Separation anxiety, palpitations, inappropriate behavior. Just some of the signs of addiction.

Webster’s Dictionary defines addiction – “Compulsive need for and use of a habit-forming substance characterized by well-defined physiological symptoms upon withdrawal; also; persistent compulsive use of a substance known by the user to be harmful.”

Guidewell Emergency Systems reports the ten most common signs of addiction:

1. Mood swings
2. Tolerance
3. Withdrawal symptoms
4. Change in appearance
5. Irresponsibility
6. Financial trouble
7. Substance seeking
8. Unhealthy friendships
9. Isolation
10. Unsuccessful attempts to stop

We’re all familiar with these signs of addiction in people who use heroin or cocaine. But what about those who use cell phones?

Like you, I might have dismissed this as nonsense until I read a recent report in The Wall Street Journal that discussed the extremes that teachers must go to in attempts to control cell phone usage in the classroom in today’s schools. Sarah Krouse reports that before class each day, a high school teacher in Indianapolis grabs a clear plastic bag and fastens it to her waist with a ribbon. The homemade pouch is a repository for phones that are either confiscated or handed over voluntarily by students who don’t want to be tempted to tap or swipe during class.

Why not just put all cell phones in a box when students enter class and pick them up when they leave? The teacher says the magic of the makeshift vault isn’t that it keeps devices out of reach. It’s that it lowers students’ anxiety by keeping phones in view! It seems that when administrators employed a range of strict measures to keep them out of the classroom entirely, this introduced another distraction: withdrawal pangs!

Some teachers use lockable pouches that let students hold their phones rather than having to leave them alone in their lockers. (Perish the thought!) Others have set up charging stations in classrooms, betting that the visibility and value of a charge will keep students at ease. Some teachers have resorted to dangling extra credit and other prizes as the best defense against phone withdrawal.

Still other schools have bought a bunch of locking foamlike pouches from a company called Yondr that also markets its devices to theaters that want to prevent audiences from filming performances. The students can keep their phones with them but can’t access them without a special magnetic unlocking mechanism.

Some schools have opted for the carrot over the stick. At High Point Academy, Fort Worth, Texas, students in Jayne Lawrence’s English and Creative Writing classes download an app called Pocket Points that tracks when they touch their phones. Students can redeem points for different tiers of awards that kick in at 10, 15, and 24 class hours off the phone, earning prizes ranging from a drink at Starbucks to the ability to drop their worst test score. (In other words, teachers are rewarding students just because they don’t misbehave?)

Ms. Lawrence says the system is worth it because it gives her a way to combat students’ addiction without confrontation. “The quickest way here to burn a relationship is to take something from them, “she says.

The real problem is social media. Students cannot live without it. Yet a recent Pew Research Center study found that 45% of teens felt overwhelmed by the drama of social media.

As a result, many teens find themselves taking voluntary breaks from social media. A study by the Associated Press and NORC Center for Public Affairs Research conducted at the University of Chicago found that 60% who have taken breaks have taken three or more, and 23% of teens who haven’t taken a break from social media have wanted to take one. About half of teens say their social media breaks are typically a week or longer.

In my opinion, the problem is really the adults, not the children. Teachers who fear confrontation. School administrators who fear confrontation. Parents who fear confrontation. Where are the adults in this situation? If the adults fear the reaction of students to discipline, the game is over. When parents and teachers care more about being friends to their children and students than training and educating them, they are abdicating their roles as adults and it is the children who will suffer the most in the long run.

I began this discussion by describing the symptoms of addiction. Regardless of whether we are talking about cocaine or cell phones, it is still addiction. Remember the definition of addiction says, “persistent compulsive use of a substance known by the user to be harmful.”

Cancer. Perhaps no other single word strikes more fear in the hearts of human beings.

As a doctor, I know from experience that when you use the word cancer to describe your patient’s condition, little else you say will be remembered. It’s like a ticking time bomb we’re all afraid will someday explode.

But today there is good news about cancer – if you live in the United States. The American Cancer Society has just released the latest cancer survival rates and the cancer mortality rate in the U.S. has plunged nearly 30% since its peak in 1991. The largest annual decline occurred in 2017 but the trend line continues.

The Wall Street Journal editorial board says the reasons for this decline are numerous. They include fewer Americans are smoking, which has reduced the incidence of lung cancer. More Americans are also being diagnosed with cancer at earlier stages thanks to better tests and screening, which increases the chances of survival.

Here are some heart-warming five year survival statistics:

• Prostate Cancer– 98%
• Melanoma– 92%
• Breast Cancer– 90%

Melanoma death rates for men declined by a stunning 7.6% annually between 2013 and 2017. The death rate for breast cancer declined by an average of 1.5% annually from 2008 to 2017.

Scientific breakthroughs have enabled doctors to harness a victim’s immune system to increased survival rates by multiples over traditional chemotherapy. This is especially helpful in cancers with low survival rates such as metastatic melanoma and lung cancer.

The Cost of Cancer Survival

But none of this comes without a cost. The drugs that have enabled these advances in cancer survival require tremendous investments by pharmaceutical companies and therefore aren’t cheap once approved by the Food and Drug Administration. Yet these drugs hold the key to cancer treatment success.

Socialized medicine systems such as the United Kingdom and Canada don’t allow for these expensive drugs and therefore these countries do not enjoy our cancer survival rates. The U.K.’s National Institute for Health and Care Excellence (a misnomer at best) has rejected immunotherapies because they are too expensive. Better healthcare comes at a price that socialized systems are not willing to pay.

As a result, these systems have lower cancer survival rates. The age-adjusted mortality rate is about 20% higher in the U.K. and 10% higher in Canada and France than in the U.S. Survival rates for hard -to-treat cancers are also higher in the U.S. than in most countries with nationalized health systems.

The British medical journal Lancet published last year that an individual diagnosed with pancreatic cancer between 2010 and 2014 had nearly twice the likelihood of surviving five years in the U.S. than in the U.K.

Here are some five-year survival comparisons:

• Brain Cancer
  • U. S. – 36.5%
  • France – 27.2%
  • U. K. – 26.3%
• Stomach Cancer
  • U. S. – 33.1%
  • France – 26.7%
  • U. K. – 20.7%

The availability of expensive drug treatments is only one reason for better survival rates in the U.S. Another reason is better methods of detecting cancer at earlier stages. MRI scanners are more widespread and available for earlier diagnosis. Other diagnostic advances include Google’s artificial intelligence (AI) that can now detect breast and lung cancers with better accuracy – meaning fewer false positives and negatives – than radiologists. AI systems are also enabling researchers to identify more genetic links and to personalize treatments.

If you are unfortunate enough to be diagnosed with cancer, you can take heart in knowing that you have the best chances of survival if you live in the U.S. However, this advantage over other nations will disappear if we ever allow socialized medicine to be introduced into the American healthcare system.

Everyone wants the best quality drinking water. Who produces the best drinking water – public or private companies?

Elizabeth Warren, naturally, has a plan. Like all of her plans, it calls for more government control. But statistics show that private companies do a better job.

Seth M. Siegel is a self-described drinking-water activist who is the author of Troubled Water: What’s Wrong With What We Drink. Siegel writes in The Wall Street Journal that 85% of drinking water utilities are owned and managed by municipalities and other public entities. The rest are controlled by private companies, some closely held, others publicly traded. A recent report from the National Academy of Sciences concluded that for-profit companies do a better job than government entities at removing contaminants from drinking water.

You may be surprised, as I was, to learn there are over 50,000 water suppliers in the U.S., many times the combined number of electricity and gas utilities. This amounts to more than 16 water utilities for every U.S. county! They are not all in rural counties. Los Angeles County has more than 200 of them. In all, 92% of drinking-water utilities serve 10,000 or fewer customers each.

This large number of water suppliers increases inefficiency and waste. More importantly, it adversely affects the quality of water. Siegel says, “The smaller the drinking-water utility, the greater the likelihood that it lacks the funds needed to hire highly skilled engineers, buy new treatment equipment, and replace aging infrastructure.”

This also impacts violations of the Safe Drinking Water Act. Siegel says, “Government companies are nearly 30% more likely than their private counterparts to incur violations of the Safe Drinking Water Act, according to a 2016 study in the American Journal of Political Science. Many of these violations go on for years, subjecting millions to water with unsafe levels of contaminants.”

There are reasons for these differences. Private water companies are subject to a layer of regulatory oversight from state public utility commissions from which municipal utilities are ordinarily exempt. When violations are found, regulators are often reluctant to hit small municipalities with fines, and are quicker to punish violations of private operators. That fear of a financial penalty encourages private companies to be more vigilant.

Yet Senator Warren would have us believe that more government-run utilities would give us more high-quality drinking water.

Solutions

Siegel suggests the following solutions:

• Consolidation of utilities beginning with serial violators
• Incentives for smaller communities to merge with larger neighbors
• Sell local water services to private companies or outsource their management

Each of these solutions is aimed at encouraging larger companies, both private and public, that have greater resources to modernize their equipment, invest in infrastructure, and become more efficient through mergers.

Warren supports legislation introduced in the Senate by Bernie Sanders that would provide incentives for communities to terminate contracts with private water suppliers and restore water utilities to public ownership and management. This is no solution at all. It would eliminate the best of the water suppliers and discourage the mergers that would lead to more modern methods of assuring high quality drinking water. Eliminating competition by private water suppliers is a dangerous step in the wrong direction.