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Trans-Atlantic Scorecard – July 2019

Welcome to the fourth edition of the Trans-Atlantic Scorecard, a quarterly evaluation of U.S.-European relations produced by Brookings’s Center on the United States and Europe (CUSE), as part of the Brookings – Robert Bosch Foundation Transatlantic Initiative. To produce the Scorecard, we poll Brookings scholars and other experts on the present state of U.S. relations…

       




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Trans-Atlantic Scorecard – October 2019

Welcome to the fifth edition of the Trans-Atlantic Scorecard, a quarterly evaluation of U.S.-European relations produced by Brookings’s Center on the United States and Europe (CUSE), as part of the Brookings – Robert Bosch Foundation Transatlantic Initiative. To produce the Scorecard, we poll Brookings scholars and other experts on the present state of U.S. relations…

       




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Trans-Atlantic Scorecard – January 2020

Welcome to the sixth edition of the Trans-Atlantic Scorecard, a quarterly evaluation of U.S.-European relations produced by Brookings’s Center on the United States and Europe (CUSE), as part of the Brookings – Robert Bosch Foundation Transatlantic Initiative. To produce the Scorecard, we poll Brookings scholars and other experts on the present state of U.S. relations…

       




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Trans-Atlantic Scorecard – April 2020

Welcome to the seventh edition of the Trans-Atlantic Scorecard, a quarterly evaluation of U.S.-European relations produced by Brookings’s Center on the United States and Europe (CUSE), as part of the Brookings – Robert Bosch Foundation Transatlantic Initiative. To produce the Scorecard, we poll Brookings scholars and other experts on the present state of U.S. relations…

       




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First Steps Toward a Quality of Climate Finance Scorecard (QUODA-CF): Creating a Comparative Index to Assess International Climate Finance Contributions

Executive Summary Are climate finance contributor countries, multilateral aid agencies and specialized funds using widely accepted best practices in foreign assistance? How is it possible to measure and compare international climate finance contributions when there are as yet no established metrics or agreed definitions of the quality of climate finance? As a subjective metric, quality…

       




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Does decarbonization mean de-coalification? Discussing carbon reduction policies

In September, the Energy Security and Climate Initiative (ESCI) at Brookings held the third meeting of its Coal Task Force (CTF), during which participants discussed the dynamics of three carbon policy instruments: performance standards, cap and trade, and a carbon tax. The dialogue revolved around lessons learned from implementing these policy mechanisms, especially as they…

       




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Strengthening Medicare for 2030 - A working paper series


The addition of Medicare in 1965 completed a suite of federal programs designed to protect the wealth and health of people reaching older ages in the United States, starting with the Committee on Economic Security of 1934—known today as Social Security. While few would deny Medicare’s important role in improving older and disabled Americans’ financial security and health, many worry about sustaining and strengthening Medicare to finance high-quality, affordable health care for coming generations.

In 1965, average life expectancy for a 65-year-old man and woman was another 13 years and 16 years, respectively. Now, life expectancy for 65-year-olds is 18 years for men and 20 years for women—effectively a four- to five-year increase.

In 2011, the first of 75-million-plus baby boomers became eligible for Medicare. And by 2029, when all of the baby boomers will be 65 or older, the U.S. Census Bureau predicts 20 percent of the U.S. population will be older than 65. Just by virtue of the sheer size of the aging population, Medicare spending growth will accelerate sharply in the coming years.


Estimated Medicare Spending, 2010-2030



Sources: Future Elderly Model (FEM), University of Southern California Leonard D. Schaeffer Center for Health Policy & Economics, U.S. Census Bureau projections, Medicare Current Beneficiary Survey and Centers for Medicare & Medicaid Services.

The Center for Health Policy at Brookings and the USC Leonard D. Schaeffer Center for Health Policy and Economics' half-day forum on the future of Medicare, looked ahead to the year 2030--a year when the youngest baby boomers will be Medicare-eligible-- to explore the changing demographics, health care needs, medical technology costs, and financial resources that will be available to beneficiaries. The working papers below address five critical components of Medicare reform, including: modernizing Medicare's infrastructure, benefit design, marketplace competition, and payment mechanisms.

DISCUSSION PAPERS

  • Health and Health Care of Beneficiaries in 2030, Étienne Gaudette, Bryan Tysinger, Alwyn Cassil and Dana Goldman: This chartbook, prepared by the USC Schaeffer Center, aims to help policymakers understand how Medicare spending and beneficiary demographics will likely change over the next 15 years to help strengthen and sustain the program.
  • Trends in the Well-Being of Aged and their Prospects through 2030, Gary Burtless: This paper offers a survey of trends in old-age poverty, income, inequality, labor market activity, insurance coverage, and health status, and provides a brief discussion of whether the favorable trends of the past half century can continue in the next few decades.
  • The Transformation of Medicare, 2015 to 2030, Henry J. Aaron and Robert Reischauer: This paper discusses how Medicare can be made a better program and how it should look in 2030s using the perspectives of beneficiaries, policymakers and administrators; and that of society at large.
  • Improving Provider Payment in Medicare, Paul Ginsburg and Gail Wilensky: This paper discusses the various alternative payment models currently being implemented in the private sector and elsewhere that can be employed in the Medicare program to preserve quality of care and also reduce costs.

Authors

Publication: The Brookings Institution and the USC Schaeffer Center
     
 
 




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Strengthening Medicare for 2030


Event Information

June 5, 2015
9:00 AM - 1:00 PM EDT

Falk Auditorium
Brookings Institution
1775 Massachusetts Avenue, N.W.
Washington, DC 20036

Register for the Event

In its 50th year, the Medicare program currently provides health insurance coverage for more than 49 million Americans and accounts for $600 billion in federal spending. With those numbers expected to rise as the baby boomer generation ages, many policy experts consider this impending expansion a major threat to the nation’s economic future and question how it might affect the quality and value of health care for Medicare beneficiaries.

On June 5, the Center for Health Policy at Brookings and the USC Leonard D. Schaeffer Center for Health Policy and Economics hosted a half-day forum on the future of Medicare. Instead of reflecting on historical accomplishments, the event looked ahead to 2030—a time when the youngest Baby Boomers will be Medicare-eligible—and explore the changing demographics, health care needs, medical technology costs, and financial resources available to beneficiaries. The panels focused on modernizing Medicare's infrastructure, benefit design, marketplace competition, and payment mechanisms. The event also included the release of five policy papers from featured panelists.

Please note that presentation slides from USC's Dana Goldman will not be available for download. For more information on findings from his presentation download the working paper available on this page or watch the event video.

Video

Audio

Transcript

Event Materials

     
 
 




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The stunning ignorance of Trump's health care plan


One cannot help feeling a bit silly taking seriously the policy proposals of a person who seems not to take policy seriously himself. Donald Trump's policy positions have evolved faster over the years than a teenager's moods. He was for a woman's right to choose; now he is against it. He was for a wealth tax to pay off the national debt before proposing a tax plan that would enrich the wealthy and balloon the national debt. He was for universal health care but opposed to any practical way to achieve it.

Based on his previous flexibility, Trump's here-today proposals may well be gone tomorrow. As a sometime-Democrat, sometime-Republican, sometime-independent, who is now the leading candidate for the Republican presidential nomination, Trump has just issued his latest pronouncements on health care policy. So, what the hell, let's give them more respect than he has given his own past policy statements.

Perhaps unsurprisingly, those earlier pronouncements are notable for their detachment from fact and lack of internal logic. The one-time supporter of universal health care now joins other candidates in his newly-embraced party in calling for repeal of the only serious legislative attempt in American history to move toward universal coverage, the Affordable Care Act. Among his stated reasons for repeal, he alleges that the act has "resulted in runaway costs," promoted health care rationing, reduced competition and narrowed choice.

Each of these statements is clearly and demonstrably false. Health care spending per person has grown less rapidly in the six years since the Affordable Care Act was enacted than in any corresponding period in the last four decades. There is now less health care rationing than at any time in living memory, if the term rationing includes denial of care because it is unaffordable. Rationing because of unaffordability is certainly down for the more than 20 million people who are newly insured because of the Affordable Care Act. Hospital re-admissions, a standard indicator of low quality, are down, and the health care exchanges that Trump now says he would abolish, but that resemble the "health marts" he once espoused, have brought more choice to individual shoppers than private employers now offer or ever offered their workers.

Trump's proposed alternative to the Affordable Care Act is even worse than his criticism of it. He would retain the highly popular provision in the act that bars insurance companies from denying people coverage because of preexisting conditions, a practice all too common in the years before the health care law. But he would do away with two other provisions of the Affordable Care Act that are essential to make that reform sustainable: the mandate that people carry insurance and the financial assistance to make that requirement feasible for people of modest means.

Without those last two provisions, barring insurers from using preexisting conditions to jack up premiums or deny coverage would destroy the insurance market. Why? Because without the mandate and the financial aid, people would have powerful financial incentives to wait until they were seriously ill to buy insurance. They could safely do so, confident that some insurer would have to sell them coverage as soon as they became ill. Insurers that set affordable prices would go broke. If insurers set prices high enough to cover costs, few customers could afford them.

In simple terms, Trump's promise to bar insurers from using preexisting conditions to screen customers but simultaneously to scrap the companion provisions that make the bar feasible is either the fraudulent offer of a huckster who takes voters for fools, or clear evidence of stunning ignorance about how insurance works. Take your pick.

Unfortunately, none of the other Republican candidates offers a plan demonstrably superior to Trump's. All begin by calling for repeal and replacement of the Affordable Care Act. But none has yet advanced a well-crafted replacement.

It is not that the Affordable Care Act is perfect legislation. It isn't. But, as the old saying goes, you can't beat something with nothing. And so far as health care reform is concerned, nothing is what the Republican candidates now have on offer.


Editor's note: This piece originally appeared in U.S. News and World Report.

Authors

Publication: U.S. News and World Report
Image Source: © Lucy Nicholson / Reuters
      
 
 




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Careful or careless? Perspectives on the CARES Act

The Coronavirus Aid, Relief, and Economic Security (CARES) Act, passed by the Senate on March 25 and expected to be rapidly approved by the House and President, is the largest aid package in history. The bipartisan deal allocates $2 trillion in an effort to mitigate the mounting fallout from the COVID-19 pandemic, including $1.5 trillion…

       




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Trans-Atlantic Scorecard – July 2019

Welcome to the fourth edition of the Trans-Atlantic Scorecard, a quarterly evaluation of U.S.-European relations produced by Brookings’s Center on the United States and Europe (CUSE), as part of the Brookings – Robert Bosch Foundation Transatlantic Initiative. To produce the Scorecard, we poll Brookings scholars and other experts on the present state of U.S. relations…

       




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Trans-Atlantic Scorecard – October 2019

Welcome to the fifth edition of the Trans-Atlantic Scorecard, a quarterly evaluation of U.S.-European relations produced by Brookings’s Center on the United States and Europe (CUSE), as part of the Brookings – Robert Bosch Foundation Transatlantic Initiative. To produce the Scorecard, we poll Brookings scholars and other experts on the present state of U.S. relations…

       




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Pete and Gerry’s launches a reusable egg carton

The country’s leading organic egg brand has created the industry’s first reusable egg carton.




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Politics Trump Economics in the Complex Game of Eastern Mediterranean Hydrocarbons


A 2010 publication of the U.S. Geological Survey caused major excitement in Cyprus, an island that at the time was suffering from the economic collapse of its neighbor and major trading partner, Greece. According to the publication, the seabed of the Eastern Mediterranean could contain up to 120 trillion cubic feet (tcf) of natural gas.3 Three years later, the Cypriot administration has high hopes that natural gas exports may get Cyprus—the third smallest European Union member state—back on its feet, after its own financial collapse in 2012. Unfortunately for the Cypriots, the reality on the ground is sobering, and it is currently unclear whether Cyprus will become a producer, or an exporter, of natural gas. Around Cyprus, other countries hope to benefit from the energy potential as well, including Israel, Lebanon and the Palestinian Authority. In the Israeli Exclusive Economic Zone (EEZ), in particular, substantial reserves of natural gas have been found, though the verdict is out whether these will in fact all be produced.

Exploration of Cyprus’s offshore concessions is at an early stage. Energy majors such as ENI and Total are among the first to explore possible gas (and oil) reserves and they expect results not before 2015. To date, only two test wells have been drilled by Houston-based Noble Energy. Proven reserves have been downgraded since and are currently estimated to be between 3 and 5 tcf. At this level of reserves, investing in a natural gas liquefaction terminal, which the Cypriot administration has supported, is not economically viable. A better alternative would be to construct a pipeline to Turkey, which has a large and rapidly growing market for natural gas.

Download the full piece »

Downloads

Image Source: © Handout . / Reuters
      
 
 




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Should "Progressives" Boycott Whole Foods Over CEO's Statements on Health Care?

I am constantly amazed at the level of political discourse in the US. So a debate about health care degenerates into scares about "death panels" and boycotts of Whole Foods because their CEO is against it. It is all a bit much, and a complete mystery




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Food for Thought: Do The Health Care Views of Whole Food's CEO Keep You Away?

I went to Whole Foods in Oakland on Saturday, like I do most weekends, but I missed the dance/theater/protest against the grocery chain's co-founder and CEO John Mackey, he of the now infamous quote: "A careful reading of both the Declaration of




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USA: food scarcity and the “efficiency of the market”

In the midst of the COVID-19 pandemic, millions tried to prepare for social isolation like they would for a blizzard—stocking up not just on toilet paper and sanitizer, but also on pantry basics like milk, eggs, flour, and beans. Faced with this sudden surge in demand, grocery stores across the country were completely overwhelmed. Not just shelves but entire stores were cleared out, so “one-per-customer” rules were established on select items and notices were posted detailing which were out of stock. As we have written elsewhere, the capitalists can’t efficiently sustain supply chains through a crisis such as this.




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Why are so many visions of the future dominated by cars?

The private car has dominated our design dreaming for a hundred years; no wonder it is so hard to break the habit.




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UK carbon emissions down 38% since 1990

Even if you factor in offshoring of jobs and industry, emissions are way, way down.




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Italian energy giant to phase out coal, go carbon neutral before 2050

In the future, we'll be buying energy from utilities that look very different than what we are used to.




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A major U.S. utility company just pledged to go carbon-free for the first time in American history

Are the tables finally starting to turn?




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Wretched Excess or the future of housing design? Another look at the car elevator

There is a perverse logic to this idea of bringing your car to your apartment.




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Wretched Excess or Clever Design? Apartment tower with car elevators is definitely the former.

Two years ago we couldn't decide, but when you see it in action the answer is obvious.




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Something Old, Something New, Something Borrowed, Something...Green? Ritz-Carlton, Charlotte Delivers Eco-Friendly Weddings

As more eco-conscious couples take their walk down the aisle, a growing green wedding industry has responded in kind. Enter "Something Green," a new service introduced by The Ritz-Carlton, Charlotte. "We are constantly looking for




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Larch Corner is a Passivhaus wooden wonder that shows how we should be thinking about carbon

Mark Siddall of LEAP measures and calculates everything, thinks about it, and then calculates it again.




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Instant Car Showroom Is Built Out Of Shipping Containers

Design takes advantage of a shipping container attribute: Speed.




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Wonderful Uber ad demonstrates why we have to get rid of cars

Whether they are are autonomous, self-driving or "shared" like Uber and Lyft, they are still congestion.




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Are electric cars part of the climate solution or are they actually part of the problem?

If we are really going to make a dent in emissions we have to take real estate away from people who drive and redistribute it to people who walk and bike.




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Climate Care Heads Down Under

Australians may be world leaders in terms of greenhouse gas emissions, but with their new government signing Kyoto as one of its first acts in power, it seems change may well be in the air. So, is Australia about to go green in a big way? UK-based




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Is Zero-Carbon Farming Even Possible?

That's the question I'm scratching my head over while reading about the ambitious goals of one Douglas Jones, a 20 year old studying at the University of New South Wales (UNSW) in Sydney, Australia who hopes to turn his family's 1500 acre dairy




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Kylie Kwong Cooks Carbon Clean

Kylie Kwong is a well known Australian celebrity chef. What is probably less well known is her passion for the environment. A commitment well demonstrated via her Sydney chinese restaurant, Billy Kwong.




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Sydney Becomes Australia's First Carbon-Neutral Government Body

Last month the City of Sydney declared that it had become Australia’s first carbon neutral government. It is important to note that whilst the total area of this southern metropolis is said to be equal to the size of London




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Trulia study finds Americans say they care about the environment but aren't willing to pay for it

The extremely dated "It ain't easy being green" title of this Trulia survey actually misinterprets the data; judging by the questions they asked, it is perfectly easy being green; it just ain't cheap.




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Side mirrors no longer required on cars in Japan. Is this a good idea?

It would save fuel and be safer for pedestrians and cyclists. But is it too complicated?




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Ozone Hinders Plants' Ability to Absorb Carbon Dioxide

Ozone — best known for filtering out harmful UV light as a component of the Earth's stratosphere — could dramatically reduce plants' ability to act as a carbon sink and thus cause further accumulation of greenhouse gases in the atmosphere, according to




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Scientists Develop Potent Acids to Take Down Destructive Fluorocarbons

While their brethren, the dreaded chlorofluorocarbons (CFCs), may be on the wane, fluorocarbons -- a class of equally dangerous industrial gases -- are still wreaking havoc. As the name implies, the main distinguishing characteristic between CFCs and




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NRDC Assesses Biochar - Says High Hopes For Carbon Storage Premature

There's been lots of back and forth in the past year on biochar, ranging from research showing it has huge potential for absorbing carbon emissions on one side, to uncertainty about its potential, to outright




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Startup upcycles discarded chopsticks into new decor & furniture (Video)

Billions of chopsticks are thrown out each year worldwide. This Vancouver company is trying to turn some of of these into new items for the home.




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Five Scary Fall New York Fashion Week Faux Pas

We usually don't like to point out the negative aspects of things here on TreeHugger, but when it comes to New York's just ended Fall Fashion Week, I am forced to ask, "Wha' happened?"




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The war on cars is over, if you want it

Todd Litman calls the war on cars a bad joke. He gives us a lot of ammunition in the fight to end it.




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It's time to stop cars from making legal right turns on red lights

It was actually introduced to save fuel, but there have been unintended consequences.




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Are people on bikes more dangerous than people in cars?

In a word no. But people in cars seem to get a free pass for everything.




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Solar panel-carrying donkeys bring internet to Turkish sheepherders (Video)

These "plug-and-play" donkeys, equipped with solar panels, allow sheepherders to catch up on the news and socializing while out on their rounds.




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Submit Your Best Green Tweets for Carnival of the Green

We here at TreeHugger recently announced that the Carnival of the Green will now include a Twitter section.You can still submit as normal via email, of course, but this new part of the Carnival will be called "Best Green Tweets." So, if you use Twitter




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Kids Discover Nature Hosts Carnival of the Green

This week is Carnival of the Green #188 and it's being hosted by Kids Discover Nature, the place to find great outdoor activities for your children. No matter where you live, you can help your little ones learn about and experience nature by following




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Submit Your Best Green Tweets for Carnival of the Green

We here at TreeHugger recently announced that the Carnival of the Green will now include a Twitter section.You can still submit as normal via email, of course, but this new part of the Carnival will be called "Best Green Tweets." So, if you use Twitter




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The EcoChic Hosts Carnival of the Green

This week is Carnival of the Green #193 and it's being hosted by The EcoChic, a blog that takes us through the life of a thirty-something mom. She looks for ways to reduce her environmental impact on the Earth while sharing these ideas, products and




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Submit Your Best Green Tweets for Carnival of the Green

We here at TreeHugger recently announced that the Carnival of the Green will now include a Twitter section.You can still submit as normal via email, of course, but this new part of the Carnival will be called "Best Green Tweets." So, if you use Twitter




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Submit Your Best Green Tweets for Carnival of the Green

We here at TreeHugger recently announced that the Carnival of the Green will now include a Twitter section.You can still submit as normal via email, of course, but this new part of the Carnival will be called "Best Green Tweets." So, if you use Twitter




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Gaiam Hosts Carnival of the Green

This week is Carnival of the Green #196 and it's being hosted by Gaiam's blog, Stream of Consciousness, which is under Gaim's umbrella site called Gaiam Life. This "guide to a better living" highlights green living in addition to personal growth,