Tutorial For Trump – Chapter One

Trump’s dishonest healthcare op-ed shows his leadership is the blind leading the visually impaired. The President has no clue about the complexity of the greedy business of American healthcare and needs a tutorial.

Trump’s Policy To Bring Drug Prices Down Has A Loud Bark But No Bite

President Donald Trump, during his campaign, said it was unacceptable for the pharmaceutical industry to gauge patients, who are already suffering, with the astronomical prices they charge for the life and limb saving drugs. He was going to fix that and was the man to do so.

Now that he is the president and his Republican party controls both the House and Senate, he has the best chance to make that happen. As President,  he stood in front of the White House on May 11, 2018, unveiling his proposals to reduce the staggering high prices of drugs in America and said, “We are very much eliminating the middle men. The middle men became very, very rich.

Trump/Azar 5/11/18
As President, he stood in front of the White House on May 11, 2018, unveiling his proposals to reduce the staggering high prices of drugs in America and said, “We are very much eliminating the middle men. The middle men became very, very rich.” (AP Photo/Carolyn Kaster)

For a brief moment, I thought he was on the right track. It seemed he understood that one of the main reasons healthcare costs in America are so high is the layers and layers of unnecessary middle men. Of course, there is the more serious problem of policies and laws enacted by corrupt politicians beholden to the special interest lobbyists. Trump also said he would take on the special interests. The question is, will he actually follow through on his promise? Looking at the man Trump appointed and standing next to him in front of the White House as his Secretary of Health and Human Services (HHS), Alex Azar, I would say, don’t hold your breath.

1600px-Donald_Trump_and_Mike_Pence_congratulate_Alex_Azar
The question is, will Trump actually follow through on his promise? Looking at the man Trump appointed and standing next to him in front of the White House as his Secretary of Health and Human Services (HHS), Alex Azar, I would say, don’t hold your breath.

Azar was the president of the American division of the pharmaceutical giant, Eli Lilly and oversaw its lobbying efforts for the company. If we think he will actually bring change that will reign in the greed of PHARMA and bring down drug prices, we will be sadly mistaken. In the past few months, Trump and Azar have been working on policies to bring drug prices down.  Meanwhile, the pharmaceutical industry was nervously thinking their enormous profits would be in jeopardy. However, when the actual proposed policies were recently released, the industry breathed a sigh of relief. The proposals had no teeth that would bite into the industry’s ability to charge prices the way they want to. The drug industry dodged a bullet and, of course, naturally the stock prices of the pharmaceutical companies soared.

Trump, true to his character, is long on rhetoric and short on substance. “We’re going to see those prices come down,” he said. “It will be a beautiful thing.” He is not serious about any policies that will actually bring drug prices down and consequently some relief to patients, especially senior citizens who spend a big chunk of their social security check on purchasing medicines. Americans spend on an average $1,162 per person on prescription drugs compared to $497 per in the United Kingdom, thanks to their nationalized health care system. Unfortunately, the largest government health insurance program in America, Medicare, is forbidden by law to negotiate low prices, a law enacted by Republican congress and signed by George W. Bush, thanks to the special interest lobbyists like Alex Azar.

Medicare has 60 million members and has the economy of scale to bargain for low prices, which would be the case if America truly is a free market economy. With corrupt political system, influenced by the special interest pharmaceutical lobby, the laws are skewed in favor of greedy drug industry, not average Americans. If Trump wants to bring prices down, the first thing he can do is to make his Republican congress repeal the law forbidding Medicare from bargaining for low prices. Democrats would love Medicare to have that power but Republicans oppose it. As long as Paul Ryan is the speaker and Azar the HHS secretary, Medicare has a no chance to get that power.

Only informed and activated citizens can bring the change through the political process by voting the corrupt politicians and law makers out of office. Dr. Robert Zarr, a pediatrician practicing for 15 years in Washington DC and also the president of PNHP, said that PHARMA represents the biggest evils and barriers to practicing physicians, nurses, therapists, healers and to all Americans in this country. To prescribe life saving medication is extremely difficult because the price of that medication is outside of the reach of ordinary Americans. During a protest in front of PHARMA in Washington DC, Dr. Zarr said that the doctors should realize that enough is enough and it is time they fight back for all their patients, so finally we can have a day when medicines are actually affordable.

I hope the concerned doctors, in whose hands the patients trust their lives, will lead the charge and the citizens can follow.

All those American citizens hoping to change the healthcare system for the better, so they can afford quality healthcare, may have an opportunity this coming midterm elections to elect lawmakers who truly do fight the powerful special interest pharmaceutical lobby.

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Buddha, Papa John’s, Applebee’s and Obamacare

“Anger, ignorance and greed are the three demons in a man’s life.” – Buddha

John Schnatter of Papa John’s Pizza and Zane Tankel, the owner of Applebee’s franchise, said that they would transition some of their fulltime employees to part timejust because of Obamacare. There was a businessmen in Vegas that said he fired some of his employees for the same reason. Another Georgia businessman called C-SPAN and said that he made sure that a couple of workers that he fired, also because of Obamacare, were the ones that voted for Obama. These businessmen are angry with Obama for trying to provide access to affordable quality healthcare for every American. They are barking up the wrong tree.

Surgery
An artificial knee replacement surgery costs six to ten times less in India than a comparable quality surgery in America and also includes two weeks of home physical therapy after surgery.

Many of these businessmen say they would like to provide healthcare to all their employees only if healthcare is less expensive. That’s the crux of the problem; escalating healthcare costs. I have been practicing neurosurgery in Flint, Michigan, for 16 years and I know how GM got bankrupted partly by the skyrocketing healthcare costs. Last year, my father underwent a knee replacement in India, operated by an Orthopedic surgeon trained in England, using an artificial joint prosthesis from an American medical device company, DePuy. The total cost of the surgery including four days of private room and two weeks of physical therapy cost me less than $8000. The same surgery cost on average of $160,000 in Texas, in 2009 and still costs $45,000 to $70,000 across the country.

Most of the businessmen that are upset with the Affordable Care Act are unfortunately ignorant of the real, deep-rooted cause that is destroying healthcare in America. J. Patrick Rooney and Dan Perrin, architects of Health Savings Accounts during the George W. Bush era, wrote in their book, America’s Health Care Crisis Solved and I quote;

“The problem is greed. The ship has lost its moral rudder. It is awash in greed. We can’t expect the industry to fix itself. There’s just too much self-interest at stake. We can exhort our health care providers to charge less, but we doubt that will work. The money is too easy, and the greed too strong.”
It is ironic that greed, the essence of unregulated capitalism that creates millionaires and billionaires, is also responsible for pushing the middle class into poverty and creating many of the poor in the current economy.
The healthcare industry has not been immune to that greed. Clearly, healing the sick in America has become a mega business, costing the nation $2.8 Trillion to be precise. I don’t find it surprising at all, for America’s business is business. Instead of being angry with Obamacare, the emphasis should be in bringing down the costs of the healthcare business which has created a medical industrial complex that is highly profit oriented, driven by greed and perpetuated by a corrupt political system and benefits mostly the special interests. I am not sure if the owners of Papa John’s or Applebee’s will be in favor of voluntary implementation of less greedy practices or mandatory laws to prevent such practices in the healthcare industry. That is against the core profit motive of business and will be like shooting one’s own greedy capitalist foot.

Papa John’s would rather pass on the 11 to 14 cent per pizza extra cost of providing healthcare to its employees onto the customers than accept a little less of the $100 million per year profit. I am sure he considers himself a compassionate man because he made some charitable donationsbut I am not sure if Buddha would have called it compassion, when such charity is the money made off of the sweat and tears of the hard working employees that were denied basic healthcare. On the other hand there are businessmen that say, even if one doesn’t provide healthcare to their employees out of compassion or kindness, it makes good business sense to do so, for healthy and happy employees are more productive for the bottom line.

Martin, a part owner of Ian’s Pizza, and owns a handful of pizzerias in Wisconsin, provided healthcare benefits to all his employeeseven before Obamacare mandated the employers to provide healthcare. He did it because he believed that was the right thing to do.

That, I am sure Buddha would have agreed, is a true compassionate businessman.