Pauly Ryan says that he wants to destroy American healthcare:
Oops.
Tag: Healthcare
Face Plant
He’s trying to look chill, but he’s just a bitch
Paul Ryan has had to postpone the vote on Trumpcare because he is unable to secure the votes for the measure:
“The closer,” it turns out, needs extra innings.
After a frenetic 48 hours of Oval Office lobbying sessions, closed-door talks in the Cabinet room and shuttle diplomacy on both ends of Pennsylvania Avenue, President Donald Trump and Speaker Paul Ryan pulled the plug Thursday on a scheduled vote on their health care legislation after falling short of the support needed for passage.
Conservative House hardliners would not budge on their demanded concessions. Moderate Republicans grew skittish of the new proposed changes. And, as the morning turned to afternoon without an accord on final legislative language, Republicans fretted about the optics of jamming the far-reaching bill through in the middle of the night.
Pauly, you had one job, and all it required was the ability to count to 218, and you couldn’t manage that.
This is what happen when you let the Teabaggers go off their meds and run for office.
I Knew That It Was Bad………
But I did not realize that Trumpcare was actually worse than a complete repeal of Obamacare:
The Congressional Budget Office recently said that around 24 million fewer Americans would have health insurance in 2026 under the Republican repeal plan than if the current law stayed in place.
That loss was bigger than most experts anticipated, and led to a round of predictable laments from congressional Democrats — and less predictable ones from Republican senators, including Bill Cassidy of Louisiana and John Thune of South Dakota, who told reporters that the bill needed to be “more helpful” to low-income people who wanted insurance.
But one piece of context has gone little noticed: The Republican bill would actually result in more people being uninsured than if Obamacare were simply repealed. Getting rid of the major coverage provisions and regulations of Obamacare would cost 23 million Americans their health insurance, according to another recent C.B.O. report. In other words, one million more Americans would have health insurance with a clean repeal than with the Republican replacement plan, according to C.B.O. estimates.
I knew that it was bad legislation, but I did not know that it was literally worse than nothing.
This is a level of active stupidity that literally buggers the mind.
“Literally worse than nothing,” kind of sounds what a mandated truth in advertising law would label Republican think tanks.
It’s Cheap, It Works Better, Let’s Kill It
I just discovered that the Veterans Administration has a medical records system that it been running and evolving since the late 1970s.
It runs better than commercial systems, largely because doctors have been brought into the system early, and because it has an open architecture it can be easily adapted to the specific needs of specific departments and locations.
It’s also much cheaper than the commercial alternatives.
Of course, this means that it must be replaced by an over priced under performing system from a politically connected contractor:
Four decades ago, in 1977, a conspiracy began bubbling up from the basements of the vast network of hospitals belonging to the Veterans Administration. Across the country, software geeks and doctors were puzzling out how they could make medical care better with these new devices called personal computers. Working sometimes at night or in their spare time, they started to cobble together a system that helped doctors organize their prescriptions, their CAT scans and patient notes, and to share their experiences electronically to help improve care for veterans.
Within a few years, this band of altruistic docs and nerds—they called themselves “The Hardhats,” and sometimes “the conspiracy”—had built something totally new, a system that would transform medicine. Today, the medical-data revolution is taken for granted, and electronic health records are a multibillion-dollar industry. Back then, the whole idea was a novelty, even a threat. The VA pioneers were years ahead of their time. Their project was innovative, entrepreneurial and public-spirited—all those things the government wasn’t supposed to be.
Of course, the government tried to kill it.
Though the system has survived for decades, even topping the lists of the most effective and popular medical records systems, it’s now on the verge of being eliminated: The secretary of what is now the Department of Veterans Affairs has already said he wants the agency to switch over to a commercial system. An official decision is scheduled for July 1. Throwing it out and starting over will cost $16 billion, according to one estimate.What happened? The story of the VA’s unique computer system—how the government actually managed to build a pioneering and effective medical data network, and then managed to neglect it to the point of irreparability—is emblematic of how politics can lead to the bungling of a vital, complex technology. As recently as last August, a Medscape survey of 15,000 physicians found that the VA system, called VistA, ranked as the most usable and useful medical records system, above hundreds of other commercial versions marketed by hotshot tech companies with powerful Washington lobbyists. Back in 2009, some of the architects of the Affordable Care Act saw VistA as a model for the transformation of American medical records and even floated giving it away to every doctor in America.
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The Hardhats’ key insight—and the reason VistA still has such dedicated fans today—was that the system would work well only if they brought doctors into the loop as they built their new tools. In fact, it would be best if doctors actually helped build them. Pre-specified computer design might work for an airplane or a ship, but a hospital had hundreds of thousands of variable processes. You needed a “co-evolutionary loop between those using the system and the system you provide them,” says one of the early converts, mathematician Tom Munnecke, a polymathic entrepreneur and philanthropist who joined the VA hospital in Loma Linda, California, in 1978.
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Munnecke, a leading Hardhat, remembers it as an exhilarating time. He used a PDP11/34 computer with 32 kilobytes of memory, and stored his programs, development work and his hospital’s database on a 5-megabyte disk the size of a personal pizza. One day, Munnecke and a colleague, George Timson, sat in a restaurant and sketched out a circular diagram on a paper place mat, a design for what initially would be called the Decentralized Hospital Computer Program, and later VistA. MUMPs computer language was at the center of the diagram, surrounded by a kernel of programs used by everyone at the VA, with applications floating around the fringes like electrons in an atom. MUMPS was a ludicrously simple coding language that could run with limited memory and great speed on a low-powered computer. The architecture of VistA was open, modular and decentralized. All around the edges, the apps flourished through the cooperation of computer scientists and doctors.
………
This is bitter fruit for many VistA fans. Some still say the system could be fixed for $200 million a year—the cost of a medium-sized hospital system’s EHR installation. “I don’t know if there even is an EHR out there with data comparable to the longitudinal data that VistA has about veterans, and we certainly do not want to throw that data out if a new EHR were to be used,” says Nancy Anthracite, a Hardhat and an infectious-disease physician.
Eventually, this system will be shut down, and replaced by a more expensive inferior commercial system, because that is how the government rolls these days.
It’s been heading in this direction for a while, but the institutionalization of dumbing down government agencies so as to require expensive contractors really got its start in Dick Cheney’s programs when he was Secretary of Defense, and it became an existential need in response to the Clinton administration’s “Reinventing Government” initiative.
It all comes down to normalizing corruption.
Tweet of the Day
It’s almost as if a shadowy cabal figured out how to get people to pay more to die faster. pic.twitter.com/9yvlvNZN0d— Honest Hillary (@Honest_Hillary) February 8, 2017
H/t Naked Capitalism.
Yes. I know, it’s an old tweet. I was cleaning up drafts, and felt the need to share this. 
Single Payer Now
We have now discovered that our healthcare system has even corrupted the world renowned Mayo Clinic:
Mayo Clinic, one of the country’s top hospitals, is in the midst of controversy after its CEO said that the elite medical facility would prioritize the care of patients with private health insurance over those with Medicare and Medicaid.
The prioritization by the Rochester, MN-headquartered medical practice was recently revealed by the Minneapolis Star Tribune. And it has quickly drawn out some sharp critics—as well as sympathizers.
In a statement to the Minnesota Post Bulletin, Dr. Gerard Anderson, the director of the Johns Hopkins Center for Hospital Finance and Management, compared the prioritization to policies seen in developing countries. “This is what happens in many low-income countries. The health system is organized to give the most affluent preference in receiving health care,” he wrote.
Likewise, Minnesota Department of Human Services Commissioner Emily Piper, expressed surprise and concern by the statements of Mayo’s CEO, Dr. John Noseworthy. “Fundamentally, it’s our expectation at DHS that Mayo Clinic will serve our enrollees in public programs on an equal standing with any other Minnesotan that walks in their door,” she said. “We have a lot of questions for Mayo Clinic about how and if and through what process this directive from Dr. Noseworthy is being implemented across their health system.”
………
Mayo can use its standing as a prestigious institution to negotiate higher prices with commercial insurance companies, but it can’t do the same with the government. As such, those with private insurance can bring more money to the hospital than patients with the same treatments on government programs. Under the ACA, the number of people covered by Medicare and Medicaid has expanded. However, the law also decreased the number of uninsured, which can be costly to hospitals.
In his speech, Noseworthy said that Mayo had reached a “tipping point” with a recent 3.7 percent surge in Medicaid patients. “If we don’t grow the commercially insured patients, we won’t have income at the end of the year to pay our staff, pay the pensions, and so on,” he said. “So we’re looking for a really mild or modest change of a couple percentage points to shift that balance.”
Nevertheless, the nonprofit still generated substantial profits in 2016: $475 million.
Seriously: We need to burn down the existing healthcare system.
This is Not a Surprise
It turns out that Trumpcare incentivizes overpaying insurance executives:
Concealed within the 123 pages of legislative verbiage and dense boilerplate of the House Republican bill repealing the Affordable Care Act are not a few hard-to-find nuggets. Here’s one crying out for exposure: The bill encourages health insurance companies to pay their top executives more.
It does so by removing the ACA’s limit on corporate tax deductions for executive pay. The cost to the American taxpayer of eliminating this provision: well in excess of $70 million a year. In the reckoning of the Institute for Policy Studies, a think tank that analyzed the limitation in 2014, that would have been enough that year to buy dental insurance under the ACA for 262,000 Americans, or pay the silver plan deductibles for 28,000.
As part of an effort to rein in soaring executive pay, the ACA decreed that health insurance companies could deduct from their taxes only $500,000 of the pay of each top executive. That’s a tighter restriction than the limit imposed on other corporations, which is $1 million per executive. The ACA closed a loophole for insurance companies enjoyed by other corporations, which could deduct the cost of stock options and other “performance-based” pay; for insurance companies, the deduction cap is $500,000 per executive, period.
The idea was to signal that the ACA, which cemented health insurance companies into the center of American healthcare, wasn’t a pure giveaway to the industry.
“Consumers across America should know that when they pay their hard-earned dollars to cover the soaring cost of premiums, they are not just chipping in to pay for the CEOs’ next new yacht,” said then-Sen. Tom Harkin (D-Iowa).
………
The House Republican bill repeals the compensation limit as of the end of this year. The GOP hasn’t exactly trumpeted this provision; it’s six lines on page 67 of the measure, labeled “Remuneration from Certain Insurers” and referring only to the obscure IRS code section imposing the limit. Repeal of the provision apparently means that the insurers will be able to deduct $1 million in cash per executive, plus the cost of “performance-based” stock awards and options, like other corporations.
This is just how Republicans roll.
Take money from poor people so that rich folk can afford that 3rd yacht.
They really should have been drowned at birth, all of them.
Sweet Irony
Breitbart News just came out against Trumpcare:
Donald Trump has been very good for the news business — and the news business has been very good for Donald Trump.
But no publication has had a more mutually beneficial relationship with our new president than Breitbart. Trump’s campaign brought the site’s brand of reactionary populism into the mainstream — and its former mastermind into the West Wing. By the time the ballots were cast, no other news outlet had grown its audience more over the 2016 cycle.
And Breitbart, of course, supplied Trump with a megaphone, a strategist, and relentlessly positive coverage — even when the mogul’s campaign manager low-key battered one of the site’s reporters.
So, Breitbart’s latest headline on the Trump-Ryan health-care plan is probably causing some consternation at 1600 Pennsylvania Avenue.
Any heartburn being experienced by Steve Bannon, former editor-in-chief of Breitbart, is the source of much pleasure for me personally.
Once Again, Their Evil Outstrips My Fertile Imagination
The Republicans are proposing a bill that would allow employers to coerce genetic testing from their employers and share the data with whomever they please:
A little-noticed bill moving through Congress would allow companies to require employees to undergo genetic testing or risk paying a penalty of thousands of dollars, and would let employers see that genetic and other health information.
Giving employers such power is now prohibited by legislation including the 2008 genetic privacy and nondiscrimination law known as GINA. The new bill gets around that landmark law by stating explicitly that GINA and other protections do not apply when genetic tests are part of a “workplace wellness” program.
The bill, HR 1313, was approved by a House committee on Wednesday, with all 22 Republicans supporting it and all 17 Democrats opposed. It has been overshadowed by the debate over the House GOP proposal to repeal and replace the Affordable Care Act, but the genetic testing bill is expected to be folded into a second ACA-related measure containing a grab-bag of provisions that do not affect federal spending, as the main bill does.
“What this bill would do is completely take away the protections of existing laws,” said Jennifer Mathis, director of policy and legal advocacy at the Bazelon Center for Mental Health Law, a civil rights group. In particular, privacy and other protections for genetic and health information in GINA and the 1990 Americans with Disabilities Act “would be pretty much eviscerated,” she said.
………
Employers got virtually everything they wanted for their workplace wellness programs during the Obama administration. The ACA allowed them to charge employees 30 percent, and possibly 50 percent, more for health insurance if they declined to participate in the “voluntary” programs, which typically include cholesterol and other screenings; health questionnaires that ask about personal habits, including plans to get pregnant; and sometimes weight loss and smoking cessation classes. And in rules that Obama’s Equal Employment Opportunity Commission issued last year, a workplace wellness program counts as “voluntary” even if workers have to pay thousands of dollars more in premiums and deductibles if they don’t participate.
Actually, this explains a lot about Obamacare.
It appears that it was drawn up under the assumption that the average American was a fat ignorant slob with no agency, and so they needed to be coerced.
And people wonder why, even as people support almost all the parts of the ACA, they hate the whole package.
Because it was delivered to the American public dripping with contempt. (“Deplorables”)
Tweet of the Day
Heritage Foundation: It sucks.
FreedomWorks: It sucks.
Club for Growth: It sucks.
Democrats: Needs some tweaking! https://t.co/ezpXEskarD— Bodega Fats (@GarbageApe) March 8, 2017
This is, of course the comments on Paul Ryan’s Obamacare repeal plan.
I’m beginning to think that if you took every member of the DNC and examined them, you would not find enough testicles to match those of the eunuchs corps at Topkapı Palace.
This is truly pathetic.
H/t Ny Mag
Why Running Helathcare Like a Business Does Not Work, Part LVXXI
The Department of Health and Human Services decided to tie reimbursement rates to hospitals to patient satisfaction.
The result was happier but sicker and deader patients:
When Department of Health and Human Services administrators decided to base 30 percent of hospitals’ Medicare reimbursement on patient satisfaction survey scores, they likely figured that transparency and accountability would improve healthcare. The Centers for Medicare and Medicaid Services (CMS) officials wrote, rather reasonably, “Delivery of high-quality, patient-centered care requires us to carefully consider the patient’s experience in the hospital inpatient setting.” They probably had no idea that their methods could end up indirectly harming patients.
Beginning in October 2012, the Affordable Care Act implemented a policy withholding 1 percent of total Medicare reimbursements—approximately $850 million—from hospitals (that percentage will double in 2017). Each year, only hospitals with high patient-satisfaction scores and a measure of certain basic care standards will earn that money back, and the top performers will receive bonus money from the pool.
………
In fact, a national study revealed that patients who reported being most satisfied with their doctors actually had higher healthcare and prescription costs and were more likely to be hospitalized than patients who were not as satisfied. Worse, the most satisfied patients were significantly more likely to die in the next four years.
………
As a Missouri clinical instructor told me, “Patients can be very satisfied and dead an hour later. Sometimes hearing bad news is not going to result in a satisfied patient, yet the patient could be a well-informed, prepared patient.”
We don’t need to market incentivize healthcare, we need to take the market out of healthcare.
Tweet of the Day
Obamacare vs GOP replacement pic.twitter.com/QVbtap4JYM— Pixelated Boat (@pixelatedboat) March 7, 2017
We’re only arguing about the relative level of suckage. 
H/t naked capitalism
Could I Have this Translated Please?
In the Telegraph, they had a headline that is uniquely British:
More Than 600 Health QUANGO Chiefs on Six-Figure Salaries amid NHS Cash Crisis
The translation is as follows:
Now that the Conservatives have privatized much of the British National Health Service, not only is there no money, but much of what there is is being wasted on overpaid executives.
QUANGO stands for, “Quasi-Autonomous Non-Governmental Organization”.
Basically, it’s where you screw the taxpayers, and make your friends rich(er) by privatizing essential government services, creating private profits and poorer services: (1£= about $1.22)
More than 600 NHS quango chiefs are now on six-figure salaries, with a doubling in the number earning more than the Prime Minister in just three years, new figures show.
Many of the highest earners have made repeated demands on the Government to increase NHS funding as it battles against its worst financial deficit in history.
But figures uncovered by the Telegraph, show that the nine main health quangos are now employing 628 officials on salaries of at least £100,000.
They include 93 taking home more than Theresa May’s £149,440 salary – up from 48 at their predecessor bodies three years earlier.
Among the highest paid is the NHS deputy medical director, earning around £225,000 a year.
Dr Jonathan Fielden is currently suspended from work and banned from contact with patients, after being arrested on suspicion of voyeurism.
The findings come as the NHS attempts to make £22 billion in savings. On Friday Simon Stevens, who earns around £195,000, said the NHS needed more money. He told an audience: “We do need capital; we’ve said that from the get go.”His plea came the day after the Chief Inspector of Hospitals, Prof Sir Mike Richards, who is paid around £240,000, said the health service was standing on a “burning platform”.
And last year Jim Mackey, who earns between £215,000 and £220,000 as head of another watchdog, NHS Improvement, spoke of how he believed there was “a door open” at the Treasury , saying the NHS needed to “get our case together” to get more funds.
Patients groups said the scale of the spending on salaries was “truly shocking” and “eyewatering”.
While this is going on, medical professionals are increasingly underpaid, and so are fleeting the system, but the top 1% has got to get their vig.
The Tories are trying to run the NHS like a business: Burn it down for the insurance money.
Working for the public good has been replaced by looting, and we see this in the United States as well.
Yeah, He’s Running for President in 2020
Corey Booker, after getting savaged by the Democratic wing of the Democratic Party for voting with big pharma to ensure that people would be impoverished by their extortion, has signed on to a very similar measure to the one that he voted against:
Pilloried by his party’s left wing for voting in January against a non-binding measure with a similar goal, Sen. Cory Booker is joining Sen. Bernie Sanders on Tuesday to unveil a bill to allow the importation of pharmaceuticals from Canada and other countries.
Booker, who has been mentioned as a potential 2020 presidential candidate, came under fire on social media and liberal blogs as too beholden to special interests after he and 12 Democratic colleagues, including fellow New Jersey Sen. Bob Menendez, voted against a drug-importation amendment to the 2017 budget resolution.
That amendment, sponsored by Sanders, of Vermont, and Sen. Amy Klobuchar, D-Minn., was part of a series of votes, all defeated, to amend the budget resolution the Republican majority was using to start the process of repealing the Affordable Care Act. Sanders reacted angrily after the 46-52 vote, telling USA Today his Democratic colleagues lacked “guts” and he hoped that “in the coming weeks and months you’re going to see many of them develop the courage to stand up to Pharma.”
I am an optimist: I think that our nation might survive 4 years of Donald Trump.
I don’t think that it can survive another presidency of an Ivy League educated neoliberal who runs the country primarily for the benefit Ivy League educated neoliberals.
I really have to start looking into aliyah.
Sow the Wind, Reap the Whirlwind
It appears that after decades of organizing disruption at Democratic Congressmen’s town halls, Republicans are worried that people are angry with them for attempting to destroy their health insurance:
House Republicans during a closed-door meeting Tuesday discussed how to protect themselves and their staffs from protesters storming town halls and offices in opposition to repealing Obamacare, sources in the room told Politico.
House GOP Conference Chairwoman Cathy McMorris Rodgers invited Rep. David Reichert, a former county sheriff, to present lawmakers with protective measures they should have in place. Among the suggestions: having a physical exit strategy at town halls, or a backdoor in congressional offices to slip out of, in case demonstrations turn violent; having local police monitor town halls; replacing any glass office-door entrances with heavy doors and deadbolts; and setting up intercoms to ensure those entering congressional offices are there for appointments, not to cause chaos.
“The message was: One, be careful for security purposes. Watch your back. And two, be receptive. Honor the First Amendment, engage, be friendly, be nice,” said Republican Study Committee Chairman Mark Walker (R-N.C.). “Because it is toxic out there right now. Even some of the guys who have been around here a lot longer than I have, have never seen it to this level.”
………
Democrats, meanwhile, dismissed Republicans’ security ramp-up as an attempt to shield themselves from criticism.
“I think what you’re seeing is Republicans trying to use security to try to hide themselves from their constituents because they have no plan for a replacement and very little support from Donald Trump,” said Rep. Ruben Gallego (D-Ariz.). “They’re going to use so-called security to keep people away.”
Bingo, Representative Gallego.
I love this quote, “Many of these lawmakers in safe districts have never dealt with such severe blowback.”
To quote Finley Peter Dunne, “Politics ain’t beanbag.”
The Onion Nails It ……… Again
Man Dying From Cancer Spends Last Good Day On Phone With Insurance Company
As an aside, this is the real problem with ObamaCare.
Basically, the ACA brings in John Dillinger to supervise bank security.
Barack Obama, Shut the F%$# Up
Barack Obama has a sad, because it’s all liberal’s fault that Obamacare is unpopular.
Yeah, I guess the fact that he killed the public option and spent the entire process fellating big insurance and big pharma, giving people rate increases, narrow networks, and balance billing had nothing to do with this:
President Barack Obama said on Friday that criticism from the left wing of his own Democratic Party helped feed into the unpopularity of Obamacare, his signature healthcare reform law.
………
But Obama also said Liberals like former Democratic presidential candidate Senator Bernie Sanders had contributed to the program’s unpopularity.
During Sanders’ campaign for the presidential nomination, he proposed replacing Obamacare with a government-run single-payer health insurance system based on Medicare, the government plan for elderly and disabled Americans.
“In the ‘dissatisfied’ column are a whole bunch of Bernie Sanders supporters who wanted a single-payer plan,” Obama said in the interview.
“The problem is not that they think Obamacare is a failure. The problem is that they don’t think it went far enough and that it left too many people still uncovered,” Obama said.
“They” are right.
If you had been more interested in a good policy than you had been to check off a box on your Presidential legacy, the program would have been better, less expensive, and more universal, and far less unpopular.
You improved on the status quo, but you did so in a way calculated to make minimum changes and to keep the malefactors of the US health insurance system in the driver’s seat, because ……… markets.
What’s more, your program was structured in a way to make it as opaque and politically unpopular as possible.
Look in the mirror, dude.
The Glory of the US Medical Industrial Complex
Our healthcare system under-performs by any sane measure of efficiency or outcomes:
Historically, the United States has spent more money than any other country on healthcare.
In the late 1990s, for example, the U.S. spent roughly 13% of GDP on healthcare, compared to about a 9.5% average for all high income countries.
However, in recent years, the difference has become more stark. Last year, as Obamacare continued to roll out, costs in the U.S. reached an all-time high of 17.5% of GDP. That’s over $3 trillion spent on healthcare annually, and the rate of spending is expected accelerate over the next decade.
………
Today’s chart comes to us from economist Max Roser (h/t @NinjaEconomics) and it shows the extreme divergence of the U.S. healthcare system using two simple stats: life expectancy vs. health expenditures per capita.
………
Not only is U.S. healthcare spending wildly inefficient, but it’s also relatively ineffective. It would be one thing to spend more money and get the same results, but according to the above data that is not true. In fact, Americans on average will have shorter lives people in other high income countries.
Life expectancy in the U.S. has nearly flatlined, and it hasn’t yet crossed the 80 year threshold. Meanwhile, Chileans, Greeks, and Israelis are all outliving their American counterparts for a fraction of the associated costs.
For any improvements that Obamacare has made to the medical situation, we still have narrow networks, balance billing, and a system where it is literally impossible to avoid being charged for out of network services, all the things that prevent people from seeking help except when the situation is dire.
Then again, Obama is getting lots of funding for his presidential library and his foundation from Wall Street and health insurance types, so I guess it all works out for him.
Just imagine what he could have netted if he had gotten the TPP through. That library would have gold plated bidets in its executive offices.
H/t The Big Picture
Remember When I Said that Big Pharma was Fueling the Opioid Epidemic?
We now have accusations that drug companies bribed doctors to overprescribe Fentanyl:
Fentanyl is an incredibly potent opioid painkiller; it acts quickly and powerfully, but doesn’t last as long as others, meaning its medical application is limited. So if you’re a drug company trying to boost sales of your new fentanyl spray, how do you sell more of a product that very few people have a real need for? You could bribe doctors with paid “speaking engagements,” take them out and show them the “best nights of their life,” all so they write prescriptions for patients who probably shouldn’t be getting your drug.
This is according on an indictment [PDF] filed yesterday by the Justice Department against the former CEO and five other employees of Insys Therapeutics, makers of the Subsys brand fentanyl spray, a fast-acting form of the drug that was primarily intended for cancer patients experiencing high levels of pain that couldn’t be managed through more traditional opioids.
The DOJ alleges that, starting in 2012, former Insys CEO Michael Babich and his fellow defendants bribed and provided illegal kickbacks to at least ten physicians — mostly operators of pain clinics — in ten different states.
Clearly. the problem is that our regulatory solution does not have enough free market.
I’d like to see a sh%$ load of prosecutions.
Well, This is a Hoot
It appears that in discussions with the Republican Party leadership, representatives of the healthcare and insurance industries said that they Obamacare repealed and replaced with Obamacare:
The nation’s health insurers, resigned to the idea that Republicans will repeal the Affordable Care Act, on Tuesday publicly outlined for the first time what the industry wants to stay in the state marketplaces, which have provided millions of Americans with insurance under the law.
The insurers, some which have already started leaving the marketplaces because they are losing money, say they need a clear commitment from the Trump administration and congressional leaders that the government will continue offsetting some costs for low-income people. They also want to keep in place rules that encourage young and healthy people to sign up, which the insurers say are crucial to a stable market for individual buyers.
………
On Tuesday, Marilyn Tavenner, the chief executive of America’s Health Insurance Plans, a leading industry trade group, warned that the state marketplaces were already on unstable financial footing. Failing to continue the funding aimed at low-income Americans, she said, would have far-reaching consequences because the business would become much tougher for insurers.
………
Hospital groups also held a news conference on Tuesday to warn of what they said would be the dire financial consequences of a repeal if the cuts to hospital funding that were part of the Affordable Care Act were not also restored.
………
Ms. Tavenner did not give many details about her group’s positions, but she said its top priority was to stop the immediate threat of eliminating the subsidies for plans sold to low-income people. House Republicans have already sued to block these payments, and the lawsuit is now delayed. If the new administration chose not to defend the lawsuit, the money would disappear, and insurers would probably rush to the exits because fewer potential customers would be available.
Another of the industry’s concerns is ensuring that enough young and healthy people sign up to stabilize the market. Republicans have discussed eliminating one of the law’s main tools, the so-called individual mandate, a tax levied on those who do not enroll.
In talking with Congress, Ms. Tavenner said, her members are emphasizing the need for some alternative, especially after criticism by insurers that the penalty is not large enough to persuade enough people to enroll. “There’s not one magic solution,” she said. She pointed to some of the provisions in Medicare that encourage people to sign up before they become sick. And she discussed some options to ease how insurers price their policies to be able to offer plans that are less expensive to younger people.
She also argued that the insurers had no desire to return to the time before the law was passed, when people with pre-existing conditions were routinely denied coverage in the individual market.
So basically, they want the subsidies, marketplaces, and mandates, but apart from that they are fine with whatever is done.
Of course, subsidies, marketplaces, and mandates are Obamacare: The rest is commentary.*
*Yes, I am applying a quote from Rabbi Hillel.