Hillary's Health Plan: annotated version
The Waffle Queen, also known as #WhichHillary, has responded to a request for her comments by the New England Journal of Medicine
An uncritical reading will think Medusa's "vision for health care" is just wonderful. However, we must read everything the Mad Bomber says, and parse it like a lawyer--just as she is and she does.
why working to expand health care access for every American and improving the health and well-being of kids and families has been the most important cause of my life.
Okay, if you calling support for mass incarceration, breaking up families of immigrants, bombing women and children in countries other than our own, and as a bonus, for terrorizing Bill Clinton's sexual victims as embodying the health and well-being of kids and families, then I got a bridge to sell you.
We need to expand Medicaid in every state so that everyone has access to care, regardless of their income and where they reside.
Medicaid, really? You know the plan that governors control and not the Federal government? Why not support Medicare as in Medicare-for-all?
As President, I will fight for every American to have access to affordable, quality health care.
"Affordable health care" is neither equitable, cost-effective, nor freeing us from being indentured Insurance company clients.
By securing new coverage for millions of previously uninsured people and providing peace of mind, the Affordable Care Act is an essential step toward universal health care.
Damn you Hillary, why can't we just have Medicare-for-all (MFA)? Why do you pussy-foot around this issue--is it because you don't really care and don't want to alienate Insurance companies and Big Pharma? This incremental change--if it's truly any change at all, will lead to an increase of preventable deaths for perhaps millions.
Why would your "snail-care" improvements of About to Collapse Anyway (ACA) prevent those unnecessary deaths?
Let's talk about a few of the many reasons people die unnecessarily in our current society.
1. People still can't get into see doctors:
A. 33 million (10% of the population) are still uncovered.
B. Even if they can get into see a health-care professional, many times they are so-called physician extenders, whom most of the time are "physician pretenders".
2. People who have had the correct evaluation and treatment plans are often unable to afford the treatments.
Many times, insurance companies deny standard of care treatment because it cuts into their bottom line--and your lifeline by rejecting payments for treatments. Use any excuse you can think of, it all amounts to the same thing: You ain't gonna get what you need anyway--because we say so.
3. Speaking about Medicaid, not Medicare, you have to be practically be completely asset-free and near poverty to qualify.
4. There are administrative requirements which make care-giving burdensome, affecting quality health-care, but that is a subject best deferred to another essay.
Instead of repealing the ACA, my plan will build on its progress. We must work to expand Medicaid coverage in the 19 states that have left 3 million Americans without health insurance because their states refused to expand Medicaid and enroll people eligible for coverage
But we're still talking about the onerous medicaid programs instead of MFA. Why can't you just stop this deflection to one of the root causes of our current health dilemma? Oh, I forgot who your sponsors are.
And finally, we need to ensure the availability of a public option choice in every state, and let Americans over 55 buy in to Medicare.
This sounds laudable--but why have a cutoff age on the public option at all? Why not just do the simple thing?
Taken together, these policies will increase competition, choice, affordability and the number of Americans with insurance.
Competition between insurance companies? Wait till I stop laughing...Okay, ready to proceed. If we are to have private insurers in the health market, open up each state to as many insurance companies that want to enter. They have pseudo-monopolies now (technically that's Insurance Company Oligopoly [ICO]).
First, to immediately relieve Americans of health cost burdens, I will extend a refundable tax credit of up to $5,000 per family for excessive out-of-pocket health costs. And I will impose a requirement on all insurers to limit out-of-pocket prescription drug costs to $250 a month on covered medications.
If we are to continue ICO, there doesn't seem to be a commitment to universal health care in the form of state markets because she discusses a Medicaid model which is notoriously politicized. The second part of that quote talks about "covered medications". Ha, ha. You can bet that the insurance companies will cover less and less drugs and non-medical treatment.
Second, to directly address rising prescription drug costs, I will work to remove barriers to competition by streamlining approval of high-quality biosimilar and generic drugs. That includes proposals to ensure that drug companies justify their prices, eliminate “pay to delay” practices, and allow Medicare to directly negotiate for better prices.
Streamlining drug approval has hidden dangers. Although the FDA usually carries the water for Big Pharma, sometimes drugs are rushed through phase 3 trials much too quickly so that exposure of more people to the treatment may reveal drug-associated risks unforeseen. There is also the matter of revolving door relations between FDA upper echelons and Big Pharma--just as harmful as the Wall Street revolving door with Treasury. Finally, regretfully, the FDA has frequently been lax in allowing drug trials which are not sponsored by the manufacturer to enter into evaluation. Corruption has seeped into the evaluative process. Adverse reports are suppressed. Statistics are misapplied. Data is even deliberately altered.
Who is to be the watchdog of these pay-to-delay (also known as it's cheaper if you die already) Big Pharma and ICO collaboration? What types of penalties will be allowed by the "Federal Consumer Response Team" (for medical issues) to assess? Will they have subpoena powers? Will the watchdog be able to issue penalties? Will the agency, if it indeed is created, be able to recommend criminal prosecution to the Department of Justice--and will the DOJ listen?
Incorporating the first-hand knowledge and experience of providers, we need to streamline and enhance the policies of private and public payers to move our health care system toward practices that reward high-quality, patient-centered care, improve outcomes, and reduce costs.
Wouldn't that be wonderful? It's doable. With Clinton's track record of reneging on promises, can we believe this goody-goody proposal? Personally I think such an effort if effectuated would be an excellent thing.
As we do, we must promote integrated mental health care, and enforce insurance coverage parity requirements to ensure that mental health care is not siloed.
Injecting a note of reality here, as I commented to another essay, my insurance agent told me that the two major problems that the ICO was having was for the inability to exclude pre-existing conditions AND EQUALLY as much to the mandated increased mental health care by the ACA. ICO will fight tooth and nail over these two points. I do not see HRC doing anything about this except for her readily-broken position statements.
This will improve our ability to respond to public health emergencies — from natural disasters, to issues of environmental justice like Flint, to escalating rates of addiction and obesity, to infectious diseases like Ebola and Zika.
Now actually I agree very much with this section--the problem reflexively returns to the lap of BHO. He could have put some punch into the EPA and DHS so that this clean water problem, especially including Flint--but many other locations as well. I realize I am deflecting--but Obama could have spent a few billion bucks on improving water infrastructure that he is otherwise diverting to useless stealth fighters, etc. With HRC essentially running an I'm-not-Trump campaign, she really seems to be Obama 2.0.
I will work to ensure that our scientific community and regulatory system are promoting innovation and will increase funding for biomedical research across all diseases, including specific investments for research into diseases like Alzheimer’s and HIV/AIDS.
So who is going to do this research? NIH for sure, but that organization farms out a lot of the R&D to Big Pharma. Plus Uncle Sam also "incentivizes" Big Pharma to R&D on new drugs and technology. If the U.S. does not pass MFA, at the very least Big Pharma should repay Uncle Sam the same proportion of money spent on drug development as contributed by the Feds to proprietary Big Pharma products. In other words if drug development for Drug A costs $6 B but the Feds contribute $3 B, then 50% of drug prices should be rebated to the treasury. I have not heard that idea debated--but in lieu of MFA, this sounds to be an equitable way to handle drug prices--in addition to drug price ceilings for each particular agent.
More available information — with careful protections for privacy and security — will make our markets more efficient and transparent.
It took me a few minutes to stop laughing when the Queen of Secrecy talks about "transparency". My Dad had a saying for that type of talk: "Clear as mud".
There are parts of her NEJM article which I did not quote but which do have admirable-sounding theses. But this is Hillary Clinton we are talking about--who believes anything she says?
Comments
ROTFLMAO!!
I'm not going to go over every damned lie she said except for this one.
No need to rehash how much damage welfare reform did to children in this country. By the time they left office poverty rates had sky rocketed!
It been over 6 f'cking years since the ACA was passed and I haven't heard that one person was working to make it better so that it is THE step toward universal health care.
And as we all know, just having insurance doesn't mean jack if people's deductibles are too high!
I'm sorry Hillary, I heard pretty much this same bullshit from Obama during his first candidacy and while I and millions like me were calling, emailing and signing petitions during the health care debate, I found out that he had already made deals with the insurance and pharmaceutical companies while congress was still working on it.
Scientists are concerned that conspiracy theories may die out if they keep coming true at the current alarming rate.
If I read that as an online date entry, the invocation of God
puts it right into the NO bin. That is just how I think.
As well, don't many Doctors refuse or limit the number of Medicaid patients, too low a compensation?
Hey! my dear friends or soon-to-be's, JtC could use the donations to keep this site functioning for those of us who can still see the life preserver or flotsam in the water.
Drs may decline to see or limit medicaid patients
but if they participate in Medicare (meaning CMS submits payment to them directly) they must see Medicare patients, even if they also have Medicaid.
I shan't link to GOS,
but in a recent post, I do feel for teacherken. Think of him what you will, but this is sad beyond belief:
A 70 yo man with multiple health issues, can only see a physician's assistant for evaluation, Dx and Tx?
Has he never seen his "Doctor"?
When I see my physician (yes a real one, BSc, MSc, MD, FRCPS(C), FRCFM)(*) it's often with his "intern" (what the British call a "junior doctor", i.e. having his MD but not yet fellowship) by his side and the two of them interacting between them.
I know enough med to help them with their Dx.
What degree/diploma does a "physician's assistant" have? No wonder US-style health care is so bad, if even patients like TK can't see a fully accredited physician for health care.
*1 Fellow of the Royal College of Physicians and Surgeons of Canada
*2 Fellow of the Royal College of Family Medicine
PS It is not unusual in Canada to see a "real" doctor, rather than a junior, for anything else than a sniffle.
There are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns – the ones we don't know we don't know.
Chelsea Clinton goes after the “Marijuana Causes Death” vote
[video:https://www.youtube.com/watch?v=TucRv_01D04]
there goes the next political candidate of the future we don't
need. Trade runs in families. Apparently running for political power is a trade and gets inherited from one generation to the next. Appropriate for imperial regimes.
https://www.euronews.com/live
I've seen some old friends drink themselves to death
but no one has ever smoked themselves to death. I know people who crashed cars while drunk, but no one who has even been ticketed for a traffic violation when driving while stoned.
As a Hellery surrogate pitching the evils of Reefer Madness, Chelsea can go to hell.
Donnie The #ShitHole Douchebag. Fake Friend to the Working Class. Real Asshole.
She's a mealy-mouthed little know-nothing
just like her mother.
"by the way, marijuana CAN lead to death"
says Jimmy, "if you combine marijuana with dark skin and a cop.
Then it can, definitely. Definitely."
Yep, thanks. If it weren't for Trump Clinton would lose California too.
Goood morning.
The Reactionaries and Police State advocates will love her.
There she is, ready to step into Mom and Dad's authoritarian shoes. I can see it now: "Ready for Chelsea?" "It's her turn!"
Twain Disciple
Don't be so hard on Dr. Chelsea
After all, she operates a Hospital for Decrepit Secretaries of State.
Let's just forget that fracking is orders of magnitude greater danger to your health. Chelsea let's be scientific--we must list Fracking as schedule 1 and let NIH study it before releasing into public water supplies. Oh, I forgot, Chelsea attended the University of Petrochemicals, where her mother sits on the board of Directors.
Medicare and Medicaid are
Medicare and Medicaid are substantially privatized (Medicare Advantage and Medicaid managed care). As such they do not provide a foundation for universal comprehensive publicly funded healthcare.
HR 676 “Expanded and Improved Medicare for All” provides this foundation. A national health service (VA for All if the privatization occurring in the VA were reversed) would also provide this foundation. Anything that leaves profit in the insurance picture will not.
Allowing insurance companies to “compete across state lines” is a right-wing meme. Insurance companies are increasingly consolidated into a few large companies. They are not subject to anti-monopoly regulations. Insurance companies will incorporate into the state with the fewest regulations, a race to the bottom.
The ACA provided an 8-year patent protection for biologics which was bad enough. The TPP provides for 12 years. Where does Clinton/Kaine stand on this?
A tax credit doesn’t do any good for a person who doesn’t have the cash to pay for treatment in the first place.
There are two Medicares now, mine is called Original
I have been covered since 2005 (Parts A-Medical and B-Hospital). Can't even afford a co-pay now much less my slice of the four hundred bucks an hour doctor bill, but it is good to have for emergencies I guess. Better than nothing. The 2017 Handbook arrived couple days ago. Look at what is not covered (hint: don't grow old)
Insurance industry "needs more healthy people in the pool!" lol
Thanks
HR 676
Except for cosmetic surgery and acupuncture HR 676 Expanded and Improved Medicare for All covers all the items in this list. There are no premiums, co-pays, or deductibles. https://www.congress.gov/bill/114th-congress/house-bill/676
"There are no premiums, co-pays, or deductibles."
Seriously? Then why does the 2017 Handbook list them as not covered? Did you try the coverage link or are you making copy pasta? Nothing wrong with that, but "no premiums, co-pays, or deductibles" does not match up with my experiences by which I have eternal debt to show for. Maybe you are talking about Medicare Advantage, I don't know, never could afford the extra policies to cover everything.
Peace
HR 676 is not today's Medicare (edited)
I was describing the coverage and payment provisions proposed in the bill HR 676 - Expanded and Improved Medicare for All. It is not the same as making today's Medicare (whether "original" or Medicare Advantage) available to everyone, or as a buy-in option.
Edit: Also to clarify: There are not 2 Medicares. Both “original” Medicare and Medicare Advantage cover the same percentage of the same services. With the former the government pays the provider. With latter the government pays a private insurance company which pays Medicare. In the past Medicare Advantage cost the government a lot more than original. Some of this was supposed to be corrected by provisions of the ACA.
Medicare Advantage plans may offer additional benefits, and people with “original” Medicare may purchase supplemental plans to pay an additional percentage of the cost of Medicare covered services.
2nd edit: With latter the government pays a private insurance company which pays
Medicarethe provider.Bizarre how links change
I see you were suggesting a fix, a new Medicare-for-all law. Thanks for that.
I swear the first time I clicked the link to that bill returned this:
and now:
? ~shrug~
Why it shows Actions (8) when there are none I don't know. Tax dollars at work.
Cheers
Thank you for the link.
I am going to start including it in all my correspondence w/ anyone in the House (or in the Senate for that matter), and tell them to push it. Perhaps we should start a coordinated effort.
Hmm!
More God Given incrementalism.
Just what the country doesn't need.
A Clinton presidency is going to be a complete waste of time, money and lives.
(And Chelsea Clinton, despite Stanford and Oxford, appears to be an idiot.)
Gëzuar!!
from a reasonably stable genius.
Give the girl a break.
It's not easy to lie on cue, to free-associate lies, and to remember the party line lies you've already told to avoid contradicting yourself. Chelsea's new at this. Her parents have been at it for decades.
Twain Disciple
You got this especially right
They've been copying each other's most exclusionary practices - from the beneficiary's side (maybe we're just consumers these days and no longer beneficiaries...), we experience the collusion by insurance companies as a race to the bottom.
'What we are left with is an agency mandated to ensure transparency and disclosure that is actually working to keep the public in the dark' - Ann M. Ravel, former FEC member
I've bumped into this issue as things are
As things currently stand, there really is no way to point out errors against patients/consumers. There is SUPPOSED to be a mechanism, and it's written into the U.S. code and all, but the insurance companies simply ignore the requirements and... well and they do nothing but whistle. No one cares. I've had one of these situations, and I complained until I was hoarse. The answer to your question about whether the DOJ will listen or not is that A) one must get an attorney (an attorney must file these claims with the DOJ), and B) one must act as a whistleblower and file a case under seal. They DOJ may or may not take up the matter... if they do, the whistleblower gets a cut of what the gov recoups. Otherwise, one is free to have their attorney pursue the matter (which is nearly impossible to talk a law firm into doing, no matter how clear-cut the case).
If one wants to read up on Qui Tam cases.
'What we are left with is an agency mandated to ensure transparency and disclosure that is actually working to keep the public in the dark' - Ann M. Ravel, former FEC member
The Dem establishment (HRC) is the worst enemy of single payer
Majority in U.S. Support Idea of Fed-Funded Healthcare System
Even the Donald wants single payer on certain days.
The political revolution continues
Warning: highly unPC content below
Important parts of the coalition supporting Killary are against single payer because they think it would mean losing jobs in insurance offices for their members, esp. bilingual jobs.
Mind, I don't begrudge anyone a good job, but something has to give somewhere.
Mary Bennett
There will always be room for bilingualism in health care
and not just Spanish. Another Clintonist lie.
Tax credits like this only work for the well-to-do
Because you've got to pay up front, and next year you'll get your money back.
And did you notice, it's up to $5000 for excessive costs, which means first you hit a threshold, THEN you get a tax credit.
That's sure going to help a lot of people.
............
Edited to remove evidence that I didn't read the parent carefully enough.
Now interviewing signature candidates. Apply within.
That is always the biggest, screaming
tell that they either don't get it, or do get it and just don't give two shits (I lean hard towards the latter): tax credits.
*hawk**spit* Tax credits. Fucking tax credits. They do jack shit for the vast majority of people.
It's reminiscent of Romney and his plan to cut capital gains taxes. Well, that's just fucking ducky when half the country doesn't even know what the hell capital gains are in the first place, because they've never had money to invest. Ever. And never will.
If they really gave a damn but still insisted on tweaking the ACA instead of offering a real solution? Then cap the goddamned premiums and/or eliminate the fucking deductibles. I thought the ACA was supposed to outlaw policies that were no more than catastrophic plans yet here we are, with 99% of policies utterly useless because you have to cough up $10,000 dollars or more before the insurance companies will even consider covering a damn thing.
Well, I don't have a spare $10,000 dollars per year just lying around, just like I don't have parents who can nonchalantly part with a million dollars so I can start a business.
The 99% are not even on their radar and never have been. They couldn't possibly make that any clearer - they really can't - unless one of them were to come right out and say, "fuck you, go eat cake".
I so desperately wish we could get a general strike organized; I truly believe that's our last option before violence. Unfortunately I don't see it happening. I just don't.
(I apologize for all the f-bombs but the whole subject makes me furious. My husband desperately needs medical care for several issues and he'll never get it, yet there's that bite out of his paycheck every week, money we need for other things, money thrown out the window, never to be seen again.)
"When we remember we are all mad, the mysteries disappear and life stands explained." - Mark Twain
No apology needed, Late Again
I tried to keep my essay semi-serious so I avoided the F-bomb carpet bombing that analysis of Hillary's "Health Care Plan" deserved.
Here's an idea, probably useless, but consider it anyway: We can organize National Hospital Day, where as many people as can be motivated coordinate and then go to each Hospital Emergency Room in the United States and wait to be seen for "serious illnesses" like cough, cold, sore throat, diarrhea. By law , Hospitals must evaluate you, even if no treatment is rendered. The down-side of my proposal is that legitimate patients would have to wait inordinate time for treatment actually needed.
I fear violence.
I, too, see the violence appearing and lasting quite a while.
I was alive (and reading at an adult level) in 1968. I remember what that was like. (NOT fun!)
And the violence I foresee in our future will make 1968 look like a walk in the park in the Spring time. Or Hellery and Co. will get us into a fullblown war with Russia and China at the same time to keep the violence from happening here at home, by getting everybody killed off overseas instead.
I do not want this to happen -- any of it -- but unless serious, radical changes are made, I fear it will happen. And anybody who doesn't fear that isn't paying attention!
"US govt/military = bad. Russian govt/military = bad. Any politician wanting power = bad. Anyone wielding power = bad." --Shahryar
"All power corrupts absolutely!" -- thanatokephaloides
The War on The World requires
The War on The World requires cannon-fodder - and what a great way to get rid of ALL of those pesky protesters/young political activists/organizers! All Ready For Hillary! (No revolution/democracy for you!)
http://www.cnn.com/2016/02/02/politics/women-military-draft-generals/ind...
http://www.nytimes.com/2016/06/15/us/politics/congress-women-military-dr...
Because the world's largest military needs to be bigger than ever - how else can they invade so many of other people's countries to kill them and take their country and stuff for American Business Interests and Multinationals? And even if it takes every American citizen there is to do that, it still leaves Those Who Matter safe, sound and profitably in control, right? Heil Hitlery?
http://www.stripes.com/news/house-bill-requires-women-to-sign-up-for-dra...
Job creators!!! (Cue heavenly music a la Maher)
http://www.nytimes.com/2016/06/15/us/politics/congress-women-military-dr...
Yup, All Ready For Hillary, all right!
http://www.cnn.com/2013/03/13/us/military-sexual-assault/index.html
So, a bill can pass sending women into combat - but not one to give them recourse against military rapists, in order to stop it, or at least reduce the incidence...
http://www.motherjones.com/politics/2014/09/sexual-violence-american-mil...
https://www.theguardian.com/society/2011/dec/09/rape-us-military
Something more than cannon-fodder, I guess...
Psychopathy is not a political position, whether labeled 'conservatism', 'centrism' or 'left'.
A tin labeled 'coffee' may be a can of worms or pathology identified by a lack of empathy/willingness to harm others to achieve personal desires.
Military rape is most important health care and judicial matter
This is an aspect of Health Care, as well as justice, too infrequently discussed. Use of women as combatants should be voluntary. Women are the care givers in our society and rarely are murderers, military or not.
it's Hillary Clinton we're talking about
..... which means we're probably dealing with a bunch of admirable-sounding feces.
"US govt/military = bad. Russian govt/military = bad. Any politician wanting power = bad. Anyone wielding power = bad." --Shahryar
"All power corrupts absolutely!" -- thanatokephaloides
Don't forget, Military is the
Don't forget, Military is the riskiest job(wars) at the lowest pay level one can get. Most Privates are lucky to clear 750monthly after taxes! Low cost cannon fodder for the Corporatocracy wars, fighting for the Oligarchy is more "privilege" than job, and dying for your Oligarchs is your sacred duty as God told them so!
Snark alert!
So long, and thanks for all the fish