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Wednesday, July 20, 2016

The Trump campaign health care policy position

Well, as of July 19th, he's no longer "the presumptive nominee," he's now the official GOP candidate.

Count me among the millions of people continually aghast at the prospect of the vulgar, belligerent, policy-detail-dementia'd, make-shit-up-on-the-fly, unabashed war crimes proponent Donald J. Trump as U.S. President in 2017. Nonetheless, he could very well win the election, given Hillary Clinton's ineradicably high "trustworthiness" negatives.

Can we tell what he might actually try to do in the health care space were he to win the White House?

Probably not. But, here's what's on his campaign website.
We will work with Congress to make sure we have a series of reforms ready for implementation that follow free market principles and that will restore economic freedom and certainty to everyone in this country. By following free market principles and working together to create sound public policy that will broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans...

Congress must act. Our elected representatives in the House and Senate must:
  1. Completely repeal Obamacare. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.
  2. Modify existing law that inhibits the sale of health insurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.
  3. Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.
  4. Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.
  5. Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.
  6. Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.
  7. Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.
That's pretty much it. A "Seven Point Plan" at this stage. Oh, and, of course, this:

Providing healthcare to illegal immigrants costs us some $11 billion annually. If we were to simply enforce the current immigration laws and restrict the unbridled granting of visas to this country, we could relieve healthcare cost pressures on state and local governments.
We'll take these up point-by-point shortly (nothing in the foregoing about InfoTech, we can note). But first...

Also, for now, see "Donald Trump’s Health Care Ideas Bewilder Republican Experts."

And, from Politico a few months back:
“It’s kind of warmed-over Republican mush,” said Tom Scully, who was a top health official in George W. Bush’s administration. “I just don’t think there’s a whole lot to shoot at.”
“I’m not sure health care issues matter much to the Trump candidacy,” added Doug McAuliffe, a GOP consultant who worked on Chris Christie’s super PAC before the New Jersey governor dropped out of the race. “The Trump candidacy is based on his vainglorious message. When it comes to issues, he ranges from uninformed to helter skelter.”
Critics say there’s no way to predict where Trump might come out on these issues if he secures the party’s nomination for president. His evolution — from professed admiration of Scotland and Canada’s single-payer health systems to denunciations of health insurers’ profits — suggests a willingness to tout different, in some cases even contradictory positions, based on political expediency.
I'll eventually get around to the health policy proffers of both the Clinton and Libertarian campaigns as well.

Tangentially, see my prior post "145 Tech Leaders on the 2016 election."


The Libertarian candidates (Johnson-Weld) have nothing directly on health care as of today. From their website "Issues" page.

The Hillary Clinton "Issues" page is fairly overflowing with topical detail across a breadth of policy areas. "Health Care" specifically is here.


A young writer reached out to me this morning, offering to comp me his new book in return for a review. He'd seen a comment I'd left on Amazon concerning another book on the topic.

I opted to just buy it and add it to my never-ending reading pile. Looks interesting. Stay tuned.
This book will help anyone who is interested in learning more about death, coping with a loss, approaching death, or explaining death to a child. It is an exploratory journey that includes multiple viewpoints, including Steve Jobs’s embrace of his death, Ray Kurzweil’s striving for immortality, and Joseph Campbell’s view of death as the “ornament of life.” The book looks at death from the perspectives of atheists, Christians, and Tibetan Buddhists, among many others. Interestingly, it considers the often unexplored aspects such as the curious relationship between death and ayahuasca. It is a guidebook, offering insights and comfort on a topic that many find frightening or macabre...
Maybe it's again a good time to contemplate death.
“I genuinely believe that if Trump wins and gets the nuclear codes there is an excellent possibility it will lead to the end of civilization.”
LOL. The guy who ghostwrote "The Art of the Deal." See "DONALD TRUMP’S GHOSTWRITER TELLS ALL."


Speaking of "death."

Okeee Dokeee, then. Never mind any due process quibbles and the precise, narrow Constitutional and statutory definitions of "Treason."

RNC: And Now for a Different Take on Obamacare ACA
m, not repeal, urged by former HHS Secretary

by Shannon Firth
Washington Correspondent, MedPage Today

CLEVELAND -- Could a Republican administration repeal Obamacare? That was the topic up for discussion at a briefing Tuesday, held outside the Republican National Convention.

"I do not believe ... that my political party is going to be able to put together a complete repeal, and I don't think it should," said Tommy Thompson, JD, a fellow of the Council on Foreign Relations, who served as Secretary of Health and Human Services under President George W. Bush, and four terms as governor of Wisconsin...
Maybe they'll want to shoot him as well.


I just learned from my sister that my niece April and her brainiac husband Jeff Nyquist, PhD, co-founders of NeuroTrainer, are taking the Silicon Valley startup VC plunge at the end of this month. Way cool. I first mentioned this project back during WinterTech: "#WinterTech 2016: Venture Capital in #HealthIT."

More on my beloved April here.

The NeuroTrainer Facebook page is here.

New at THCB: "Is the Public Option an Option?" apropos, see my 2009 post "Public Optional."


The principal elevator speech on national health policy in two words (irrespective of party)? "Payment Reform." The finest clinical infrastructure in the world is of no use if people can't access it when in need because of crushing costs.

The 2016 partisan span runs from "Single Payer" (which I took a first run at in 1994) to (the mythical) "Free Market" (via which -- all together now -- to "Repeal and Replace ObamaCare").

This just in from Health Affairs:

Since the Affordable Care Act’s (ACA) health insurance marketplaces first took effect in 2014, news story after story has focused on premium increases for certain plans, in certain cities, or for certain individuals. Based on preliminary reports, premiums now appear set to rise by a substantial amount in 2017.

What these individual data points miss, however, is that average premiums in the individual market actually dropped significantly upon implementation of the ACA, according to our new analysis, even while consumers got better coverage. In other words, people are getting more for less under the ACA.

Covered California, that state’s marketplace, just announced premium increases averaging 13.2 percent. But even if premiums increase by the 10 or 15 percent overall that some are predicting for 2017, they will still be far lower than premiums otherwise would have been in the absence of the law. Moreover, this analysis does not include the effects of premium and cost-sharing subsidies that serve to make ACA marketplace plans more affordable for many people...
Of course, the GOP side is not gonna buy any of this. It's an enduring article of faith for them that if we simply permit the (mythical) "free market" to work its wonders, MRIs will soon cost only $29.99 at Jiffy-Scan in the strip mall, and the CABG px will be a mere $149.99 at the Walmart walk-in AcuteCardioCare Clinic near you.


OK, this is funny. H/T to one of my FB pals.


More to come...

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