The Republican plot to devour retirees’ nest eggs…AKA Balanced Billing

Given that all the soon-to-be president said on the campaign trail it is hard for me to determine just what he is for or against.  He has nominated a backer of the “balanced billing” as head of the DHH so I assume he is in favor of putting a major chuck of healthcare expenses on the backs of us seniors.  Here is a story about that:

Perhaps the most monstrous thing about the American medical system — and the bar for that title is high indeed — is predatory billing.

A great many medical providers adjust their prices based on how defenseless the patient is, and bleed the weakest ones for every last red cent, often with preposterously inflated charges for things like aspirin and bandages. A 2015 study looked at the worst price gougers in the country and found 50 hospitals that charged uninsured people roughly 10 times the actual cost of care.

Key to this practice is something called “balance billing,” and it’s why the American Medical Association is strongly supporting Donald Trump’s pick of Rep. Tom Price (R-Ga.) to lead the Department of Health and Human Services, which oversees Medicare. Balance billing is forbidden for Medicare enrollees, but Price wants to allow it — thus allowing doctors and hospitals to devour the nest eggs of thousands of American seniors.

So what is balance billing? It’s the practice of billing the patient for the difference between the sticker price and what insurance will pay. So if a hospital visit costs $1,000, but your insurance will only cover $300, some providers will “balance bill” you for $700….

But allowing balance billing in Medicare is a straight-up evil policy. Republicans will attempt to camouflage it as allowing “free contracts” between patients and doctors or similar nonsense. Don’t believe a word of it, seniors. They want your retirement money.

Source: The Republican plot to devour retirees’ nest eggs

Will Mr. Trump actually back this idea of turning seniors over to the mercy of healthcare providers? I hear stories of the uninsured being billed several times more than the insurance companies pay. To allow people who can’t afford insurance to be gouged in this manner  seems out and out evil to me but that is what some of the folks in the GOP intend to do.

I’m sure they will take advantage of it with a Medicare change also. The Republicans like Mr. Ryan would love to completely eliminate Medicare but they realize that it would be a death sentence to maintaining their political office.

But as I said at the beginning of this post we really don’t know where Mr. Trump will come down on this issue or any other for that matter.  I mainly bring up this topic so that when seniors hear a term called “balanced billing” hidden inside the upcoming Medicare debates they will understand it really means gutting this protection for us and future seniors.  But that has been the agenda for the right wing of the GOP since Medicare’s inception fifty years ago. Unfortunately now could just be the time that they actually do it.


Apples and Oranges… Definitely


The contrast between the outgoing president and the incoming one could not be more stark. One thoroughly thinks through a situation while the other takes gut action with little or no knowledge of the situation. One is perhaps too cautious and the other is absolutely too dangerous.

 “I know more about ISIS than the generals do, believe me,” he said. He didn’t need to seek counsel on foreign affairs because “I have a very good brain and I’ve said a lot of things.” And in an interview on Sunday, he said he isn’t bothering to receive daily intelligence briefings like previous presidents did, because “I’m, like, a smart person.”

So Trump knows all. Yet at the same time, he tries to convince the public that there’s almost no such thing as truth. He lies constantly, of course, dismissing any evidence contrary to the position he’s taking at a particular moment as nothing but the product of dishonest media or his partisan opponents. He’ll even say something, then tell you he never said it….

This is shaping up to be a president and an administration that not only thinks they know what they don’t actually know, but won’t accept what they ought to know. And the contrast with the president Trump is replacing could hardly be more stark. One of Barack Obama’s most important intellectual traits is his high tolerance for ambiguity and uncertainty. Unlike some of his predecessors, Obama is eager to admit that there are some things we struggle to predict, that we might be wrong, and that our decisions could produce unintended consequences…

One could argue that at times Obama was too cautious, too concerned with what he didn’t know or could not be known. But now we’ll find out what it’s like to have a president who thinks he knows everything, even as he knows almost nothing.

Source: Donald Trump, the all-knowing know-nothing

I think it is safe to say that we have never had a president even remotely like the one who will soon be taking over the Oval Office. I try not to be fearful about much as fear is usually more damaging to  your personal sense than anything it could provide. But this Trump presidency does scare me. He is just so reckless with his words (tweets) that I am sure it was cause frequent problems for our country and its established freedoms and liberties.

But I also try to be the optimist in that I believe our system of checks and balances will ameliorate much of his recklessness.  But maybe that is putting too much hope into our broken legislative arena? Since Republicans will also control the congress and probably the Supreme court will there be enough people there  who put loyalty to country above party to reign in this incoming president?  I have my doubts but then again I try to be an optimist.


Hastening FDA Approvals …

I am currently reading a book by Tom Friedman about the pace of change in our world today. I will soon be putting out a post on the book but the point for mentioning it here is that it has gotten me to think differently about many of our current regulatory process and how they need to be speeded up. One of those areas is the FDA approval of new drugs. Here is something about that from my friends at the PBS Newshour.

HARI SREENIVASAN: And, Ed, this has already gotten pushback from the likes of Bernie Sanders and Elizabeth Warren.

ED SILVERMAN: Right.Well, the concern is that, in making the approval process more flexible for new uses for existing medicines, it’s actually lowering the standards, because of instead of using what is considered the gold standard, randomized control trial, the new approach would allow the agency possibly to look at other sorts of data, something like safety surveillance data, patient-reported outcomes, these observational studies.

These are the sorts of things that are legitimately useful and tell us real things, but they’re not the same as having a full-blown trial. And that’s the sort of tool that is used to determine the safety and effectiveness of any medicine. So, that’s a big potential difference.

Source: Major health bill would fund medical research, hasten FDA approvals | PBS NewsHour

There are many in my generation who are very risk averse, they will do almost anything to reduce risk to as near zero as possible.  Unfortunately that concept is proving to be more  harmful than helpful in our fast moving world of today and especially tomorrow.

I can remember in my corporate  worklife how the stodgy corporation I worked for when they told me “We encourage you to take risks, just never fail”. In other words don’t take risks. If we are to survive the coming years we need to shed that mentality.

If Tom Friedman is correct, and I think he is, medical technology will be speeding up more and more in the coming years. Now that  the gnome has been mapped we are starting to learn at a much more rapid pace than ever in the past. As is the case in the technology field what is invented today will be obsolete in three to five years to be replaced by the next generation of advances.  We are now advancing in these fields more in 5 years than in the previous one hundred and that pace will only become faster and faster in the coming years.

To me it goes something like this.  Yes, we can spend 6 years testing a drug to make sure that that one person in 10,000 is not harmed but by doing that we are denying the other 9,999 the benefits of its use.  We simply can’t go at a snails pace when the rest of the world will be running like jackrabbits. Even now the U.S. is falling behind in the drug race. Part of it is due to the extreme testing process and another by the exorbitant profits demand by U.S. drug manufactures. Too many regulations in one area and not enough in the other…

There Is No Such Thing As Facts Or Truth Anymore..

Are we entering a different world now or is this just a dangerous  curve in the road? That seems to be the question that many are asking. As the below quote says all of the people around our future president basically are saying that he is simply someone pushing the envelope when he tells us out and out lies.

One pro-Trump pundit argued last week, for example, that there’s “no such thing” as facts anymore. Corey Lewandowski added that American voters “understood that sometimes, when you have a conversation with people, whether it’s around the dinner table or at a bar, you’re going to say things, and sometimes you don’t have all the facts to back it up.”

2016-12-05_14-36-08.pngOutgoing RNC Chairman Reince Priebus, who’ll soon become the White House chief of staff, was asked on CBS’s “Face the Nation” yesterday about Trump lying about voter fraud. Priebus, without proof, said it’s “possible” that millions of illegal ballots were cast. When host John Dickerson noted that there is no evidence to support such a claim, Priebus responded, “I think the president-elect is someone who has pushed the envelope and caused people to think in this country.”

This is, of course, bordering on madness. Asked to defend his boss’ demonstrable lie, the incoming White House chief of staff thinks it’s great that the president-elect is “pushing the envelope” – as if making transparently false claims to the nation is somehow cutting-edge….

This is no small moment. Americans are being told that their incoming president lied to them, got caught, and this is somehow a positive development that should inspire confidence in our reality-challenged leader….

When he lies, are Americans supposed to give Trump a pass because he likes to “push the envelope”? When the president chooses to replace the truth with ridiculous falsehoods, are we supposed to find this “refreshing” because most presidents at least try to be honest?

Source: Trump allies defend his election lie as ‘refreshing’ | MSNBC

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Part 6 – How Did We Get Here — A Sense Of Dignity..

slice26  This is a continuing post on trying to understand how we got to where we are in America today. Lets start off with some quotes from a recent PBS Newshour:

DAVID BROOKS:  On the issues, they preferred her. She got better marks on the economy and foreign policy. But they just didn’t get the sense she was a reformer. So they want some unnamed change.

I think they also wanted some sense of dignity, some sense of being heard. I mean, in some sense, there is something noble, in that people that was people who felt marginalized, working-class voters, A, taking over their party fromsandb21 basically what had been a corporate party, and then asserting their will on the country, against groups of people who were more privileged than they are, both on the left and the right….

And so there is something nice about that. I think Trump is the wrong vehicle for that. But, you know, you’re living in a town, there are no jobs in the town, you know your friends are dying of O.D.-ing on opiates or something, you’re having trouble paying your bills, you’re playing by the rules, and other people are getting benefits without playing by the rules.

Maybe you’re willing to tolerate a lot of bigotry from Donald Trump if you say, just change things, just change things.

And so I don’t — I think the voters who voted for him certainly are willing to tolerate a lot of ugliness, but maybe, if you’re in desperate circumstances, or you think the country is deeply in trouble, you’re willing to tolerate that without necessarily liking it.

Source: Shields and Brooks on a ‘political earthquake’ and how America can move forward | PBS NewsHour

I think Mr. Brooks seems to have a good sense of what the Trump voter might be like. They are frustrated that the world is moving too fast and their “skills” no longer matter in the 21st century. They don’t see a path forward for them or their children.  And that is where the trouble mainly lies.  It is now a fact of life that in order to make it in this new world order you must be willing to embrace change and lifelong learning and many of our institution are just not set up to make that happen yet. Especially those in more isolated areas. Read more