There is a massive scandal raging at Michigan State University and widely across the national women's gymnastics program. One physician, left largely unsupervised for decades, is alleged to have committed perhaps hundreds (or more) sexual assaults on innocent athletes, some of them minors. We had policies for physician offices 25 years ago. Apparently not everyone was paying attention. A draft chaperone policy can be found at our Dropbox link. Updates will follow. This is NOT legal advice.
The U.S. health
care system was complicated before the Affordable Care Act, and the
overwhelming complexity of ACA made it much worse. Add to this
thousands of pages of Obama-era regulations and there is a lot to
know about the current health care system.
This cannot be
fixed with slogans.
The GOP Menu (maybe)
tanks and the GOP have been circulating the same ideas for decades.
Accounts – good for the affluent, not so good for anyone else
of health insurance – does absolutely nothing for consumers,
except expose them to lousy insurance plans - but good for lousy
insurance companies and salesmen
consumer choices – as in buying oncology is like buying a
subsidies, replace with tax credits (subsidies!)
for Big Pharma – yes, Congressmen are for sale (both parties)
Medicaid – give Medicaid policy to Sam Brownback and Paul Lepage -
Send poor people
back to Emergency Departments (which hurts hospitals)
So What Am I Saying?
The GOP does not
have a coherent plan to replace the Affordable Care Act and may never
have such a plan. There will likely be a repeal, total or partial,
but the replace will be difficult.
The GOP might
eventually have a plan to make Rush Limbaugh, the Koch brothers, the
Tea Party and Fox News happy, sort of. Even that may fail.
The GOP has been
blaming ACA for higher consumer costs (higher deductibles and
co-pays) , and may replace ACA with a plan with – you guessed it –
higher deductibles and co-pays,, including for seniors.
Repeal and Replace, or Partial
Repeal and Partial Replace, or Reform and Repair, or ?????
On Super Bowl
Sunday President Trump told Fox News that “repeal and replace”
could take up to a year. Huuuge!
A few days earlier
Rep. Jim Jordan, on the far right wing of Congress, said the total
and complete and quick repeal of ACA was the only viable strategy.
In the last ten
days or so “repair” has become a popular word, often in a phrase
such as “reform and repair.” This implies that not all of ACA
would be repealed, some of it would be repealed and new features
would be added as a repair.
Republicans in Congress and get seven or eight different answers.
There is also squabbling about whether health care should be done
before tax reform. The House majority and the Senate majority have
different ideas, and the Senate majority is pretty thin.
So, the GOP has
painted itself into a corner. The GOP could recover, stranger things
have happened in Washington, but as of early February consensus is
not looking either quick or easy, which makes near term legislation
IF, repeating IF
the GOP can agree on a plan, the various pieces and parts must
through the legislative process. Some parts could move through
reconciliation, others through the standard legislative process. This
could cause a problem in the Senate.
The Longer Term
House Speak Paul
Ryan has promised to”fix” Medicare.
There are ways to
fix Medicare, but Ryan apparently has no clue. There are serious
reform efforts already in motion to move Medicare from the original
fee-for-service model to a more sophisticated value-based model, the
legislation passed by bipartisan votes.
His approach is to
turn Medicare into a for-profit play pen for insurers and doing
tremendous damage to senior citizens. Wow.
President-elect Donald Trump has started inauguration week by promising to unveil a new replace plan for the GOP repeal-and-replace project.
Trump is now promising, or at least dancing around promising:
universal insurance coverage
In other words, none of this is realistic in the slightest. Reality is no longer a concern.
The only way "inexpensive insurance” works is if it really “cheap insurance.” Also known as lousy insurance.
Reports have Congressional Republicans wondering where this came from and what it will look like. Not to mention, what it would cost? And how is it conservative?
Trump has at least one good idea, the Medicare and Medicaid programs should be able to negotiate fixed prices with Big Pharma. Problem is, Congressional Republicans are committed to protecting Big Pharma even if the taxpayers continue to be cheated.