Just a few thoughts….

Tomorrow will mark the end of ONE MONTH of sheltering in place for us.  We have been retired for several years… so we have been for the most part sheltering in place for years.. 🙁 All too many are looking for a answer, for a solution, for adequate therapy.

I starting thinking back… We have had four Presidents over the last 27 yrs… two from each party and we have had Congress that has been controlled by each party at times and split at times.

What has really changed ?

In 2006 Medicare folks gone prescription coverage for the first time since it was started in 1965..  Democrats fought against that bill being passed tooth and nail.  Barb has been on Medicare disability since 1997 and without her Medicare she was virtually otherwise uninsurable.  All she has was Medicare A & B and a Medicare supplement was either unavailable or so outrageous premiums , so all deductible, copays and all her meds were out of pocket.  I can remember picking up a 90 day supply of her meds and having $2000 – $3000  less in my pocket leaving the pharmacy.

In 1999 Congress gave us the “Decade of Pain Law”…. brought the 5th vital sign to the practice of medicine.. that was everyone had to assess and treat a pt’s perception of pain. When this law expired it was not renewed. Just by chance a <R> controlled Congress passed this law and a <D> controlled Congress and a newly elected <D> President was in power at the time

Obama was sworn in Jan 2009 and the Affordable Care Act was signed into law March , 2010.  We supposedly had abt 10% of the population without any insurance – which today we still have that same percentage.  Some people got low premiums and high deductibles … some people got high premiums and high deductibles.  Some people basically got put on Medicaid – under a different name (AKA).

2016 brought us the infamous CDC’s opiate dosing guidelines. What a CLUSTER -F !

For the last President election, I used this graphic a lot. Congress is now SPLIT.. and we have a lot of DEADLOCK at that level and all the other 2 odd millions Federal employees are pretty much do what they damn please. So much infighting in Congress … among our elected leaders.. does anyone really know what is going on..

It would seem that no matter who has been in power over at least the last 27 yrs… really not much as changed. What has changed – behind the scene – is that during the 90’s all the insurance companies that were historically been not for profit companies – meaning that their policy holders – owned the company..

Well most in the 90’s DEMUTALIZED and became FOR PROFIT … publicly traded stocks… and they started being concerned about their stock price and their bottom line.  Also during this time, the PBM industry -Prescription Benefit Managers – got a strangle hold the prescription business… Today they tell pharmas that if they want their particular med on their approved formulary … they will REBATE/DISCOUNT/KICKBACK up to 75% of the wholesale price of the med to the PBM for that privilege.

I have come to the conclusion that is really doesn’t matter much if a <R> or a <D> is in Congress “the seniority system” of Congress will prevail.  For something to become a law.. it has to go thru a committee in each the House and Senate and the chairperson of those committee is a member of the same party that is in control of their respective part of Congress..  Chairperson doesn’t want to hear a bill.. it goes NO WHERE…  If approved by the committee the bill then goes to the floor of the respective part of Congress and if the person who is speaker of the House or majority leader of the Senate doesn’t want to have a vote on the bill … it goes NO WHERE.

Just look at what Harry Reid – then majority leader of the Senate – under Obama did… for SEVEN YEARS he refused to bring the MANDATORY ANNUAL BUDGET up for a vote..  He only brought it up for a vote the last year of Obama’s administration.. maybe because the budget would mostly the new President’s being in office would have to deal with it.

It is claimed that 98% of member of Congress will get re-elected… doesn’t really matter what they have promised and not follow thru on… what they have not done period. It is claimed that people believe that the person in Congress representing them are “good guys”.. if all the rest of those bums that need to get voted out.

I have come to the conclusion unless you CLEAN HOUSE and virtually destroy the seniority system… nothing is going to change.

IMO, the community needs to have created a nonprofit and have at least $500,000 in the bank and one or more lobbyists firms aligned…  to hit the ground a couple of weeks after the new members of Congress are sworn in. If no positive actions or no action in the right direction and the next election is six months away… the community gets a list of who needs to GO  and OUT THEY GO !

If No VOTERS see the lights… and acts accordingly … then the community is going to remain walking around “in the darkness”

 

2 Responses

  1. You pretty much said it all Steve If I could condense it I would say what you basically said “We need to throw EVERYONE out of office start over again,have Health providers back to non profit throw the PBM in prison and have one term for all seats” Well that was fun for a minute.In reality we all no we are f*^#@ked and nothing will change sort of a revolution. Im terrified for my kids and that makes this political system joke we have,not very funny

  2. Doctors (and Patients) of Courage has been leading the charge to fire the incumbents since November, with our Communication Campaign. We are working on a questionnaire to send out to all candidates. But the interest in this has declined to the point that I am pausing the Monday night webinar. Nothing is going to be done effectively with the interest shown. Hopefully when the politics starts up again and we re-open the campaign, people will join and we can be effective. At least, if things don’t change, people can’t blame anyone but themselves because the road was available for change.

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