The Blame Game Continues Amid a Sea of Rudderless Boats and a Lack of Leadership

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Here I thought that both the GOP and the Democrats were going to play nice, the blame game continues. But they are at it again!

A few days before the Senate GOP was to announce that they were releasing the “New and Better Health Care Act” the Democrats in Congress said they were prepared to try new tactics in order to stop the bill that Mitch McConnell and the Republicans are determined to pass through the Senate. According to a senior Democratic aide, they’ll be doing the following:

  • Slow all action on the Senate floor to a crawl by objecting to “unanimous consent” requests (which are required to move anything forward), with the possible exception of some honorary resolutions.
  • Make multiple requests to move the health care bill that passed the House into the Senate committee process, as a way of highlighting the secrecy with which the Senate version is being crafted.
  • Make parliamentary inquiries (which can further slow things down) on the secrecy of the GOP bill.
  • Hold a talkathon starting today and stretching until at least midnight tonight, wherein Democratic senators will rail against the bill on the Senate floor.

“These are merely the first steps we’re prepared to take in order to shine a light on this shameful Trumpcare bill and reveal to the public the GOP’s true intentions: to give the uber-wealthy a tax break while making middle class Americans pay more for less health care coverage,” Senate Minority Leader Chuck Schumer said in a statement. “If Republicans won’t relent and debate their health care bill in the open for the American people to see, then they shouldn’t expect business as usual in the Senate.”

It really looks like large rudderless sailboats trying to get to some finish line without any significant Captains to navigate the waters and guide the ships. Where are the leaders and I am also including the President??

Christopher Wilson, Editor at Yahoo News stated that amid complaints about the secrecy with which Republicans are drafting a health care bill, the White House Tuesday put the blame on Senate Democrats for refusing to cooperate. But a spokesman didn’t address the complaints of outside groups that very much want to be heard in the process.

At Tuesday’s White House briefing, press secretary Sean Spicer was asked how the current legislative process differs from the way the Democratic Congress enacted Obamacare in 2010. The Senate’s health care bill is being written in secret by a group of 13 Republican legislators chosen by Majority Leader Mitch McConnell; senators outside the group, and even some of those in it, say they don’t know what it contains.

Republicans have long complained that Obama’s Affordable Care Act was written in secrecy without Republican input and rammed down the throats of Americans. The bill passed after months of hearings and debate. President Obama convened a bipartisan summit on health care on Feb. 25, 2010.

“I think we wanted to be part of the process back then,” said Spicer. “If you look at what Sen. Schumer said in February in a MoveOn.org call where he said no Democrats [are] going to go near this and what he said as part of a letter May 9, he said, ‘No Democrats are going to be part of an effort to repeal Obamacare.’”

“They have chosen to make themselves not part of this process,” continued Spicer. “When Sen. McConnell brings the bill forward, I’m sure there will be plenty of time to have debate. It’s the Senate, there’s always going to be time to debate.”

Spicer was reminded that McConnell was planning on voting on the bill as early as next week in order to have it passed by the customary July 4 recess.

“Well, OK, but again, next week, I’ll let Sen. McConnell determine the Senate schedule and run the Senate that he sees fit,” said Spicer. “But let’s not mistake ourselves with how they approach this thing. Their leader, Sen. Schumer, made it very clear on at least two separate occasions that they didn’t want to be part of this process. They didn’t want to repeal and replace Obamacare, they were happy with Obamacare. We believe that Obamacare is failing; we want a better system for the American people, a patient-centric health care system that brings down costs and brings more accessibility to people. That’s it. They made it very clear that they didn’t want to engage in this process. So to turn around now and second-guess, that’s something they should take up with their own leader.”

A Congressional Budget Office estimate of the House legislation projects that 23 million people will lose health care by 2026 if passes, and that it would increase the costs for Americans who are older or who have lower incomes. Some analysts believe that one reason for Obamacare’s instability is intentional sabotage by Republicans. Really, look at the numbers of Exchanges failing or have failed and the insurance companies out of covering Obamacare patients.

Democrats have complained about the legislative process, with Sen. Claire McCaskill of Missouri ripping it as a “backroom” deal earlier this month. On Tuesday, a trio of Democratic senators live-streamed their trip to the CBO in an attempt to procure a copy of the legislation. They were unsuccessful.

Outside medical groups have also said they have been cut out of the process. The American Heart Association, the American Cancer Society and the March of Dimes have all been ignored by McConnell’s office, according to a Los Angeles Times report.

“The Senate staff generally don’t know anything,” Dick Woodruff, vice president of the American Cancer Society’s advocacy arm, told the LA Times. “There are so few people who understand what is going on that having meetings isn’t particularly productive. … This is such a closed process.”

“It is deeply disturbing,” said Erika Sward, assistant vice president of the American Lung Association, in an interview with the LA Times. “Patients groups like ours need to make sure that our patients’ needs for healthcare will be met. … We can’t do that if we can’t see what is being proposed.”

Last week, a group of seven governors — including Republicans John Kasich of Ohio and Charlie Baker of Massachusetts — sent a letter to McConnell and Schumer asking to be a part of the process. And it is not just Senate Democrats, nonprofit groups and governors that wanted to be a part of the process, but members of the Republican caucus.

“Would I have preferred a more open process? The answer is yes,” said Sen. Bill Cassidy of Louisiana. So, why didn’t the Leaders allow this to happen?

“No [I haven’t seen it], nor have I met any American that has,” said Sen. John McCain of Arizona when asked about it. “I’m sure the Russians have been able to hack in and gotten most of it.”

“I’m not going to vote for a bill whose impact has not been analyzed by the CBO,” said Sen. Susan Collins of Maine. “I think that it is not a responsible way to legislate, when you don’t know the impact on cost and coverage. I always believe legislation is best crafted through the normal order. I think it’s much better to have committee consideration of bills, public hearings and to have a full debate. That’s the process for most well-considered legislation.”

Even Sen. Mike Lee of Utah, who is a member of the working group that was reportedly writing the legislation, expressed frustration Tuesday afternoon about being left out of the process.

“Even though I’ve been a member of this working group assigned to help narrow some of the focus on this, I haven’t seen the bill,” said Lee. “It has become increasingly apparent over the past few days that even though we thought we were going to be in charge of writing this bill within this working group, it’s not being written by us. It’s apparently being written by a small handful of staffers for members of the Republican leadership in the Senate. So if you’re frustrated by the lack of transparency in this process, I share your frustration wholeheartedly.”

Trump himself has criticized both the Senate and House bills, despite toasting the passage of the latter with a large Rose Garden celebration at the White House. During the briefing, Spicer said that Trump wants a health care bill that has “heart” in it, but didn’t specify what that meant.

Spicer also could not confirm that Trump or any member of the White House staff had seen a copy of the Senate bill. Last week multiple sources reported that Trump had called the House bill “mean” during a meeting with GOP senators.

Sen. Bob Corker, R-Tenn., said on MSNBC Tuesday morning that all Republican senators would meet Wednesday to outline the health care bill, with the language being revealed on Thursday.

Senate Republicans on Thursday unveiled their plan to repeal and replace the Affordable Care Act — also known as Obamacare. The long-awaited plan marks a big step toward achieving one of the Republican Party’s major goals. Here are 3 charts that breakdown and compare the features of the ACA, the House and the the Senate the features of the health care bills.Reformchart.1

Reformchart.2

Reformchart.3The Senate proposal is broadly similar to the bill passed by House Republicans last month, with a few notable differences. Senate Majority Leader Mitch McConnell, who has been criticized for drafting the bill in secret with just a dozen Republican Senate colleagues, says the proposal — which he calls a discussion draft — will stabilize insurance markets, strengthen Medicaid and cut costs to consumers.

“We agreed on the need to free Americans from Obamacare’s mandates. And policies contained in the discussion draft will repeal the individual mandates so Americans are no longer forced to buy insurance they don’t need or can’t afford,” McConnell said.                                                                                                                    Instead, the bill entices people to voluntarily buy a policy by offering them tax credits based on age and income to help pay premiums.                                                This bill is better designed than the House version, according to Avik Roy, founder of the Foundation for Research on Equal Opportunity, because it offers more help to older people who can’t afford insurance while making coverage cheaper for young healthy people.                                                                                                                             “The bill will encourage a lot more of those individuals to buy health insurance,” Roy says. “That, in turn, will make the risk pool much healthier, which will also lower premiums. And the tax credits in the bill will also be better-designed.”                     But Caroline Pearson, a senior vice president at the consulting firm Avalere Health, says the bill bases its tax credits on lower-quality insurance. “If you’re paying a similar percentage of income, you’re getting a less generous product under this new plan,” she says.                                                                                                                                                                                                                                                                                                                   The plan keeps some popular parts of Obamacare. It allows parents keep their children on their policies until age 26 and requires insurers to cover people with pre-existing conditions.                                                                                                              But it then allows states to opt out of that requirement.                                                 “The protections around pre-existing conditions are still in place in the Senate bill, but the waiver authority gives states options that could include limiting coverage for people with pre-existing conditions,” says Pearson.

Those waivers would allow state to drop benefits required by Obamacare, such as maternity coverage, mental health care and prescription drug coverage.

Both bills would eliminate most of the taxes imposed by the Affordable Care Act.

And they would bar people from using tax credits to buy policies that pay for abortion and also block Planned Parenthood from getting any money from Medicaid for a year.

Perhaps the most sweeping move, however, is that the Senate plan follows the House lead in completely changing how the government pays for health care for the poor and the disabled — and goes even further.

Today, Medicaid pays for all the care people need, and state and federal governments share the cost.

But Medicaid has been eating up an ever-larger share of federal spending. The Senate Republicans’ plan puts a lid on that by rolling back the Obama-era expansion of the program and then granting states a set amount of money for each person enrolled. Republicans also want to change the way the federal government calculates payments to the states starting in 2025, reducing the federal government’s contribution to the states.

“The Medicaid cuts are even more draconian that the House bill was, though they take effect more gradually than the House bill did,” Pearson says. “So we’re going to see very significant reductions in coverage in Medicaid and big cuts in federal funding that will result in significant budget gaps for states.”

But, maybe those aren’t so bad considering the unbelievable inefficiencies and yes, abuses and fraud inherent in the Medicaid system. But this safety net is an important and integral part of the health care system, unless we really end up with a real single payer health care system.                                                                               Several Republican senators have already said they oppose the bill, at least as of now. Senate leaders are aiming for a vote before July 4.

Are they all kidding themselves?? Right now there are Senators who will not vote for this bill and therefore visualize the effect of failure to pass the bill before they have full involvement of both parties and come to grip with the reality of the non sustainability of Obamacare , the good aspects of the Affordable Care Act and the need to modify and improve this bill created with great intentions. Remember my warning. If they screw things up, they, the GOP, will lose big time and I mean they will lose the midterm elections and probably the next presidential election as well as the continual fighting, bickering and inability to run our wonderful country.

Wake up and smell reality! They should all read our chapter on project development and error analysis in our book on process improvement. Their ignorance and arrogance is getting in the way of decision-making.

Next week I am going to discuss how the “More Improved Affordable Health Care Act” could affect we the people and how health care workers feel about it and how it would change the insurance business.

 

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