Health Care

The Build Back Better Plan

by Dave

Biden’s “Build back better” package is very close to passing. Senator Joe Manchin, Senator from West Virginia, has been in negotiations with Senator Chuck Schumer, to find a way to pass this bill. If it passes, it may have been stripped of very critical elements.

The bill is hated by Republicans. They will immediately point to the enormous cost of the bill. Democrats counter by saying they have closed tax loopholes in the bill so it pays for itself. At least it does as initially proposed.

Link from the White House summarizing the bill. It is a combination of many programs, including extension of child care credits, measures to combat climate change, expand health benefits, reduce prescription drugs costs and expand educational programs beyond high school. I call them the “goodies” and others would call them social benefits.

All eyes are now on Senator Kyrsten Sinema, to see if the bill passes. If Sen. Sinema goes along with the plan, the Senate would be divided 50:50, and VP Kamala Harris could vote to break the tie. The two holdouts are quite different. Senator Joe Manchin is quite vocal on what he doesn’t like in a bill, and has worked with the majority leader to find a compromise. Not so with Senator Sinema. She doesn’t talk to the press.

It appears from the trickle of news, she’s onboard with all the social benefits in the program. She is from Arizona, so unlike Joe Manchin, there is no climate change issues. (Manchin is from West Virginia, known for its coal production). It’s the self funding part of the bill. The claim of Republicans is that it would be absurd to make a massive increase in government spending at a time when the country is on the brink of recession. I admit, they have a point.

The apparent objections from Kyrsten Sinema, are the minimum tax rate of 15% for corporations and the carried forward interest provision. Many corporations have sufficient write-offs so they pay no federal tax.

See link: Sinema Seeks to Keep Private Equity Break, Curb Corporate Tax

So, as the Bloomberg article suggests, if the Democrats satisfy Sinema and reduce the applicability of the minimum tax rate, they lose Manchin. They also will be immediately shown as hypocrites, because they claimed the package was self funding.

The bill will repeal Trump’s personal tax cuts in 2017, the so-called “welfare for the rich,” where rich is defined as those with income over $400,000. So far, leaked reports are that Sinema objections are on the corporate tax benefits (or loopholes), which is still a big piece of the self-funding claim.

I don’t know if we have a “humpty-dumpty” moment, where through the compromises needed to get Manchin and Sinema onboard, we lose the vital elements of the package, one of which is the increase in renewable energy. Trump put us behind for four years, with climate change deniers and fossil fuel advocates. I hoped Biden could reverse this, and bring internation cooperation together again, as Obama was trying hard to do.

I guess the real solution is to elect a few more Democrat senators, so two senators can’t change the bill, so it does not provide what it should (Manchin’s cuts) or is not funded properly (Sinema’s cuts). The Republicans in the end, may celebrate, with a bill that does not deliver the goods, particularly in reduction of fossil fuel consumption and is not self funding. A win for oil companies and corporate America.

Global warming is here. California wildfires continue to grow. Yes, Washburn which threatened Yosemite is under control, but the McKinney fire, right on the California/Oregon border is only 10% contained, and has destroyed 57,000 acres. Horrible injuries and loss of lives with homes and wilderness destroyed.

We can do better than this.

Stay tuned,

Dave

Humpty dumpty reference:

Something beyond repair. from a children’s rhyme: Humpty Dumpty sat on a wall, Humpty Dumpty had a great fall, All the king’s horses, And all the king’s men, Couldn’t put Humpty Dumpty together again.

Making American Great again – for insurance companies

by Dave

Part of the Obamacare program is to provide grants to non-profit organizations to help people obtain coverage for health insurance under the Affordable Care Act.  They are called Navigators, which I think, given the complexities of health insurance, is a wonderful name.   Their budget was slashed in 2017, after Trump was elected from 63 million to 36 million dollars.  Now only 10 million dollars will be budgeted.

It gets worse.  The navigators will help people get insurance plans which are not at all compliant with the Affordable Care Act.  The navigators should inform consumers of other options, like “association health plan” and short term, limited duration insurance  lacking in standard health services like preventative services and prescription drug coverage.

Democrat Senator Ron Wyden got it right when he stated, “This move amounts to federally funded fraud – paying groups to sell unsuspecting Americans on junk plans.”

One last element is guaranteed to open the door wide open to fraud.  The Navigator groups are not required to have a physical presence in the areas where they operate.  This means it’s going to be on internet, and over chat sessions.   It’s going to be bad.  Ron Wyden says Trump is on a sabotage crusade to wreck the Affordable Care Act.  That’s exactly right.

Stay tuned,

Dave

Breastfeeding Resolution – Additional comments

by Dave

I neglected to add a few items. First, after the resolution was introduced by Russia instead of Ecuador,  it passed.  I don’t know the final vote.   Frequently, when it becomes obvious that a resolution will pass, and it is not what the US wants, countries will simply abstain.

I also neglected to include the entire Trump tweet,  which says  the US “strongly supports breastfeeding but we don’t believe women should be denied access to formula. Many women need this option because of malnutrition and poverty.”   Along with calling the New York Times article a “fake”,  this is equally dishonest.  There was nothing in the resolution denying access to formula.  Of course, this would be impossible.   WHO and other women’s health organization all recognize that when breast feeding is not possible, then formula is the right solution and women have to be able to purchase formula.

The US Health and Human Services put out a statement, saying this was a women’s choice.   Of course it is.   But unfortunately, they are often fed wrong information from advertisers.  All the World Health Organization was trying to do, is counter decades of formula promotion.

A link to the original New York Times article was not given.   It looked like it was for subscribers only,  but really NYT maintains a limit on the number of free accesses, which I guess I used up.  Here’s the original story:  NYT article.

Every journalist would like actual quotes from people attending the meeting.   NYT articles simply stated that:

The showdown over the issue was recounted by more than a dozen participants from several countries, many of whom requested anonymity because they feared retaliation from the United States. Health advocates scrambled to find another sponsor for the resolution, but at least a dozen countries, most of them poor nations in Africa and Latin America, backed off, citing fears of retaliation, according to officials from Uruguay, Mexico and the United States.“We were astonished, appalled and also saddened,” said Patti Rundall, the policy director of the British advocacy group Baby Milk Action, who has attended meetings of the assembly, the decision-making body of the World Health Organization, since the late 1980s.

Health and Human Services responded as follows:

“We recognize not all women are able to breast-feed for a variety of reasons. These women should have the choice and access to alternatives for the health of their babies, and not be stigmatized for the ways in which they are able to do so.” The spokesman asked to remain anonymous in order to speak more freely.

Again, this misinformation about choice and access.  It wasn’t part of the WHO  resolution.   Of course, HHS isn’t about to issue a statement that perhaps all the millions of dollars of political donations could be impacted, if Trump supported the breastfeeding resolution.

I am very glad we have journalists like Adam Jacobs,  with the New York Times, who provide accurate honest reporting.   I really put facts first.

Both Bush and Obama supported the World Health Organizations efforts in breastfeeding as the preferred feeding at least in the first 6 months.  If fact,  George W. Bush was a very strong advocate, as per the “failing fake NYT:

Twelve years ago, during the George W. Bush administration, the Department of Health and Human Services promoted breast-feeding in a public health campaign that suggested that failing to breast-feed would be as bad for your baby as riding a mechanical bull while pregnant. A senior scientific adviser to the Office on Women’s Health in the department at that time said that it was risky not to breast-feed, and compared not breast-feeding to smoking during pregnancy.

The breastfeeding incident would not be so bad, if the Trump administration just backed off, and apologized to Ecuador for their heavy handed approach.  It is hardly Trump’s style.  And his combination of threats and demands hasn’t been working in many areas.  Hillary Clinton’s campaign slogan of “Stronger Together”  can be restated as “Weaker apart” – case in point being the recent NATO summit, or the NAFTA negotiations, or trade war with China.

The swamp has been referred to by Donald Trump as the cozy relation of business lobbyists to government.  The main targets of industry are those that make regulations,  the Environmental Protection Agency,  Department of Interior (oil drilling leases), Department of Energy,  Consumer Finance and Protection Bureau, and of course,  Health and Human Services. It’s filling up fast, particularly at the EPA.

I think we will hear more about HHS in this month.  HHS is now defying the court ordered re-uniting of illegal immigrant parents with  children.

Stay tuned,

Dave

Breastfeeding resolution

by Dave

Truly disgraceful is a term Trump uses whenever the Deputy  Attorney General Rosenstein or Special Counsel Mueller begins investigating friends and Trump campaign officials of breaking the law.  It isn’t.  It’s good to see the laws of our country  applied equally.  The Trump foundation can be investigated just as thoroughly as the Clinton foundation.

What was truly sad, and disgraced our country is the action taken by the US at the World Health Organization.  I came close to crying when I read it.   Not fake news, Donald Trump.   Real shameful action by the US to help US companies producing baby formula to the detriment of their baby’s immune system.

Excellent research,  much of it by US scientists in close collaboration with other scientists around the world, has resulted in a much better understanding of the immune system, and how to keep us disease resistant, beginning at age 0 with mother’s milk.   I think there isn’t a mother in the world  who doesn’t want the best health for her infant.  But there is a tremendous amount of advertising which has been going on for decades, telling new moms that formula is better in general.

This is the USA Today’s story:

No country in the world supports breastfeeding moms like they should, according to a new report released Tuesday by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).  WHO and UNICEF recommend mothers breastfeed infants within the first hour of birth, exclusively for six months and continue breastfeeding, while adding complementary foods, until the child is at least 2-years-old. Breastfeeding has a host of health benefits, most notably improving a baby’s immunity.   “Breastmilk works like a baby’s first vaccine, protecting infants from potentially deadly diseases and giving them all the nourishment they need to survive and thrive,” Tedros Adhanom Ghebreyesus, director-general of WHO, said in a release.

According to Dr. Prakash Sunder Shrestha, President of the Nepal Breastfeeding Promotion Forum, “The persistent failure of governments to invest significantly in breastfeeding is hard to
comprehend. Many thousands of babies die each year because they did not enjoy the benefit of breastfeeding and multiple thousands more grow up deprived of the many wonders of this special gift of god of nature and of the mother.

The NYT reports:

,” A resolution to encourage breast-feeding was expected to be approved quickly and easily by hundreds of government delegates who gathered this spring in Geneva for the United Nations-affiliated World Health Assembly…  the US delegation, embracing the interests of infant formula manufacturers, upend the deliberations.”

Ecuador was ready to sponsor the resolution. The US objected to two key passages, calling on countries to “protect, promote and support breastfeeding”  and another passage to restrict the promotion of food products which many experts say have a deleterious effects on children.  Another words,  remove any significant recommended actions.

This was crazy and really sad.    The US did not negotiate with Ecuador; it threaten them with a cut off of all military and foreign aid if Ecuador did not remove these key statements.   Ecuador refused to cave in to US demands, but did not want to introduce the resolution.  It got ugly:

The showdown over the issue was recounted by more than a dozen participants from several countries, many of whom requested anonymity because they feared retaliation from the US.  Health advocates scrambled to find another sponsor for the resolution, but at least a dozen countries, most of them poor nations in Africa and Latin America, backed off, citing fears of retaliation according to officials from Uruguay, Mexico and the US.

Finally, Russia came to the rescue, introducing the resolution to the World Health Assembly.

Of course, Donald Trump tweeted that none of this was true.

“The failing NY Times Fake News story today about breast feeding must be called out.” (See PS)

The Trump administration and its  support for business profits above everything, including keeping babies healthy, which needs to be called out.   Poorer  countries have another problem – contaminated water is often mixed with the formula.   Mothers sometimes dilute the formula to make it last longer- resulting in malnutrition.   Profits from baby’s formula and snacks totaled 71 billion dollars.  There’s millions of dollars ready to support the formula makers, and nothing there to help support the mothers, particular from the HHS.

Read the links, then decide who should be “called out.”

Stay tuned,

Dave

PS:  (7/12/18):  I didn’t include the full Trump tweet, which stated: US “strongly supports breastfeeding but we don’t believe women should be denied access to formula. Many women need this option because of malnutrition and poverty.”    Still dishonest, because there was nothing in this resolution denying access to formula.

See Reuter’s article:

https://www.theatlantic.com/health/archive/2018/07/the-epic-battle-between-breast-milk-and-infant-formula-companies/564782/

https://www.bupaglobal.com/en/your-wellbeing/family-life/breastfeeding-around-the-world

 

 

The Art of the Deal: Fixing Obamacare

by Dave

Since the ACA was passed in 2010, the Republicans have predicted the eventual demise, either through court challenges or legislative repeal. President Trump nominated Tom Price as the Health and Human Services Department. He demonstrated a real knack of avoiding the question, and instead talking in general terms of what are the good intentions of the Department.  Spin all the positives possible.

The question Price would like to respond to, is: “Doesn’t the Department have the public’s best interest in mind when it comes to health care?” Or at least “Isn’t everything proposed by Republicans excellent, as compared to what we have.”

The link below is his interview on Meet the Press:

Youtube video: Meet the Press

He is correct that HHS administers five health plans.  He’d love to talk about the other 4 non-controversial plans.

Trump has tweeted repeatedly, is that he will never own Obamacare, just let it implode.   So Price as the plan’s administrator will be accused of neglecting the program for partisan purposes.

Now,  any fix of Obamacare will not happen with Tom Price as secretary.   What a fix would entail is increased subsidies for lower income families to encourage enrollment  massive advertising with reminders that people without insurance will face tax penalties.    It will take legislative action to fix Obamacare.

Trump could emerge on top, being the ultimate deal maker between feuding Democrats and Republicans.  To avoid alienating Republicans, he should never talk of a fix, but rather a merger of taking the best of both plans, and putting together one that will work for all Americans.    Call it a consolidated or reconciled bill or non-partisan bill.   Yes, that’s BS, but it’s the only BS that will work.   Price would be replaced by a real expert in healthcare systems.  Defunding of Planned Parenthood and abortion payments would not be part of the consolidated plan.

The Democrats have come up with a new slogan,  “A Better Deal” in which they will include a promise of a better health plan.   Trump would steal their thunder by endorsing what is basically their plan.

The Trump health plan would be despised by many Republicans, but now it would be the Republicans who would have to vote down something the Democrats support.

Stay tuned,

Dave