Health professionals declare war on TrumpCare™

Back when esnl was in knee-pants, members of the healthcare professions were adamantly opposed to government involvement in their bailiwick, with doctors especially deriding government involvement in the insurance racket as nothing less than [horrors] socialized medicine!.

Doctors in particular could be relief on by the GOP as reliably in their pocket.

But no more.

Consider the just-announced declarations of war from three healthcare alliances, allergists, psychologists, and nurses.

Allergists take a resolute stance

First, from the American College of Allergy, Asthma and Immunology and the American Academy of Allergy, Asthma and Immunology:

The American College of Allergy, Asthma and Immunology (ACAAI) and the American Academy of Allergy, Asthma and Immunology (AAAAI) are gravely concerned about the impact President Trump’s proposed budget, released earlier today, will have on the future of medical research. We call on Congress to reject the proposed cuts to the National Institutes of Health (NIH) and instead, build on the commitment made last year to begin increasing spending for medical research.

The President’s budget blueprint recommends significant, largely unspecified, cuts to the budget of the NIH. In total, the proposed reduction would amount to approximately 20 percent of the NIH’s entire budget.

ACAAI president Stephen A. Tilles, MD and AAAAI president David B. Peden, MD said the following upon learning of the proposed cuts: “Although the budget blueprint released by President Trump earlier today is short on specifics, it is hard to imagine how cuts of this magnitude could be accomplished without doing serious harm to the core mission of the NIH – medical research. Together, we call upon Congress to reject any cuts to the NIH that would decrease the NIH’s ability to conduct life-saving medical research and training.”

NIH, and in particular the National Institute of Allergy and Infectious Diseases (NIAID), the National Heart Lung and Blood Institute (NHLBI) and the National Institute of Environmental Health Sciences (NIEHS) are providing vital funding for medical research that could lead to life-improving treatments for individuals suffering from allergies, asthma, immunologic disorders and infectious diseases (including HIV/AIDS, emerging and reemerging infectious diseases).

Each year, billions of dollars are spent treating the causes and symptoms of food, drug and skin allergy, immunodeficiency, and asthma. Through the work of NIAID, NHLBI and NIEHS and the research they are funding, we have the opportunity to identify and develop life-saving and life-improving treatments for these widespread chronic conditions.

This past October, NIAID researchers announced promising results from an NIH sponsored clinical trial on the efficacy and value of an intervention for treating children and young adults with peanut allergies. This January a NIAID sponsored expert panel issued clinical guidelines to help health care providers give parents and caregivers important information on early introduction of peanut-containing foods to infants to prevent the development of peanut allergy. These are the type of results the American people can expect from supporting NIH (NIAID, NHLBI and NIEHS) and their medical research mission.

ACAAI and AAAAI call on Congress to continue its bi-partisan support for the NIH and the NIAID, NHLBI and NIEHS as it completes the 2017 appropriations process and embarks on enacting appropriations bills for fiscal year 2018.

And the headshrinkers weigh in

From the American Psychological Association:

The American Psychological Association and its affiliated APA Practice Organization sent a letter to congressional leaders stating their opposition to the American Health Care Act after a Congressional Budget Office analysis projected that the bill, if enacted into law, could double the proportion of Americans without health insurance by 2026.

“We believe that any health care reform legislation to repeal and replace the Patient Protection and Affordable Care Act considered by Congress should increase the number of Americans with coverage for mental health and substance use disorder services, including behavioral health treatment,” said the letter to Speaker of the House Paul Ryan, R-Wis., and House Minority Leader Nancy Pelosi, D-Calif., signed by APA President Antonio Puente, PhD, and Interim CEO Cynthia Belar, PhD. “As the recent analysis by the Congressional Budget Office concludes, the American Health Care Act would significantly decrease Americans’ access to these services, and by 2026 would take coverage away from an estimated 24 million people who would have otherwise been covered under current law.”

The letter voiced concern that the AHCA would severely undermine Medicaid by instituting per capita caps in federal payments to states that would not keep pace with per enrollee spending growth and by eliminating the Medicaid expansion for Americans with incomes below 138% of the federal poverty level. The CBO projected the AHCA would cut Medicaid spending by $880 billion over the next ten years and remove coverage from 14 million beneficiaries by 2026.

“These cuts are unconscionable in light of the large unmet need for mental and behavioral health and substance use services, as evidenced by the tens of thousands of Americans dying each year due to opioid addiction,” said the letter. “By drastically reducing federal spending for Medicaid, and by removing the requirement that Medicaid benchmark plans cover mental health, substance use, and behavioral health services, the American Health Care Act would jeopardize coverage for these life-saving treatments for the entire Medicaid population.”

The letter also expressed concern at the elimination of vitally important funding for the Prevention and Public Health Fund, and its prohibition on funding for providers that primarily offer reproductive health services under Medicaid. This change would effectively cut off access to care for many low-income women and sexual and gender minorities, many of whom would not have access to health care if they could not access these service providers. The CBO analysis projected that the proposed cuts in Medicaid funding to reproductive health care providers would increase Medicaid spending by $21 million in the first year.

In addition, the CBO estimated that the AHCA would reduce the quality and reliability of private sector insurance by allowing plans to offer coverage with less actuarial value, increase out-of-pocket costs for lower-income and less healthy Americans and make it harder to shop for and compare plans.

“While we support efforts to strengthen and stabilize our nation’s health care system and extend insurance coverage and protections, we oppose the American Health Care Act due to the adverse impact it will have on Americans with mental health, behavioral and substance use disorders,” said the letter.

Copies of the letter were also sent to Senate Majority Leader Mitch McConnell, R-Ky., and Senate Minority Leader Charles Schumer, D-N.Y.

Nursing colleges fire a broadside

Nurses play a critical role in healthcare, monitoring physicians and their use of possibly dangerous drug mixes and doses [we know personally of many cases when nurses saved patient lives because they caught doctor errors], and they are the front line monitors of patient health.

And now the colleges that our nation’s nurses are making their position clear.

From the American Association of Colleges of Nursing:

President Trump released his FY 2018 America First – A Budget Blueprint to Make America Great Again. The budget proposes wide sweeping and devastating cuts to programs that ensure health across the nation. The American Association of Colleges of Nursing (AACN) strongly opposes these cuts and warns both the Administration and Congress that decreasing federal dollars by this magnitude will threaten the lives and livelihood of millions of Americans. The association believes that safeguarding the public is not solely a defense effort, it is also a public health one.

“To raise our concerns, AACN’s membership will be on Capitol Hill on March 20, and we plan to share with Congress the vital importance of funding for research, workforce, and health programs,” said Dr. Juliann Sebastian, AACN’s Chair of the Board of Directors.

The budget proposal outlines a 20 percent reduction to the National Institutes of Health (NIH), slashing the funding by $5.8 billion dollars and folds the Agency for Healthcare Research and Quality under NIH. Funding for biomedical and healthcare research has a priceless return on investment. Scientific discoveries improve health, help cure diseases, and translate to advancements in quality care. The financial impact of research is two-fold. First, the findings translate to direct cost savings to the healthcare system, patients, and the community. Secondly, research dollars spur local economies by creating jobs and opportunities for community engagement. Cuts this deep to the nation’s epicenter for healthcare research is not only concerning, it is unprecedented.

Equally problematic, the budget proposes debilitating reductions to health professions and nursing workforce programs by $403 million dollars. This is counterintuitive to the Administration’s goal of increasing access and reducing costs. Forecasts project that nurses will be called upon even more to coordinate care, provide preventive services, and manage chronic diseases, in addition to their current roles across the spectrum of care delivery. Supporting the growth of the nursing workforce for current and projected trends is a necessary investment to ensuring that the nurses educated today are ready for the challenges of tomorrow.

“Health care cannot be transformed without foundational support for the programs that hold the system up,” said AACN’s President and CEO, Dr. Deborah Trautman. “Congress will ultimately be responsible for passing a budget and we are committed to working with them to ensure that federal funding underscores sustainability and progress toward a healthier nation.”

If the folks who care most about your health are condemenign this latest TrumpTravesty™, it’s time for us to join them.


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