Six States Celebrating America 250 By Raising Your Gas Tax

 by Larry Behrens via WattsUpWithThat.com,

The final countdown for America’s 250th birthday is on. Families will be planning road trips, parades, vacations, reunions, and cookouts to celebrate the greatest nation in history. But in six states, politicians have a different idea for the party: raise taxes.

Beginning July 1, drivers in California, Washington, Illinois, Maryland, Virginia, and Mississippi are scheduled to see higher state gas taxes. In other words, as the country prepares to celebrate casting aside a tax-heavy king in favor of freedom, these states will use the occasion to fatten government coffers one gallon at a time.

The worst offenders will be no surprise. California, Washington and Illinois  — we’ll call them the Axis of Glut.

Their governors are often the first to fake outrage when gas prices rise. They blame oil companies. They blame “price gouging.” They blame world events. They blame everyone except the politicians who keep piling taxes, mandates, and regulations onto every gallon drivers buy.

Yet these same states already have some of the worst gas prices in the nation, some of the highest gas taxes in America, and now they are getting ready to raise those taxes again.

California’s gas tax is already the highest in the country and is scheduled to climb again on July 1, from 61.2 cents to 63.4 cents per gallon, under the state’s annual inflation adjustment. The same report noted California’s average price for regular gasoline was nearly $6 per gallon in early June.

Illinois is no better. The state says its motor fuel tax will rise on July 1 because the law requires an annual inflation adjustment. Washington joined the club with a gas tax increase last year and then baked in automatic increases going forward. Starting July 1, 2026, the state’s fuel tax rises by 2% every year unless lawmakers change the law.

This is the dirty hustle behind inflation-indexed taxes. Politicians get to raise taxes without holding a press conference to admitting it. They pass the law once, then every year drivers get mugged by a formula.

As of June 8, the national average for regular gas was $4.164, down 38.2 cents in a single month. That is welcome relief for families, workers, small businesses and anyone trying to get through summer. But the national average would look even better if it were not being anchored down by tax-heavy states that treat drivers like a rolling ATM.

The problem is not limited to the six July 1 tax-hike states. Seven of the ten most expensive states for gas are run by Democratic governors. That is not a coincidence.

Taxes play a major role in the high-price reputation of many of these states. So do their regulatory regimes, special fuel rules, anti-energy policies and climate mandates that make fuel harder to produce, refine, transport and sell.

The result is predictable.

Families, small businesses, truckers, and farmers all pay more. Then the same politicians who helped drive up the cost pretend they are shocked by the bill.

That is not compassion. That is government gluttony.

Supporters claim the money goes to roads and infrastructure. But that excuse only goes so far. Every tax increase is sold as necessary. Yet somehow the burden always lands in the same place: on the people who drive to work, school, church, the grocery store or a summer vacation.

That is what makes the timing so perfect, and so insulting.

America’s 250th birthday should be a celebration of freedom, independence and the rejection of government overreach. The American Revolution was born from the idea that people should not be treated as endless revenue sources for rulers who never seem to have enough.

Nearly 250 years later, millions of drivers will pull into gas stations in California, Washington, Illinois, Maryland, Virginia, and Mississippi and get a reminder that some politicians still have not learned the lesson.

The country is moving toward a better energy future: lower prices, more production, more reliability and less punishment for the people who keep America moving. But these six states are choosing a different path.

America 250 should remind us why this country was born: because free people eventually get tired of being treated like revenue.

https://www.zerohedge.com/personal-finance/these-are-six-states-celebrating-america-250-raising-your-gas-tax

Trump Says "Secret Military Mission" Allowed 200 Ships, 100 Million Barrels To Cross Hormuz

 Confirming our reported from both a week ago (see "As Gulf States Plan Bypass Pipelines, US Military Is Quietly Helping Ships Cross Hormuz") and this afternoon ("Growing Number Of Oil Tankers Successfully Sneak Through Hormuz, Shrinking Iran's Leverage") moments ago Trump posted on Truth Social that he had "directed our Great U.S. Military to execute a secret mission to support Oil Tankers and other Commercial Ships through the Strait of Hormuz." Of course, the mission wasn't that secret if we discussed how the US military was helping ship cross the Strait one week ago. 

In any case, Trump added that "this effort has resulted in more than 100 MILLION Barrels of Oil making its way through the Strait, and into the Open Market. More than 200 Commercial Ships have safely traveled through the Strait," which would explain why oil prices have remained low and confirms what Goldman's Delta One head, Rich Privorotsky, wrote this morning, namely that "a lot has been thrown at the oil market and it’s simply not going up, which is remarkable given the level of escalation. The only conclusion that really fits the price action is that barrels are still getting through the Strait of Hormuz, visibly or otherwise. There doesn’t seem to be a more rational explanation."

"This wildly successful effort is because the UNITED STATES of AMERICA CONTROLS the Strait of Hormuz — NOT Iran" Trump concluded.

Trump's post also validates what JPMorgan EM strategy team pointed out a week ago, namely that ship - and crude - transits are far higher than what official trackers have indicated: 

• New higher equilibrium appears to be established in Strait with vessel crossings remaining in the c.25 per day mark for nearly a week, according to JPM EM Strategy methodology. 
• Estimated energy exports continue to be very strong - around 3.6 mbd over the past two days and the 7DMA remaining around 2.5mbd. This has been driven by strong refined chemical tanker transits which have risen to more than 50% of pre-conflict levels. 
• Reports that US are quietly coordinating with shippers to ensure safe transit without explicit escort. 

Here, JPM suggests that Bloomberg's data is showing muted transits as it can't keep an accurate read of actual crossings due to AIS transponders being turned off during crossings.

Now the question is whether Iran, whose leverage in the conflict would be viewed as dramatically reduced as a result of this development, will allow stealthy tankers and other ships, with transponders shut, to continue crossing the strait affirming Trump's implicit claim that the country no longer has control over the strait, or if Tehran will make a public demonstration of how much control it still has. 

https://www.zerohedge.com/energy/trump-says-secret-military-mission-allowed-200-ships-100-million-barrels-cross-hormuz

DHS Directs ICE To Deport Illegal Aliens Who Vote In American Elections

 by Bryan Hyde via American Greatness,

The Department of Homeland Security (DHS) General Counsel James Percival has directed Immigration and Customs Enforcement (ICE) to impose strict penalties, including deportation, on illegal aliens who vote in American elections.

According to a DHS press release, the Immigration and Nationality Act directs the removal of aliens who illegally vote or make a false claim to US citizenship.

🇺🇸 DHS told ICE to deport any undocumented immigrant who votes in a U.S. election.

The directive, signed Monday, ties directly to Trump's executive order on election integrity.

Illegal voting and false citizenship claims are now being treated as deportable offenses under the… pic.twitter.com/HGSGkmewQR

— Mario Nawfal (@MarioNawfal) June 9, 2026

DHS states that these provisions allow for the removal of illegal aliens if they illegally participate in our elections. No criminal conviction is required for their removal.

Percival said, “The importance of free, fair, and honest elections is without question. Echoing the words of President Trump, ‘the right of American citizens to have their votes properly counted and tabulated, without illegal dilution, is vital to determining the rightful winner of an election.”

Percival added, “Illegal voting by aliens dilutes the votes of American citizens and undermines our democracy. It must have consequences.”

DHS says the directive will help further implement policies similar to those from President Donald Trump’s March 2025 executive order, “Preserving and Protecting the Integrity of American Elections.”

Trump’s order directs actions across the federal government, including the verification of voter eligibility, grant administration, information-sharing, enforcement of federal integrity laws, improving voting systems, and criminal prosecution of unlawful voting by aliens.

The latest directive follows an August 2025 announcement by US Citizenship and Immigration Services, which updated its policy manual to bar green card holders who have voted or registered to vote from obtaining citizenship.

https://www.zerohedge.com/political/dhs-directs-ice-deport-illegal-aliens-who-vote-american-elections

The Case Against Calling It 'Emergency Medicine'

 Names matter. They shape expectations, guide behavior, and in medicine, determine how systems are built, how resources are allocated, and how clinicians practice. The name "emergency medicine" is one of the most consequential misnomers in American healthcare. It implies a discipline defined by urgency and life-threatening conditions. The reality, borne out by decades of data, is considerably more complicated, and the gap between the name and the reality has quietly become a crisis of its own.

This is not an indictment of emergency physicians. This is a challenge to the institutional mythology that has calcified around a specialty name, one that legitimizes overutilization and may be doing patients and the system a quiet, compounding harm.

Are Most Emergency Department Visits Actually Emergencies?

The data on how "emergent" most emergency department (ED) visits are is consistent, voluminous, and largely ignored. The U.S. logs approximately 155 million ED visits annually -- at a cost that reached $76.3 billion in 2020 alone. If these were primarily emergencies, such spending might be justified. But the acuity data tell a different story.

A 2025 analysis from Texas A&M's School of Public Health found that nearly 40% of ED visits involved conditions that physicians viewed as non-urgent or issues better suited for primary care. Other research suggests the U.S. sustains an estimated 18 million avoidable ED visits each year, adding $32 billion in costs to our healthcare system annually.

The ED has become a primary care safety net, a walk-in clinic for the underinsured, a behavioral health intake system, and, occasionally, a place where someone arrives dying and a clinician saves their life. To name the whole enterprise after that last function is to let the exceptional eclipse the ordinary.

Does the Name Itself Make Things Worse?

The name "emergency department" gets us into trouble because the word "emergency" does something powerful. It confers urgency on every visit. It implies that every diagnostic question is a crisis requiring full investigation before discharge. It shifts the default position from restraint to action -- clinically appropriate for a small fraction of patients, but a systematic mismatch for the majority who actually need triage, reassurance, a referral, and perhaps a conversation with a social worker.

When a patient goes to a place called an "emergency department," they arrive expecting emergency-level evaluation. When that evaluation includes a CT scan, a battery of labs, and a 4-hour stay for a sore throat, they are not being managed to their actual need. They are being processed to satisfy a label.

Nowhere is the mismatch between name and practice more consequential than in diagnostic imaging. Emergency physicians have among the highest CT scan rates in medicine, and a substantial body of evidence suggests much of it is clinically unnecessary.

A systematic review in the Annals of Emergency Medicine found that unnecessary ED imaging costs the healthcare system close to a billion dollars annually. A 5-year study at one ED in an urban academic medical center found a 67% increase in CT angiography for headache and dizziness, while the rate of findings of acute pathology fell by 38% over the same period. More scans, but no greater pathology.

The driver is not clinical uncertainty alone; it is fear. A survey of 435 emergency physicians found that 97% acknowledged ordering at least some medically unnecessary imaging, with fear of missing a low-probability diagnosis and fear of litigation as the primary drivers. That fear is not irrational: more than 75% of emergency physicians will be named in a malpractice claim at some point in their career.

But here's the uncomfortable data point: a landmark study in the New England Journal of Medicine tested malpractice tort reform in three states and found it produced no reduction in imaging rates, hospitalization rates, or per-visit costs. The ordering culture runs deeper than fear of litigation. It is embedded in professional identity, and that identity is shaped, in part, by the name and the responsibility it construes.

All this unnecessary testing is also counter-intuitive to emergency medicine, a field where clinical decisions should be based on available history and exam findings, not working up chronic ailments, benign diseases, and morphing into a center for incidental findings.

Time for a Rebrand

So, what should we call it?

What happens inside EDs is better described as acute unscheduled care: care that is unplanned, time-sensitive from the patient's perspective, and distributed across a wide spectrum, from the trivially minor to the immediately life-threatening.

"Department of Medical Access" would be a more accurate name. The reconceptualization invites a redesign: acuity-stratified care pathways, embedded primary care and behavioral health clinicians, and a culture of diagnostic stewardship rather than diagnostic maximalism. This may controversially eliminate the need for emergency medicine specialists in favor of triage specialists who triage patients to the appropriate care. It creates the political and cultural space for imaging and laboratory stewardship programs that currently struggle against the gravitational pull of a specialty's self-conception.

It also resets patient expectations on both sides of the gurney, which may be the highest-leverage intervention available.

The ED is considered one of the most important institutions in American medicine. It is also one of the most misnamed. Renaming is not a retreat. It is a reckoning and the beginning of a more honest conversation about what acute unscheduled care actually requires, who is best positioned to provide it, and how the genuinely emergent can receive the concentrated brilliance it deserves without being diluted across a hundred ankle sprains and a thousand sore throats.

Call it what it is. Then build what it needs.

Stephen P. Wood, DMSc, ACNP-BC, is a clinical associate professor and program director of the Adult-Gerontology Acute Care Nurse Practitioner Program at Northeastern University's Bouvé College of Health Sciences, and holds visiting research appointments at Harvard Medical School's Center for Bioethics and Harvard Law School's Petrie-Flom Center. He practices clinically in emergency medicine and critical care and serves as a tactical paramedic with the Quincy Police Department's SWAT Unit.

https://www.medpagetoday.com/opinion/second-opinions/121625

AMA Adopts Policy Pushing Back on AI Creep in Medicine

 Artificial intelligence (AI) in medicine must always be overseen by physicians, according to a policy adopted by the American Medical Association (AMA) on Tuesday.

At its annual meeting on Tuesday, AMA's House of Delegates passed a resolution requiring its leaders to advocate for legislation and regulation requiring AI tools to "integrate with the physician-led team and be used at the direction of the treating physician; respect the continuity of care and best practices related to transitions of care; have transparent, auditable data demonstrating safety and efficacy; [and] be subject to relevant and appropriate regulations (including but not limited to those related to liability and documentation)."

The resolution also calls for the AMA to "study emerging concepts around the regulation and licensure of autonomous and semiautonomous augmented and/or artificial intelligence performing clinical functions, and their potential impact on the profession and the physician-patient relationship."

The AMA must "clearly affirm that the practice of medicine must remain under physician oversight, and that AI should augment, not replace physicians," Avani Patel, MD, MHA, of Jackson, Mississippi, said Saturday during a discussion of the topic.

She shared a story from another delegate involving an AI program that misread lab results and reported that a patient had an HbA1c of 11.2, resulting in the AI's diagnosis of diabetes, but the number was actually the patient's hemoglobin level.

"As AI continues to expand into diagnosis, treatment recommendations, prescribing, and even utilization management, the AMA needs to provide clear policy direction now, while continuing to study emerging issues," said Patel. "This is a time for physicians to lead, not to wait."

"This body can make a statement now that AI should not be replacing physicians," Leanna "Leif" Knight, MD, a Resident and Fellow Section delegate from Providence, Rhode Island, said during the discussion. "While AI may serve as a useful clinical tool, I'm opposed to it replacing physicians with independent AI prescribers or diagnostic systems."

"We have all made huge sacrifices to become a physician, to be able to be at a patient's bedside when they're in need," she continued. "While AI may one day be more efficient than us, we cannot sacrifice sufficiency for the humanity of being someone's doctor."

Knight also warned that AI technologies may "be disproportionately deployed in underserved communities, creating a system where vulnerable patients get algorithmic care instead of direct physician evaluation. AI should automate decisions [but] it should not replace us. We should support policies that preserve meaningful physician oversights and protect patients."

LaTasha Seliby Perkins, MD, of Alexandria, Virginia, spoke for the American Academy of Family Physicians (AAFP) in favor of additional study rather than passing a resolution, calling it a very complicated issue.

"AAFP has an ethical application of AI as a part of our policies. It shows how AI may reduce administrative burden, but current shortcomings make clinical decision-making support inadvisable without physician verification and guidelines," she said. "AAFP supports using AI where physicians can verify the output."

Seliby Perkins was one of several speakers expressing concern about Utah's state-run pilot program that would allow AI-based prescription renewals. AI-issued medication refills "for hypertension, diabetes, depression, anticoagulation, and controlled substances are not merely administrative transactions," she said.

https://www.medpagetoday.com/meetingcoverage/ama/121695

AMA to Fund Studies Comparing Care From Physicians vs NPs, PAs

 by Cheryl Clark

Concerned that unsupervised nurse practitioners (NPs) and physician assistants (PAs) provide patient care that is not as good or safe as that provided by physicians, the American Medical Association (AMA) House of Delegates voted Tuesday to fund independent studies that compare outcomes.

"Legislators continue to hear claims from NP and PA advocacy groups that studies say they are just as good or better than physicians," said Rebekah Bernard, MD, of Fort Myers, Florida.

"We know these studies are referring to patients that are being seen for low conditions, for simple problems and always involve physician oversight," added Bernard, who was representing the Florida delegation, which introduced the proposal with delegations from Texas and Oklahoma. "But legislators are not hearing these caveats. We need rigorous, independent data on the safety, efficacy, and cost of unsupervised NPs and PAs, and we need it urgently."

Speakers said state regulatory agencies need data based on science in order to set scope-of-practice rules.

Several delegates said they've been referred to see patients who were previously inappropriately treated by mid-level providers.

Michael Lubrano, MD, of Massachusetts, speaking for the American Academy of Pain Medicine, cited Medicare data indicating "an explosion of nurse practitioners providing unsupervised advanced chronic pain injection therapies with unclear oversight and accreditation processes."

An essential pain procedure code, he said, was flagged for overutilization, but the claims did not come from physician proceduralists. "This is a wake-up call," he noted. "The nursing organizations are not going to fund legitimate comparative studies because they know what the outcomes will be."

The resolution, which prompted a 35-minute debate, received pushback from some delegates who did not think state lawmakers and licensing agencies would believe an AMA-funded study that concluded that physicians provide better care than advanced practice nurses or physician assistants.

"I think that it's a clear conflict of interest when we are specifically looking at studies to say that our care is superior to others," said Brandi Ring, MD, of Keene, New Hampshire, speaking for the American College of Obstetricians and Gynecologists. "I think that's true ... but who else is going to believe that that is true? The nurse practitioner agencies, the physician assistant agencies will not, and our legislators are swayed by their testimony significantly."

Douglas DeLong, MD, of Cooperstown, New York, pointed out that if "we looked at something where Big Pharma has funded drug studies, that implies an implicit bias. I think this could come back to bite us."

Delegates clarified that the intent is that the AMA will find legitimate researchers who will conduct the studies honestly and objectively.

The original resolution was that the AMA would merely advocate for and support such studies. But after vigorous discussion, it was amended to specify that the AMA will "fund independent, academically rigorous studies performing comparative effectiveness analyses of patient outcomes between autonomous non-physician practitioners and physician-led (MD/DO or foreign equivalent) care models."

The studies will look at patient safety, care quality, utilization, access, cost, and health outcomes, with a goal of publication in a peer-reviewed scientific journal.

Luke Selby, MD, of Westwood, Kansas, said the hope was that the AMA would solicit proposals from academic researchers, "and ask them to look at the question, and we'll get back what we get back, and it will be editorially independent."

https://www.medpagetoday.com/meetingcoverage/ama/121693

Lawsuits Claiming Social Media Is 'Addictive' Gain Momentum

 Social media has been on trial for allegedly harming youth mental health, and tech companies have been facing uphill legal battles in recent months.

In a landmark case in March, a California jury found Meta and Google liable for the depression and anxiety of a woman who compulsively used social media as a child, awarding her $6 million.

Last month, a Kentucky school district secured $27 million in settlements after alleging social media companies fueled a mental health crisis among students. And the Supreme Court declined to hear Meta's challenge to a Vermont social media addiction lawsuit.

Other individuals, school districts, and attorneys general have brought cases, too.

Their strategy has been alleging that social media apps are designed to be addictive -- and those claims appear to be resonating.

"Unlike prior cases, which have primarily focused on harmful content like false or harassing statements, the plaintiff instead targeted the platforms' core design features," Ashley Shea, MS, a PhD candidate at Cornell University in Ithaca, N.Y., told MedPage Today in an email regarding the California case.

Shea explained that the case used a "relatively novel argument" that "common features of social media platforms (such as autoplay, infinite scroll, and pull-to-refresh) exploit the cognitive vulnerabilities of the adolescent brain and therefore constitute defective and harmful product design."

Section 230 of the federal Communications Decency Act provides technology platforms protection from liability related to third-party content, but focusing on the design of the platforms themselves and how they allegedly "create an addictive experience for users" is a different strategy, said Cayce Myers, PhD, JD, LLM, of Virginia Tech in Blacksburg, Va.

The cases recently brought against social media companies have been compared with the "type of cases that came out in the 90s against Big Tobacco," Myers said.

The argument that the "systems themselves are designed to be addictive," coincides "with a larger social discussion around the net impact of social media on the mental health of adolescents," he said.

Recent studies have suggested that addiction to screen time, including social media, was tied to suicidality in U.S. kids, that social media "detox" was linked to better mental health for 18- to 24-year-olds, and that increases in social media use during early adolescence were significantly associated with lower performance in key areas of cognitive function.

But it is important to interpret these and other findings with caution, experts said.

"I think we need to be clear that much of the relationship between social media use and mental health is correlation rather than causation," pediatrician Heidi Schumacher, MD, of the University of Vermont Larner College of Medicine in Burlington, who also is a member of the American Academy of Pediatrics (AAP) Council on Communications and Media, told MedPage Today.

Additionally, "every child develops their own unique relationship with social media," Schumacher noted.

"I find that, for many of the young people I work with, social media can be a really positive experience," she explained, "especially marginalized youth in communities where they might seek connection beyond, say, their small community."

"Finding folks that they connect with in the bigger world can be a really positive experience, and yet of course, when social media becomes problematic or excessive, there can be real consequences," she added.

AAP has pushed for more child-centered design when it comes to social media. Platforms should prioritize child privacy, encourage critical thinking and healthy social connection, and offer age-appropriate content, Schumacher said.

The organization also has called for companies to help take the burden off of parents. For instance, Schumacher said: "When a new parent buys a car seat for a baby, it is their responsibility to install the car seat according to the instructions, and to strap their baby in consistently. But the parent has to rely on the manufacturer to build a car seat that has their child's safety top of mind, and on regulations to ensure that quality standards have been met. Why shouldn't we expect similar layers of protection for young people as they engage in digital media platforms?"

Meta and Google have denied direct links between social media use and mental health concerns and have said their platforms have safety features for kids, have pointed to the First Amendment as protection, and have appealed the California verdict.

What happens in that appeal and others will matter, Myers said. "People are paying attention to it," he said. "These lawsuits are paralleling a larger societal discussion on the topic."

https://www.medpagetoday.com/special-reports/features/121698