Sunday, October 01, 2017

How The Trump Regime Has Been Sabotaging The American Health Care System


Obama appointed Andy Slavitt to head the Centers for Medicare and Medicaid Services (CMS) in 2015 and he served until Putin managed to install Trump in the White House. His tweet above caught my attention Friday. It's a shame Tom Price got fired for corruption-- in his case both predictable and inevitable-- instead of for working to destroy the American healthcare system, something he's been doing with the connivance of Trump, Pence, Paul Ryan and the congressional Republicans. When Slavitt tweeted, he was responding to Bloomberg reporter Steven Dennis having posted a letter to Price and Mnuchin from Oklahoma Secretary of Health and Human Service Terry Cline. Here's the letter:

Oklahoma is one of the reddest states in America and one of the most supportive of Trump in last year's election. He beat Hillary 949,136 (65.3%) to 420,375 (28.9%), one of the only states where she didn't hit the 30% mark. Trump won every single county in the state, one, Cimarron County, 89.3% to 6.5%. But even in Oklahoma, state officials are starting to blame the Trump Regime for rising health insurance premiums. Cline blamed Price for missing a deadline for Oklahoma's Innovation Waiver, which could have been used to lower premiums for 130,000 Oklahomans by around 30%.

"After months of development, negotiation, and near-daily communication over the past six weeks, the State and your departments agreed that waiver approval must be received no later than September 25, 2017. As late as last Friday, September 22nd, an agreed upon approval package had been circulated with the state expectation, and federal department promise, that waiver approval would be forthcoming on Monday, September 25. When your departments communicated on Monday that the waiver approval would not be provided, with no reason for the delay or timeframe for approval, the Oklahoma reinsurance program was effectively inoperative for the 2018 plan year. Three days later, beyond health plan commitment and rate filing deadlines, Oklahoma is forced to withdraw our waiver request due to failure of the Departments to provide timely waiver approval... The lack of timely waiver approval will prevent thousands of Oklahomans from realizing the benefits of significantly lower insurance premiums in 2018." Maybe they were flying around on chartered jets partying again.

Price and Mnuchin to Oklahoma patients: "Fuck off!"

Or did Trump order them to do it to sabotage a state where he expected no one to blow the whistle on him and them-- his way of living up to his explicit threats to let the healthcare system implode? There is little question in the minds of officials who have worked in the public health sector, like Slavitt, that Trump and his Regime-- with the connivance of congressional Republicans-- are purposely undermining the healthcare system and attempting to wreck it. Friday, Will Drabold, elucidated on another instance of Price (and Trump) working to purposely screw up healthcare, this time by "delaying" a rule to punish drug makers who price gouge. The rule is another Affordable Care Act regulation, meant to protect low-income and vulnerable Americans, that the Republicans hate.
That rule was created in 2010 under the Affordable Care Act to protect hospitals from being overcharged on prescription drugs that are supposed to be discounted under a program known as 340B. The program, which dates back to the early 1990s, is essentially an agreement between drug companies and the government to discount drugs to hospitals and health clinics that serve high numbers of low-income patients.

The rule mandated by the ACA was written to deter price gouging. Under the rule, if a drug manufacturer is found to have “knowingly and intentionally” overcharged customers, a fine of up to $5,000 could be imposed for each instance of overcharge.

While the rule was supposed to go into effect on Sunday, it’s now been delayed until July. The Department of Health and Human Services quietly logged the delay into the federal register on Thursday.

Thursday’s delay marks the fourth time this year the administration has delayed implementation of a rule that would punish drug companies for price gouging hospitals and patients who are supposed to benefit from discounted drugs.

...While stumping for president, Trump promised to “bring down” the cost of prescription drugs. In a meeting earlier this year with CEOs of pharmaceutical companies, he told them they needed to lower prices. He blasted “RIPOFF DRUG PRICES” in August on Twitter.

But beneath the tweets, consumer advocates, hospital groups and others say Trump has gone back on his campaign promise to penalize drug companies for increasing prescription drug prices. Critics argue the president and his administration do not hold pharmaceutical companies accountable on how they price the drugs they sell to hospitals serving low-income patients because former pharmaceutical executives oversee Trump’s health policies. In fact, a longtime lobbyist for drugmaker Gilead Sciences, Joseph Grogan, who lobbied against the ACA’s 340B rule, now runs the White House group focused on lowering drug prices.

“If you’re looking for ways to combat the high cost of prescription drugs, it doesn’t make sense to attack and limit [340B] in any way,” a Washington health care lobbyist opposed to the pharmaceutical agenda said, speaking anonymously in order to candidly assess the Trump administration.

“Thus far, what we have seen from the [Trump] administration ... has been to hurt the 340B program.”

...When the federal government sought further public comment earlier this year on whether to penalize drug companies that overcharge, hospitals weighed in. They said the penalty was crucial in preventing egregious price increases on discounted prescription drugs. Of 51 comments submitted, 21 supported further delay. All of those came from pharmaceutical companies or industry groups.

Entities like hospitals that receive discounted drugs can no longer sue drug manufacturers after a 2011 Supreme Court decision, forcing them to rely on the “honor system” or pressure from HRSA to ensure the right price.

...Since 2010, 82 rural hospitals in the U.S. have closed. Many of them serve high populations of Medicare and Medicaid recipients, giving them access to 340B discounts, and 40% of rural hospitals operate at a loss, Diane Calmus of the National Rural Health Association, said.

“High drug costs are an issue not only for hospitals, but patients they’re providing care for,” Calmus said. Her group is frustrated with the seven-plus-year delay in implementing the rule to penalize price gouging. ”[Drug] prices are rising dramatically without justification. We see drugs that have been around for a while, jumping by large margins without an explanation.”

...It’s not hard to track the transition of the pharmaceutical industry into Trump’s White House. Just look at the LinkedIn profile for Joe Grogan, the former industry executive who now leads the Office of Management and Budget’s Health Programs.

Grogan joined the Trump administration in March after about a six-year stint as a lobbyist for drugmaker Gilead Sciences. His lobbying disclosure form for the first quarter of 2017 listed Grogan as lobbying on “pharmaceutical policy as it relates to payments under the 340B program” on behalf of a leading prescription drug manufacturer.

Gilead, which has faced criticism for pricing its hepatitis C medication at $1,000 per pill, spent $1,050,000 on three lobbyists, including Grogan, in the first quarter of 2017 alone, according to the same disclosure form.

At the White House, Grogan has taken leadership of Trump’s working group focused on lowering drug prices. In June, Kaiser Health News obtained documents from those meetings that showed pharmaceutical company executives were crafting the administration’s approach to lowering drug costs. Also in June, Politico pointed out that as of then Grogan has not obtained the necessary ethics waiver to work for the government on issues he had previously lobbied on.

The same week Grogan joined the White House, the administration delayed the implementation of the price gouging punishment rule that it further delayed this week. After a delay in May, the government invited further comment on a rule that had already taken seven years to develop.
Illinois emergency room doctor and dedicated Berniecrat David Gill wasn't surprised to see the Trump Regime to start sabotaging the Affordable Care Act. "It comes as no surprise to learn that the Trump administration is taking steps to make health insurance and prescription medication more expensive," he told us last night. "This is the same president who supports proposed health care reforms which would leave 26 million more Americans without insurance, in order to fund an $800 billion tax cut for his fellow residents of the swamp. His hypocrisy knows no bounds. We absolutely must establish a new House Democratic majority in the 2018 mid-terms, to serve as a true check on his gluttonous excesses. My campaign team and I are running hard here in IL-13, to make sure that this is one of the seats that turns from red to blue next year."

Oklahoma has been one of the reddest bastions in the country but there is one bright spot on the horizon, Tom Guild, an unabashed Berniecrat who's looking like he could actually win the Oklahoma City district, OK-05. He helped give us some insight into what happened with the healthcare shenanigans down there. If you want to help his campaign, you can do it here.
Dr. Terry Cline, Oklahoma’s Secretary of Health and Human Services and Commissioner of Health at the Oklahoma State Department of Health recently chided both Washington munchkin secretaries for denying the state of Oklahoma a waiver that would have helped more than 130,000 of our fellow Oklahomans struggling with dramatic increases in premiums. It would have afforded more than a 30% premium reduction for 130,000 Okies who are now forced to buy health insurance under the Affordable Care Act rendered virtually unaffordable because of the actions of Trump appointees. Dr. Cline reluctantly withdrew Oklahoma’s waiver request, because the high flyers in Washington, DC (aka The Swamp) did not approve Oklahoma’s request by the date required for it to go into effect for 2018.

The Trump Administration has shamelessly added to the burden of tens of thousands of our citizens in intentionally undermining the ACA and forcing working people in the Sooner State (and elsewhere) to unfairly and unnecessarily shoulder huge health care premium increases. The failure to grant a waiver to the state of Oklahoma reminds us of yesteryear, when the question was asked, “Have you no shame? Have you no sense of decency, sir?” The action of Trump and Trump’s cabinet appointees are despicable and unforgiveable. It is disgraceful to intentionally add to the burden of working families struggling to obtain health care, raise families, and survive. The Swamp is alive and well in the nation’s capital. We need to put a stake through the Swamp Monsters hearts in the 2018 elections and put an end to their disgraceful actions.

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At 6:27 AM, Anonymous Anonymous said...

Further proof that the current system, a klugey cluster fuck of esoterica, must be burnt to the ground and replaced with MFA/SP. When such a CF of E exists, if it CAN be sabotaged by stridently partisan hacks, it SHALL BE.

But don't blame only the Rs. The lobbies WROTE this cluster fuck. The Ds built this cluster fuck. And neither party nor the corporations will ever FIX this cluster fuck.

They all exist only to make this cluster fuck worse.

Voters? What happens next to 300 million of us/US is up to you. Keep the democraps around and it will only ever get worse.

At 4:52 PM, Anonymous Anonymous said...

I continue to be amazed that the medical industry isn't flexing its massive political muscles to oppose what Trump is clearly doing to their incomes. Do those involved in the business not recognize that they will soon have no incomes if Trump succeeds? Have they forgotten Sue Lowden of Nevada, who declared that doctors should be willing to accept chickens and other barter in lieu of fees? Hospitals are already closing all across Red State America, yet the outcry is barely perceptible.

I have already given up on the medical industry because of their laxity in defending their turf, so to speak. I'm stocking up on my meds because I can't be sure I will still be able to get them before too much longer. I won't bother with any intensive care of any kind, because I'd rather go out in somewhat good shape than to be debilitated and left unable to have a life when my treatments get cut off. And, if possible, I will die on the steps of some governmental agency with a big sign announcing my passing - and why.


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