US national policy issues looming after healthcare?

Atom-smashing scientists are unnerved by harsh Trump budget


The president wants the federal government to spend less on science and medicine, saying the cuts would encourage private-sector investment. Researchers at the Oak Ridge National Laboratory, however, say the U.S. needs federal science dollars to compete with China.

So at least two things I disagree with Bernie Sanders about- raising minimum wage with our present set of global circumstances, and blocking TPP.

OK gang, here is a scary one on the crime and domestic terrorism front:

The River of Blood monument marks a fictional site of the American Civil War, on a golf course owned by Donald Trump.

An Ancient Bloodsport in Modern California
By MIKE MCPHATE


In cockfighting, roosters battle to the death. The fights, banned in California sine 1905, have occured mostly in the Central Valley and along the border with Mexico.

In cockfighting, roosters battle to the death. The fights, banned in California sine 1905, have occured mostly in the Central Valley and along the border with Mexico. Alexandre Meneghini/Reuters
Good morning.

In a secluded barn just west of Fresno, the evidence of killing was everywhere — a weight scale, a blood-spattered wall, a wooden fighting ring and dozens of mutilated, dead roosters.
When sheriff’s deputies arrived a couple weeks ago, roughly 100 people scattered, driving off or running through nearby fields.
The deputies arrested four men, charging them in connection with an illegal cockfighting ring.

Cockfighting, an ancient bloodsport, pits roosters against one another in gladiatorlike combat to the death. It’s been banned in California since 1905.

Yet many locations, concentrated heavily in the Central Valley, still raise roosters for fighting, said Eric Sakach, a senior law enforcement specialist for the Humane Society.

Since late last year, news reports have provided accounts of cockfighting operations in Corcoran, East Palo Alto, Santa Maria and Fontana.

The southern border area is another hot spot, in part because of its proximity to Mexico, where cockfighting is allowed. In 2007, the authorities in San Diego’s Otay Mesa, a community along the border, seized more than 5,000 roosters in what was called the country’s largest cockfighting raid.

California has been a destination for cockfighting because it usually regards participation as a misdemeanor, unlike neighboring states that impose felony charges, said Mr. Sakach.

The secretive events are advertised by word of mouth, with codes words sometimes assigned to gain entry. The rooster owners contribute to a purse that can grow to $15,000 or more.

Spectators drink beer and place side bets as the roosters peck and claw each other to the death, aided by blades affixed to their legs. Losers are tossed into a garbage can.

Californians enjoy a number of legal ways to gamble, casinos and horse tracks for example, that don’t involve the possibility of arrest. Why cockfighting?

Mr. Sakach attended cockfights as an undercover investigator. He suggested there was an “adrenaline rush” that came with breaking the law.
But the allure also speaks to a more primal instinct, he said.
“The gambling is a huge factor,” he said. “But the bottom line is the entertainment value of watching two animals slice or stab each other to death is a driver.”

By Ezekiel Emanuel May 5 at 7:51 PM

Ezekiel Emanuel is chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania.

The Republicans’ health bill is an act of supreme hypocrisy and insensitivity to the experience of Americans. It will damage — not improve — the U.S. health system.





Obamacare was a failure because it passed with only Democratic votes — so charged Republicans. All through 2009, Democrats tried to get Republicans to engage in discussions about health-care reform. Remember the “Gang of Six” or the “Gang of Eight” that Sen. Max Baucus (D-Mont.) ran to try to craft a bipartisan bill? After Sen. Olympia Snowe (R-Maine) voted for the bill in committee, she reversed herself under extreme Republican pressure. Now, given their own opportunity for a bipartisan health reform bill, Republicans passed a totally partisan bill, and they never even tried reaching out to Democrats to see if there could be consensus.



Democrats are giving insurance companies bailouts — so charged Sen. Marco Rubio (R-Fla.). The Affordable Care Act contained risk corridors, which were a way to spread the risk across insurers when the exchanges just started and no one knew who would buy insurance. In 2014, Republicans voted to block funding for these risk corridors — a main reason that premiums on the exchanges went up so much in 2016 and 2017. Now, in their own bill, Republicans have included tens of billions of dollars for insurance companies. A bailout? No, Republicans re-labeled this a “stability fund.”


Republicans promised they would never allow insurance companies to discriminate against people with preexisting conditions. Well, so much for that. House Speaker Paul D. Ryan’s (R-Wis.) bill allows states to grant companies the ability to charge exorbitant fees to people with preexisting diseases. The Republican claim that no state will pass such bills is ridiculous. Why have the option then? More important, we know states have done much worse in the past. Remember Arizona denying bone-marrow transplants to patients with curable cancer on Medicaid? Who would have thought that could happen?

And those high-risk pools Republicans claim will protect people with preexisting conditions? They don’t work. Even with Rep. Fred Upton’s (R-Mich.) amendment offering an extra $8 billion to the stability fund, the pools would be totally underfunded. Just do the math. Insuring patients with serious illnesses will cost about $10,000 each (a conservative estimate), so Upton’s money covers fewer than 200,000 Americans. Not even a modest fig leaf.

Other Republican axioms: Obamacare is collapsing; the exchanges are dying; premiums are skyrocketing; and a third of counties have only one insurer. Let’s put aside that the Congressional Budget Office and Standard & Poor’s concluded that the exchanges are stable. Let’s put aside that Anthem just announced it is doing well in the exchanges. If they wobble, it is the Republicans’ doing.

A few fixes would enhance the exchanges’ functioning: 1) Enforce the mandate so more healthy Americans buy in the exchanges; 2) guarantee funding for subsidies to consumers so insurance companies can lower premiums; 3) fund the risk corridors and reinsurance payments; and 4) increase targeted advertising so more people know about the subsidies and the requirement to get insurance.

Republicans passed exactly one fix: The stability fund does provide some reinsurance help. But that’s the only thing their bill does to help fix the system. Republicans are undermining and not enforcing the mandate. Republicans decided not to appropriate money for subsidies. And Republicans have severely limited advertising.

This bill will make things worse. It will not improve the number of insured; estimates show that the bill will force tens of millions of Americans to lose coverage.

This bill will increase costs. Cutting essential benefits means people must pay for those uncovered services — whether that’s maternity care, mental-health care or dental care for children. With more uninsured people, hospitals will increase what they charge to cover the uncompensated care they give, driving up premiums. And there is no provision to reduce deductibles.

Most important, this bill has no serious cost control ideas in it. No change in how doctors and hospitals are paid to improve quality and lower costs. No measures to reduce drug prices. No attempts to lower Medicare costs through site-neutral payments — that is, paying the same price regardless of where a procedure is performed — or to prevent hospitals from buying up physician practices to increase their bargaining power and raise their costs.


Republicans promise cost control later, in future legislation. But any additional health-care legislation will require support from Democrats in the Senate. After this hyper-partisan bill, there is no chance a single Democrat will collaborate before the next election.

Desiring to do something, Republicans have only shown hypocrisy and callousness. As polls suggest, they won’t have to wait long to see the repercussions of their actions — only until 2018.

Trump Spurns Congress as He Signals Medical Marijuana Fight
Bloomberg

by Toluse Olorunnipa




President Donald Trump signaled he may ignore a congressional ban on interfering with state medical marijuana laws, arguing in a lengthy statement that he isn’t legally bound by a series of limits lawmakers imposed on him.

Trump issued the “signing statement” Friday after he signed a measure funding the government for the remainder of the federal fiscal year, reprising a controversial tactic former presidents George W. Bush and Barack Obama used while in office.

Trump also suggested he may ignore gender and racial preferences in some government programs as well as congressional requirements for advance notice before taking a range of foreign policy and military actions.

Attorney General Jeff Sessions has vowed to crack down on marijuana and has dismissed arguments for its medical use as “desperate.”

“I reject the idea that we’re going to be better placed if we have more marijuana,” Sessions said in a speech to law-enforcement officials in March. “It’s not a healthy substance, particularly for young people.”

Twenty-nine states and the District of Columbia, Guam and Puerto Rico now allow for medical marijuana use, according to the National Conference of State Legislatures.

Trump argued in the statement that his constitutional prerogatives supersede the restrictions Congress placed on him as a condition for funding government operations.

Power Struggle

Steve Bell, a senior adviser at the Bipartisan Policy Center in Washington, said Trump’s signing statement signaled a desire to usurp power from the legislative branch.

“It is the constitutional prerogative of the Congress to spend money and to put limitations on spending,” Bell, a former staff director of the Senate Budget Committee and an aide to former Republican Senator Pete Domenici of New Mexico, said by phone. “This is an extremely broad assertion of executive branch power over the purse.”

In the signing statement, Trump singled out a provision in the spending bill that says funds cannot be used to block states from implementing medical marijuana laws.

“I will treat this provision consistently with my constitutional responsibility to take care that the laws be faithfully executed,” he said.

Making a Statement

Obama also occasionally released signing statements objecting to congressional restrictions on his authority. The White House didn’t respond to requests for comment Friday on whether Trump plans to abide by the congressional restrictions.

Bell said Trump’s stance on the medical marijuana provision in the bill was at odds with the 10th Amendment, which protects states from federal overreach.

Tim Shaw, a senior policy analyst at the Bipartisan Policy Center, said that the president is bound by the language in the spending bill that now bears his signature.

“Part of the argument here in this signing statement is that he has the constitutional requirement to execute the law,” Shaw said in an interview. “But this is one of those laws, and Congress has the ultimate authority over funds getting spent.’’

During a “Fox & Friends” interview this morning, Health and Human Services Secretary Tom Price said it’s only natural that people who are sicker and riskier have to pay more for health insurance -- that's "pricing for what an individual's health status is."
**
Price revealed Republican thinking. In a “free market” for health care, the older and sicker would be charged higher insurance premiums** because they’re more likely to cost more, and the younger and healthier would be charged less because they’re likely to cost less.

Which is why a civilized society doesn’t rely on the free market for determining the price of health insurance.