Articles Posted in Health Care Reform

Mick_Mulvaney_Official_Portrait_113th_Congress_cropped-249x300The  Trump budget for the federal government would be a huge step back from investment in medical research with consequences for many years in progress on promoting health and fighting disease.

The budget announcement, tilted so far toward guns over butter, proved so challenging to even members of Trump’s own controlling party that lawmakers hastened to underscore that Congress, and not the chief executive, theoretically, holds  the nation’s purse strings.

The president would boost allocations for the military by more than $50 billion, and significantly increase spending for homeland security, with billions for his proposed border wall as well as more customs and immigration agents nationwide. He would gut almost 80 federal programs, providing support for everything from the arts and public broadcasting to home weatherization, rural economic development, legal services for the poor, and meals on wheels food services for the old and sick.

AHCA-CBOAfter seven years, many dozens of repeal votes in Congress, and with the health of hundreds of millions of Americans at stake, can it be that the GOP’s plans to repeal the Affordable Care Act will come down to numbers?

The headlines about Obamacare’s potential replacement, the American Health Care Act, aka Trumpcare, may be rife with partisan politics. But after another helter-skelter week of attempted health care policy-making by Congress and the president, and with more crucial House action on tap in the days ahead, there’s lots of math that’s worth a review:

  • 14 million (2018), 21 million (2020), 24 million (2026)

Foxx-275x300Call it creepy or maybe a too-early April Fool’s joke. What else can be said about a Republican-backed measure, advancing in the House of Representatives, that puts Big Brother in charge— big time —in many workplaces via so-called wellness programs?

It’s called the  “Preserving Employee Wellness Programs Act.” This Orwell-inspired bill,  pushed by North Carolina Republican Congresswoman Virginia Foxx, gives employers scary control over their workers. Employees who participate in job-related health programs can be compelled to undergo genetic tests, and to provide the results to employers, albeit in supposedly anonymized fashion. If they fail to do so, they could face thousands of dollars in fines.

Disclosure of extremely personal, private medical information has been barred by the 2008 Genetic Information Nondiscrimination Act, aka GINA. It arose partly after a 1998 court case, in which clerical and administrative workers were allowed to sue their employer for requiring testing for “highly private and sensitive medical genetic information such as syphilis, sickle cell trait, and pregnancy” without their consent or knowledge during a general employee health exam. GINA has been key in blocking employers from tapping into genetic and other confidential medical information as part of increasingly popular but largely ineffective workplace wellness programs. Because most Americans, more than 155 million of them, get their health insurance at work, many companies have launched and expanded such programs as way to reduce their coverage costs.

Medicaid-300x225Republicans have long fumed about the federal government’s role in health care, ever since Medicare for the elderly and Medicaid for the poor were both passed in 1965. Now, though, we’re at a crossroads, where a frontal assault on Medicaid could cause big damage to both programs.

The temptation for too many Americans, as I’ve written before, may be to skip over the Medicaid-related parts of the GOP proposals to repeal and replace the Affordable Care Act, aka Obamacare. That would be wrong because those parts of the American Health Care Act, aka Trumpcare, may be the most radical and will be detrimental to the poor, working poor, children, sick, disabled, and seniors. They will hit many millions more middle-class Americans than might be thought.

Opponents also say that Trumpcare and its Medicaid and health insurance changes will harm Medicare, the linchpin of health care coverage for seniors.

ahca-300x169The president and his GOP allies on Capitol Hill already have rammed through two U.S. House committees a plan to repeal and replace the Affordable Care Act, aka Obamacare. But to paraphrase a best-seller’s title, those who will be affected by the American Health Care Act, the AHCA, are from Earth, while the Republicans who are pushing Trumpcare must be from Pluto.

That’s because their Trumpcare, as evidence already has shown, will divide Americans as never before, while at the same time unifying them in opposition to it and disbelief about its current form.

Here’s what the suddenly engaged, now arm-twisting president Tweeted about the House legislation:  “Our wonderful new Healthcare Bill is now out for review and negotiation. ObamaCare is a complete and total disaster— is imploding fast!”

goodlatte-300x256We all know how con artists work the streets. One might bump into you in a train or in a crosswalk, while the other grabs your wallet. Or one might smile and chat with a mom at a playground, while her partner nabs the purse.

Patients and consumers may want to watch carefully for the congressional version of the distraction scam, a series of stealth bills that aim to strip them of valuable legal rights and protections they’ll need if harmed by big hospitals, rich doctors, big insurance companies, or giant corporations. With so much commotion under way with the new administration, Republicans sneakily have launched a furious, multi-pronged so-called “tort reform” campaign. They’ve wanted it for a long time. They insist it is needed to curb excess and frivolous lawsuits, to save money for Uncle Sam (who often is a defendant), to make the economy work better, and to add jobs, and to make life in general more wonderful.

Their arguments are counter-factual and lacking in evidence.

Thanks to a tip from a finance wizard who helps me with pension savings, I’ve come across some entertaining and instructive videos about our American health care system. What’s up with the high costs? Do we get value for spending far more than any other civilized country? How could we do better?

Here’s one video explaining our health care costs, a bit over seven minutes, which is forever in YouTube land, BUT it covers a complex subject compactly and well. And another one here about five years worth of Obamacare. Both are by John and Hank Green, the Vlogbrothers.

Both point out how if we really wanted to save money and make American health care truly affordable, we’d empower a big buyer of health care services (like we already do with Medicare) to negotiate prices with providers.  That, of course, would mean something like “Medicare for All,” They do that all over the world and most advanced countries pay far less for the same care as a result.

Congressional Republicans took their first break from Washington under the new Trump Administration. And those, like Sen. Tom Cotton, R.-Ark., who actually tried to  hear out constituents in town halls got caught in an angry backlash. Voters let their lawmakers know they were furious about GOP plans to repeal and replace the Affordable Care Act, aka Obamacare.

The electorate’s rising anger led to reports that the GOP, even in its hard-core House majority, might be jammed up in its long-pledged vow to immediately unwind Obamacare, especially how it added health insurance coverage for tens of millions of Americans, notably through an expansion of the Medicaid program. John Boehner, the former GOP House speaker, flatly proclaimed that his party would leave most of the ACA undisturbed.

ryanMembers of Congress are home in their districts for a week-long break, and many lawmakers are expected to get an earful from voters upset over many issues at the start of the Trump Administration, especially this: What the heck’s going on with health care?

Republicans have insisted for years now—counter-factually, as the evidence has amply demonstrated—that they had a cheaper, better, more inclusive alternative to the Affordable Care Act, aka Obamacare. The promised to repeal the ACA on the day they gained control of Congress and the White House. That hasn’t happened. Nor has the GOP proffered its vaunted replacement. Instead, the party had talked in recent days about an ACA repair.

But under fire from their most conservative party members, Republican leaders have thrown up what they call an outline of Trumpcare. The GOP has moved from lots of R’s—repeal, replace, and repair—to some C’s and D’s: Costly, callous, divisive, and cruel. Those are some ways their retread plan elements (dubbed “déjà vu all over again” in one report) could be described. The outline still faces major challenges, not the least of which is whether a chaotic White House and a lumpen Congress can conduct the nation’s business and enact public policy.

thomas-price-225Republicans jammed through their health policy guru in the middle of the night, and they and their new HHS Secretary are still trying to figure out what to do with the Affordable Care Act, aka Obamacare. Insurance markets are on the brink of chaos, and the mess is angering increasing number of Americans who may soon see their costs rise, their medical care decline, and their health imperiled.

The president and the speaker of the house continue to be at odds as to the timing of the GOP’s long-promised pledge to repeal and replace Obamacare, with the timeline stretching to the year’s end or beyond before the public gets to see the outlines or details of Republicans’ Trumpcare.

Proposals for ACA ‘repair’

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