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Health Care In America

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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...
When I left the union and I got the paper work for COBRA I couldn't believe what I was looking at. It was well over 2 grand a month. That's when I started to believe in socialized medicine. We have to pay taxes we may as well get something for it. Why should our tax $$$ be spent 0verseas? Time to end our never ending war in the middle east and take care of our own people here in America.
 

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And that is why wages are stagnant......... designed when .gov takes over it's a HUGE monster but goes in their income bracket!
 

Uglytruth

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66% can't come up with $1000 so this is designed to break you financially & mentally.
 

latemetal

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66% can't come up with $1000 so this is designed to break you financially & mentally.
If you can't come up with a $1,000, you have been broken...amazing the people who MUST spend every last dime.
 

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When I left the union and I got the paper work for COBRA I couldn't believe what I was looking at. It was well over 2 grand a month. That's when I started to believe in socialized medicine. We have to pay taxes we may as well get something for it. Why should our tax $$$ be spent 0verseas? Time to end our never ending war in the middle east and take care of our own people here in America.
That's the scam though. Goobermint creates the problem and then offers the solution. Socialized medicine will just lower the standard of care for all over time and of course jack up the national credit card even faster.

The vast majority of people would do well to reject this scam, pay for most health care services out of pocket, and stack some savings for just in case. The way to kill the federal beast is to strangle it of resources. Feeding it is just a bad idea.

 
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goldielox1

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When I left the union and I got the paper work for COBRA I couldn't believe what I was looking at. It was well over 2 grand a month. That's when I started to believe in socialized medicine. We have to pay taxes we may as well get something for it. Why should our tax $$$ be spent 0verseas? Time to end our never ending war in the middle east and take care of our own people here in America.
It's not an "either/or" proposition. The government has no rightful business in overseas occupations or in health care domestically.
 

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Medical Research? Congress Cheers. Medical Care? Congress Brawls.


The New York Times

By ROBERT PEAR
16 hrs ago


WASHINGTON — They cannot agree on subsidies for low-income people under the Affordable Care Act or even how to extend funding for the broadly popular Children’s Health Insurance Program — two issues requiring urgent attention as Congress returns to work.

But a more exotic corner of the medical world has drawn rapturous agreement among Republicans and Democrats: the development of new treatments and cures through taxpayer-funded biomedical research.

For the third straight year, lawmakers are planning to increase the budget of the National Institutes of Health by $2 billion. In the process, they have summarily rejected cuts proposed by President Trump.

The push for additional funding reflects a fascination among legislators with advances in fields like molecular biology, genetics and regenerative medicine, even as they wage bitter battles over just how large a role the government should play in financing health care and providing coverage.

At a recent hearing, Senators Lamar Alexander of Tennessee and Tim Scott of South Carolina, both Republicans, and Maggie Hassan of New Hampshire, a Democrat, pressed scientists to explain exactly how gene editing technology could lead to new treatments for sickle cell anemia, H.I.V., cystic fibrosis, Alzheimer’s and other diseases.

Ms. Hassan wanted to know the relative merits of different techniques for editing DNA and RNA — what she called “this incredible cutting-edge technology.”

Why is medical research so much less contentious than fundamental issues like health insurance coverage?

Anthony J. Mazzaschi, a lobbyist at the national organization representing schools of public health, said “the charisma of the cure, the hope and promise of curing disease, seems to excite members of Congress,” including some in their 70s and 80s who are “facing the prospect of disease and disability head-on.”

And that prospect is bipartisan. “Disease doesn’t impact just Republicans or Democrats,” said Representative Diana DeGette, Democrat of Colorado. “It impacts everybody.”

While the search for new treatments and cures is advancing at breakneck speed, ideas about how to help patients pay for them lag far behind. And Republicans who sometimes laud the N.I.H. as the National Institutes of Hope also support dismantling the Affordable Care Act, which could limit access to the new treatments.

“If we are spending billions to incentivize the development of new drugs, I think we also have to ensure that patients can afford those drugs,” said Representative Jan Schakowsky, Democrat of Illinois. “It is almost cruel to find a cure and then have it priced so high that a patient can’t afford it.”

The challenges facing patients and policymakers were illustrated this past week when a Philadelphia company said it would charge $850,000 for a new gene therapy to treat a rare inherited form of blindness. (The company, Spark Therapeutics, said it would pay rebates to certain insurers if the medicine, given in a one-time injection, did not work as promised.)

Members of Congress have friends, relatives and constituents who suffer from cancer, Alzheimer’s and other diseases, but lawmakers may have less interaction with people who are uninsured and unable to afford doctor visits or prescription drugs.

“Sadly,” said R. Alta Charo, a professor of law and bioethics at the University of Wisconsin at Madison, “the cynic in me says it’s because of the prevalence of selfishness. We all want to know there’s something out there that will cure us if we need it, but many of us are quite reluctant to pay for somebody else to get cured when they need it.”

Sherri J. Bale, a geneticist who worked at the N.I.H. for 16 years before founding GeneDx, a genetic testing company in Gaithersburg, Md., said: “Gene therapy has fabulous promise. We will soon be able to treat and even cure people with genetic diseases where we previously had nothing at all to offer them. But where are they supposed to get the money to pay for these treatments — thousands of dollars a month?”

“What good is the research if all you do is treat people in a clinical trial and publish a few papers?” Ms. Bale asked. “I’m afraid that patients will be left in the lurch.”

With huge bipartisan majorities, Congress in 2016 passed the 21st Century Cures Act, to speed the discovery of cures and the approval of new drugs and medical devices. Senator Mitch McConnell of Kentucky, the majority leader, called it “the most significant legislation” passed by Congress in 2015-16.

Nine-year-old Max Schill of Williamstown, N.J., who has a rare genetic condition known as Noonan syndrome, which causes heart defects and growth delays, was the public face of patients who could benefit from that legislation.

“Max bravely visited nearly every senator’s office with handmade drawings asking for support,” said Senator Robert Menendez, Democrat of New Jersey.

But while a few children with rare diseases can sometimes elicit an outpouring of concern, millions of Americans continue to lack health insurance.

A month after President Barack Obama signed the medical cures bill in December 2016, surrounded by members of both parties, Republicans in Congress ramped up their campaign to demolish the Affordable Care Act — a law that Mr. McConnell once described as “the single worst piece of legislation that has been passed in the last half-century.”

Republicans in Congress and the Trump administration appear uncertain whether they want to repeal what remains of the Affordable Care Act or stabilize insurance marketplaces created by the law. They cannot agree among themselves, much less with Democrats, over the future direction of federal health policy.

Funds for the Children’s Health Insurance Program, which serves nearly nine million children, and for community health centers, which serve more than 24 million patients, are in limbo because of inaction by Congress.

The partisan divide was evident last week when Mr. Trump proposed to relax certain health insurance rules. Senator Alexander and other Republicans hailed the move as a way to reduce costs for 11 million small-business employees and self-employed people.

But the House Democratic leader, Nancy Pelosi of California, said the president’s proposal was a recipe for “junk health insurance” that would strip consumers of vital protections provided by the Affordable Care Act.

Bipartisan Senate efforts to stabilize insurance markets face long odds in the House.

Mr. Alexander, the chairman of the Senate health committee, and Senator Patty Murray of Washington, the senior Democrat on the panel, drafted a bill to continue paying cost-sharing subsidies to insurance companies on behalf of low-income people.

But their bill met fierce resistance from conservative House Republicans, who said it would prop up the health law and bail out insurers.

By contrast, the appeal of biomedical research often appears to transcend politics. In a decision applauded by scientists, Mr. Trump decided to retain the director of the National Institutes of Health, Dr. Francis S. Collins, who led the government’s 15-year effort to map the human genome and inspires lawmakers with his infectious enthusiasm for medical research.

When Dr. Collins and Scott Gottlieb, the commissioner of the Food and Drug Administration, appeared at House and Senate hearings to assess progress under the Cures Act, one theme ran through questions from members of both parties: What more can we do to help you?

The N.I.H. has an annual budget of roughly $32 billion, and over 80 percent of it goes out in grants to more than 300,000 scientists at universities, medical schools and other research institutions that can lobby local members of Congress.

Dr. Matthew H. Porteus, a pediatrician and stem cell biologist at Stanford University who testified at the Senate hearing on gene editing, said he was impressed with the level of congressional interest and surprised at the lack of partisanship.

“The senators’ questions were spoken as if they were experts,” he said. “If you didn’t know what party each senator belonged to, you’d have no idea, based on the questions they asked.”

At the same time, Dr. Porteus said, “it’s really disappointing” that Congress has been unable to find money for a long-term extension of the Children’s Health Insurance Program.

“If you can’t provide the best possible care for people today, and CHIP is an essential part of that for millions of children,” Dr. Porteus said, “you’ll be in a poor position to provide advanced care to people in the future.”

http://www.msn.com/en-us/news/polit...ngress-brawls/ar-BBHWlNN?li=BBnb7Kz&ocid=iehp
 

goldielox1

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Gubmint needs to get out of both health research and insurance. Argument solved.
 

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These are all horrible ideas IMO

1) a national fee schedule is price control (and an opportunity to learn for the millionth time that fixed pricing affects availability of service). The "correct" answer is to require published pricing where everyone knows the cost before hand and you aren't charged differently from anyone else

2) banning imports is ok but bypassing the FDA by stipulating that regulatory approval by a foreign country is adequate is a bad idea unless the patient indemnifies the supplier and accepts the risk of side effects. Even with the FDA process the drug companies are constantly sued for side effects, this won't get better without GAMP oversite

3) eliminate FDA involvement with generics is oversimplification and dangerous. A lot can go wrong with drug manufacture. The FDA does a lot more than just approve the generic (such as audit the process of production and participate in defining the acceptance criteria for the drugs value). Even the term generic is an oversimplification. There are tiers, bio similar means "close enough" not the same thing just cheaper

4) health courts is the exact opposite direction. It's easy to say no lawyers but this will be a boon for the trial lawyers lobby. Yeah, we'll just open another front that adds cost and instability to the supplier that should make the cost come down ;)

Conceptually we need less government and the patient needs to accept more liability. Pricing need to be published and the regulations that dictate what can and has to be bundled needs to be canceled. The free market would work if you let it (competition)

Think VIOXX, a great pain killer that's non opioid that was helping millions. But no, the 99% that benefited were told they couldn't have it because 1% were getting leaky heart valves. If the consumer knows and chooses to rake it with the informed risk they should be able to IMO
 

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On health care, Democrats are shifting to offense


Associated Press
By RICARDO ALONSO-ZALDIVAR, Associated Press
1 hr ago



WASHINGTON — Democrats are shifting to offense on health care, emboldened by successes in defending the Affordable Care Act. They say their ultimate goal is a government guarantee of affordable coverage for all.

With Republicans unable to agree on a vision for health care, Democrats are debating ideas that range from single-payer, government-run care for all, to new insurance options anchored in popular programs like Medicare or Medicaid. There's also widespread support for authorizing Medicare to negotiate prescription drug prices, an idea once advocated by candidate Donald Trump, which has languished since he was elected president.

Democrats are hoping to winnow down the options during the 2018 campaign season, providing clarity for their 2020 presidential candidate. In polls, health care remains a top priority for the public, particularly for Democrats and independents.

"We're tired of just playing defense," said Sen. Tim Kaine, D-Va., the party's 2016 vice presidential candidate. "It is now time to talk about the next big idea. It is a good time for everybody to put their big ideas on the table." His offering: "Medicare-X," a public insurance plan to be initially deployed in communities that lack private insurer competition.

Rising Democratic ambitions come as a cloud of uncertainty lingers over former President Barack Obama's health law. While major provisions have survived the GOP onslaught, some Republicans are vowing to go for repeal again. Congress has ended the health law's requirement that most people get coverage, and that's expected to lead to higher premiums in 2019. But bipartisan legislation to stabilize insurance markets doesn't seem to be getting traction.

Obama's former health secretary, Kathleen Sebelius, says she sees Democrats reclaiming a core belief that health care should be a right guaranteed under law.

"Coverage for all is as much of an organizing principle for Democrats as eliminating Obamacare is for Republicans," said Sebelius. "But it turned out that (Republicans) didn't have any idea what that meant. I think Democrats have a much clearer vision."

Time will tell. Here's a sample of ideas under debate by Democrats and others on the political left:

—Medicare for All: Vermont Sen. Bernie Sanders made single-payer, government-run health care the cornerstone of his campaign for the 2016 Democratic presidential nomination. It remains the most talked-about health care idea on the left. Financing would be funneled through the tax system. Individuals wouldn't have to worry about deductibles, copays or narrow provider networks. Although state-level attempts to enact single-payer care have foundered because of the large tax increases needed, about one-third of Sanders' Democratic colleagues in the Senate are co-sponsoring his latest bill.

—Medicare-X: The legislation from Sens. Kaine, and Michael Bennet, D-Col., would allow individuals in communities lacking insurer competition to buy into a new public plan built on Medicare's provider network and reimbursement rates. Medicare would be empowered to negotiate prescription drug prices. Medicare-X would be available as an option through HealthCare.gov and state health insurance markets. Enrollees could receive financial assistance for premiums and copays through the Obama health law. Eventually, Medicare-X would be offered everywhere for individuals and small businesses.

—Medicare Part E: Yale University political scientist Jacob Hacker has proposed a new public health insurance plan based on Medicare, for people who don't have access to job-based coverage meeting certain standards. It would be financed partly with taxes on companies that don't provide insurance. Consumers would pay income-based premiums. Hospitals and doctors would be reimbursed based on Medicare rates, generally lower than what private insurance pays. "The crucial part of this is that you have guaranteed health insurance, just like you have guaranteed Medicare or Social Security," said Hacker. He's working with Democrats in Congress to turn the concept into legislation.

—Medicaid Buy-In: Sen. Brian Schatz, D-Hawaii, and Rep. Ben Ray Lujan, D-N.M., have introduced legislation that would allow states to open their Medicaid programs up to people willing to pay premiums. Although Medicaid started out as insurance for the poor, it has grown to cover about 75 million people, making it the largest government health program. Most beneficiaries are now enrolled in private insurance plans designed for the Medicaid market.

Expect more ideas as the year unfolds, said Neera Tanden, president of the Center for American Progress and a former top aide to Obama as well as Hillary Clinton. "Democrats are much more comfortable with an expansionist view," said Tanden. "Almost every Democrat is talking about truly universal health care."

Some Republicans are taking note. In a recent floor speech, Sen. John Barrasso, R-Wyo., said "it's interesting listening to Democrats, because they think they have good ideas and they're just proven wrong by the facts."

Barrasso aimed his criticism at Sanders' single-payer plan. "Democrats who are pushing for a Washington takeover of America's health care are still not coming clean about the rationing of care that it would cause," he said.

But in Sanders' home state of Vermont, primary care physician Dr. Deborah Richter says she believes it's only a matter of time before the Unites States adopts single-payer. Activists who failed in an earlier attempt in the state are now focused on passing a plan that would cover just primary care.

"I think the next election will be a move to the left," said Richter. "Whether Democrats will be willing to go for the whole system is pretty doubtful. I feel it might be possible for us to do it in phases."

http://www.msn.com/en-us/news/polit...ng-to-offense/ar-BBI4tvN?li=BBnb7Kz&ocid=iehp
 

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Obamacare On Its Last Legs? ... I Hope!
RonPaulLibertyReport


Streamed live 54 minutes ago
Obamacare is a crony-politically-connected program that has punished Americans who need the exact opposite. Government must GET OUT of the healthcare industry. Ron Paul discusses on today's Liberty Report!
 

goldielox1

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I wonder if anyone in Congress is setting up a contingency budget for "if" the dollar collapses? You know one that will require 95% reduction of federal government and balancing the budget. I know it's a long shot and all that printing the dollar into oblivion would ever backfire.
 

searcher

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I wonder if anyone in Congress is setting up a contingency budget for "if" the dollar collapses? You know one that will require 95% reduction of federal government and balancing the budget. I know it's a long shot and all that printing the dollar into oblivion would ever backfire.
Wouldn't surprise me if contingency plans haven't already been drawn up. That could be an opportunity to kinda wipe the slate clean and go cashless. And maybe government by decree.

Have you ever wondered why we need 18 billion for a wall but nothing for health care?
 

goldielox1

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Wouldn't surprise me if contingency plans haven't already been drawn up. That could be an opportunity to kinda wipe the slate clean and go cashless. And maybe government by decree.
I imagine that it has been drawn up but probably not by anyone in congress. Of course someone in Congress will pop up with bill in hand a day after it happens, just like they always do.

Have you ever wondered why we need 18 billion for a wall but nothing for health care?
I wonder a lot of things.
 

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Trump White House clears path for Medicaid work requirement

BY Terence Cullen
NEW YORK DAILY NEWS
Updated: Thursday, January 11, 2018, 8:21 AM



States will now be able to impose work requirements on able-bodied, low-income American adults to receive Medicaid benefits, the Trump administration signaled Thursday.

The move is expected to impact millions of Americans who rely on the state-federal program to help get health coverage.

It will allows states to deny Medicaid to able-bodied adults without a job, according to reports.

Community involvement that’s commensurate with employment will be counted as a job under the new guidelines. That exemption also covers people undergoing treatment for substance abuse problems.

Medicaid directors speak out against latest GOP health care bill

“Medicaid needs to be more flexible so that states can best address the needs of this population,” Seema Verma, the Medicaid and Medicare chief, said in a statement. “Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries.”

Ten states, all of which have Republican governors, recently applied for waivers to impose work requirements.

Kentucky will likely become the first state to receive a waiver, which could happen as soon as Friday, the Washington Post reported.

States can typically apply for waivers to make tweaks to the biggest government health plan, which covers more than 70 million people.

NYC pharmacist scammed millions from state Medicaid, AG charges

Medicaid doesn’t currently require recipients to have a job.

Elderly and disabled recipients will be exempt from the new rule, as well as pregnant women.

States have been advised to take into account recipients who look after an elderly relative or children.

Almost 60% of working-age Medicaid recipients are in fact working full- or part-time jobs, according to a Kaiser Family Foundation study. Many of their employers, however, don’t offer healthcare coverage.

Cuomo rips Trump’s rule favoring states against Medicaid funding

Recipients who aren’t working were mostly taking care of a relative, attending school or too sick.

The majority of those polled by the nonpartisan foundation opposed the Trump administration’s proposed cuts to Medicaid, but 70% said they supported some sort of work requirement.

Advocates for the poor and Democrats are likely to pan the move.

“It is a very major change in Medicaid that for the first time would allow people to be cut off for not meeting a work requirement, regardless of the hardship they may suffer,” Judy Solomon with the Center on Budget and Policy Priorities told the Associated Press.

Upstate GOPers still hoping to hit N.Y. on Medicaid

Republicans will likely see it as a major reform victory on a stable of the social safety net for more than 50 years.

Medicaid has expanded over the years beyond the impoverished, to cover people in nursing homes and newborns.

The Obama administration stretched the guidelines for Medicaid coverage to allow millions of working adults to qualify for the program.

http://www.nydailynews.com/news/pol...h-medicaid-work-requirement-article-1.3750874
 

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Some Medicaid patients could have to WORK to be eligible for taxpayer-funded health care as Trump allows states to set job requirements
  • Administration said it'd allow states to test requiring some recipients to work
  • Issued guidance making it easier for states to propose test programs that implement such requirements
  • Medicaid is a federal-state collaboration covering more than 70 million people
  • It was expanded to cover those with jobs that don't provide health insurance


Read more: http://www.dailymail.co.uk/news/article-5258147/Major-shift-Trump-opens-way-Medicaid-work-requirement.html#ixzz53stjpxuy
Follow us: @MailOnline on Twitter | DailyMail on Facebook
 

Ensoniq

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Hey, who is cutting the strings on my hammock damnit
 

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More than three million Americans drop off health insurance rolls as uninsured number sees biggest jump since Obamacare
  • New tax law canceled the 'individual mandate' from Obamacare that forced Americans to buy medical insurance
  • As a result, 2018 will see more Americans uninsured, beginning with a 3.2 million increase during 2017
  • Young Americans who are healthy and don't believe they need insurance, and poor Americans who can't afford it, are the groups that are shedding insurance
  • Gallup's survey found the latest uptick in uninsured numbers was the largest since it started measuring in 2008


Read more: http://www.dailymail.co.uk/news/article-5276219/More-3-million-Americans-drop-health-insurance.html#ixzz54OVjP0cM
Follow us: @MailOnline on Twitter | DailyMail on Facebook
 

goldielox1

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Freedom is nice isn't it?
 

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ROBBING US BLIND: The Medical System Has You RIGHT WHERE THEY WANT YOU | Dr Jay Nielsen MD
Reluctant Preppers


Published on Feb 1, 2018
Have you noticed that your family is paying skyrocketing fees for worse and worse medical care? And facing higher premiums and deductibles for less coverage & restricted access to: procedures, alternate therapies, or safer approaches? Not only are you waiting longer, to spend fewer minutes, with a less-qualified caregiver, who doesn't take the time to really listen and understand your situation and needs, but the drugs you get prescribed are dangerous, and NOWHERE IS YOUR TRUE HEALTH AND WELLBEING THE REAL GOAL?

Our off-grid medical doctor, Jay Nielsen MD, returns to Reluctant Preppers to help us launch the premier of a whole new playlist on HEALING YOURSELF! Dr. Nielsen, an ex FDA research insider, exposes the rampant corruption and conflicts of interest that keep fattening up BIG PHARMA, BIG HOSPITALS, and BIG INSURERS, at the expense of you and your family.

Tune in for this kickoff episode of a hard-hitting and gripping series that will confirm your intuitive awareness that ALL IS NOT RIGHT WITH SO-CALLED "HEALTH CARE" which has nothing to do with your health, and everything to do with fleecing you, keeping you dependent on and ever-increasing pile of dangerous drugs, and injurious neglect!

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searcher

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Patient Dumping: A “New” Cost Savings Strategy for Hospitals
Posted on February 1, 2018 by Yves Smith

Yves here. One has to wonder what might explain the increase in the appalling practice of patient dumping. The Health Care Renewal website has for some time been writing about the destructive impact of managerialism, as in rule by MBA, on the policies of large medical organizations such as hospital networks. But that even if ultimately true, is still an awfully broad brush.

I thought private equity might have something to do with it, since there was a spell when private equity firms were snapping up hospital chains until they found out the regulatory restrictions were sufficiently tight that they couldn’t do much to wring more in profits from them. I knew private equity experts Eileen Appelbaum (now co-head of CEPR) and Rosemary Batt had researched private equity hospital deals, and so I pinged Eileen. From her reply:

I haven’t investigated this, but have seen reports of patient dumping. I don’t think PE-owned hospitals are worse in terms of treatment of patients than other hospitals. We interviewed nurses who had worked in both nonprofit and PE-owned hospitals. They had some unfortunate stories to tell, but in both contexts.

Here’s something I wonder about. I happen to know a trauma doc. The hospital he works at – a major suburban hospital with a first rate reputation – has outsourced its emergency room to a trauma doctor practice. Before, if an uninsured, indigent person showed up at the ER, was treated, but couldn’t pay, it was the hospital that took the loss. The doctors got paid for their work in any case.

Now that the ER has been outsourced to the docs, they take the loss and don’t get paid for their work when they treat a patient that can’t pay. As they are not hospital employees, they also can’t do social admissions in such cases. As far as I know, his practice treats indigent patients – he grouses enough about having to work without getting paid. I’m sure he and his colleagues would not engage in patient dumping. But the financial incentives might lead others to do that.

Contrast that with Montefiore, where all the docs are employees on salary and the hospital actually rents rooms in the community in order to be able to care properly for patients who are poor and homeless.

By Dorothy J. McNoble, JD, MD, who can be reached at Badmedicine005@gmail.com

On a cold December night in Santa Cruz, California, a hospital employee at Dominican Hospital wheeled a patient out of the emergency room and left the patient on a bus bench in front of the hospital. The patient, a homeless man clothed only in a hospital gown was rescued by a passerby who realized that the patient had no clothing, no shoes, and no possessions and was unable to seek shelter or clothing.

A nearly identical incident occurred in Baltimore around the same time. This patient was “discharged” from the University of Maryland medical Center Emergency Room clothed only in a hospital gown and was unable to seek help or shelter. That patient too was rescued by a good Samaritan passerby who documented these events on his cell phone.

Both incidents were eventually reported by the media, and the Baltimore rescuer was interviewed by the host of “The Takeaway” on NPR. NPR also interviewed, Arthur Caplan, a well-known medical ethicist. He stated that these “hospital dumping” events have been occurring with increasing frequency in recent years, in spite of a specific federal prohibition against this behavior. He was referring to the Emergency Medical and Active Labor Act of 1986 which requires hospitals to provide emergency care irrespective of the patient’s ability to pay for that care.

Over the years, the law has been interpreted to specifically prohibit discharging patients from the emergency room or the hospital if they do not have the means to obtain shelter, and personal and medical necessities such as food, medicine and follow up care. I was surprised to read about these incidents and to learn that they are not isolated events. I worked for 30 years providing surgical care in hospitals which served large numbers of indigent, homeless, mentally impaired, addicted and otherwise socio-economically disadvantaged patients.

In my experience, hospitals routinely made “social admissions.” That is, patients who were without access to shelter and other basic needs were admitted to the hospital or kept in the emergency room until a “safe” discharge plan could be put in place. A phalanx of case managers and social workers worked to find housing, make arrangements for follow up in county hospitals or, in some cases, prepare expedited Medicaid eligibility documents so that some of the patients could even be placed in care or nursing homes.

Of course, many patients left, did not make it to their follow up appointments and otherwise ended up in a revolving door of social admissions, discharges and readmissions. However, in my 30 years, I never saw an instance of patient abandonment such as described in the two incidents above.

Would the hospitals where I worked have expended so many resources providing custodial care for the socio-economically disadvantaged patients if there were no federal “Sword of Damocles” (the EMTALA) law putting them at risk for prosecution? I do not know the answer to that question, but I can say that my colleagues never exhibited the cruelty or indifference described above, in spite of the often exhausting and overwhelming task of caring for these complicated patients.

I do not know if the changing economic landscape for hospitals is responsible for more aggressive “dumping” policies. Across the country, hospitals, in order to survive have merged into more profitable “health care systems.” which have a cancer-like expansion of marketing and administrative bureaucracies whose mission is to block access to indigent and Medicaid patients and attract the well-insured ones (In the past five years, hospitals have experienced a 3000% increase in the number of administrative personnel in these hospitals systems). The “financialization” of health care has meant that the health care dollars are increasingly diverted from patient care to profits and marketing. This is as true in the not-for-profit as in the for profit hospitals. One need only see the explosion of hospital advertising to realize that there is a serious diversion of money away from patient care.

Finally, in this era of reduced emphasis on regulatory compliance, there is the possibility that there may be decreased EMTALA enforcement. As I said above, I would like to think that hospital staffs would never abandon patients in need. However, the very need to pass an EMTALA law proves that such legal constraint is necessary.

This entry was posted in Banana republic, Free markets and their discontents, Guest Post, Health care, Legal, Regulations and regulators on February 1, 2018 by Yves Smith.

https://www.nakedcapitalism.com/2018/02/patient-dumping-new-cost-savings-strategy-hospitals.html
 

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On a cold December night in Santa Cruz, California, a hospital employee at Dominican Hospital wheeled a patient out of the emergency room and left the patient on a bus bench in front of the hospital. The patient, a homeless man clothed only in a hospital gown was rescued by a passerby who realized that the patient had no clothing, no shoes, and no possessions and was unable to seek shelter or clothing.

A nearly identical incident occurred in Baltimore around the same time. This patient was “discharged” from the University of Maryland medical Center Emergency Room clothed only in a hospital gown
What happened to their clothes? Surely they didn't enter the hospital naked.
 

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I don't like the term "uninsured"; I prefer the term "self-insured" or "self-responsible".
 

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Investigation launched into former Aetna medical director who admits he NEVER viewed patient records before approving or denying care
  • A probe has been launched into Aetna's former medical director Dr. Jay Ken Iinuma
  • Iinuma admitted he never checked patient medical records when approving or denying services
  • The primary care physician relied on nurse recommendations for patients rather than doing his own review
  • California's Insurance Commissioner Dave Jones said the case is 'troubling'
  • He also said Iinuma's careless practices could be 'potentially a violation of law'
  • Jones urges patients who believe they were 'adversely affected' by Iinuma's practices to contact his office


Read more: http://www.dailymail.co.uk/news/article-5380133/Investigation-launched-former-Aetna-medical-director.html#ixzz56tCHtHm5
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Why US healthcare is more expensive than all other wealthy nations - but life expectancy is the LOWEST
  • Americans spent almost twice as much on health care costs than other wealthy nations in 2016
  • The Harvard team found physician salaries and service prices are some of the main reasons why American's pay more for health care than their peers
  • They found these costs are not due to the utilization of medical services


Read more: http://www.dailymail.co.uk/health/article-5495439/Doctors-salaries-contribute-high-healthcare-costs.html#ixzz59eBz5NRz
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The American Healthcare System Shows Why We Can’t Trust Free Market Spin Doctors

Posted on April 12, 2018 by Yves Smith

Yves here. Many readers will find the criticisms in the post to be understated. For instance, it’s odd to see Frank spend so much time on the difficulty of shopping for health insurance, when the problem of shopping for medical services is even greater due to the vast information asymmetries. Prices are famously opaque, particularly for surgeries and hospitalizations. You as a patient can’t do a very good job of assessing whether your doctor is any good, and most people wind up relying on proxies like bedside manner that can be misleading. And American doctors love to overtest and overtreat, and that is enabled by patients who have been encouraged to expect too much of medicine.

By Jag Bhalla, an entrepreneur and writer. His current project is Errors We Live By, a series of short exoteric essays exposing errors in the big ideas running our lives. Follow him: @hangingnoodles. Originally published at Jag Bhalla’s Big Think blog

Jag Bhalla interview with Economist Robert H. Frank

Fans of “let-the-market-decide” thinking face a trillion-dollar puzzle that’s deadly as well as costly. To diagnose this unhealthy situation, we’re fortunate to have Robert Frank (RF), an economist who writes regularly for The New York Times (he’s also written booksI regularly quote).

JB:I’ve long felt that core economic ideas (~creeds) are ailing and failing to meet clearly desirable collective goals. Your latest NYT pieceprovides a great and glaring example, as you say America “spends far more on health care than any other nation, yet gets worse outcomes.” What are the numbers (per capita)?

RF:American per capita health care expenditures are more than twice the average of those in the 35 advanced countries that make up the Organization for Economic Cooperation and Development. That was a spending difference of more than $5,000 per person in 2016. But although we spend 18 percent of our national income on health care (or $1.65 trillion more annually than if we spent at the average OECD level), our system delivers significantly less favorable outcomes on the measures we care most about. Among developed countries, for example, we have the lowest life expectancy, the greatest incidence of chronic illnesses, and the highest infant, child, and maternal mortality rates.

JB:Why does America’s more market-oriented system (unique among rich nations) do so badly? How does the persistence and worsening of inefficiencies square with the markets-deliver-efficiency creed (the deep faith that markets self-organize to everyone’s benefit and incentives ensure efficient resource usage)?

RF: No developed country other than the United States relies on largely unregulated insurance companies for the provision of health care. As I explained in the column you mentioned, we almost certainly would have adopted the single-payer systems common in other countries except for a regulatory loophole during World War II.

The problem with private insurance is that it tends to break down when potential policy holders have much better information about their individual risks than insurers do. That information asymmetry is clearly present for individual risks of illness. People who know themselves to be most at risk of needing costly care are more likely than others to buy insurance, which drives premiums up, making insurance less attractive to the healthiest people. As those people drop out of the insured pool, rates rise further, which makes insurance still less attractive to the healthiest policy holders who remain, and so on. Economists call this an adverse-selection problem.

The American health insurance system was in the throes of the resulting death spiral when the Affordable Care Act was adopted. That legislation reversed the decline in the insured population and made tentative first steps at cost control. But it was not enough to eliminate our system’s glaring inefficiencies.

JB:Can you say a bit more about why the US spends so much more?

RF:Administrative costs under private insurance plans, for example, are about six times as high as under single-payer plans like Medicare. And unlike private insurance plans, single-payer plans spend virtually nothing on advertising and marketing. But by far the most important reason for higher health care costs in the US is that service providers charge so much more here than elsewhere. The average cost of coronary bypass surgery, for example, is more than three times higher in the United States than in France, and a day in an American hospital costs twelve times as much as one in The Netherlands.

JB:When Republicans were campaigning to repeal the Affordable Care Act, market enthusiasts like Paul Ryan insisted that competition among private insurers would lead to both lower prices and higher quality health care. Competition seems to have delivered high-quality goods at reasonable prices in many markets. Why shouldn’t we expect the same with health care?

RF:Economic theory tells us that this would be a reasonable expectation if certain conditions were met. Many of these conditions concern whether buyers and sellers can assess the attractiveness of transactions they are considering. Because insurance companies find it difficult to measure the risks posed by potential policy holders, we get the adverse selection problem described earlier. A related problem arises on the buyer’s side. In practice, people have little knowledge of the treatment options for the various maladies they might suffer, and policy language describing insurance coverage is notoriously complex and technical. Although consumers can easily compare the prices charged by competing insurance companies, they simply cannot make informed quality comparisons in this industry.

Because of the latter asymmetry, companies are under pressure to compete by highlighting the lower prices they’re able to offer if they cut costs by degrading the quality of their offerings. For example, it’s common for insurance companies to deny payment for procedures that their policies ostensibly cover. If policy holders complain loudly enough, they may eventually get reimbursed, but the money companies save by not paying others enables them to offer price cuts, which are a decisive competitive advantage over rivals that don’t employ this tactic. Such tactics are essentially absent under single-payer systems like Medicare.

In short, market competition often does deliver the benign results that its proponents claim, but only when important conditions are satisfied. In markets for the delivery of health care, many of those conditions just aren’t met.

JB:So the very same “self-interest” that drives markets, in practice often becomes collectively pathological. Your NYT piece ends on an optimistic note by saying, “there are attractive paths forward” to fix this deadly “national embarrassment without requiring painful sacrifices.” How can we overcome the “self interest” of those gaining from the current $ trillion overspend?

RF:Steps that would permit an orderly transition to Medicare-for-All are described in a recent American Prospect articleby the Yale political scientist Jacob Hacker. A similar transition proposal has been suggested by policy analysts at the Center for American Progress.

My remark about no painful sacrifices being required for this transition was about the citizens whose tax dollars would support a single-payer system. Since the overall cost of single-payer would be so much lower than under the current system, the switch would actually save money for most of those taxpayers. But because the tax increases required to pay for the switch are far more visible that many of the hidden levies that pay for our current system, we’d want to explain carefully why people’s net outlays for health care would actually be going down.

Because the biggest savings associated with single-payer come from reduced payments to service providers, the switch would require American doctors and administrators to work for significantly less than they currently earn. But how painful would those sacrifices be? We know that highly qualified people are eager to become health-care professionals in countries where providers earn nothing like the premium salaries we see here. If you saw Michael Moore’s interviews with British NHS doctors inSicko, you probably were struck, as I was, by how content they seemed with their standard of living.

A consistent message from the happiness literature is that once a certain absolute material standard is achieved, satisfaction from pay is heavily reference dependent. For doctors to be happy with their pay, they must earn as much as other doctors in the same environment earn. Another consistent message from this literature is that the comparisons that really matter are highly local. That helps explain why American doctors who work for non-profit clinics like Mayo, Cleveland, and Kaiser, who earn substantially less than their fee-for-service counterparts while delivering measurably better health outcomes for their patients, nonetheless seem quite content with their terms of employment. My own view is that asking fee-for-service physicians to work under such contracts here would not qualify as demanding painful sacrifices from them.

Doctors like the ones Atul Gawande profiled in this New Yorker piece would no doubt scream bloody murder if forced to live on only what they could garner under Medicare reimbursement rates. For some of them, the switch really would constitute a painful sacrifice. I probably should have written the last sentence in my column as “Avoiding this national embarrassment would actually require few painful sacrifices.”

JB:It’s critical that we inject more realism into economic creeds (“just so” stories). Without more market realism (“realonomics”?) we won’t be able to detect and diagnose when markets get stuck in counterproductive conditions (where chronic inflammation or cancerous growth imposes a “private tax” burden on individuals and businesses (~$19k per employee).


This entry was posted in Banana republic, Guest Post, Health care on April 12, 2018 by Yves Smith.
 

Joe King

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United States relies on largely unregulated insurance companies
BS. There's plenty of regulations concerning healthcare and insurance. It's just that most regulations are those of the States. Federally, PPACA and Dodd Frank are just two recent attempts.
JB:Can you say a bit more about why the US spends so much more?
Yea, because they charge enough here to subsidize the rest of the World and feed a zillion leaches sucking money off the healthcare system.
 

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Top medical journals accused of skewing research by raking in millions of dollars in 'bribes' from drugs firms

  • Nearly two-thirds of medical research in the US is paid for by drug firms who could have a financial stake in the outcomes
  • Several of the top medical journals have been found to be raking in millions of dollars from pharmaceutical companies through kickbacks and reprinting fees
  • The journal for the American Medical Association gets 52 percent of its revenue from reprinting studies by pharmaceutical companies
  • Editors at the journal of the American College of Cardiology received $15 million in kickbacks from drug firms


Read more: http://www.dailymail.co.uk/health/article-5609901/Top-medical-journals-accused-skewing-research-receiving-MILLIONS-bribes.html#ixzz5CjlkKBw8
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Doctors all over the US are keeping their licenses to practice medicine despite rampant sexual misconduct against patients, shocking investigation reveals

  • In recent months, Hollywood moguls, elite journalists and top politicians have been pushed out of their jobs or resigned their posts
  • When the doctors are disciplined, the punishment often consists of a short suspension paired with mandatory therapy
  • The sentencing of Larry Nassar has put a high-profile case of physician misconduct in the spotlight
  • Current guidelines from the Federation of State Physician Health Programs, are largely silent on handling sexual misconduct treatment


Read more: http://www.dailymail.co.uk/news/article-5615841/AP-investigation-Doctors-licenses-despite-sex-abuse.html#ixzz5CkkzQlyS
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FWIW (dyodd)

They Want You DRUGGED FOREVER - You HAVE to hear this!
FullSpectrumSurvival



Published on Apr 16, 2018
Goldman Sachs and certainly countless other chemical pharmaceutical and bioengineering companies do not want to cure you. They do not want you to get better. They want you to be a source of recurring income for the rest of your miserable little lives.

This analyst and countless others have expressed how cures exist but they will never make it to market because once you are cured, you are no longer a viable source of income and when companies are Too-Big-To-Fail and they give their dividends to government organizations through stocks, they cannot afford to lose you as a patient.

Please excuse my volatility in this video. I cannot stand for us all, human beings, to be treated like rats in a maze but to companies so large, that is what we are... We are useless eaters so they are going to profit off of us in as many ways as they can.
 

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Things like this DRIVE people to seek alternative medicine. When you can't trust your Dr who can you trust? I fail to see any difference from the child molesters to the medical fields rapists & thieves who want nothing but their own version of a patient sponsored / fleeced ATM machine .
 

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Through the Revolving Door, with a Few Stumbles – Health Care Corporate Executives and Consultants Continue to Become Leaders of Trump’s Department of Health and Human Services

Posted on April 19, 2018 by Yves Smith

Our mini-fundraiser for Water Cooler is on! As of this hour, 105 donors — our goal is 275 –have already invested to support Water Cooler, which provides both economic and political coverage, to help us all keep our footing in today’s torrent of propaganda and sheer bullsh*t. Independent funding is key to having an independent editorial point of view. Please join us and participate via Lambert’s Water Cooler Tip Jar, which shows how to give via check, credit card, debit card, PayPal, or even the US mail. To give more, click on the arrow heads to the right of the amount. Thanks to all!

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

We continue to see a remarkable stream of people transiting the revolving doorfrom high-level positions in health care corporations to high-level positions in health care policy or regulation for the Trump administration. Lately, though, these transitions have not been without missteps.



The most recent cases we have found, in the order of their public appearance, appear below.

John Bardis, Who Went from MedAssets to Assistant Secretary of Health and Human Services for Administration, Resigned Under Fire
We first discussed the appointment of Mr Bardis in May, 2017, here. We noted then that most recently Mr Bardis was the CEO of a health care financial firm and thus was responsible for that company’s financial fortunes. While he has previous experience running other health care related companies, he seemed to have no direct experience in health care or public health, per his official biography.

On March 22, 2018, Politico reported

John Bardis, a top HHS official who signed off on ex-Secretary Tom Price’s charter jet flights, is resigning effective April 6, the agency confirmed Thursday.​
The health care entrepreneur and longtime friend of Price’s from Georgia served as HHS assistant secretary of administration since March 2017 and was responsible for departmental operations. He also helped oversee the ReImagine HHS project, an initiative to overhaul the agency and cut costs.​
Bardis’ office has been the focus of a probe about whether Price’s use of charter-jet flights for routine domestic travel — which cost more than $400,000 — complied with federal regulations. The HHS inspector general’s office, which is conducting the probe, told POLITICO that the final report is expected later this spring.​

Note that the resignation under fire of Dr Tom Price, Trump’s first Secretary of the Department of Health and Human Services (DHHS) after accusations of conflicts of interest and abuse of his office was a signal example of major issues affecting the leadership of health care and public health agencies in the Trump administration. We had written about some of Dr Price’s less well publicized conflicts of interests and questionable conduct before we was appointed Secretary of DHHS, here, and here.

Now a good buddy of Price’s, who also had a severe conflict of interest, has come a cropper.

Daniel Best from Corporate Vice President of Industry Relations at CVS Health, and from Pfizer Before Then, to Senior Adviser to the Secretary of DHHS for Drug Pricing Reform

This transition was described in some detail in FierceHealthCare on March 29, 2018:

Daniel M. Best, the former corporate vice president of industry relations for CVS Health’s Medicare Part D business, will serve as senior adviser to the secretary for drug pricing reform.​

Given,

The Trump administration has outlined a number of policy changes it believes can drive down drug prices, and the president predicted during his State of the Union address that drug costs ‘will come down substantially.’ But skeptics argue that some of those changes—like making generic drugs free for Medicare patients, or moving expensive drug coverage out of Part D plans—would merely shift the cost and raise premiums.​
Best, who will help oversee some of those efforts, worked at Pfizer for 12 years prior to his time at CVS. HHS highlighted his expertise in the pharmaceutical industry generally, and his familiarity with Medicare Part D specifically, as critical to the task of trying to reduce prescription drug costs.​

However, this appointment rapidly generated some public political push-back because of its revolving door nature. As reported by Vox on April 9, 2018,

Rep. Keith Ellison (D-MN), one of the top progressives in the House and deputy chair of the Democratic National Committee, sent a letter Monday to HHS Secretary Alex Azar inquiring about the appointment of Daniel Best to oversee drug pricing reform. Best most recently worked at CVS CareMark before starting at HHS last week. He also worked at Pfizer for four years in the early 2000s.​
Given Mr. Best’s career working for the pharmaceutical and pharmacy industry, the decision to hire him poses significant potential for conflicts of interest, placing him in a position to make decisions that may pit the income of his former employers against the interests of patientsin reducing prescription drug prices,’ Ellison said in the letter, shared exclusively with Vox.​
Ellison flaggedpast drug price hikes at Pfizerand a lawsuit filed against CVS CareMark by HIV patients over access to drugs. In general, pharmacy benefits managers are under the microscope of both parties these days for their role as mysterious administrators with great power over drug transactions.​
The Congress member includes a string of questions about who was involved in hiring Best, whether outside groups (particularly pharmaceutical lobbying groups) were consulted, and how Best will prevent any potential conflicts of interest from getting in the way of his job description.​

So this case of the revolving door has not gone without (negative) notice, although whether that will be sufficient to change anything remains to be seen.

Note that public biographical information on Mr Best seems to be scanty, but there is nothing to indicate that he has training, experience, or expertise in biomedical science, health care, or public health.

Adam Boehler from CEO of Landmark Health, Previously Founder of Avalon Healthcare Solutions and Trellis Rx, and Operating Partner of Private Equity Company Francisco Partners, to Director of Center for Medicare and Medicaid Services (CMS) Innovation Center (CMMI)

As reported, again by FierceHealthCare, this time on April 6, 2018,

Health and Human Services Secretary Alex Azar has named a successful healthcare entrepreneur to lead the Centers for Medicare & Medicaid Services Innovation Center.
Adam Boehler, the founder and former CEO of Landmark Health, will join the department next week as the deputy administrator and director of the center. Landmark is a medical group that uses a technology platform to deliver medical services to complex and chronically ill patients at home.​

The article also documented that:

He is also the founder of Avalon Healthcare Solutions, a company which provides lab benefit management services, and Trellis Rx, a company that partners with health systems to fund, build and operate specialty pharmacies. Boehler was formerly an operating partner at Francisco Partners, a global private equity firm focused on healthcare technology and services investing.​

According to Bloomberg, Mr Boehler has extensive background in the financial sector:

Mr. Adam Boehler serves as Executive Chairman at Avalon Health Management LLC and Avalon Health Services, LLC. Mr. Boehler served as Principal at Accretive, LLC. He served as Vice President of Business Development at MedeAnalytics, Inc. since July 2005. Mr. Boehler joined MedeAnalytics, Inc. in February 2005 and was responsible for all hospital sales, product marketing, and business development. He also drove several major product solutions from concept to customer sale and established MedeFinance’s international business in London. Prior to joining MedeAnalytics, Inc. (formerly MedeFinance), Mr. Boehler was an Associate at Battery Ventures. While at Battery, he focused on investments in software and emerging technologies. Previously, Mr. Boehler was an investment banker at Wasserstein Perella in their media, telecommunications, and technology group, where he worked on merger and acquisition transactions with leading companies such as News Corp., Imax, and SpectraSite Holdings. In addition, he spent time as a public finance consultant for the Financial and Fiscal Commission in South Africa, where Mr. Boehler focused on provincial revenue issues​

His educational background was:

Mr. Boehler graduated magna cum laude from the Wharton School at the University of Pennsylvania.​

So he also seems to have no training, experience, or expertise in biomedical science, health care, or public health.

Dr Kenneth William Staley from Consultant for McKinsey to Coordinator of US Government Activities to Combat Malaria

The information made public about this appointment was extremely sparse, e.g., see this brief item from the Kaiser Family Foundation on April 10, 2018, in its entirety:

President Donald J. Trump Announces Intent to Appoint Personnel to Key Administration Posts On Monday, President Trump announced his intent to appoint several individuals to key positions in the administration, including Kenneth William Staley,a consultant at McKinsey, to the position of Coordinator of U.S. Government Activities to Combat Malaria Globally (4/9).​

At least he actually is Dr Staley, according to the US Department of State website.

Acting Deputy Assistant Secretary for Counterproliferation in the Department of State’s Bureau of International Security and Nonproliferation. His portfolio includes preventing the smuggling of weapons of mass destruction (WMD), international threat reduction, nuclear nonproliferation policies, tracking, controlling, and securing dangerous chemical and biological material, multilateral arms control, nonproliferation, WMD terrorism, disarmament issues, and responsible use of chemical and biological sciences.​
Previously, Dr. Staley served as Director for Biodefense Policy at the White House Homeland Security Council, where he coordinated implementation of the National Strategy for Pandemic Influenza and the development of policies related to biodefense and the medical consequences of weapons of mass destruction.​

So he does have a substantial clinical and public health background relevant to his appointment.

Summary
We have long chronicled cases in which people leave government leadership positions having to do with medical science, health, health care and public health and soon wind up working for corporations regulated or affected by the policies of these government agencies. These were examples of the outgoing revolving door. Such transitions raise worries that people in government might behave in ways that increase their attractiveness for such jobs when they leave.

However, in the Trump regime, we have seen a new a even more pernicious species of the revolving door, transitions from leadership positions in or lobbying/ advocacy positions for health care corporations directly into positions in government agencies that regulate or whose policies influence those selfsame corporations.

So, as I have said before, e.g., one month ago,

The revolving door is a species of conflict of interest. Worse, some experts have suggested that the revolving door is in fact corruption. As we noted here, the experts from the distinguished European anti-corruption group U4 wrote,

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 of revolving door transits suggests that regulatory captureis likely to become much worse in the near future.

Remember to ask: cui bono? Who benefits? The net results are that big health care corporations increasingly control the governmental regulatory and policy apparatus. This will doubtless first benefit the top leadership and owners/ stockholders (when applicable) of these organizations, who are sometimes the same people, due to detriment of patients’ and the public’s health, the pocketbooks of tax-payers, and the values and ideals of health care professionals.

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.


This entry was posted in Banana republic, Free markets and their discontents, Guest Post, Health care, Politics, Regulations and regulators, Ridiculously obvious scams on April 19, 2018 by Yves Smith.

https://www.nakedcapitalism.com/201...-trumps-department-health-human-services.html
 

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More Than 4 Million Americans Have Lost Health Insurance Since 2016


by Tyler Durden
Fri, 05/04/2018 - 21:25


Even before the GOP killed Obamacare's individual mandate back in December as part of their tax-reform plan, the number of Americans going without health insurance had been rising.



And now, according to a recent study, the number of uninsured US adults between the ages of 19 and 64 climbed to 15.5% in March 2018 compared with 12.7% in 2016. That's tantamount to 4 million people losing insurance, according to CBS.

The number of uninsured adults between the ages of 19 and 64 rose to 15.5 percent in March 2018, up from 12.7 percent in 2016.​
An estimated 4 million people lost individual coverage during that period, while the number of people with employer-sponsored coverage stayed steady.​
Adults with lower incomes - about $30,000 for an individual and $61,000 for a family of four - saw a much higher increase: 25.7 percent in March 2018 compared to 20.9 percent in 2016.​


Perhaps the biggest contributor to rising uninsured rates, according to the study, is the coverage gap, which leaves poor Americans in many states unable to afford health insurance. The gap first emerged in 2012, after the Supreme Court ruled that Obamacare's mandate forcing states to expand Medicaid was "unconstitutionally coercive".

The biggest increases in uninsured rates in recent years have occurred in states that did not expand Medicaid, which shouldn't come as a surprise.

Another factor may be related to the so-called coverage gap. When the ACA was passed, it mandated that all states expand their Medicaid coverage, including increasing qualifying income limits. At the same time, the ACA ruled that people whose income fell below 100 percent of the poverty level would not qualify for the ACA's government subsidies to help pay health insurance premiums. The assumption was these people would be covered by expanded Medicaid coverage, Collins explained.​
That plan went haywire when the Supreme Court later ruled that states were not required to expand Medicaid coverage but could do so voluntarily. As a result, people in nonexpansion states with incomes below the ACA subsidy limits often don't qualify for Medicaid. Indeed, the survey found the steepest increases in uninsured rates occurred in states that did not expand Medicaid.​
Collins predicted the rising uninsured trend is likely to continue. One reason: The repeal of the individual mandate, which required people to buy insurance or face penalties. The new tax law did away with that provision and eliminated penalties starting in 2019.​
Commonwealth found that 5 percent of people with insurance are planning to drop coverage once the mandate becomes obsolete. "That's not a huge number, but it is something," said Collins.​
At least one former ACA antagonist is warning that the repeal of the individual mandate was a mistake. Tom Price, former secretary of the Department of Health and Human Services, said during a recent health-care conference in Washington that eliminating the individual mandate would almost certainly drive up premiums. Last year, the CBO forecast that 13 million people would lose coverage if the mandate was eliminated.

Of course, this trend can't continue for much longer until Obamacare experiences an all-out collapse as insurers decide that it's simply no longer worth it to offer health-care plans on the ACA's exchanges. As premiums soar, more and more people will be forced out of the market, deteriorating risk pools and forcing insurance companies to reconsider their participation.

In an interview last year, Aetna CEO Mark Bertolini warned about the impending Obamacare "death spiral", saying "it's not going to get any better; it's getting worse."

https://www.zerohedge.com/news/2018-05-04/more-4-million-americans-have-lost-health-insurance-2016
 

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Remember it was designed to fail....... after it took all your wealth........ so they have more control....... when your poor........ and beg them for help........ when you have no other options........ and they laugh at you poor, weak, helpless, filthy, unwashed masses while they collect their pensions they burdened you with.
 

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Disease and Wall Street: A Business Partnership that leaves Americans in the Dust
RT America



Published on May 9, 2018
On this episode of America’s Lawyer, Mike Papantonio and Lee Camp discuss a Goldman analyst report that says curing disease is not good for business. Brigida Santos then talks about a study that links early brain disease with youth tackle football. Then Mollye Barrows discusses the NXIVM sex cult and allegations that they are covertly recruiting new members. [Episode 71]

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Trump blasts drugmakers and healthcare 'middlemen' for making prescription medicines unaffordable despite his own administration abandoning ideas to lower drug costs since his campaign

  • Trump blasted drugmakers and healthcare 'middlemen' for making prescription medicines unaffordable for Americans
  • He made remarks at the White House Rose Garden in a speech to introduce what he called 'the most sweeping action in history' to lower drug prices
  • Effort comes as millions of Americans struggle with the cost of their medications
  • Trump campaigned on lowering prescription drug prices ahead of 2016 election
  • But his administration has since abandoned ideas to lower drug costs he supported during the campaign


Read more: http://www.dailymail.co.uk/news/article-5719475/Trump-blasts-drugmakers-middlemen-high-U-S-drug-prices.html#ixzz5FIl7yNGv
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