Please Call It TrumpCare

Please Call It TrumpCare
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Clash of the Titans: TrumpCare vs. ObamaCare

What is health care? Do they care? What do they care about? What is health? Very simple basic questions. But you cannot construct or reconstruct 10% of our economy on a fabricated, cynical, spiteful timeline without first asking these metaphysical questions? How do you know if you have arrived if you don’t know where you are going?

Now, remember in January 2017, President Trump promised to cover everyone at a lower cost.

“We’re going to have insurance for everybody,” Trump told The Washington Post. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.””[They] can expect to have great health care. It will be in a much simplified form. Much less expensive and much better,” he said.CNN Jan 17, 2017

In 1949, the World Health Organization (WHO) offered this definition of health. I can remember being asked this very question in the first month of medical school. The answer was always wrong. It is not the absence of disease.

Health is a state of complete mental, physical and social well-being, and not merely the absence of disease or infirmity.

What is your mission? What is your future vision? What are you trying to accomplish?

Care: a person or thing that is an object of attention, anxiety, or solicitude The flower garden was her special care.

The Republican controlled Congress has floated their initial document. Let us be clear about this document. This is a reaction. This is a promise to deconstruct a despised system. Despised by whom? We could be done with this in a few months by some simple changes to the current law. That is not in the cards.

With whom have you consulted? What is your consensus? How can you possibly and ethically propose a system with such a narrow base and lack of consensus? The answer is the Republicans are not interested. They’re interested in simply ramming through their own narrow vision. This has been opposed by all the medical societies and organizations.

They do not care about you. So, how can this be called a health care system?

Even the most conservative Republican commentators admit you cannot withdraw entitlements that have become part of common law. We do not know the full details of the plan. We cannot even begin to know the ramifications economically, medically and socially. As the of first draft of this blog, they had purposely ignored the Congressional Budget Office. The non-partisan office. Hours ago, the CBO issued its draft. All the gains of the ACA could be wiped out. Vehement denials follow.

I personally never supported the ACA otherwise known as ObamaCare. My writings here in the Huffington post from the past can be easily recalled. It was basically a Republican Plan. My objections were not political. This was not a left-right issue. The real issue was the politicization of medicine. Which has now moved into hyperdrive. I will admit my family has personally benefitted. So have millions and millions of Americans.

What do politicians know about medicine? About health? About curing and healing. The debate is not new. The abject cynicism is.

The ACA was all about amplifying insurance based limitations, allowing for cost increases and the indignities of prior authorizations. No controls on drugs prices. No controls on equipment manufacturing.

I do support a more robust, healthier and vibrant health care system. But the debate has never been about health care. It has always been about cost-shifting, zero sum economics, and conflated general budgetary savings.

I have always favored more universal principles. Everyone should be covered for catastrophic loss. Hospitalization is where fortunes are lost. The average hospital bed today is about $10,000 to 20,000 per day. An ICU bed maybe double that. An average 4-5 hospital stay can easily run $80,000 to $100,000. A major stroke or heart attack. Could ring up a $250,000 bill. Even complex or prolonged Emergency Room workups could run up to $25,000+ for 8-12 hours.

Coverage for these catastrophic loss. That should be the minimum. It was proposed in June 1990 and failed.

We should be funding progressive models of health maintenance. And I don’t mean simple HMOs ― health mainenance organizations. What politicians and bureaucrats called managed care. What we called mangled care. I am proposing truly new health and wellness based models.

We are headed for major chaos. It need not be so. Congressional leaders need to “do their job.” They need to understand their solemn duty and pledge to provide for the greatest common (public) good. We do not have that government today. It is dysfunctional and morally bankrupt. Or worse. Out of this, how can we expect a positive, creative and beneficial system?

Step back from the precipice. Listen to those of use who know and deal with all these vital issues daily. Engage the frontline.

Next up: the Greek parable of Hygieia and Aschlepius.

Mar 13, 2017

Carmel, CA

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