Socialist Commie Health Care Thread

[LFC]

Sept 21, 2021 15:44:32 GMT goldenvalley said:

From the above post: "awareness of the benefits of personalized medicine." What is personalized medicine? Is it simply a phrase designed to somehow contrast with "socialized" medicine that otherwise has no real meaning?

From that link:

Personalized medicine — also known as precision medicine — promises to use genetic characteristics and other traits to identify which treatments are best for a particular patient.

Sinema co-chairs the Personalized Medicine Caucus along with Republican Sen. Tim Scott of South Carolina and two House members. The lawmakers introduced the group in coordination with a pharma industry group, the Personalized Medicine Coalition.

“Raising awareness of the benefits of personalized medicine helps detect and prevent diseases, while making health care more affordable and accessible for Arizona families” was Sinema’s quote in the press release.

But affordability has not been a hallmark of personalized medicine so far. Like other recent pharma products, genetically targeted medicines and tests can come with extremely high prices while sometimes delivering mediocre benefits, health policy analysts say.

One of the best-known precision medicines is Merck’s Keytruda, used against a variety of cancer tumors with certain genetic profiles. It costs more than $100,000 a year.

“It’s a good drug,” said Vinay Prasad, an associate professor at the University of California-San Francisco who studies health policy and cancer drugs. “But behind it is a marketing machine that is trying to maximize its use.”

In any case, personalized medicine generally “has been a mixed bag,” with prices for cancer drugs that are “universally horrendous,” he said. Industry enthusiasm may be “motivated by the fact that when something is called precision or personalized, the regulatory bar needed to approve it is lower,” he added. “And that is often good for profits.”

Once again, follow the money.

[LFC]

This is just sad. Government at its most purchased. There's no legitimate reason for this, only greed.

Asked about a “stalemate” on drug pricing reform, Sen. Bernie Sanders (I-VT) had a few choice words for his colleagues.

“So-called ‘stalemate’ is you have 90 percent of the people who think we should go forward and a few who don’t — that’s not a stalemate,” Sanders told reporters. “You have a few people who received a lot of funding from the pharmaceutical industry who object to it.”

Sanders stressed the popularity of legislation to lower the cost of prescription drugs.

“It’s a sad state of affairs that we don’t have one Republican who’s supporting lowering costs of prescription drugs and yet a handful of Democrats who also oppose it,” Sanders said.

Although Sanders didn’t call her out in his remarks, Sen. Kyrsten Sinema (D-AZ) has reportedly expressed her opposition to the current prescription drug negotiation in the House and Senate bills.

[LFC]

Mark Cuban is opening a company to supply affordable generic drugs.

Billionaire investor Mark Cuban launched an online pharmacy Thursday that offers more than 100 generic drugs at an affordable price with a goal of being “radically transparent” in its price negotiations with drug companies.

Key Facts
• The Mark Cuban Cost Plus Drugs Company (MCCPDC) is a registered pharmaceutical wholesaler and purchases drugs directly from manufacturers, bypassing middlemen to lower the price of more than 100 medications, it said in a statement.

• For example, the leukemia drug imatinib is priced at $47 a month on MCCPDC compared to the $9,657 retail price.

• The online pharmacy’s prices for generics factor in a 15% margin on top of actual manufacturer prices and a $3 pharmacist fee, the statement said.

• The markup on generics average “at least” 100%, the MCCPDC said, while the Wall Street Journal reports in some cases it exceeds 1,000%.

• The company doesn’t process insurance claims and requires customers to pay for their medications out of pocket, noting its drugs cost less than most insurance plans’ deductible and copay requirements.

• Customers have to request a new prescription from their provider to place an order for medications on the MCCPDC website.

[Bact PhD]

Jan 23, 2022 14:52:48 GMT LFC said:

Mark Cuban is opening a company to supply affordable generic drugs.

Billionaire investor Mark Cuban launched an online pharmacy Thursday that offers more than 100 generic drugs at an affordable price with a goal of being “radically transparent” in its price negotiations with drug companies.

Key Facts
• The Mark Cuban Cost Plus Drugs Company (MCCPDC) is a registered pharmaceutical wholesaler and purchases drugs directly from manufacturers, bypassing middlemen to lower the price of more than 100 medications, it said in a statement.

• For example, the leukemia drug imatinib is priced at $47 a month on MCCPDC compared to the $9,657 retail price.

• The online pharmacy’s prices for generics factor in a 15% margin on top of actual manufacturer prices and a $3 pharmacist fee, the statement said.

• The markup on generics average “at least” 100%, the MCCPDC said, while the Wall Street Journal reports in some cases it exceeds 1,000%.

• The company doesn’t process insurance claims and requires customers to pay for their medications out of pocket, noting its drugs cost less than most insurance plans’ deductible and copay requirements.

• Customers have to request a new prescription from their provider to place an order for medications on the MCCPDC website.

Interesting. This got my attention:

The company aims to complete the construction of an $11 million pharmaceutical factory in Dallas that spans roughly 22,000 square feet by the end of this year.

So not only do Cuban et al. want to serve as a lower-cost distributor, but they want to get into the manufacturing side of it? If I have to hazard a guess, said factory would be manufacturing the (relatively) simple stuff (and when I say “simple,” either the synthetic process is straightforward, the chemical building blocks are dirt cheap and available by the ton, or both. The paperwork to get the appropriate certifications is no joke, either.

I sincerely hope Cuban, or this partner, has truly done his homework WRT the manufacturing end of things.

[pnwguy]

Jan 23, 2022 18:34:21 GMT Bact PhD said:

Jan 23, 2022 14:52:48 GMT LFC said:

Mark Cuban is opening a company to supply affordable generic drugs.

Interesting. This got my attention:

The company aims to complete the construction of an $11 million pharmaceutical factory in Dallas that spans roughly 22,000 square feet by the end of this year.

I've got to wonder if this is inaccurate.  22K square feet is too tiny to manufacture most anything of scale, especially something that needs to have the level of hygiene requirements for FDA scrutiny.  I've seen a large share of manufacturing facilities in my career, and that's a pretty small building. I'm thinking the writer dropped a zero.

[AnBr]

That or it will actually be a warehouse instead.

[Bact PhD]

Jan 23, 2022 21:17:52 GMT AnBr said:

That or it will actually be a warehouse instead.

That’s my guess, between my comments above and pnwguy’s remark re the size issue.

[LFC]

Welcome to America's best healthcare system in the world. For one hospital it just crashed up against the free market. I can't believe this lawsuit got anyplace. I understand the dangers but these are private employees. Why they hell did they believe they could simply prevent them from changing jobs? I wonder if they had non-compete  agreements to keep them indentured.

A hospital in northeastern Wisconsin has lost a court battle to keep health care staff who want to work elsewhere.

On Monday, Outagamie County Circuit Court Judge Mark McGinnis held a hearing on a case that involves staff who were part of ThedaCare’s radiology and cardiovascular team, deciding the employer can't force workers who had resigned to stay until replacements were hired.

The civil court case between ThedaCare and Ascension Wisconsin comes at a time when health professionals are in great demand across the U.S.

Attorneys for Ascension argued in court Monday that ThedaCare had known for weeks the employees were resigning and should have prepared for that instead of responding with a "frantic, last-minute lawsuit."

Just days before, seven former employees of ThedaCare were to start new jobs at Ascension's St. Elizabeth Hospital in Appleton. Judge McGinnis had temporarily blocked the move until a court hearing could be held and ThedaCare could find replacement staff at ThedaCare Regional Medical Center in Neenah.

In arguing for the temporary injunction, lawyers for ThedaCare said the facility "will not have adequate staffing to treat trauma and stroke victims — some of whom will die as a result of the lack of timely care."

[LFC]

RonJohn is calling for another swing at throwing tens of millions of people off of their health insurance. I guess this is what "compassionate conservatism" looks like.

100th Time’s The Charm?

Sen. Ron Johnson (R-WI) told Breitbart News Radio on Monday that Republicans should come up with a plan to kill Obamacare again if they take control of Congress and the White House in 2024.

• Senate Minority Leader Mitch McConnell (R-KY) is absolutely going to love another Republican senator putting out more agenda proposals ahead of the 2022 midterms. It’s really working out for National Republican Senatorial Committee chair Rick Scott (R-FL), who says “hell yeah!” to telling Americans they need to pay more taxes.

• A record 31 million Americans now have health care thanks to Obamacare, the White House reported last year.

Yeah, throwing 31 million Americans off of their health insurance with no viable alternative is going to play reeeaaalllll well. As long as Moscow Mitch is in the leadership position he'll never let it happen. He saw how bloodied they got the last time.

As for Rick Scott, well I personally think the man is batshit nuts but I can't fault him on saying we need higher taxes. We do and I disagree that it should only be on the highest incomes. No doubt it should primarily come from the wealthest, plus a restoration of a reasonable business tax level, but I have no issue with additional tax revenues coming from more people as well. Of course his whining about "free government stuff" puts him right back in the batshit crazy Republican camp so I don't take his proposal seriously.

[LFC]

How pathetic. Chuckles Gr-Ass-ley is begging the Democrats to pass the prescription drug pricing bill he and Ron Wyden (D-OR) worked out because if they lose control of the House and/or Senate in 2022 he knows the Republicans will never pass it.

GOP Sen To Dems: Pls Pass Drug Reform Before My Party Takes Over

Sen. Chuck Grassley (R-IA) admitted during a Senate Finance Committee hearing on Wednesday that his and committee chair Ron Wyden’ (D-OR) drug reform bill will likely die if the GOP takes control of Congress.

• Grassley acknowledged “the difficulty of passing something like this in a Republican Congress.”

• The GOP senator told Democrats they had an “opportunity” to “do it right now.” In fact, “If we want to reduce drug prices, then we need to do it now,” Grassley said.

[LFC]

Republicans did, in fact, block the capping of insulin costs. The cruelty is always the point. Also not allowing the Democrats to accomplish things.

Republicans probably don’t like being thought of as the party of the callous, inhumane, “kick the poor” caucus. Which is weird, because they could have voted to ensure every American suffering from diabetes could procure their life-dependent doses of insulin at $35 a pop, and they chose not to.

Thanks to 43 Republican senators voting “nay,” Democrats couldn’t overcome the 60-vote filibuster to cap the price of insulin at $35 for everyone. Mind you, this isn’t “free” or “socialized” health care—it’s insulin.

Roughly 1 in 10 Americans have diabetes (37.3 million) and about 1 in 3 (96 million) have pre-diabetes, according to the CDC. In a country with both an obesity crisis and a health-care system where even people with “good insurance” can go bankrupt because of a health crisis, you’d think the GOP would be looking for ways to puff up its supposed “economic populist” credentials, rather than voting against a modest price control that would help keep tens of millions of Americans from, you know, dying.

But we shouldn’t be surprised. Republicans are fine with Americans paying nearly eight times more than comparable countries for a relatively cheap medicine. The cost of insulin in America is about $100 per unit, four times the price in Chile, which was ranked as having the second-highest price in a study by Rand Corporation. According to a recent survey by CharityRx, 80 percent of Americans have racked up thousands of dollars of credit card debt to pay for this medication.

[snip]

Thankfully, Senate Majority Leader Chuck Schumer was able to corral every Democratic senator (including the usual obstructionist Sens. Joe Manchin and Krysten Sinema) to sign off on a deal that will include a $35 cap on the price of insulin for seniors on Medicare.

Yet even in defeat, Republicans still managed to stick it to the average American. One should be used to this barbarism by now, but the GOP’s utter refusal to cap the price of insulin hits hard because it’s so personal.

Schumer said he's bringing it back in September. They can block it again if they like right before the elections. I like that they are being forced to vote on things rather than hiding behind Grandma Mitch's dress.

“We needed 10 Republicans, we only got seven. I’m gonna bring that back in September. They’re gonna feel the heat and I’m hopeful we can get in done, but they’re gonna feel the heat,” he says.

[LFC]

A right-wing judge once again tries to make sure America doesn't have anything nice. They really do want us to collapse into a pile of serfs who cling to their religion for some comfort and who are overseen by a ruling class. And if they become to expensive to have around and can't afford to survive? F*** 'em. And once again all you have to do with these Federalist judges (I don't know for sure so I'm assuming on this one) is raise the (correct) religion card and facts no longer matter. You can literally utter any demonstrable lie you wish but as long you "believe" then it gets instant priority over reality.

A U.S. district judge in Texas, known for his hostility towards the Affordable Care Act, delivered a significant blow against the law’s critical preventative care provisions in a Wednesday ruling.

First, Judge Reed O’Connor ruled that the U.S. Preventive Services Task Force, or PSTF, is unconstitutional, finding that its members are not appointed properly. PSTF is a group of experts that makes recommendations for what qualifies as a preventive measure covered by the ACA.

He did not settle on a remedy for what he claims is an unlawful body and asked for further briefings. His decision, depending on its ultimate scope, could let private health insurers stop covering an incredibly wide swath of preventative care: from cancer screenings to sexually transmitted infection tests to pregnancy care.

According to the American Medical Association, the ACA provision mandating that insurers cover over 100 preventative care services for free resulted in about 151 million people getting those services in 2020 alone.

O’Connor also ruled in favor of a business owner who claimed that the ACA’s mandate that he must provide coverage for PrEP drugs — which work to prevent the transmission of HIV — violated his religious beliefs.

The business owner, conservative activist Steven Hotze, argues, among other things, that providing the coverage “facilitates and encourages homosexual behavior, intravenous drug use, and sexual activity outside of marriage between one man and one woman.”

When the government disputed that assertion, O’Connor brushed the rebuttal aside, saying that its factual merit didn’t matter.

“Defendants inappropriately contest the correctness of Hotze’s beliefs, when courts may test only the sincerity of those beliefs,” he writes.

[LFC]

Just a reminder...

Pat Bagley
@patbagley

List of when countries adopted universal healthcare with list of when they realized it was a disaster and gave it up
#MedicareForAll

[LFC]

The Twitter blue checkmark madness did manage to bring out a bit more awareness of just how badly Americans are getting raped over the cost of insulin.

The tweet, which stayed publicly viewable for at least four hours, began a viral spread, garnering at least 1,798 retweets and 12,800 likes before the account was set to protected, meaning that only approved followers can see its tweets. The account currently shows zero followers.

In the ensuing time, the real, verified Eli Lilly Account, with the handle @lillypad, acknowledged the false information in a 4:09 pm tweet. "We apologize to those who have been served a misleading message from a fake Lilly account. Our official Twitter account is @lillypad."

But, it wasn't enough to dam the flood of outrage and scorn over the all-too-real prices of insulin in the US. "Apologize to diabetics for price gouging," one Twitter user responded. "Why don't you make affordable insulin instead of apologizing?" another tweeted in a growing pile-on.

The reason for the backlash is painfully obvious. Insulin, a hormone made by the body to process and use blood sugar (glucose), can be a vital drug to the 37.3 million Americans who have diabetes, which is a set of conditions that, broadly speaking, disrupts the ability of the body's cells to use sugar. About 8.4 million Americans rely on insulin to survive, according to the American Diabetes Association. Generally, it costs $10 or less to make a vial of insulin. Yet, patients in the US can easily see monthly insulin bills of hundreds of dollars.

For instance, the list price for Eli Lilly's brand-name product Humalog U-100 is $274.70 for a single 10 mL vial. People with diabetes often require two, three, or more vials per month. A five-pack of 3 mL Humalog U-100 KwikPens has a list price of $530.40. Eli Lilly also has a non-branded generic product, called Lispro Injection U-100, which has list prices of $82.41 for a single 10 mL vial or $159.12 for a five-pack of 3 mL—and those are relatively bargain prices. Eli Lilly just recently reduced Lispro's list price, dropping them 40 percent in 2021 amid public backlash.

[jackd]

Demand, baby! We're talking' basic capitalism here!

[LFC]

This guy is definitely not a fan of Trump being involved with healthcare again.

Dr. Rob Davidson
Follow @drrobdavidson

As a doctor, Trump's announcement tonight sends a shiver down my spine. Medical professionals are still burned out, still dealing with the fallout of Trump's presidency. In case anyone forgot, here's a list of how he harmed our patients and attacked health care access (🧵): 1/10

[LFC]

Welcome to the wonderful world of Big Pharma where they'll "invest" billions to kill people for a profit. This one stinks to high heaven and clearly one or more higher ups in the FDA were in on it.

The Food and Drug Administration’s process for approving the Alzheimer’s drug Aduhelm, despite great uncertainty about whether it worked, was “rife with irregularities,” according to a congressional investigation released on Thursday. The agency’s actions “raise serious concerns about F.D.A.’s lapses in protocol,” the report concluded.

The 18-month investigation, initiated by two congressional committees after the F.D.A. approved the drug, also strongly criticized Biogen, Aduhelm’s manufacturer. Internal documents showed the company set “an unjustifiably high price” of $56,000 a year for Aduhelm because it wanted a history-making “blockbuster” to “establish Aduhelm as one of the top pharmaceutical launches of all time,” even though it knew the high price would burden Medicare and patients, the report found.

The investigation said Biogen was prepared to spend up to several billion dollars — more than two-and-a-half times what it spent developing the drug — on aggressive marketing to counter expected “pushback” over whether Aduhelm was worth its price. The report said the campaign planned to target doctors, patients, advocacy groups, insurers, policymakers and communities of color, who were drastically underrepresented in its clinical trials of the drug.

The F.D.A. is now evaluating two other Alzheimer’s drugs for possible approval early next year, including one that Biogen helped develop. The congressional report said the agency “must take swift action to ensure that its processes for reviewing future Alzheimer’s disease treatments do not lead to the same doubts about the integrity of F.D.A.’s review.”

Representative Frank Pallone, a Democrat and chair of the House Energy and Commerce Committee, said in a statement that the report “documents the atypical F.D.A. review process and corporate greed that preceded F.D.A.’s controversial decision to grant accelerated approval to Aduhelm.”

His committee conducted the investigation with the House Committee on Oversight and Reform, chaired by Representative Carolyn Maloney, also a Democrat. In a statement, she said she hoped the report would be “a wake-up call for F.D.A. to reform its practices and a call to action to my congressional colleagues to continue oversight of the pharmaceutical industry to ensure they don’t put profits over patients.”

The report said Biogen set a high price for Aduhelm because, according to a company presentation, “our ambition is to make history.” Anticipating criticism, “Biogen developed an external narrative about the drug’s value to sell to patients and the public,” the report said.

Biogen planned “an extensive media campaign directed at patients” that would involve connecting more than 50 journalists with medical experts supportive of the drug to “‘shape the narrative’ around Aduhelm,” the report said.

[LFC]

Following up on the Biogen post, the drug they were pushing worked on something called the amyloid protein. This article in Science from July '22 notes that the basic research is questionable at best and potentially widely useless and misleading. This may mean that an enormous amount of Alzheimer's research was doomed to fail. Hey, Bact! Knock yourself out!

Late last week came this report in Science about doctored images in a series of very influential papers on amyloid and Alzheimer’s disease. That’s attracted a lot of interest, as well it should, and as a longtime observer of the field (and onetime researcher in it), I wanted to offer my own opinions on the controversy.

First off, I’ve noticed a lot of takes along the lines of “OMG, because of this fraud we’ve been wasting our time on Alzheimer’s research since 2006”. That’s not really the case, as I’ll explain. But don’t get your hopes up: from one point of view, the main inaccuracy in that statement is that we’ve been actually been wasting our time in Alzheimer’s research for even longer than that. So that's not very comforting, either. We’ll start with some background and history, the better to appreciate the current furor in context. Those of you who know the field can skip ahead to later sections as marked, but your admission ticket is valid for the entire length of the ride if you want to get on here.

[LFC]

I liken this to movie ads I've seen. If they're pushing, pushing, and pushing a movie before its release you can be pretty sure it's a shitty movie. I call it the "Marley and Me Effect." Turns out its the same for shitty pharmaceuticals.

Some new drugs sell themselves with impressive safety and efficacy data. For others, well, there are television commercials.

According to a new study, a little over 70 percent of prescription drugs advertised on television were rated as having "low therapeutic value," meaning they offer little benefit compared with drugs already on the market. The study, appearing in JAMA Open Network, aligns with longstanding skepticism that heavily promoted drugs have high therapeutic value.

"One explanation might be that drugs with substantial therapeutic value are likely to be recognized and prescribed without advertising, so manufacturers have greater incentive to promote drugs of lesser value," said the authors, which include researchers at Harvard, Yale, and Dartmouth.

The US is one of only two countries that allows direct-to-consumer (DTC) drug advertisements, such as TV commercials. (The other is New Zealand.) Physicians, medical associations, and consumer advocates have long railed against the unusual practice. In 2006, consumer advocacy group Public Citizen summarized DTC advertising as "nothing less than an end-run around the doctor-patient relationship—an attempt to turn patients into the agents of pharmaceutical companies as they pressure physicians for medications they may not need."

In 2015, the American Medical Association called for an all-out ban on DTC ads for prescription drugs and medical devices. AMA members said the ads were "driving demand for expensive treatments despite the clinical effectiveness of less costly alternatives."

But DTC drug ads have continued, fueled by billions of dollars from the pharmaceutical industry.

[LFC]

We're Number 1!!! We're Number 1!!!

Americans spend an exorbitant amount of money on health care and have for years. As a country, the US spends more on health care than any other high-income country in the world—on the basis of both per-person costs and a share of gross domestic product. Yet, you wouldn't know it from looking at major health metrics in years past; the US has relatively abysmal health. And, if anything, the COVID-19 pandemic only exacerbated the US health care system's failures relative to its peers, according to a new analysis by the Commonwealth Fund.



Compared with other high-income peers, the US has the shortest life expectancy at birth, the highest rate of avoidable deaths, the highest rate of newborn deaths, the highest rate of maternal deaths, the highest rate of adults with multiple chronic conditions, and the highest rate of obesity, the new analysis found.

"Americans are living shorter, less healthy lives because our health system is not working as well as it could be," Munira Gunja, lead author of the analysis and a senior researcher for The Commonwealth Fund’s International Program in Health Policy and Practice Innovation, said in a press statement. "To catch up with other high-income countries, the administration and Congress would have to expand access to health care, act aggressively to control costs, and invest in health equity and social services we know can lead to a healthier population."

[LFC]

Gee, who could have seen scam degrees coming out of a privatized healthcare system?

More than 2,800 people may be working as nurses under false pretenses after allegedly buying a fake diploma for between $10,000 and $15,000 from a massive Florida-based scheme recently busted by federal investigators. State and federal authorities are now working to track down the alleged fraudulent nurses, and in some cases, immediately annulling their licenses.

Last week, the Department of Justice announced charges against 25 people in five states connected to the alleged scheme. The investigation, code-named Operation Nightingale, found evidence that the 25 defendants worked to sell more than 7,600 fake diplomas, along with transcripts, between 2016 and 2021, making over $100 million in the process. The fraudulent diplomas and transcripts were allegedly issued from three accredited Florida-based nursing schools: Siena College and Sacred Heart International Institute in Broward County and Palm Beach School of Nursing in Palm Beach County.

The three schools are now closed, and the 25 defendants each face up to 20 years in prison.

"Health care fraud is nothing new to South Florida, as many scammers see this as a way to earn easy, though illegal, money," acting Special Agent in Charge Chad Yarbrough, FBI Miami, said in a statement. "What is disturbing about this investigation is that there are over 7,600 people around the country with fraudulent nursing credentials who are potentially in critical health care roles treating patients."

With a fake diploma and transcript, an unscrupulous aspiring nurse can qualify to take the national nursing board exam. And if they pass the exam, they can become licensed nurses and get a job in a health care setting. Federal authorities reported that of the 7,600 people with the alleged fake diplomas, around 37 percent—more than 2,800 people—passed the exam. Many went on to get jobs as licensed nurses.

[LFC]

North Carolina Republicans have finally seen the light. Funny how Democratic ideas become good ideas when they can't squeeze any more political gains, just political hits, out of opposing them. Doing the right thing because it's the right thing? Yeah. Sure.

Leaders of the North Carolina Senate and House of Representatives announced Thursday morning that they had reached an agreement on how to expand the state’s Medicaid program to cover hundreds of thousands of mostly low-income workers with health care.

“We reached this deal late last night, but put the finishing touches on this morning, and felt like we needed to go ahead and get it out there,” said House Speaker Tim Moore (R-Kings Mountain).

Senate leader Phil Berger (R-Eden) said that the proposal agreed upon Wednesday night will build upon a bill that passed the House of Representatives on Feb. 16 with a wide bipartisan majority. The negotiated bill will be amended to include revisions to the state’s certificate of need laws, which regulate how much hospitals can expand, how much they can spend on capital projects, where they can build and whether the private market can offer services in their regions to compete for health care dollars.

The two men said they had not yet spoken with Gov. Roy Cooper about their agreement. The governor, while commending their work, quickly questioned their timeline.

The Medicaid program will not be expanded unless a state budget for the coming biennium is passed and enacted. That is unlikely to happen until late spring or early summer, closer to the July 1 start of the next fiscal year. Any budget proposal put forward could put Cooper in a difficult negotiating spot if the Republicans leading the General Assembly include fiscal items and policy statements the governor is loath to support.

“Since we all agree this is the right thing to do, we should make it effective now to make sure we leverage the money that will save our rural hospitals and invest in mental health,” Cooper said in his statement about the Medicaid expansion agreement. “I look forward to reviewing the details of the bill.”

Medicaid expansion has been a priority for Cooper since he came into office in 2017. He vetoed several budgets from the General Assembly during his term, in part, because Republicans, until recently, have been vehemently opposed to adding more North Carolinians to the Medicaid rolls.

[LFC]

Christians were given a special carve-out from Obamacare by Chuckles Gr-ass-ley. I wonder how many of these so-called Christian health networks are scams or at least enriching those who run them, without strict government regulation.

Joe Guarino rescued an entire industry with help from what some called “divine” intervention.

A little-known lobbyist from Virginia, Guarino was hired in 2007 by the Alliance of Health Care Sharing Ministries, the trade association for nonprofit alternatives to medical insurance founded on Christian principles. Health care sharing ministries take fees from members, which are then used to pay other members’ health bills.

At the time, the industry had been tainted by a scandal involving one of the largest ministries in the country, the Christian Brotherhood Newsletter, based outside Canton, Ohio. State authorities won $14 million in civil judgments against two of its top leaders for enriching themselves instead of paying the medical bills of its members. A ProPublica investigation last month revealed that many of the Brotherhood’s executives, including Daniel J. Beers, were involved years later in the launch of a second scandal-plagued ministry, Liberty HealthShare.

The Washington-based alliance was looking to Guarino to repair the industry’s reputation and pass laws to fend off a looming movement to regulate the business. The lobbying effort is an example of how the ministries have quietly worked over the years to shield themselves from consumer protection laws and preempt government oversight.

One more special right for religion. In conservative circles the right to religious freedom is greater than any other right, expect maybe the right to bear arms. Bold of nauseating selling out mine.

Guarino met with lawmakers in Virginia, Arkansas and Idaho. “Most of the time I was hiring local lobbyists, training them, and then they got the bill passed for us,” Guarino explained.

Although it did not attract much attention, the campaign was a remarkable success. By 2008, 15 states had passed safe harbor laws. Then, a new threat emerged. In 2009, President Barack Obama proposed his sweeping reform of the health care system. Central to the law was a provision referred to as the “individual mandate,” which required that every American obtain health insurance or face a fine. The mandate presented a direct threat to health care sharing ministries: If members were forced to buy insurance, they would likely leave en masse.

Although Guarino was embarrassingly outgunned by the health insurance lobby, he was determined to slip some version of a safe harbor carve-out into whatever the Democratic-controlled Congress handed the president. “I went and saw 150 congressional staffers during that time,” Guarino said.

The turning point came when Guarino reached out to a GOP state legislator he knew in Iowa and asked if she could put him in touch with Republican Chuck Grassley, the state’s longtime senator who wielded power as a member of the Senate Finance Committee. The lawmaker had known Grassley’s family since childhood and agreed to set up a meeting. “Lo and behold, that happened,” Guarino said. “As a Christian, I look at this and say, ‘Oh, this is God’s way of orchestrating things.’”

Guarino told ProPublica that he and his clients got on the phone with Grassley. Together they crafted an amendment to Obamacare that exempted members of sharing ministries from having to obtain health insurance on religious grounds. Behind the scenes, Grassley got that carve-out into the Senate version of the bill, Guarino said. (Grassley did not return a request for comment.)

The passage of the Affordable Care Act was chaotic and, for ministries, that was fortuitous. The House version, which many Democrats preferred, didn’t include Guarino’s exemption. If the House bill prevailed in negotiations between the two chambers, ministries would be extinct.

But with the sudden death of Sen. Ted Kennedy, Democrats lost their filibuster-proof majority in the Senate and could not pass the House version. They were forced to go with the Senate bill that included the carve-out.

The exemption — just 200 words in a 900-page bill — survived tense negotiations between the chambers, going virtually unnoticed. Obama signed the ACA into law in March 2010.

“That’s our language right in the bill,” Guarino told ProPublica.

[goldenvalley]

Mar 10, 2023 21:42:06 GMT LFC said:

Christians were given a special carve-out from Obamacare by Chuckles Gr-ass-ley. I wonder how many of these so-called Christian health networks are scams or at least enriching those who run them, without strict government regulation.

I wonder how many of them fold because a couple of their members get a catastrophic disease or are in accidents with expensive injuries and long term needs. They realize they can't pay out what is needed, leaving their insureds going to Medicaid to get coverage.  That only works if they have a low enough income.

[LFC]

Mar 10, 2023 21:45:49 GMT goldenvalley said:

Mar 10, 2023 21:42:06 GMT LFC said:

Christians were given a special carve-out from Obamacare by Chuckles Gr-ass-ley. I wonder how many of these so-called Christian health networks are scams or at least enriching those who run them, without strict government regulation.

I wonder how many of them fold because a couple of their members get a catastrophic disease or are in accidents with expensive injuries and long term needs. They realize they can't pay out what is needed, leaving their insureds going to Medicaid to get coverage.  That only works if they have a low enough income.

Yeah, all about "God(tm) will provide" until He(tm) doesn't. Then the burden is tossed onto the taxpayers.