lot. The next chart sets out the factors which this group identify as being among the three most important reasons for not owning. What stands out is that just one-in-ten of them cite positive-sounding reasons: 10 per cent say they like their current home and just 8 per cent prefer the flexibility of renting. The upshot is that as few as 1 per cent of millennials appear to be happy with the idea of never owning a home.

It’s this finding that goes a long way to explaining why politicians are so keen to be seen to be offering hope on home ownership.

And, with ‘purchase costs’ (such as the deposit, stamp duty and estate agents fees) being cited by millennials as the main barrier to owning, it’s easy to understand the temptation to focus on subsidising buyers. Measures such as the removal of stamp duty for first time buyers of property worth up to £300,000 – which Philip Hammond announced in the Autumn Budget – give the impression of extending home ownership to a wider group. But they largely miss the mark. The OBR’s assessment of the stamp duty policy was that it would benefit just 3,500 first time buyers who would not otherwise have been able to buy a home, costing roughly £160,000 per additional owner.

Supply-based approaches represent a preferable and more sustainable option, but they take time to take effect. That’s not to say government should give up, and the Autumn Budget plans for returning housing capital spending back to the levels of the 2000s (outside of the fiscal stimulus peak of 2008-10) is a very welcome one.

But it’s hard to escape the conclusion that, even if we get to grips with the longer-term problem, home ownership will remain off-limits for significant numbers of millennials. Some might expect to benefit from the bank of mum and dad in the near-term and from inheritances as they age. But such support may come too late to cover expensive family-rearing years for many households, and will never arrive for many – mainly lower income – others.

That reality raises a number of challenges for today’s young people. Over the longer-term, home ownership plays an important role in building wealth (via semi-enforced saving), providing leverage and hedging against costs and location in retirement. In its absence, alternatives are needed.

More immediately, the generally higher housing costs associated with renting leave young people with less disposable income and less opportunity to save than earlier cohorts faced. The chart below sets out the share of income allocated to rent among younger respondents to the NMG survey. It shows that 30 per cent of renters in this group spend more than one-third of their pre-tax income – a threshold that is often taken as a sign of housing unaffordability. And that figure jumps to a massive 71 per cent among the poorest fifth of millennials.

We’ll turn to the question of how the country might rise to these challenges in a forthcoming policy options paper for the Intergenerational Commission. But our politicians – unlike our estate agents – need to be more honest about the housing aspiration gap. It’s good to offer hope, but a healthy dose of realism would sharpen the focus on the broader living standards challenge posed by our housing crisis.

Output: A majority of millennials anticipate they will own a home in the future despite being pessimistic about their overall prospects. A recent survey commissioned by the Bank of England found that 52% of under-35s expect to buy a home at some point in the future, 24% expect never to buy and 25% are unsure. Purchase costs, such as deposits, estate agency fees and stamp duty, were cited as the biggest barriers to home ownership. An earlier Ipsos MORI poll found 71% of respondents thought millennials faced worse prospects than their parents of owning a home.