Obamacare is the law of the land

The problem with that is that Trump had done something useful, surely he’d be taking credit for it, right?

NPR: President Trump Pivots On Bipartisan Health Care Bill

President Trump said he supports a bipartisan effort that would effectively shore up the Affordable Care Act. But he’s also distanced himself from it. What’s behind the complicated politics at play?

He has the attention span of a toddler mixed with a terrier?

Sean Hannity called him and told him he should be against it?

I’m surprised Hannity can even talk with that orange Twinkie in his mouth. Must be pretty tiny.

Fox and Friends split 3-2 against and so Trump went with the majority.


Yep, this is fascinating. Basically the old guard Senate Republicans appear to be revolting against Trump and Ryan both here.

12 GOP co-sponsors, and they’re not back-benchers:

The GOP sponsors, many of them influential committee chairs, are: Alexander, Mike Rounds (R-SD), Lindsey Graham (R-SC), John McCain (R-AZ), Bill Cassidy (R-LA), Susan Collins (R-ME), Joni Ernst (R-IA), Lisa Murkowski (R-AK), Richard Burr (R-NC), Bob Corker (R-TN), Johnny Isakson (R-AK) and Chuck Grassley (R-IA).

That’s filibuster proof.

Your court, Paul Ryan.

Just get trump to say he’ll fight it in two weeks, then he’ll never do it until the WaPo points out that he never made good on his promise to kill the ACA.

Seeing Ernst and Grassley on there makes me not wish for their untimely demise for the first time in a long time.

Let’s not get ahead of ourselves, old boy.

But what does Fox & Friends say about all this? That’s all that matters to Trump.

If they called the ACA stabilization TrumpCare I am absolutely convinced Trump would just talk about how amazing his health care is. He doesn’t care the slightest about anything except claiming he won something.


http://www.11alive.com/mobile/article/news/health/tennessee-rep-wants-ers-to-be-able-to-send-people-away/85-485009727

I’ll have what he’s having.

You can’t spell Cornyn without the crony.

It’s a thorny problem, the current ER laws. An ER has to provide a screening exam, and at that point, if the problem isn’t emergent, they are legally allowed to discharge the patient. However, the optics and potential liability if something goes wrong is high enough that most (read: all) hospital systems go ahead and treat the patients for their non-emergent issue at that time.

That sounds ok, all in all, cause you don’t want to miss an emergency. Unfortunately, a whole lot of people go to the ED for common primary care reasons, and they are seen, then undergo expensive testing to rule out emergencies, and then get their common issue treated. They then often don’t pay for that very expensive (likely 10-100 times the cost of the same evaluation in a PCP office) service, leading the hospital to file it to charity. People know that they will get treated at the ED, and will not have to pay for that treatment, so they go there for all of their care.

So the question is where do you draw the line? It’s not easy to figure out where, but all attempts to draw it anywhere but getting full treatment in the ED have led to significant lawsuits with big payouts and lots of gun shy hospital systems. Thorny indeed, but there is an issue there, not necessarily just evil politicians wanting people to die already.

This may be true at some of the religious non-profit hospitals but my understanding is the for-profit hospitals (which are a majority) send out bills. They may well write off those bills later, after the patients declare bankruptcy.

If health care in the US did not cost double for the same procedures as it does in other countries, and if we had coverage for everybody this issue wouldn’t happen. Rather than blaming the indigent who are often desperate and also lack the knowledge to tell an emergent from non-emergent condition, we should be looking at systemic change to avoid this problem altogether.

I’m not blaming anyone, or giving advice on how to fix it. It is a legitimately difficult problem without a clear answer. I agree that wholesale change, like single payer, is the likeliest way to solve the problem, but the devil will be in the details.

You can’t just provide Financial Assistance willie nillie. The non-profits will also send a bill, but whichever department is responsible for Financial Assistance is going to try and qualify them for FA. They might even encourage them to sign-up for a Medicaid process. The point is, it is not automagic, and the systems often pay third parties for things like credit reports and what not because gain, it can’t just be opinion that qualifies you or that is, you guessed it, another lawsuit potential.

It is cheaper to see the PCP for these common problems, but they will make you pay before they see you. Urgent care, also cheaper, again requires payment.

There are a efforts, mentioned above in an article, to shift non-emergent to express type services, sometimes run by a nurse but I believe there are legal issues to have someone go to the ER/ED and not be seen by a physician so there is a physician review in there somewhere.

So sending people away from the ED who need care would just wind up with deaths, PR nightmares and providers horrified that someone was hurt or killed as result.