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Brugger: Back to the future on health care

Now we have the first draft of “Repeal and Replace.” Are you excited? Are you ready to pay a lot less for your health insurance? Did you notice that in the advanced publicity for this highly advertised bill that no one is saying that you can have the same coverage for less money? True, your kids can stay on your insurance until they are 26, and insurance companies can’t reject you for a pre-existing condition. It doesn’t say anything about how much it will cost, though.

Frankly, I had hoped for more. Trump’s support came from the center of the country, and I doubt that much in the bill will help the population of that area at all. The bill will allow us to have less coverage for less money. It will give us tax credits rather than subsidies when we buy insurance. It will take away the taxes now levied on pharmaceuticals, durable medical equipment, and high-end medical plans. But it will not solve the problems of the high cost of insurance in many parts of more rural America.

Most American geography can be characterized as sparsely populated. It can also be considered economically stagnant. These areas do not attract medical providers. The providers who do practice there do not need to join insurance plans that restrict payments because their practices are full with patients who pay the fees when they choose to go to the doctor and the guaranteed fees from Medicare and Medicaid. Small hospitals are closing or are providing a limited scope of care. Getting advanced medical care involves travel expenses and time away from home.

To add insult to injury, the exchange premiums in these areas are huge — especially in areas where incomes are lower. This is not because an insurance exchange is a bad idea. It is because the number of individuals covered is too small and the population often does not have adequate preventative care. Insurance always needs to balance risk and numbers of people insured. The higher the number of people who have the same insurance, the lower the risk that all of them will use it at the same time.

What is needed is larger insurance regions. Rather than a state-by-state approach, the exchange should be set up to cover several states or the whole country. If, for instance, Idaho, Utah, Montana, Nevada and Wyoming were all in one exchange, there could be enough people to adequately fund lower premiums.

I am not advocating single-payer insurance. Mandating single-payer would be too disruptive to our economy. It would also negate any positive effects of competition in the marketplace. We could, however, restructure the insurance industry to be more financially advantageous to the insured by eliminating individual state control and surrendering it to regional cooperatives governed by the federal mandates for coverage.

Rural medicine is in crisis because of the lack of providers. The ACA had a provision to encourage more doctors to go into family medicine, but it was not enough. The nation needs to turn out more doctors, nurse practitioners, and physician’s assistants, ASAP! Congress should place high priority on funding more medical education in every practical way possible. Comprehensive preventative care means that disease processes are not advanced when encountered, and the costs to keep a patient enjoying a good quality of life are much less. We need medical providers throughout the country.

The Republicans have a public relations problem. They named the ACA “Obamacare” to increase negative perception, but several studies showed that people loved the plan when it was presented without Obama’s name attached to it. Just patching the ACA might allow the name to endure. Therefore, the repeal-replace promise.

The Republicans also have a funding problem. Lobbyists for the pharmaceutical, durable medical equipment, and insurance industries want a repeal of the taxes and spending restrictions imposed by the ACA. I do not object to the practice of lobbying. Many of my personal interests are supported by lobbying efforts in Washington and Boise. What I object to is so much money being offered that it amounts to a practical bribe for votes. It can obscure the need for a fresh look at an issue.

Do we really want to go backward on health care? The future promises even larger leaps in medicine which lead to wonderful quality-of-life enhancements. Should we increase the resentment of those who cannot afford them or cannot find providers for them? If we believe that life is one of our inalienable rights, we cannot ignore the need for the best of health care for all.

Other View: Republicans are threatening to expose Trump as the emperor with no clothes

It’s almost like Republicans are tired of having President Donald Trump’s evidence-free allegations laid at their feet. Almost.

Late Monday, House Intelligence Committee Chairman Devin Nunes’s, R-Calif., spokesman threatened to subpoena the Trump administration to produce evidence of Trump’s claim that then-President Barack Obama wiretapped Trump Tower. The White House has declined to produce this evidence publicly.

“If the committee does not receive a response by, the committee will ask for this information during the March 20 hearing and may resort to a compulsory process if our questions continue to go unanswered,” Nunes spokesman Jack Langer said.

Then, on Tuesday, Sen. Lindsey O. Graham, R-S.C., made his own threat. Last week, Graham—who is clearly skeptical of the wiretapping claim and chairs a subcommittee looking into it—asked the Justice Department and the FBI to provide copies of any warrants or court orders related to the alleged wiretapping. Having not received anything back, Graham said he would announce his next steps Wednesday and may push for a special committee.

“They’re about to screw up big time if they keep running to the intel committee and not answer that letter,” Graham said, according to CBS’s Alan He. He added: “If they don’t honor this request and give us an answer, then I would say that we need a joint select committee because regular order is not working.”

It’s clear as day what’s going on here.

The White House’s reactions to Trump’s evidence-free claims is to call for investigations. That has the triple benefit of putting the onus on someone else to look into it, to buy some time and hope people forget that the president is making such wild allegations, and in this case to give themselves an excuse to clam up. The White House initially said that it wouldn’t comment on Trump’s wiretapping claim while it was being investigated, and then it said it couldn’t provide evidence because of separation of powers—another claim that strained credulity.

But that also puts Republicans like Nunes and Graham in the position of having to account for these claims. By pushing the administration to produce evidence—or else—they are effectively putting the ball back in the executive branch’s court. The subtext: You can’t just make these claims and then ask us to deal with the fallout.

Our View: Celebrating sunshine

Sunshine Week holds special significance this year.

We have a president who refers to the press as the “enemy of the people.” We have an administration that dismisses news it does not like as “fake news.” Information is disappearing from government websites. State lawmakers are seeking to make Idaho government less transparent. And we still have too many local governments oblivious to open-meetings and open-records laws.

These days, it seems the First Amendment is under attack from all sides, and our tradition of free expression seems to be fading. In our new reality, our leaders’ relentless repetition of falsehoods and attempts to silence dissent are threatening the spirit of a free and open society.

So, yes, Sunshine Week – celebrated by free-speech advocates and the media to bring attention to government transparency and First Amendment rights – is especially important this year, March 12-18.

But for all the efforts to discredit the press, to create a post-truth reality of alternative facts, we still believe the First Amendment is imperishable.

First of all, it’s enshrined in our Constitution: “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.”

In just 45 words, James Madison raised these freedoms to be the most important in the Bill of Rights, guaranteeing free expression and individual liberties unheard of at the time. These rights have transcended any president or legislature or local government. And they’ve survived attacks from all three for 228 years.

Second, these rights survive because people are willing to fight — and in some cases, die — for them. And they’re sustained in small ways, too, whenever someone writes a letter to the editor, buys a newspaper, attends church, holds a meeting without fear of government interference, or assembles to peacefully protest.

We encourage everyone to make one small gesture in support of the First Amendment this week. It’s seldom one or two grand actions that defend against attacks on our freedoms — it’s the collective will of a people, the sum of many small actions.

Let us all do our parts.

Letter: Trump and the First Amendment

Very fake MSM tries to set the narrative. The left wing disingenuous Old Gray Lady is upset along with very fake journalists. When I write a letter to this newspaper I am expressing an opinion based on facts collected from multiple sources. When journalists speak or write today they disseminate opinion instead of being objective reporting the truth. There’s a new sheriff in town, DJT, and he sets the narrative. 

Celebrities, very fake forth estate, dedicated left wing crybabies and never Trumpers — you can all whine until the cows come home. You see, while you’ve been acting out infantile temper tantrums, the Donald and his minions have been swamp draining in D.C. This is evident by all the leaking of sensitive information meant to embarrass or dissuade the administration. 

As a former associate professor of management and an organizational development trainer for a large corporation, here are couple things I taught: 1) Don’t put stuff in writing that’s not factual or true lest it come back to bite you. 2) If you want to find organizational leaks, plant disinformation with the suspect leakers. You’ll find out where the leaks came from. I had 17 different jobs with the same company for 25 years. Many of my assignments were spent as a “fixer.” Some of us, like DJT know that, in any organization, there are many imbeds that need a job change. That includes reporters with an agenda. When DJT scolds the MSM he is merely exercising free speech as protected by the First Amendment.

Mike Tylka