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Tuesday, February 28, 2017

Selling the repeal and replacement of Obamacare

Readers know that I do not freak about President Trump. I support him and try to analyze his moves, without giving him my advice because he does not seek nor need it.

Some are impatient with his handling of the repeal and replacement of the Patient Protection and Affordable Care Act of 2010.

However, his approach is that of a corporate executive, not a politician. And when you are dealing with an industry that represents nearly a fifth of the national economy, diligence matters.

Over the weekend, he met with the nation's governors, focusing on hospitalization insurance -- which is how we finance most of health care.

Republican rival, Governor John Kasich of Ohio said, "He listened very carefully to what I had to say. We talked about the whole range of issues, including the high cost of pharmaceuticals contained in the Medicaid plan."

At the Governors Ball that Trump hosted on Sunday, it was Democratic Governor Terry McAuliffe of Virginia, who made the toast to the president.

After meeting with Trump and Republican Governor Rick Scott of Florida, Republican Governor Scott Walker of Wisconsin said, “Governors are more effective. They’re more efficient. They’re more accountable. For years, governors have said, ‘Give us the tools not just on health care, but on education, transportation, and other issues. Now is our chance to do it.”

On Monday, President Trump met with Brad Wilson, president and CEO of Blue Cross and Blue Shield of North Carolina; Mark Bertolini, chairman and CEO of Aetna; Bruce Broussard, CEO of Humana; and so on, and so on. He wanted them aboard, too.

These are the people who will take the calls from irate constituents and costumers, and who will carry out Trump-o-care.

From CNN:
"We're very glad to be with him today to hear that message and certainly willing and wanting to witness how this all will transition to a workable plan for the United States," said Joe Swedish, CEO of Anthem, which has said it is evaluating whether it will participate in Obamacare next year.
This is a dance, a negotiation, and a way to bring people on board. Getting a Democrat to vote for Trump-o-care seems unlikely but President Trump can get a nice majority of Americans on board by doing the repeal and replacement this way.

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  1. Getting the governors and insurance CEOs on board to help work this really smart. Really. Smart.

    1. I still don't think a lotta people understand how smart Mr. Trump is. He'll get this done.

    2. It boggles the mind that people don't recognize his smarts. But I guess that is a reflection of their lack of smarts.

  2. "repeal and replacement of Obamacare"

    Clyde, scrap the Caddy.

  3. In the few years it has been in effect Obama Care has inserted itself into many facets of the health care industry. It will take some time and much attention to detail to extricate us from its clutches. This cartoon explains it a bit more graphically:

    - Elric

  4. The reason I've been largely silent on this is because of the complexity of the situation.
    I see two approaches. The one I would prefer is to burn the whole thing down. Abolish all occupational licensing and the whole concatenation of institutions, associations and political relationships that such licensing has created. Doing so would also destroy the medical insurance industry and make every medical service rendered subject to market pressures and negotiations. It would require the reinstitution of charity hospitals and foundations to help with catastrophic health problems. We aren't going to get that.
    What we are going to get is a walk-back through the mess the democrats left us with Obamacare and some rejiggering of the insurance model, hopefully setting us on a course to where insurance will no longer be tied to employment. Making insurance mandatory at some basic level may be OK, but doing so in the way done by Obamacare where the basic requirements are up to corrupt state insurance boards and the companies is ridiculous. We ought to be able to buy cheap out of state catastrophic plans for health like we do for cars.
    One other thing to keep in mind is that political arguments that may win the day today may be based on bullshit. Remember how one of the big arguments against HMO's (and I was never a fan of those thing, mind you, I'm just making a point about liars and policy) back in the 1990's was that they were refusing to pay for bone marrow transplants in breast cancer treatment? I knew a doctor who went through three of them at a cost of a hundred thousand dollars each. Well, it turns out the damned things never worked in the first place. The doctor died, by the way. The HMO's were only asking for evidence that they worked before dishing out the millions lusted after by the oncology community, and they were right to.
    But the damn oncologists went about stirring up hatred for HMO's and insurance companies in their lust for that money.
    Money. That's what this is all about. If you want the moneyed interests out of it do it my way. Burn the whole thing down. Make medicine a mom and pop business with charities helping out, not this corporatistic hell that will only get worse.

    1. This IS the right way because it would restore a direct relationship of doctor to patient, but it is probably too late to effect. Doctors in private practice had a brief moment to help control this spiral when Medicare was created by formalizing what many were already doing voluntarily, namely caring for the indigent. But they put their faith in an Academy that betrayed them to Leviathan out of envy and spite.
      What has to be avoided at all costs is a single payer system of government insurance. Free stuff is bad, but really bad when it involves medicine which as you know is a fragile chimera of moral duty and real expense. The more free it appears the worse it gets. In Manhattan where Trump lives it is almost all pay for play but costs are so high most MDs can hardly maintain an office. Still the care for those who pay directly is better than most.
      I hope Obama care dies but I also hope people can be persuaded that coughing up some personally is really in their best interests. A hard sell especially to the young whose economic future Obama and the Democrats sold for the personal Vainglory of a hollow political victory. We often mock the young as living at home in a basement but their plight is real. Even the criminal crier Schumer knows this to be true and admitted it last year when he effectively labeled Ocare a mistake,a now forgotten lapse into the truth which, were it replayed today, he would label a Russian hack and Fake News.

    2. Imagine being stuck between student debt and this ridiculous health care system, and looking forward to a collapsing social safety net that the liberals think they're going to save by importing a bunch people with IQ's of 80.

    3. Obama planned to import them by the thousands because he knew his plan would create a huge sinkhole in available care. Bloomberg said once about the incompetence he was all for but would never experience "Well at least they (those other than himself) will get something!" Virtue broadcasting at megawatt levels fit for a billionaire.

    4. You identify with the tea party? See how far the conversation has moved. We used to start with tort reform and true single payer: you use the service, you pay for it. Now it's how do we fairly reign in corporations. Too far gone. Free market economics has lost because what we believe is a free market has no characteristics of a free market.

  5. People who wanted to "pass the plan (ACA) to see what is in the plan" are now screaming that after 1 month in office Trump is "taking too long."

  6. This is why I thought Trump would be the man for the job.

    The Art Of The Deal.