Tales from the DOG Patch: Numero Deux

A tip of the hat to Dr. Roy Poses, who did a pleasant job summarizing the primary blast from the DOG Patch. (For individuals who missed it, it is a distillate of all of the dander we have mustered in latest well being coverage debates as they veer increasingly more towards the totally surreal.) Dander omnium gatherum, hurled willy-nilly on the light readers of HCRenewal. Prepared or not, one other dispatch from the DOG Patch.

Dr. Shulkin on the VA. We commented on the latest posting, additionally from Dr. Poses, coping with VA Secretary David Shulkin’s “apparently scandalous journey” to Europe manner again in July. We have recognized Shulkin for a very long time. He cares about good authorities however you’d by no means know that from his personal OIG’s hatchet job charging “severe derelictions.” Lots of that is within the above linked submit, in addition to associated articles in most newspapers. Immediately nonetheless we study from John Kelly that the secretary’s “job is protected.” Until, that’s, “different stuff comes out.” One of many higher Trump appointees, Shulkin now will get to stroll the tightrope whereas political hacks decrease down within the VA attempt to undermine him. His crime: Seemingly dragging his heels on doing himself out of a job. A lot of of us (viz. White Home insider and Wisconsin brewmaster Jake Leinenkugel) trying to privatize VA well being care. Shulkin understands the nice value–despite the numerous depredations and flaws nonetheless enormously widespread with its patients–of the establishment that started with the Philadelphia Naval Residence across the Conflict of 1812. These guys circling the wagons contained in the White Home signify the swampiest of Washington swamps. Let Shulkin be Shulkin.

Mr. Azar goes to Washington. And suggestions his hand. In our first DOGpatch dispatch we questioned aloud which manner the brand new HHS Secretary would head after being sworn in. First indications at the moment are in. He needs, within the curiosity of “inexpensive” premiums, to subject junk insurance coverage. It certain matches into the grand scheme of issues, White Home-style. If you cannot do in Obamacare in a single swell foop, grind it down underfoot one function at a time. So ideological. So unfair. Particular person mandate already on its manner out. Now comes waivers permitting low-cost insurance policies, insurance policies that’re not ACA-compliant, to go to cherry-pickers with out regard to pre-existing situations. Extending brief time period cruddy insurance policies from three months to a yr may profit a couple of wholesome younger workers–maybe those states like Wisconsin and Indiana (wrongly) imagine, through their ideological GOP governors, they will lure again to their states. However the price may simply grow to be a number of the sicker of us whose premiums will grow to be unaffordable. We see the hand of Mike Pence’s Indiana favourite, Seema Verma, in all of this. Hey, in the event that they’re sick throw ’em below the bus. Your company donors need their low-cost labor pool again. And, then, what’s Azar’s lengthy sport? To ingratiate himself solidly with government department insiders in an effort to do one thing that Trump says he wants–most temptingly, new methods to jawbone drug costs down–for his vaunted base? That is one thing Azar may most likely pull off. Will he even attempt?

Placing the Assault on Experience in Perspective. A ebook from a few yr in the past, Tom Nichols’s The Dying of Experience, is summarized properly within the newest variety of Harvard’s alumni journal. I imply, in fact that is the place you’d discover it. Most of our “thought leaders,” elite consultants, and favored members of the punditocracy come from elite west- and east-coast establishments. After all the loudest plaints will come from their ranks. However Nichols is slightly totally different. He has authorities expertise and teaches in a wide range of establishments whereas making an attempt to succeed in the general public. The ebook is slightly repetitive however its gist might be discovered right here, apparently unencumbered by paywall. We’ll need to wade into this brief ebook and see who and what and the place Nichols factors the finger. However we all know all of the isms already. Narcissism. Submit-modernism. Managerialism. Consumerism. All rampant in scientific drugs, tutorial drugs and well being coverage. Nichols is rightly frightened in regards to the casualness and fecklessness with which individuals now in energy strategy all the pieces from nuclear warfare danger to cyber-threats to the function of execs in managing well being. He is pessimistic.

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