Hasta La Gadget!

The war to reform American medicine has been won.

The transformation began with the enactment of Medicare and Medicaid during the Johnson years — which allowed prices to be contained as a growing percentage of bills were paid by large entities, especially the government — and the HMO act during the Nixon years — which endorsed the idea of an efficient system where experts decided on how to treat any problem, effectively setting limits on volume.

Once the tools were in place to control both price and volume, the rest was just fine-tuning, which is still ongoing. The basic principles were ratified in Obamacare and are no longer under serious challenge. The change hasn’t relied entirely on government action, but reflects private sector movement in the same direction.

There will continue to be attacks from extremists in caves on both sides who refuse to acknowledge that the war is over and continue to lob grenades in an effort to enlarge consumer choice (from the right) or enact a single-payer scheme (from the left), but these are becoming increasingly irrelevant minor distractions.

Basically, we’ve gone from a system where patients paid most of the bills to one where insurers do. That’s illustrated in a nifty chart showing how patients were paying more than 20 percent of hospital bills in 1960 but only three percent now. The change in doctor bills went from 60 percent payment from patients then to 10 percent.

The new system delegates decisions on both treatment and payments to institutions with both expertise and market clout. As a result, medical economics are beginning to resemble ordinary economics. The old rules where supply created demand and costs weren’t a consideration in making treatment decisions are disappearing.

From the patient’s perspective, this all means that we’re living longer and better and are less likely to confront difficult decisions about whether to deplete our assets to finance the medical care we need. A growing number of walk-in clinics offer appropriate care at an affordable price. Our care will rely increasingly on protocols based on evidence, a change that will inevitably grate on patients and doctors who’d like more freedom to make their own choices, however suboptimal.

The scenario is less rosy for providers. The number of days we spend hospitalized has been declining for decades and many hospitals have gone out of business when they couldn’t fill their beds.

In an effort to capture a growing share of a shrinking market, hospitals are hiring physicians in the hope that this will help fill beds.

Physicians who see their incomes declining are increasingly willing to make such deals. A lawyer who negotiates such deals reflects that his clients are not going in the payroll to make more money, but as a strategy to slow their declining income. More than half of America’s physicians are now employees.

Medicare Part A spending per beneficiary peaked in 2011 has been falling annually since and is projected to be less this year than it was in 2008. That relieves pressure on the Medicare spending and sends a positive signal about government health spending generally, which has been a major component of deficit concerns.

It could also alleviate the wage stagnation issue as employers can direct a larger amount of higher compensation payment toward salaries rather than health insurance premiums.

The changes that have swept through so much of our economy in the past few decades, resulting simultaneously in greater efficiencies and painful adjustments for those who the old ways worked well for, are finally impacting American medicine.

A high-profile federal trial began Wednesday for three family members and a close family friend who have been charged with illegally possessing and distributing medical marijuana, among other offenses. If convicted, the defendants face minimum mandatory sentences of 10 years in prison.

Rhonda Firestack-Harvey, 55, her son Rolland Gregg, 33, and Rolland’s wife Michelle Gregg, 35, as well as the family’s close friend Jason Zucker, 38, grew marijuana on the property of their home in a rural town in northeast Washington. Larry Harvey, Firestack-Harvey’s husband and Rolland Gregg’s father, was originally charged in the case as well. However, the federal government agreed last week to dismiss all charges against Harvey because he was recently diagnosed with late-stage cancer.

The defendants maintain that the pot patch was in compliance with state law and that the plants were for their own medical use. (Washington state legalized medical marijuana in 1998.) But in 2012, federal law enforcers raided the Harvey home and shut down their operation.

The federal government has long prohibited the cultivation, possession and sale of marijuana in any form. States such as Washington that have legalized marijuana or softened penalties for possession have only been able to do so because of federal guidance urging prosecutors to refrain from targeting state-legal marijuana operations.

Following the raid, the Department of Justice charged each defendant with multiple felonies, including manufacturing, possession and distribution of marijuana, as well as possessing a firearm in furtherance of drug trafficking. (The family keeps several guns at the house, which it says are for hunting and defense. But federal prosecutors say the presence of firearms shows the defendants were involved in drug trafficking.)

At issue in the case is a historic measure, included in the federal spending bill signed by President Barack Obama in December 2014, that prohibits the Department of Justice from using funds to go after state-legal medical marijuana programs. In a motion to dismiss all charges filed in 2014, Harvey’s attorney argued that this provision protects patients such as Harvey and his family from federal prosecution.

U.S. District Court Judge Thomas O. Rice, however, rejected the motion earlier this month.

State authorities raided the Harvey home in August 2012, according to court documents, and found 74 plants growing near the house. Officers seized 29 of the plants in order to bring the family into compliance with state law, which limits collective crops to no more than 45 plants.

A week later, however, federal authorities conducted a more comprehensive raid, seizing the family’s remaining marijuana plants along with about five pounds of raw cannabis and some marijuana-infused edibles. Authorities also seized a sedan, several hundred dollars, firearms and some personal belongings.

“This is not the kind of spectacular haul that the DEA is typically called in for,” the family’s attorneys wrote in a letter to Attorney General Eric Holder in February 2014, urging him to reconsider the charges. “Just the opposite, the evidence seized is consistent with the type of strict medical dosage that occurs with a doctor’s supervision.”

All of the defendants were state-licensed medical marijuana patients. Before the raid, according to attorneys, Larry Harvey ate marijuana-infused cookies to ease symptoms related to gout, chronic pain and inflammation. The lawyers noted that his wife, who has osteoarthritis and has undergone joint and bone surgeries, used medical cannabis to ease her inflammation and pain. Rolland Gregg and Zucker used medical marijuana to treat back injuries, attorneys say, while Michelle Gregg used cannabis for appetite stimulation due to wasting brought on by a medical condition she hasn’t disclosed.

“The Obama administration has so far ignored a congressional order to stop prosecuting patients in medical marijuana states,” said Kris Hermes, a spokesman Americans for Safe Access, referring to the provision in the spending bill. Hermes’ group advocates for increased legal access to marijuana and more research into the drug.

“With no place to turn from a vengeful federal government,” Hermes argued, the defendants “will be forced to rely on jurors to do the right thing and acquit.”

Betsey Johnson is just as well known for her bold designs as she is for her eccentric, blonde hair. In a conversation with HuffPost Live Tuesday, the designer revealed that the same hairstylist has been doing her hair for 23 years, and that her look takes 12 hours to complete.

Johnson told host Caroline Modarressy-Tehrani that she chose her stylist, Andrew, based on his talent with extensions. “He’s the only one that can give me this hair,” she said. “And I love him. He knows how long to keep me a certain way. He’s a dear friend.” Andrew is based in London, so either Johnson flies to London or he goes to her.

After more than two decades of working together, Johnson and her stylist have discovered a way to pass the time while she’s in the salon chair.

“I only see him four times a year, but when I see him, it’s for 12 hours a pop. We watch at least 5 movies — it’s easy because we just sit and watch videos and it’s fun.”

Watch the full conversation on HuffPost Live.

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BEIRUT (AP) — Islamic State militants have moved a large group of Christians they abducted to one of their strongholds as fighting raged on Wednesday between the extremists and Kurdish and Christian militiamen for control of a chain of villages along a strategic river in northeastern Syria, activists and state-run media said.

The Khabur River in Hassakeh province, which borders Turkey and Iraq, has become the latest battleground in the fight against the Islamic State group in Syria. It is predominantly Kurdish but also has populations of Arabs and predominantly Christian Assyrians and Armenians. In pre-dawn attacks, the IS on Monday attacked communities nestled along the river, seizing at least 70 people, including many women and children. Thousands of others fled to safer areas.

The fate of those kidnapped, almost all of them Assyrian Christians, remained unclear Wednesday, two days after they were seized. Relatives of the group searched frantically for word on the fate of the loved ones, but none came.

“It’s a tragedy … It is true what they say: history repeats itself,” said Younan Talia, a high ranking official with the Assyrian Democratic Organization who spoke to The Associated Press from Hassakeh.

He was referring to the 1933 massacre by Iraqi government forces of Assyrians in Simele, a town in northern Iraq, after which the community fled to the Khabur region, and massacres against Armenian and Assyrian Christians under the Ottoman empire.

State-run SANA news agency and the Assyrian Network for Human Rights in Syria said the hostages have been moved to the Islamic State-controlled city of Shaddadeh, south of the city of Hassakeh. The United States and a coalition of regional partners are conducting a campaign of airstrikes against the group, and have on occasion struck Shaddadeh, a predominantly Arab town.

“In addition to its strategy of terrifying people, taking hostages to use as human shields to protect from coalition airstrikes is another of its goals,” said Osama Edward, director of the Stockholm-based Assyrian Network for Human Rights in Syria.

The mass abduction added to fears among religious minorities in both Syria and Iraq, who have been repeatedly targeted by the Islamic State group. During the group’s bloody campaign in both countries, where it has declared a self-styled caliphate, minorities have been repeatedly targeted and killed, driven from their homes, had their women enslaved and places of worship destroyed.

The Assyrians are indigenous Christian people who trace their roots back to the ancient Mesopotamians.

Talia said IS militants had raided 33 Assyrian villages on Monday, picking up as many as 300 people along the way. Many were plucked from their beds at dawn. A man who refused to leave his home was set on fire along with his house.

He added that more than 700 families who fled Khabour region had arrived in Hasaskeh, while 200 other families fled to Qamishli.

“We are watching a living history and all that comprises (it) disappear,” wrote Mardean Isaac of A Demand for Action, an activist group that focuses on religious minorities in the Middle East.

He called for further airstrikes to assist those Assyrian and Kurdish forces fighting the militants in Syria.

In its first comments on the subject, SANA said around 90 civilians had been kidnapped by the extremists. It said that the militants burned people’s homes and stole their properties, adding that those kidnapped were taken to Shaddadeh.

It quoted the patriarch of the Greek Catholic church, Gregory III Laham, as saying that in addition to the abductions, the militants destroyed the historic church in Tal Hurmiz, one of the oldest in Syria.

“Does the world need additional proof to stand united effectively against this epidemic and this criminal, inhuman group,” he asked.

Edward, who said his organization relied on observers on the ground in Syria, said two historic churches have been burned by the militants, one in Tal Hurmiz and the other in Qaber Shamiyeh.

Yunan Ruel Odishu, a priest from Tal Hurmiz currently in Dohuk, Iraq, said the Islamic State group issued a statement last month warning them to remove the cross from the village church, but the priest there didn’t respond.

“In the last few days, they attacked all the villages. We think as a response to that,” he said.

The Britain-based Syrian Observatory for Human Rights and a Christian group called the Syriac Military Council said heavy clashes against militants in the area were continuing. The group, which is fighting alongside Kurds and Arab militiamen, said three of its fighters were killed in Tal Hurmiz Tuesday.

“The Syriac Military Council and the Khabur Guards are determined to fight back ISIS, to regain the Assyrian villages and to release the Assyrian Christian hostages from ISIS,” it said in a statement, using an alternate acronym for the Islamic State group.

The Islamic State group has a history of killing captives, including foreign journalists, Syrian soldiers and Kurdish militiamen. Most recently, militants in Libya affiliated with the extremist group released a video showing the beheading of 21 Egyptian Christians.

The extremists could also use the Assyrian captives to try to arrange a prisoner swap with the Kurdish militias it is battling in northeastern Syria.

Talia appealed for “anyone with a free conscience” to address the tragedy of the Assyrians.

“We have lost our homes, our property, everything. But the hardest thing we lost is our dignity,” he said.

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Associated Press writer Bram Janssen in Irbil contributed to this report.