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With health care costs on the rise, a growing number of Americans are throwing out the old way of seeing a doctor and turning to a membership model. A monthly or annual fee gets you direct access to a doctor, no insurance needed.Twenty years into her career, bogged down by red tape, too many patients and long days, Dr. Shaila Pai-Verma was looking for a better way to practice medicine.“I was just miserable,” she said. “The joy of medicine is gone and then you're just doing paperwork.”So, a year ago, she started a new primary care practice with a new business model.“The patient basically has a direct contract with the physician and they take insurance companies out of it,” she explained.Patients pay a flat monthly or yearly fee. In exchange, they receive a broad range of primary care services and quick, unlimited access to their doctor via in-person office visits, phone or by text.“Everyone wants everything immediate. And so, I think this is it. It's good, especially in this time for people to have access,” said Pai-Verma.Membership fees range from about 5 to 0 per month on average – about 0 less than having typical health insurance. Most patients still carry catastrophic coverage for emergency treatments and hospitalizations, but that insurance is usually only -100 a month, so patients still save money.For Bonnie Micheli and her family, it was all about access.“With this, it's just so much easier to just know that I can contact directly here within a few hours for any issues that I'm having,” said Micheli.In late September, a bipartisan proposal was introduced in Congress that would expand access to the model and allow people to use their health savings account for direct primary care (DPC).Because they see fewer patients than traditional practices, some critics say the model could worsen the shortage of primary care physicians, a trend that’s already driven by burnout.But according to a recent study, DPC members had 25% lower hospital admissions and the cost of emergency room claims was reduced by 54%.“There's less ER visits and you know, better health care for the patient,” said Pai-Verma.While there is still debate, for a growing number of Americans, like Micheli, it’s becoming a simplified health insurance alternative.“Honestly, it’s just so nice to know what I'm paying every month or if you do the annual, what you're getting for that money, and you know exactly who to go to when you have a problem.” 2467

With Christmas right around the corner, many businesses around San Diego County are getting ready to open their doors to sell fresh Christmas trees. Many of the farms begin welcoming customers the day after Thanksgiving, when people typically start decorating for Christmas. Check out the list below to find out where you can grab a fresh Christmas tree:  378

While playing "Candy Land," did you ever imagine yourself walking through the Peppermint Forest or seeing life-size gumdrops at Gumdrop Mountains?Well, the Food Network is making that a reality with their newest baking competition show "Candy Land," which is inspired by the iconic board game "Candy Land."Hosted by actress Kristin Chenoweth, five teams of professional cake and sugar artists will come together over six episodes to compete by making "heavenly confectionery showpieces" while also dealing with Lord Licorice's curveballs along the way.The singer even tweeted out her excitement for the show. 616

When you leave the big cities and head out to lesser populated areas of the United States, you realize President-elect Joe Biden may have won but President Donald Trump still enjoys plenty of support. "Since I was 18, I voted for Democrats, every time, but this year I voted for Trump," Scott Will, a new Trump voter in Westmoreland County, Pennsylvania, said. "My dad, he is a Joe Biden fan. He is calling me and teasing me about," Will said jokingly. While Trump is projected to lose the 2020 election, he did set voting records. Thus far, Trump has received more than 10 million more votes than four years ago. That is more votes than any American presidential candidate in history, except Biden. CHANGING REGIONS POLITICALLY While he lost the election, Trump did improve his margins in several key areas around the country. In Kenosha County, Wisconsin, Trump did 3% better. In Miami-Dade County, Florida, Trump did `12% better. And in Mahoning County, Ohio Trump actually flipped this county for the first time since Eisenhower. For perspective, this county, which includes Youngstown, Ohio, went for the Obama/Biden ticket in 2008 by 30 points. "The funny thing here is Trump stole the Democratic message. Can the Democrats steal it back?" Paul Sracic, a political scientist at Youngstown State University, said. Sracic said in defeat, Trump's legacy maybe forever changing politically places like Youngstown. Sracic said old trade deals, like NAFTA, were particularly toxic in this part of Ohio and voters rewarded Trump for getting rid of it and promising old jobs would come back. "Trump didn’t create these voters, they were waiting for Trump," Sracic said.WILL THESE VOTERS RESPECT BIDEN? At Thanos Restaurant in Mahoning County, Ohio, diners here know how Trump changed this area's politics. Ken Morrow eats here twice a day. In 2016, he voted for Bernie Sanders. In 2020 he voted for Trump. "For me, it's confusing," Morrow said, commenting on the election results and Trump's refusal to concede. His advice to Biden? "We need a lot of good paying jobs around here, everything is gone," Morrow said. Every Trump voter we spoke with said they would respect Biden come January 20th."I am very conservative," Jean Hasey said. "He’s going to be my president because I'm an American and a patriot," Hasey added. But she said -- uniting the country may be a tall task. "I think it’s going to be hard, very very hard," Hasey added. 2447

We've heard about telehealth for people, but now it's there for animals too. According to the American Veterinary Medical Association, there's been a significant increase in telemedicine, and some veterinarians are entirely virtual.The pandemic has proven we can do almost anything from our couches, computers and phones. We've grown accustomed to all things virtual and it seems our pets are used to it too.“It really highlights the value of something like this and it also really highlights where society is living. Even before the pandemic, turned to google, turned to the internet first. It's our first step in almost everything,” says Dr. Sarah Machell.Machell is the lead veterinarian for Vetster, which provides on-demand virtual care for your pet.“Consultations, meeting pet owners in their homes, where they are with their pets, and helping to address urgent and preventive care health conversations to them,” Machell said.She says the company, which launched in October 2019, wasn’t formed because of the pandemic, but they certainly evolved at the right time."The veterinary clinics themselves are feeling a really heavy surge with the pandemic. It’s a pretty crushing situation for them. We already as a profession had some staffing challenges, not enough veterinarians for how many pets and pet owners there are,” Machell said.Pet owners, she says, often have a hard time getting an appointment. Or they have to wait in their cars with their animal outside of their clinic. And, according to Vetster, 50% of pet owners don't even have an established home clinic.“There was a poll recently that showed 37% of American households welcomed a new pet into their home during the pandemic. Pandemic puppies are a real thing,” Machell said.“I think it offers a great addition to the tools I have at my disposal. Telehealth can be used very much the same way,” said Dr. Douglass Kratt, president of the American Veterinary Medical Association. The AVMA serves roughly 96,000 veterinarians across the country. They've been through a lot this year, adjusting to new norms, like all of us. As in human medicine, they've had to perfect, or initiate virtual options.“It doesn’t replace your veterinarian. What it does is help your vet better serve you and your family member,” Kratt said.Kratt admits there are some obvious challenges.“I can’t hear if your dog is coughing, I can’t listen to the heart and lungs via telemedicine so that wouldn’t be amenable,” Kratt said.He says, however, it's effective overall, and especially worthwhile if it's with your established vet. But if you don't have one, Vetster and other businesses like it aim to help.“There are so many pets and pet owners who sometimes sit on things and aren’t sure if they need to go into a clinic, really appreciate that piece of mind in the middle of the night that no, you don’t need to pack yourself up and get into a vet clinic. This is something you’re okay to wait until the morning,” Machell said.And she says they're prepared to help all animals from pocket pets to exotic and large animals. It’s yet another adjustment and another pivot in 2020. 3131