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Sunday, January 22, 2017

World Unites in Opposition to Trump Presidency

Seattle and the World March in Opposition to Trump
Yesterday, I awoke at 5:40AM energized and ready to participate in my democracy with the fullness of my mind, body, and spirit, by marching in the Seattle Women’s March against the Trump Administration. Cycling onto the ferry for my commute into the city, I expected to see a few dozen other women like me, the outliers in society. Instead I was greeted by an armada of pink-pussy-hatted faces, representing almost the entire ferry population. There were so many women protestors, the ferry had to open the men’s restroom on the ferry for women, because the lines were too long in the women’s facilities. An air of friendship, comradery, and generosity permeated the air as people walked through the boat giving signs, stickers, and other protest materials to wear. Upon exiting the boat at the Coleman Dock, I parked my bicycle and decided to walk with the group, two miles to the start of the march, in Judkins Park. A sea of people, from all walks of life, black, brown, caramel colored, purple haired, red haired, and everything in between made their way to the start of this historical occasion. The Pacific Northwest weather even managed to grant us one of the rare sunny warm days of the past two months.

As a lifelong political activist and someone who marched for the ill-fated Equal Rights Amendment in the 70’s, I am no stranger to demonstrations, marches, and expressions of free speech. This demonstration, originally designed as a women’s march to protest the policy positions of the Trump Administration, was expected to draw 75,000 people, and there were 130,000 souls marching shoulder to shoulder in Seattle. Aside from the sheer size of the group, I was awestruck by octogenarians with walkers, canes, and wheel chairs who were going to march up to eight miles in protest to the new presidential administration! As we rounded the corner past Judkins Park onto Jackson Street, looking down the hill toward Elliott Bay there was a continuous sea of people for blocks. A massive wall of humanity, shoulder-to-shoulder, consumed four traffic lanes, and spilled over onto the sidewalks unbroken for the four miles to Seattle Center. The creativity of the protest signs was museum worthy and I was gifted a hand-painted one with a single image about reproductive rights, which I am preserving. Though viewpoints varied from the environment, healthcare, reproductive rights, education, immigration, and fair treatment for all people regardless of race or social orientation, everyone was peaceful, kind, and engaged. There were many children in the march, with their parents and grandparents, holding handmade signs. I spoke to as many children as I could, thanking them for participating in the march and telling them about their 1st amendment rights. One little girl, who was eight-years-old, said, “Oh, I thought that was going away.” I told her, well with Trump and some of the Republicans, they would like to make some of our 1st amendment rights go away (freedom of the press) and that is why we need to be here. It is so important that you stand up for your free speech, because that is what makes a true democracy. She said “Oh, I see, with a solemnity rare in someone her age.”
 The extensive presence of the Millennials, bodes well for the future of this nation, for they will be paying the price for our mistakes in stewardship. These young people are our future and it was a revelation to see them in full force. And the young parents, figuring out the logistics to bring not just one, but often two children, including infants and toddlers to the event was inspiring. Throughout the entire day, I never heard a single parent berating their children. Which, if you travel in the U.S. you will find that public displays of repudiation and disciplining children are common fare.
Recognizing the “Women’s March” was not a local event, but a national one, and globally represented in hundreds of cities throughout the world, from Paris, to Brasilia, millions marched against the Trump dogma. The sanctity and preservation of our world depends on cooperation among peoples and nations which are vastly disparate and hope is realized through the millions who dedicated their time to the belief in democracy on this day.  This march best represented our America, inclusive, engaged, peace-loving, and generous.

And this is the healthpolicymaven signing off a bit more encouraged than on November 8, 2016. Please continue to read this column for critical information on healthcare under the Trump Administration.

Healthpolicymaven is a trademark of Roberta E. Winter and Praevalere Inc, in continuous use since 2007.

Saturday, January 14, 2017

Health Scare-Trump Cabinet Nominations Round II

The Trump Administration has fired all diplomats and staff associated with the Obama Administration, many of them career employees of the government, without securing replacements. Among other things, this means the nation’s nuclear arsenal, which comes under the Department of Energy and is currently overseen by a nuclear physicist, who has also been given his walking papers, will be administered by former Texas governor and Dancing with the Stars contestant, Rick Perry, who has not yet been confirmed. As promised, here is Round II of the Trump nominations to run important government agencies, their views, and what it might entail for you.
What’s at Stake
The Food and Drug Administration (FDA) oversees food and drug safety for the nation. This is one of the most powerful non-cabinet level positions.
This agency conducts surveillance on food safety and oversees the standards by which new drugs, including biologicals are approved for sale in the U.S. It also reviews over the counter medications, cosmetics, and natural food products like vitamins. The agency enforces strict labeling, as well as contamination prevention standards. It also determines which food can be imported into the U.S.
James O’Neill is under consideration for Commissioner of the FDA.
The other individual under consideration is a venture capitalist who own a genetic testing company, Balaji S. Srinivasan.
The third person under consideration is an actual MD, Scott Gottlieb, and he served as deputy commissioner for the FDA from 2005-2007.

Here is a direct quote from Mr. James O’Neill, “We should reform FDA so there is approving drugs after their sponsors have demonstrated safety-and let people start using them, at their own risk, but not much risk of safety,” unquote.[1]
Regarding Balaji, just the fact he is a venture capitalist in the healthcare industry should be scary enough, because excessive profiteering in U.S. healthcare is a bigger problem than the insurance question.
Dr. Gottlieb is a member of the conservative American Enterprise Institute and is at least, experienced and qualified for the job.
O’Neill will kill people if he allows the pharmaceutical industry, which uses unethical direct to consumer advertising, coercion throughout the medical system, and heavy lobbying to get what it wants, police itself. Case in point, during the Bush Administration Pharma was successful in preventing Medicare from being able to negotiate the price of drugs for their programs when Part D was added. How has that worked out for you? Dr. David Kessler, who served as FDA Commissioner under Bush and Clinton has this to say, “This will set back the competitiveness of the American pharmaceutical industry, which has been the envy of the world, by 50 years.”[2]
The Department of Commerce is the federal government agency which oversees the collection of economic, financial, and trade data across the land, which is used for policy making. Additionally, the U.S. Census Bureau is also part of this agency and a new national census is due shortly, since the last full census was in 2010.
The nominee for Secretary of Commerce is Wilbur Ross, a former banker who is now a billionaire through acquiring businesses and restructuring them.
Mr. Ross is a former Democrat, with an Ivy league education, at Harvard and Yale. He is 79 years old, which makes the number two appointee for this role very critical. Ross will want to influence trade deals, but there may be conflicts of interest given his far-flung business interests. His current wife, Betsy McCaughey has also been named an economic advisor.
He is certainly competent to run the Commerce Agency, because of his banking and business experience. Ross was a latecomer to the Trump camp, as he was a supporter of Senator Marco Rubio in the primary election. Ross replaces another billionaire, who was appointed by Obama.
The U.S. Trade Representative negotiates international trade agreements, which are crucial to the economy.
Robert Lighthizer is the nominee for U.S. Trade Representative. If he pursues Trump’s agenda, his job would include renegotiating NAFTA and the Trans Pacific Trade Agreements.
Lighthizer is an attorney, which is a requirement for this job, He has a history of representing steel workers in trade litigation disputes. A big concern was the Chinese “price dumping” of steel to drive American producers out of business.
Several unions are interested in renegotiating trade agreements if it means saving American jobs, which could coincide with Trump’s agenda.
The Small Business Administration (SBA) works to promote business and provide financial assistance for small business development. The SBA has a 124 billion loan portfolio.
Linda McMahon, wife of the impresario of World Wrestling Entertainment and a billionaire, is the nominee to run the SBA. She had an unsuccessful run for the senate in Connecticut. She was the CEO of WWE, which made a mint in pay-for-TV.
McMahon had been a supporter of Governor Chris Christie’s presidential run. She knows how to run a business and grow it.
It is difficult to see how a billionaire from the entertainment industry will give much of a boost for small businesses, but heh, this is a political appointment. Thanks for your checks Linda.
The Office of Management and Budget (OMB) oversees the financial reporting for the federal government.
Mike Mulvaney is the nominee to head the OMB. He is a founding member of the ultra-conservative, House Freedom Caucus and is responsible for getting rid of Speaker of the House, John Boehner.
Mulvaney will be looking for ways to cut taxes and reform the tax code.  He came to office in 2010 with the Tea Party Movement. He demanded a dollar-for-dollar spending cut proposal to authorize the Hurricane Sandy Disaster Relief funding.
Mulvaney once favored shutting down the government versus voting for a spending bill. He will be the one putting the brakes on infrastructure spending and torpedoing the Affordable Care Act.
The Department of Homeland Security (DHS) was started after 9/11 and secures the nation’s borders, airport security, and cyber security infrastructure. The agency is also responsible for enforcement of immigration laws.
Thomas P. Bossert has been appointed as head of the Department of Homeland Security. He comes from the private sector and was formerly a security advisor under George Bush.
Bossert is a beltway insider, with previous national security experience. He is a senior fellow at the Atlantic Counsel, working on the Cyber Statecraft Initiative. (Donald Trump's Cabinet Is Taking Shape: Here's The Latest List, 2017)
Since one of Trump’s platforms was to build a wall between Mexico and the U.S. this will come under the purview of the DHS and you can expect huge cost overruns. Trump also wants to vet immigrants based on religion and has threatened to send back millions of residents.
Special Adviser to the President-which can mean just about anything you can imagine.
Jared Kushner, Donald Trump’s son-in-law and himself a real estate magnate also with daddy’s money has already been appointed to this newly created role.
Kushner was responsible for jettisoning Chris Christy from the cabinet and holds sway with Trump. U.S.policy on Israel and the West Bank will be influenced by him.
The appointment of any family member is considered in violation of the anti-nepotism laws, which have prevented Congressman even from having their children work as interns. But why should this be any different, Trump didn’t disclose his income tax return, hasn’t set up a blind trust, and has gleefully exclaimed he is exempt from prosecution as president. (Nixon thought so too.)
The Director of Trade and Industrial Policy is a new office under president elect Trump.
Peter Navarro has been appointed to this role. He is a professor of economics and public policy at the University of California, Irvine.
He has been highly critical of China’s trade policies and we can expect some action here. Navarro is the author of  "Death by China".
I think we can expect the Trans Pacific Trade Agreement to go away. The problem is, China will absorb the vacuum left by the U.S. extraction. It remains to be seen how a professor will fare with the sharks and oligarchs in Trump’s cabinet.
The Department of Veterans Affairs oversees the administration of veteran’s healthcare and other veteran’s benefits.
David Shulkin is the nominee for Secretary of Veterans Affairs. He is a physician and was an Obama appointee to Veterans Health in 2015. He has experience running large healthcare entities, like the University of Pennsylvania and Beth Israel Medical Center in New York.
He was responsible for cutting the time veterans had to wait for treatment and restoring credibility to the agency.
He rejects privatization of the Veterans Administration as it would add billions to the cost of providing care. Good call and good health care, both provided at the capable hands of Dr. Shulkin.
The Department of Labor is responsible for enforcing the nation’s labor laws, including collective bargaining, and enforcement of ERISA, PPACA, COBRA, FMLA, and other health & welfare laws. The agency oversees workplace safety and administration of unemployment benefits. This agency also makes legislative recommendations.
Andrew Puzder is the nominee for Secretary of Labor and he is the Chief Executive of the Hardee’s and Carl’s Junior chains. He obtained his JD from Washington University School of Law in St. Louis.
It is rumored that Puzder is most like Trump in personality. I wonder if that includes crotch-grabbing. He is also anti-union. Unlike Trump, he has only been married twice. As Secretary of Labor he could determine which businesses are inspected, audited, or fined.
He is adamantly opposed to minimum wage laws, overtime requirements, and of course, the mandate to provide medical insurance to his workers. His goal is to deliver the least expensive, but profitable unhealthy food to the public, so that we as taxpayers can foot the bill for the diabetic epidemic. Don’t expect Puzder to look out for your job security.
Though not a government agency, this week, Trump created a presidential task force to evaluate the safety of vaccinations, with only one caveat, there were no scientists or doctors included to lead the review. The effectiveness of vaccinations has been proven through many Cochrane published gold-standard studies, by actual scientists. I guess this is the loose style that Trump will deploy in administering our government resources, which has scary implications for national health.

If anyone wishes to harm the U.S.A., the transition chaos created by the Trump Administration certainly makes the nation vulnerable on many fronts. Though America loves to criticize the educated, one would think that even the less enlightened would still be concerned about the safety of their energy supply, their medications, and their food supply.
And this is the healthpolicymaven signing off, wishing you fully informed consent in all our decisions.
The healthpolicymaven is a trademark of Roberta E. Winter and Praevalere Inc. Feel free to share this article with anyone whom you feel may benefit. She is the author of a guidebook to the U.S. healthcare system, which was published in 2013.


Donald Trump's Cabinet Is Taking Shape: Here's The Latest List. (2017, January 14). The New York Times. Retrieved from

[1] Trump Weighs Nontraditional Pick for FDA, Thomas M. Burton, Wall Street Journal, Saturday January 14, 2017
[2] Trump Weighs Nontraditional Pick for FDA, Thomas M. Burton, Wall Street Journal, Saturday January 14, 2017