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[ame]https://twitter.com/realDonaldTrump/status/697182075045179392[/ame]Comment
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This is sort of amazing and you know what? I will actually give a kudos to Alex Jones for apologizing for an utter bullshit story
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[ame]https://twitter.com/jdawsey1/status/845386061949915142[/ame]Comment
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Extreme inexperience from the House GOP and the White House. Ryan is an ideologue and not really a leader. He is no Pelosi, not even a Boehner.
The dirty secret is the GOP has a decent slice of it's elected leaders that likes the ACA. Some of those yes votes were not solid but they publicly didn't want to publicize it. There was a chance if the vote was forced and it was obvious that they had 30 noes, that might have turned into 50 noes. The ACA is more popular than people think. The concept hasn't changed much, when it was under water in polling it was 40 to 45 percent approve and the opposition was split pretty evenly. Half disapproved because they didn't like it and the other half disapproved because it didn't go far enough.Comment
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One of the Freedom Caucus people (I forget who) said that if the Bill had been simply to repeal Obamacare (no replacement) it would have easily passed. He based this on the fact that Repeal laws passed when Obama was still President.
I don't think that's remotely true. It's easy to vote for a bill that you know the President will veto no matter what. It's nothing more than symbolic. It's tougher to vote for a bill that you know the President's going to sign and thousands of your constituents will be harmed by.Comment
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The Freedom Caucus is delusional, it's like they don't know the ACA was passed with 60 passes. You can't do a straight repeal.Comment
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Some random thoughts from the trenches on the ACA/AHCA .......
Basic health screening - blood pressure, lipids, fasting serum blood sugar, evaluating kidney and liver function, over 40 getting an EKG - has potential to decrease the costs of the later stage care for uncontrolled hypertension, atherosclerotic heart disease and diabetes ....... this assuming that follow-up care is pursued and provided after screening.
The ACA has increased the number of new patient's I see for screening on a daily basis who, heretofore did not have insurance and were unable or unwilling to pay cash for an office visit, routine screening labs and exams ($100 for new patient office visit, depending on age and screening diagnostics - another $100 - $300).
In GA, health insurance obtained through the exchanges is ok but not great. My personal opinion is that even though co-pays might be high and coverage not as generous, individuals should bear a portion of the cost for their care. Keep in mind, GA is one of the 18 states that did not expand Medicaid coverage. So, the new patients I am seeing all obtained commercial insurance in the market place.
This is one of the fundamental benefits to the nation's overall health provided by the ACA. My sense is that the AHCA, especially as the Freedom Caucus wanted it to be formulated, would have reduced the numbers of folks seeking screening.
I actually liked the work provisions for Medicaid eligibles in the AHCA. I posted this up thread a while back that the Medicaid expansion, Medicaid itself, makes it more beneficial to play the system than to be a net tax payer into it by working. When I worked in the ER up until June of last year, the numbers of Medicaid (Wellcare in GA) eligible and enrolled folks I saw coming there for basic care that did work the system was maddening.
Hospitals and for profit, free standing medical practices benefit from increased insurance coverage. These places rarely refuse care (ERs cant under EMTALA) and eat the cost when it is beneficently provided for nothing. The AHCA would have fundamentally reduced the availability of HC insurance increasing the cost burden to HC providers at multiple levels.
If the ACA is to be improved upon, measures need to be undertaken to increase Insurers participation in the market place ...... this is complicated stuff but there are things that can be done at both the federal and state levels that are cost effective.
There needs to be fundamental changes in how pharmaceuticals are made available to HC consumers. Once again, this is also complex but there are reasonable ways to do this. Medicaid formularys hold costs of pharmaceuticals down by implementing innovative competitive processes. Putting those kinds of things in place commercially has potential to do this. The pharmaceutical lobby strongly opposes, conceptually and in practice, all of this. They've achieved success inpreventing any kind of federal legislation to hold pharmaceutical costs down ...... I don't think the Feds should be involved here. The free market has the potential to do this if there were commercial regulatory incentives implemented to increase the kinds of things I posted about regarding value pricing for reimbursements and organizing the delivery of care.Last edited by Jeff Buchanan; March 25, 2017, 07:56 AM.Mission to CFB's National Championship accomplished. But the shine on the NC Trophy is embarrassingly wearing off. It's M B-Ball ..... or hockey or volley ball or name your college sport favorite time ...... until next year.Comment
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Conservatives once warned that Obamacare would produce the Democratic Waterloo. Their inability to accept the principle of universal coverage has, instead, led to their own defeat.
Sent from my iPad using TapatalkGrammar... The difference between feeling your nuts and feeling you're nuts.Comment
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Trump came over to the House on Thursday to talk Republicans into supporting the bill. When it became abundantly clear that Trump pretty much had no clue about the bill's substance, they actually lost votes after the meeting.
Donald Trump had heard enough about policy and process. It was Thursday afternoon and members of the House Freedom Caucus were peppering the president with wonkish concerns about the American Health Care Act—the language that would leave Obamacare’s “essential health benefits” in place, the community rating provision that limited what insurers could charge certain patients, and whether the next two steps of Speaker Paul Ryan’s master plan were even feasible—when Trump decided to cut them off.
"Forget about the little shit," Trump said, according to multiple sources in the room. "Let's focus on the big picture here."
The group of roughly 30 House conservatives, gathered around a mammoth, oval-shaped conference table in the Cabinet Room of the White House, exchanged disapproving looks. Trump wanted to emphasize the political ramifications of the bill's defeat; specifically, he said, it would derail his first-term agenda and imperil his prospects for reelection in 2020. The lawmakers nodded and said they understood. And yet they were disturbed by his dismissiveness. For many of the members, the "little shit" meant the policy details that could make or break their support for the bill—and have far-reaching implications for their constituents and the country.
The president had been working on many of them individually in recent days, typically with what members described as "colorful" phone calls, littered with exaggerations and foul language and hilariously off-topic anecdotes.Comment
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ClownshowComment
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http://m.mentalfloss.com/article.php?id=93520
I thought this was an interesting fluff article about how Germany is making alternative energy work for them.To be a professional means that you don't die. - Takeru "the Tsunami" KobayashiComment
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[ame]https://twitter.com/seanspicer/status/229644347228950528[/ame]Comment
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Drip, drip, dripComment
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