‘Uncharted territory’: How would a TikTok ban in the US work?

‘Uncharted territory’: How would a TikTok ban in the US work?
‘Uncharted territory’: How would a TikTok ban in the US work?
Mario Tama/Getty Images

(NEW YORK) — Awkward dads and their eager children may not dance together on TikTok for much longer — at least not in the U.S.

The prospect of a nationwide TikTok ban has escalated from a theoretical possibility to a serious policy consideration, drawing growing support in Washington, D.C.

However, scant details are known about how the policy would be implemented and what it would mean for more than 100 million U.S.-based users of the app.

China-owned TikTok has faced growing scrutiny from government officials over fears that user data could fall into the possession of the Chinese government and the app could ultimately be weaponized by China to spread misinformation.

The Biden administration has stiffened its posture toward TikTok in recent weeks, endorsing a bipartisan bill earlier this month that would empower the federal government to ban apps like TikTok.

The administration’s stance hardened further this week, when officials demanded that TikTok’s Chinese owner sell its stake in the app or risk getting banned, the company and a U.S. official previously told ABC News.

A TikTok ban could take effect in a variety of ways, including its forced removal from Apple and Google app stores or an outright block of access by internet service providers, experts told ABC News.

While dedicated users would find ways to circumvent any government crackdown, the app would suffer a dramatic decline in popularity and eventually be rendered defunct, they added.

“The U.S. doesn’t typically ban websites like this — it would be very much uncharted territory,” Timothy Edgar, a computer science professor at Brown University and a former national security official, told ABC News. “It would be an enormous undertaking.”

TikTok did not respond to ABC News’ request for comment.

In response to bans of TikTok on some government devices, TikTok previously told ABC News in a statement: “We appreciate that some governments have wisely chosen not to implement such bans due to a lack of evidence that there is any such need, but it’s disappointing to see that other government bodies and institutions are banning TikTok on employee devices with no deliberation or evidence.”

“We share a common goal with governments that are concerned about user privacy, but these bans are misguided and do nothing to further privacy or security,” the company added.

Here’s what to know about the different ways the government could implement a nationwide TikTok ban, and what it would mean for TikTok users:

The removal of TikTok from app stores

A simple way to significantly curtail access to TikTok is in the form of a mandatory withdrawal of the app from major app stores, such as those maintained by Google and Apple.

Such a measure would bar new users and limiting existing ones, experts said.

“It would prevent new users from downloading and installing the app,” Qi Liao, a professor of computer science at Central Michigan University, told ABC News. “And the app would not be able to download updates, eventually becoming obsolete.”

The approach has gained support from at least one U.S. Senator. Last month, Sen. Michael Bennet, D-CO, sent a letter to Apple CEO Tim Cook and Google CEO Sundar Pichai, calling on their companies to remove TikTok from their respective app stores and cited concerns about how TikTok handles the data of American users.

Google and Apple did not respond to a previous request for comment about the letter.

Savvy users could get around such a ban by using offline app installation that bypasses the app stores, Liao said.

Still, an app store ban would immediately limit TikTok’s audience, he added.

“As soon as you ban TikTok on the app store, it’s going to make an impact,” Liao said.

A block of access to TikTok’s servers or IP address

A ban of the app could also take effect using a barrier that blocks access to TikTok’s web servers or its IP address, the experts said.

In such a case, attempts to access the app would fail because users would not be able to receive digital content from TikTok or reach its web host.

“It would do enormous damage to TikTok,” Edgar said.

The government could use a “sinkhole,” or a specially designed server that redirects web traffic when users try to reach illicit websites, such as child pornography or pirated material, Edgar said.

“Users may go to a page saying, “TikTok was banned by the U.S. government and this page was seized by the Department of Justice,'” Edgar said.

As with other approaches, users could elude the government-imposed barrier, experts said.

To access the app, users could use a Virtual Private Network, or VPN, which allows one to pose as a user logging on from a location abroad, thereby circumventing the U.S.-specific ban, Liao said.

“In China, it’s the reverse,” Liao said. “People use a VPN to access blocked U.S. services because the Chinese government has such censorship.”

Despite the readily available workaround, the effort required to log in from a VPN will deter many people from continuing their use of TikTok, Edgar said.

“One you’ve banned it, mainstream users may not want to take those kinds of risks — it may not be that important to them,” he said. “TikTok influencers will lose huge amounts of followers.”

A clampdown by internet service providers

A TikTok ban may take shape as a denial of access imposed by internet service providers, companies like Verizon and AT&T that deliver internet access for individuals, homes, businesses and other institutions, experts said.

Internet service providers could “totally block the TikTok network,” leaving all customers unable to access the app, Liao said.

A TikTok ban imposed by India in 2020 required internet service providers to deny customers the ability to use the app, Sarah Kreps, director of Cornell University’s Tech Policy Institute, told ABC News.

“This is a case where in the U.S. you’d have to get Verizon to essentially block this app,” she said.

Liao, who noted that India’s approach also mandated the removal of TikTok from app stores, said a denial of access by internet service providers would expand measures that some companies already take to prevent the use of specific websites, such as age-inappropriate content.

“They’re already doing lots of traffic shaping,” Liao said.

Customers could potentially get around a barrier from internet service providers, or ISPs, by using a different SIM card, the chip implanted in a mobile device that identifies a customer, Liao said. Users could also forego a SIM card altogether, he added.

“Then you’ll completely bypass the ISP-blocking of TikTok,” he said.

As with the other solutions, this approach would not eliminate access entirely but would shrink the user base, Kreps said.

“The hope with that would be to slow down the flywheel,” she said. “You’re not going to prevent every single user from using TikTok but that would certainly make it much more difficult to use.”

Copyright © 2023, ABC Audio. All rights reserved.

Trump claims he will be arrested on Tuesday amid hush money payments investigation

Trump claims he will be arrested on Tuesday amid hush money payments investigation
Trump claims he will be arrested on Tuesday amid hush money payments investigation
Scott Olson/Getty Images

(NEW YORK) –Former President Donald Trump claimed in a post on his social media platform that he will be arrested on Tuesday related to the Manhattan district attorney’s investigation into hush money payments made to adult film star Stormy Daniels ahead of the 2016 presidential election.

As part of the post, Trump also called on his supporters to protest.

In a statement, a Trump spokesperson appeared to walk back the comments.

A Trump spokesperson said there is no notification the DA “has decided to take his Witch-Hunt to the next level. President Trump is rightfully highlighting his innocence and the weaponization of our injustice system. He will be in Texas next weekend for a giant rally.”

Trump has not been charged with a crime in the probe.

ABC News has not verified the claims and the Manhattan district attorney’s office has no comment.

This is a developing story. Check back for updates.

Copyright © 2023, ABC Audio. All rights reserved.

Family, FBI seeking info after US citizen kidnapped from home in Mexico

Family, FBI seeking info after US citizen kidnapped from home in Mexico
Family, FBI seeking info after US citizen kidnapped from home in Mexico
KABC

(LOS ANGELES) — A California family is desperate for news after their mother was kidnapped outside her home in Mexico more than five weeks ago and has not been seen or heard from since.

Maria del Carmen Lopez, 63, a dual U.S.-Mexico citizen, was kidnapped in Pueblo Nuevo in the state of Colima on Feb. 9, according to the FBI, which is conducting a joint investigation with law enforcement authorities in Mexico.

Her family told ABC Los Angeles station KABC that witnesses described seeing a white van drive onto her property.

“There was an exchange of words,” her daughter, Zonia Lopez, told KABC in an emotional interview this week. “She was refusing to get into the van.”

Another individual reportedly got out of the vehicle and helped pull the mother of seven into the van and then they drove off, according to her family. The woman’s family has been unable to get ahold of her since.

“We all started calling her, to see if she would pick up her phone or answer a message, and we have not heard from her,” Zonia Lopez told KABC.

“At this point, we need answers, we need to find my mother,” she told the station.

The FBI’s Los Angeles Field Office announced this week it is offering up to a $20,000 reward for information leading to her location.

The State Department advises U.S. citizens not to travel to the state of Colima due to “widespread” violent crime and kidnapping.

The Lopez family — which said investigators informed them their mother’s case may be part of an organized kidnapping — is not losing hope.

“Us knowing how strong she is, and that she’s fully thinking of us seven, and if we’re bringing out that energy to her and we maintain those thoughts, we know we’re going to have our mom,” Zonia Lopez told KABC.

Maria del Carmen Lopez is described as a Hispanic female with blonde hair and brown eyes who is 5’2″ and weighs approximately 160 pounds.

Anyone with information about her physical location should contact their local FBI office or the nearest American Embassy or Consulate.

Copyright © 2023, ABC Audio. All rights reserved.

Texas announces takeover of Houston’s school district, sparking concerns from educators

Texas announces takeover of Houston’s school district, sparking concerns from educators
Texas announces takeover of Houston’s school district, sparking concerns from educators
ilbusca/Getty Images/STOCK

(HOUSTON) — The announcement that Texas state officials are taking over leadership of Houston Independent School District later this year is drawing concerns from some community members and educators about state government overreach and the decision’s impact on schools.

Some experts are calling the move a major “blow” to Texas’ largest public school district, marking a turning point in education policy that follows years of controversial decisions in the state, including legislation on race, parental rights and gender-affirming care.

“Texas has the ninth largest economy in the world,” Kevin Malonson, executive director of nonprofit Teach Plus Texas told ABC News. “As Texas thinks, so goes the rest of the country.”

The state’s Education Agency is enforcing one of the largest school district takeovers in the history of the U.S., with some educators, who are already facing high attrition levels and staffing challenges, saying they’re uncertain about their futures. Teachers told ABC News they are worried the takeover could prompt school closures, among other reforms in the nation’s eighth largest school district.

“A lot of teachers that were thinking about leaving or retiring are going to do so, so it [the takeover] has caused an instability within the teaching force in our school district,” Houston Education Association (HEA) President Michelle Williams told ABC News.

“The uncertainty is really just everything driving teachers to make decisions about what they’re going to do – whether they’re going to break the contract or stick it out,” Williams said.

But Mike Morath, the state’s commissioner of education, told ABC affiliate KTRK in Houston that the intervention was “necessary.” He said TEA is appointing a new Board of Managers for the school district because of academic failures by Wheatley High School.

Wheatley violated the state’s 2015 law – HB 1842 – that mandated an “intervention” and sanction of a public school that has received an academically unsuccessful performance rating for at least two consecutive school years, Morath said.

“What that law requires is if that threshold is ever met, that the commissioner of education is required, it’s not discretionary, is required to either order a closure of that school or order a board of managers for the whole district,” Morath told KTRK. “It’s not in the best interest of kids at Wheatley to close Wheatley, so that leaves us with the board of managers,” he said.

Due to the school’s underwhelming performance, the law was triggered in 2019. Morath wrote in a recent letter to the superintendent and board of trustees, “the district obtained an injunction” that prevented TEA from taking that required intervention action.

Earlier this year, the Texas Supreme Court delivered an opinion that vacated this long-standing injunction, and it was formally dissolved on March 1.

The job description for the school district’s Board of Managers states a desire for the new board to improve academic outcomes for students, but the district claims it has already made recent improvements.

“In the last 19 months, we have already seen vast improvements,” HISD Superintendent Millard House II wrote in a statement earlier this week. “Because of the hard work of our students, teachers, and staff, we have lifted 40 of 50 schools off the D or F TEA accountability ratings list,” he said.

Malonson said the move breaks from precedent in the state. He said Texas normally opposes state mandates, instead it would leave decisions up to the school districts.

“Texas is all about local control,” Malonson told ABC News. “That’s the elephant in the room. This flies in the face of everything Texas is about as far as local control. And it’s not just people at the state level that talk about local control, it’s the districts, it is – that is a thing – that is as Texas as Texas can be.”

As Houston residents have seen the TEA intervention unravel for more than three years, some are worried that TEA can’t be trusted, Malonson said.

“All they hear is TEA is coming in to take over, TEA is the boogeyman, for a lot of people,” he said. “Literally, this is a state takeover of your school district. It is going to make you anxious.”

But, Congresswoman Sheila Jackson-Lee, D-Texas, went even further saying the impact of this decision could reverberate around the country because Houston is the “most diverse” city in the nation. The Houston representative is calling for a federal civil rights investigation.

“This proposed takeover is devastating,” Rep. Jackson-Lee told ABC News. “I need them [the Department of Education] to seek more information and investigate this situation. I need them to determine whether there is due process, whether children are protected by equal protection of the law, whether the civil rights of the children are violated. And frankly, I need them to assess whether a title six complaint is warranted.”

More than 80% of HISD students are Black and Hispanic, according to school district data. Title VI of the federal Civil Rights Act of 1964, prohibits discrimination on the basis of race, color or national origin.

The U.S. Department of Education told ABC News it has been in contact with Jackson-Lee’s office regarding the matter and it values and encourages community input in education decisions.

“We cannot prejudge the effect of state and local decisions that have not yet been implemented,” a spokesperson for the department said in regards to the state’s announcement.

Michelle Williams has taught at HISD for over a decade. She’s most concerned about closures or her school being turned over to the charter system, but she also believes TEA’s move is political.

“It’s partisan politics playing with [the] education of 196,000 students,” Williams told ABC News. “We’re a democratic city that constantly has pushed back against the governor [Republican Greg Abbott]. During the pandemic, HISD was one of the school districts that instituted a mask mandate with the state saying that we cannot institute a mask mandate. So we have done some things that have pushed back on the political atmosphere.”

As the process plays out, Malonson cautions against immediate reactions before the appointment of the new board on June 1st.

“Today, tomorrow, even next week, not a whole lot of stuff is going to happen,” Malonson said. “I’m certain that there is a hefty amount of skepticism and fear about, like, just what TEA is going to do.”

He added, “So I think for the morale of the city, being the largest district in the city, the largest in the state. I think it’s going to be a blow to the morale of the city and people are just going to be wondering what happens next.”

Copyright © 2023, ABC Audio. All rights reserved.

Sarah Huckabee Sanders signs bill to create ‘monument to the unborn’ on Arkansas Capitol grounds

Sarah Huckabee Sanders signs bill to create ‘monument to the unborn’ on Arkansas Capitol grounds
Sarah Huckabee Sanders signs bill to create ‘monument to the unborn’ on Arkansas Capitol grounds
Steven Ferdman/Getty Images

(NEW YORK) — Republican Gov. Sarah Huckabee Sanders quietly signed into law on Thursday a bill that will create a “monument to the unborn” on the grounds of the Arkansas State Capitol.

Sanders’ team confirmed the bill signing in a release late Friday.

State Senate Bill 307, sponsored by Republican state Sen. Kim Hammer and Rep. Mary Bentley, allows for private funds “of gifts, grants, and donations from individuals and organizations” to pay for a monument to “unborn children aborted during the era of Roe v. Wade.”

Once the monument is installed, it would then be maintained by taxpayer funds due to its location.

Bentley said its intent is to “remember those children we were not able to protect and we will not be able to forget.”

Holly Dickson, executive director of the ACLU of Arkansas, an organization that challenged the installation of a Ten Commandments monument on State Capitol grounds in 2017, called the move to place an anti-abortion monument there a “performative political stunt.”

“Arkansas is ranked as one of the worst states in the nation for overall child well-being, maternal health, and the life expectancy among adults, yet the legislature has enacted dangerous limits and bans on reproductive healthcare. Lawmakers should be working to protect Arkansans with real solutions instead of this type of performative political stunt,” Dickson said in a statement to ABC News.

A total ban on abortion, except to save the life of the mother in a medical emergency, took effect in Arkansas last June when the Supreme Court struck down Roe v. Wade.

But despite a super majority of Republicans in the legislature identifying with anti-abortion rights, the bill to make a monument enshrining Arkansans’ aborted fetuses did not see unanimous support among Republicans in the state legislature.

The House passed the legislation Tuesday in a 60-19 vote with two Republicans voting “no.” Ten Republicans didn’t vote, and another ten Republicans voted “present,” which has the same effect as voting no. When the bill moved through the state Senate last month, two Republicans didn’t vote and one Republican voted present.

“From a Christian perspective, this has the look and feel of spiking the football,” said state Rep. Steve Unger, a Republican who voted against the bill, on the House floor. “It looks like gloating.”

“Public memorials to our nation’s wars where we face an external threat are right and proper,” he added. “A memorial to an ongoing culture war where we seem to be shooting at each other is not.”

Unger told ABC News on Friday, “My comments reflected my beliefs, but I respect other convictions.”

Rep. Jeremiah Moore, the other House Republican to vote against creating the monument, warned it could “have an unintended effect on the pro-life cause.”

“I believe that life is precious, but we must approach this issue with grace. It will serve as a poke in the eye to all those who don’t share our beliefs,” he said in a floor speech.

Rep. Tippi McCullough, a Democrat who voted against the legislation, told ABC News, “I could think of a thousand ways to better spend money that would be helpful to our citizens.”

“This bill makes no real distinctions in the type of abortions it would enshrine with a statue on Capitol Grounds. That means a woman who went through a traumatic pregnancy that resulted in the death of her child-to-be would have to face a monument commentating that awful moment when she comes here to the people’s house,” McCullough said in a statement to ABC News. “Abortion was legal in this country for nearly 50 years. Putting a monument outside these walls won’t change that. The state has no business in a woman’s healthcare or in a family’s tragedy.”

Hammer, one of the bill’s sponsors, countered the criticism to say, “Abortion had no unintended affect because it achieved what those who supported it intended for it to do which is to kill innocent lives.”

“Many tax dollars went to organizations that supported and encouraged abortions,” Hammer told ABC News in a statement. “Rep. Moore can defend his own comments. I will defend remembering the 250,000 innocent babies through a visual reminder in the hopes that we will never repeat a terrible chapter in our nation’s history.”

Hammer also said he is in touch with a company already that wants to donate the monument but did not disclose the company’s name or a description of the design. The secretary of state will have final approval of the monument’s maker and design, which the Capitol Arts and Grounds Commission will select, according to the bill’s text.

While there are hundreds of anti-abortion monuments across the country, this appears to be among the first approved for the grounds of a state Capitol.

The National Day of Remembrance for Aborted Children, an anti-abortion rights group, which says it exists “to honor the gravesites of our unborn brothers and sisters,” told ABC News it was not aware of any other currently existing monuments to unborn children on the grounds of other State Capitols.

Lawmakers in Tennessee approved legislation in 2018 allowing for a similar privately-funded monument to anti-abortion rights on its state Capitol grounds, but that monument has yet to be installed, said spokesperson John Jansen.

Monuments already on Arkansas Capitol grounds include statues honoring the Little Rock Nine, the first Black students to enter Little Rock Central High School under the landmark ruling in Brown v. Board of Education, and one of the Ten Commandments, which was damaged a day after it was installed when a man ran it over in protest. It has since been repaired.

Copyright © 2023, ABC Audio. All rights reserved.

All Time Low premieres video for ’Tell Me I’m Alive’ track “Calm Down”

All Time Low premieres video for ’Tell Me I’m Alive’ track “Calm Down”
All Time Low premieres video for ’Tell Me I’m Alive’ track “Calm Down”
Fueled By Ramen

All Time Low has premiered the video “Calm Down,” a track off the band’s just-released new album, Tell Me I’m Alive.

The clip finds a heavily bearded Alex Gaskarth waking up in a hospital to find that everyone around him won’t stop smiling. Not in a fun, happy way, but in a creepy way like in that horror film from last year.

You can watch the “Calm Down” video, which Gaskarth co-directed, streaming now on YouTube.

Tell Me I’m Alive, the follow-up to 2020’s Wake Up, Sunshine, is out now. It also includes the single “Sleepwalking,” which hit #1 on Billboard‘s Alternative Airplay chart.

All Time Low will launch a U.S. tour in support of Tell Me I’m Alive in May.

(Video contains uncensored profanity.) 

Copyright © 2023, ABC Audio. All rights reserved.

Music notes: Avril Lavigne, Taylor Swift, Louis Tomlinson, the Jonas Brothers and more

Music notes: Avril Lavigne, Taylor Swift, Louis Tomlinson, the Jonas Brothers and more
Music notes: Avril Lavigne, Taylor Swift, Louis Tomlinson, the Jonas Brothers and more

Mod Sun’s fans are not happy Avril Lavigne reportedly broke their engagement to date rapper Tyga. Page Six reports the crowd at Mod’s recent concert began chanting “F*** Tyga” after Travie McCoy of Gym Class Heroes started it. 

Taylor Swift put her crafting skills to work when creating a special backstage pass for her dad, Scott Swift. She shared the handmade work to her Instagram Story and joked, “Made my dad’s tour credential. We are a small family business.” The pass reads “D.O.H.,” which means “dad of headliner.”  

Liam Payne saluted Louis Tomlinson on the premiere of his documentary, All These Voices. “I’m so thankful to have you in my life mate I feel so lucky and I know you know this but you were part of a small group of people that literally saved my life, you dragged me out of something so dark I’ve never shared it but your approach is something I admire and aspire to so I can one day do the same,” he wrote in part.

The Jonas Brothers kicked off the City Concert Series on Today, performing at Rockefeller Plaza.

Pitbull celebrated his Ne-Yo collab “Time of Our Lives” hitting 1 billion Spotify streams. “Another billion another blessing,” he wrote. “Everyday above ground is a great day.”

Britney Spears shared a photo of herself when she was 13 and revealed she “used to make music videos with my friends at their house.” She wrote on Instagram, “We never had a real guy to play our love interest so we used our imaginations… Antonio Banderas was always my love interest and the video was the worst thing I have ever seen in my entire life.”

Calvin Harris brings a framed picture of “Da Ya Think I’m Sexy?” rocker Rod Stewart to every gig, he told BBC Radio 2. He said the photo is like “having someone just cheering you on in the corner.”

Copyright © 2023, ABC Audio. All rights reserved.

Less staff, longer delays and fewer options: Rural America confronts a health care crisis

Less staff, longer delays and fewer options: Rural America confronts a health care crisis
Less staff, longer delays and fewer options: Rural America confronts a health care crisis
Hinterhaus Productions/Getty Images/STOCK

(NEW YORK) — More than 40,000 graduating medical students learned Friday where they will spend the next three to seven years of their medical training.

With the United States grappling with a simultaneous shortage of primary care physicians and a rural health care crisis, many of the graduating students are set to enter the front lines of the country’s health care shortage.

At least 136 rural hospitals and health systems closed between 2010 and 2021, and over 40% of rural hospitals operate with negative profit margins. Despite billions of dollars in investment in health care, hospitals throughout the United States face the possibility of shutting down.

“I would say it is probably the worst time for health care that we ever experienced,” Joanne Conroy, the chief executive officer and president of Dartmouth Health, told ABC News. She noted that increased costs, inflation, limited housing, and workforce shortages have made running rural hospitals more challenging.

“We know what to do if we face another pandemic,” Conroy said. “The question is whether or not we have the financial resilience in order to survive it.”

Many hospitals that remain open have cut costs to survive, offering fewer services and beds.

In 2020, 47% of rural community hospitals did not provide obstetric services, with 89 obstetric units closing between 2015 and 2019. Seven million women reside in counties with limited or no access to maternity care, impacting half a million newborns annually.

According to Conroy, patients can already feel the impact of the crisis, noting that some women in New Hampshire need to drive two hours to deliver their babies. Other effects include fewer available beds in emergency rooms, delays for elective surgery and longer wait times for prescriptions or ambulance pickups.

For new medical professionals entering their residency, especially those joining rural systems, the circumstances of the struggling health systems are out of their control.

“It is not my job to fix all of the problems for an entire community, that’s impossible. When you feel like that’s your responsibility, burnout is basically inevitable,” said Katie Stevenson, a Tufts medical student. “When you feel like your goal is to do the best you can with the resources you have, you are able to right-size your expectations a bit.”

An increasing number of students are entering medical school programs that focus on rural medicine. In 2019, the Health Resources and Services Administration issued grants to create 32 newly accredited rural residency programs, supplementing the preexisting programs.

This year, Tufts School of Medicine will graduate its tenth class of students from its Maine Track MD program – a partnership with Maine Medical Center that allows students to pursue a community-based curriculum and gain financial incentives to encourage primary-care specialties.

Graduating roughly 40 students annually, 27% of Maine Track students have been matched to programs in Maine and 47% have been matched into primary care programs, according to Dena Whitesell, an assistant dean for students at Tufts and psychiatrist at Maine Medical Center.

“We know that students and residents who live in an area [and] who train in an area are more likely to practice in that area in the future,” Whitesell said.

Liv Fauver, a Tufts student who matched with a University of Vermont residency program, grew up in rural New Hampshire and said she felt motivated to work in a similar community where she could positively impact the local residents.

“I think for me, my goal is to live and work in the community that I serve,” she said. “So I’m really in a place where I go home or go to the grocery store and see my patients all the time, because that’s the world that I live in and work in.”

While rural hospitals have closed in record numbers, PCPs – medical professionals who patients regularly use for checkups and other routine care – face additional challenges, especially in rural areas, according to experts.

Greg Sawin, a PCP who has practiced in Massachusetts and Maine as well as Duke University School of Medicine professor, said he worries that the goals of primary and long-term preventative care can sometimes be at odds with larger health care systems.

“We get paid to do things to people. We don’t get paid to keep populations healthy,” he said.

Moreover, he believes the costs associated with medical schools – including the high cost, the likelihood of incurring debt and substantially higher pay to pursue competitive specialties like orthopedic surgery or dermatology, for example – disincentivize primary care options like family or internal medicine.

“It can be very appealing to want to go into a specialty where you’re guaranteed to make more money and pay that debt off more easily,” Stevenson said.

Owen Foster lives in rural Vermont and has felt the impact of the decreased number of available PCPs, spending six months to book an appointment with a doctor. Living in a rural area, Foster shares his dilemma with millions of Americans in rural areas impacted by the shortage of PCPs.

“You need basic things at certain intervals in your life,” he told ABC News. “If you don’t have a primary care provider, you can’t get that and you can’t get the referrals you need, so it’s really, really difficult.”

What makes Foster’s experience unique is his position as the state of Vermont’s top health care regulator. As chair of Vermont’s Green Mountain Care Board, he oversees the quality and cost of the state’s health care system.

Learning about the shortage of primary-care physicians in Vermont, Foster decided to use the opportunity to find a PCP as a chance to examine the market as a “secret shopper.”

“What I found was I was completely incapable of getting a doctor,” he said. “I called eight places and the best I got was on an indefinite wait list, which never came to fruition.”

Rural areas comprise about two-thirds of the primary care health professional shortage areas nationwide, even though only 20% of Americans live in rural areas.

The problem is also likely to worsen over time. Projections indicate that the United States will likely suffer a shortage of between 17,800 and 48,000 PCPs by 2034.

Moreover, health care professionals believe that the shortage of PCPs can make other elements of health care more expensive and worsen overall patient outcomes. Sawin gave the example of a person getting strep throat. Without a PCP, the person might go to a local hospital emergency room, which is significantly more expensive than other treatment options.

“In terms of mismatch of resources, you know, a kid with strep throat showing up in the ER is like cutting butter with a chainsaw,” Sawin said.

Foster added that primary care providers are “critical to controlling the costs of a health care system” due to their role in the early identification of issues, their ability to diagnose mental health issues, and their approach to preventative medicine.

According to Foster, PCPs in rural areas, however, struggle to find and retain staff, negotiate with insurance companies and prevent burnout. The shortage of PCPs, combined with the increased health care needs of the older population in rural areas, creates a concerning combination.

Despite these issues, Foster said he was optimistic about some approaches to make primary care more financially feasible, including adding a floor for PCP spending within health plans and government involvement in rate setting.

A new generation of students graduating from rural track programs also has the potential to reverse the tide of the PCP shortage in rural areas, with 571 additional primary care matches this year. Stevenson, for example, matched with the Swedish Cherry Hill rural program in Washington state.

“I think we have an opportunity in this country to do a much better job of taking care of our patients if we do a better job of funding primary care and preventative care and creating healthy environments,” Stevenson said.

Copyright © 2023, ABC Audio. All rights reserved.

Paul McCartney “very happy” with New York concert tribute

Paul McCartney “very happy” with New York concert tribute
Paul McCartney “very happy” with New York concert tribute
Bob Gruen

Paul McCartney was celebrated with a musical tribute in New York earlier this week, as previously reported. While he wasn’t there to see it himself, it certainly appears that he approved of what went down.

The Music of Paul McCartney, a benefit show put on by New York City entrepreneur Michael Dorf, featured performances by Patti SmithGraham Nash, Nancy WilsonWings guitarist Denny LaineBruce Hornsby, Natalie Merchant and more. McCartney took to social media to show his appreciation. 

The Beatles legend shared the Rolling Stone article about the concert, adding the comment, “Last night’s tribute concert made this boy from Liverpool very happy.” 

And it was all for a good cause, with the concert raising money for organizations that provide music education programs and opportunities for underserved youth.

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‘Jurassic Park’ star Sam Neill reveals he’s battling stage 3 blood cancer

‘Jurassic Park’ star Sam Neill reveals he’s battling stage 3 blood cancer
‘Jurassic Park’ star Sam Neill reveals he’s battling stage 3 blood cancer
Mark Metcalfe/Getty Images for AFI

Actor Sam Neill revealed to The Guardian he has been battling angioimmunoblastic T-cell lymphoma, a form of blood cancer, ahead of the release of his memoir, which addresses his health.

The paper reveals the book opens with a shocker: “The thing is, I’m crook. Possibly dying,” he reportedly writes in the beginning of Did I Ever Tell You This?

The cancer was stage 3, the 75-year-old explains, but he’s now cancer free thanks to a new chemotherapy drug he was switched to when the usual kind failed.

Neill, who played paleontologist Dr. Alan Grant in the Jurassic Park movies and reprised in the recent Jurassic World: Dominion, explains he was diagnosed after feeling swollen glands while promoting that trilogy’s third film.

The actor says his isn’t a cancer memoir, but the illness forms a “spiral thread” throughout, intermingled with anecdotes from his early life, growing up in Ireland and New Zealand, and from his time in the movie business.

He “never” set out to write a memoir, the actor explains, but while he was being treated last year, “I found myself with nothing to do … I love going to work. I love being with people every day and enjoying human company and friendship and all these things. And suddenly I was deprived of that. And I thought, ‘what am I going to do?'”

“As I went on and kept writing, I realised it was actually sort of giving me a reason to live and I would go to bed thinking, ‘I’ll write about that tomorrow … that will entertain me.'”

Neill says, “I can’t pretend that the last year hasn’t had its dark moments … But those dark moments … have made me grateful for every day and immensely grateful for all my friends. Just pleased to be alive.”

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