Rep. John Lewis at 2017 'Save Our Care' Rally. Photo by 'Mobilus in Mobili,' Creative Commons License 4.0

Donald Trump has unveiled his latest attempt to win back support from a constituency he's pissed off, announcing yesterday that 33 million Medicare beneficiaries will receive a nice gift card for $200 that can be applied to prescription drug co-pays. No word on how exactly Trump will come up with $6.6 billion without a congressional appropriation, or when exactly the program would be rolled out — beyond Trump's standard time frame of "in the coming weeks" — or the most important question, whether the new Trump Cards would feature the Great Man's Mussolini face or just a lot of fake gold lettering.

In addition to the prescription cards, Trump signed executive orders that would supposedly ensure insurance protection for people who have preexisting conditions and to prevent "surprise" medical bills, but which don't actually do that.

The believe-it-when-you-see-it cards were part of a rambling weirdass Trump speech in North Carolina that was supposedly the rollout of his beautiful new healthcare plan, or maybe a sneak preview of the nonexistent plan that will be much better than Obamacare, just you see. Hilariously, Trump referred to the dogs' breakfast of non-measures as his "plan," although whatever the hell the new measures actually turn out to be, they're well short of the full healthcare plan Trump has been promising would be revealed "in about two weeks" most of the summer, and for that matter, since he began running for president years ago.


The drug card plan, as healthcare blog STAT News points out, is mostly vapor at this point. It sounds a bit like the scheme that the pharmaceutical industry refused to get roped in to last month, as the New York Times reported a week ago. Big Pharma had been on the verge of a deal to substantially limit Medicare patients' out of pocket prescription costs, but the deal fell apart when White House negotiators insisted the drug companies pay for $100 cards to be sent out before the election. So now the idea is back, with double the payout but no clear way to pay for it.

A White House spox told STAT the billions of dollars needed to pay for the cards would come from savings resulting from the "most favored nation price" prescription drug scheme Trump executive-ordered into existence September 13. The EO called for setting up a pilot program that would require the industry to sell certain high-priced drugs to Medicare at the same price as industrialized nations with socialized medicine, only here it wouldn't be socialism.

Bit of a problem with that, though! That demonstration program itself hasn't yet been put in place either, so as STAT puts it, "the Trump administration is effectively pledging to spend $6.6 billion in savings that do not currently exist." Since the actual program doesn't yet exist, even on paper in any detail, Bloomberg notes it's unclear whether it really could result in enough "savings" to pay for the cards.

Also, considering that under the Constitution, Trump would need Congress to appropriate the funds, that $6.6 billion is nothing but a gleam in Trump's dictatorial eye. STAT notes that the scheme "has never been formally proposed or sketched out by health officials," so if we were on Medicare, we wouldn't go spending $200 on something else while we wait for that Trump Card.

Hey, doesn't promising to pay for one thing with phantom "savings" from another thing that doesn't exist sound a lot like how Donald Trump ran his real estate deals? Maybe the prescription card program could be named "Bankrupt Casino Royale."

Presumably, Trump thinks just the empty promise of an imaginary card will be enough to sway at least some seniors to vote for him in hope that the benefit will materialize. Maybe some folks will believe him. You're not still mad about that whole 'Let Nana die of COVID-19 for the economy' thing, are you?

Also during Trump's Message: I Pretend to Care tour yesterday, the Great Man signed two executive orders that won't have any real effect on healthcare because they simply call on Congress to take action. The first directs Congress to ensure protections for folks with preexisting conditions, which as you may recall are already part of the Affordable Care Act. But Trump is suing to overturn Obamacare, so he would like Congress to please protect one thing that people like, while getting rid of everything else. It's so smart of him!

Trump insisted he was making history by signing the "first-ever executive order to affirm it is the official policy of the United States government to protect patients with pre-existing conditions," and said that now he'd signed a statement with those words, "This is affirmed, signed, and done so we can put that to rest." In reality, all the order does is hand the issue off to Congress — If the ACA is overturned without Congress passing a new law, his "official policy" won't do squat.

Same deal with the order to protect people from "surprise medical billing," which occurs when insurance won't cover some part of an otherwise-approved medical procedure. For instance, people sometimes arrange to have surgery in an in-network hospital, with an in-network surgeon, but find out later that the anesthesiologist wasn't in the insurer's network, so they're stuck with a huge bill. Trump's executive order called on Congress to solve the problem, but doesn't by itself do jack shit to end the practice. What a hero!

During the speech, Trump, who oversaw the failed GOP attempt to repeal the ACA (with no replacement), bragged that Democrats have never done much of anything to help reform healthcare, and said, with whatever counts for him as a straight face, "We've really become the healthcare party, the Republican Party." Just putting that in bold so we can call it a boldfaced lie (shut up, we know the real term, but there's no "baldfaced" type.)

At least if you leave out Great Conservative Thinkers like known goatfucker Erick Erickson, who explained he's against protections for preexisting conditions, because "personal responsibility":

He has a point! People should have to pay higher rates, or not be covered at all, if they've engaged in irresponsible behavior like having a baby, being a woman, getting old, having allergies, getting a tumor, or being born with a heart defect and needing surgery for it.

THE HEALTHCARE PARTY, folks.

[STAT / Bloomberg / NBC News / Photo by 'Mobilus in Mobili,' Creative Commons License 4.0]

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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