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Trump suspends arms treaty to focus on China, Russia threats

WASHINGTON — The Trump administration is pulling the plug on a decades-old nuclear arms treaty with Russia, lifting what it sees as unreasonable constraints on competing with a resurgent Russia and a more assertive China. The move announced Friday sets the stage for delicate talks with U.S. allies over potential new American missile deployments.

In explaining his decision, which he had foreshadowed months ago, President Donald Trump accused Moscow of violating the 1987 Intermediate-Range Nuclear Forces treaty with "impunity" by deploying banned missiles. Moscow denies it is in violation and has accused Washington of resisting its efforts to resolve the dispute.

Democrats in Congress and some arms control advocates criticized Trump's decision as opening the door to an arms race.

"The U.S. threat to terminate the treaty will not bring Russia back into compliance and could unleash a dangerous and costly new missile competition between the United States and Russia in Europe and beyond," the private Arms Control Association said. It argued that Washington had not exhausted options for drawing Russia back into compliance.

Trump said in a statement that the U.S. will "move forward" with developing its own military response options to Russia's banned deployment of cruise missiles that could target western Europe.

"We cannot be the only country in the world unilaterally bound by this treaty, or any other," Trump said. Other officials said the treaty could still be saved if Russia reverses course and returns to compliance, but that window of opportunity will close in six months when the American withdrawal is due to take effect.

The Trump decision reflects his administration's view that the arms treaty was an unacceptable obstacle to more forcefully confronting not only Russia but also China. China's military has grown mightily since the treaty was signed, and the pact has prevented the U.S. from deploying weapons to counter some of those being developed in Beijing. 

Leaving the INF pact, however, risks aggravating relations with European allies, who share the administration's view that Russia is violating the treaty but who have not endorsed a U.S. withdrawal.

Secretary of State Mike Pompeo, speaking to reporters after Trump's statement, said Russia will be formally notified today that the U.S. is withdrawing from the treaty, effective in six months. In the meantime, starting today, the U.S. will suspend its obligations under the treaty.

Pompeo said that if, in the coming six months, Russia accepts U.S. demands that it verifiably destroy the cruise missiles that Washington claims are a violation, then the treaty can be saved. If it does not, "the treaty terminates," he said.

Administration officials have dismissed concerns that the treaty's demise could trigger a race to develop and deploy more intermediate-range missiles. U.S. officials have emphasized their fear that China, which is not party to the treaty, is gaining a significant military advantage in Asia by deploying large numbers of missiles with ranges beyond the treaty's limit. Whether the U.S. will now respond by deploying INF noncompliant missiles in Asia is unclear. In any case, it seems unlikely Beijing would agree to any negotiated limits on its weaponry.

Russia accused the U.S. of unilaterally seeking to neuter the treaty.

"I 'congratulate' the whole world; the United States has taken another step toward its destruction today," said Konstantin Kosachev, head of the foreign affairs committee in Russia's upper house of parliament.

INF was the first arms control measure to ban an entire class of weapons: ground-launched cruise missiles with a range between 310 miles and 3,400 miles. At the time, in the late stages of the Cold War, the U.S. and its allies were mainly concerned by the perceived threat of Russian medium-range nuclear missiles that were targeted at Europe. The U.S. deployed similar missiles in response, in the 1980s, leading to negotiations that produced the INF treaty.

Rep. Adam Smith, a Washington state Democrat and new chairman of the House Armed Services Committee, blasted Trump for raising the risk of nuclear war.

"The administration's ideological aversion to arms control as a tool for advancing national security is endangering our safety, as well as that of our allies and partners," Smith said. 

U.S. officials say they have little reason to think Moscow will change its stance in the next six months.

"We have raised Russia's noncompliance with Russian officials — including at the highest levels of government — more than 30 times," Pompeo said. "We have provided Russia an ample window of time to mend its way. Tomorrow that time runs out."

Jens Stoltenberg, the NATO secretary-general, said in an interview Friday with The Associated Press that Russia can still save the treaty by returning to compliance before the U.S. withdrawal takes effect.

"But at the same time, we have started to assess the consequences, look into options," Stoltenberg said. "We need to make sure that we respond as an alliance, all 29 allies, because all allies are involved and all allies are affected."

Cold, but fun
Cold, but fun: Cone Park workers like winter rec jobs

SIOUX CITY -- The cold temperatures might make some think twice about working in a city park where tasks include routing people down snowy inner tube lanes.

But then, there's the freedom of being outdoors, plus, yes, free hot chocolate.

So, while patrons who come to Cone Park enjoy their skating experiences and tubing at thrilling speeds, the primarily young people who serve as park workers for the city also relish their jobs.

"You get to play in the snow, and there's nothing better than that," said Cone employee Gabbie Jansen, 18, of Sioux City.

Admittedly, conditions can be brisk working outside, Jansen said. The cold spell that enveloped the Upper Midwest and Siouxland resulted in closing of Cone Park on Tuesday and Wednesday, due to way-below-zero wind chill readings.

"That wouldn't have been fun for anyone," said Jansen, a West High School graduate who is a Briar Cliff University freshman.

"If you don't like the cold, this isn't the job for you. But if you bundle up, it isn't bad."

Jansen is working at Cone Park now for a second winter season, which matches the number of years the park has been in operation, at 3800 Line Drive in the Singing Hills area.

More than 20,000 people visited Cone Park during its first winter, from mid-December to mid-March. The tubing hill, which usually has at least six lanes open, can accommodate up to 225 users during three-hour sessions.

Additionally, there is a 5,400-square-foot ice skating rink. Next to the main tubing hill this year is the new Blue Bunny Hill, a shorter hill designed for people of all ages. Riders on both hills utilize a carpet lift to get them to the tops.

Parks and Recreation Department Director Matt Salvatore said the crew of primarily part-time employees, who work under the direction of John Byrnes, are a strong group. Byrnes worked as an intern at the park last winter, and was promoted to be the on-site manager this year, due to his exuberant performance of Cone tasks, Salvatore said.

Byrnes, 26, is a University of Northern Iowa graduate who has a background in winter recreation activities.

"I truly love it. Truly, it is so much fun. Managing Cone Park is awesome," Byrnes said.

He manages 40 workers, the overwhelming majority of which are teenagers working part-time, termed Winter Recreation Attendants, in the city parlance.

"They are a little bit older this year. I really like this group," Byrnes said.

Jansen said the learning curve is easier for second-year workers like herself, so "this year has gone a lot smoother."

Most nights, there are 10 employees, with seven working outside duties. Through cross-training, many perform multiple tasks, from routing patrons up the hill to overseeing the downhill descents to working inside the lodge selling concessions.

"They are charged with the safety of the hill, and we don't take that lightly," Byrnes said.

Like lifeguards at a swimming pool, they rotate duties throughout a shift, plus get breaks from the sometimes cold temperatures. That's where the free hot chocolate comes in.

"We don't freeze them to death," Byrnes said.

Additionally, a few Cone Park workers don't work directly with the public, and begin an overnight job many days. After the park closes at 9 p.m., those employees minutes later drive equipment to sculpt the hill after the impact of the tubers.

"It is just a good time to groom when the sun isn't out," Salvatore said.

In working the five- or six-hour shifts, Jansen prefers the outside to inside duties.  The inside tasks include selling concessions, admissions and making reservations for busy days, such as weekends and the popular Snow Glow evenings that sell out.

"I love working outside, because you get to interact with more people, and get the fun parts of it, like spinning them at the start of the (tubing) ride," said Jansen.

Reese Miller, a senior at East High School, is another Cone Park worker.

"Everyone really gets along pretty well. Obviously, when you are with people a lot, it can be like with siblings, with a bit of bickering. But it is good camaraderie," Miller said.

His favorite task is routing people riding tubes at the top of hill, where the key point is spacing them out, for safety sake, until the prior person reaches the bottom of the hill.

"I really enjoy a chance to work outside, even in the winter," Miller said. "It is usually not too cold."

Justin Wan, Sioux City Journal 

Sioux City Musketeers' Jordan Steinmetz, right, and Muskegon Lumberjacks' Matthew Staudacher compete for the puck during a hockey game in Sioux City, Iowa on Friday, Feb. 1, 2019. Sioux City Journal Photo by Justin Wan

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Iowa Business Council wants more diverse, robust state workforce

SIOUX CITY -- Georgia Van Gundy, the executive director and board secretary of the Iowa Business Council, said Friday that Iowa has work to do to attract a skilled and diverse workforce to the state.

"Everybody talks about population and diversity, and we want to get something done in this area," Van Gundy said in a Friday morning meeting with the Journal editorial board. She was accompanied by Wells Enterprises Inc. president and CEO Mike Wells. 

The Council on Monday recently released its 2019 competitive dashboard report, which examines Iowa's business competitiveness in five metrics -- economic growth, education and workforce, governance, health and wellness and demographics and diversity. 

Iowa's demographics and diversity rating was poor. The state is the 46th least-diverse state, according to the report, and the state is 30th in overall population. Only 14.1 percent of the state's population is non-white. 

Van Gundy said the state needs to find a way to attract skilled workers, and in general to increase the state's population and diversity. 

Wells and Van Gundy stopped short of taking a position on immigration, which in theory would bring in more diverse workers. Van Gundy told the Cedar Rapids Gazette this week that immigration is "something we're going to tease out." 

"When we look at diversity, it isn't so much about immigration as much as it is, what can we do to make the state of Iowa look similar in diversity of those folks that live here, similar in demographics of what we see across the United States?" Wells said. 

For Wells, that means businesses need to embrace and encourage affordable housing options, local quality-of-life and cultural offerings that workers find appealing, as well as bilingual accommodations in the workplace. 

Van Gundy said IBC is "putting together a group of thought leaders" in Iowa to examine the diversity and population issue. 

Policies supported by IBC include Gov. Kim Reynolds' $20 million recommendation for workforce housing tax credits program and reforming childcare benefits regulations to allow recipients to earn more money without losing their benefits. Benefits currently begin being cut off when a recipient's pay goes above 145 percent of the poverty level. 

Van Gundy called it "the childcare cliff effect," and Wells said a number of people find themselves "trapped" in un- or under-employment due to the risk of losing their state childcare benefits. 

"That's when individuals are not taking pay raises, because they lose too much of their childcare benefits in order to do that," she said. The group supports raising the scale to 200 percent of the poverty level, "So that they could continue to increase their income and not significantly lose their benefits." 

Both Van Gundy and Wells spoke at length about Iowa's efforts to improve the state's quality of life. The number of active primary care physicians in Iowa decreased to 82.8 per 100,000 in 2018, and it appears that doctors and other educated people are leaving the state for more attractive opportunities in other parts of the country. 

"Our challenge as a state is to create those opportunities in these communities, so that when you're a well-educated 20-something, you don't feel like you've got to run to the east and the west coast to get the 'life experience' that you're looking for," Wells said. 

Trump health chief asks Congress to pass drug discount plan

WASHINGTON -- The Trump administration's top health official asked Congress on Friday to pass its new prescription drug discount plan and provide it to all patients, not just those covered by government programs like Medicare.

The plan would take now-hidden rebates among industry players like drug companies and insurers and channel them directly to consumers when they go to pay for their medications.

Patients with high drug copays stand to benefit from the proposal, while people who take no prescription drugs, or who rely on generics mainly, would probably pay somewhat more, since premiums are expected to rise.

A day after unveiling the plan as a proposed regulation, Health and Human Services Secretary Alex Azar raised the stakes by calling on Congress to make it law and broaden it to include people covered by employer health insurance, not just Medicare and Medicaid beneficiaries.

"Congress has an opportunity to follow through on their calls for transparency ... by passing our proposal into law immediately and extending it into the commercial drug market," Azar said in a speech at the Bipartisan Policy Center think tank.

Ahead of next week's State of the Union speech, President Donald Trump is under political pressure to show results for his promise to slash prescription drug costs. Data show that prices for brand-name drugs have continued to rise, though at a somewhat slower pace. Polls show consumers across the political spectrum want government action.

Democrats say the administration's plan doesn't go far enough because it still leaves drug companies free to set high list prices. They say drug pricing is like a black box, and it's impossible to tell if prices reflect actual costs or if companies are charging what they think the market will bear.

House Speaker Nancy Pelosi, D-Calif., says she's also worried that the plan would raise premiums. HHS acknowledges Medicare prescription premiums would go up $3 to $5 a month.

Nonetheless, the administration's proposal appears to be in the mix as Congress gears up to craft legislation addressing prescription drug costs.

The complex plan would work by doing away with an exemption from federal anti-kickback rules that currently allows drugmakers, insurers and middlemen called pharmacy benefit managers to negotiate rebates among themselves.

Drug companies pay rebates to make sure their medications are covered by insurance plans that are the intermediaries between them and patients. HHS says hidden rebates can amount to up to 30 percent of a drug's list price. Insurers say they use the money from rebates to hold down premiums for all consumers.

Under the plan, the current anti-kickback exemption for industry rebates would be replaced with a new one for discounts offered directly to consumers.

Azar said the idea would reshape the drug pricing system, shifting it away from hidden rebates to upfront discounts, creating pressure on drugmakers to keep prices down. The proposal was co-authored with the HHS inspector general's office.

Experts say it will take time to sort out all the potential consequences.

Peter Bach, director of the Center for Health Policy and Outcomes at New York's Memorial Sloan Kettering Cancer Center, said the current system of rebates harms patients who take costly drugs with high copays.

Think people with cancer, patients with intractable illnesses such as multiple sclerosis or rheumatoid arthritis, and those who take brand-name medicines with no generic competition. Patients' cost sharing is often based on list prices, not the cost of the drug after rebates.

"Simply put, those on no medications at all will just see their premiums go up and see no savings because they don't take any medicine," said Bach. "Those on generics only may be essentially in this category (as well).

"But those on expensive medications ... they will see savings in total," he added. More than half a million people filled at least $50,000 in prescriptions in 2014, according to an Express Scripts report.

Insurers and pharmacy benefit managers like Express Scripts and CVS oppose the administration plan, saying it will undercut their ability to bargain with drugmakers for lower prices.

Drugmakers have applauded the administration's action.

Consumers are worried about prices for brand-name drugs, particularly new medications that promise breakthrough results. Generics account for nearly 90 percent of prescriptions filled, but brand-name drugs account for more than 70 percent of the spending.

Azar contends that under the current system everybody but the patient benefits from high prices. A high list price makes room for bigger negotiated rebates for insurers and middlemen. And drugmakers then merely build that expectation into their prices.

Before joining the Trump administration, Azar was a top executive for drugmaker Eli Lilly. That led to criticism that he would be an industry pawn. But the drugmakers vehemently disagree with some of his other ideas, including an experiment using lower international drug prices to cut some Medicare costs.