I said all along the Rinos would not repeal the ACA, they only voted to repeal it because they knew Obama would veto it, they get less than 5% of the ACA Medicaid vote and don't want to lose it, fk the rest of their base they cater to the Medicaid leaches
He should have made fun of their diminished brain activity and reasoning skills.....
Hey Meghan....... you don't want to know it but your dad's a traitor & should be treated as such.
At least that's what us deplorables are saying about him........
If the mother can't afford to pay for the abortion herself, some states (like Illinois, for instance) have safe haven laws that allow one to abandon a baby up to 30 days old at a police or fire station with no questions asked. The baby then may be adopted into good families and raised with no welfare involved. The outcome does not have to be nasty.
There's a lot wrong with the official story, including the fact that the shooter appeared to be perfectly normal and with no motivation. Are TPTB evil enough to stage a false flag attack (of course there were dead victims, not actors; the story would not have sold without an actual massacre) where innocents are murdered to further their agenda? Sadly, the answer is, yes. So we must follow the story wherever the facts lead us.
P.S., I find myself wondering if we're being tested by an "if they believe this, they'll believe anything" script. I do think we're being conditioned.
WASHINGTON — President Trump signed an executive order on Thursday that clears the way for potentially sweeping changes to the country’s health insurance system, including sales of cheaper policies with fewer benefits and protections for consumers than those mandated under the Affordable Care Act.
The president’s plan, an 1,100-word directive to federal agencies, laid the groundwork for an expanding array of health insurance products, mainly less comprehensive plans offered through associations of small employers and greater use of short-term medical coverage.
It was the first time since efforts to repeal the landmark health law collapsed in Congress that Mr. Trump has set forth his vision of how to remake the nation’s health care system using the powers of the executive branch. It immediately touched off a furious debate over whether the move would fatally destabilize the Affordable Care Act marketplaces or add welcome options to consumers complaining of high premiums and not enough choice.
In Congress, the move seemed to intensify the polarization over health care. The Senate majority leader, Mitch McConnell of Kentucky, said the president was offering “more affordable health insurance options” desperately needed by consumers. But the Senate Democratic leader, Chuck Schumer of New York, said Mr. Trump was “using a wrecking ball to single-handedly rip apart our health care system.”
Most of the changes will not occur until federal agencies write and adopt regulations implementing them. The process, which includes a period for public comments, could take months. That means the order will probably not affect insurance coverage next year, but could lead to major changes in 2019.
“With these actions,” Mr. Trump said at a White House ceremony, “we are moving toward lower costs and more options in the health care market, and taking crucial steps toward saving the American people from the nightmare of Obamacare.”
“This is going to be something that millions and millions of people will be signing up for,” the president predicted, “and they’re going to be very happy.’’
But many patients, doctors, hospital executives and state insurance regulators were not so happy. They said the changes envisioned by Mr. Trump could raise costs for sick people, increase sales of bare-bones insurance and add uncertainty to wobbly health insurance markets.
“Today’s executive order could leave millions of cancer patients and survivors unable to access meaningful coverage,’’ said Chris Hansen, the president of the lobbying arm of the American Cancer Society.
In a statement from six physician groups, including the American Academy of Family Physicians, the doctors predicted, “Allowing insurers to sell narrow, low-cost health plans likely will cause significant economic harm to women and older, sicker Americans who stand to face higher-cost and fewer insurance options.”
While many health insurers remained silent about the executive order, some voiced concern that it could destabilize the market.
The Trump proposal “would draw younger and healthier people away from the exchanges and drive additional plans out of the market,” warned Ceci Connolly, the chief executive of the Alliance of Community Health Plans. “In turn, premiums would continue to increase, threatening the security of affordable coverage for millions of working families.”
The Affordable Care Act has expanded private insurance to millions of people through the creation of marketplaces, also known as exchanges, where people can purchase plans, in many cases using government subsidies to offset the cost. It also required that plans offered on the exchanges include a specific set of benefits, including hospital care, maternity care and mental health services, and it prohibited insurers from denying coverage to people with pre-existing medical conditions.
The order’s quickest impact on the marketplaces would be the potential expansion of short-term plans, which are exempt from Affordable Care Act requirements. The Obama administration limited the length of time people could enroll in such plans because companies were marketing them to healthy customers and luring people away from Affordable Care Act marketplaces, said Sabrina Corlette, a research professor at Georgetown University. She predicted companies would seize the opportunity to resume sale of such policies, which are much less expensive than A.C.A. plans. “There are companies that are poised to aggressively market this stuff,” she said.
Many health policy experts worry that if large numbers of healthy people move into such plans, it would drive up premiums for those left in Affordable Care Act plans because the risk pool would have sicker people.
“If the short-term plans are able to siphon off the healthiest people, then the more highly regulated marketplaces may not be sustainable,” said Larry Levitt, a senior vice president for the Kaiser Family Foundation. “These plans follow no rules.”
Short-term policies could be useful to people in counties where only one insurer is offering plans in the Affordable Care Act marketplace, according to a White House document.
But short-term policies can also limit benefits and charge higher premiums to people who have expensive medical conditions, a type of discrimination banned in policies regulated under the Affordable Care Act.
Mr. Trump’s order would also eventually make it easier for small businesses to band together and buy insurance through entities known as association health plans, which could be created by business and professional groups. A White House official said these health plans “could potentially allow American employers to form groups across state lines” — a goal championed by Mr. Trump and many other Republicans — allowing more options and the formation of larger risk pools.
Association plans have a troubled history. Because the plans were not subject to state regulations that required insurers to have adequate financial resources, some became insolvent, leaving people with unpaid medical bills. Some insurers were accused of fraud, telling customers that the plans were more comprehensive than they were and leaving them uncovered when consumers became seriously ill.
“This could turn back the clock three decades on small business insurance,” Mr. Levitt said. Without the oversight by states, “this could create an unregulated and risky market that we haven’t seen for decades,’ he said.
The order won applause from potential sponsors of association health plans, including the National Federation of Independent Business, the National Restaurant Association, the U.S. Chamber of Commerce and Associated Builders and Contractors, a trade group for the construction industry.
The White House released a document saying that some consumer protections would remain in place for association plans. “Employers participating in an association health plan cannot exclude any employee from joining the plan and cannot develop premiums based on health conditions” of individual employees, according to the document.
But state officials pointed out that an association health plan can set different rates for different employers, so that a company with older, sicker workers might have to pay much more than a firm with young, healthy employees.
“Two employers in an association can be charged very different rates, based on the medical claims filed by their employees,” said Mike Kreidler, the state insurance commissioner in Washington.
Mr. Trump’s order followed the pattern of previous policy shifts that originated with similar directives to agencies to come up with new rules. Within hours of his inauguration in January, he ordered federal agencies to find ways to waive or defer provisions of the Affordable Care Act that might burden consumers, insurers or health care providers. In May, he directed officials to help employers with religious objections to the federal mandate for insurance coverage of contraception.
Both of those orders were followed up with specific, substantive regulations that rolled back policies of President Barack Obama.
In battles over the Affordable Care Act this year, Mr. Trump and Senate Republicans said they wanted to give state officials vast new power to regulate insurance because state officials were wiser than federal officials and better understood local needs. But under the order, the federal government could pre-empt many state insurance rules, a prospect that alarms state insurance regulators.
The National Association of Insurance Commissioners, representing state officials, has long opposed association health plans because they could be largely exempt from state regulation. Ted Nickel, the president of the National Association of Insurance Commissioners, who is also the top insurance regulator in Wisconsin, said the proliferation of association health plans could further destabilize “already fragile markets.’’
Another part of Mr. Trump’s order indicates that he may wish to crack down on the consolidation of doctors, hospitals and other health care providers, a trend that critics say has driven up costs for consumers. Mr. Trump said that administration officials, working with the Federal Trade Commission, should report to him within 180 days on federal and state policies that limit competition and choice in the health care industry.
Democratic leaders blasted the administration on Thursday night over President Trump's decision to end key payments to insurers offering ObamaCare coverage, calling the move "spiteful."
"Sadly, instead of working to lower health costs for Americans, it seems President Trump will singlehandedly hike Americans' health premiums," Senate Minority Leader Charles Schumer (D-N.Y.) and House Minority Leader Nancy Pelosi (D-Calif.) said in a joint statement.
"It is a spiteful act of vast, pointless sabotage leveled at working families and the middle class in every corner of America. Make no mistake about it, Trump will try to blame the Affordable Care Act, but this will fall on his back and he will pay the price for it," they continued.
The White House announced Thursday night that the administration would no longer make the disbursements, known as cost-sharing reduction (CSR) payments. The administration argued in a statement that it "cannot lawfully" make the payments.
"Based on guidance from the Department of Justice, the Department of Health and Human Services has concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare," White House press secretary Sarah Huckabee Sanders said.
Trump had repeatedly threatened to cut off the payments, which help low-income people afford co-pays, deductibles and other out-of-pocket costs associated with health-insurance policies. Insurers have warned of massive premium hikes or an exit from the individual market with the payments.
The Congressional Budget Office (CBO) said in August that insurance companies would raise premium prices by about 20 percent for ObamaCare plans if the payments were cut off, saying that around 1 million people would be uninsured in 2018.
The CBO also said that cutting off the payments would raise the federal deficit by $194 billion through 2026.
"President Trump has apparently decided to punish the American people for his inability to improve our health care system. Trumpcare collapsed because Americans overwhelmingly recognized the cruelty and higher costs it meant for them and their loved ones. Now, millions of hard-working American families will suffer just because President Trump wants them to," Schumer and Pelosi said.
By Roy Poses, MD, Clinical Associate Professor of Medicine at Brown University, and the President of FIRM – the Foundation for Integrity and Responsibility in Medicine. Originally published at Health Care Renewal
Last week, we discussed what appeared to be the most egregious case of the health care revolving door seen so far. A health care corporate lobbyist without any direct medical, health care, public health or biomedical science experience was named Acting US Secretary of Health and Human Services after being confirmed as Deputy Secretary.
Former Top Executive of Pharmaceutical Company Eli Lilly Considered for Nomination as Secretary of Health and Human Services
Only a week later, an even more egregious case may be in the works. The name being “floated” as nominee to be the next Secretary of Health and Human Services is Mr Alex Azar, who through this year was a top pharmaceutical executive. Again, he has no experience in medicine, the health professions, public health or biomedical sciences.
Azar has spent most of the past decade inside the drug industry, one of the key sectors he’ll regulate at HHS. Azar joined pharmaceutical giant Eli Lilly and Company in June 2007 as a senior vice president of corporate affairs and communications right after leaving the Bush administration.
He rose to head Lilly’s U.S. operations in 2012, a position he held until this January, when he left the company. At Lilly he worked on both international and federal government affairs and public policy. Other areas of focus included counterfeit medicines and health information technology.
By the way,
As part of his role at Lilly, Azar served on the board of directors for BIO, a drug lobby.
Mr Azar did have prior experience in the Department of Health and Human Services, but essentially as a lawyer/ administrator,
He served as the department’s general counsel and deputy secretary during the Bush administration.
Political, but No Medical, Health Care Professional, Public Health or Biomedical Science Credentials
I entered healthcare largely by accident. After law school, I clerked for Justice Antonin Scalia and then joined a D.C. law firm. I went to work for my mentor Ken Starr immediately after he became the Whitewater independent counsel.
While at my law firm, Wiley, Rein & Fielding, I was active in the Bush-Cheney campaign in 2000. After Bush won, I received a call from the office of Tommy Thompson, Secretary of the Department of Health & Human Services, asking me if I’d have interest in being General Counsel of HHS. I’ll confess that I wrestled with the question, since I had not focused on health law in my legal career.
The Politico article suggests that the Trump regime might consider most of Mr Azar’s credentials to be the top US health official are political,
He has also been a harsh critic of Obamacare and cheered GOP efforts to repeal and replace it, telling Fox Business in May that the Obamacare is ‘fundamentally broken’ and ‘circling the drain.’
Azar emerged as a strong backer of former Florida Gov. Jeb Bush’s Republican presidential campaign in 2016, serving on Bush’s 30-member Indiana steering committee in the lead-up to the election.
Azar knows Vice President Mike Pence from his time at Lilly, which is headquartered in Indianapolis.
Note that were he to become Secretary of DHHS, unless the Affordable Care Act (“Obamacare”) were to be repealed, he would be charged with enforcing it.
Azar clerked for Supreme Court Justice Antonin Scalia and, after Bill Clinton became president, worked under special counsel Kenneth Starr as he investigated Clinton’s failed Whitewater real estate investments.
Lilly’s Poor Ethical Track Record on his Watch
Unlike the Mr Hargan, who transited the revolving door from a lobbying position, Mr Azar had direct operational responsibility, in this case, for Eli Lilly’s US operations. Thus he ought to be held responsible for the company’s ethical misadventures during the time he was there. In fact, the company has had a few such misadventures, some of which we have previously discussed.
Jury Found Takeda and Eli Lilly Concealed Cancer Risks of Actos, Company Subject to Punitive Damages of $36.8 Million – 2014
We discussed this in 2014. This case seemed to involve serious deceptions, since the judge said in one ruling:
the evidence during the trial showed that the companies ‘disregarded, denied, obfuscated and concealed’ for more than a decade that Actos could increase patients’ risk for bladder cancer.
Lilly Pleaded Guilty to Charges Related to Deceptive Marketing of Zypresa as Part of an Over $1 Billion Settlement – 2009
At the time, this was considered a landmark case. Eli Lilly pleaded guilty to a misdemeanor criminal charges and settled allegations about questionable marketing practices for its anti-psychotic drug Zyprexa for over $1 billion in 2009 (see post here). The settlement provided some instructive information about how big pharmaceutical companies employ ghost writing to sell product (see this post). The company pushed Zyprexa for elderly patients with dementia, despite the lack of evidence that the drug’s benefits outweighed its clear harms, thus likely leading to patient harm.
Many other cases of dubious Lilly practices that did not necessarily lead to legal settlements or criminal charges can be found here. These practices include older, lesser cases involving the revolving door; and various instances of apparently deceptive marketing practices such as planned obsolescence of drugs, use of physician “thought leaders” as covert drug marketers, payments to patient advocacy groups presumably to encourage them to act also as covert drug marketers, etc, etc
Furthermore, the company was involved in several major cases of misbehavior overseas about which Mr Azar may or may not have been aware. These included:
– Lilly Fined by Brazil for “Sham” Litigation to Extend Patent on Gemzar – 2015
– Lilly Settled Case Alleging it Bribed Foreign Officials to Win Business – 2012
We discussed this here. This case seemed serious since it involved lavish gifts and payments made from 2006-2009 to Chinese physicians who worked for the government , bribes to health officials to Brazil starting in 2007, and other such transactions in other countries in previous years.
Last week we noted that Mr Trump famously promised to “drain the swamp” in Washington. Last week, despite his previous pledges to not appoint lobbyists to powerful positions, he appointed a lobbyist to be acting DHHS Secretary. This week he is apparently strongly considering Mr Alex Azar, a pharmaceutical executive to be permanent DHHS Secretary, even though the FDA, part of DHHS, has direct regulatory authority over the pharmaceutical industry, and many other DHHS policies strongly affect the pharmaceutical industry. (By the way, Mr Azar was also in charge of one lobbying effort.)
So should Mr Azar be confirmed as Secretary of DHHS, the fox guarding the hen house appears to be a reasonable analogy.
Moreover, several serious legal cases involving bad behavior by his company, and multiple other instances of apparently unethical behavior occurred on Mr Azar’s watch at Eli Lilly. So the fox might be not the most reputable member of the species.
The literature makes clear that the revolving door process is a source of valuable political connections for private firms. But it generates corruption risks and has strong distortionary effects on the economy, especially when this power is concentrated within a few firms.
The ongoing parade of people transiting the revolving door from industry to the Trump administration once again suggests how the revolving door may enable certain of those with private vested interests to have excess influence, way beyond that of ordinary citizens, on how the government works, and that the country is still increasingly being run by a cozy group of insiders with ties to both government and industry. This has been termed crony capitalism. The latest cohort and now this most flagrant example of revolving door transits suggests that regulatory capture is likely to become much worse in the near future.
So, as we have said before [before, before…] The continuing egregiousness of the revolving door in health care shows how health care leadership can play mutually beneficial games, regardless of the their effects on patients’ and the public’s health. Once again, true health care reform would cut the ties between government and corporate leaders and their cronies that have lead to government of, for and by corporate executives rather than the people at large.
Let me at least try to provide a new picture of the revolving door…
In post-election glow, Democrats hold health care banner high
Election results in Maine and Virginia show the ACA and backing for Medicaid, once issues that tripped up Democrats, have shifted to become a liability for Republicans.
By Noam N. LeveyTribune News Service
“There has been a major change here,” said Robert Blendon, an expert on public opinion about health care at Harvard’s Kennedy School. “Democrats for years wouldn’t talk about health care. … Now, the implication is that if you are a Democrat running in 2018, you can talk about protecting health care for millions of Americans.”
Tuesday’s elections don’t ensure health care will remain a winning issue for Democrats in 2018. But the emergence of health care as a political liability for Republicans marks a dramatic turnabout for the Republican Party, which for years reaped huge electoral gains by playing on the unpopularity of the 2010 law.
Tuesday’s results also represent a warning sign for Republicans eager to revive their campaign to repeal the law and its historic coverage expansion.
“In a year when attacks on health and health care came from every corner, voters in Maine sent a clear message: Access to health care coverage for low-income people should be expanded, not threatened or cut,” said Robert Restuccia, executive director of Community Catalyst, a national patient advocacy group. “We hope that elected officials in Congress and other states will take heed.”
The electoral results will pave the way for Medicaid expansion not only in Maine, but also perhaps in Virginia, where the GOP-controlled state Legislature had blocked expansion there for years. Democrats on Tuesday came close to taking a majority in the state House of Delegates, though final results won’t be known until later this week.
Meanwhile, advocates are eyeing new efforts to force leaders in other states to expand Medicaid eligibility, including in Idaho and Utah.
Thirty-one states and the District of Columbia have expanded eligibility for the government health care program since 2014, using federal money made available by the law to cover poor, working-age adults, a population that was historically not eligible for the coverage.
A small shift from the military budget to the health budget could go a long way, methinks... I remember - working construction - that when "laid off" I kept my union coverage for 3 months, then I had to fork out $900/month for COBRA, just when all "savings" were gone... It just didn't make sense...