Tag: Donald Trump

“Sons of Liberty” Flea Into King George’s (or Donald’s) Open Arms.

Jun 29, 2023

BY MIKE MAGEE

If there is a silver lining to the Trump assault on decency and civility, it is our majority response to this “stress test” of our Democracy, and the sturdiness (thus far) of our Founders’ vision.

It was, after all, a long shot when Alexander Hamilton, under the pen name Publius, published Federalist No. 1 on October 27, 1787, writing: “It has been frequently remarked that it seems to have been reserved to the people of this country, by their conduct and example, to decide the important question, whether societies of men are really capable or not of establishing good government from reflection and choice, or whether they are forever destined to depend for their political constitutions on accident and force.”

Two weeks before the Iowa caucus in 2016, Trump himself sided with “force” and signaled a rocky road ahead when he stated in Sioux City, Iowa, that “I could stand in the middle of Fifth Avenue and shoot somebody, and I wouldn’t lose any voters, OK? It’s, like, incredible.”

In so doing, he was taking on medieval jurist, Henry de Bracton, who wrote in On the Laws and Customs of England in 1260 that “The king should be under no man, but under God and the law.”

Of course, Trump, while representing our Executive branch, was not acting alone. He was supported by members of our Legislative branch as they successfully stacked the Judicial branch with religious conservatives. The net impact was this past year’s overturning of Roe v. Wade, and a Christian Evangelical legislative windfall (and subsequent political backlash) in multiple Red States across the union.

Trump Earns a Failing Grade in Civics (K-12) in North Carolina.

Jun 13, 2023

BY Mike Magee MD

Events over the past year clearly have confirmed that we are a “work in progress” even as we stubbornly affirm our good intentions to create a society committed to “life, liberty, and the pursuit of happiness.”

With the Dobbs’ decision, our Supreme Court has unleashed long-abandoned regressive state laws designed to reinforce selective patriarchy and undermine the stability and confidence of America’s women and families. As a result, our nation’s health professionals, and the patients they care for, potentially find themselves “on the wrong side of the law.”

It calls to mind the well-worn phrase of mothers everywhere to their bossy children, “Who died and left you boss?”

Since our former President, on the eve of his latest indictment, decided to deliver a message to North Carolina Republican supporters this past weekend, claiming that he was engaged in the “final battle” with “corrupt” forces, most especially the “Deep State” that was “out to get him,” I decided to fact check his claims with the kids of North Carolina.

North Carolina’s K-12 lesson plan, titled “The Rule of Law,” begins with the Teddy Roosevelt quote, “No man is above the law, and no man is below it” from his 1903 State of the Union address.

Trump As Catalyst For Legal and Cultural Reform

Apr 5, 2023

BY MIKE MAGEE

Former President Donald Trump’s indictment this morning reinforces most Americans’ belief that “No man is above the law.” But few of us have taken the time to explore what that statement means when it comes to building a healthy nation, and why we believe it.

How do you create a healthy nation?

This is at once a very simple and a very complex question. It is at the heart of successful and failed nation building.

It applies equally to a self-assessment of our approach to rebuilding Germany and Japan as part of the Marshall Plan after WW II, and to our own struggles with autonomy and disparity in America where our very beginnings were (and continue to be) marred by a history of enslavement of blacks, forced migration and cultural destruction of Native Americans, and subjugation of women.

The law, a blend of agreed upon rules, regulations and boundaries, arose in layers over time, and reflected the communities where they emerged. Our own American legal system, on which we relied to launch this nation-building exercise in 1776, is dynamic and continues to evolve to this day.

As legal historian Lawrence Friedman wrote, “Despite a strong dash of history and idiosyncrasies, the strongest ingredient in American law at any given time is the present – current emotions, real economic interests, and concrete political groups.” It is then “a study of social development unfolding through time…”

When building a nation, some countries like France and Germany, relied on written codified rules, statutes or “rational instruments” on which they leaned to create order and to base decisions. But our laws, upon which this nation was built, if they have a basis, were descendant from British law.

A Dream Day at The Beach

Aug 17, 2022

BY MIKE MAGEE

Senator Lindsey Graham (R.,S.C.) is on summer recess. A consummate professional politician, and war hardened lawyer, Sen. Graham has made a career out of flipping on a dime. His moral calculus has been flexible enough to wiggle and weave, and switch sides if cornered.

In a dream, I caught a glimpse of him reading on one of his state’s beautiful beaches. He was juggling a weighty 1215 page classic – Leo Tolstoy’s “War & Peace” in one hand, and a yellow highlight marker in the other.

He looked a bit on edge, maybe because this week a federal judge refused to block a subpoena seeking his testimony for a Fulton County, Georgia, Grand Jury probe into efforts by then-President Donald Trump and his potential state Republican “alternate electors” to overturn Georgia’s Biden victory in the 2020 election.

A Bizarre Claim of Right to Try

Jan 18, 2019• 4

By ARTHUR CAPLAN, KELLY MCBRIDE FOLKERS, and ANDREW MCFADYEN

A patient with glioblastoma recently received an experimental cancer vaccine at the University of California, Irvine. Notably, this is being hailed as the first case of someone utilizing the Right to Try Act of 2017. ERC-USA, a U.S. subsidiary of the Brussels-based pharmaceutical company Epitopoietic Research Corporation, says it provided its product, Gliovac, to the patient at no cost. The vaccine is currently undergoing Phase II clinical trials. A handful of people in Europe have received access to it through “compassionate use.” This patient did not qualify for ongoing clinical trials in the U.S. The patient, who remains anonymous, is the first known individual to receive an experimental medicine that has not been approved by the FDA, as permitted under the federal right to try law.

Glioblastoma is a nasty cancer – John McCain and Ted Kennedy passed away after battling the disease for just over a year. We believe that patients with terminal illnesses, like those with glioblastoma, should have every reasonable tool at their disposal to treat their disease.

That being said, we’ve argued before that right to try laws are not the best way to help desperate patients. They still aren’t. The number of cases claimed to date is exactly one. And, further examination of what we know about this case does not make a strong argument for the widespread usage of the right to try pathway.

A Vote For Trumpcare

Nov 12, 2016• 59

By NIRAN AL-AGBA, MD

The world is not going to end. We witnessed a revolution earlier this week. The people have spoken and they chose the anti-establishment, street smart, government shrinking candidate who bucks the status quo. We find ourselves in uncharted territory, with an unpredictable President-elect, who has unclear plans for healthcare. Here is what we do know. Mr. Trump is a successful entrepreneur. Forbes describes the entrepreneurship pathway as having no clear story line, but a “sense of chaos, hectic decision making, and moments of great fear and doubt.” Improving our broken healthcare system will involve decision making in the face of great uncertainty. Mr. Trump has a well-developed tolerance for this sort of ambiguity and is likely the right man for the job.

Mr. Trump won over the white working-class individuals in small rural areas. Sluggish economic recovery in these areas played a significant role in his unanticipated victory. It is these disenchanted individuals watching the American Dream slip through their fingers who voted for Mr. Trump. Those same people want the freedom to buy the insurance they need, and not what the bloated government shoves down their throats. 25% of the population lives in rural areas yet only 10% of the physicians practice in there. Physicians are leaving the system in droves, closing their patient panels, and not keeping up with demand, thereby threatening patient access in these isolated locales.

No, I Didn’t Expect That Either.
What’s Next?

Nov 9, 2016• 5

By MATTHEW HOLT

As a Democrat, I can only hope this is a Dewey defeats Truman moment, but at 2.00am ET on Nov 9, President Trump with a Republican House and a open Supreme Court seat seems to be our new reality. For the health care establishment, this is a bombshell. It’s been easy for Congressional Republicans to vote to repeal the ACA when they knew Obama would veto it. But what happens next when Trump is happy to sign the “repeal”?

It’s hard to figure out what’s there in terms of putting together to “replace” either in the Congressional Republicans or in what passes for policy in what passes for the Trump camp. As Margalit Gur-Aire said on THCB recently other than one speech with some stale talking points about block grants for Medicaid and selling insurance across state lines, Trump seems to have no ideas about health care. (To be fair he doesn’t seem to have any ideas about anything, or he claims they’re a secret).

Then we have the issue of his relationship with Congress. Now he’s President he may declare a truce, but then again he might decide to tweet into oblivion Paul Ryan and the many others who wouldn’t support him. And he might of course self-immolate as he tries to manage his business, his relationship with Russia and his soon to be launched TV network–while actually having to be President.

But if he’s going to end Obamacare, Trump is going to have to worry about two things. First, he has said that he wants to repeal it but is going to make sure everyone can buy health insurance, even if they have preconditions. When the middle aged white working class who voted for Trump discover that their Medicaid and their health insurance goes away, and that insurers wont sell them insurance if they’re not a good risk, they might be unhappy.

Second, the other people who are going to be unhappy are the health care industry stakeholders. Health care is a series of complex legislative and market interactions. As a consequence of the ACA, most health insurers, providers and even pharma or device companies have made huge changes to their business strategy. Those business strategies and investment are now six years old. Like Wall Street and corporate America, Trump is going to make the health care establishment deeply uncomfortable. The question is, once big pharma, insurers and providers lean on the Administration, will anything actually change, or will we see the route towards value-based care continue?

Not only that, but the sea-change that is just starting in the shift from FFS to value-based payments from Medicare & CMS is underway because the country can’t afford continued health care cost growth. That remains the same. Eventually that reality will impinge even on a Trump administration.

So what happens next? Well it’s amateur hour and we’ve all failed to predict it thus far, so it’ll be tough to do it now. But health care will be a sideshow.

Oh, and time to repeal the frigging electoral college.

Looking Back From 2019: Why the Republicans Nationalized Healthcare

May 7, 2016• 4

By JOE FLOWER

Screen Shot 2016-05-08 at 11.41.21 AM It was the Mother of unintended consequences.

By the time of the 2016 elections, health plans, hospitals and health systems had squeezed and consolidated and trimmed and cut costs under the gun of lower Medicare reimbursements and the new rules of Obamacare — but mostly they had adapted. Most of them had survived.

On November 9, the country woke to find itself with a Republican President-elect, a Republican majority in the House, and a Republican majority of 55 in the Senate. The Grand Old Party was dedicated to repealing #EveryWord of the Affordable Care Act, the hated Obamacare which was, after all, “destroying the country,” “the worst thing to happen to the country since the Civil War,” and “equivalent to slavery.”

The changes to healthcare did not wait until Inauguration Day, much less until the 115th Congress could assemble to gut the law. They began instantly.

November 9, of course, was just nine days into the annual Open Enrollment period for plans under the Affordable Care Act exchanges. Many of the 12.7 million who had signed up for 2016 could see that the subsidies they were getting through the exchanges would likely disappear in the wake of the election, and decided not to sign up. “Why chance it?” as Betty Cornwall of New Rhodes, Kentucky, put it to Fox News’ Megyn Kelly.

Health plan strategists, masters of not getting blindsided by risk, decided that it was a bad idea to sign up millions of people for plans without knowing what would happen to the law. They did not want to get stuck with serving people who did not pay, and did not want to get blamed for dumping people after they had signed up. So most large health plans withdrew immediately from the exchanges, before many more people could sign up, draining the exchanges in many states of any choices at all.

Seven Pillars of Trumpcare

Mar 26, 2016• 18

By SAURABH JHA, MD

flying cadeucii It is possible that in a few months from now, only Nate Silver’s prediction models will stand between Donald Trump and the White House. I will leave it to future anthropologists to write about the significance of that moment. For now, the question “What will President Trump be doing when he is not building a wall?” has assumed salience.

This is relatively easy to answer when it comes to health policy. Just ask what people want. Seniors don’t want Medicare rescinded. Even the free market fundamentalist group, the Tea Party, wants Medicare benefits as they stand. At one of their demonstrations against Obamacare a protester warned, without leaving a trace of irony, “Government, hands off my Medicare.”

Rest assured, Trump will protect Medicare. Even raising the eligibility age for Medicare may be off the cards as far as he is concerned. He has promised that no one will be left dying on the streets. That people no longer die on the streets, but in hospitals, because emergency rooms must treat patients regardless of their ability to pay, is irrelevant. The point is that Mr. Trump knows that the public values their healthcare. Trumpcare will show that Trump cares.

The End of Civilization and the Real Donald Trump

Mar 15, 2016• 17

By ART CAPLAN

Screen Shot 2016-03-15 at 9.13.00 AM The pandemic started quietly. In the spring of 2017 A few hundred dead chickens appeared in markets in Hong Kong and a few other cities in China. Public health officials in China were slow to respond. They did not want to panic the public about an avian flu outbreak. Nor were they eager to take the steps necessary to contain such an outbreak—the killing hundreds of thousands of chickens and poultry with devastating economic consequences. While the delay went on a few cases began to occur on Canadian and American poultry farms. Department of Agriculture experts traced the outbreak to waterfowl migrating from Northern flyways, probably from Asia. Inquiries were made about avian flu outbreaks in Asian nations. Then the unthinkable happened. Humans in Hong Kong began to get sick. Very sick. Some died. Those who died were in their twenties.

The avian flu virus had mutated. H7N9m had transformed into an agent that not only could infect humans but did so with a transmissibility and lethality that had not been seen since the Spanish flu outbreak of 1918.

Then the first American died. A young man back from a business trip to Hong Kong. The media, already primed for hysterical coverage following the severe Zika outbreak in the Southern United States in the summer and fall of 2016, went into full panic-dispensing mode. ‘Experts’ began to appear on the cable channels who suggested that the outbreak was the result of irresponsible genetic research in China. Still others suggested that it was the bioterror work of North Korean scientists. One or two pointed toward ISIS arguing that they had grown desperate in the face of the massive air war that the new administration had launched. Still others saw the hand of right or left wing domestic terrorists. And an accident at an American lab was put into the boiling cauldron of speculation and conspiracy.