Expense Manager Services

Getting a handle on Unmanaged Spend through Expense Manager Services

Health Care

Health Care

John McCain pretty much killed Trumpcare and the bill’s sponsor tweeted a surprising response

Sorry, Lindsey.
Image: Getty Images

The latest trainwreck of a GOP health care plan looks likely to die — and, once again, John McCain could be the dude who killed it. 

On Friday, the Republican senator announced he would vote against the Graham-Cassidy bill. With zero support likely from Democrats, and Republicans Rand Paul and Susan Collins against it, that pretty much dooms the measure. 

SEE ALSO: Jimmy Kimmel tears apart his critics on health care bill

One of the men behind the bill — Sen. Lindsey Graham — was likely frustrated. But he still had some kind words for his colleague and longtime friend. 

McCain, Graham, and Joe Lieberman are known as the “three amigos” of the senate. Apparently, that’s a sacred bond that can’t be broken by torpedoing your friend’s terrible health care bill.

Remember, it was McCain who dramatically killed the last GOP effort to repeal Obamacare. His heroics the second time around are being praised by people across the political spectrum. 

The Arizona senator’s decision was met with support from Sen. Bernie Sanders, who has proposed his own “Medicare for all” plan, at a rally in San Francisco.

Jimmy Kimmel was pretty happy too, after absolutely slamming the plan on his show. 

Don’t relax yet, though. It’s possible that before the Sept. 30 deadline, Republicans somehow get the necessary votes for a bill that would — according to the Brookings Institution — cause 21 million people to lose their health insurance every year from 2020 to 2026. 

Thank you McCain and Collins (and I guess Paul, even though he’s not supporting the bill because it’s not draconian enough) for hopefully saving the country from this monstrosity. 

WATCH: Stephen Colbert and ‘SNL’ have figured out the right way to use President Trump

Read more: http://mashable.com/2017/09/22/john-mccain-tweet-graham-cassidy-healthcare-bill/

Health Care

John McCain won’t back Graham-Cassidy bill, likely ending GOP health care push

(CNN)Sen. John McCain announced Friday in a statement that he cannot “in good conscience” vote for the GOP’s latest plan to overhaul Obamacare, likely ending Republicans’ latest effort to repeal and replace the Affordable Care Act.

“I cannot in good conscience vote for the Graham-Cassidy proposal,” the Arizona Republican said in a statement. “I believe we could do better working together, Republicans and Democrats, and have not yet really tried. Nor could I support it without knowing how much it will cost, how it will (affect) insurance premiums, and how many people will be helped or hurt by it. Without a full CBO score, which won’t be available by the end of the month, we won’t have reliable answers to any of those questions.”
McCain’s “no” vote makes it very likely Republicans won’t be able to repeal and replace Obamacare before September 30, as Sen. Rand Paul of Kentucky said he would not back the effort and Sen. Susan Collins of Maine is also expected to vote “no” on the proposal.
    Republicans need at least 50 votes to pass the measure under the process of reconciliation.
    McCain was one of three most-watched members on the fence and considered a key vote on the bill. Without his support, Republicans would need to get Sen. Lisa Murkowski, a Republican from Alaska, as well as Collins to sign on. It’s unlikely considering the fact that Collins said Friday afternoon that she was leaning against the bill and had key concerns that the legislation did not do enough to protect individuals with pre-existing conditions.
    “I’m leaning against the bill,” Collins said Friday at a Portland, Maine, event, according to The Portland Press Herald.
    A Republican aide involved in the process said Friday afternoon that GOP leaders are at the “evaluating options” stage right now.
    The aide added, “I’m not breaking news telling you this isn’t good.”
    Paul, the only other Republican other than McCain who has so far definitively come out against Graham-Cassidy, is “unlikely” to change his mind even if changes are made to the bill, his spokesman Sergio Gor told CNN.
    McCain’s announcement comes despite that one of the bill’s key sponsors — Sen. Lindsey Graham of South Carolina — is a close confidant. The thinking was if anyone could convince McCain to vote “yes,” it would be Graham.
    “I take no pleasure in announcing my opposition. Far from it,” McCain said. “The bill’s authors are my dear friends, and I think the world of them. I know they are acting consistently with their beliefs and sense of what is best for the country. So am I.”
    McCain has said for weeks that he would not support health care legislation that had not gone through “regular order,” meaning Senate hearings, an amendment process and a rigorous floor debate.
    Graham said he “respectfully” disagrees with McCain and will “press on” with his legislation.
    “My friendship with John McCain is not based on how he votes but respect for how he’s lived his life and the person he is,” Graham said in a statement and on Twitter.
    McCain voted “no” on the last health care proposal in July for the same reason. McCain’s dramatic floor vote, which happened just weeks after he was diagnosed with brain cancer, came in the early morning and was captured as one of his most “maverick” moments in the Senate.

    Democrats praise McCain

    Just moments after McCain announced his opposition, Democrats seized on the opportunity to bring back bipartisan talks that had stalled last week.
    Democratic Sen. Patty Murray of Washington and Republican Sen. Lamar Alexander of Tennessee had held bipartisan hearings over the last month on how to stabilize Obamacare marketplaces and were making progress in their negotiations. But the House leadership made it clear last week that the chamber probably would not be able to pass such a bill.
    As soon as McCain announced his opposition, Murray announced she was still open to reigniting those talks.
    “I agree with Senator McCain that the right way to get things done in the Senate — especially on an issue as important to families as their health care — is through regular order and working together to find common ground,” Murray said. “I’m still at the table ready to keep working, and I remain confident that we can reach a bipartisan agreement as soon as this latest partisan approach by Republican leaders is finally set aside.”
    Senate Minority Leader Chuck Schumer also praised McCain shortly after his announcement.
    “John McCain shows the same courage in Congress that he showed when he was a naval aviator,” the New York Democrat said in a statement. “I have assured Senator McCain that as soon as repeal is off the table, we Democrats are intent on resuming the bipartisan process.”
    For her part, House Minority Leader Nancy Pelosi said her members would continue working “to put the stake in the heart of this monstrous bill.”
    “This weekend, we will continue to highlight the devastating costs Republicans are trying to inflict on hard-working Americans,” she said in a letter to colleagues.
    This story has been updated and will update with additional developments.

    Read more: http://www.cnn.com/2017/09/22/politics/john-mccain-health-care/index.html

    Health Care

    A furious Jimmy Kimmel slams the new GOP health bill in a monologue everyone should watch.

    Sen. Bill Cassidy has failed the “Jimmy Kimmel Test.”

    Spectacularly so.

    In a blistering monologue delivered Tuesday night, late-night host Kimmel accused the Louisiana Republican of coming on his show and lying “right to my face” about health care.

    At issue: the latest Republican attempt to “repeal and replace” the Affordable Care Act, with a bill co-sponsored by Cassidy. This bill comes just a few months after Cassidy appeared on Kimmel’s show in the wake of Kimmel’s newborn son’s open-heart surgery and his heart-wrenching monologue about the importance of health insurance.

    “A few months ago, after my son had open-heart surgery, which was something I spoke about on the air, a politician, a senator named Bill Cassidy from Louisiana, was on my show, and he wasn’t very honest. It seemed like he was being honest. He got a lot of credit and attention for coming off like a rare, reasonable voice in the Republican Party when it came to health care for coming up with something he called — and I didn’t name it this, he named it this — the ‘Jimmy Kimmel Test,’ which was, in a nutshell, no family should be denied medical care, emergency or otherwise, because they can’t afford it.“

    Kimmel argued that instead of passing Cassidy’s Jimmy Kimmel Test, the new bill cruelly rips away many of the protections Cassidy promised to uphold.

    “Now, I don’t know what happened to Bill Cassidy. But when he was on this publicity tour, he listed his demands for a health care bill very clearly. These were his words. He said he wants coverage for all, no discrimination based on pre-existing conditions, lower premiums for middle-class families, and no lifetime caps. And guess what? The new bill does none of those things.

    Coverage for all? No. In fact, it will kick about 30 million Americans off insurance. Pre-existing conditions? Nope. If the bill passes, individual states can let insurance companies charge you more if you have a pre-existing condition. You’ll find that little loophole later in the document after it says they can’t. They can, and they will.

    But will it lower premiums? Well, in fact, for lots of people, the bill will result in higher premiums. And as far as no lifetime caps go, the states can decide on that, too, which means there will be lifetime caps in many states. So not only did Bill Cassidy fail the Jimmy Kimmel Test, he failed the Bill Cassidy Test. He failed his own test. And you don’t see that happen very much.”

    The proposed law, as drawn up by Cassidy and three other GOP senators, would indeed drastically weaken many of the Affordable Care Act’s consumer guarantees, much as Kimmel described it.

    According to an NPR analysis of the bill, states could indeed waive the Affordable Care Act’s essential benefits requirement and allow insurers to charge customers with pre-existing conditions more or reject them outright.

    Additionally, states could permit insurers to reinstitute lifetime coverage caps, limiting the amount they pay out over a customer’s lifetime.

    Cassidy responded to Kimmel shortly after the segment aired, disputing the host’s characterization of the bill and encouraging his colleagues to vote for it.  

    Senators and bill co-sponsors Dean Heller (left) and Cassidy. Photo by Aaron P. Bernstein/Getty Images.

    “We have a September 30th deadline on our promise. Let’s finish the job,” he said in a statement provided to Vox. “We must because there is a mother and father whose child will have insurance because of Graham Cassidy Heller Johnson. There is someone whose pre-existing condition will be addressed because of GCHJ.”

    It is difficult to imagine that will be enough for Kimmel, who concluded by pleading with his audience at home to “call [their] congressperson.”

    “You have to do this. You can’t just click ‘like’ on this video,” he said.

    The future of health care in America could hang in the balance.

    Read more: http://www.upworthy.com/a-furious-jimmy-kimmel-slams-the-new-gop-health-bill-in-a-monologue-everyone-should-watch

    Health Care

    Heres Whats in Republicans Latest Obamacare Repeal Bill

    When Republicans in the U.S. Senate fell one vote short in July, it looked like their seven-year bid to undo the Affordable Care Act, aka Obamacare, had failed. Now there’s an effort to see if a different repeal bill, known as Graham-Cassidy, can make it through the Senate before a Sept. 30 deadline. Proponents say it would put reshaping health insurance in the hands of the states. Its detractors call it the same old steep cuts in coverage in a new wrapper.

    1. What would Graham-Cassidy do?

    The proposal by Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana would replace Obamacare’s insurance subsidies with lump-sum "block grants" to states, which would decide for themselves how to help people get health coverage. The bill, if signed into law, would spell an end to the Obamacare requirements that individuals obtain health insurance, that most employers provide it to their workers, and that insurers can’t deny coverage or charge more to people with pre-existing medical conditions. The proposal would end the Obamacare tax on medical devices while keeping others intact, including taxes on the wealthy, to fund the block grants. Those grants would expire in 2026.

    2. How is it different from previous repeal attempts?

    The Graham-Cassidy bill leaves to the states many questions that other Republican proposals would have had the federal government handle, like setting the size of insurance subsidies. It also strives to equalize Medicaid spending between states, and would cut the program in the mostly Democratic states that expanded it under the ACA, while sending billions to the mostly red states that didn’t.

    3. How is it like previous repeal attempts?

    In addition to ending Obamacare mandates, it would cap spending on Medicaid, the huge federal program for the poor and disabled.

    4. Why does the bill face a deadline?

    Republicans hold 52 seats in the 100-member Senate. They want to use a procedure, budget reconciliation, that allows legislation to pass with a simple majority rather than the 60-vote supermajority required to move most bills to a final vote. The Senate’s parliamentarian has ruled that the ability to use reconciliation under the current budget resolution ends when the fiscal year expires on Sept. 30.

    5. What has to happen between now and Sept. 30?

    Graham-Cassidy was formally introduced last week. Major bills usually aren’t voted on without a score from the Congressional Budget Office, which will assess whether Graham-Cassidy meets the standards for a simple-majority reconciliation measure. The CBO said Monday it will offer a partial assessment of the measure early next week but won’t have estimates of its effects on the deficit, health insurance coverage or premiums for at least several weeks.The parliamentarian also has to rule on whether any of its provisions aren’t eligible for reconciliation, which is supposed to be limited to tax and spending provisions.

    6. What are its chances?

    Uncertain. Since Democrats have unanimously opposed efforts to repeal the ACA, Republicans need the support of at least 50 of their 52 members. (Vice President Mike Pence, in his role as president of the Senate, would cast the tie-breaking 51st vote.) Senator Rand Paul of Kentucky says he’ll oppose Graham-Cassidy because even it retains too many elements of Obamacare. So much depends on the three Republicans who caused the defeat of the last Obamacare repeal bill — Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona.

    7. What would happen in the House?

    If the Senate passes Graham-Cassidy, the Republican-controlled House would have a chance to adopt it — but only word-for-word, unchanged. If the House demands changes, they would need the support of 60 senators, which is a near-impossibility. House Speaker Paul Ryan has spoken positively about the bill, as has Republican Representative Mark Meadows, chairman of the conservative House Freedom Caucus. But a significant number of House Republicans come from states that could lose billions in Medicaid money under Graham-Cassidy.

    8. Who’s for the bill?

    President Donald Trump says he supports it, though he has yet to do any active lobbying. Republicans feel pressure from their base for failing so far to repeal Obamacare — a failure Trump has excoriated them for.

    9. Who’s against it?

    Along with Democrats, several Republican governors in states that expanded Medicaid. Credit ratings agency Fitch Ratings said Friday that because Medicaid spending represents one-third of state budgets, the bill would pose big challenges for them, particularly those that took advantage of Obamacare’s Medicaid expansion.

    10. What happens if it fails?

    Democrats and Republicans on the Senate’s health committee are working together to see if they can write a narrow bill to address some of Obamacare’s flaws that threaten to lead to fewer choices and higher premiums for some people who buy individual insurance policies.

    The Reference Shelf

      Read more: http://www.bloomberg.com/news/articles/2017-09-19/what-s-in-last-republican-shot-to-kill-obamacare-quicktake-q-a

      Health Care

      Union Power Is Putting Pressure on Silicon Valleys Tech Giants

      Organized labor doesn’t rack up a lot of wins these days, and Silicon Valley isn’t most people’s idea of a union hotbed. Nonetheless, in the past three years unions have organized 5,000 people who work on Valley campuses. Among others, they’ve unionized shuttle drivers at Apple, Tesla, Twitter, LinkedIn, EBay, Salesforce.com, Yahoo!, Cisco, and Facebook; security guards at Adobe, IBM, Cisco, and Facebook; and cafeteria workers at Cisco, Intel, and, earlier this summer, Facebook.

      The workers aren’t technically employed by any of those companies. Like many businesses, Valley giants hire contractors that typically offer much less in the way of pay and benefits than the tech companies’ direct employees get. Among other things, such arrangements help companies distance themselves from the way their cafeteria workers and security guards are treated, because somebody else is cutting the checks. Silicon Valley Rising, a coalition of unions and civil rights, community, and clergy groups heading the organizing campaign, says its successes have come largely from puncturing that veneer of plausible deniability.

      That means directing political pressure, media scrutiny, and protests toward the tech companies themselves. “Everybody knows that the contractors will do what the tech companies say, so we’re focused on the big guys,” says Ben Field, a co-founder of the coalition who heads the AFL-CIO’s South Bay Labor Council. Labor leaders say their efforts have gotten some tech companies to cut ties with an anti-union contractor, intervene with others to ease unionization drives, and subsidize better pay for contract workers.

      “If you want to get people to buy your product, you don’t want them to feel that buying your product is contributing to the evils of the world,” says Silicon Valley Rising co-founder Derecka Mehrens, who directs Working Partnerships USA, a California nonprofit that advocates for workers. Tech companies have been image-conscious and closely watched of late, she says, and the coalition is “being opportunistic.”

      The first such recent effort, in 2014, unionized 87 Facebook Inc. shuttle drivers employed by contractor Loop Transportation Inc. “We won by beating up Facebook, not beating up Loop,” says California Teamster leader Rome Aloise. Initially, Loop resisted recognizing the union, citing Facebook’s opposition, according to Aloise. So the Teamsters forced a vote by the drivers that was supervised by the National Labor Relations Board (the union won); union activists drew media attention to stories of Facebook shuttle drivers sleeping in their cars between grueling split shifts. “We got press in Japan and Germany and all over the world by saying Facebook,” Aloise says. “Nobody would’ve given a shit if I was saying Loop.”

      Eventually, Facebook says, it OK’d proposed terms of the contract, which hiked drivers’ average pay by half, to $27.50 an hour, and for the first time provided fully paid family health care. Facebook also agreed to cover Loop’s added costs. Loop signed the contract. It didn’t respond to requests for comment, but Facebook denies discouraging unionization. “Our vendor workers are valued members of our community,” Facebook said in a statement. A spokeswoman says collective bargaining is up to contractors and their employees, but notes that since 2015, Facebook has required contractors to provide anyone doing “a substantial amount of work” for the company an hourly wage of at least $15 and three weeks of paid time off.

      When more than 500 cafeteria workers employed by Flagship Facility Services sought this year to join the union Unite Here!, Facebook says it didn’t direct Flagship’s handling of the situation. But it made clear to the contractor that Facebook would be neutral toward the organizing campaign and wouldn’t punish Flagship if the workers unionized, the spokeswoman says. Like Facebook, Flagship took a neutral position, and the workers joined the union in July.

      Where possible, Silicon Valley Rising has pushed for policies that would more broadly strengthen labor’s position. In San Francisco the coalition persuaded the city transit authority to make it easier to deny permits to companies facing labor strife. In Santa Clara, where Intel Corp.’s unionized cafeteria staff had lost their jobs after the company brought in a new nonunion contractor, the coalition led the passage of a municipal law designed to avert such situations. The ordinance requires that new building service or food service contractors retain the old contractor’s employees for at least 90 days. After protests outside Intel’s headquarters, the cafeteria workers unionized again in an election last year. According to Unite Here, Intel and its contractor didn’t campaign against the union in the lead-up to the vote. Intel declined to comment.

      The Valley campaign resembles a 1990s-era push by the Service Employees International Union to organize tens of thousands of janitors who were technically employed by building management companies. Apple Inc. was a prime target—the campaign included a hunger strike, a boycott, and a full-page ad in the —and workers there unionized after the contractor dropped its opposition to the union, presumably with Apple’s blessing. That offered a model for SEIU’s organizing of other tech janitors and, more recently, the Valley’s security guards.

      Tech companies are open to such outcomes partly because contracted service staff represent a tiny share of their overall costs, says former SEIU leader Stephen Lerner, who led the ’90s campaign. It’s much less threatening to a company to have outside contractors unionize, he says, than it would be to let, say, Facebook engineers do so. David Huerta, president of one of SEIU’s California locals, says organizing among direct employees is a longer-term possibility.

      Union critics say tech companies will come to regret intruding on contractors’ labor relations. “The fact that they have to browbeat employers or subcontractors into taking away rights from workers shows that the union business model is failing,” says F. Vincent Vernuccio, a fellow at free-market think tank Mackinac Center for Public Policy who served on President Trump’s transition team.

      Leaders of Silicon Valley Rising say they’ll support any workers who want to organize. Their near-term challenge is establishing a role for organized labor in Google Inc.’s massive planned expansion in San Jose. The city has voted to negotiate exclusively with Google on the sale of land for a new campus, and organizers want any deal to include provisions addressing such issues as affordable housing and the creation of quality jobs for local residents. “We expect our contractors to treat their employees well and we choose partners who do so,” Google spokesman Ty Sheppard said in an emailed statement. “We’ll be collaborating closely with city officials and community members as part of the public approval process.”

      On Aug. 24, Silicon Valley Rising hosted a forum for San Jose residents to air their concerns and demands. As English-, Spanish-, and Vietnamese-speaking attendees broke into groups to brainstorm, an official from the city manager’s office circulated through the crowd to listen. When the crowd reconvened, Andrew Barney, a former Intel cafeteria worker, drew cheers and applause when he said, “I think Google should pay the residents of this community for being allowed to squat in our backyard.”

      “Google’s vulnerable right now with all this building and everything they’re doing, and they need a lot of approvals,” says the Teamsters’ Aloise. “We may just pick one, one time, to get involved, and see if we can stop it and have them come to us and say, ‘What do you need?’ ”

        BOTTOM LINE – Silicon Valley Rising has unionized about 5,000 contract employees by working consistently to call out the tech companies where they work.

        Read more: http://www.bloomberg.com/news/articles/2017-09-14/union-power-is-putting-pressure-on-silicon-valley-s-tech-giants

        Health Care

        Schumer, Pelosi say they have deal with Trump to protect ‘Dreamers’

        Democratic congressional leaders emerged from a meeting with President Donald Trump Wednesday vowing to pursue an agreement protecting immigrants who were brought illegally into the U.S. as children from deportation.

        In a joint statement, Senate Minority Leader Chuck Schumer, D-N.Y., and House Minority Leader Nancy Pelosi, D-Calif., said they and Trump had “agreed to enshrine the protections of DACA into law quickly, and to work out a package of border security, excluding the wall, that’s acceptable to both sides.”

        An estimated 800,000 young immigrants are currently covered by the Deferred Action for Childhood Arrivals program, or DACA, which was formed by former President Barack Obama in 2012. Earlier this month, the Trump administration announced it was winding down the program over the next six months, putting pressure on Congress to pass a legislative solution.

        A source briefed on the meeting confirmed to Fox News that Trump and the leaders agreed to pair the DREAM Act, which provides for giving young illegal immigrants eventual citizenship, with some measures enhancing border security. The source said that those measures do not include Trump’s long-promised wall across the U.S.-Mexico border.

        However, White House Press Secretary Sarah Sanders issued a tweet denying that the border wall was off the table. A Democratic aide familiar with the conversations told Fox News that Trump “was clear he would continue to fight for the wall separate from this agreement.”

        Prior to Sanders’ tweet, the White House issued a statement describing the meeting as “constructive” and “a positive step toward the President’s strong commitment to bipartisan solutions for the issues most important to all Americans.” The statement added that the three had discussed “policy and legislative priorities,” including “tax reform, border security, DACA, infrastructure and trade.”

        During a White House meeting with moderate House members from both parties earlier Wednesday, Trump had urged lawmakers to come up with a bipartisan solution.

        “We don’t want to forget DACA,” Trump told the members at the meeting. “We want to see if we can do something in a bipartisan fashion so that we can solve the DACA problem and other immigration problems.”

        The apparent deal is the latest example of Trump’s sudden pivot to bipartisanship after months of railing against Democrats as “obstructionist.” He has urged them to join him in overhauling the nation’s tax code, among other priorities.

        Trump, who was deeply disappointed by Republicans’ failure to pass a health care overhaul, infuriated many in his party when he reached a three-month deal with Schumer and Pelosi to raise the debt ceiling, keep the government running and speed relief to states affected by recent hurricanes.

        “More and more we’re trying to work things out together,” Trump explained Wednesday, calling the development a “positive thing” for both parties.

        “If you look at some of the greatest legislation ever passed, it was done on a bipartisan manner. And so that’s what we’re going to give a shot,” he said.

        The “Kumbaya” moment now appears to extend to the thorny issue of immigration, which has been vexing lawmakers for years.

        Funding for Trump’s promised wall had been thought to be a major point of contention between Republicans and Democrats as they attempted to forge a deal.

        House Speaker Paul Ryan, R-Wis., who also sat down with Pelosi to talk immigration Wednesday, told the Associated Press that deporting the so-called “Dreamers” was “not in our nation’s interest,” and said the president had “made the right call.”

        “I wanted him to give us time. I didn’t want this to be rescinded on Day One and create chaos,” Ryan said, arguing the time would allow Congress to “come up with the right kind of consensus and compromise to fix this problem.”

        Fox News’ Chad Pergram and The Associated Press contributed to this report.

        Read more: http://www.foxnews.com/politics/2017/09/13/schumer-pelosi-say-have-deal-with-trump-to-protect-dreamers.html

        Health Care

        Universal healthcare in the US is possible. We already have proof | Farzon A Nahvi

        Bernie Sanders and Kamala Harriss universal healthcare bill is a step towards a humane and cost-effective system. Naysayers are denying reality, writes emergency medicine physician Farzon A Nahvi

        Speaking to opponents of universal healthcare in the US today is much like speaking to a moon-landing denier or any other conspiracy theorist they insist on arguing impossibility in the face of proven reality.

        As Bernie Sanders, Kamala Harris and 15 other senators release details of their universal healthcare bill one that guarantees access to healthcare for all Americans while simultaneously creating cost savings there will be many healthcare conspiracists claiming that such a plan is infeasible. So as we consider these arguments in the coming weeks, we must always be prepared to make sure they pass the look! test.

        That is, when someone argues that something cannot be done, we neednt argue. Rather, we simply need to point and say: Look!

        Someone doesnt believe we landed on the moon? But look! Theres an American flag up there! Someone doesnt believe we can insure every single American while simultaneously reining in the exorbitant costs of our healthcare system? But look! Every other developed country in the world is already doing it!

        These medical conspiracists claim that such a system would be impractical, overly expensive, or provide inferior care. But to make these claims in the face of obvious proof is laughable.

        If Canada is able to provide coverage for each of its citizens from birth to death, with no out-of-pocket-costs to any of them, all the while providing high-quality care with excellent patient outcomes at half the cost of our system, it is unacceptable to say that we somehow cannot.

        Real people living in other countries are currently enjoying these systems. They can change jobs without fear of losing access to their diabetes medications. They can go jogging without worry that one slip and broken bone would send their families into bankruptcy. They can go to their doctor never questioning that, at the end of the day, she has any incentive to do anything but make them better.

        So how could one be so bold as to deny this reality?

        The truth is that nobody is content with our current healthcare system. We do poorly when it comes to access to care and equity, administrative efficiency and cost containment, as well as basic health outcomes.

        We pay more than double what other countries do, and get worse results. Our life expectancies are shorter than any other developed nation. Children die in the US unlike in any other modern society. Medical bills are the leading cause of bankruptcy in the US. Our overspending in healthcare directly limits what we can do with defence, education and infrastructure.

        Yet when it comes to talk of change, people become skittish. Doctors become scared that change would mean lower incomes. Patients fear longer wait times and loss of access to services.

        The fear of losing the small benefits we currently enjoy is prohibiting us from enjoying far greater ones at half the cost. Its as if were so scared of losing our crumbs that we are ignoring the entire loaf sitting within reach.

        We need to learn to trust our eyes and ears and be suspicious of the naysayers fearmongering us away from something better. We can, and should, argue about the precise form our system will take the USs universal healthcare system will almost certainly have a different flavour than, say, Frances but we can no longer accept that such a system is impossible.

        Importantly, we should never forget the stakes. Real Americans are going through real pain every day. I have seen a patient come to my emergency room stating: They diagnosed me with cancer but said they couldnt see me because I have no insurance. I have nowhere to go.

        I have seen a patient having a florid heart attack walk out against medical advice stating, Thanks doc, but my brother went through this and lost his house. Im gonna go. And I have heard many well-insured patients say I hear you and you seem nice, but all you doctors want to do is make money off me, so I dont know who to trust.

        To experience all this while knowing that something better is already out there is simply unacceptable.

        Those who deny the plausibility of a universal healthcare system are inevitably the same people who stand to benefit most from our current system. They can argue up, down, left and right, but ultimately they can never pass the look! test. The next time they try to claim that universal health care would be impossible in the US, point them to footage of Neil Armstrong bouncing on the moon and dare them to deny reality. A universal healthcare system is not only possible here, but long overdue.

        • Farzon A Nahvi is an emergency medicine physician and an instructor of emergency medicine in New York City

        Read more: https://www.theguardian.com/commentisfree/2017/sep/15/universal-healthcare-us-possible-bernie-sanders-kamala-harris

        Health Care

        The 48 most revealing lines of Steve Bannon’s ’60 Minutes’ interview

        (CNN)Former Trump White House chief strategist Steve Bannon sat down with “60 Minutes” for his first major interview since leaving 1600 Pennsylvania Avenue. Known for his rhetorical bomb-throwing and willingness to poke the political establishment in the eye, Bannon did not disappoint in his conversation with Charlie Rose.

        Below are the 48 most revealing lines from Bannon about President Donald Trump, his time in the White House and the Republican Party.
        1. “The Republican establishment is trying to nullify the 2016 election.”
          Think about this statement. Republicans are in control of the House, the Senate and the White House. This should be an absolute Republican Golden Age. Instead, Bannon sees an ongoing civil war in which the GOP establishment continues to try to rob the populist strain in the party of its rightful credit and power.
          2. “They do not want Donald Trump’s populist, economic nationalist agenda to be implemented.”
          The “they” here is Senate Majority Leader Mitch McConnell and House Speaker Paul Ryan. And it’s not entirely what “they” have blocked of Trump’s agenda but presumably Bannon means failing to repeal Obamacare or approve funding for the border wall? (Worth remembering: Trump didn’t really run on a set of issues; he ran on a willingness to say controversial and un-politically correct things.)
          3. “The ‘drain the swamp’ thing was — is Mitch McConnell was day one did not want to — did not want to go there. Wanted us to back off.”
          McConnell has been in the Senate since 1985. He is a consummate insider who has made his name in Washington by his ability to outmaneuver his opponents using Senate arcana. He literally is the so-called “swamp” and has made a very good living for himself and his party by being just that.
          4. “They’re going to be held accountable if they do not support the President of the United States.”
          The former top strategist for the Republican President is openly threatening members of his party who disagree with Trump. Oh, also this news that Bannon is organizing primary challengers against GOP incumbents who don’t fall in line with Trump.
          5. “The swamp is a business model. It’s a successful business model.”
          He’s not wrong.
          But it’s also worth noting that draining the swamp is a business model, too. Lots of outside groups and political consultants have raised lots of money and gotten very rich by promising to drain the swamp.
          6. “In the 48 hours after we won, there’s a fundamental decision that was made … We embraced the establishment.”
          This was, to Bannon’s mind, a very bad decision.
          7. “So he looks around and I’m wearin’ my combat jacket, I haven’t shaved, I got — you know, my hair’s down to here …”
          Bannon is talking about Trump son-in-law Jared Kushner, who apparently made the decision to embrace the establishment after Trump won. But, it’s an important point. Bannon — all double button-down shirts and unruly hair — didn’t look like official Washington. Kushner, suit and tie at all times, did.
          8. “That would be probably — that probably would be too bombastic even for me, but maybe modern political history.”
          Bannon is responding to Rose’s question of whether the firing of former FBI Director James Comey was the biggest mistake in political history. Suffice to say, it’s so far the worst mistake of Trump’s political history.
          9. “By the Easter break, we’ll do repeal and replace.”
          Bannon argued that Ryan promised Trump that Congress would get rid of the Affordable Care Act in the spring, handle tax reform over the summer and do infrastructure in the fall. It, um, hasn’t played out like that.
          10. “I think their choice is going to be you’re not going to be able to totally repeal it.”
          This is right. And John Boehner, the former speaker of the House, was right when he predicted Republicans wouldn’t repeal Obamacare. The issue? Getting rid of it sounds good. But replacing it with something else is very complicated and Republicans don’t agree on how to do it.
          11. “I’m worried about losing the House now because of this — of — because of DACA.”
          Bannon opposes the six-month window Trump gave Republican in Congress to get something done on DACA. His worry — Republicans debate and debate it but get nothing done in time — is a legitimate one.
          12. “I think what we have to do is focus on the American citizens.”
          This is Bannon’s politic(!) way of saying that he thinks Trump should have simply ended DACA.
          13. “I think — I think as — as the work permits run out they self deport.”
          “The answer is self-deportation.” — Mitt Romney, 2012.
          14. “There’s no path to citizenship, no path to a green card and — no amnesty. Amnesty is non-negotiable.”
          Bannon’s view is not uncommon among Republicans in Congress — especially in the House. That reality makes clear how hard it will be for Ryan and McConnell to find any sort of deal on DACA that a majority of their conference will be for.
          15. “You couldn’t be more dead wrong. America was built on her citizens.”
          This response from Bannon comes in response to Rose pointing out that the US was conceived as a melting pot. Bannon, um, disagrees. Vehemently.
          16. “Economic nationalism is what this country was built on. The American system.”
          Bannon’s argument — which he goes into slightly more detail on with Rose — is that the US has to look out for itself and its manufacturing sector, first, second and last. And that people who aren’t citizens aren’t part of that equation.
          17. “Because unable to really to come to grips with the problems in the church, they need illegal aliens, they need illegal aliens to fill the churches.”
          Um, what? By Bannon’s logic, the reason the Catholic Church opposes the repeal of DACA is because they know the faith is struggling and the only way to make their numbers is to allow undocumented immigrants to pack into their church services.
          Bet you didn’t know that.
          18. “I’m a street fighter. That’s what I am.”
          Hadoken!
          Also, same. Except the exact opposite.
          19. “Donald Trump’s a fighter. Great counter puncher. Great counter puncher. He’s a fighter.”
          The “counterpuncher” thing is straight from the mouth of Trump. What’s interesting about it is that it’s not totally true. Trump does do best when he is in a back and forth with someone — President Obama, Hillary Clinton, Jeb Bush, Marco Rubio, Ted Cruz, etc. But, it’s not at all clear to me that Trump is always counterpunching. It feels like he is just punching a fair amount of the time.
          20. “I was the only guy that said he’s talking about something, taking it up to a higher level.”
          Bannon on Trump on Charlottesville. It’s not clear to me how Trump’s attempts at both-side-ism when dealing with neo-Nazis and white supremacists was him “taking it up to a higher level.”
          21. “When you side with a man, you side with him. I was proud to come out and try to defend President Trump in the media that day.”
          So, because Bannon said he was for Trump and had worked to get him elected, the only honorable thing to do was to defend Trump on Charlottesville? That is, to me, odd logic.
          22. “I’m talking about obviously, about Gary Cohn and some other people. That if you don’t like what he’s doing and you don’t agree with it, you have an obligation to resign.”
          Cohn, the chief economic adviser to Trump, is Jewish. In an interview with the Financial Times post-Charlottesville, Cohn said Trump “can and must do better” in condemning hate groups. That, according to Bannon, is a bridge too far — and Cohn should have resigned.
          23. “David Duke — the President has condemned David Duke and what David Duke stands for.”
          Eh …
          In an interview with CNN’s Jake Tapper in February 2016, Trump said this of Duke: “I don’t know — did he endorse me, or what’s going on? Because I know nothing about David Duke; I know nothing about white supremacists.”
          He later blamed a bad earpiece for the comments.
          24. “I don’t need to be lectured — by a bunch of — by a bunch of limousine liberals, OK from the Upper East Side of New York and from the Hamptons, OK, about any of this.”
          Remember that at the heart of Bannonism (and Trumpism) is a hatred for elites. That distaste comes out in this quote from Bannon. He views elitists as having lectured him his whole life about how to act and what to say — even though they allegedly lack the life experience he has.
          25. “There’s nothing to the Russia investigation. It’s a waste of time.”
          I don’t know if Bannon is echoing Trump here or the other way around. Either way, this is exactly what Trump continues to say about the special counsel investigation into Russian interference in the 2016 election.
          26. “I think it’s far from conclusive that the Russians had any impact on this election.”
          This is a common talking point from the President — and others around him. But it misses the point. No one is alleging that Russian altered the election results. Trump won. Period.

            Bannon: GOP wants to ‘nullify’ 2016 election

          What is at issue is how Russia tried to meddle in the election, whether and where they had success and if anyone in Trumpworld colluded with the Russians to make all of this happen.
          27. “I don’t think the President goes out of his way — what his point is, why pick another fight?”
          “Donald Trump’s a fighter. Great counterpuncher. Great counterpuncher. He’s a fighter.” — Steve Bannon, #18
          28. “He criticizes the Russians all the time.”
          He really doesn’t.
          29. “The elites in this country have got us in a situation, we’re at not economic war with China, China is at economic war with us.”
          “The elites.” (See #23)
          30. “That’s the geniuses of the Bush administration. I hold these people in contempt, total and complete contempt.”
          I wrote last week about how Trump had killed the Republican Party George W. Bush tried to build.
          31. “They’re idiots, and they’ve gotten us in this situation, and they question a good man like Donald Trump.”
          Don’t hold back, Steve! Tell us what you really think!
          32. “The Condi Rice, the George W. Bush, his entire national security apparatus.”
          It’s interesting to me that in the entire Bannon interview so far, he’s attacked Democrats not at all and Republicans a whole lot.
          33. “Reince started off and Reince said, ‘You have — you have two choices. You either drop out right now, or you lose by the biggest landslide in American political history.'”

            Bannon: Cohn should have resigned

          Bannon on the release of the “Access Hollywood” tape — and how he was the only one who told Trump to stay in the race and ignore it. (I wrote more about this last Friday.)
          34. “Christie, because of — Billy Bush — weekend — and — was — was — not looked at for a cabinet position.”
          The New Jersey governor disagrees.
          35. “Actually, the Grim Reaper.”
          36. “You can call me anything you want. OK?”
          Um, OK?
          37. “I’m not cut out to be a staffer.”
          One-thousand percent true. It was always an odd fit for Bannon to be in the White House staff. He is a charge the gates kind of guy. Not a stand behind them one.
          38. “I cannot take the fight to who we have to take the fight to when I’m an adviser to the President as a federal government employee.”
          It’s a fascinating window into Bannon’s thinking that he believes he can only have real influence on who he needs to influence by being something other than the chief strategist to the president of the United States.
          39. “A Darwinian environment for ideas is positive.”
          This sounds like a Decemberists lyric.
          40. “I think what he does on Twitter is extraordinary. He disintermediates the media.”
          Two sentences that explain why Trump will never, ever give up his Twitter feed — regardless of whether Bannon (or Trump) is right about social media.
          41. “The pearl-clutching mainstream media.”
          I rarely wear pearls to the office. And, when I do, I try not to clutch them.
          42. “I don’t think he needs — The Washington Post and The New York Times and CBS News. And I don’t believe he thinks that they’re looking out what’s in his best interest, OK?”
          (screams) The media’s job is not to look out for any President’s “best interest.”
          43. “(General Kelly’s) not going to be able to control it either because it’s Donald Trump.”
          Bannon couldn’t be more right about this. Trump is Trump. No one will change that.
          44. “Hillary Clinton’s not very bright.”
          The hottest of hot takes.
          45. “Sherrod Brown gets this. Tim Ryan gets this … The people around (Chuck) Schumer get this.”
          The Bannon endorsement! My guess is that these three Democrats will not be touting Bannon’s kind words about them.
          46. “And (Bernie Sanders) did not have the guts to take on Hillary Clinton in that primary.”
          I’m not sure it was about guts but there’s no question that Sanders could have gone after Clinton WAY harder than he did in the 2016 Democratic primary.
          (Greg Krieg and I talked about that here.)
          47. “I think he’s at 30 — I think he’s 36% or 38% because he hasn’t — we haven’t gotten the wall built.”
          That is not the reason I would have cited for Trump’s low approval ratings.
          48. “We’re going to win in ’18 and we’ll pick up six or seven Senate seats. I think we’ll pick up a couple of seats in the House. And he’ll win in a huge landslide in ’20.”
          This prediction is predicated on Trump continuing to do what he promised to do as a candidate, according to Bannon.

          Read more: http://www.cnn.com/2017/09/11/politics/bannon-60-minutes/index.html

          Health Care

          Bannon: GOP ‘trying to nullify’ Trump’s election

          Washington (CNN)Former White House chief strategist Steve Bannon claimed “the Republican establishment is trying to nullify the 2016 election” in an interview that aired on CBS’s “60 Minutes” Sunday night.

          Naming Senate Majority Leader Mitch McConnell and House Speaker Paul Ryan specifically, Bannon told CBS’s Charlie Rose: “They do not want Donald Trump’s populist, economic nationalist agenda to be implemented. It’s very obvious.”
          Bannon recalled a meeting with McConnell in Trump Tower, when the Kentucky Republican asked Trump to clamp down on his “drain-the-swamp” rhetoric.
            “Oh, Mitch McConnell when we first met him, I mean, he said — I think in one of the first meetings in Trump Tower with the President — as we’re wrapping up, he basically says, ‘I don’t want to hear any more of this ‘drain-the-swamp’ talk,'” Bannon recalled. “He says, ‘I can’t — I can’t hire any smart people,’ because everybody’s all over him for reporting requirements and — and the pay, et cetera, and the scrutiny. You know, ‘You gotta back off that.'”
            Steve Bannon just destroyed Reince Priebus on the ‘Access Hollywood’ tape
            Asked about attacking the very people Trump needs to enact his agenda, Bannon said GOP leaders won’t provide such help “unless they’re put on notice.”
            “They’re going to be held accountable if they do not support the President of the United States,” he said. “Right now there’s no accountability. … They do not support the President’s program. It’s an open secret on Capitol Hill. Everybody in this city knows it.”
            Catholic bishops strike back at Bannon
            Neither McConnell nor Ryan’s offices immediately responded to CNN requests for comment about Bannon’s remarks.
            Bannon criticized the House and Senate leadership for what he said was their overpromising and underdelivering on health care, saying they told the White House that they would repeal and replace Obamacare in the first few months of the administration and the new Congress before moving on to a tax overhaul by summer and infrastructure legislation by year’s end — none of which, as of yet, has happened.
            While Bannon said he does not entirely blame the Republican leaders for their inability to move such major legislation, he said they were unaware of the divisions within their own party.
            “There is wide discrepancy in the Republican Party, as we know today, now that we’re in it,” Bannon said. “But I will tell you, leadership didn’t know it at the time. They didn’t know it ’til the very end.”
            Bannon was ousted in mid-August amid a reshuffling of power within the White House, just a few weeks after retired Marine Corps Gen. John Kelly took over as chief of staff with a goal of instilling order in a chaotic operation beset by internal divisions, staff infighting and a storm of controversies.
            Bannon has since returned to his role as executive chairman at the conservative online publication Breitbart News, a job he held before joining Trump’s campaign. Sunday’s interview is the first time has spoken out publicly since his firing.
            His exit meant one of the White House’s most controversial staffers, the man generally perceived as the driving force behind Trump’s “nationalist” ideology, would no longer be at the center of the Trump universe.

            Read more: http://www.cnn.com/2017/09/10/politics/steve-bannon-donald-trump-mitch-mcconnell-paul-ryan-60-minutes/index.html

            Health Care

            Trump Officials Temper Expectation of 15% Corporate Tax Rate

            Two top Trump administration officials said it may not be possible for President Donald Trump to deliver on his promise to cut corporate tax rates to 15 percent.

            In separate appearances Tuesday, Treasury Secretary Steven Mnuchin and Marc Short, Trump’s legislative affairs director, both said Trump is still committed to that rate cut — down from the current 35 percent — but acknowledged the potential for compromise.

            “The president has made it clear since the campaign, ideally he’d like to get it down to 15 percent. I don’t know if we’ll be able to achieve that given the budget issues, but we’re going to get this down to a very competitive level,” Mnuchin said Tuesday at the CNBC Institutional Investor Delivering Alpha Conference in New York. “What the exact number is is less important, what’s important is making sure we have a competitive system.”

            “Ultimately there’s probably compromise to get to the best deal,” Short told reporters at an event sponsored by the Christian Science Monitor. He also said that Trump continues to believe that a 15 percent corporate rate would best stimulate the economy, while convincing American businesses to keep their tax addresses in the U.S.

            Steve Schwarzman, the chief executive officer of Blackstone Group LP, a private equity firm, said later at the CNBC event that he’s optimistic the corporate rate will wind up “somewhere between 25 and 28 percent.”

            “I think there’s certainly consensus to do that,” Schwarzman said.

            Trump wants the lower corporate tax rate to also apply to certain pass-through businesses, such as S corporations and partnerships, which don’t pay taxes themselves, but pass their earnings through to their owners, who pay taxes at their individual rates, Mnuchin said. However, he said “service companies that are pass-throughs will not get the benefit of the rate.”

            Pass-Through Difference

            “If you earn money that’s clearly income, if you’re an accountant firm and that’s clearly income, you’ll be taxed at income rates — you won’t be taxed at pass-through rates,” Mnuchin said. “If you’re a business that’s creating manufacturing jobs you’re going to get the benefit of that rate because that’s going to be passed through to help create jobs and better wages.”

            Mnuchin also repeated that Trump is committed to eliminating the special tax treatment of carried interest — but not for all the investment firms that make use of it. “The president’s been very clear that hedge funds will not have the benefit of carried interest,” he said. But other firms — “entities that do create jobs,” Mnuchin said — may still qualify.

            Carried interest is the portion of an investment fund’s returns that are paid to investment managers. It’s currently taxed as capital gains, at rates as low as 20 percent. The top individual income tax rate is 39.6 percent, though Trump and congressional Republicans have proposed cutting it to 35 percent.

            Trump is planning an aggressive travel schedule, taking him to as many as 13 states over the next seven weeks, to sell the idea of a tax overhaul as the administration tries to avoid repeating the communications failures of its attempt to repeal Obamacare. However, Republican leaders have yet to unveil details of what Trump has called a “massive” tax regime change, including such basic matters as where to set the corporate tax rate and how to set up individual tax brackets. Mnuchin and Short both said details will come later this month.

            ‘Pretty Close’

            The White House and members of Congress are “pretty close to finalizing” a bill and have settled many of the disagreements that divided their effort early in the process, Short said. The White House is wary of relying solely on Republican support for the legislation after seeing the health-care bill collapse and is genuinely seeking Democratic support, Short said.

            While the president is eager for a bipartisan tax deal — and his tax tour will visit states where Democrats hold Senate seats — Mnuchin said that if needed the administration will encourage Republicans to use the reconciliation process. Doing so would allow them to bypass a Senate filibuster and pass a bill on a partisan basis.

            Mnuchin also said that he is considering backdating any tax changes to Jan. 1 of this year, which “would be a big boon for the economy.”

            Read more: Trump Debt Limit Deal Undermines Trust Among GOP on Tax Overhaul

            While Trump is committed to a permanent tax overhaul, Mnuchin has at times appeared to be managing down those expectations. “As I said this is a pass-fail exercise. Passing tax reform, which hasn’t been done in 31 years, that’s a win,” the Treasury chief said Tuesday, adding that stock markets have a “built-in” expectation of success.

            Trump last week cut a short-term debt ceiling and government spending deal with Democrats to clear the deck for a major tax bill, but the agreement could complicate tax efforts by sowing doubt among the GOP about its unpredictable president. As Mnuchin worked to sell an 18-month debt-ceiling increase to Republicans and Democrats during a meeting in the Oval Office last week, Trump abruptly decided to go for a three-month increase in line with what Democrats wanted.

            “We could have done a one-year deal, this wasn’t widely reported, on the debt ceiling,” Mnuchin said Tuesday. “But the president wants to raise military spending. That’s one of his main priorities, particularly in the mix of what’s going on in North Korea and other areas. The president wants to increase military spending and that’s something he is going to demand for December.”

              Read more: http://www.bloomberg.com/news/articles/2017-09-12/mnuchin-says-tax-overhaul-may-be-backdated-to-start-of-the-year