Secretary Tom Price had a strange and somewhat incoherent interview with CNN’s Dr. Sanjay Gupta.

Here are the most insane moments of their interview:

#1 – Price refused to admit that it “defies common sense” to strip away $1 trillion from healthcare funding when Trump promised to get all Americans insured with the government’s help.

#2 – Price declared that Medicaid patients are only concerned about losing their Medicaid because they are afraid of something “new.”

#3 – Price struggled to defend efforts to gut the requirement for essential health benefits, which provide coverage for things like hospitalizations, maternity care and prescription drugs, offering such sweeping generalities that the only reply Dr. Gupta could offer was, “I don’t know what that means.”

#4 – Price could not refute Gupta’s assertion that TrumpCare would legalize healthcare “plans that are cheap but useless.”

#5 – Even though the TrumpCare plan he tried to push through Congress would put insurance out of reach for 24 million people and repeal the individual mandate, Price proved himself utterly divorced from realty by agreeing that “absolutely,” everyone should have insurance.

Vox had two great articles on the opiod crisis.  Drug overdoses now kill more Americans than HIV/AIDS did at its peak. In 2015, more than 52,000 people died of drug overdoses, nearly two-thirds of which were linked to opioids like Percocet, OxyContin, heroin, and fentanyl. That’s more drug overdose deaths than any other period in US history — even more than past heroin epidemics, the crack epidemic, or the recent meth epidemic. And the preliminary data we have from 2016 suggests that the epidemic may have gotten worse since 2015.  Vox has maps and charts that tell the story:

  1.  Drug overdoses now kill more people than gun homicides and car crashes combined.
  2. Drug, painkiller, heroin, and other opioid overdose deaths are still on the rise.
  3. Opioid overdoses are one reason US life expectancy declined for the first time in decades.
  4. The epidemic is much worse in some states than others.
  5. By and large, the drug overdose epidemic has hit white Americans the hardest.
  6. Americans consume more opioids than any other country.
  7. In some states such as South Carolina, doctors have filled out more painkiller prescriptions than there are people.
  8. Drug companies have made a lot of money from opioids.
  9. At the same time, Americans report greater levels of pain.

A Senate investigation into the pharmaceutical companies’ role and responsibility for the nation’s worst drug overdose crisis in history:  Sen. Claire McCaskill (D-MO), the top Democrat on the Senate Homeland Security and Governmental Affairs Committee, announced that she is requesting marketing, sales, and addiction study material from the companies behind America’s top five opioid products. The investigation, she said, will draw out the role that opioid manufacturers played in causing the epidemic and letting it continue.

As USA Today noted, McCaskill will need Republican support on the committee to be able to subpoena opioid makers’ documents should the companies not comply with her requests.

Drug manufacturers played a major role in the epidemic. By marketing their opioid painkillers as safe and effective, they convinced doctors to prescribe painkillers in droves to patients. That allowed the drugs to proliferate, leading not just to widespread painkiller misuse but also to the misuse of more dangerous opioids like heroin and illegally manufactured fentanyl. With this, the risk of overdose increased — spawning the opioid crisis we have today. As opioid painkiller sales increased, more people got addicted — and died.Annual Review of Public Health

Much of this was the result of misleading marketing by major drug companies. In fact, Purdue Pharma, a producer of “hillbilly herion” OxyContin, in 2007 was forced to pay hundreds of millions of dollars in fines due to its false claims about opioids.

In wide-ranging investigations, the Los Angeles Times has uncovered more evidence of how Purdue’s misleading advertisement played out at the ground level. It found that Purdue exaggerated the effectiveness and safety of OxyContin, while covering up any criticisms and complaints about the drug. As a particularly egregious example of why Purdue and its marketers did this, one sales memo uncovered by the Times was literally titled “$$$$$$$$$$$$$ It’s Bonus Time in the Neighborhood!”

Other opioid makers have faced similar allegations. Insys, a drugmaker, allegedly pushed its fentanyl spray for uses far beyond late-stage cancer pain treatment, according to McCaskill’s office. A sales representative claimed that the company’s informal motto was, “Start them high and hope they don’t die.”

A 2014 study in JAMA Psychiatry found many painkiller users were moving on to heroin, and a 2015 analysis by the Centers for Disease Control and Prevention found that people who are addicted to prescription painkillers are 40 times more likely to be addicted to heroin.

Most Americans (50%) get health insurance through their work, and another 34 percent rely on the government through Medicare or Medicaid. Because of the ACA, only 9 percent are uninsured. The rest — those who are too young to qualify for Medicare and too rich to qualify for Medicaid but want to buy insurance — deal with insurers that sell plans to individuals.

The Obamacare exchanges created to help some 13 million Americans buy quality and affordable insurance outside of the employer-based market. And the overwhelming majority of these people happen to live in rural parts of the country — the very same places that voted for Donald Trump.

Map of counties with 1 ACA insurer and how they voted in the 2016 election

Will Trump undermine these marketplaces or try to make them work by messing with or weakening provisions like the individual mandate or the subsidies?

If Trump wants to reduce the whole structure of the ACA into unworkable rubble so that Democrats will have to agree to replace it, the administration will have to sabotage it. Unfortunately, there’s a pretty easy path for them to do it.

First, the administration could eliminate enforcement of the individual mandate, which requires Americans to buy health insurance or pay a tax penalty.

Second, the administration could cut outreach about open enrollment.

Third, if Trump wants to throw Obamacare’s exchanges into chaos, he could choose to stop defending a lawsuit filed by the House of Representatives that attempted to halt the government from making what are known as “cost-sharing reduction” payments to insurers. Under the Affordable Care Act, carriers are required to limit how much low-income customers pay out of pocket for things like deductibles and co-pays. In return, the companies are supposed to get direct subsidy payments from Washington to cover the expense. Those checks are worth billions to the industry, since more than half of marketplace enrollees benefit from cost-sharing reductions, and are absolutely essential to making the marketplaces work.

Republicans in the House of Representatives sued the Obama administration a few years ago to stop the payments, arguing that because Congress had never technically allocated the money to fund them, the government was disbursing the cash illegally. If Trump drops the appeal, it could have profoundly damaging consequences for the insurance market. Insurers would still be required to keep offering low-income customers their discounts but wouldn’t be compensated for it. The result would be financially disastrous.  Ending the cost-sharing reduction payments would require an active decision on the Trump administration’s part.

Buzzfeed had an article about Secretary Tom Price’s refusal to acknowledge his Constitutional duty to follow the law of the land as it pertains to regulations in the ACA.  Price is the man in charge of either fixing Obamacare, or neglecting Obamacare but he refuses to disclose what he will do after Republicans failed to pass a bill repealing the law.  Price avoided giving direct answers about whether he will try to strengthen or weaken Affordable Care Act regulations when he appeared before the House Appropriations Committee last week.

He could make changes that independent experts, insurers, and health care providers are calling for to stabilize markets and bring down prices. Or, as Trump proposed, he could do nothing and cause some markets to fail.

Larry Levitt of the Kaiser Family Foundation told BuzzFeed News the best thing the Trump administration could do for markets is clear up this uncertainty.

“The single most important thing the Trump administration could do right now is to assure insurance companies that it intends to run the program effectively,” said Levitt.

“That would include things like continuing outreach, enforcing the individual mandate, making the cost-sharing subsidy payments to insurers, and settling the lawsuit over the risk corridor program and making those payments.”

The administration could significantly bring down premiums by supporting these programs and enforcing the individual mandate, Andy Slavitt, an administrator at the Centers for Medicare and Medicaid Services, argued in a recent op-ed.

URGENT!  OPPOSE ANTI-LIFE LEGISLATION!

Dear Friend,

Next Wednesday, March 29, the House of Representatives will consider legislation that, if passed, will arbitrarily devalue human life and will make it much more difficult to hold abortionists and birth control drug manufacturers accountable in American courts.  As a friend and fellow supporter of the pro-life cause, I urge you to contact your state’s congressmen and tell them to vote NO on this offensive effort to devalue human life and undermine Americans’ right to hold abortionists and birth control drug manufacturers accountable for the harms they have caused.

H.R. 1215, the “Protecting Access to Care Act,” would limit recovery for families who have lost their ability to have children due to preventable medical errors.  The bill would place a maximum value of $250,000 in non-economic damages no matter how egregious the conduct, even in cases where a doctor intentionally sterilizes a man or woman against his or her will.  Depriving someone of the ability to have children can never be adequately compensated, but capping the value of their suffering is just plain offensive.  For this reason alone, H.R. 1215 must be opposed.

The bill, however, would have other anti-life effects.  For example, H.R. 1215 devalues the life of children, mothers, and the elderly.  By imposing caps on non-economic damages, H.R. 1215 devalues human life without regard for the facts of any particular case.  Because children, the elderly, and stay at home moms usually have significantly reduced economic earning potentials (and thus economic damages), the vast majority of damages in their cases come from loss of life, pain and suffering, and other hedonic damages.  By arbitrarily capping these types of damages, Congress is devaluing the worth of our children, mothers, and grandparents’ lives.

     Furthermore, H.R. 1215 immunizes abortionists and birth control drug manufacturers.  When abortionists prescribe life-ending drugs like Mifepristone and Misoprostol to terminate healthy pregnancies, they should be held accountable when even more devastating injuries occur. H.R. 1215 would immunize the negligence of abortionists and shield defective birth control drug manufacturers from liability.  When providers and prescribers can’t be held responsible for the defects in abortifacients, they are more likely to be prescribed.

In short, this legislation seeks to attack pro-life policies by way of restricting citizens’ ability to hold bad actors accountable.  To be clear, the American citizens did not ask for this legislation – well-connected and well-funded special interests did.  It is reprehensible that this Congress is considering legislation that would promote anti-life policies through the backdoor of “civil justice reform”.  I ask that you contact your state’s congressmen and tell them to fight this arbitrary devaluation of human life, protect the rights of Americans to hold abortionists and birth control drug manufacturers accountable in court, and vote NO on this anti-life legislation.

With kindest personal regards, we remain

                                          Sincerely,

HUNTER W. LUNDY

Wow.  Where to start.  There have been so many articles about how bad Trumpcare is for everyone except insurance companies and rich people.

Vox analyzed the net financial impact of the Republican bill on premiums, after tax credits, plus cost-sharing. “We estimate that the bill would increase costs for the average enrollee by $1,542, for the year, if the bill were in effect today. In 2020, the bill would increase costs for the average enrollee by $2,409.”

“In general, the impact of the Republican bill would be particularly severe for older individuals, ages 55 to 64. Their costs would increase by $5,269 if the bill went into effect today and by $6,971 in 2020. Individuals with income below 250 percent of the federal poverty line would see their costs increase by $2,945 today and by $4,061 in 2020.”

Buzzfeed reported that Trumpcare  includes a tax break for insurance company executives making over $500,000 per year.  The average compensation for top health insurance executives is in the millions. In 2014 the Institute for Policy Studies found that this cap generated $72 million in additional tax revenue.

Companies can generally deduct employee salaries as a business expense but in 2013 the Affordable Care Act capped the deductions on health insurance executive salaries at $500,000.

NPR had a sober article explaining why the Republican plan will not fix any of the current problems with health care coverage. NPR explains why the law will not increase coverage, provide the consumers more chocie, or lower health care costs.

As part of Obamacare, the federal government increased payroll taxes to help pay for the Medicare Trust Fund. That fund is used to reimburse hospitals when seniors come in and need treatment.

Trump’s bill does away with those new taxes. As a result, the Medicare Trust Fund would go broke about four years earlier than currently projected, in 2025 instead of 2029. This would either force hospitals to either swallow the costs themselves, turn away Medicare enrollees, or both. Here’s what the tax repeal would do to the trust fund, according to the Brookings Institution:

Repealing the ACA’s tax on high income households and hospitals would exhaust the Medicare Trust fund by 2024 http://brook.gs/2hSsObR 

Contribution from freelance writer, Jessica Walter.

The U.S. Senate Lists Worst Scams Targeting Seniors

Fraudsters impersonating the IRS and conning thousands of people, have led to the U.S. Senate publishing the top scams targeting the country’s older people. The Treasury Inspector General for Tax Administration called these scams ‘the most persistent fraud in IRS history’. Targeting over 1.97 million people, they call seniors telling them that they will be arrested unless they immediately pay alleged tax debts.

Scams Covered More Than 21 States

A review of over 5 million complaints lodged with the Federal Trade Commission from 2015 to 2016, revealed that America’s over 60s population mostly reported imposter scams, tech support hoaxes and telemarketing practices. It’s believed that the IRS scammers conned victims in at least 21 states. One senior told a committee that he had lost around $8,000 to fraudsters impersonating the IRS, who threatened him that he would be arrested ‘within an hour’ if he didn’t pay what they said he owed in overdue taxes. Overall, in 2010, this type of theft cost seniors over $2.9 billion, according to the MetLife Mature Market Institute.

60% of Senior Survey Respondents Targeted by Scammers

In a separate survey conducted by Home Instead Inc, it was found that over 60% of American seniors who took part have been targeted by an online scam. 38% of seniors said that someone had tried to scam them online, while 28% said they had downloaded a computer virus by mistake.

Why are Seniors Targeted?

Unfortunately, many scammers see older people as easy pray for their scams. Sometimes, when an older person is quite isolated and lonely, they are more vulnerable to these types of crimes. When a professional and friendly person calls, and engages them in a friendly conversation, the senior can often end up trapped by the attention. Quite often the scammers are very experienced and can tell when someone would make a good target. But seniors shouldn’t automatically be seen as easy targets by scammers, just because they are older. In fact, while there are of course vulnerable elderly people, there are also a growing number of ‘superagers’, who stay active, both mentally and physically, enjoy being challenged and are on a par with the average 25-year-old.

What Seniors (or Anyone) Can Do to Protect Themselves

Social Security, the IRS and Medicare & Medicaid Services do not make phone calls asking for Social Security details or bank information. People should not give out their private details over the phone. If people believe they are victims of fraud, they should call the relevant companies directly, make a report with local police and inform the Federal Trade Commission.

Be wary of emails or messages that request urgent action, such as a problem with a bank account or taxes. These are very likely to be a scam. If you are unsure at all, contact the companies directly by phone to check whether the messages are legitimate. Be cautious about what you share on social media. Remember you can adjust privacy settings to limit who can see what information.

If you’re interested in Jess’s writing, contact her!

The New York Times reported that The American Medical Association, a powerful lobbying group representing the nation’s doctors, announced that it opposed the House Republicans’ proposed legislation to replace the federal health care law, because the bill “would result in millions of Americans losing coverage and benefits.”

All of the major hospital groups, including the American Hospital Association, also came out against the bill. Trumpcare will most likely “lead to tremendous instability for those seeking affordable coverage,” the hospitals said in a letter to Congress. The hospitals also raised concerns about Republicans’ plans to significantly alter Medicaid, which they said could result in a loss of coverage and cuts to health care services.

The American Nurses Association, which strongly backed Obamacare, tweeted,“The #AHCA threatens health care affordability, access, & delivery for individuals across the nation. Therefore, we oppose. #ProtectOurCare”

The Wall Street Journal emphasized the backlash from senior groups including the AARP.  The AARP, which represents nearly 40 million older Americans, opposed the legislation in a letter to Congress arguing that the act would increase the cost of health care for older people. The criticism also took the form of a snarky video in which a squirrel helps explain the harmful impact of what the group calls the bill’s “age tax.” Older Americans generally spend more on health care, but under Obamacare, insurance companies couldn’t charge them more than three times as much as younger clients. The replacement bill pushes that ratio to 5-to-1. According to the group, the age band provision is “Washington politician speak for overcharging older Americans for their health insurance while lining the insurance companies’ pockets.”

Jonathan Chait at the New Yorker Magazine had a great article on the social catastrophe that is Trumpcare.

“The Congressional Budget Office’s analysis of the American Health Care Act describes, in dry budgetary language, a social catastrophe. The bill would deprive 14 million American citizens of their health insurance next year, a number that would rise to 24 million by the end of the decade.

The changes Trumpcare would impose upon the health-care system are easy to understand. It is, quite simply, a redistribution bill. It would reduce taxes on the rich, and thus reduce the amount of subsidies for coverage for people who can’t obtain it through their job or Medicare. By 2026, CBO finds, the average subsidy would be about half as large. But the cut would not be distributed evenly. Middle- to upper-middle class customers buying insurance, especially young and healthy ones, would get larger subsidies. Poor, sick, and old customers would get enormous cuts in their subsidy levels. CBO has a graph showing the bill’s effect on Americans who make less than 200 percent of the federal poverty level. The dark-blue bars represent the status quo. The light-blue bars show what Republicans hope to “achieve”:

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