One basic axiom for a party in trouble with voters is to absorb and expand the reach to new voters. The Democratic Party is losing touch with voters, so here are some expansion ideas. My main suggestion is to steal some thunder from the Republicans and drifting voters by daring to embrace some populist ideas, rather than softening some core beliefs. Here are some examples:
Reform higher education
One way is to fund a new layer of colleges, as in California, that are aimed at where the jobs are. An example would be UC Davis, with its wine-making classes. Another would be to provide money for “canon schools,” which focus on the Western canon (Aristotle, Shakespeare, Dante, Cervantes), including critiques of these works. Already we have four-year ex-community colleges in Bellevue, Edmonds, so build a system that meets the market and grants full degrees and graduate programs.
Dilute urban voters
Cities like Seattle can harden into monocultures, so provide examples and incentives to widen the electorate. Locally, I can envision a Seattle/Bellevue/Tacoma/Everett Council, starting with the ports and economic development. Or steal a page from the littoral cities of Northern Europe and its Hanseatic League, by creating such an alliance of various shoreline cities in Puget Sound. That would align Seattle with such issues as the struggling airport in Bellingham, building out Fort Worden in Port Townsend, finishing PACE (a long-delayed performing arts venue) in Bellevue, taking over the ferry system, and saving Orcas and Puget Sound. Seattle would gain friends in these other places, and the urban agenda would be enhanced in these ballooning burbs.
Encourage mergers
Loaned executives from the merger-and-acquisitions firms, plus state grants to mitigate the costs, would create a new efficiency among the surfeit of entities addressing such problems as the homeless, housing, schools, hospitals, struggling arts organizations, and prolific state agencies and boards. Ideally this effort is driven by a new non-profit, not the state’s economic development agencies (themselves in need of merger-medicine). Here is another way for brainpower in Seattle to share the wealth and learn by widening the scope.
Create Competitive Grant Programs
Many cities and regions need new facilities, so create a generous competitive-grant program, funded by a high-income tax, that spreads the wealth and is bottom-up, populist-style, not Seattle-driven or special-interest-driven.
Such programs would widen the urban electorate, align Seattle with broader needs, and actually deliver “abundance” projects.
Skyline residentDavid Brewster, a founding member of Post Alley, has a long career in publishing, having founded Seattle Weekly, Sasquatch Books, and Crosscut.com. His civic ventures have been Town Hall Seattle and Folio Seattle.
Dear Skyline Residents, >> We have established a list of residents who are happy to have CLEAN, clamshells dropped at their door in a paper bag, on Tuesday morning before noon. They will deliver the items to Wheels, a shelter, at 715 Spring St and 8th Av. If you find that you are able to help please contact Diana Caplow or Linda Marcuse. >> For the CASCADE TOWER >> *Janet Miller – 12 floor only >> *Mary Montgomery – apt. 708 >> *Pearl McElheran apt. 2209 >> *Baugh apt. 1004 >> *Caplow apt. 201 >> >> For the OLYMPIC TOWER >> *Judy McBroom apt. w1712 >> *Cory apt. w1213 >> *Krasner & Pereira apt. w411 >> *Karen McMichaels apt. W1812 >> *Marcuse apt. W1013
Earlier this week Donald Trump called for a second civil war at a US military base. This scenario can be resisted and prevented, if we have the courage to listen, interpret, and act. And this Saturday we will have the occasion to act.
The listening is important. The speech was given at the base now known again as Ft. Bragg. The fort was named for a confederate general. It was renamed Ft. Liberty. Under this administration, it was renamed Fort Bragg, now ostensibly to honor another American serviceman, not the confederate general. It is a dishonest pretense that dishonors everyone. The fort is now named again after a confederate general, as Trump made clear. The tradition that is now in fact being honored, that of oathbreakers and traitors.
In Trump’s speech, the existence of the United States is placed in doubt. We are not a country but a divided society in which some of us deserve punishment by others. He made no mention of the world today, nor of any common American interest that might necessitate national defense. There was no concern about threats from China or Russia. Middle Eastern dictatorships, the only countries that Trump singled out, garnered great praise because their leaders gave Trump money. There was no mention of any wars that are actually underway, such as the Russian invasion of Ukraine. (continued on page 2 at www.skyline725.com)
As you may have heard, RFK Jr. has already revealed eight names for the new ACIP committee. As mentioned earlier, there was a spectrum of possibilities on who these names would be, going from “best case” to “worst case.” Let’s say there are some major red flags. But there may be more names, and I want to wait to comment until the entire list is revealed and I have a steady head. More soon.
Part of the exhaustion this week isn’t just professional. It’s also deeply personal…
Every night, I ask my girls about their day. Most of the time, their answers reflect their innocence and uncomplicated lives (“Someone cut in front of me in the lunch line.”) But my daughter’s response stopped me.
Daughter: Aiden* was being really mean today.
Me: Well, sometimes when someone is mean, that means they are really sad inside.
Daughter: That makes sense because he was crying all day.
Me: Why was he crying?
Daughter: Because his parents had to go back to Mexico.
Me: For a summer vacation?
Daughter: No, forever. He doesn’t know when he will see them again. He has to live with his grandma. [pause] Are you going to have to go to Mexico?
One in eight students in states like California have at least one undocumented parent. So I suppose it was only a matter of time before my daughters’ world collided with the reality of immigration policy. But nothing prepares you for the conversation.
Regardless of where you stand politically on immigration, it’s essential to understand that policy changes impact not just individuals who are deported, but the communities they leave behind, especially children. (continued on website www.skyline725.com)
Spending millions of dollars to parade troops and tanks down American streets isn’t patriotism — it’s performance art at taxpayer expense.
This isn’t how a democracy honors its military. It’s how a fading empire stages a spectacle. Our veterans need health care. Our children need books. Instead, we get freshly repainted tanks rolling past crumbling schools.
We haven’t just blurred the line between governance and entertainment — we’ve erased it. We have become a reality show. And it’s obscene.
FOX 13 Seattle and ROOT Sports will carry live local broadcasts of all Seattle Orcas games throughout the 2025 Major League Cricket season
From Bob P. “Just discovered that Seattle has a Cricket team. Perhaps we are among the last to learn this. A game will be televised tomorrow. We plan to watch.”
The coming game is Saturday, June 14 at 6 PM PDT with a watch party in South Lake Union. FOX 13 Seattle and ROOT Sports will carry live local broadcasts of all Seattle Orcas games throughout the 2025 Major League Cricket season. The home games are at Marymoor Park in Redmond.
Ryan Miller, President and CEO of Terwilliger Plaza
Portland, OR – May 29, 2025 – Ryan Miller, CEO and President of Terwilliger Plaza has been awarded Executive of the Year by LeadingAge Oregon, a non-profit statewide association of mission driven organizations dedicated to advancing quality aging services. With a leadership style that is collaborative and engaging, Miller has a depth of expertise in the senior living industry. The award recognizes his exceptional leadership, visionary approach and commitment to continuous improvement within the Terwilliger Plaza community.
According to Stephanie Roberts, Director of Community Life at Terwilliger Plaza, “Ryan has truly set a new standard for both service and quality of life in senior living through his commitment to innovation and fostering a strong, inclusive culture. His vision extends far beyond simply improving day-to-day operations. He has created a vibrant and inclusive environment where both staff and resident Members feel like valued members of a supportive, interconnected community.”
Miller’s ability to foster innovation is evident in the way he integrates cutting-edge technologies and forward-thinking practices, ensuring that both staff and resident Members benefit from the latest advancements in care and service. Beyond driving operational efficiency and success, Miller is seen through the community as a true mentor, consistently guiding his team with patience, insight, and a genuine desire to see others succeed. During his tenure he has cultivated a culture of growth and empowerment through the organization.
As President and CEO, Miller has guided the Terwilliger Plaza community through the completion and opening of the $160-million Parkview expansion, a 10-story building that adds 127 independent living apartment homes to the Terwilliger Plaza community. Upon certification, Parkview is anticipated to be the largest Passive House structure on the West Coast, and the largest Passive House senior living building in the country. With the opening of Parkview, and with increased consolidations in the industry, Terwilliger Plaza now ranks 85th in capacity out of the top 200 single site senior living communities nationally.
Established in 1962, Terwilliger Plaza is a single-site non-profit Continuing Care Retirement Community (CCRC), offering a continuum of care that includes independent living, assisted living, with 24/7 on-site licensed nursing within assisted living. One of only two CARF accredited CCRC’s in the state of Oregon and the only SAGECare Platinum Credentialed CCRC in Oregon, Terwilliger Plaza is distinctive in its representative self-governance board structure. Located in Portland, Oregon, the community comprises resident Members who are volunteers, patrons, educators, and active participants in the city’s vibrant culture of civic duty and personal responsibility.
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They’ve defied our courts, deported Americans, disappeared people off the streets, attacked our civil rights, and slashed our services. The corruption has gone too. far. No thrones. No crowns. No kings.
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OF ALL THE medical challenges that scientists have faced, Alzheimer’s disease, the most common form of dementia, has been one of the trickiest. Between 1995 and 2021 private money spent on Alzheimer’s research came to $42.5bn, but more than 140 trials failed to yield a single drug capable of slowing the disease. Yet the tide may be turning. There are now two working drugs, offering modest benefits, on the market, and a new review paper suggests more could soon follow.
There are 182 clinical trials for Alzheimer’s treatments under way in 2025—an 11% increase on last year—testing 138 different drugs, of which 12 are likely to complete their final “phase 3” trials this year. Moreover, this pipeline includes medicines aimed at a diverse range of targets in the brain, reflecting an increasingly sophisticated understanding of the molecular processes behind Alzheimer’s and dementia.
For decades, the theory that has dominated Alzheimer’s research, and drug pipelines, has been the amyloid hypothesis. It argues that the primary cause of the disease is the accumulation of plaques of beta-amyloid proteins in the brain. These supposedly lead to a cascade of negative effects including neuronal dysfunction, brain-cell death and neuroinflammation.
The amyloid hypothesis was supported by genetic evidence, which showed mutations in certain genes within families were linked to early onset of the disease. The success of the two drugs already treating Alzheimer’s—lecanemab and donanemab, which arrived on the market in 2023 and 2024, respectively—proves that a connection exists. Both help clear amyloid from the brain, and offer modest help to a subset of patients for whom the drug is thought to be safe and useful. They slow the progression of the disease by about one-third, according to clinical trials, meaning patients can retain their quality of life for longer.
Chart: The Economist
The excitement generated by these drugs has been tinged, however, with a feeling that they were not much to show for decades of effort. The singular focus on amyloid was probably misplaced. James Rowe, a professor of cognitive neurology at the University of Cambridge, says that although amyloid accumulation is a critical “early trigger” for the disease, by the time patients arrive at his clinic, other neural processes are accelerating the illness. These include the accumulation of a misshapen version of another protein, called tau; increased metabolic stress on brain cells; neuroinflammation; and degeneration of the brain’s blood supply. (continue on page 2 of www.skyline725.com)
This more nuanced understanding of Alzheimer’s is at last being reflected in drug development. That is the conclusion of Jeffrey Cummings at the University of Nevada, Las Vegas, and colleagues, in their new review, published on June 3rd in Translational Research & Clinical Interventions.
Academic experts, and investors, agree. Dame Kate Bingham is the managing partner of SV Health Investors, a venture-capital firm based in London that, in 2015, started the first fund dedicated to discovering new treatments for dementia. At the time, the drug pipeline for Alzheimer’s was mainly focused on tackling amyloid. She says the growing diversity of potential targets today gives her increased optimism.
Fully one-third of the new drugs are repurposed, which means they are already approved for use in other conditions and are being redeployed to Alzheimer’s. The appeal of this approach is that the drugs already have known safety and toxicity profiles, and can be approved quickly and developed cheaply. One of the better known is semaglutide, a diabetes and weight-loss drug whose anti-inflammatory and metabolic benefits have led to its being tested as a treatment for mild cognitive impairment. The drug piromelatine, meanwhile, works on melatonin and serotonin receptors in the brain, which help regulate sleep. As healthy sleep is thought to increase the rate at which amyloid and other waste proteins are cleared, improving it may slow the progression of Alzheimer’s.
Then there is AR1001 (also known as mirodenafil), which was originally developed for erectile dysfunction and is being tested for its neuroprotective properties. The drug increases levels of a molecule in the brain called cGMP which, in turn, activates pathways that support the survival of nerve cells and improve connections between them. Drugs of this kind are known to improve blood flow, so AR1001 might also improve the brain’s vascular health.
Another repurposed drug is nabilone, which interacts with the cannabinoid receptors in the body. (The most well known molecule of this kind is tetrahydrocannabinol, the active compound in cannabis). It was originally developed to treat nausea and vomiting in those undergoing cancer chemotherapy. It is now being tested as a potential treatment for agitation and behavioural problems in those with Alzheimer’s. Guanfacine, a drug that improves attention and executive function in those with ADHD, is also being tested to see if it can offer similar benefits.
Repurposed drugs do not necessarily have a higher chance of success in late-stage trials than those with a novel mechanism. Indeed, Dame Kate argues that innovative approaches which use new molecular targets, rather than repurposing, will have the greatest impact on the disease.
Fresh approaches
One area of innovation is centred on drugs that can tackle inflammation in the brain. Particular attention is being paid to brain cells called microglia, which play an important role in the brain’s immune response and, most probably, its fight against Alzheimer’s. Microglia have been described as acting as the brain’s fire service, police and binmen, because they simultaneously respond to emergencies, maintain order and clear up debris. A number of drugs are trying to target the protein TREM2 on the surface of microglia in the hope of boosting their activity.
Combinations of drugs are also being tested. For example, it is hoped that pairing dasatinib, a cancer drug, with quercetin, a molecule derived from plants, will clear ageing and dysfunctional cells. Drug combinations that target different pathways and components of an illness have made big inroads into other complex diseases such as cancer and HIV.
Some of the errors of the past have been corrected. Dr Rowe says that early attempts to design amyloid-clearing drugs did not remove enough amyloid, or did so too slowly. The patient selection in trials was also poor, with many patients included who—it later turned out—did not have Alzheimer’s at all.
Today’s trials still have blind spots, warns Antonella Santuccione-Chadha, the founder of the Women’s Brain Foundation, a non-profit based in Switzerland that studies how sex affects brain and mental health. Many still fail to differentiate patients by sex, she says. Yet women are twice as likely to develop Alzheimer’s, a difference that cannot be explained solely by their longer lifespans, and the disease seems to progress differently in their brains. At any given stage of the disease, tau proteins spread farther in women than in men, says Dr Chadha.
It would help the trials—and patients—if more people were tested for Alzheimer’s earlier on, so that they could be enrolled to try the new drugs. A single register of those with the disease would also be useful, making it easier for patients to find trials, and for drug companies to find patients.
Much, therefore, remains to be done. But for those suffering from a horrible and as yet insurmountable disease that steals so many minds, there is also some much needed hope. ■
Thanks to Mary M. (Ed note: Although the note is about 6/11, it applies to any local protest March including this weekend’s No King event.)
Please see the notice below from the East Precinct’s Crime Prevention Coordinator.
Planned rally this evening at Cal Anderson Park (with possible march through First Hill and Downtown)Upcoming ActivityA rally is planned tonight (6/11) to begin at Cal Anderson Park at 7:00 pm.There may be a march associated with this rally that may travel through either Capitol Hill and First Hill and return to Cal Anderson Park, or begin in Capitol Hill and travel to the Federal Building/Federal Courthouse in Downtown.
It is likely unaffiliated small groups intent on committing violence and/or property damage will attempt to embed themselves un this rally.Be aware of potential no-notice lane closures. A march and rally are planned this Saturday (6/14) beginning at Cal Anderson Park and marching to the Seattle Center beginning at 12:00 pm.Be aware of potential no-notice lane closures.
Suggested Action: Bring in garbage cans and small items from sidewalks and alleyways.Lock and secure dumpsters. Report property damage and crime to the contact information below. Reporting Property Damage and CrimeAny real-time reports or property damage or violence need to be called in to 9-1-1.
SPD states it is essential they are logged and queued, in case of escalated behavior and for documentation purposes. 9-1-1 communicates with each precinct from a dedicated dispatch person who relays all information coming into the call center.
For follow-up questions or concerns after any related incident that is not time sensitive, you may email Joseph Elenbaas (contact info below). Joseph Elenbaas (he/him) #8174 Crime Prevention Coordinator Seattle Police Department | East Precinct C: 206-247-2831 P: 206-684-5
Please let me or Linda Marcuse know if you can bring washed, clam shells from Skyline to the Women’s shelter in the Presbyterian Church on Spring St. It is a 5 minute walk on 8th Av. Proceed to Marion, Madison, then Spring. Make a left turn; entrance is a few feet away. If you can have clam shells dropped at your door once a week for delivery, that would be great. Your effort will be greatly appreciated by the shelter as well as Skyline. Diana Caplow Linda Marcuse
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Today President Donald J. Trump made it clear that the provocations he and his administration are escalating in Los Angeles and now elsewhere are using the issue of immigration to suppress dissent entirely.
In the Oval Office today, Trump said of the military parade scheduled for this Saturday: “If there’s any protester wants to come out, they will be met with very big force…. For those people that want to protest, they’re going to be met with very big force.”
His statement comes after the administration instituted aggressive immigration sweeps in Los Angeles during which Immigration and Customs Enforcement (ICE) met the few hundred protesters with violence.
Then, over the protests of both Los Angeles mayor Karen Bass and California governor Gavin Newsom, Trump federalized 4,000 members of California’s National Guard and ordered 700 Marines to Los Angeles. He and his advisors have repeatedly threatened to arrest anyone who does not cooperate with ICE, including Mayor Bass and Governor Newsom.
Trump has said he based his decision to federalize the National Guard on his insistence that Los Angeles is staggering under violent riots, but in fact the protests are largely peaceful and local officials maintain they can handle the situation.
Still, Trump described Los Angeles as “invaded and occupied by Illegal Aliens and Criminals,” and said “violent insurrectionist mobs are swarming and attacking our Federal Agents to try and stop our deportation operations.” Secretary of Homeland Security Kristi Noem called Los Angeles a “city of criminals,” and other MAGA lawmakers have gotten into the act. Will Sommer of The Bulwark pointed out today that MAGA influencers are also pushing for more crackdowns and more cruelty in a feedback loop as they and White House officials push each other toward more and more cruelty toward immigrants.
But the narrative that L.A. is under siege is hard to make stick. Protesters have been filming the bands playing and people dancing at the protests, which remain small. They have also filmed the ICE agents shooting less-lethal bullets at individuals, including an Australian journalist who was speaking to a camera when she was shot from behind. The complaint against SEIU leader David Huerta, who has been charged with conspiring to impede an officer, says that he walked and sat on a public sidewalk in such a way that he blocked an ICE van before an officer pushed him to the ground and arrested him.
Economist Paul Krugman notes that “Los Angeles right now is probably as safe as it has ever been,” and Newsom has been meeting the claims of MAGA politicians that the city is a hellscape with actual statistics showing that California is safer than their own states. He reminded Oklahoma senator Markwayne Mullin that Oklahoma’s murder rate is 40% higher than California’s and, after Alabama senator Tommy Tuberville called for Newsom to be arrested, retorted: “Alabama has 3X the homicide rate of California. Its murder rate is ranked third in the entire country. Stick to football, bro.”
As Maria Sacchetti of the Washington Post noted today, California recently became the fourth largest economy in the world. It has the highest number of immigrants in the country—although many have moved in the past few years to more affordable states—and unemployment numbers are close to the national average.
But Trump has always managed his public affairs by projecting dominance in a fake world; his political instincts for keeping attention on himself have been compared to the kayfabe of professional wrestling. (continued on Page 2 at www.skyline725.com)
This afternoon he upped the ante again. In a speech at the Army base at Fort Bragg, North Carolina, Trump delivered a fiercely partisan speech that sounded like it was written by White House deputy chief of staff Stephen Miller. In front of a crowd of enlisted personnel who journalist Jane Coaston reported had been carefully selected to be Trump supporters and “to be fit and not look fat,” Trump claimed the U.S. was under a “foreign invasion” because of “stupid people or radical Left people or sick people.” He goaded the personnel into booing Newsom and Bass.
Since the days of George Washington, the American armed forces have been strictly nonpartisan, declaring their allegiance to the U.S. Constitution itself rather than to any leader.
Simon Rosenberg of Hopium Chronicles noted that Trump is “turning the world’s powerful military away from its focus on Russia and China toward a new enemy—the American people themselves.” He mused: “I’ve been saying that I felt Trump’s dramatic escalation in recent days was driven in part by Musk’s emasculation of him last week. I also wonder whether it’s being driven by Zelensky’s profound humiliation of Putin, and Putin lashing out at Trump for not delivering Ukraine to him.”
Steven Lee Myers of the New York Times reported today that right-wing bots, trolls, conspiracy theorists, and MAGA influencers are flooding social media with messages designed to attack immigrants and Democrats and defend Trump. Many of those accounts are linked to Russia and Russian disinformation.
It certainly feels as if administration officials are going for broke in ways that benefit Russia. Director of National Intelligence Tulsi Gabbard today released a video warning that the world is close to a nuclear war caused by a political elite that expects it can survive one in special bunkers. Gabbard has a history of parroting Russian propaganda, and famously, Russian president Vladimir Putin has used the threat of nuclear war to press his demands against Ukraine.
A YouGov poll out today shows that only 34% of American adults approve of Trump’s deployment of Marines to the Los Angeles area to respond to protests over the enforcement of immigration laws while 47% do not approve. Only 38% of American adults approve of Trump’s deployment of National Guard soldiers to L.A., while 45% disapprove. A strong majority—56%—of Americans think state and local officials should take the lead in responding to the L.A. protests, while only 25% think the federal government should.
Strikingly, 50% of adults disapprove of the administration’s handling of deportations, while only 39% approve.
Those numbers were gathered before Pentagon comptroller Bryn MacDonnell told the House Defense Appropriations Committee today that the Pentagon estimates the cost of federalizing the National Guard and deploying the Marines to Los Angeles at $134 million.
Today the Department of Justice announced it was indicting Representative LaMonica McIver (D-NJ) on three counts of “forcibly impeding and interfering with federal law enforcement officers” after a May 19 event in front of a Newark, New Jersey, ICE detention center. McIver was at the detention center with others as part of her oversight responsibilities, and a video shows her being jostled with a crowd that includes an ICE officer, but no one breaks stride. McIver called the charges “a brazen attempt at political intimidation.”
Tonight Governor Newsom delivered a prime-time address about the events of the past few days. He outlined the story of the ICE raids and Trump’s escalation of conflict. He urged protesters to exercise their First Amendment rights peacefully and warned that anyone participating in violence would be held accountable.
Then the governor launched into a wholesale condemnation of the Trump regime. He warned that “[i]f some of us can be snatched off the streets without a warrant, based only on suspicion or skin color, then none of us are safe. Authoritarian regimes begin by targeting people who are least able to defend themselves. But they do not stop there.”
Newsom called Trump out for firing the government watchdogs that could hold him accountable for fraud, and for declaring war “on culture, on history, on science, on knowledge itself. Databases quite literally are vanishing. He’s delegitimizing news organizations and he’s assaulting the First Amendment…. [H]e’s dictating what universities themselves can teach. He’s targeting law firms and the judicial branch that are the foundations of an orderly and civil society. He’s calling for a sitting governor to be arrested for no other reason than…, in his own words, ‘for getting elected.’”
“[T]his isn’t just about protests here in Los Angeles,” Newsom said. “When Donald Trump sought blanket authority to commandeer the National Guard, he made that order apply to every state in this nation. This is about all of us. This is about you. California may be first, but it clearly will not end here. Other states are next.”
“Democracy is under assault right before our eyes,” Newsom said. “This moment we have feared has arrived. He’s taking a wrecking ball…to our founding fathers’ historic project: three coequal branches of independent government.”
Newsom urged Americans to stand up for the country. “I know many of you are feeling deep anxiety, stress, and fear,” he said. “But I want you to know that you are the antidote to that fear and that anxiety. What Donald Trump wants most is your fealty, your silence, to be complicit in this moment,” Newsom said.
“Do not give in to him.”
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The proposed limits on federal loans fall well below the costs of medical school. Critics say this could deter students from pursuing medicine.
Patients awaiting treatment at the University of New Mexico hospital in Albuquerque last year. The United States is expecting to face a shortage of nearly 200,000 physicians by 2037, according to a federal health agency.Credit…Ramsay de Give for The New York Times
President Trump’s policy agenda would make deep cuts in government health plans and medical research, and, critics say, could also make finding a doctor more difficult. The Republicans’ major domestic policy bill restricts loans that students rely on to pursue professional graduate degrees, making the path to becoming a physician harder even as doctor shortages loom and the American population is graying.
The bill, which passed in the House last month and carries the president’s support, would cap direct federal unsubsidized loans at $150,000 — far less than the cost of obtaining a medical education — and phase out the Grad PLUS loans that help many students make up the difference.
Medicine, dentistry and osteopathic medicine are among the most expensive graduate programs.
The price of a four-year program in osteopathic medicine is $297,881 at a public school, on average, and $371,403 at a private school, according to the American Association of Colleges of Osteopathic Medicine. The average indebtedness of their graduates is $259,196.
The proposed loan caps, which would affect students who begin their studies in 2026, “will either push students and families into the private loan market, where they take on more risk and have less consumer protection, or simply push people out of higher education altogether,” said Aissa Canchola Bañez, policy director at the Student Borrower Protection Center, a nonprofit advocacy group.
Private student loans are also not eligible for Public Service Loan Forgiveness programs, which many students rely on to manage their debt. Students from low-income families may have difficulty qualifying for private loans.
In a letter to congressional leaders, the American Medical Association asked lawmakers to carve out exceptions in the law for medical education, saying that the current bill would deter good candidates from applying to medical school, discourage physicians from working in underserved areas and make medical school unaffordable for all but the very wealthy. Critics said it could also drive more doctors away from lower-paying primary care fields, an area of acute need, and into more lucrative specialties. (continue page 2 on www.skyline725.com)
Conservatives have argued for decades that the availability of federal student loans allowed tuition costs to balloon — a proposition rejected by the Association of American Medical Colleges, which instead blames the rising cost of living. Studies examining the relationship between loans and tuition have varied in their conclusions.
Sara Robertson, the press secretary for the Republicans on the House Education and Workforce Committee, said the proposed loan limits “will drive down the cost of medical school and thus reduce the need for students to borrow in the first place.”
She said private lenders would offer students lower interest rates than the government’s Grad PLUS program would. The private market, though, has shrunk markedly since the Great Recession, according to Lesley Turner, an associate professor of public policy at the University of Chicago and an author of an unpublished paper that linked loans to rising tuition.
In an email, Dr. Turner said it wasn’t clear that “the same level of nonfederal funding would be available today.” Because of inflation, she noted, the $150,000 limit for medical students is “substantially reducing the amount these students can borrow, even compared to the status quo before the Grad PLUS program.” The program was started in 2006.
Ms. Robertson said schools could also help close the gap. “Nothing in the bill prevents colleges from providing additional financial aid to low-income students pursuing medical school,” she said.
That is not an option for schools of osteopathic medicine, most of which are private and not attached to universities with foundations, and which currently enroll almost one-third of the nation’s future doctors, said David Bergman, senior vice president of government relations and health affairs for the American Association of Colleges of Osteopathic Medicine. And many academic medical centers, which have lost millions of dollars in research grants abruptly pulled by the Trump administration, are facing severe financial strain.
A vast majority of medical students rely on loans, not just those from low-income backgrounds, Mr. Bergman noted.
Ending federal involvement in administering and subsidizing student loans was one of the goals laid out in Project 2025, the Heritage Foundation’s conservative blueprint for overhauling the government. It argued that leaving student loans to private lenders and ending federal loan forgiveness programs would “allow for market prices and signals to influence educational borrowing.”
President Trump’s policy bill would allow medical residents to defer not only their loan payments but also the interest on those payments, a provision that many medical professionals have supported. But the legislation would prohibit residents from counting those low-paid years of training as public service, limiting their eligibility for a popular loan forgiveness program that encourages young doctors to work in underserved areas.
As a result, “access to much-needed medical care for patients in rural and underserved communities will be diminished,” the American Medical Association’s chief executive, Dr. James L. Madara, wrote in the letter to House Speaker Mike Johnson and the House Democratic leader Hakeem Jeffries.
The changes will disproportionately affect low-income students with backgrounds that are underrepresented in medicine, who may face more difficulty obtaining private loans, said Dr. Virginia Caine, president of the National Medical Association, which represents Black physicians and which advocates health equity. In turn, she said, it will limit those students’ ability to return to serve in their communities.
“Only rich students will survive,” she said, noting that, on average, Black medical students already graduate with more educational debt than their peers.
A higher debt burden and inability to secure loan forgiveness may also drive students away from lower-paying specialties like primary care, despite an anticipated shortage of primary care physicians, Dr. Caine said.
By 2037, the United States is expected to face a shortage of 187,130 physicians, including 87,150 primary care physicians like internists and pediatricians who play a pivotal role in the early detection and management of chronic disease, according to the federal Health Resources and Services Administration. (There are currently 933,788 professionally active physicians.)
Already, some 75 million Americans live in areas where it is difficult to get access to primary care. The ratio of primary care providers is projected to decline to 76.8 per 100,000 people by 2037, from 81.6 per 100,000 in 2022.
At the same time, President Trump’s recent budget proposal would cut off funds used to train new pediatricians, who are already in short supply: It entirely eliminates funding for graduate medical education at 59 of the nation’s children’s hospitals, where more than half of all pediatricians and pediatric specialists are trained. The program trained 15,860 medical residents and fellows in 2022-23, according to the Children’s Hospital Association.
The irony of slashing loans for medical school, many officials said, is that medical students are more likely than many other graduates to be able to repay them.
“We have a default rate that ranges from 1.1 percent to 1.4 percent,” Mr. Bergman said. “This is not a problem that needs to be fixed.”
Roni Caryn Rabin is a Times health reporter focused on maternal and child health, racial and economic disparities in health care, and the influence of money on medicine.
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Flatbed train cars carrying thousands of tanks rolled into Washington, D.C., yesterday in preparation for the military parade planned for June 14. On the other side of the country, protesters near Los Angeles filmed officers from Immigration and Customs Enforcement (ICE) throwing flash-bang grenades into a crowd of protesters. The two images make a disturbing portrait of the United States of America under the Donald J. Trump regime as Trump tries to use the issue of immigration to establish a police state.
In January 2024, Trump pressured Republican lawmakers to kill a bipartisan immigration measure that would have beefed up border security and funding immigration courts because he wanted to campaign on the issue of immigration. During that campaign, Trump made much of the high immigration numbers in the United States after the worst of the coronavirus pandemic, when the booming U.S. economy attracted migrants. He went so far as to claim that migrants were eating people’s pets.
Many Trump supporters apparently believed officials in a Trump administration would only deport violent criminals, although Trump’s team had made it clear in his first term that they considered anyone who had broken immigration laws a criminal. Crackdowns began as soon as Trump took office, sweeping in individuals who had no criminal records in the U.S. and who were in the U.S. legally. The administration worked to define those individuals as criminals and insisted they had no right to the due process guaranteed by the U.S. Constitution.
Anna Giaritelli of the Washington Examiner reported that at a meeting in late May,White House deputy chief of staff Stephen Miller, who appears to be leading the administration’s immigration efforts, “eviscerated” federal immigration officials for numbers of deportations and renditions that, at around 600 people per day, he considered far too low. “Stephen Miller wants everybody arrested,” one of the officials at the meeting told Giaritelli. “‘‘Why aren’t you at Home Depot? Why aren’t you at 7-Eleven?’” Miller said.
After the meeting, Miller told Fox News Channel host Sean Hannity that the administration wanted “a minimum of 3,000 arrests for ICE every day, and President Trump is going to keep pushing to get that number up higher each and every single day.” Thomas Homan, Trump’s border czar, took the message to heart. “You’re going to see more work site enforcement than you’ve ever seen in the history of this nation,” he told reporters. “We’re going to flood the zone.”
According to a recent report by Goldman Sachs, undocumented immigrants made up more than 4% of the nation’s workforce in 2023 and are concentrated in landscaping, farm work, and construction work. Sweeps of workplaces where immigrants are concentrated are an easy way to meet quotas. (continued on page 2 at www.skyline725.com)
