Category Archives: Republicans

Executive (Dis)order

The signing this morning of an executive order by the Orangutan will have, in the opinion of some of the bloggers and politicians, spell disaster for the nation’s health care system.

It will, if carried into action, likely siphon healthy people from the Affordable Care Act-compliant market, continuing a pattern of regulatory actions under the Trump administration that have undermined the ACA.

The rationale for such a move that has been given is that since Congress has not been able to repeal and replace the ACA, an executive order will, piece by piece.

Coupled with the recent budget move to eliminate the CHIP program for children’s health (New York State faces dire consequences if Congress does not act on CHIP), and cut backs to Medicare and Medicaid, the intent here is to privatize health care for some, and eliminate it for others, and to get government out of health care providing altogether.

There are provisions in this order for greater competition, short-term coverage, and lower premiums with less coverage. Why this is better is beyond me, unless the Orangutan is seeking to destroy health care so that single-payer will be the only option.

Cutting healthy people out of the ACA means leaving sick people to struggle with a health care law that many say needs to be fixed, not repealed and replaced. But because the Tea Party ranted and raved before it was enacted, and the Orangutan and the GOP campaigned on getting rid of it, they had no choice but to sabotage it if they could not do so through legislation.

I predict that we will soon see the total collapse of our health care system thanks to this stupid, overreaching, and ill-advised Executive Order. I even read today that the Vice President had to remind the Orangutan to sign the darn thing, something that almost slipped what is left of his so-called mind.

Welcome to Crackerbox Palace.

Advertisements

The End of the World Is Near (The Health Care World, That Is)

Fellow blogger, Joe Paduda, brilliantly summed up the current GOP attempt to blow up the nation’s health care system in today’s post.

Rather, than repeat and comment on what he wrote, I am letting you read the post here.

Then there is a great graphic on what the Cassidy-Graham bill will mean for states, and from a brief look at it, I can say that they are playing favorites with some, but not all of the states of the former Confederacy, and sticking it to those states in the North (and West like California) who they have disdain for.

Because of it’s dire impact on the health care system, it should actually be called the Butch Cassidy and the Sundance Kid bill, because like those two 19th century bandits, they are going to rob us blind. How do you say “We are taking back your health care” in Spanish?

But, in actuality, it is just another way of giving a tax break to the wealthy at the expense of everyone else.

If this bill passes, and the Orangutan signs it, the end of the world in health care would soon follow. The only option then would be single-payer, and it would be ironic and even cruel if that was the GOP’s game plan all along. Wreck the health care system so that single-payer is the only option left, and if that fails, they drop the whole thing and move on.

We shall see next week, as there are two Senators who may hold the future of health care in their hands, Collins of Maine and Murkowski of Alaska.

The “Curse” of For-Profit Health Care

Recently, Vermont Senator Bernie Sanders introduced a Medicare for All bill into the U.S. Senate, and many Democratic Senators signed on as co-sponsors of the bill.

Earlier yesterday morning, on his way to a photo-op in Naples, Florida to see the damage from Hurricane Irma (why didn’t he go to the Keys), the Orangeman tweeted that Senator Sanders’ bill would visit a curse on the U.S.

This from a man who said that he preferred the Canadian system, and told the Australian Prime Minister to his face, and the cameras, that they had a better health care system than the US.

What are we to make of someone who likes other countries health care systems as long as it is not our system? What do we do when the elected leaders of this country are dead set against providing the best health care system to their constituents, and in fact, are determined to take away what little health care they already have?

I find it rather odd, and callous that the Orangutan calls Sen. Sanders’ plan a curse, when millions of Americans are cursed everyday with not having any health care, or minimal care at best.

No, what is a curse are families going broke paying for medical care, individuals forgoing needed care because it costs too much, doctors and nurses burned out because they are overworked, underpaid (in some cases), and trying to work in a broken, bureaucratic, sclerotic, and byzantine system.

The American “health care” system is the curse. The cure, or rather the silver bullet for this vampiric monster, is single-payer. Maybe Sen. Sanders’ bill won’t pass this time, with this Congress and this President, but it or something like it should in the future.

Our curse as a nation is in our slavish devotion to making everything conform to the will and whim of the free market. We have seen that the free market is great for the production and selling of goods and services, but health care is not a consumer good. It is a right of every man, woman, and child.

The Canadians, the Australians, the British, and many other nations are not so slavishly devoted to the free market as we are when it comes to providing health care to all their citizens, and they cannot be called “Socialist” or “Communist” in any way, shape, or form.

Only because of the greed of a few insurance companies, Wall Street players and their investor clients, as well as very wealthy Libertarian brothers from the energy sector do we continue to be cursed with the worse system for providing health care.

Finally, the ultimate curse this nation has is the individual who said single-payer would be a curse. And like Dracula, only the light of day will stop him.

Single Payer Supported by Majority of Physicians

A shout-out to Dr. Don McCanne for posting the following article from Merritt Hawkins.

Merritt Hawkins
August 14, 2017
Survey: 42% of Physicians Strongly Support a Single Payer Healthcare System, 35% are Strongly Opposed
By Phillip Miller
A plurality of physicians strongly support a single payer healthcare system, according to a new survey by Merritt Hawkins.
The survey of 1,033 physicians indicates that 42 percent strongly support a single payer health care system while 14 percent are somewhat supportive. Over one-third (35 percent) strongly oppose a single payer system while six percent are somewhat against it. The remaining three percent neither support nor oppose single payer.
The results contrast with a national survey of physicians Merritt Hawkins conducted in 2008, which indicated that 58 percent of physicians opposed single payer at that time while 42 percent supported it.
In Merritt Hawkins’ experience, there are four reasons why a growing number of physicians are in favor of single payer. First, they are seeking clarity and stability. The fits and starts of health reform and the growing complexity of our current hybrid system are a daily strain on most doctors. Many of them believe that a single payer healthcare system will reduce the distractions and allow them to focus on what they have paid a high price to do: care for patients.
Second, it’s a generational issue. The various surveys that Merritt Hawkins has conducted for The Physicians Foundation in the past show that younger doctors are more accepting of Obamacare, ACOs, EHR, and change in general than are older physicians As the new generation of physicians comes up, there is less resistance among doctors to single payer.
Third, there is a feeling of resignation rather than enthusiasm among some physicians about single payer. These physicians believe we are drifting toward single payer and would just as soon get it over with. The 14% of physicians surveyed who said they “somewhat” support single payer are probably in this group.
Fourth, there is a philosophical change among physicians that I think the public and political leaders on both sides of the aisle now share, which is that we should make an effort to cover as many people as possible.
However, while single payer has gained acceptance among some physicians, it remains strongly opposed by over one third and strongly or somewhat opposed by over 40 percent. It is still a polarizing issue among physicians and is likely to remain so for the foreseeable future.
So, if a majority of physicians support single payer, and they are the ones we should listen to when it comes to taking care of our health, and if a growing majority of Americans are coming around to this idea, then the only ones standing in the way are our politicians.
POTUS, the Secretary of Health and Human Services, Mitch McConnell, Paul Ryan, Rand Paul, and the medical-industrial complex of insurance companies, drug companies, and medical device manufacturers are all opposed and are preventing this nation from joining the rest of the developed world in providing health care to ALL its citizens.
And there is one more obstacle in our way: Wall Street investors and their clients who are funding insurance and medical companies, engaging in adverse selection and determining who lives and who dies. Who gets covered and who goes into bankruptcy.
They need to removed from the equation.

Trump and the Social Determinants of Health

Here’s a little light reading for your weekend, courtesy of Patricia Illingworth, writing today in Health Affairs blog about the Social Determinants of Health and the take on it by the current administration.

Ms. Illingworth rightly points out that those below the poverty level and without a college degree, both whites and minorities, suffer more serious illnesses such as diabetes, asthma, heart disease, as well as smoking, drinking and using illegal drugs more than those with college degrees.

She also states that cuts to education, energy, the environment, housing and urban development, among other social sectors, impacts health, and that if these social determinants are underfunded, people will need more health care. And now that the health care reform debate is stalled, the current POTUS is still trying to destroy the ACA, and has threatened members of his own party, including the Senate Majority Leader, Mitch McConnell.

Ms. Illingworth cites a study published by the Brookings Institution, that showed that “deaths of despair”—those associated with drugs, alcohol, and suicide—have risen significantly among middle-aged white non-Hispanic Americans without a college degree.

Living conditions, Ms. Illingworth reports, also affects rates of asthma, which are the leading cause of children’s visits to ER’s, hospitalizations, and absenteeism. And, it is more prevalent in poor and minority communities.

All of this is not surprising, since 1980, this nation has waged a relentless war against its poor and minority citizens. This war began the day Ronald Reagan took the oath of office and began dismantling not only the New Deal programs, but cutting back the programs created under the Great Society of the 1960’s.

With each successive Republican administration, as well as the rise of Republican power  in Congress since the ascension of Newt Gingrich to Speaker of the House, and in many states, especially in the formerly solid Democratic South, poverty and illness among the poor and minority, as well as whites have increased. And the loss of manufacturing and other support services jobs associated with manufacturing have resulted in the current opioid crisis, which only yesterday was addressed as a national emergency by the POTUS.

But Democrats are not without fault here too. Failure to stand up to the Reaganite Counter-Revolution, the pursuit of a failed “free trade” policy that has outsourced jobs or allowed companies to offshore jobs, as well as paying deference to the will of Wall Street and Corporate America, has brought us the current occupant of the Oval Office.

In the recent health care debate in Washington, many placed their confidence in moderate Republican senators to defeat the repeal and replace measures, but as Andrew Sullivan wrote four years ago in his blog, The Dish, “What Moderate Republicans?”, Sullivan says the following:

“There is effectively no Republican party any more. There is a radical movement to destroy the modern American state and eviscerate its institutions in favor of restoring a mythical, elysian, majority-white, nineteenth-century past. This crisis is proving that more powerfully than even watching Fox. We need to see what is in front of our nose: a cold civil war has broken out between those properly called conservatives, defending the credit of the government, empirical reality, and adjustments to modern life and those properly called radical reactionaries declaring our current elected president and Senate as illegitimate actors, bent on the destruction of America, and therefore necessitating total political warfare, even to the point of threatening to destroy the global economy.”

The current architect of this destruction is not the man with the orange hair, but one Stephen K. Bannon, the former head of Breitbart. Bannon’s radical agenda is to destroy the “deep state”, and to create what Sullivan so rightly predicted four years ago, as he said above.

Bannon has been identified as a racist, anti-Semite, and has no business in the White House. Another member of this cabal is Stephen Miller, who a few weeks ago, revealed his true colors by openly defending restricting legal immigration, something that brought his family, and mine, as well as millions of others, to this country.

I could go on, but this post is about health care.

The main point is, we need to stop playing games with people’s health and do what other Western and developed countries provide to their citizens, health care for all.

If you don’t believe me, then maybe the words of a billionaire will convince you. Warren Buffett, one of the richest men in America, and an astute and very successful businessman, unlike a certain neophyte politician, has said the following with regard to single payer.

“…government-run health insurance “probably is the best system” because it would control escalating costs. We are such a rich country. In a sense, we can afford to do it, … In almost every field of American business, it pays to bring down costs.”

It is time to give every American health care. Then we will see a vast improvement in the social determinants of health.

Another Scheme to Delay the Inevitable, part 2

Last week, I reported on an effort to create payer-provider partnerships, and said that it was another scheme to delay the inevitable move towards a Medicare for All, single-payer system.

Thanks again to Dr. Don McCanne for this week’s article from Modern Healthcare, on yet again another delaying tactic. This time it is from Congress, and while it purports to be “bipartisan”, it really isn’t, because they are very partisan in Congress today; partisan to the health care industry’s profit-making off of sick people.

Without further ado, here is the article in full:

http://www.modernhealthcare.com/article/20170803/NEWS/170809957

IT IS HIGH TIME TO STOP WASTING TIME, WASTING ENERGY AND THE PATIENCE OF THE AMERICAN PEOPLE WITH “SOLUTIONS” THAT ONLY MAKE THINGS WORSE, NOT BETTER. IT IS TIME TO EXPAND MEDICARE TO EVERYONE, WITH NO BUY-IN, AND BE DONE WITH IT.

 

 

Another Scheme to Delay the Inevitable

After my last post on my personal health issue and the debate over the health care bills that now have been shelved, I thought I’d share with you the following article in its entirety that is just another scheme to delay the inevitable fact that we will need and have a single-payer, Medicare for All health care system.

The article came to me courtesy of Don McCanne, former President of Physicians for a National Health Program (PNHP).

Here is the article:

Healthcare Dive
August 2, 2017
Health reform driving payer-provider partnerships
By Les Masterson
Payers and providers have for decades stayed in their silos, leading to a more fractured and adversarial healthcare system. That relationship, however, is starting to soften for many in the industry. Payer-provider partnerships put the two groups on the same team in hopes of reducing costs and improving care and outcomes through sharing data and better communication.
A major driver of these partnerships is the move away from fee-for-service payments and toward valued-based payments and population health management.
The payer-provider partnerships popping up across healthcare vary in type, size, location and model. There are 50/50 joint ventures with co-branding, and less intensive partnerships like accountable care organizations (ACO), patient-centered medical homes (PCMH), pay for performance and bundled payments.
The first step in these partnerships is building trust between payers and providers.
Another key is communication. (Chuck Lehn, president of Banner Health Network) acknowledged that communicating across systems and platforms between two organizations and healthcare providers requires time, attention and resources.
Caring for the whole patient works best when payers and providers share data, so there is improved care management, better interventions and better analytics around population health.
The two sides can go much deeper into care for patients by going beyond claims. In partnerships, payers shouldn’t have to wait for claims to see how their members are doing and doctors shouldn’t have to hope that their patients tell them when they have received care elsewhere.
In addition to regular back and forth, payers and providers need regular meetings, whether monthly or quarterly, that focus on strategic issues about the partnership, said (James Leatherwood, marketing communications manager at Availity).
One barrier that still needs resolution in partnerships is moving providers away from phone communication.
Leatherwood said a more efficient way is a queue system. In this system, a provider could check the status of all claims and get alerts when they need to provide more information. The system would allow providers to look in one queue, update the claims information and then move on with their day. Payers would have their own queue and would get alerts when providers have questions. This would reduce phone calls and create immediacy.
Leatherwood said the healthcare system is stuck in a “chart chase” between providers and payers, and moving to an automated queue system would be a gamechanger.
“I think in the near-term what we’re going to see is larger healthcare providers are going to be more strategic, working directly with payers. The health plans are going to be more interested not just in working with the staff level, but executive levels,” said Leatherwood.
The third part of a successful partnership is aligning incentives that focus on keeping people healthy and creating a positive healthcare experience, said (Thomas Robinson, partner at Oliver Wyman).
Partnerships must provide patients the right incentives, integration, investment, insight and innovation to work with the plan to deliver improvements across cost, quality, outcomes and experience, said Robinson.
“The point of these partnerships is to create something new, rather than just building the same old offerings with a narrow network. Successful partnerships will take the opportunity to innovate around the product and experience now that the incentives, insight, investment and integration are all for it,” said Robinson.
Aetna and Banner Health agreed on the partnership in October 2016 and have been laying out the groundwork before its launch this month in Maricopa and Pinal counties in Arizona. The two companies hope to expand the program statewide ultimately.
To prepare for the partnership, Tom Grote, who became CEO of Banner/Aetna joint venture in May, told Healthcare Dive that Banner Health and Aetna have developed joint operating committees, including marketing/sales and population health, that include members from both organizations.
The partnership looks to improve consumer experience by fully integrating providers, Aetna and administrative services, while eliminating redundancies in care and administrative problems. Aetna and Banner Health expect streamlining care and services will lead to savings for patients and employers.
(Brigitte Nettesheim, president of transformative markets for Aetna) said the partnerships are about “each side playing to its strengths, aligning incentives and driving scale.”
(Tom Leyden, director II of the Value Partnerships Program at BCBSM) said providers want to be active participants in system transformation.
“This requires ongoing support from the payer and demonstrated evidence of practice transformation and clinic results from the provider community,” said Leyden. “Administration of these programs is an integral aspect of measuring performance.”
Leyden said the payer strives to make the programs as manageable as possible because physicians need to perform many administrative tasks on an ongoing basis. BCBSM regularly solicits feedback from providers during quarterly meetings and phone calls, emails, webinars and in-person meetings on what’s working, what’s not and what needs to be changed.
“If we keep the customer — the end user — in mind and build partnerships with that as our North Star, we believe we will have a more successful, efficient and collaborative health system,” said Grote.
McCanne says they are the ones who control the medical industrial complex, and are part of the problem with our health care system. I agree.
And finally, here is a video from MSNBC with Ali Velshi debating a GOP’er on single-payer and Canada. The GOP’er says Canadians flock to the US for medical care, namely surgery, but Velshi disputes that rather forcefully.
Until we get these defenders of the status quo removed from Congress, we will never have the kind of health care all other developed nations have.
Health care is not a business, health care is a human right.