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Kamala Harris Election Campaign

Trumpers: Kamala has no plan! Open borders!
(Vice presiddnts have few plans of their own.)
Kamala lays out plan.
Trumpers: she is flipflopping! She is just a chameleon. Just like Trump said! Flipflopping from Indian to black.
 
small enough where it’s just one guy to turn that giant water faucet in canada off and on

edit

and another guy to tell him when. and a third to pay those guys. and another to collect taxes to pay them other guys. and that’s it.
 
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Tero said:
Trumpers: Kamala has no plan! Open borders!
(Vice presiddnts have few plans of their own.)
Kamala lays out plan.
Trumpers: she is flipflopping! She is just a chameleon. Just like Trump said! Flipflopping from Indian to black.
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T****y, releasing his plan for immigration: Herp. Herp a derp. Herp a derpity derp. Flippetty floppety, glibbety globbety minpy moopy moo!

Trumpistas: Sounds of drowning noises from all the tears they cried at this "predisential" solution.
 
acbytesla said:
The US federal government monitors and manages the practice of medicine in a number of ways, including:
Regulation
The FDA regulates the marketing and use of medical products, such as prescription drugs, medical devices, and supplements. The FDA monitors products after they are approved to ensure they are still safe and to track any adverse events.
Reimbursement
The Centers for Medicare and Medicaid Services (CMS) regulates reimbursement for healthcare products and services for Medicare and Medicaid. CMS also operates the federal insurance marketplaces created by the ACA.
Funding
The federal government funds research that leads to new treatments and options for patients and providers. The Health Resources and Services Administration (HRSA) funds health programs for underserved Americans and workforce education programs.
Public health surveillance
The federal government tracks infectious disease outbreaks in the US and worldwide.
Contracts
The federal government finances contracts to encourage public health initiatives, develop state and local provider contracts, and support ongoing activities.
Cost control
The federal government controls costs by setting provider rates, capping annual out-of-pocket fees, and negotiating drug prices.

While State and local governments play a key role in the US healthcare system, including licensing health care professionals, regulating health insurance plans, and operating safety-net facilities, the Federal government has the authority through the Supremacy Clause to over-rule State Medical practices.
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Additional commentary:

The FDA regulates the marketing and use of medical products, such as prescription drugs, medical devices, and supplements. The FDA monitors products after they are approved to ensure they are still safe and to track any adverse events.

The FDA doesn't regulate supplements as medicines at all, the extent of supplement regulation by the FDA is based on them being treated as food items, not medicines. FDA monitors drugs for safety after they've been approved, but monitoring for medical devices is quite limited - mainly implantable devices like pacemakers and insulin pumps, and even that's sketchy sometimes.

The Centers for Medicare and Medicaid Services (CMS) regulates reimbursement for healthcare products and services for Medicare and Medicaid. CMS also operates the federal insurance marketplaces created by the ACA.

CMS regulates reimbursement for services only for Medicare, and then only for bog-standard original medicare. They don't regulate provider reimbursement for services performed by contracted providers under a Medicare Advantage product - most insurers peg their reimbursement policies to medicare levels, but they frequently pay at a higher % than Medicare.

CMS doesn't regulate reimbursement for services by Medicaid - Medicaid reimbursement levels are developed by the states, but similar to MA, if the state uses a managed medicaid approach, most medicaid managers (they're not technically insurance companies) negotiate their own contracts with providers, and often pay at a different rate than the state-developed reimbursements. The state pays the insurer at the state-level, but insurers frequently pay out at a higher rate, and make up the difference through care management, steerage, and quality control practices.

The federal government finances contracts to encourage public health initiatives, develop state and local provider contracts, and support ongoing activities.

Can you elaborate on this?

The federal government controls costs by setting provider rates, capping annual out-of-pocket fees, and negotiating drug prices.
Nah, not really. The fed only sets provider rates for Medicare, not for anything else. And even then, they set the defined rate for what the fed pays for bog-standard original fee-for-service Medicare, not for Medicare Advantage plans. They don't set provider rates for Medicaid, nor for any employer or individual plans. It would probably be beneficial for all of us if the *did*... but they don't.

Similarly, the fed only negotiates drug prices for Medicare, and that's a very new practice, within just the last couple of years I think. Medicare isn't my focus field, so I'm not sure when it finally actually went into effect.

The fed only caps annual out of pocket fees for ACA regulated plans for Individuals and Metal Small Group. They don't cap larger employer coverage, they don't apply caps to pre-aca Grandfathered plans, they don't even cap Medicare.

++++++++++++++++++++++++++

An even larger miss, however, is that the fed doesn't manage medicine pretty much at all. The fed doesn't set Standards of Practice, pretty much doesn't get involved at all. They don't even define the distinction between elective and non-elective medicine, nor between cosmetic and reconstructive services. They don't have requirements around how medicine should or should not be delivered, or when it should be withheld.

The only thing that even comes close are related to prescription tracking for controlled substances, like opioids and amphetamines and such.
 
acbytesla said:
Yes it does. That the Federal government doesn't usually exercise that authority does not that they don't have it. If the Food and Drug Administration says that a specific drug or treatment isn’t effective or harmful it can and has made them prohibited.
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Well, no not really.

When FDA approves a drug, they approve it based on clinical data showing efficacy for a specifically tested indication. But once it's approved there are no guardrails in place to limit what those drugs get prescribed for. And a LOT of drugs get used for secondary indications.

For example... my antiseizure drug is only FDA approved for the treatment of seizure disorders. But it gets used as a secondary treatment for frequent migraines in people without seizures too.

Lupron is another good example. It's approved by the FDA for treatment for ovarian and testicular cancers. It gets used for those, certainly. But it also gets used as a short-term treatment for severe endometriosis and fibroids prior to surgery. It also gets used for the treatment of precocious puberty. And more recently, it's being used to halt the natural progression of normal puberty in adolescents.

Lupron has some very real long-term health risks. Usage for cancers is approved because the risk is balanced against the dying from cancer aspect. Usage for endo & fibroids is short term - usually about 3 months, rarely longer than that - and it's intended to prevent additional immediate harm from occurring until surgery can be performed. For precocious puberty, it's generally reasonable, because the long-term health risks from having the pituitary process trigger prior to the adrenal are worse than the long-term risks of Lupron, and some of those risks from Lupron don't manifest until after the adrenal has done its thing.

Use of Lupron in normally progressing adolescents is a very different story. The long-term risks aren't offsetting an immediate harm, and in many cases the patients aren't even aware of the long term risks and complications they face. Lupron used in this way actually introduces *new* health risks that aren't present in the other uses.

But there's not a single thing the FDA can do about it. FDA says "this drug can be used", it doesn't specify what the drug can be used *for*.
 
acbytesla said:
This demonstrates again why the US Constitution is undemocratic crap. And another reason to abolish the US Senate. A bill can run the gauntlet of passing through the committees in the House, get passed on the floor of the House, and 41 percent of Senate representing 30 percent of the US can prevent it from ever being voted on on the Senate floor.
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:eye-poppi

You're advocating that we eliminate a major check to the power of the legislative branch. You're also declaring that the document that ensures the rights of the citizens is undemocratic. You're pretty much taking a position that reduces the checks and balances on the power of the president.

And you think the other guys are the authoritarians?
 
JoeMorgue said:
They expected specific kinds of bad actors.

They never accounted for the specific kind of "Trump Bad."
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They did though. The specific kind of populist blowhard that Trump represents is exactly why the legislative and the judicial branches exist in the first place, and why it is so hard to enact new laws - to prevent a cult of personality from driving the boat.
 
JoeMorgue said:
"We don't govern, we just pass laws" is at best, technically true in the absolutely worst kind of technically true.
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Same problem with the executive branch "we don't make law, we just implement them" is also the worst kind of technically true.

Right now, regardless of how you feel about the individuals involved or some of their decisions, the judicial branch is the only one that's actually doing their job as intended. They interpret the law and ensure that such laws are constitutionally valid.
 
theprestige said:
Harris should have been going to the border, and attending meaningfully to border issues all along. A pro forma appearance during campaign season is textbook "too little, too late".
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She was meeting with the leaders of Latin American countries trying to address the mass migration at its root.

You know, actually trying to solve the problem.

Maybe watching a bunch of pampered, middle aged lawyers cospaying as GI Joe and taking romantic cruises with paramilitary units is what you like to see in your leaders, but I prefer real action.
 
Emily's Cat said:
:eye-poppi

You're advocating that we eliminate a major check to the power of the legislative branch.
Click to expand...

The Senate is part of the legislature. Not a check against it.

You're also declaring that the document that ensures the rights of the citizens is undemocratic.
Click to expand...

No, it enumerates them. And, you know, that whole slavery thing.

You're pretty much taking a position that reduces the checks and balances on the power of the president.
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Well, no, that's not how that works. Besides, when was the alst time the senate has checked the power of president i nthe same aprty as the majority? Build Back Better?

And you think the other guys are the authoritarians?
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Yes, they practically print t-shirts with the phrase "I'm an authoritarian"
 
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