It has been one week since Trump’s ever so important and ever so dramatic Presidential briefing on telehealth and drug prices. And there has not been much else in the way of details or explanations to follow it. So, as the coronavirus continues to sicken and kill people what can we conclude about Trump’s announcement and plan of attack for handling the continued viral threat?
He still doesn’t get it. He still doesn’t understand what is necessary to eliminate the coronavirus or have any realistic, long range plan to tame the threat to our public health.
Here’s why.
-He still keeps referring to the Coronavirus as the “Chinese” virus.
This language is a favorite of reactionary politicians like Tom Cotton, junior senator from Arkansas, and hired hacks like trade advisor Peter Navarro. It is used to make you think that China invented the novel coronavirus and, then in an act of pure evil, secretly shipped it over here specifically so that they could hurt him and, and, and get Joe Biden elected! Obviously!! Because Biden’s weak on China while Trump is manly powerful against them.
The virus probably did first appear in China (just as the “Spanish flu” was first observed in the state of Kansas before it got a nickname), but there is no evidence that China invented it or somehow exported it to the U.S. And even if they did, and even if they lied, it is still the job of the president of this country to understand dangers to the country and act to protect us - without looking for scapegoats for whining about it. Which he does, all the the time.
-Trump still believes in the quick fix and fantasy plans.
Trump started his briefing by trying to make us believe that the virus is coming under control. This was done by citing some hand picked statistics about a drop in the percentage rate of infection in certain states followed up with some claims that deaths are going down. And all the while the text behind him showed that more than 155,000 American people have died of the virus. Does anyone really think that this virus is coming under control or that a lot more people are not going to die?
The first big bombshell purpose of Trump’s presidential briefing was to introduce an executive order expanding access to telehealth services, mostly in rural areas. This effort would build on the Medicare and Medicaid agencies services to double health care services. The Veterans administration is also taking action to increase telehealth services to all veterans and their families. There is also an effort to expand telehealth services to rural areas, and, get this, “an order that directs the federal government to launch a joint initiative in 30 days to improve the healthcare communications infrastructure and to expand health care services.”
This measure to expand telehealth services is the technological equivalent of the hydroxychloroquine panacea: a quick fix that has Trump believes has magical power to radically stop the virus and make people healthy and happy again.
At one time a nationwide program, with particular efforts in rural areas, to develop and extend telehealth access and programs might have been something very useful.
But the announcement of the program, coming now so close to the election and with Trump trailing Joe Biden in so many polls, looks to be nothing more than an attempt to buy some popularity in places where he may be electorally weak. But it is just the kind of quick fix without any real hope of meaningfully helping people that Trump believes in.
Particularly in rural areas it is fantasy to believe that telehealth services can make a dent in coronavirus health problems. Many rural areas do not even have sufficient basic internet services, or lack the bandwidth capacity to make significant doctor-patient interactions possible. Had Trump and the Republicans put money into such infrastructure and services back in 2017, when they still had lots of money, rural telehealth services might have been become a reality. But no, it was more important to give away money in a massive tax cut that went mostly to rich people (more on this in later blogs). Infrastructure is expensive in both time and money. Trump sacrificed the opportunity to tackle this problem but decided a tax cut, given while the economy was still strongly recovering from the Obama year, was more important.
The tax giveaway was also more important than providing the medical infrastructure to go with the telehealth services. Rural areas, especially in many conservative states, are vastly underserved by doctors, hospitals and other medical providers. Moreover, since many conservative states neither established health insurance exchanges for ObamaCare medical insurance, or took the federal Medicaid expansion, many rural residents simply can’t afford the services anyway.
-Trump and the Republicans will not do what is necessary to really lower drug prices.
The other major part of Trump presidential briefing concerned his stupid, cheaply theatrical, and ultimately ineffective efforts to lower drug prices.
Trump certainly knows that people are upset with high drug prices, and angry with the companies that set those prices. So he has a few gimmicks that he hopes might lower the price of a few drugs and impress people with his powerful, manly efforts to help them.
As is typical with Trump, and all of the Republican party, there is no substantial, legislative program to reduce drug cost - just a few moves that sound good but offer no real hope.
In keeping with the tough guy image he has crafted for himself, the main announcement was that “President Trump had signed four executive orders to help lower prescription drug cost for Americans.”
Trump has been braying and bragging about how he was going to “order” pharmaceutical companies to lower their prices for drugs for some time. He has grandly and buffonishly claimed that he, unlike other presidents - especially democrat ones-, will actually use his executive power to force these evil, wicked, companies to bend to his will and simply cut drug prices.
This is the most common and delusional of all of Donald Trump fantasies about himself - that simply by exercising his mighty will, and a slew of executive orders, he can fix anything he wants.
But you can’t fix any part of the American healthcare system without fundamentally changing the way care is financed and provided. That is what ObamaCare so dramatically proved. And this has to be done legislatively, so that both the incentives and the punishments that underlie the change are enshrined in the law of the land.
If Trump really thinks that he can use executive orders to force all American and foreign-owned drug companies to radically reduce their prices just because he says so, he’s stupid. No president has the right to dictate to any company how they set their prices or sell their products. We have a crisis in housing, but would Trump stand still for a government that dictated how much he could charge for rent or put a limit on the price of a building he wanted to sell?
No. If Trump really intended to radically reduce drug prices he would have to do one simple thing: change the law and let the federal government (through Medicare, Medicaid, Veterans Administration, etc.) bargain for discounts on all purchases.
The immense buying power of the federal government gives it the bargaining power to negotiate huge discounts. After all, isn’t this just how it works in the private sector? If you buy a lot more of any manufactured product, don’t you get a discount? Of course you do. Just ask anybody who has ever sold something to Walmart or Home Depot.
Drugs are a manufactured item. And as with anything else, the cost of manufacturing each item is spread out over the number of items produced and sold. The more you make, the less each thing will cost. And because you are selling a lot of those things you can sell each one at a reduced price and still make a nice profit. Again, ask anybody who has manufactured and sold anything to Walmart. Or somebody at GM. Or anybody that makes and sells a lot of things.
The federal government buys more drugs than anyone else in the world. But the federal government does not now have the legislative power to negotiate for volume discounts. That, surprise, is how drug costs are kept down in other countries. When all or more of the nation’s health care is financed by the central government, and they buy most of the drugs, then they make a real effort to buy cheap, not expensive. Foreign drug companies know this, adapt to it, and still manage to make good profits.
Government discounts could be a win-win situation for both consumer and producers. But this would require a change in the law concerning how the government buys drugs. And that is why it will not happen under Trump and the Republicans.
There are too many drug companies that make too many political contributions to Republicans. There are still too many reactionary Republicans who think that discounts are a sign of communism, or socialism or some other thing that does not fit into their political theology of rugged individualist capitalism. It would also require some good insightful and informed legislation. Something that the reactionary Republicans have, for most of the Trump years, simply given up on doing. Anybody remember, “repeal and replace?” Wasn’t Trump going to get rid of ObamaCare and replace it with something else? Something big and beautiful and better than you’ve ever seen?
-You have to vote for the Democrat if you want lower drug prices.
When we vote for Joe Biden to be president we will have someone who has actually helped craft and pass laws that fundamentally change health care. The ObamaCare exchanges and the expansion of Medicaid, along with such laws as no preexisting conditions, have enabled Americans to get insurance that ordinarily would not be available to them. It has literally saved lives and reduced pain and suffering for millions of people. And, because these things were brought about by laws, not just some “Executive Order” they have had the power to survive repeated attempts by reactionary Republicans to repeal them and deprive Americans of their health care—just as with Social Security and Medicare, two other pieces of legislation designed to help ordinary Americans that the Republicans have been trying to destroy for years.
Trump and the reactionary Republicans have failed to control the coronavirus. It will take someone who actually recognizes the need to act decisively against it and will do something. legislatively and otherwise, to get rid of it.
Trump is worthless and so is the Republican party. Vote for the Democrats, up and down the whole ballot.