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Archive for the ‘Healthcare’ Category

Why Is Trump’s Scorched-Earth Campaign to Destroy Obamacare Getting So Little Attention?

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Kevin Drum writes at Mother Jones:

Andrew Sprung calls Obamacare “London after the Blitz.” It’s still standing, but the damage done by the Trump administration is already severe:

Uncertainty over CSR reimbursement and enforcement of the individual mandate have themselves driven premiums up by over 20% in 2018 (Gaba’s estimate) and driven many insurers out of the individual market.

Those premium hikes will probably knock several million unsubsidized buyers out of the individual market. Weakened mandate enforcement, real or perceived, will probably reduce the numbers of people enrolled not only in the individual market but also in employer-sponsored insurance and Medicaid. An increased percentage of unsubsidized enrollees in the individual market who do stay in will probably be underinsured, pushed into bronze plans and/or overburdened by the combination of rising premiums and out-of-pocket costs. Poor-to-nonexistent outreach from HHS may result in many current marketplace enrollees failing to shop anew and so re-enrolling in a suboptimal plan. Trump’s threat to issue an executive order that reportedly would empower association health plans to evade state regulation via ERISA could bleed health enrollees out of the individual market.

Red states, meanwhile, are lining up to accept HHS’s invitation to propose work requirements, time limits and more frequent enrollment redeterminations on Medicaid enrollees, which will likely inhibit reduce Medicaid takeup.

It’s easy to blame the media for everything, but this act of petty revenge is pure Trump. That said, it’s a little shocking that this hasn’t gotten more press attention. A president of the United States, acting out of pique, has undertaken a deliberate and calculated plan to undermine a program that provides health care to 20 million Americans at a very reasonable price. There is no feasible replacement in the works, and Republican efforts over the past year have demonstrated that even if there were, it would still take a toll of 20 million or more people:

And it just keeps coming. CSR games were just the start. They’ve been followed by a nearly weekly parade of sabotage: cutting the enrollment period, slashing the outreach budget, shutting down the website once a week, and now by a transparent invitation to cut back on Medicaid.

I know that not everything I think is important is big news. But this is astonishing stuff: a president deliberately undermining a successful program that provides access to health care for millions. And there are new announcements every few days, so it’s not like you’re stuck for ideas after you’ve written the story once. . .

Continue reading.

Written by LeisureGuy

3 October 2017 at 9:33 am

Las Vegas Official Sets Up Gofundme To Aid Shooting Victims — The Price Of No Universal Health Care

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Zaid Jilani reports in The Intercept:

Last night, a Las Vegas gunman killed over 50 people and injured hundreds in the worst mass shooting in American history.

The hundreds wounded are being tended to in Clark County’s network of hospitals in Nevada. But because this is a country that has never had guaranteed universal health care, they will soon be besieged by a second tragedy: enormous medical bills.

This morning, Clark County Commission Chair Steve Sisolak, set up a GoFundMe, a private crowdfunding platform, to request charity for those injured in the massacre.

Sisolak, who is running for governor as a Democrat, pitched in $10,000 and explained that he is currently at the county’s level-one trauma center with victims:

I’m Steve Sisolak, Clark County Commission Chair from Las Vegas. We are raising funds to assist the victim’s of the tragic Las Vegas shooting. I am at Clark County’s only level-one trauma center with the victims and their families as we speak.

Funds will be used to provide relief and financial support to the victims and families of the horrific Las Vegas mass shooting?.

Nevada’s Republican Gov. Brian Sandoval vetoed legislation over the summer that would have allowed Nevadans to buy into the state’s Medicaid program.

Asking strangers for charitable donations to tackle medical bills is ubiquitous in the United States. A report by NerdWallet released in 2015 found that $930 million of the $2 billion raised by GoFundMe since its 2010 launch have been related to medical bills. Yet NerdWallet’s comprehensive survey of crowdfunding sites found that barely 1 in 10 medical campaigns raised the full amount they asked for.

Contrast this American experience with that of some of our allies. In June, dozens of people were injured and eight people were killed when London terrorists ran a van through a crowd and then proceeded to stab multiple people. It was the second major terror attack of the year, the first one being in March in Manchester.

In the United Kingdom, most health care is free. The National Health Service, erected in the ashes of World War II, provides comprehensive health care to all British citizens.

At the London attack, NHS staff were on the scene within  six minutes,aiding the injured. Last month, the NHS gave a special honor to the first responders, nurses, and doctors who aided the victims of the London terror attack. “They highlighted the resilience and the compassion of the NHS staff who time after time responded to victims, who had suffered unimaginable injuries – putting the needs of those people first. This is the NHS at its best,” Jane Cummings, chief nursing officer of the NHS, said. . .

Continue reading.

Of course, if Trump’s efforts to sabotage the Affordable Care Act work, millions of Americans who now do have healthcare insurance will lose it and join the ranks of the millions who currently have no healthcare insurance.

It strikes me that a nation has a vested interest in making sure its citizens are healthy and educated, since that would make the nation stronger.

Written by LeisureGuy

2 October 2017 at 11:27 am

Ex-Medicare head says Trump ‘purposely’ raising insurance premiums to make Obamacare implode

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John Bowden reports in The Hill:

The former head of the Centers for Medicare and Medicaid Services (CMS) under President Obama blamed President Trump on Friday for rising health-care premiums around the country.

Andy Slavitt, who was acting CMS administrator from 2015 to 2017, accused Trump on Twitter of “purposely raising” health-care premiums as part of his plan to let ObamaCare “implode.”

“I ran this government agency under President Obama,” Slavitt wrote. “Make no mistake. Trump is purposely raising people’s premiums.”

Slavitt was reacting to news reports that Oklahoma’s health commissioner was blaming the Trump administration for missing a deadline to approve a waiver for the state, which Oklahoma officials say will mean higher premiums for thousands of residents.

“Three days later, beyond health plan commitment and rate filing deadlines, Oklahoma is forced to withdraw our waiver request due to the failure of departments to provide timely waiver approval,” Oklahoma Health Commissioner Terry Cline wrote to administration officials earlier Friday.

“The lack of timely waiver approval will prevent thousands of Oklahomans from realizing the benefits of significantly lower insurance premiums in 2018,” the letter added, saying approving the waiver would have helped more than 130,000 Oklahomans and reduced premiums by 30 percent.

Trump has frequently threatened to end ObamaCare subsidy payments to insurers and let the program “implode” amid GOP efforts this year to repeal the health-care law. . .

Continue reading.

Written by LeisureGuy

1 October 2017 at 3:20 pm

Congress fails to act, 9 million children lose healthcare

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The GOP goal of taking healthcare away from millions of Americans did not succeed in repealing the Affordable Care Act and eviscerating Medicaid, but at least they have been successful in making sure millions of children won’t have healthcare.

The GOP is the anti-American party.

Brandon Carter reports in The Hill:

Congress missed a deadline to reauthorize the Children’s Health Insurance Program (CHIP) over the weekend, leaving federal funding to expire at the end of the month, according to ABC News.

Neither the House nor the Senate took up a vote to reauthorize the program, which helps states provide inexpensive health insurance to children in lower-income families.

Congress was on track to miss the deadline earlier this week, and though the Senate released a bipartisan, five-year bill to reauthorize the program, a vote wasn’t scheduled.

The House Democratic Caucus chairman, Rep. Joe Crowley (D-N.Y.), blamed Republicans for missing the deadline in a tweet on Sunday and said CHIP should be a priority for Congress. . .

Continue reading.

It looks very much as though missing the deadline was deliberate, part of the GOP move to destroy the social safety net.

Written by LeisureGuy

1 October 2017 at 1:43 pm

The Trump Administration Just Confirmed That It Is Sabotaging Obamacare

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Eric Levitz reports in New York magazine:

The Trump administration has spent much of its first year in office trying to sabotage America’s health-care system. In interviews with major publications, Donald Trump repeatedly threatened to destabilize the Affordable Care Act marketplaces — by abruptly halting subsidies to insurers — as a means of eroding popular support for the law. Meanwhile, his Health Department spread doubt about whether it would enforce the tax penalty for refusing to sign up for insurance; cut funding for the law’s outreach groups; slashed Obamacare’s advertising budget by 90 percent; spent a portion of the remaining ad budget on propaganda calling for the law’s repeal; cut the open-enrollment period by 45 days; and announced that it would be taking (where people can enroll in Obamacare online) offline for nearly every Sunday during that time period, for “maintenance” purposes.

These acts of sabotage were never subtle. But until this week, Health and Human Services employees at least tried to maintain a veneer of (implausible) deniability. Sure, Tom Price’s department would evince contempt for the ACA — and all Americans who rely on it for basic medical needs — with virtually everything it did. But the agency’s civil servants wouldn’t actually say, explicitly, “My colleagues and I are working to undermine a program that we are legally bound to administer to the best of our abilities.”

That changed Wednesday night. Earlier in the day, BuzzFeed News revealed that the Trump administration had instructed the Health Department’s ten regional directors not to participate in state-based events promoting ACA enrollment, as they had for each of the past three years. After multiple outlets asked the agency for a comment on the move, HHS press secretary Caitlin Oakley offered the following:

Marketplace enrollment events are organized and implemented by outside groups with their own agendas, not HHS. These events may continue regardless of HHS participation.

Obamacare has never lived up to enrollment expectations despite the previous administration’s best efforts. The American people know a bad deal when they see one and many won’t be convinced to sign up for ‘Washington-knows-best’ health coverage that they can’t afford. For the upcoming enrollment period, Americans are being hit with another round of double-digit premium hikes and nearly half of our nation’s counties are facing Obamacare monopolies. As Obamacare continues to collapse, HHS is carefully evaluating how we can best serve the American people who continue to be harmed by Obamacare’s failures. [Emphasis mine.]

So: Asked to respond to the allegation that it is deliberately undermining ACA-enrollment efforts — in defiance of its legal responsibilities — the Trump administration released a written statement explicitly discouraging Americans from enrolling in the program.

This is an expression of proud disdain for the president’s constituents, the most basic norms of good governance, and factual reality, all in one. Oakley is correct that Americans looking for coverage on the individual market will likely see double-digit premium hikes next year. But she neglects to mention that insurers — and the Congressional Budget Office — have said, repeatedly, that the primary cause of said hikes is the uncertainty generated by acts of sabotage like the one she is ostensibly defending.

If the Trump administration was worried about Obamacare’s rising premiums, it would be increasing investments in enrollment promotion, not slashing them. Sick people will tend to seek out health insurance, whether or not they’re exposed to advertising and events encouraging them to do so. But many healthy people will not. And the fewer healthy people who participate in the exchanges, the more expensive it will be for insurers to provide coverage for them — and, thus, the higher they will raise their premiums.

The administration’s handling of open enrollment is nearly as strategically incoherent as it is morally odious. . .

Continue reading.

Written by LeisureGuy

28 September 2017 at 12:12 pm

The Cynicism Behind Graham-Cassidy Is Breathtaking

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Kevin Drum notes:

It’s hard to know how to react to the cynicism of the Graham-Cassidy health care bill. For starters, of course, it’s as bad as all the other Republican repeal bills. Tens of millions of the working poor will lose insurance. Pre-existing conditions aren’t protected. Medicaid funding is slashed. Subsidies are slashed.

But apparently that’s not enough. Republican senators (and President Trump, of course) obviously don’t care what’s in the bill. Hell, they’re all but gleeful in their ignorance. Nor is merely repealing Obamacare enough. Graham-Cassidy is very carefully formulated to punish blue states especially harshly. And if even that’s not enough, after 2020 it gives the president the power to arbitrarily punish them even more if he feels like it. I guess this makes it especially appealing to conservatives. Finally, by handing everything over to the states with virtually no guidance, it would create chaos in the health insurance market. The insurance industry, which was practically the only major player to stay neutral on previous bills (doctors, nurses, hospitals, and everyone else opposed them) has finally had enough. Even if it hurts them with Republicans, Graham-Cassidy is a bridge too far:

The two major trade groups for insurers, the Blue Cross Blue Shield Association and America’s Health Insurance Plans, announced their opposition on Wednesday to the Graham-Cassidy bill….“The bill contains provisions that would allow states to waive key consumer protections, as well as undermine safeguards for those with pre-existing medical conditions,’’ said Scott P. Serota, the president and chief executive of the Blue Cross Blue Shield Association.

….America’s Health Insurance Plans was even more pointed. The legislation could hurt patients by “further destabilizing the individual market” and could potentially allow “government-controlled single payer health care to grow,” said Marilyn B. Tavenner, the president and chief executive of the association. Without controls, some states could simply eliminate private insurance, she warned.

Literally nobody in the health insurance industry likes this bill. The chaos and misery it would unleash are practically undebatable. It’s being passed for no reason except that Republicans have screwed up health care so epically that they have only a few days left to pass something, and Graham-Cassidy is something.

If there’s any silver lining at all to this mess, it comes from AHIP’s Marilyn Taverner:  . . .

Continue reading.

Written by LeisureGuy

21 September 2017 at 8:26 am

A set of articles on the heroin crisis. Read about it. It’s worse than you think.

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From David Pell’s newsletter NextDraft:

“Once a bustling industrial town, Huntington, West Virginia has become the epicenter of America’s modern opioid epidemic, with an overdose rate 10 times the national average. This flood of heroin now threatens this Appalachian city with a cycle of generational addiction, lawlessness, and poverty.” The new Netflix documentary Heroin(e) (produced in collaboration with my friends at the excellent Center for Investigative Journalism) tells the story of three women on the front lines of the battle to save small towns from the perfect storm of America’s opioid/heroin disaster. It’s only thirty minutes. Take the time to watch it. Below, I’ve shared a collection of articles to frame this pressing story.

+ Cincinnati Enquirer: Seven days of heroin: This is what an epidemic looks like.

+ “Often omitted from the conversation about the epidemic is the fact that it is also inflicting harm on the American economy, and on a scale not seen in any previous drug crisis.” Even if politicians are not moved by the moral issue, they should be moved by the economic factors. The New Yorker on the cost of the opioid crisis.

+ “Distributors have fed their greed on human frailties and to criminal effect. There is no excuse and should be no forgiveness.” From the Charleston Gazette-Mail: Drug firms poured 780M painkillers into WV amid rise of overdoses.

+ What can a company like Purdue Pharma do to make ends meet when the domestic market finally gets hit with regulations? The family behind the company decided to follow in the deadly footsteps of big tobacco. From the LA Times: OxyContin goes global.

+ Bloomberg: Big Pharma’s Tobacco Moment as Star Lawyers Push Opioid Suits.

+ When American states started to legalize marijuana, drug cartels saw the writing on the wall. They knew they’d need a new source of income, and the opioid crisis provided them with a market of addicts suddenly facing a legal crackdown on pain pill mills. From the great Don Winslow: El Chapo and The Secret History of the Heroin Crisis.

+ And for a look at the rise of pill mills (a hurricane that hit Florida long before Irma), check out the book American Pain, by John Temple.

Written by LeisureGuy

13 September 2017 at 2:00 pm

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