Sunday, March 26, 2017

Presidential Conflicts of Interest Act

To Senators Shelby and Strange and Representatives Byrne, Roby, Rogers, Aderholt, Brooks, Palmer and Sewell

Donald Trump's selfish refusal to abide by generally accepted standards of conduct applicable to government officials is miring him, he may not be able to extricate himself, and the country's governance and possibly national security are being impaired in the meantime.

The Russian cloud over Trump is the biggest problem now. Trump's improper conduct is a major contributing factor to his being mired in questions of whether he is hiding something concerning Russia, and whether Putin holds something over Trump.

Trump's position is that he has right to do whatever he wants with his businesses, particularly without regard to the policy reason for conflict of interest rules applicable to governmental officials. Trump's attitude is that his businesses are none of the country's business, he can hide his businesses from public view and has no obligation of transparency, and he can use his Presidential office to make his businesses more profitable and increase his personal wealth.

This attitude of Trump is a major factor in creating his big Russia problem, which is now a big problem for the country. Whatever Russia connections ultimately come to light, Trump was lax in his standards of conduct for himself and his associates. Trump either knew or did not care what he knew about Paul Manafort's involvement with Russia when Trump selected Manafort as his campaign manager from April to August.

Trump refused to release his tax returns in accordance with the accepted practice of Presidential candidates. This created suspicion and is adding to Trump's Russian mire now.

Connect that to Trump's "mysterious" affection for Putin, which has been festering for months, and more suspicion grows from Trump's refusal to abide by generally accepted standards of conduct about conflicts of interest and transparency. This was greatly complicated by Trump asking the Russians to interfere in the election.

Trump's misconduct carried forward to his solution for his business interests. The solution he announced in January is grossly inadequate when measured against magnitude of the conflicts of interest and the public policy concerns about conflicts of interest. That selfish continuation of his refusal to abide by generally accepted standards of conduct flows into his Russia problem now, which seems set to drag on for months.

Ever since Trump was elected, much attention has been paid to the problems that Trump and his business interests could cause in the conduct of his Presidency and country's governance. Trump has disregarded all of the same, and the Republicans have kept Congress from taking any action,

Chickens are coming home to roost.

Elizabeth Warren has introduced a Presidential Conflicts of Interest Act.

How much longer are Republicans going to turn a blind eye?

Elizabeth Warren — US Senator for Massachusetts
I'm taking aim at Donald Trump with a bill that would force him to release his tax returns and divest from potential conflicts of interest. Americans deserves answers.

Add your name today to become a citizen co-sponsor

Sunday, March 19, 2017

Does politics make us idiots

From: Rob Shattuck <>
Date: Sun, Mar 19, 2017 at 7:41 PM
Subject: Does politics make us idiots re health care?

Meredith Kilgore PhD
Department of Health Care Organization and Policy
UAB School of Public Health

Dear Dr. Kilgore:

I am endeavoring to absorb (mainly via the early morning and Sunday political talk shows) the debate about the American Health Care Act. I am trying to get a sense of what will result if it is enacted into law.

The bill has not been finalized, and significant changes are being negotiated. Also, the bill is only the first part of a multi-step legislative and regulatory plan, which could take many months to implement.

For various reasons, it seems preposterous to be able to have much sense of what will result if the American Health Care Act, and its follow ons, are put into effect.

While the proponents of the American Health Care Act will have control over the regulatory component, the additional legislative components will be subject to the uncertainties of future Congressional action.

The CBO report makes projections that are adverse to the proponents of the American Health Care Act.

The proponents try to deflect the CBO report by using speculative contentions that, I think, are dubious and not likely to play out the way the proponents say. Frankly, I don't know how the proponents actually believe what they say will happen.

Given that, it is understandable if I say our Alabama legislative delegation in Washington will not provide help to Alabamians who want a good sense of what will result with their health care under the American Health Care Act.

I have endeavored to say what I think in a blog, which you can find at Alabama expertise re health care.

I am sending this email to you because of your Department's orientation, which is described on the Department's website to be about the following,
"The collected laws, regulations, and approaches taken to making decisions and implementing policy to protect the health of communities and populations. Public health policy issues include a wide range of topics including health care reform, insurance reform, prevention of communicable diseases, food safety, and stem cell research."
That is exactly the academic expertise which I seek for my purpose.

We have no choice but to live with our politics. I believe our politics limits us in solving our problems. I believe the American Health Care Act is a good example.

I will post this email at Does politics make us idiots?

If you think our politics can do better than how I say it is doing regarding the American Health Care Act, that would be very significant. Please email me if that is the case. Otherwise I will understand if you do not reply.

Thank you.

Statements re health care

[Revised 3/23]
There have been no replies to the solicitation of statements from Alabama health care experts, which I made in Alabama expertise re health care. A House of Representatives vote is planned for today. Compiled below are press releases and other statements from Alabama's seven members of the House. They are of scant help in explaining to  Alabamians what Alabamians should want to understand. I believe "My statement" set out in Alabama expertise re health care is apt for the purpose (including an edit I added to the statement reflecting amendments under consideration).

Rep. Byrne has the below March 19 blog post

Why Obamacare Must Go


Mar 19, 2017 
“In a death spiral.” Those are the words Mark Bertolini, CEO of Aetna, one of our nation’s largest insurance companies, used to describe the Affordable Care Act, or Obamacare.
When I first ran for Congress in 2013, repealing and replacing Obamacare was a top priority. I introduced a bill to repeal the law, which passed the House but never reached the President’s desk. Unfortunately, with President Obama in the White House, our efforts never succeeded. Even when we finally got a repeal bill to the President’s desk, he vetoed it.
Thankfully, last year’s elections completely changed the dynamics. President Trump is committed to repealing and replacing Obamacare, and Republicans control both the House and the Senate. The stage is set to finally get rid of this failed law.
Why is this so important? Because Obamacare is a fundamentally flawed law that cannot simply be fixed or patched back together. Obamacare has cost the economy $53 billion and an estimated 176,897,428 paperwork hours.  Those are funds and time that employers can’t use to hire people and jumpstart the economy. 
More importantly, with its government mandates, higher taxes, and increased regulations, Obamacare is hurting hardworking American families. We have seen canceled plans, higher premiums, fewer choices, and increased deductibles. 
Believe it or not, former President Bill Clinton might have put it best when he called Obamacare “the craziest thing in the world.” He also pointed out that it has resulted in “people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half.”
I’ve heard story after story from people who live in Southwest Alabama who have been negatively impacted by this law. In fact, I have had people come up to me with tears in their eyes to show me their cancellation notice or premium increase letter.
Despite President Obama’s promise that “if you like your plan, you can keep it,” 4.7 million Americans were kicked off their health care plans by Obamacare. Many of these Americans liked the plan they had, only to have the federal government step in and tell them it was not good enough.
Premiums are also skyrocketing. Seven states have seen premium increases of more than 50% in 2017.  In Alabama, this year’s premiums on the exchange increased 58% on average for a benchmark plan and 36% for the individual market as a whole. For those with employer-sponsored coverage, individual premiums are up 27% on average nationwide, more than double the average rise in workers’ wages.  Deductibles are up an average of 60% since 2010.
Americans are also facing fewer and fewer health care choices, with five states – including Alabama – only having one insurer to choose from. In fact, next year, some counties in the United States may not have a single option on the Obamacare marketplace.  At that point, those Americans relying on Obamacare will have nowhere to turn and the law will have failed. 
The bottom line is that Obamacare is on a collision course. If Congress were to sit back and do nothing, Obamacare would implode. This would leave millions of Americans with no insurance and the overall insurance market for the rest of us in a dangerous condition. So, Congress must act and rescue the American people from this broken law.
I have pledged to repeal and replace Obamacare since being elected to Congress, and I remain committed to honoring that pledge. Now, under unified Republican government, we have the best opportunity we have ever had to get rid of this failed law and instead provide Americans with the freedom, choice, and control that they deserve.
Rep. Roby made the below March 22 press release

We Must Keep our Promise to Repeal and Replace Obamacare

Mar 22, 2017 Issues: Health CareRepeal Obamacare
WASHINGTON, D.C. – U.S. Representative Martha Roby (R-Ala.) today voiced her support for the American Health Care Act (AHCA) and called on her fellow House conservatives to keep their promise to repeal and replace Obamacare.

In a speech from the House floor, Roby reminded her colleagues of the repeated promises Republicans have made to do away with Obamacare for the last seven years.

“I’ve heard from countless constituents negatively impacted by Obamacare,” Roby said. “And in response, I made a promise - the same promise President Trump and every conservative in Congress has made over and over: give us the majority in the House and Senate, give us a Republican in the White House, and we will repeal Obamacare and replace it with reforms that work.

Roby acknowledged that no bill is perfect, but she said that passing the ACHA this week is Republicans’ best opportunity to deliver on their promise.

“Mr. Speaker, I am confident that this bill puts us on a path toward lower costs and better care – and away from government-controlled health insurance.

“It represents our opportunity to undo the damage of Obamacare and help American families like we said we would. For seven years we have been promising, and this is our chance to deliver.”

The House of Representatives is scheduled to vote on the Affordable Health Care Act on Thursday, March 23. If passed, the bill will be taken up by the Senate.

The text of Rep. Roby’s remarks as prepared is below:

Thank you, Mr. Speaker.

Seven years ago this week, in this chamber, the House gave final passage to the Affordable Care Act, better known as Obamacare.

I wasn’t in Congress then. Many of us weren’t. But for my fellow conservatives here today, that vote seven years ago marked a decision point or a moment of affirmation to answer the call to public service and help chart a better way for this country.

And for seven years we have made the case against Obamacare. As the law has been implemented, that case has largely been made for us. Millions have been forced away from the health care plan and doctor they liked, despite promises to the contrary.

This year alone, in Alabama, health insurance premiums are rising by 58 percent. That’s on top of already steep increases the past two years.

Our average deductible for the supposedly affordable Bronze plan is now six thousand dollars.

I’ve heard from countless constituents negatively impacted by Obamacare. I’ve listened to their stories about how higher costs and fewer choices have made it that much harder to keep their families healthy and make ends meet.

And in response, I made a promise; the same promise President Trump and every conservative in Congress has made over and over: give us the majority in the House and Senate, give us a Republican in the White House, and we will repeal Obamacare and replace it with reforms that work.

So Mr. Speaker, I am pleased that we are finally in a position to deliver on that promise. The voters gave us what we asked of them, and it’s only right that we keep our end of the bargain.

With the American Health Care Act, we begin the process of repealing Obamacare once and for all.

This bill dismantles the taxes, mandates, and entitlement spending that make up the core of Obamacare.

It cuts taxes on prescription drugs, over-the-counter medications, insurance premiums, and medical devices.

It eliminates the individual and employer mandate penalties that have forced millions into expensive, inadequate plans.

It replaces the Obamacare entitlement with refundable tax credits so that people who don’t receive insurance through work can put their own tax dollars toward a health plan of  their choice.

Mr. Speaker, many have asked why our plan to repeal and replace Obamacare is a process. Why is this bill only one step and not the full package?

It’s an understandable question. For the last several years, Americans have been sold the false hope that the government has a magic wand with which it can quickly solve all their problems.

The truth is, of course, that it can’t. It never can. And the only proof you need is Obamacare itself.

That’s why Congressional Republicans and the Trump Administration are taking completely a different approach than President Obama and the Democrats used seven years ago.

Instead of claiming “we need to pass the bill so you can find out what is in it,” we have worked in a transparent way. The bill text has been posted online for three weeks. It has gone through three separate committee mark-ups, and will come to the House floor in regular order.

Instead of one giant bill like Obamacare, we are using a more responsible, three-step process. First, we’ll repeal Obamacare with all its taxes, mandates and spending through budget reconciliation. Next, the Trump Administration will use its executive authority to weed out the more intricate Obamacare policies one-by-one to stabilize the market and lower costs. And finally, Congress will move forward with legislation addressing more specific policies, such as allowing individuals to purchase insurance across state lines.

I believe this will ultimately lead to better, more stable health care policy that empowers patients, increases choices, and lowers costs.

Mr. Speaker, no bill is perfect. I’m sure if every member of this body came up with their ideal health reform bill, they’d each be pretty different. It’s supposed to be that way, because we all represent different districts with different needs.

There may well be some changes made here in the House or in the Senate that can make the bill better. That’s part of the process, so I certainly remain open to those.

But, Mr. Speaker, I am confident that this bill puts us on a path toward lower costs and better care – and away from government-controlled health insurance.

It represents our opportunity to undo the damage of Obamacare and help American families like we said we would.

For seven years we have been promising, and this is our chance to deliver.

I urge my colleagues to support the American Health Care Act, send it to the Senate, and get us one step closer to delivering on our promise.

Rep. Rogers
No press release or other statement found.

Rep. Aderholt issued below statement on March 17th.
“President Trump called me to the Oval Office this morning to discuss the American Healthcare Act, because of his understanding that I could not support the current language of the bill.


March 11, 2017 
Press Release
Huntsville, AL – Today, Congressman Mo Brooks (AL-05) appeared on America’s News Headquarters to discuss the House leadership health care replacement plan.  Brooks affirmed his commitment to deliver a clean repeal of Obamacare to the American people.  

To watch video of the interview, click HERE 
or on the image above. 
Excerpts from the interview:
Congressman Brooks stated, “We are being asked to vote for the largest Republican welfare plan in the history of the Republican Party.  That should be a hard swallow and a hard sell.  We’ll see how it plays out.  To get my support we have to keep our commitments to the American people.  We promised that we were going to repeal Obamacare.  The House leadership plan is not a repeal of Obamacare.  It keeps substantial parts of Obamacare in place, and it copies or repackages other parts of Obamacare.  A repeal bill is like what Congressman Steve King out of Iowa has, it’s a nice two page bill, two sentences, the Affordable Care Act is hereby repealed effective such-and-such a date.  What we have on the Republican side right now is a bill that is easily over a hundred pages long. That is not a repeal.  So let’s keep our promise, repeal it.”  
Brooks added, “Once we repeal it, then we need to in my judgement, interject competition into the marketplace.  Allow interstate competition amongst health insurance carriers and providers.  On the other hand, the health insurance industry has various parts that are exempt from antitrust laws which promote oligopolies and monopolies, which suppresses competition and makes pricing go up.  So let’s go ahead and do our best to ensure that we eliminate those antitrust exemptions in the health care industry.” 
Brooks concluded, “Then finally my position is, once we’ve got the repeal and we have interjected competition into the marketplace with all the benefits that comes from that, with price suppression, better quality of service, let’s turn this over to the states in the form of block grants and let the 50 states handle this health care issue.”

Rep. Palmer issued below statement on March 16th.
“We have one opportunity to answer the healthcare crisis the American people are facing. In my opinion, the current bill does not answer this crisis. I voted against the American Health Care Act in the Budget Committee because the promises of changes in the future are insufficient. Now that the bill has been reported out of committee, I will continue to work for the changes that are necessary to ensure Medicaid is a viable and affordable program to provide healthcare to the people who need it most. In that regard, I believe block granting Medicaid to the states and requiring work for able-bodied working age adults are essential to achieving this objective. I look forward to working with my colleagues to make these and other improvements to this bill.”

Rep. Sewell has three press releases

Rep. Sewell Statement on GOP Health Bill

Mar 7, 2017 
Press Release
The GOP health bill would make large cuts to Medicaid, destabilize Medicare by reducing funding for the Medicare trust fund, and increase health costs for working and low-income families.
Washington, D.C. – On Monday, Republicans in Congress released legislation to replace the Affordable Care Act. The GOP health bill would make large cuts to Medicaid, destabilize Medicare by reducing funding for the Medicare trust fund, and increase health costs for working and low-income families. Estimates suggest that 357,000 Alabamians are at risk of losing their coverage if the Affordable Care Act (ACA) is repealed.
“For my constituents, access to healthcare is a life or death issue,” said Rep. Terri Sewell (D-AL). “After seven years of calling for the Affordable Care Act’s repeal, it is unconscionable that the best Republican leadership has to offer is a plan that cuts Medicaid, destabilizes Medicare, and takes insurance away from millions of hardworking Americans. In fact, estimates suggest that 357,000 Alabamians are at risk of losing their coverage if we repeal the ACA. Our access to care is a fundamental right, not a privilege. Protecting care for seniors, disabled Americans, and working and low-income families goes to the heart of who we are as a country. We cannot settle for a health plan that leaves millions of Americans without the coverage they need.”
Studies show that the GOP health plan would increase costs for the average enrollee by $1,542 if the bill were in effect today. At the same time, the proposed bill eliminates requirements for insurance companies to cover preventative care, and makes it possible for insurers to discriminate against seniors. By cutting Medicaid and reducing health assistance to low-income families, the health bill would reduce revenue for rural hospitals,700 of which nationwide have been labeled as financially at risk.
Patients across Alabama’s 7th District would lose assistance under the GOP health plan. In Jefferson County, residents’ health coverage tax credits will be 33% lower than they were under the ACA.
Despite concerns raised by both Republicans and Democrats, House Republicans plan to move forward with consideration of the health bill in the Ways and Means Committee and Energy and Commerce Committee on Wednesday, March 8. Rep. Sewell is a member of the Ways and Means Committee and will participate in tomorrow’s markup of the GOP health bill.

Rep. Sewell Votes Against GOP Repeal Bill

Mar 9, 2017 
Press Release
The House Ways & Means Committee voted to advance the bill in Congress, despite not yet having any estimate for the bill’s cost or impact from the Congressional Budget Office
Washington, D.C. – On Thursday, the House Ways & Means Committee considered amendments to the Republican health plan and voted to advance the bill in Congress, despite not yet having any estimate for the bill’s cost or impact from the Congressional Budget Office (CBO). Congresswoman Terri A. Sewell (AL-D) offered amendments to the bill that would prohibit increases in taxes and medical costs for rural farmers and prevent rural hospital closures. The amendments offered by Rep. Sewell were defeated in party-line votes. Rep. Sewell opposed the Republican repeal bill when the Committee voted to advance the bill.
“I voted against today’s GOP repeal bill for one simple reason: it would raise health costs for working families and struggling Americans while decreasing their quality of coverage,” said Rep. Terri Sewell. “My constituents work hard to provide for their families, and additional health costs jeopardize their access to care. The Republican health bill would bankrupt low-income families and the rural hospitals that depend on their access to care by eliminating income-based support for health coverage, slashing Medicaid, and erasing preventative care coverage. The amendments I offered today would have protected rural Americans from increased health costs and growing health disparities. Without those safeguards for working families, and with no estimate yet for this bill’s cost, I could not in good conscience vote for this legislation.”
Among the amendments offered by Rep. Sewell was a measure that would prohibit the Republican health bill from increasing taxes or medical costs for rural farmers and farmers with disabilities. Rep. Sewell drew inspiration for the amendment from a rural farmer in Alabama whose access to health insurance through the Affordable Care Act saved him from financial disaster.
Rep. Sewell also spoke at the hearing about the need to protect against increased health disparities for minority populations. For a wide range of diseases today, the mortality rate for African Americans is much higher than that for other populations. With cancer, for instance, the mortality rate among African Americans is 20 percent higher than it is for white populations.
Rep. Sewell voted against the Republican repeal bill when it passed the Ways & Means Committee early Thursday morning in a party-line vote.

Rep. Sewell Statement on CBO Analysis of GOP Repeal Bill

Mar 13, 2017 
Press Release
The nonpartisan CBO releases projections of how many Americans would gain or lose insurance under the Republican proposal to repeal the Affordable Care Act
Washington, D.C. – Today, the nonpartisan Congressional Budget Office (CBO) released projections of how many Americans would gain or lose insurance under the Republican proposal to repeal the Affordable Care Act as well as cost projections for the proposed bill. The CBO analysis comes nearly a week after the Ways & Means Committee considered and voted to advance the Republican repeal bill. Congresswoman Terri A. Sewell voted against the repeal bill in committee.
“The CBO report released today makes one thing clear: the Republican repeal bill will cost American lives and leave millions uninsured,” said Rep. Terri Sewell. “Under this bill, 14 million Americans would lose their insurance within the next year. Over the next decade, that number would rise to an unsustainable 24 million uninsured Americans. Our healthcare infrastructure, from our rural hospitals to our network of family physicians, cannot withstand that kind of blow to health coverage. I believe that all Americans have a right to affordable healthcare, but this legislation turns healthcare into a privilege. For families in my district, the Republican repeal bill means more expensive coverage with fewer protections. We cannot ask working Americans to go broke, bankrupt, or do without healthcare.”
Today’s report from the CBO and Joint Committee on Taxation shows that by 2018, five million fewer people would be covered under Medicaid, six million fewer Americans would be covered in the individual market, and a total of 14 million more Americans would be without insurance. The CBO report estimates that in 2018 and 2019, average premiums for single policyholders in the non-group market would rise 15 to 20 percent under the GOP repeal bill.
In addition, the report shows that low-income seniors will see premium increases of $12,900, while the average 40 year old will see an average premium increase of $700. CBO projects that the actuarial value of all plans will decrease under the AHCA.
On March 9, Rep. Sewell voted against the Republican repeal bill when it passed the Ways & Means Committee in a party-line vote. Rep. Sewell’s remarks during the committee hearing are available here.