Patient Money: Containing the Costs of Pet Care

Last year the Nocella family adopted two puppies, a pit bull mix named Pokie and a “puggle” named Browny. Since then, Ms. Nocella estimates, the family has spent as much as $5,000 on veterinarian bills.

The dogs have had routine checkups and shots, of course. But then there were unexpected costs: Pokie arrived with a bad case of worms and kennel cough; some strange bumps on her paws turned out, after $700 worth of tests, to be warts. Browny has severe allergies and requires frequent trips to the vet.

Last November, Pokie swallowed Advil pills, which are toxic to dogs. She went into renal failure and required emergency treatment overnight in a nearby animal hospital. The treatment was successful and Pokie is fine, but the incident set the Nocellas back $2,300.

Pet owners like Ms. Nocella are spending more on veterinarian bills than ever before. The American Pet Products Association estimates that Americans will spend $12.2 billion on veterinary care this year, up from $11 billion last year and $8.2 billion in 2006.

Advances in veterinary medicine mean more extensive, and expensive, treatments are available for animals, but even ordinary costs like flea and tick protection can add up quickly. Here are some ways to curb those costs while still giving your pet the best of care.

LOW-COST ALTERNATIVES Local shelters often offer free or low-cost spaying and neutering for dogs and cats, said Dr. Louise Murray, vice president at the American Society for the Prevention of Cruelty to Animal’s Bergh Memorial Animal Hospital in New York and author of “Vet Confidential.” To find a shelter near you, check the A.S.P.C.A. Web site at www.aspca.org/pet-care/spayneuter.

Shelters where pets can be adopted may offer low-cost vaccinations and checkups. Mobile clinics, usually sponsored by local governments or animal protection agencies, also provide routine pet care for far less than a traditional vet would charge.

Veterinarian schools are another good source of low-cost care. Students are carefully supervised by qualified veterinarians, so pets receive quality care — everything from heartworm tests to major surgery, often for as little as a third of the price at a veterinarian’s office.

THE RIGHT VACCINES Keeping up with a pet’s shots will save money, not to mention misery, in the long run by preventing many serious illnesses. But that does not mean a pet needs every vaccine available.

“A corgi who lives on the Upper East Side doesn’t need the same protocol as a Labrador in Connecticut,” Dr. Murray said. “Your veterinarian should customize a vaccine plan that fits your pet.”

A HEALTHY DIET Many vets sell prescriptions and high-quality pet food, but the same brands are sold for much less at many pet supply stores or Web sites. Still, do not skimp on quality.

“Cats, for example, are carnivores and aren’t meant to eat carbohydrates,” Dr. Murray said. “Feeding them only the cheap dried food can lead to diabetes or blockages that will cost you a lot more in the long run than the price you’ll pay for the right food.”

DRUG DISCOUNTS If a pet needs regular medication, discount chains such as Costco can be cheaper than a regular drug store or the vet’s office, said Dr. Sharon Friedman, a veterinarian at the Berkley Animal Clinic in Berkley, Mich. But consult a veterinarian first, she advised, to be sure to buy the right medicine at the right dosage.

On the other hand, do not assume that tick and flea treatments or heartworm medications are cheaper at the big discount chains. Manufacturers want to distribute these medicines through veterinarians’ offices, so they often offer promotions and discounts there that are not available elsewhere.

“One company recently offered two free tick and flea treatments if you bought six doses. That worked out to be less expensive than PetMeds, a popular online store, or Costco,” Dr. Friedman said. “It often pays to ask.”

Many Web sites sell high-quality pet medications at good prices, but a recent Food and Drug. Administration. investigation caught some sites selling counterfeit, unapproved or expired drugs. Beware of any site that sells medications without requiring a veterinarian’s prescription.

The F.D.A. also recommends that consumers look for sites accredited as a Veterinary-Verified Internet Pharmacy Practice Site, part of a voluntary accreditation program.

CONSIDER INSURANCE Pet health insurance is a booming industry, growing more than 20 percent every year, although only an estimated 3 percent of pet owners have bought policies. While Ms. Nocella has never seriously considered buying pet insurance, she does acknowledge it might have come in handy the day Pokie ate the Advil.

But like health insurance for humans, pet insurance can be complicated and highly restricted. Some policies will not cover older pets or genetic conditions that certain breeds are known to have, such as hip dysplasia in retrievers.

Others limit coverage to only one treatment per illness. So if your dog develops asthma, for instance, some policies will cover just the first trip to the vet although treatment will require multiple visits.

Prices for pet insurance can range from $12 to $50 a month, depending on the type and age of the pet and any pre-existing conditions. In almost all cases the pet owner pays up front, then files a claim for reimbursement.

Costs are higher to insure older, sicker pets, or for policies that cover preventive care, such as vaccines and veterinarian office visits.

Many pet owners prefer to save for unexpected vet expenses in an emergency fund instead of paying premiums for coverage they may not use. Dr. Murray suggested putting away a little each week until savings reach $2,000 to $3,000.

“That’s the minimum you’ll need if a serious situation arises and your pet needs lifesaving care,” she said.

 

Patient Money: Containing the Costs of Pet Care

Last year the Nocella family adopted two puppies, a pit bull mix named Pokie and a “puggle” named Browny. Since then, Ms. Nocella estimates, the family has spent as much as $5,000 on veterinarian bills.

The dogs have had routine checkups and shots, of course. But then there were unexpected costs: Pokie arrived with a bad case of worms and kennel cough; some strange bumps on her paws turned out, after $700 worth of tests, to be warts. Browny has severe allergies and requires frequent trips to the vet.

Last November, Pokie swallowed Advil pills, which are toxic to dogs. She went into renal failure and required emergency treatment overnight in a nearby animal hospital. The treatment was successful and Pokie is fine, but the incident set the Nocellas back $2,300.

Pet owners like Ms. Nocella are spending more on veterinarian bills than ever before. The American Pet Products Association estimates that Americans will spend $12.2 billion on veterinary care this year, up from $11 billion last year and $8.2 billion in 2006.

Advances in veterinary medicine mean more extensive, and expensive, treatments are available for animals, but even ordinary costs like flea and tick protection can add up quickly. Here are some ways to curb those costs while still giving your pet the best of care.

LOW-COST ALTERNATIVES Local shelters often offer free or low-cost spaying and neutering for dogs and cats, said Dr. Louise Murray, vice president at the American Society for the Prevention of Cruelty to Animal’s Bergh Memorial Animal Hospital in New York and author of “Vet Confidential.” To find a shelter near you, check the A.S.P.C.A. Web site at www.aspca.org/pet-care/spayneuter.

Shelters where pets can be adopted may offer low-cost vaccinations and checkups. Mobile clinics, usually sponsored by local governments or animal protection agencies, also provide routine pet care for far less than a traditional vet would charge.

Veterinarian schools are another good source of low-cost care. Students are carefully supervised by qualified veterinarians, so pets receive quality care — everything from heartworm tests to major surgery, often for as little as a third of the price at a veterinarian’s office.

THE RIGHT VACCINES Keeping up with a pet’s shots will save money, not to mention misery, in the long run by preventing many serious illnesses. But that does not mean a pet needs every vaccine available.

“A corgi who lives on the Upper East Side doesn’t need the same protocol as a Labrador in Connecticut,” Dr. Murray said. “Your veterinarian should customize a vaccine plan that fits your pet.”

A HEALTHY DIET Many vets sell prescriptions and high-quality pet food, but the same brands are sold for much less at many pet supply stores or Web sites. Still, do not skimp on quality.

“Cats, for example, are carnivores and aren’t meant to eat carbohydrates,” Dr. Murray said. “Feeding them only the cheap dried food can lead to diabetes or blockages that will cost you a lot more in the long run than the price you’ll pay for the right food.”

DRUG DISCOUNTS If a pet needs regular medication, discount chains such as Costco can be cheaper than a regular drug store or the vet’s office, said Dr. Sharon Friedman, a veterinarian at the Berkley Animal Clinic in Berkley, Mich. But consult a veterinarian first, she advised, to be sure to buy the right medicine at the right dosage.

On the other hand, do not assume that tick and flea treatments or heartworm medications are cheaper at the big discount chains. Manufacturers want to distribute these medicines through veterinarians’ offices, so they often offer promotions and discounts there that are not available elsewhere.

“One company recently offered two free tick and flea treatments if you bought six doses. That worked out to be less expensive than PetMeds, a popular online store, or Costco,” Dr. Friedman said. “It often pays to ask.”

Many Web sites sell high-quality pet medications at good prices, but a recent Food and Drug. Administration. investigation caught some sites selling counterfeit, unapproved or expired drugs. Beware of any site that sells medications without requiring a veterinarian’s prescription.

The F.D.A. also recommends that consumers look for sites accredited as a Veterinary-Verified Internet Pharmacy Practice Site, part of a voluntary accreditation program.

CONSIDER INSURANCE Pet health insurance is a booming industry, growing more than 20 percent every year, although only an estimated 3 percent of pet owners have bought policies. While Ms. Nocella has never seriously considered buying pet insurance, she does acknowledge it might have come in handy the day Pokie ate the Advil.

But like health insurance for humans, pet insurance can be complicated and highly restricted. Some policies will not cover older pets or genetic conditions that certain breeds are known to have, such as hip dysplasia in retrievers.

Others limit coverage to only one treatment per illness. So if your dog develops asthma, for instance, some policies will cover just the first trip to the vet although treatment will require multiple visits.

Prices for pet insurance can range from $12 to $50 a month, depending on the type and age of the pet and any pre-existing conditions. In almost all cases the pet owner pays up front, then files a claim for reimbursement.

Costs are higher to insure older, sicker pets, or for policies that cover preventive care, such as vaccines and veterinarian office visits.

Many pet owners prefer to save for unexpected vet expenses in an emergency fund instead of paying premiums for coverage they may not use. Dr. Murray suggested putting away a little each week until savings reach $2,000 to $3,000.

“That’s the minimum you’ll need if a serious situation arises and your pet needs lifesaving care,” she said.

 

Patient Money: Containing the Costs of Pet Care

Last year the Nocella family adopted two puppies, a pit bull mix named Pokie and a “puggle” named Browny. Since then, Ms. Nocella estimates, the family has spent as much as $5,000 on veterinarian bills.

The dogs have had routine checkups and shots, of course. But then there were unexpected costs: Pokie arrived with a bad case of worms and kennel cough; some strange bumps on her paws turned out, after $700 worth of tests, to be warts. Browny has severe allergies and requires frequent trips to the vet.

Last November, Pokie swallowed Advil pills, which are toxic to dogs. She went into renal failure and required emergency treatment overnight in a nearby animal hospital. The treatment was successful and Pokie is fine, but the incident set the Nocellas back $2,300.

Pet owners like Ms. Nocella are spending more on veterinarian bills than ever before. The American Pet Products Association estimates that Americans will spend $12.2 billion on veterinary care this year, up from $11 billion last year and $8.2 billion in 2006.

Advances in veterinary medicine mean more extensive, and expensive, treatments are available for animals, but even ordinary costs like flea and tick protection can add up quickly. Here are some ways to curb those costs while still giving your pet the best of care.

LOW-COST ALTERNATIVES Local shelters often offer free or low-cost spaying and neutering for dogs and cats, said Dr. Louise Murray, vice president at the American Society for the Prevention of Cruelty to Animal’s Bergh Memorial Animal Hospital in New York and author of “Vet Confidential.” To find a shelter near you, check the A.S.P.C.A. Web site at www.aspca.org/pet-care/spayneuter.

Shelters where pets can be adopted may offer low-cost vaccinations and checkups. Mobile clinics, usually sponsored by local governments or animal protection agencies, also provide routine pet care for far less than a traditional vet would charge.

Veterinarian schools are another good source of low-cost care. Students are carefully supervised by qualified veterinarians, so pets receive quality care — everything from heartworm tests to major surgery, often for as little as a third of the price at a veterinarian’s office.

THE RIGHT VACCINES Keeping up with a pet’s shots will save money, not to mention misery, in the long run by preventing many serious illnesses. But that does not mean a pet needs every vaccine available.

“A corgi who lives on the Upper East Side doesn’t need the same protocol as a Labrador in Connecticut,” Dr. Murray said. “Your veterinarian should customize a vaccine plan that fits your pet.”

A HEALTHY DIET Many vets sell prescriptions and high-quality pet food, but the same brands are sold for much less at many pet supply stores or Web sites. Still, do not skimp on quality.

“Cats, for example, are carnivores and aren’t meant to eat carbohydrates,” Dr. Murray said. “Feeding them only the cheap dried food can lead to diabetes or blockages that will cost you a lot more in the long run than the price you’ll pay for the right food.”

DRUG DISCOUNTS If a pet needs regular medication, discount chains such as Costco can be cheaper than a regular drug store or the vet’s office, said Dr. Sharon Friedman, a veterinarian at the Berkley Animal Clinic in Berkley, Mich. But consult a veterinarian first, she advised, to be sure to buy the right medicine at the right dosage.

On the other hand, do not assume that tick and flea treatments or heartworm medications are cheaper at the big discount chains. Manufacturers want to distribute these medicines through veterinarians’ offices, so they often offer promotions and discounts there that are not available elsewhere.

“One company recently offered two free tick and flea treatments if you bought six doses. That worked out to be less expensive than PetMeds, a popular online store, or Costco,” Dr. Friedman said. “It often pays to ask.”

Many Web sites sell high-quality pet medications at good prices, but a recent Food and Drug. Administration. investigation caught some sites selling counterfeit, unapproved or expired drugs. Beware of any site that sells medications without requiring a veterinarian’s prescription.

The F.D.A. also recommends that consumers look for sites accredited as a Veterinary-Verified Internet Pharmacy Practice Site, part of a voluntary accreditation program.

CONSIDER INSURANCE Pet health insurance is a booming industry, growing more than 20 percent every year, although only an estimated 3 percent of pet owners have bought policies. While Ms. Nocella has never seriously considered buying pet insurance, she does acknowledge it might have come in handy the day Pokie ate the Advil.

But like health insurance for humans, pet insurance can be complicated and highly restricted. Some policies will not cover older pets or genetic conditions that certain breeds are known to have, such as hip dysplasia in retrievers.

Others limit coverage to only one treatment per illness. So if your dog develops asthma, for instance, some policies will cover just the first trip to the vet although treatment will require multiple visits.

Prices for pet insurance can range from $12 to $50 a month, depending on the type and age of the pet and any pre-existing conditions. In almost all cases the pet owner pays up front, then files a claim for reimbursement.

Costs are higher to insure older, sicker pets, or for policies that cover preventive care, such as vaccines and veterinarian office visits.

Many pet owners prefer to save for unexpected vet expenses in an emergency fund instead of paying premiums for coverage they may not use. Dr. Murray suggested putting away a little each week until savings reach $2,000 to $3,000.

“That’s the minimum you’ll need if a serious situation arises and your pet needs lifesaving care,” she said.

 

Borrowing Costs Rise for Spain and Portugal

MADRID — Spain and Portugal on Wednesday managed to raise the targeted amounts in their latest debt auctions, an important test of market confidence amid Lisbon’s negotiations for a financial bailout and Madrid’s attempts to avoid needing one.

Spain sold €3.37 billion, or $4.9 billion of debt, with the average yield on the benchmark 10-year bond rising to 5.47 percent from 5.16 percent last month. The auction met with strong demand and was at the top end of its target. That was an improvement on a Treasury bill auction on Monday, when Spain barely managed to meet its minimum target despite offering higher rates to investors.

Portugal also had to offer higher rates in the sale of €1 billion of short-term Treasury bills, but met its target and drew strong demand. Analysts suggested that the result will encourage the Portuguese Treasury to sell more short-term debt while its bailout talks continue.

The bond auctions came amid worries that the financing difficulties of ailing euro economies are far from resolved — even those of countries already rescued, like Greece. Athens received a €110 billion bailout last year but may still have to restructure its debt because of the unsustainable cost of repaying investors at double-digit interest rates.

The Greek finance minister, George Papaconstantinou, on Wednesday again ruled out such a move, saying it held “huge dangers for Greece, for Greek banks, for households,” Bloomberg News reported. But such statements have failed to persuade investors.

Meanwhile, strong gains in last weekend’s elections in Finland by nationalist politicians, who are skeptical about having to bail out fellow euro members, have raised concerns about completing the €80 billion rescue package requested by Portugal. In the Portuguese auction Wednesday, yields for six-month bills rose to 5.53 percent from 5.12 percent at the last auction on April 6.

“The costs of funding are up sizably as a result of the spillover effects from Greek restructuring talks, and this might reignite contagion fears,” Chiara Cremonesi, a fixed-income strategist at UniCredit, wrote in a note to investors regarding Spain and Portugal. “The good news is that demand was healthy, and this will reassure investors.”

Market sentiment has seesawed in the past months amid diverging signals from European politicians about their willingness to provide further financing to countries that have already requested a rescue and prepare for possible additional bailouts. In particular, any bailout of the Spanish economy, which is bigger than that of Greece, Ireland and Portugal combined, could put the survival of the euro in question.

At its previous auction of 10-year bonds, for instance, the Spanish Treasury managed to lower slightly its borrowing costs after a mid-March agreement by European leaders to strengthen the European Financial Stability Facility available to rescue troubled economies, as well as allow the facility to purchase government debt in some conditions.

Since then, however, the European political landscape has become more fragmented because of the fall of the Portuguese government and the Finnish election result.

Officials from the International Monetary Fund, the European Commission and the European Central Bank arrived in Lisbon last week to start negotiating the terms of a bailout. Their goal is to complete a deal by mid-May, before the general election scheduled for June 5. June is also the month when Portugal faces its toughest refinancing hurdles of the year.

Slovaks dissent over fund

A Slovak governing-coalition party said Wednesday that it would not support the creation of the European Union’s permanent bailout fund, potentially endangering the bloc’s main tool to quell fiscal crises, Bloomberg News reported from Bratislava, the country’s capital.

The Freedom and Solidarity party, one of four coalition members, will vote against Slovak participation in the so-called European Stability Mechanism, which is set to be created in 2013 to help distressed countries, the party’s leader, Richard Sulik, said. While supporting the creation of the temporary rescue facility, the coalition last year rejected Slovakia’s participation in an international bailout of Greece.

 

Braves 4, Mets 0; Braves 4, Mets 2: Stay in Atlanta Costs Mets Two Games and a Pitcher

“Ideally, in a perfect world, yeah,” Collins said of Bay. “Which you know, now it’s not really perfect.”

?If by that he meant that things could not get much worse, then yes, the world is not perfect for the Mets right now. With their pitching staff in a state of near disarray because of heavy use and Chris Young’s shoulder injury, they were forced to play a doubleheader they wanted no part of, and not surprisingly, they were swept by the Atlanta Braves.

?In games that are starting to have an air of ominous inevitability, the Mets lost twice, 4-2 in the first game and 4-0 in the second, a game in which they were held to two hits and made one costly base-running mistake.

?They have dropped seven games in a row, 10 of 11, and their 4-11 record is the worst in the National League.

From ownership to the front office to the players, the Mets desperately wanted to get off to a fast start this season. Instead, the losses are coming in bunches, with four in three miserable days. The seven-game slide is their longest losing streak since the end of the 2004 season, and it is the first time since 1982 that the Mets endured four losses in consecutive doubleheaders.

? “Hopefully this is kind of an eye-opening little streak for us — that we need to get better, we need to improve, and there’s a lot of things we need to work on,” David Wright said.

?But it may also be an eye-opening streak for the fans, who are increasingly being turned off. That, obviously, is not good news for the Mets’ organization, which needs to generate more revenue through tickets sales and sponsorships to help stabilize their murky financial situation.

? The player the Mets will turn to now to stabilize matters on the field is coming from Class AAA Buffalo. Dillon Gee will be called up to pitch Sunday in place of the right-handed Young, who was placed on the 15-day disabled list with biceps tendinitis in his right shoulder, making Saturday even worse.

?Young, who had been impressive in his first two starts, going 1-0 with a 1.46 earned run average, developed soreness in his shoulder, which is worrisome even if he and the Mets have played down the severity.

?Young had arthroscopic shoulder surgery in 2009 and made only four starts in 2010 because of lingering soreness. He said this injury was not related to the old one, and that it should not prevent him from coming off the disabled list when he is eligible April 26.

?“The irritation of the biceps tendon is just lingering, and the best thing for it is rest,” he said.

?Young said he had not had a magnetic resonance imaging test on the shoulder, in part because he did not think it would be helpful, even though M.R.I.’s are often standard with any injury involving the shoulder or elbow.

Young had been scheduled to pitch Friday, but when the shoulder pain flared, his start was pushed to Sunday and the relief pitcher D. J. Carrasco was called upon to replace him. Then Friday’s game was rained out, and the Braves rescheduled it as part of a doubleheader Saturday, which irritated the Mets because of their vulnerable pitching. Instead of being able to skip Carrasco, they then had to start him and Gee in two divisional games.

The Mets protested to Major League Baseball, but the rescheduling decision was upheld. Collins was asked if he understood why the Braves would choose to press their competitive advantage.

“Do I understand?” he responded. “I don’t really care to comment on it at all. They told me I’ve got to play. I’ve got to play.”

Once they did, it did not go so well. In the first game, the Braves hit four solo home runs, including one from Chipper Jones — the 45th homer of his career against the Mets — two from Alex Gonzalez and one from the rookie Freddie Freeman.

In the second game, Braves starter Jair Jurrjens pitched so well that Collins did not even feel the need to yell at his team after the game.

? Jurrjens allowed only two hits through seven innings, one of them a leadoff double by Daniel Murphy in the sixth inning with the Mets trailing, 3-0. Inexplicably, Murphy tried to steal third base and was thrown out, which earned him a lecture from Collins in the dugout runway.

?“It was an awful play,” Murphy said. “There was nothing that could have been going through my mind that could have justified that.”

?After the first game, Collins, who held a team meeting Wednesday that has been followed by four straight losses, said he remained confident that the Mets would rebound.

“I can tell you, we’re going to break out, and when we do we’re going to win a lot of baseball games,” he said.

?But for now, the Mets are tied with the Seattle Mariners with the most losses in baseball. For a team that needed a fast start, it is a perfectly awful way to begin.

 

Nitrogen pollution 'costs £280bn'

 10 April 2011 Last updated at 21:06 ET By Roger Harrabin Environment analyst Agriculture is said to produce 70% of the nitrous oxide emissions in Europe Nitrogen pollution from farms, vehicles, industry and waste treatment is costing the EU up to ￡280bn (320bn euros) a year, a report says.

The study by 200 European experts says reactive nitrogen contributes to air pollution, fuels climate change and is estimated to shorten the life of the average resident by six months.

Livestock farming is one of the biggest causes of nitrogen pollution, it adds.

It calls for changes in farming and more controls on vehicles and industry.

The problem would be greatly helped if less meat was consumed, the report says.

Nitrogen is the most common element in the atmosphere and is harmless.

It is the reactive form - mainly produced by human activity - that causes a web of related problems.

The 600-page report relies on experts from 21 countries and 89 organisations. It estimates the annual cost of damage caused by nitrogen across Europe as being ￡55-￡280bn.

Reactive nitrogen emissions from agriculture are the most intractable as they come from many diffuse sources.

The report says Europe needs nitrogen fertilisers for its own food security but blames many farmers for applying fertiliser carelessly to crops, so that excess nitrogen runs off to pollute water supplies.

Run-off from animal manure also fouls watercourses, and the release of nitrous oxides from uncovered dung heaps pollutes the air.

'Dominant driver'

Agriculture produces 70% of the nitrous oxide emissions in Europe.

New rules reducing nitrogen emissions from farms are introduced next year, but there are questions over whether these will be strict enough or properly enforced.

The report says more careful application of fertiliser will benefit farmers by saving money. It will benefit the climate by avoiding the energy used to create the fertiliser.

Lead editor, Mark Sutton from the Centre for Ecology and Hydrology near Edinburgh, told BBC News that 80% of the nitrogen in crops feeds livestock, not people.

"It's much more efficient to obtain protein by eating plants rather than animals," he said.

"If we want to help the problem we can all do something by eating less meat. Eating meat is the dominant driver of the nitrogen cycle in Europe."

The report says government efforts to control emissions of reactive nitrogen from combustion sources have been more successful.

In the 1980s nitrogen controls were placed on industrial plant and vehicles, This has led to a cut in emissions of 30%, despite an increase in traffic and economic activity.

But the traffic increase has slowed progress in reducing emissions further, and people in many areas still suffer from nitrogen-related air pollution, including small particulates that get sucked deep into the lungs, and ground-level ozone - a strongly irritant gas formed by the action of sunlight on reactive nitrogen.

The authors note that industries have typically resisted controls on nitrogen, but that the benefits of reducing its emissions far outweigh the costs.

Dr Sutton said: "This report is the first time anyone has brought together the whole suite of environmental and human health issues from nitrogen on a Continental scale.

"There have been and still are many attempts to control nitrogen but we believe the big challenge is to link existing policy areas and make them work together."