Mark Shapiro is our man, hero of our nation, the only thing that’s wrong with him is mental retardation.
That’s the ditty, recited to the tune of the Roger Ramjet cartoon opening, we’d sing on the playground of the Toronto Talmud Torah Hebrew Day School when an unpopular student was targeted for bullying. Whenever the student was encountered, we’d immediately make a circular finger motion around our heads and say “cuckoo.” Another popular taunt was to say the targeted student belonged at 999 Queen Street, which we believed, possibly mistakenly, was the address for what commonly was referred to as Toronto’s mental hospital.
I’ve evolved during the half century since I attended elementary school, and while I’ve lost touch with most of my childhood peeps, I imagine they have as well. Making fun or stigmatizing the mentally challenged or ill is no longer acceptable, even among those of us who decry wokeness. Still, there is one high profile person who hasn’t evolved, and would feel right at home on the Talmud Torah playground of my youth.
Donald J. Trump.
“Joe Biden became mentally impaired. Kamala was born that way,” Trump said to loud applause at a rally in Wisconsin this past Saturday. “And if you think about it, only a mentally disabled person could have allowed this to happen to our country.”
There is so much to criticize about Kamala Harris, particularly her record, her judgment, and her undeniably failed leadership. But to suggest that she’s mentally disabled is beyond the pale, particularly given that she passed the California bar, albeit on the second try. California’s legal licensing exam, along with New York’s, is among the most difficult and requires a certain baseline smarts and discipline. I doubt that Trump has the required focus to master the exam, and to be candid, neither do I.
Harris is blessed by Trump’s immaturity and a legacy media whose clueless reporters cheer her on for not talking to them. Harris’ handlers know they must limit her public interactions or Americans will catch on that she is bereft of ideas and can’t make a coherent argument defending policies she professes to support, at least until November 5. For a taste of the latest word salad that Harris served up, tune to the 30-minute mark of the accompanying video.
Frightening stuff, particularly given that Harris has no record to speak of supporting small businesses. She just babbles on about things that makes no sense even to her native Californians, who wisely rejected her 2020 run for president.
If Trump were a disciplined campaigner and had a mastery of the issues of greatest concern to most Americans, the AP would have already called the election in his favor. The economy and healthcare are what Americans most care about, and the two are interrelated. U.S. healthcare care spending in 2022 accounted for 17.3% of the GDP. Hospital charges comprise a significant portion of healthcare spending.
Late in his term, Trump introduced a daring initiative that would have reigned in hospital costs, saved jobs, and given Americans more access to affordable healthcare. The Biden/Harris administration derailed that effort, caving to the powerful American Hospital Association, which champions the interests of hospital CEOs at the expense of patient safety and transparency. The AHA ranks No. 4 in terms of beltway lobbying expenditures greasing the skids of Congress.
Democrats talk a good game about wanting to reform healthcare and make it better and more affordable, but it’s meaningless babble of the sort that Harris routinely spouts. Minnesota Gov. Tim Walz has demonstrated that he lacks the cajones to stand up to powerful healthcare interests, and he’s certainly no friend of nursing unions. More on that in a moment.
In 2019, the Trump administration went nuclear on the healthcare industry, introducing a surefire initiative that would have led to reduced hospital costs for patients. Trump’s ground-breaking rule was to require hospitals and insurers to disclose their secret negotiated rates for the first time and to publicize the rates they negotiate for all services, including drugs, supplies, facility fees and care by doctors who work for a hospital’s facility. Insurance companies and group health plans that cover employees were required to disclose negotiated rates, as well as previously paid rates for out-of-network treatment, in file formats that were easily computer-searchable.
The insurers, including Anthem Inc. and Cigna Corp., were also required to have to provide a transparency tool to give cost information to consumers in advance.
“Right now, there is too much arbitrage in the system,” an unidentified senior Trump administration official told the Wall Street Journal. “There are a ton of vested interests who will oppose this. We expect to get sued. We’re really goring people’s oxes.”
The unidentified Trump official was correct that vested healthcare interests would sue to block the pricing transparency initiative. The AHA did just that, but was unsuccessful, even on appeal.
It’s never been reported the Trump administration official(s) responsible for driving the price disclosure initiative, and indications are that Trump never understood the powerful implications, as he’s never championed the accomplishment. I know that one of the physicians who was instrumental behind-the-scenes for the rule was Nicole Johnson, an intrepid Ohio pediatrician who I proudly profiled in July 21, 2022.
Trump was defeated in 2020, and the Biden/Harris administration has proven to be a great ally of America’s healthcare cartel. The Biden/Harris administration declined to impose the draconian noncompliance penalties that Trump’s price disclosure rule called for, allowing most American hospitals to continue screwing patients, businesses, and insurers every which way since Sunday.
Earlier this year, an organization called Patient Rights Advocate (PRA) issued a news release disclosing that most American hospitals still weren’t complying with Trump’s price transparency rule. PRA revealed that only 35% of the 2,000 hospitals it reviewed were in full compliance, virtually unchanged from July 2023.
Despite the poor compliance, PSA said the Centers for Medicare & Medicaid Services under Biden/Harris issued penalty notices to only 14 hospitals.
Hospital pricing can vary widely, and there is no rhyme nor reason how they are determined. Trump’s pricing transparency rule would have forced prices down when patients discovered that a hospital charging $25,000 for a surgery could get the same procedure performed for half the price at a hospital of comparable or even better quality. Lower hospital prices not only benefit patients and businesses, but they also save jobs.
A study published last June as a National Bureau of Economic Research working paper documented that when companies are hit with higher healthcare premiums, they manage the costs by firing employees.
The study’s findings: As hospital prices rose 1%, so did the percentage of people who ended up out of a job. The layoffs dealt a blow to their communities. Income-tax revenue dropped and payments for tax-funded unemployment insurance increased 2.5%.
The economic hit applied to any price increase that patients pay without getting any more benefit in return, such as facility fees and surprise billing, Zack Cooper, a health economist at Yale University who was involved in the study, told the Wall Street Journal.
Hospital mergers almost invariably result in higher costs and poorer care. Joe Biden, when he was still “sharp as a tack,” understood this.
In July 2021, Biden issued an executive order calling on the Federal Trade Commission and the Department of Justice to ensure a competitive economy, instructing them to “vigorously” enforce antitrust laws that Biden said “allows them to challenge prior bad mergers that past Administrations did not previously challenge.”
FTC chair Lina Khan, an arrogant thirtysomething Ivy Leaguer failing miserably pursuing her idealistic agenda to break up Big Tech, rubber stamped two major hospital mergers that no doubt had AHA’s members smacking their lips, as well as a healthcare takeover that gave Jeff Bezos’ Amazon cause for celebration.
Khan took no action to block the merger of Chicago-based Advocate Aurora Health and Charlotte-based Atrium Health, creating the fifth-largest nonprofit health system, with 67 hospitals and $27 billion in revenues. The deal sailed through despite a class action lawsuit filed in Wisconsin alleging that Advocate Aurora – created by the merger of Chicago-based Advocate Health and Milwaukee-based Aurora Health – used the market power it achieved from the combination to charge “unreasonably high prices.”
Jim Skogsbergh, Advocate Aurora’s previous CEO, consistently ranked among Illinois’ highest paid hospital CEOs, before he sailed into the sunset. Skogsbergh also played an active role in the AHA, which last April presented him with the organization’s highest honor, the Distinguished Service Award.
Khan also didn’t move to block Amazon’s purchase of One Medical, a McMedicine chain of primary care facilities in about a dozen cities increasingly staffed by inexperienced physician assistants and nurse practitioners. The deal is another major blow to U.S. healthcare, as it will result in more Americans receiving their primary care from pretend doctors and possibly provide a meaningful boost to Amazon’s pharmacy business. My previous warnings about Amazon’s One Medical acquisition can be found here and here.
Khan also didn’t move to block Grand Rapids-based Spectrum Health’s acquisition of suburban Detroit based Beaumont Hospital, creating Michigan’s biggest hospital system as well as the state’s biggest employer. Beaumont was once a nationally respected hospital network that suffered a major patient care decline under a CEO named John Fox, who pocketed some $50 million in compensation during his seven years of leadership while aggressively cutting costs. Fox’s singular focus on boosting profits alienated the hospital system’s once world-class physicians and surgeons, who didn’t trust or have confidence in him, prompting many of them to leave or perform their procedures elsewhere.
Merging the operations of Spectrum and Beaumont, since rebranded as Corewell Health, has gone badly under the leadership of CEO Tina Freese Decker, who paid John Fox at least $10 million to go away, and is now aggressively looking to cut costs on the backs of the nurses at the former Beaumont hospitals, including trimming $3 million in nursing expenditures at what was once Beaumont’s best managed hospital with the best patient outcomes.
That’s prompted the nurses at the former Beaumont hospitals to partner with the Teamsters and petition the NLRB to organize more than 9,000 nurses, the biggest union drive in Michigan in more than a half century. A Teamsters official told me that organizing the former Beaumont nurses is part of a broader plan to organize nurses throughout Michigan.
Details about the Corewell nursing union drive can be found in my column Deadline Detroit published on Sunday. No word from the Harris campaign in support of Corewell’s nurses, not surprisingly given that hospital executives this year have so far contributed $47,593 to Harris’ campaign and only $8,351 to Trump’s campaign.
Corewell’s nursing unrest has national implications, particularly given that hospital CEO Tina Freese Decker was nominated to lead the AHA beginning in January. If the Teamsters are successful organizing Decker’s 9,000 nurses in southeastern Michigan, she will be regarded as a joke among her industry CEO peers, and not the ha-ha kind that would trigger Harris’ signature cackle.
There is a serious nursing shortage in America, as hospitals seeking to boost their profits want nurses to care for more patients and assume other responsibilities nurses say increasingly puts patients at risk. Nursing is a very stressful profession, which possibly explains why nurses are 18% more likely to commit suicide compared to individuals in the general population, according to a study based on data spanning from 2007 to 2018. Job conditions have considerably worsened since.
In Michigan alone, there are 50,000 registered nurses who have left the profession because the legal and liability risks have become too great, a Corewell nursing organizer told me.
Joe Biden and Kamala Harris profess to be champions of unions, yet they’ve done nothing in support for nurses’ unions or organizing attempts. Under Biden/Harris rule, nursing labor unrest has steadily escalated.
The Minnesota Nurses Association last year championed legislation known as “Keeping Nurses at the Bedside Act” that would have required hospitals to staff at a higher nurse-to-patient ratio. The mighty Mayo Clinic, who Walz recommended for heart surgery during the debate, opposed the bill, and threatened to relocate its planned billion-dollar hospital investment to another state.
Walz initially offered to exempt the Mayo Clinic from the legislation, but when other state hospitals protested, he watered down the bill and eliminated the original staffing provisions. Notably, the Mayo Clinic is a vehemently anti-union hospital company.
Walz also vetoed a bill that would have increased pay for rideshare drivers after Uber threatened to stop its operations in Minnesota if the legislation passed. When it comes to genuflecting to corporate interests, Walz gives Trump a good run for his money.
My guess is that most of what I’ve outlined is news to Trump. Instead, Trump chooses to focus on his childish name calling, which admittedly Harris is matching in spades.
Harris last week called Trump “one of the biggest losers of manufacturing in American history,” and vowed that “as president, I will bring autoworker jobs back to this country and create an opportunity economy that strengthens manufacturing, unions, and builds prosperity and security for America’s future.”
“I will always stand with the UAW,” Harris said.
The Biden/Harris administration’s EV mandates have resulted in lost auto jobs, and while union president Shawn Fain has endorsed Harris’ candidacy, it’s far from certain his rank-and-members respect his judgment. At a Ford plant in suburban Detroit, a Washington Post reporter recently found more workers who said they’d vote or were leaning toward Trump.