Trump's Full Court Press on healthcare

[LawBeefaroni]

the average wage worker in the United States has the second-highest tax rate in the developed world

Sure, it's a regressive tax. Working as planned.

Average workers need to have high rates so the 1% doesn't.

[malchior]

A good look at employer sponsored health care as a tax:

The third source is employer-sponsored insurance, which covers about 159 million workers, spouses, and children. Employer insurance is very costly, with the average family premium running just under $19,000 a year. For average wage workers living in a family of four, this premium is equal to 26.4 percent of their total labor compensation. If you count this premium as taxes for international comparison purposes, the average wage worker in the United States has the second-highest tax rate in the developed world, behind the Netherlands. As with Medicaid, employer insurance is very unstable, with people losing their insurance plan every time they separate from their job (66 million workers every year) or when their employer decides to change insurance carriers (15 percent of employers every year).

This is the only way to analyze it. We spend about 150% of what the rest of the advanced economies do per capita with worse results. Keep in mind that ACA targets 25% overhead going to insurance/bill processing/etc. This system is massively inefficient, costly, and shitty for many. Rural hospitals are folding at about one a month (mostly in states that didn't expand Medicaid), and overall the system is slowly failing. ACA stopped it from imploding in say 5-10 years but it is still failing. Just another ticking time bomb that the boomers have built for the rest of us.

[Kraken]

the average wage worker in the United States has the second-highest tax rate in the developed world

Sure, it's a regressive tax. Working as planned.

Average workers need to have high rates so the 1% doesn't.

Do the 1% even have health insurance? Why would they?

[LawBeefaroni]

the average wage worker in the United States has the second-highest tax rate in the developed world

Sure, it's a regressive tax. Working as planned.

Average workers need to have high rates so the 1% doesn't.

Do the 1% even have health insurance? Why would they?

That's the point. It's a tax by proxy so the 1% don't have to pay it. If it were an actual tax they might have to bear some of the burden.

[LordMortis]

Just had a youtube ad make an appeal to me that medicare for all would double our income taxes and not fix anything, informing the real problem is to fix what's broken....

I kinda wish I'da noted what the political ad's website was. I really want to know how they intend to fix what's broken that they've been sitting on for 3 plus years and didn't think about all the years leading up to it. I can't say I'd approach it with an open mind but I do want to know.

[Isgrimnur]

NPR

President Trump gave a speech and signed an executive order on health care Thursday, casting the "Medicare for All" proposals from his Democratic rivals as harmful to seniors.

His speech, which had been billed as a policy discussion, had the tone of a campaign rally. Trump spoke from The Villages, a huge retirement community in Florida outside of Orlando, a deep-red part of a key swing state.
...
The executive order he signed had previously been titled "Protecting Medicare from Socialist Destruction" on the White House schedule, but has since been renamed, "Protecting and Improving Medicare for Our Nation's Seniors."
...
The order is intended, in part, to shore up Medicare Advantage, an alternative to traditional Medicare that's administered by private insurers. That program has been growing in popularity, and this year, premiums are down and plan choices are up.

According to administration officials, the executive order directs the Department of Health and Human Services to take action to improve several aspects of Medicare, including expanding plan options for seniors, encouraging innovative plan designs, and improving the enrollment process to make it easier for seniors to choose plans.

The order also appears to include a grab bag of proposals, including removing "unnecessary regulations that get in between patients and their doctors," new online tools to help people choose their Medicare plans, quicker access to "breakthrough treatments," and better access to medical information, according to Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, who spoke to reporters in a briefing call Thursday.
...
Without a big health reform bill, the administration is positioning itself as a protector of what exists now — particularly Medicare.
...
Medicare is extremely popular. People who have it like it, and people who don't have it, think it's a good thing, too. A recent poll by the Kaiser Family Foundation found that more than eight in ten Democrats, independents, and Republicans think of Medicare favorably.

[Isgrimnur]

'Conscience Rights' for health care workers.

Last month, the U.S. Department of Health and Human Services put out a new rule that "implements full and robust enforcement" of existing laws that protect what the administration calls "conscience rights" for health care workers. The rule is set to go into effect on July 22.

NPR

In a blow to the Trump administration, a federal court in Manhattan has knocked down a rule that would make it easier for doctors and other health care workers to refuse care for religious reasons.

U.S. District Judge Paul Engelmayer ruled Wednesday that the Department of Health and Human Services, which issued the regulation earlier this year, exceeded its authority and "acted arbitrarily and capriciously" in promoting it.

The department's violations of federal law, according to the judge's opinion, were "numerous, fundamental, and far-reaching" — and he vacated the rule entirely, just over two weeks before it was set to take effect on Nov. 22.
...
As NPR has reported, this rule was part of a big push from the Office for Civil Rights to bolster "religious freedom" in health care. Severino, who is Catholic and formerly of the conservative Heritage Foundation, has argued that previous administrations did not fully enforce existing law that protected what supporters call health care workers' "conscience rights."

To remedy that, Severino created a Conscience and Religious Freedom Division in January 2018, and in May of this year, his office issued this rule.
...
Complaints of such violations are relatively rare — for a decade, the office would receive an average of one complaint like this each year. Severino frequently pointed to a jump in those complaints to 343 last year as proving the need for this rule. He attributed that increase to a strong message from his office that they were "open for business" when it came to issues of religious freedom.

However, that increase in the number of complaints is "demonstrably false," according to Engelmayer's ruling. Nearly 80% of all the complaints given to the court were about vaccinations — unrelated to health care workers and their religious beliefs in providing care.

The judge writes that only 21 — or 6% — of the complaints that the government provided the court are even potentially related to providers' moral or religious objections. During oral arguments, the government's attorney conceded that the real number of complaints was "in that ballpark."

[Isgrimnur]

Vox

A trio of Supreme Court cases consolidated under the name Maine Community Health Options v. United States may fairly be described as the first “normal” Obamacare case to reach the Supreme Court.

They do not involve an existential attack on the Affordable Care Act, and they did not arrive on the justices’ doorstep after months of political turmoil over how the courts should resolve these cases. And during arguments Tuesday, a majority of the justices appeared to treat Maine Community as what it is — a difficult dispute about how the government makes promises and whether it is required to keep them, rather than as an opportunity to retreat into partisan camps.

Maine Community involves about $12 billion in payments owed to health insurers under a program known as “risk corridors.” Obamacare’s risk corridors program sought to encourage insurers to enter an uncertain new market by agreeing to reimburse a portion of their losses if the insurance company set premiums too low.

After many insurers agreed to sell plans on the Obamacare marketplace, Congress enacted a provision in an appropriations bill — a provision known as a “rider” — seeking to prevent the government from making most of the payments under the risk corridor program. The question in Maine Community is whether the government is still obligated by the Affordable Care Act’s original promise to make these payments, or whether the rider effectively ended the requirement.

[Isgrimnur]

WaPo

During an interview with CNBC on Wednesday, Trump was asked, “[Would] entitlements ever be on your plate?” Entitlements are, of course, Washington-speak for Medicare and Social Security. Trump responded, “At some point they will be,” adding, “It’ll be toward the end of the year.” Just in case Trump misunderstood, Joe Kernen followed up, reminding him this was something he had “said you wouldn’t do in the past” and specifically mentioning Medicare. Trump cut him off. “Well, we’re going to look.”
...
Trump’s pitch when he ran for president, from the very first day of his campaign, was that he was the Republican who would, and I quote exactly, “save Medicare, Medicaid and Social Security without cuts.” He repeated that as recently as Thursday on Twitter: “Democrats are going to destroy your Social Security. I have totally left it alone, as promised, and will save it!” It was an obvious con then and is an obvious con now. In 2016, both the Trump campaign chief policy adviser and a prominent supporter assured people their man didn’t mean it.

[Isgrimnur]

CNN

The Supreme Court announced Monday it will decide the fate of the Affordable Care Act sometime next term, presumably after the presidential election.
...
Texas and other Republican-led states sued, arguing that since the mandate was no longer tied to a specific tax penalty, it had lost its legal underpinning. They also argued that because the individual mandate was intertwined with a multitude of other provisions, the entire law should fall, including protections for people with preexisting conditions.

The Trump administration filed briefs siding with Texas for the most part, although they have made a relatively new argument that the entire law should fall but the ruling should only apply to the 18 states that brought the challenge.

[Isgrimnur]

USA Today

The Supreme Court ruled Monday that Congress cheated health insurance companies by reneging on a $12 billion promise made under the Affordable Care Act.

The decision represents the high court's views on Congress' power of the purse: Lawmakers cannot promise funding in legislation and then disavow that pledge.

Associate Justice Sonia Sotomayor wrote the 8-1 opinion on the basis of "a principle as old as the nation itself: The Government should honor its obligations."

Associate Justice Samuel Alito dissented, calling it "a massive bailout for insurance companies that took a calculated risk and lost."

[LordMortis]

The Government should honor its obligations."

Have they met 2017-2020?

[Holman]

[RunningMn9]

That makes total sense. Gonna sign a brand new comprehensive health care bill that no one has ever heard of, in two weeks, because of a DACA ruling. That went against him (IIRC).

No dementia here.

[Scraper]

That makes total sense. Gonna sign a brand new comprehensive health care bill that no one has ever heard of, in two weeks, because of a DACA ruling. That went against him (IIRC).

No dementia here.

I mean how in the fuck does he still have 38% approval? It should legitimately be less than 10%. The man has no fucking clue.

[pr0ner]

I continue to be amazed someone at the White House agreed to letting Trump get interviewed by Chris Wallace.

[malchior]

I continue to be amazed someone at the White House agreed to letting Trump get interviewed by Chris Wallace.

I personally believe Trump insisted on the interview. He feels all cooped up and thought it'd be a cake walk.

[Max Peck]

There are only a couple of points where Trump is reliably consistent. If he tells a story where someone repeatedly calls him "Sir", then the story never happened. When he says that he'll be doing something in a couple of weeks, the thing never happens.

[Kraken]

There are only a couple of points where Trump is reliably consistent. If he tells a story where someone repeatedly calls him "Sir", then the story never happened. When he says that he'll be doing something in a couple of weeks, the thing never happens.

When he says "believe me," he's lying. (I know, he's almost always lying, but that's an easy tell.)

[malchior]

The 2 weeks thing is another dead give away. Anytime he says something is going to be ready in 2 weeks no one has ever heard of it.

[Alefroth]

What kind of shitty health-care related executive order is he going to crap out?

[El Guapo]

That makes total sense. Gonna sign a brand new comprehensive health care bill that no one has ever heard of, in two weeks, because of a DACA ruling. That went against him (IIRC).

No dementia here.

He has to be mixing up DACA with the ACA, right? That's the only thing I can think of.

[LordMortis]

That makes total sense. Gonna sign a brand new comprehensive health care bill that no one has ever heard of, in two weeks, because of a DACA ruling. That went against him (IIRC).

No dementia here.

He has to be mixing up DACA with the ACA, right? That's the only thing I can think of.

That's all I could come up with. Sadly, I'm not convinced he knows what ACA is or he would have said Obamacare.

[malchior]

According to some accounts John Yoo (yeah the waterboarding guy) has convinced some in the White House that the DACA ruling opens the door to the WH making policy without Congress. Maybe....being very generous here...it was a cogent thought rooted in deep authoritarianism versus lack of focus. Oh wait, that's probably worse.

[Holman]

There are only a couple of points where Trump is reliably consistent. If he tells a story where someone repeatedly calls him "Sir", then the story never happened. When he says that he'll be doing something in a couple of weeks, the thing never happens.

When he says "believe me," he's lying. (I know, he's almost always lying, but that's an easy tell.)

When he says something is "beautiful" or "tremendous" or "unbelievable," it means the thing is very very bad.

[Smoove_B]

As a reminder, today ends the promised "two weeks":

"We're signing a health care plan within two weeks. A full and complete health care plan, that the Supreme Court decision on DACA gave me the right to do" -- Trump routinely cites a two week timeframe for new policy initiatives when he's just making stuff up

EDIT: Oh, I see now that The Lincoln Project had this covered earlier today. Carry on.

[malchior]

As a reminder, today ends the promised "two weeks":

"We're signing a health care plan within two weeks. A full and complete health care plan, that the Supreme Court decision on DACA gave me the right to do" -- Trump routinely cites a two week timeframe for new policy initiatives when he's just making stuff up

EDIT: Oh, I see now that The Lincoln Project had this covered earlier today. Carry on.

He is a busy man. He just said it'll be ready by the end of the month.

[Smoove_B]

I guess this belongs here? I don't even know anymore:

President Donald Trump travels Thursday to the swing state of Ohio tosign an executive order requiring the federal government to purchase certaindrugs from U.S. manufacturers rather than from overseas companies.

The order, which Trump will sign at Whirlpool Corp.'s manufacturing plant in Clyde in the northern part of the state, instructs the government to develop a list of "essential" medicines and then buy them and other medical supplies from U.S. manufacturers instead of from companies around the world.

The White House says the order will protect the nation’s drug supply and ensure Americans have access to the essential medicines and other medical supplies. But the official trip also marks Trump's latest to a battleground state at a time when the coronavirus has sidelined regular campaigning.

Of note:

Some 72% of manufacturers that supply pharmaceutical ingredients to the U.S. are located overseas, and 13% of them are in China, Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, told a congressional panel last October. Tensions between the U.S. and China are at a peak, not only over the coronavirus but also trade and territorial disputes in the South China Sea.

Last week, Trump announced a deal with the Eastman Kodak Co. to manufacture pharmaceuticals. The administration plans to give the camera company a $765 million loan to launch a pharmaceuticals division.

[Isgrimnur]

Something something picking winners and losers.

[malchior]

Former CIGNA executive comes clean about how the industry sabotaged health care reform.

In my prior life as an insurance executive, it was my job to deceive Americans about their health care. I misled people to protect profits. In fact, one of my major objectives, as a corporate propagandist, was to do my part to “enhance shareholder value.” That work contributed directly to a climate in which fewer people are insured, which has shaped our nation’s struggle against the coronavirus, a condition that we can fight only if everyone is willing and able to get medical treatment. Had spokesmen like me not been paid to obscure important truths about the differences between the U.S. and Canadian health-care systems, tens of thousands of Americans who have died during the pandemic might still be alive.

In 2007, I was working as vice president of corporate communications for Cigna. That summer, Michael Moore was preparing to release his latest documentary, “Sicko,” contrasting American health care with that in other rich countries. (Naturally, we looked terrible.) I spent months meeting secretly with my counterparts at other big insurers to plot our assault on the film, which contained many anecdotes about patients who had been denied coverage for important treatments.

...

Clearly my colleagues and I would need a robust defense. On a task force for the industry’s biggest trade association, America’s Health Insurance Plans (AHIP), we talked about how we might make health-care systems in Canada, France, Britain and even Cuba look just as bad as ours. We enlisted APCO Worldwide, a giant PR firm. Agents there worked with AHIP to put together a binder of laminated talking points for company flacks like me to use in news releases and statements to reporters.

...

Nevertheless, I spent much of that year as an industry spokesman, my last after 20 years in the business, spreading AHIP’s “information” to journalists and lawmakers to create the impression that our health-care system was far superior to Canada’s, which we wanted people to believe was on the verge of collapse. The campaign worked. Stories began to appear in the press that cast the Canadian system in a negative light. And when Democrats began writing what would become the Affordable Care Act in early 2009, they gave no serious consideration to a publicly financed system like Canada’s. We succeeded so wildly at defining that idea as radical that Sen. Max Baucus (D-Mont.), then chair of the Senate Finance Committee, had single-payer supporters ejected from a hearing.

Today, the respective responses of Canada and the United States to the coronavirus pandemic prove just how false the ideas I helped spread were. There are more than three times as many coronavirus infections per capita in the United States, and the mortality rate is twice the rate in Canada. And although we now test more people per capita, our northern neighbor had much earlier successes with testing, which helped make a difference throughout the pandemic.


The most effective myth we perpetuated — the industry trots it out whenever major reform is proposed — is that Canadians and people in other single-payer countries have to endure long waits for needed care. Just last year, in a statement submitted to a congressional committee for a hearing on the Medicare for All Act of 2019, AHIP maintained that “patients would pay more to wait longer for worse care” under a single-payer system.

While it’s true that Canadians sometimes have to wait weeks or months for elective procedures (knee replacements are often cited), the truth is that they do not have to wait at all for the vast majority of medical services. And, contrary to another myth I used to peddle — that Canadian doctors are flocking to the United States — there are more doctors per 1,000 people in Canada than here. Canadians see their doctors an average of 6.8 times a year, compared with just four times a year in this country.

...

Most important, no one in Canada is turned away from doctors because of a lack of funds, and Canadians can get tested and treated for the coronavirus without fear of receiving a budget-busting medical bill. That undoubtedly is one of the reasons Canada’s covid-19 death rate is so much lower than ours. In America, exorbitant bills are a defining feature of our health-care system. Despite the assurances from President Trump and members of Congress that covid-19 patients will not be charged for testing or treatment, they are on the hook for big bills, according to numerous reports.

That is not the case in Canada, where there are no co-pays, deductibles or coinsurance for covered benefits. Care is free at the point of service. And those laid off in Canada don’t face the worry of losing their health insurance. In the United States, by contrast, more than 40 million have lost their jobs during this pandemic, and millions of them — along with their families — also lost their coverage.

...

Of the many regrets I have about what I once did for a living, one of the biggest is slandering Canada’s health-care system. If the United States had undertaken a different kind of reform in 2009 (or anytime since), one that didn’t rely on private insurance companies that have every incentive to limit what they pay for, we’d be a healthier country today. Living without insurance dramatically increases your chances of dying unnecessarily. Over the past 13 years, tens of thousands of Americans have probably died prematurely because, unlike our neighbors to the north, they either had no coverage or were so inadequately insured that they couldn’t afford the care they needed. I live with that horror, and my role in it, every day.

[Holman]

[Isgrimnur]

[Skinypupy]

I still say they missed an absolutely golden opportunity. Simply rebrand the ACA as “Trumpcare” and I guarantee you every MAGA would immediately be on board. They literally wouldn’t have to change a thing except the name.

It would be touted by conservative media as a huge win (since they lie about everything anyway) and all the deplorables would be ecstatic about the “new” healthcare plan that Trump came up with. It would have been a huge win.

[Alefroth]

I still say they missed an absolutely golden opportunity. Simply rebrand the ACA as “Trumpcare” and I guarantee you every MAGA would immediately be on board. They literally wouldn’t have to change a thing except the name.

It would be touted by conservative media as a huge win (since they lie about everything anyway) and all the deplorables would be ecstatic about the “new” healthcare plan that Trump came up with. It would have been a huge win.

Maybe that was the plan of which he hinted during the Wallace interview.

[raydude]

I still say they missed an absolutely golden opportunity. Simply rebrand the ACA as “Trumpcare” and I guarantee you every MAGA would immediately be on board. They literally wouldn’t have to change a thing except the name.

It would be touted by conservative media as a huge win (since they lie about everything anyway) and all the deplorables would be ecstatic about the “new” healthcare plan that Trump came up with. It would have been a huge win.

I'm willing to bet the only thing stopping this is that Trump knows it's still Obamacare, something that Obama created, and therefore he needs to kill it.

[malchior]

Is perhaps some vital context missing here?

[TheMix]

"major"? Are there degrees of EOs?

Are there any rules for EOs? Anything to stop using EOs for things that already exist? This is clearly a political move. Obviously at least some of the folks around him already know that this is law; so the only reason to do it is to try and gain favor with gullible voters that may not be aware that it already exists.

Here's hoping it turns into a meme ridiculing him. "I'll be pursuing a YUGE executive order making it illegal to rob banks! I'm protecting your money!"

[Smoove_B]

Not sure if we need to change the title to the GOP's full court press on healthcare - since they've now resumed:

A key piece of the Affordable Care Act is on trial Tuesday as a group of Texans challenge the law’s requirement that insurers cover preventive services — everything from STD screenings and HIV prevention drugs to depression checks and flu shots.

The case before Judge Reed O’Connor — the author of several anti-Obamacare rulings — at the U.S. District Court for the Northern District of Texas is the latest conservative-led legal effort to undermine the 12-year-old law, and could determine whether insurance companies are allowed to deny coverage or charge sky-high copays for common preventive care going forward.

This challenge, filed in March of 2020 by a group of Texas residents and employers and backed by former Trump officials, argues that the ACA’s preventive care mandates violate the Religious Freedom Restoration Act and that forcing people to pay for plans that cover STD screenings and HIV prevention drugs will “facilitate and encourage homosexual behavior, prostitution, sexual promiscuity, and intravenous drug use.”

This overlaps a few topics, but since the core is about healthcare and it technically has Trump-stink on it, I'll put it here.

[Zarathud]

Health care doesn’t force policy choices on its insureds. It’s a legitimate medical care even if you don’t believe in treatment.

[malchior]

Health care doesn’t force policy choices on its insureds. It’s a legitimate medical care even if you don’t believe in treatment.

I think we're about to be told that's not the case. Our robed tyrants have already hinted that the policy of the federal government shouldn't be stepping on people's "Christians" religious beliefs.