Kristof and Collins

In “Opioids, a Mass Killer We’re Meeting With a Shrug” Mr. Kristof says opioid deaths continue to climb yet G.O.P. plans would reduce help.  Nick, for them I’m sure it’s a feature, not a bug.  Ms. Collins says “You’ve Named Trump’s Worst!” and that all the cabinet members tried, but only one could triumph.  Here’s Mr. Kristof:

About as many Americans are expected to die this year of drug overdoses as died in the Vietnam, Iraq and Afghanistan wars combined.

For more than 100 years, death rates have been dropping for Americans — but now, because of opioids, death rates are rising again. We as a nation are going backward, and drug overdoses are now the leading cause of death for Americans under 50.

“There’s no question that there’s an epidemic and that this is a national public health emergency,” Dr. Leana Wen, the health commissioner of Baltimore, told me. “The number of people overdosing is skyrocketing, and we have no indication that we’ve reached the peak.”

Yet our efforts to address this scourge are pathetic.

We responded to World War II with the storming of Normandy, and to Sputnik with our moon shot. Yet we answer this current national menace with … a Republican plan for health care that would deprive millions of insurance and lead to even more deaths!

More on President Trump’s fumbling of this problem in a moment. But it’s bizarre that Republicans should be complacent about opioids, because the toll is disproportionately in red states — and it affects everyone.

Mary Taylor, the Republican lieutenant governor of Ohio and now a candidate for governor, has acknowledged that both her sons, Joe and Michael, have struggled with opioid addiction, resulting in two overdoses at home, urgent calls for ambulances and failed drug rehab efforts. Good for her for speaking up.

It should be a national scandal that only 10 percent of Americans with opioid problems get treatment. This reflects our failed insistence on treating opioids as a criminal justice problem rather than as a public health crisis.

A Times investigation published this month estimated that more than 59,000 Americans died in 2016 of drug overdoses, in the largest annual jump in such deaths ever recorded in the U.S. One reason is the spread of fentanyl, a synthetic opioid that is cheap and potent, leading to overdoses.

Another bad omen: As a nation, we’re still hooked on prescription painkillers. Last year, there were more than 236 million prescriptions written for opioids in the United States — that’s about one bottle of opioids for every American adult.

Even with all that’s at stake, there are three reasons to doubt that Trump will confront the problem.

First, Trump and Republicans in Congress seem determined to repeal Obamacare, which provides for addiction treatment, and slash Medicaid. The Congressional Budget Office estimated that the G.O.P. House plan would result in an additional 23 million Americans being uninsured in a decade — and thus less able to get drug treatment. Other, more technical elements of the G.O.P. plan would also result in less treatment.

Second, Tom Price, the secretary of health and human services, last month seemed to belittle the medication treatments for opioid addiction that have the best record, and Attorney General Jeff Sessions still seems to think we can jail our way out of the problem.

Third, Trump’s main step has been to appoint Gov. Chris Christie of New Jersey to lead a task force to investigate opioid addiction. But we needn’t waste more time investigating, for we know what to do — and in any case Christie talks a good game but bungled the issue in his home state.

Among experts, there’s overwhelming evidence of what works best: medication in conjunction with counseling. This doesn’t succeed in every case, but it does reduce deaths and improve lives. It also saves public money, because a result is fewer emergency room visits and inpatient hospital stays. So the question isn’t whether we can afford treatment for all people fighting addiction, but whether we can afford not to provide it.

The bottom line is that we need a major national public health initiative to treat as many Americans abusing drugs as possible, with treatment based on science and evidence. We also need to understand that drug overdoses are symptoms of deeper malaise — “deaths of despair,” in the words of Anne Case and Angus Deaton of Princeton University, stemming from economic woes — and seek to address the underlying issues.

Above all, let’s show compassion. Addiction is a disease, like diabetes and high blood pressure. We would never tell diabetics to forget medication and watch their diets and exercise more — and we would be aghast if only 10 percent of diabetics were getting lifesaving treatment.

Innumerable people with addictions whom I’ve interviewed haunt me. One was a nurse who became dependent on prescription painkillers and was fired when she was caught stealing painkillers from a hospital. She became homeless and survived by providing sex to strangers in exchange for money or drugs.

She wept as she told me her story, for she was disgusted with what she had become — but we as a society should be disgusted by our own collective complacency, by our refusal to help hundreds of thousands of neighbors who are sick and desperate for help.

Now here’s Ms. Collins:

It was a hard-fought race, people. But the results of our Worst Trump Cabinet Member reader poll are in.

And the winner is — Secretary of Education Betsy DeVos!

With a near tie for second place between Scott Pruitt of the Environmental Protection Agency and Attorney General Jeff Sessions. “It’s hard to be worse than Sessions or Pruitt. But DeVos deals with … children,” wrote a Michigan reader.

DeVos really hates public schools — something you don’t find often in a secretary of education. Her goal seems to be replacing them with charter schools, none of which will need much oversight because, you know, the choice thing.

Many readers noted that our secretary of education does not seem to be … all that bright. (“DeVos is a solid choice based on irony alone.”)

But I can’t help thinking Sessions might have taken the prize if his appearance before the Senate Intelligence Committee had gone on just a little longer. He clearly wowed viewers with his alleged inability to remember things. (“Wins by a Pinocchio.”) Some were taken by his resemblance to a bad hobbit or gremlin (“malevolent pixie”). But others simply found Sessions … bad. (“He is detestable and should have little tiny horns on the back of his head.”)

Pruitt, the head of the E.P.A., is a former Oklahoma attorney general who prepared for his current job by suing the agency 14 times. His champions in the Worst competition contended that, in the words of a North Carolina correspondent, “he can do major damage which will take years to undo.”

When we last left our runner-up, he was celebrating the nation’s departure from the international climate accord and kicking scientists off the Board of Scientific Counselors. Once again, some voters did get a tad personal. (“I have to pick Scott Pruitt because, besides trying to poison our planet, he always has that damnable smirk.”)

Let’s be extremely clear that this was not a scientific survey. In fact, it was pretty hard to get any count at all since many readers couldn’t resist the temptation to take the easy route and pick all of the above. (“I’ve seen better cabinets at Ikea.”) Or to name five. Or to complain that selecting one Worst was too hard. (“Trying to pick a winner from this bunch is like trying to knit a sweater with wet spaghetti.”)

It’s not that everyone was negative — there were a few kind words for James Mattis, the secretary of defense, and some mixed reviews on Secretary of State Rex Tillerson. But a lot of folks still seem to be in a state of trauma over that big meeting President Trump called last week, in which the cabinet members tried to one-up each other in the fulsomeness of their praise for their commander in chief. (“That cabinet meeting looked like one of those cheap TV ads you see where people praise a tomato slicer. …”)

Unfortunately, we couldn’t count the Worst Cabinet Member votes that were given to somebody who wasn’t actually in the cabinet. Donald Trump cannot get the prize. Nor can Jared or Ivanka or Omarosa. Also we cannot name Eric Trump’s wedding planner, even though she has just been named to one of the top jobs in the Department of Housing and Urban Development.

One reader was unnerved by rumors that Kansas Gov. Sam Brownback, after having finished wrecking his state’s economy, is now in line for a federal job and asked if he could be nominated Worst in advance.

Special tip of the hat to readers who chose Rick Perry. I have to admit I didn’t even mention him when I wrote the column proposing the Worst vote-off. But a number nominated him, generally pointing to the fact that when Perry took the job, he was unaware that the Department of Energy’s main responsibility was tending the nation’s nuclear arsenal, not traveling the world to boost the sale of American oil and gas.

Just as balloting came to a close, Perry gave an interview on CNBC in which he downplayed carbon dioxide’s role in global warming, explaining that “most likely the primary control knob is the ocean waters and this environment that we live in.”

This is a man who just keeps on campaigning. Plus, as one correspondent noted, if Perry ever won the Worst award “his acceptance speech would be epic.”

We saw a lot of votes for Tom Price, the secretary of health and human services, for his heroic efforts to ruin national health care and the social safety net. And Ben Carson got a surprising amount of support, considering that we barely ever hear about him doing anything. One reader was apparently won over by the painting the secretary of housing and urban development has in his home, showing Jesus with his arm around Ben Carson.

But DeVos is definitely our Worst Cabinet winner. For now. Do you think we should do this every few months? And what should the award look like? Anything’s possible. After all, we’ve got another three and a half years.

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