THE PROGNOSIS

John McCains surprise, middle-of-the-night thumb down that sunk his partys Obamacare repeal bill last week made for perfect political showbiz. But signals the Arizona Republican would be the final GOP defector were there all along. After all, McCains a mostly free spirit from a state that deeply benefited from the Affordable Care Act. And he likes some drama now and again.

McCains never really belonged to the brand of tea party-style Republicans who loved to rail against Obamacare. He criticized the ACA when he needed to, like when he was running for reelection in 2010 and again last year. But McCain didnt share many of his colleagues perspective that virtually anything would be better than President Obamas health-care law.

Besides, McCain is used to ducking the party line on other issues, too, like campaign finance reform and climate change.

Theres a certain impulsiveness about McCain, and every once in a while he tends to stray from orthodoxy, David Berman, a political science professor at Arizona State University, told me.

If there were ever a time for McCain to stray from orthodoxy and do whatever he wants, its now. Just a few days before the Senatevote on its "skinny repeal" bill, the 80-year-oldannounced he has glioblastoma, a common but aggressive form of brain cancer.

So while McCain sees the same realities back home as Arizonas other senator, Republican Jeff Flake, the two parted ways on Obamacare partly because they are facing far different political situations. McCain, in all likelihood, never has to worry about another election, while Flake is facing a potentially tough reelection race next year.

Speaking of those realities back home, theyre harsh.

Arizona is among the handful of Republican-led states that expanded Medicaid to cover low-income, childless adults. That program, along with new opportunities for coverage through federally subsidized marketplace plans, has provided coverage tohalf a million Arizonansover the past few years. Arizonas uninsured rate fell from 17.3 percent in 2009 to 10.8 in 2015 the 13th-largest drop in the nation during that time.

Arizona, with its expanding retiree population, has also seen its health-care sector explode in recent years. Since 2010 it has experienced the fifth-highest health-care job growth of any state, according to the U.S. Bureau of Labor Statistics.

So it was a no-go for McCain when Senate leadership pressured him to support skinny repeal that would have destabilized insurance markets without fixing Obamacares deepest problems and could have led to a return of deep Medicaid cuts proposed in the Senates replacement bill known as the Better Care Reconciliation Act. State officials had estimated that the BCRA would have cost Arizonas Medicaid program $7.1 billion by the end of 2026.

Arizona was about to get screwed, if I may, under this plan,"McCain toldPhoenix-based radio host Mike Broomhead yesterday.

Thats exactly what Arizona Gov. Doug Ducey was privately worried about, although as a Republican hed also publicly criticized Obamacare, at times calling it "ground zero" for problems with the law. Three amendments McCain offered to protect Arizona, including one to phase out Medicaid expansion over a decade instead of the seven years envisioned by the BCRA, were at the behest of Ducey. McCain said all along he would center his health-care vote on Ducey's wishes:

McCains no vote has won him praise among health-care advocates in Arizona. I think people are pretty pleased with him in the world I work in, Greg Vigdor, president of the Arizona Hospital and Healthcare Association, told The Health 202.

But McCain wasnt just frustrated by the GOP legislation itself hed also expressed annoyance all along at the Senate GOP leaderships secretive process in writing it, at times even mocking the lack of transparency.

Damned if I know,McCain responded in May when I asked whether he expects a health-care vote this summer.

Look at the concernsMcCaintweeted over the past several weeks:

Business Insiders Bob Bryan noted McCain's skepticism at the Senate's initial repeal-and-replace bill, the Better Care Reconciliation Act (BCRA):

Ultimately, I think a lot of it comes down to the unique nature of Sen. McCain as a person and a legislator, Vigdor said. He really believes in the Senate as the great bastion of debate and deliberate consideration.

McCain displayed that love for Senate procedure and regular order in a floor speech he gave on July 25, his first time in the chamber since announcing his cancer diagnosis. In that speech, which Democrats being cut out of the health-care process especially hailed, McCain in strong terms blasted GOP leadership for trying to cram through an unpopular Obamacare repeal measure and called in his party to start reaching across the aisle.

Weve tried to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them its better than nothing, asking us to swallow our doubts and force it past a unified opposition," McCain said."I dont think that is going to work in the end."

Boston Globe's Matt Visernoted Democratic leader Chuck Schumer's response to McCain's speech:

Of course McCain, who lost to President Obama in 2008, doesnt eschew the limelight, either. Reporters hounded him last week afterhe emerged as one of the chief GOP skeptics of the repeal effort. As he walked into the Senate chamber around 1 a.m. on July 28for the skinny repeal vote, he played coy amid the flood of questions about which way he leaned.

Watch the show, McCain told reporters.

He'd warned he'd vote against a repeal-replace bill if it wasn't improved....and then he did, noted HuffPost's Matt Fuller:

MSNBC's Lawrence O'Donnell:

Programming note:The Health 202 will not publish on Monday, Aug.7 and on Friday, Aug.11 next week. Well be back in your inbox on Tuesday. In the meantime, be sure to read our colleague Tory Newmyers The Finance 202 every day next week.

AHH, OOF and OUCH

Interior SecretaryRyan Zinke testifies during aSenate Energy and Natural Resources Committee hearing. (EPA/MICHAEL REYNOLDS)

AHH: What better way to mend fences than over a couple of beers? Interior Secretary Ryan Zinkesays he's patched things up withAlaska Sen. Lisa Murkowski (R) after a widely reported dispute over hervote last week against starting the health-care debate, according to the AP.

Zinke had reportedly called Murkowskito threaten repercussions for Alaskaif she failed to toe the administration's line on health care. But yesterday Zinketweeted to his nearly 50,000 followers a photo of himself and Murkowskienjoying Alaskan beers at his Washington home:

Murkowski, who leads the Senate Energy and Natural Resources Committee, was one of two Republicans to vote against starting health-care debate (along with Sen. Susan Collins of Maine) and joined both Colins and McCain to ultimately vote against the "skinny repeal" bill.

OOF: Maybe the Senate's embarrassing failure to pass Obamacare repeal was a blessing in disguise for Republicans. A new poll taken in the days just after the Senate failed to pass a series of different optionsfinds staggering oppositiontoward the GOP effort. Eighty percent of registered voters in a Quinnipiac University poll -- including 60 percent of self-identified Republicans -- said they disapproved of the way Republicans were handling health care. Just one-fourth of respondents said they were in favor of alternative health-care legislation presented by the Senate.

House Speaker Paul Ryanspeaks about health-care at hisweekly press conference. REUTERS/Yuri Gripas TPX IMAGES OF THE DAY

OUCH: Wait for it, wait for it. Here it is: The House GOP health-care defense is "maybe the Senate didn't manage to pass Obamacare repeal but thank goodness we did." That's essentially how Speaker Paul D. Ryan (R-Wis.P) responded to constituents yesterday, when they blasted congressional Republicans for getting little done this year even though they control both houses of Congressand the White House.

For eight horrible years I heard we dont have control of the House, we dont have control of the Senate, we dont have the presidency, Banker Wire employee Keith Ketzler, 62, said to Ryan, according to the AP. Ill tell you what, youre in there now and all I see is in-fighting. Its very dysfunctional. I dont see any plans for anything.

Ryan said he's worried too -- and noted that the House did pass a health-care bill in May.

I can make sure that the House delivers," Ryan said. I dont run the Senate, I run the House.

TRUMP TEMPERATURE

President Trumplistens as West Virginia Gov. Jim Justice speaks at a campaign-style rally at Big Sandy Superstore Arena in Huntington.(AP Photo/Susan Walsh)

--New Hampshire is notorious for its drug-abuse problems. But Trumpdidn't do himself any political favors by depicting the entire state as one big "drugden" in s phone call withMexican PresidentEnrique Pea Nietosix days after his inauguration. I won New Hampshire because New Hampshire is a drug-infested den, Trump told Nieto in a phone callon Jan. 27. The call was private, but The Post's Greg Millerobtained the transcript plus an equally eyebrow-raising one of a call with Australian Prime Minister Malcolm Turnbull.

There area few things that could come back to haunt Trumppolitically based on that one sentence, The Post's Amber Phillips writes. For one thing, Trump ticked off New Hampshire's two senators and its Democratic organization:

From New Hampshire Maggie Hassan (D):

From the New Hampshire Democratic Party:

The state's Republican governor, Chris Sununu, also denounced the drug commentdespite previously standing by Trump in sticky campaign situations. PerMSNBCs Shirley Zilberstein:

Some pushback to the criticism from New Hampshire Republicans:

HEALTH ON THE HILL

Senate Majority Leader Mitch McConnelltalks with reporters.(Photo by Chip Somodevilla/Getty Images)

--August recess has officially commenced, and The Health 202 couldn't be happier. But this is not how Senate Majority Leader MItch McConnell (R-Ky.) wanted to head into the long summer break, which has turnedinto the perfect storm against hisbest-laid plans. My colleague Paul Kane has the must-read take:

"Soon after Memorial Day, McConnell drew up a game plan around approving a rewrite of the Affordable Care Act by the end of June. The benefits were twofold, providing House Republicans a few weeks to approve the Senate version and send it to President Trump," Paul writes. "Also, McConnell wanted to create separation between the conclusion of the health-care debate and the start of the annual August recess, providing the month of July to rack up victories on other legislative matters. Such wins would give some Senate Republicans, wary of tackling the health-care issue back home, something else to tout with their voters."

Instead, everything got consumed by the health-care storm, which culminated in the bill failing by a single vote last week. Then yesterday, the Senate left town for a five-week breakwith no major legislative accomplishments to show for the first seven months of unified Republican control of Congress and the White House.

"When they return after Labor Day, Republicans have to tackle several must-pass bills to fund federal agencies and to increase the Treasurys borrowing authority. Those are perfunctory tasks, but without the proper tending, failure would result in government shutdowns or worse. That leaves October, maybe, for the point to legislative offense, particularly on the bid to overhaul the tax code....This is the scenario McConnell was trying to avoid back in early June."

A few more good reads from The Post and beyond:

Without fanfare or controversy, the Senate approved legislation that will keep many FDAoperations running and deliver a win to the pharmaceutical industry.

The measure is broader than some state laws, because it covers patients with serious but not imminently deadly conditions, such as muscular dystrophy.

President Donald Trump announced new efforts Thursday to use technology to improve veterans health care, saying the programs will greatly expand access, especially for mental health care and suicide prevention. Veterans living in rural areas will also benefit, he said.

Darlene Superville|AP

Dr. Jerome Adams, Trumps nominee for surgeon general, tried to make a distinction between guns and gun violence during his confirmation hearing.

STAT News

SECOND OPINION

We're not the same as antiabortion Republicans. Really.

Kristen Day

DAYBOOK

(AP Photo/Pablo Martinez Monsivais)

SUGAR RUSH

President Trump introduces new telehealth initiative for veterans:

Trump: 'Veterans means so much for me and this administration':

What Trumps golfing habits say about him:

Stephen Colbert wants to serve on Robert Muellers grand jury:

Here is the original post:

The Health 202: Here's why John McCain voted 'no' on health care - Washington Post

Our plan would stabilize markets by making the cost-sharing payments mandatory and thereby prevent rates from rising sharply.

Second, we provide a relief valve to help states deal with the high cost of pre-existing and chronic conditions. The costliest 5 percent of patients account for nearly half of all health care spending in the country. We propose a dedicated stability fund essentially a form of reinsurance that states could use to reduce premiums and limit losses for providing coverage for these high-cost patients.

Third, our proposal provides relief to certain businesses from the mandate that they provide insurance to full-time employees. It also defines full time as a 40-hour workweek to discourage businesses from manipulating employees weekly hours to skirt the mandate. More than 90 percent of large businesses offered health care before the Affordable Care Act, and studies show that they would continue to do so under this change; others would move to find employee coverage in the individual marketplace.

Fourth, our plan eliminates the Medical Device Tax, an excise charge of 2.3 percent that is often passed onto consumers and reduces funds for research and development. And finally, we provide states with additional flexibility to enter into agreements such as enabling the sale of insurance across state lines that would provide more choice and lower costs.

This proposal would not increase the federal deficit, offering several options to offset the new spending.

Our plan isnt intended to rectify everything thats wrong with American health care. We aim to solve an immediate problem and move past a seven-year stalemate in Washington that has featured Republicans trying to repeal the current health care law, Democrats trying to preserve it and neither side willing to discuss anything in between.

That approach has led us to our current moment, in which no one is happy with the status quo, least of all the American people, whose trust and confidence in Washington weakens every day that we spend fighting instead of solving real problems.

Health care is one of those problems and a textbook example of why we formed the Problem Solvers Caucus this year. We all knew the partisanship in Washington had gotten out of control and felt the need to create a bipartisan group committed to getting to yes on important issues. We have agreed to vote together for any policy proposal that garners the support of 75 percent of the entire Problem Solvers Caucus, as well as 51 percent of both the Democrats and Republicans in the caucus.

If Washington does not act to stabilize the insurance exchanges, many families we represent will lose coverage or be hit with premiums they cant afford. This isnt conjecture.

If that does happen, people will be justifiably livid that Republicans and Democrats in Congress did nothing to stop a train wreck we all saw coming.

There is a growing recognition on Capitol Hill that something must be done, as evidenced by this weeks announcement from Senator Lamar Alexander the Tennessee Republican who is chairman of the Senate Health, Education, Labor and Pensions Committee that he will soon hold hearings focused on repairing the individual insurance market.

Our proposal isnt perfect, but it represents the first and only serious bipartisan health care proposal released in this Congress. We hope our colleagues in the House and Senate, as well as the White House, will use our plan as the foundation for the health care solution that America desperately needs and deserves.

Josh Gottheimer is a Democratic representative from New Jersey. Tom Reed is a Republican representative from New York.

Follow The New York Times Opinion section on Facebook and Twitter (@NYTopinion), and sign up for the Opinion Today newsletter.

A version of this op-ed appears in print on August 4, 2017, on Page A23 of the New York edition with the headline: A Bipartisan Fix for Health Care.

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Let's Stop the Bickering and Fix the Health Care System - New York Times

LONDON, OH (WCMH) The Ohio National Guard along with the Ohio Department of Health and Madison County Public Health is hosting a free healthcare event Saturday.

GuardCare offers free healthcare services to anyone who attends, regardless of income and insurance is not needed or considered.

No appointment is necessary to attend and care provided will include immunizations, sports physicals, womens health services, and hearing and vision testing.

GuardCare is hosted each year in a different medically-underserved Ohio community.

The event is being held Saturday from 8am to 5pm at London High School, 336 Elm Street.

Through GuardCare, Ohio National Guard medical personnel support and assist local health care providers. The event also enhances the medical skills of Ohio National Guard medical personnel, many of whom work as health care professionals in their civilian occupations as well.

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Ohio National Guard, health departments hosting free healthcare event in Madison Co. - NBC4i.com

In partnership with the White House Office of American Innovation, the Veterans Affairs Department announced anexpansion of its telehealth services or anywhere to anywhere health care.

The departmentwill issue a joint regulation with the Office of American Innovation and Justice Department to allow all VA providers to administer telehealth services to veterans anywhere in the country.

Existing telehealth programs provided care to more than 700,000 veterans last year and covered at least 50 different specialties, from dentistry to dermatology.

Were removing regulations that have prevented us from doing this, VA Secretary David Shulkin said during aAug. 3 White House announcement. Were removing geography as a barrier so that we can speed up access to veterans and really honor our commitment to them.

Download our free ebook to find out how agency CIOs and CHCOs implementing the president's reorganization executive order.

President Donald Trump, who watched Shulkin and other VA doctors demonstratea live interaction with a veteran patient using video,said the program will help VA expand access to care across the country, particularly in rural locations and for veterans who need mental health care.

That means were going to be able to use VA providers in cities where there are a lot of doctors, and be able to use those doctors to help our veterans in rural areas where there arent many health care professionals, Shulkin said. And you talked about mental health and suicide prevention; this is one of those areas that we can really use that expertise.

Shulkin this year named suicide prevention as his top clinical priority. He also recently announced an expansion of VA mental health services to veterans who received a less than honorable discharge from service.

To help them administer the telehealth program, the department will roll out VA Video Connect to providers nationwide. Currently, about 300 VA providers use it at 67 hospitals and clinics.

Video Connect lets VA providers use their mobile devices to see and speak with veterans on their own mobile devices or home computers.

Shulkin, a doctor himself who still sees veterans, spoke with one of his patients in Grants Pass, Oregon, through the video screen.

SEC warns TSP participants of new scam

The department will also roll outits Veterans Appointment Request (VAR) application nationwide. The app lets veterans schedule, change or cancel their own appointments with VA providers on their own time. VA currently has the app working in 18 regions but plans to expand it to the rest of the country.

The VAR app is different from the departments attempts to update its own, in-house appointment scheduling system.

The department is evaluating a commercial scheduling solution, theMedical Appointment Scheduling System (MASS) to replace the aging system VA has now.

See more here:

VA announces expansion of 'anywhere to anywhere' health care services - FederalNewsRadio.com

With the Republican Senate failing to repeal the Affordable Care Act last week, the administration and Congress should consider paying greater attention to the healthcare problems of 2009.

When I graduated medical school in 2009, as the nation debated healthcare reform and the future of our healthcare system, the main challenges impeding doctors and patients were obvious to me. They included a rigid and perverse physician reimbursement system, a labyrinth of increasingly complicated, costly, and sometimes contradictory mandates and priorities, and a runaway malpractice system.

Medicare and Medicaid have historically reimbursed physicians via price controls, and their main cost control mechanism is to pay physicians less. This reimbursement system creates a dangerous lack of time and resources in the trenches, which facilitate myriad unintended consequences that can jeopardize care and ironically increase costs.

The price controls limit access for these patients, particularly those on Medicaid, which can lead to harmful delays or produce a heavy reliance on costly and overcrowded emergency rooms. Ultimately, the poorest patients with the greatest needs are hurt the most and have the hardest time getting help. A recent review in the Journal of General Internal Medicine found an association between hospital strain and mortality. As such, this unnecessary strain this reimbursement system produces also has the potential to harm the care of all patients.

Studies have shown that primary care can improve quality and lower healthcare costs. But the physician reimbursement system is skewed against primary care. This contributes to enormous time pressures on primary care doctors. Research in the Journal of General Internal Medicine found that the average primary care physician addresses on average 7.1 clinical problems in an on average 20.9 minute visit, leaving just 3.8 minutes per item. This time crunch hinders the ability of patients to understand their disease, treatment course, and follow up. It also impedes prevention and counseling that could facilitate healthy lifestyles and detect serious diseases earlier. This compromises care.

Consequently, fewer medical students are pursuing primary care as a career. This limits the accessibility of patients to our healthcare system. When patients are sick and don't have a primary care doctor to turn to, they must either suffer and see their condition worsen or go to expensive emergency rooms. The primary care physician shortage also limits the availability of counseling, prevention, and other services that primary care physicians offer.

The physician reimbursement system has also historically not reimbursed physicians for non-face-to-face care. In addition to impeding innovation, this unintentionally pushes healthcare services to more intensive and costly sites than necessary. This too limits access to care and contributes to rising healthcare costs.

The regulatory climate of medical practice has become increasingly complex. One-size-fits-all regulations work well for inanimate cars moving down an assembly line. Yet they fail to capture the varied backgrounds, experiences and preferences of living human beings, as well as the possible different responses to different interventions. While a certain degree of oversight is needed to ensure quality and safety, doctors have been spending more and more time on charting, paperwork, and checking off boxes and less time with their patients. Over time, healthcare systems have been forced to devote more time and resources to the administration of medicine, which takes valuable resources away from the practice of medicine.

At the same time, the unpredictability of the malpractice system has led to a constant fear of costly lawsuits, encouraging doctors to order unnecessary tests, consults, and admissions to avoid being second-guessed later in court. This practice known as defensive medicine has been estimated to cost our healthcare system between $100 billion and $200 billion annually.

Years later, now as a practicing physician, I know that the problems of our 2009 healthcare system still exist today. Few, if any, are arguing that these challenges have been resolved. In fact, in many ways they have gotten worse. The problems of our 2009 healthcare system need to be addressed now more than ever, and would go a long toward lowering costs and producing a higher-quality, more accessible healthcare system.

Jason D. Fodeman, MD, MBA is a practicing physician. He specializes in delivery systems and health policy.

Thinking of submitting an op-ed to the Washington Examiner? Be sure to read our guidelines on submissions.

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The healthcare problems of 2009 have not been fixed - Washington Examiner

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The White House wants to keep pushing on health care. The Senate has other ideas.

5:46 PM, Aug 02, 2017 | By Andrew Egger

Andrew Egger Reporter The Weekly Standard

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Gage Skidmore

Finance Committee chairman Orrin Hatch has insisted repeatedly that the window for health care has closed, and that the Senates time is better spent on other issues for now.

Theres too much animosity and were too divided on health care, Hatch told Reuters on Monday. I think we ought to acknowledge that we can come back to health care afterwards, but we need to move ahead on tax reform.

Not every senator is convinced. Health Committee chairman Lamar Alexander announced Wednesday that his committee would hold bipartisan meetings looking at Obamacare repair, which would look at ways to prevent a collapse of the health insurance market.

Asked about these meetings Wednesday, Hatch was unimpressed.

Why are they having hearings on health care? he told reporters. Were onto taxation now. Health care, as far as Im concerned, is over.

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Hatch: 'Health care, as far as I'm concerned, is over' - The Weekly Standard

Is legislative health-care reform really dead?

Most of Congress seems to think so, and President Trump agrees, if his irate tweets about taking executive action to fix health care on his own are any indication. But the fact remains that Obamacare exchanges are still struggling all across the country. While a GOP-led repeal bill might not be on the table again anytime in the near future, some lawmakers continue to float possible solutions.

In the House, a group of about 40 centrist lawmakers hopes to lead the effort to stabilize the Obamacare exchanges. Called the Problem Solvers caucus, the group includes some moderate congressmen from the New Democrat Coalition and the GOPs Tuesday Group.

Led by Democratic congressmen Tom Reed (N.Y.) and Josh Gottheimer (N.J.), the caucus is primarily focused on continuing to fund the Affordable Care Acts cost-sharing-reduction subsidies (CSR payments), which reduce the significant costs to insurers of covering low-income Americans under Obamacare.

The bipartisan group also wants to establish a federal stability fund that states could access to reduce premiums for citizens with high-cost medical needs. The moderate lawmakers hope to alter the employer mandate so that it applies only to companies with over 500 workers, which would relieve the tax burden on small businesses that choose not to provide insurance plans.

The Problem Solvers caucus has also rallied behind a few ideas that have gained bipartisan support in the past, including abolishing the ACAs medical-device tax and expanding states ability to seek waivers from some of the bills coverage rules.

On Wednesday, Republican congressman Mark Meadows, chair of the House Freedom Caucus, said health-care reform isnt over. He also said that he has met with the Trump administration to discuss the path forward, and hes confident they can develop a new plan. Meadows was one of the key GOP members to broker the deal for an amendment that enabled the American Health Care Act to pass the House in April.

Over in the Senate, a handful of moderate GOP senators have suggested providing block-grant health-care funding to the states. This proposal was put forth in an amendment last week by GOP senators Lindsey Graham and Bill Cassidy, but it has yet to receive a vote. It would need to be scored by the CBO before a floor vote could take place.

Graham and Cassidy, along with moderate GOP senator Dean Heller (Nev.), met with Trump on Friday to discuss their plan. The White House, eager to capitalize on any idea to advance reform after last weeks debacle, seems intent upon using this plan as a means of gathering momentum for further health-care negotiation.

Meanwhile, Republican senator Lamar Alexander (Tenn.) and Democrat Patty Murray (Wash.) announced Tuesday afternoon that the Senate Health, Education, Labor, and Pensions committee will hold bipartisan hearings throughout September to discuss possible ways to stabilize the ACA marketplaces.

For his part, Trump has threatened to stop doling out CSR payments, apparently with the goal of further exacerbating the problems that already exist on the Obamacare exchanges. Trump seems to believe that further devolution of the exchanges would force lawmakers to implement an immediate health-care solution, but ending CSR payments would almost certainly lead to utter chaos in the insurance markets, making a fix even more difficult.

These efforts, while uncertain and rather uncoordinated, reveal a basic fact: We simply cant afford to give up on health-care reform. The fact that bipartisan cooperation is emerging only now is shameful; Democrats should have cooperated to begin with. Obamacare reform was always going to be necessary, in one form or another. With earlier Democratic support, it mightve been feasible to develop legislation that could fix at least some of the problems with the exchanges and garner enough support to be passed into law.

Legislative efforts may be effectively dead for the near future, but as health-care policy expert Avik Roy wrote on the Corner just after the Senate vote failed early Friday:

The GOP cannot simply move on and give up on health care. Health care is the biggest driver of our debt and deficit, the biggest driver of growth in government, and one of the biggest drivers of economic insecurity for those in the middle class and below. Take some time to reflect, yes. Come up with a better strategy, yes. But to give up on health-care reform is to give up on everything conservatives stand for.

If nothing else, the evident failures of Obamacare premium costs constantly on the rise, more insurers fleeing the ACA exchanges across the country, leaving many states with just one or two insurance options on the exchanges preclude anyone in Washington from giving up on reform for good.

READ MORE: Editorial: The Republican Health-Care Fiasco Republicans Should Revisit Health Care after a Tax Reform Success Maybe Health Care Wasnt Possible

Alexandra DeSanctis is a National Review Institute William F. Buckley Fellow in Political Journalism.

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Health-Care Reform Can't Die - National Review

By Laurie Meisler

August 2, 2017

Typically, the more a developed country spends on health care, the longer its people live. The U.S., which spends the most on health care, bucks that trend. Compared to the 35 countries in the Organization for Economic Cooperation and Development, which promotes policies to improve social and economic well-being, the U.S. life expectancy of 78.8 years ranks 27th. It has the fourth highest infant mortality rate in the OECD, the sixth highest maternal mortality rate and the ninth highest likelihood of dying at a younger age from a host of ailments, including cardiovascular disease and cancer.

The U.S. is the most obese country in the OECD, leads in drug-related deaths and ranks 33rd in prevalence of diabetes. Yet 88 percent of Americans say they are in good or very good health, according to OECD statistics. Only 35 percent of Japanese, who have the highest life expectancy in the OECD, regard themselves as healthy or very healthy.

Unlike other countries in the OECD, the U.S. mostly relies on voluntary health insurance to fund health-care costs. Public health insurance, such as Medicare and Medicaid, accounts for 27 percent of coverage. By contrast, the 10 countries with the highest life expectancy depend on voluntary insurance for an average of less than 6 percent of their costs, and government spending for nearly half.

One big reason U.S. health care costs are so high: pharmaceutical spending. The U.S. spends more per capita on prescription medicines and over-the-counter products than any other country in the OECD.

Notes: *Included in per capita spending on health care

**Includes cardiovascular disease, cancer, diabetes and chronic respiratory disease

Methodology: Bloomberg ranked the OECD countries by total expenditure on health, which is the amount each country spends for both individual and collective services. Dollar figures for per capita spending use current prices and current purchasing power parities. (PPPs are the rates of currency conversion that eliminate the differences in price levels between countries.) Expenditure data include personal health care services and expenses, medical goods dispensed to outpatients; prevention and public health services; health administration and health insurance. Spending figures for 2016 are estimated or provisional. Data for related factors are for 2015 or the latest data available.

Infant mortality refers to the number of deaths of infants under one year old. Compulsory/contributory health plans include social health insurance, compulsory private insurance and compulsory medical savings accounts.

Source: OECD, The World Bank, World Health Organization, International Diabetes Federation and Diabetes Atlas

With assistance from Yvette Romero

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Americans Die Younger Despite Spending the Most on Health Care - Bloomberg

Photo Credit Linda Huang

Something unusual and important is happening in Congress: Republicans and Democrats are working together to improve the health care system. And theyre doing so in defiance of President Trump, who appears determined to sabotage the Affordable Care Act and the health insurance of millions of people.

This surprising if modest burst of bipartisanship comes just days after the Senate failed to pass a Republican bill to repeal important provisions of the A.C.A., or Obamacare. On Monday 43 members of the House outlined a proposal to strengthen the insurance marketplaces created by the 2010 law. On Tuesday Lamar Alexander and Patty Murray, the Republican and Democratic leaders of the Senate Health, Education, Labor and Pensions Committee, said they would hold hearings and introduce a bill to cut premiums and encourage insurers to sell policies on the marketplaces for 2018.

It is, of course, impossible to know if such efforts will succeed. Even if they result in legislation, Republican leaders could refuse to bring it to the floor for a vote. Having treated Obamacare as a political piata for seven years, Republicans might find it hard to actually help the program. Another danger is that Mr. Trump and his health and human services secretary, Tom Price, could try to pre-emptively weaken the marketplaces through administrative measures. Still, its good to see politicians actually doing their jobs. The sight of members of both parties working together in the public interest is uplifting, especially after the long partisan campaign to take insurance away from so many Americans.

Contrary to Mr. Trumps tweets, Obamacare is not collapsing. But it needs work, and some insurance markets are in trouble. Insurers have said they will no longer sell policies in 20 counties in Indiana, Nevada and Ohio, and many are proposing to raise premiums because of the uncertainty created by Mr. Trumps threats. Experts say insurers could withdraw from even more counties, especially in rural and suburban areas, if the president sabotages the law.

The biggest fear, one shared by Mr. Alexander and Ms. Murray, is that Mr. Trump will stop subsidies authorized by the A.C.A. to make health care affordable to low-income people. The government pays these subsidies, about $7 billion this year, to insurance companies every month. In exchange, the companies reduce the deductibles and co-pays for people who earn between 100 percent and 250 percent of the federal poverty line, or $12,060 to $30,150 a year for a single person.

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Capitol Shocker: Democrats and Republicans Start Working Together on Health Care - New York Times

Omega Healthcare Investors (OHI) shares are already a bargain, but they could get even cheaper as part of a wider market drop. With stocks sitting near record highs, a price drop of five to ten percent is fully within the realm of possibility, and investors need to plan accordingly. I am increasing my cash levels now in order to be able to take advantage of an inevitable market drop that would make quality income vehicles like Omega Healthcare Investors even cheaper.

Can you even remember the last time stock prices dropped 5 percent, 10 percent, or even 20 percent? And can you recall how painful the last bear market was for most investors? Chances are you cant because stock prices have been steadily climbing in the last couple of years, and the 2007 market crash happened almost a decade ago. In short, investors have short memories, and they have become way too complacent.

Earnings season has been pretty good so far for companies and investors, and, by extension, stocks. That said, though, todays complacency paired with investors willingness to buy into stocks at record levels is a convincing reason to be fearful. Valuations, on average, are pretty high, and they coincide with something else: Overbought sentiment.

As a matter of fact, I think there are three overriding reasons why investors should be prepared to buy into Omega Healthcare Investors as pressure on valuations begins to mount:

Omega Healthcare Investors has invested $5.8 billion in the growth of its real estate portfolio in the last thirteen and a half years - $1.3 billion in 2016 alone - in order to morph into a health care REIT with a national presence.

Source: Omega Healthcare Investors

Omega Healthcare Investors now has operating facilities in 42 states and in the United Kingdom.

Source: Omega Healthcare Investors

Omega Healthcare Investors works closely with health care facility operators. While the health care REITs relationships with its operator base have evolved over time, no operator poses an outsized risk to Omega in terms of revenues.

Source: Omega Healthcare Investors

In addition to a widely diversified real estate portfolio, Omega Healthcare Investors has had industry-beating occupancy rates.

Source: Omega Healthcare Investors

Omega Healthcare Investors just reported robust Q2-17 results, and continues to display top-shelf dividend coverage for a health care REIT. I recently doubled down on Omega Healthcare Investors as the REIT combines excess dividend coverage with an above-average commitment to raising its dividend payout every single quarter (Omega Healthcare Investors just raised its dividend for the 20th consecutive quarter and the new dividend rate is $0.64/share).

Omega Healthcare Investors is in a stable financial position and can continue to grow its dividend. I updated Omega Healthcare Investors dividend coverage chart for its second quarter results, and the real estate investment trust should have no problems growing its dividend payout by $0.01/share moving forward.

Source: Achilles Research

Omega Healthcare Investors guided for adjusted funds from operations of $3.42-$3.44/share for the current year. Based on this guidance, income investors seeking to access Omega Healthcare Investors 8.2 percent dividend, pay 9.1x 2017e AFFO. A market slide would translate into an even lower AFFO multiple (and higher cash flow yield), increasing investors margin of safety.

Income investors pay a premium to the REIT's book value. The premium valuation is justified in my opinion based on Omega's above-average dividend visibility, high cash flow yield, and potential for AFFO growth.

Investors have been piling into stocks for more than eight years (where do you think all that central bank money went?), pushing investors into risky assets and inflating their prices. Against this backdrop, I think the time has come to be a little more cautious, and raise cash in order to gobble up high-quality income vehicles when they are on sale.

If you have read my articles before you know that I have almost entirely liquidated my high-yield income portfolio earlier this year - primarily BDCs and mortgage REITs - due to concerns about stretched valuations and overbought sentiment, and because good investment opportunities have become increasingly hard to find.

Considering that a 5-10 percent market drop is entirely within the realms of possibility, having cash at hand to deploy during a market drop is the smart thing to do.

Omega Healthcare Investors has assembled a high-quality, geographically-diversified skilled nursing facility portfolio that throws off a growing stream of FFO. I have doubled down on the health care REIT because of its low valuation, and because it has a high degree of dividend coverage/visibility. Omegas second quarter results continued to show AFFO resilience and very good dividend coverage.

That said, I think income investors need to raise their cash levels in order to be able to scoop up high-quality income vehicles like Omega Healthcare Investors once the market falls back from its recent highs. Though Omega Healthcare Investors already makes a solid value proposition, I think the reward-to-risk ratio looks particularly attractive below $30.

If you like to read more of my articles, and like to be kept up to date with the companies I cover, I kindly ask you that you scroll to the top of this page and click 'follow'. I am largely investing in dividend paying stocks, but also venture out occasionally and cover special situations that offer appealing reward-to-risk ratios and have potential for significant capital appreciation. Above all, my immediate investment goal is to achieve financial independence.

Disclosure: I am/we are long OHI.

I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article.

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Omega Healthcare Investors: Strong Buy Below $30 - Seeking Alpha

Sen. Lamar Alexander, R-Tennessee, said the Senate health committee will hold bipartisan health care hearings on how to repair the individual market. In the House, a group of 40 lawmakers from both parties endorsed an outline of ideas aimed at making urgent fixes to Obamacare.

The step toward bipartisanship on health care comes as some Republicans consider an approach that diverges from the president's stance.

In tweets this weekend, he threatened to stop paying insurance companies cost-sharing subsidies that help lower out-of-pocket expenses for low-income policyholders, calling them "bailouts."

Here are some of the bipartisan efforts underway in Congress over Obamacare.

"If your house is on fire, you want to put out the fire, and the fire in this case is the individual health insurance market," he said in a statement. "Both Republicans and Democrats agree on this."

Alexander said in the statement that he was working with Sen. Patty Murray, D-Washington, to make the hearings bipartisan.

Congress has to come up with a solution before September 27, when insurers sign contracts with the federal government over what insurance plans to sell on the exchange for 2018. About 18 million Americans who get their insurance in the individual market stand to be affected, he said.

"Unless we act, many of them may not have policies available to buy in 2018 because insurance companies will pull out of collapsing markets," Alexander said.

The senator also urged Trump to temporarily keep making the cost-sharing payments so Congress could work on stabilizing the individual market for 2018.

Last week, Alexander voted for two out of the three repeal Obamacare bills that went up for a vote in the Senate.

In the House, a group of around 40 Republicans and Democrats known as the Problem Solvers Caucus endorsed an outline of ideas aimed at making urgent fixes to Obamacare.

While there is no legislative text yet, members in the caucus are moving quickly to seize the defeat of a Senate bill last Friday to garner broader support for their proposals -- and to force the GOP to ditch its quest to gut the current health care law once and for all.

The group's proposal includes mandatory funding for cost-sharing reduction payments; the creation of a stability fund; a repeal of the medical device tax; and to raise the threshold of the employer mandate so that companies with 500 employees or more, rather than 50, are required to provide workers with health insurance.

New Jersey Rep. Josh Gottheimer, the Democratic leader of the Problem Solvers Caucus, acknowledged that its initial proposal "does not attempt to do everything" -- but that it's a start.

"Instead of just focusing on killing the ACA, we're focused on how to fix it in a smart way," Gottheimer said on Monday. "When (Sen. John) McCain said on the floor it's time to work together like the country wants -- that had a big influence on our group. It was a shot in the arm."

The effort comes from Republican and Democratic lawmakers representing the most competitive districts across the country.

Rep. Martha McSally, R-Arizona, stressed the importance of the group's bipartisan approach as well as its goal to stabilize the individual market.

"The big headline here is: Democrats, Republicans trying to find a way forward. We're not going to solve everything, but we're trying to deal with the problem at hand, and that's exactly what we did," McSally, who voted in favor of the House health care bill, told CNN's Wolf Blitzer on Tuesday.

"So these are singles and doubles. It's not a home run for everybody, but we're here to govern," she added.

There are barriers ahead.

House Speaker Paul Ryan's spokeswoman made it clear that the bipartisan health care proposals were not moving anytime soon in the House.

"While the speaker appreciates members coming together to promote ideas, he remains focused on repealing and replacing Obamacare," AshLee Strong said.

At the same time, others in their party are just as insistent that it's time for the party to leave a comprehensive health care overhaul behind and focus on smaller fixes that Democrats can get behind.

CNN's MJ Lee, Deidre Walsh and Noa Yadidi contributed to this report.

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Senator announces bipartisan health care hearing on Obamacare - CNN

Senator Chuck Schumer, the minority leader, and Senator Ron Wyden, the ranking Democrat on the Senate Finance Committee, organized the drafting of the letter, which lays out their priorities. Three Democratic senators who are up for re-election next year Joe Donnelly of Indiana, Joe Manchin III of West Virginia and Heidi Heitkamp of North Dakota did not sign the letter. They could be ripe targets for Republicans looking for Democrats to get on board with their tax plan.

Despite the outreach, bipartisanship will not come easy.

On taxes, Democrats tend to favor raising taxes on the rich to pay for cuts that would reduce tax rates for middle-income families. The parties are in closer agreement on changes to the corporate tax system, but Democrats argue that the cuts Republicans are proposing are far too deep.

In the conditions laid out in their letter, the Democrats insisted that changes to tax laws not increase the tax burden on the middle class and that the wealthiest 1 percent of taxpayers not see their tax bills shrink.

They also insisted that Republicans return to regular order and not try to push a tax bill through Congress using budget reconciliation rules that require only a simple majority in the Senate.

Finally, they want a rewrite of the tax code that does not add to the deficit and is not paid for with cuts to programs such as Medicare, Medicaid and Social Security.

For much of this year, Democrats have criticized the proposed tax policies of Republicans as giveaways to the rich. It was clear on Tuesday that Republicans are not eager to let Democrats meddle with their plans for a tax overhaul, even if they would welcome a few of their votes.

We will need to use reconciliation because we have been informed by the majority of the Democrats in a letter I just received today that most of the principles that would get the country growing again, theyre not interested in addressing, Mr. McConnell said, leaving the option for Democrats to support a Republican-led tax plan. So I dont think this is going to be 1986 when you had a bipartisan effort to scrub the code.

For its part, the Trump administration has been more vocal this week about the importance of attracting some Democrats to its tax plan. At a gathering on Monday of conservative activists sponsored by Americans for Prosperity, the political network of the Koch brothers, Marc Short, the White House legislative affairs director, made the case that Democrats need to be brought into the fold. The Republican majority in the Senate, he said, was too slim for party members to count only on one another.

We ask your help, actually, reaching out to Democrats as well, Mr. Short said, noting the ones who are coming up for re-election. If they hear from their constituents that they need tax reform, thats going to be a very strong selling point.

It remains unclear how enthusiastic Democrats really would be to make compromises with Republicans that would allow Mr. Trump to score a major legislative victory. In the battle over the Affordable Care Act, even potentially vulnerable Democratic senators from states that the president won last year held firm in their opposition to the repeal of the health care law.

Relegated to the minority, however, Democrats are trying to stake out the moral high ground. Mr. Schumer warned on Tuesday that Republicans could suffer the same fate on taxes that they did on health care if they continue to operate alone.

Theres real potential for bipartisan support on tax reform, but I think our Republican colleagues, dictated by the Koch brothers hard right wing of their party, is running away from it, Mr. Schumer said. They say tax reform is hard, and it is. But its a lot harder if Republicans try to do it all by themselves.

Cooperation between the parties will be necessary for Congress to deal with more immediately pressing legislative priorities. The debt ceiling must be lifted by the end of September, and Mr. Schumer, Mr. McConnell and Treasury Secretary Steven Mnuchin huddled on Tuesday morning to discuss the way forward.

Although Mr. Mnuchin and Democrats want a clean lift of the statutory borrowing limit, many Republicans are pushing for spending cuts or changes to budget process to be linked to any legislation.

No breakthrough was made on that issue.

A version of this article appears in print on August 2, 2017, on Page A11 of the New York edition with the headline: Democrats Make Overture To G.O.P. on Tax Overhaul.

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After Health Care Victory, Senate Democrats Seek Compromise on Tax Plan - New York Times

(Jeff Greenberg/UIG via Getty Images)

While many physicians in the United States report frustrations with their work, the public continues to hold health care providers in high regard.

Nearly nine-in-ten Americans (87%) who have seen a health care provider in the past year say their concerns or descriptions of symptoms were carefully listened to, and 84% say they felt their provider really cared about (their) health and well-being, according to a Pew Research Center survey conducted in spring 2016. Just 23% of patients said they felt rushed by their health care provider, and even fewer (15%) felt confused about instructions they got for treatment or at-home care.

These findings come despite a range of negative experiences reported by health care providers themselves. Professional burnout, for example, is reportedly on the rise among physicians due to long work hours and excessive administrative burdens. Pediatricians find it harder to do their jobs as they confront a growing number ofparents who are hesitant to vaccinate their children.

Adding to this pressure, the medical personnel at the Centers for Disease Control and Prevention have had to cope with some 750 potentially serious health threats in the past two years, even as the agency faces budget uncertainties in the year ahead.Medical professionals and other stakeholders also have beenshut outof congressional deliberations about repealing and replacing the Affordable Care Act. Meanwhile, their own patients have grown more critical about the countrys health care system: A2014 Pew Research Center surveyfound that just 26% of adults say U.S. health care is above average or the best in the world, down from 39% in 2009.

Health care providers are not the only medical professionals who receive favorable ratings from the public. Medical scientists are likewise held in high esteem.

For example, in a 2016 Pew Research Center survey, 84% of Americans expressed at least a fair amount of confidence in medical scientists to act in the best interests of the public. And a 2013 survey revealed that 66% of Americans believe doctors contribute a lot to the well-being of society a higher rating than for the clergy, journalists and business executives.

Moreover, although pediatricians are confronting an increasing number of vaccine-hesitant parents, the majority of the U.S. public still wants them engaged in the issue. Nearly three-quarters of U.S. adults (73%) believe that medical scientists should have a major role in policy decisions related to childhood vaccines.

Topics: Work and Employment, Health Care, Health, Science and Innovation

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Most patients in US have high praise for their health care providers - Pew Research Center

The Latest on the Republican effort to repeal and replace the Obama health law (all times EDT):

8:30 p.m.

A federal appeals court in Washington has agreed to let a group of states get involved in a lawsuit over government payments to insurers as part of the Obama administration's health care law. It's an intervention House Republicans had opposed.

House Republicans trying to thwart the Affordable Care Act sued the administration in federal court in 2014, arguing the law lacked specific language appropriating the "cost-sharing" subsidies. A district court judge agreed with House Republicans but the case was appealed to the U.S. Court of Appeals for the District of Columbia Circuit.

On Tuesday, the court allowed a group of state attorneys general to join in the case, in defense of the subsidies. In an order, the court says the states have "demonstrated the appropriateness of their intervention."

7 p.m.

There are signs of a modest bipartisan effort to buttress health insurance markets, four days after the GOP effort to uproot and reshape the Obama health care law crumpled in the Senate.

The Republican chairman of the Senate health committee, Tennessee's Lamar Alexander, says he'll seek bipartisan legislation extending for one year federal payments to insurers that help millions of low- and moderate-income Americans afford coverage.

President Donald Trump has threatened to halt those subsidies in hopes of forcing Democrats to make concessions. Top Senate Democrat Chuck Schumer of New York says that's "not what an adult does."

3:05 p.m.

Senate Majority Leader Mitch McConnell is answering President Donald Trump's call for a change in Senate rules with a dose of political reality.

The Republican leader told reporters on Tuesday that the reason for the collapse of health care legislation was not Democrats in opposition, but rather, "we didn't have 50 Republicans."

Over the weekend, Trump tweeted that Republicans should change the rules on legislation and reduce the 60-vote threshold to eliminate possible filibusters. His tweets came after the failure of health care legislation on a razor-thin margin of 51-49 on Friday.

McConnell said there are not enough votes to change the rules in the Senate. He said, "The votes are simply not there."

2:55 p.m.

The chairman of the Senate health committee says he wants his panel to approve a one-year extension of federal payments to insurers so they can curb out-of-pocket health care costs for millions of Americans.

Tennessee Republican Sen. Lamar Alexander says he wants his committee to pass a bipartisan bill doing that by mid-September. He says he's asked President Donald Trump to continue the payments in August and September to give his panel time to do its work.

Trump has called those payments bailouts for insurers. He's threatened to halt them to force Democrats to negotiate with him over repealing and replacing the Obama health care law.

Democrats, the insurance industry and some Republicans say halting those subsidies would roil insurance markets and boost premiums for many consumers.

12:40 p.m.

The No. 2 Senate Republican leader seemed to suggest that the two parties should try working together on health care.

Sen. John Cornyn of Texas did not specify what issues the two sides could address together. But his comments followed last week's crumpling of the Senate Republican effort to repeal and replace President Barack Obama's health care law.

In remarks on the Senate floor Tuesday, Cornyn cited "fragile majorities" in the Senate and said "we are forced to work together to try to solve these problems." He added that he believes bipartisan solutions "tend to be more durable."

Along those lines, Senate GOP health committee chairman Lamar Alexander of Tennessee discussed health care Tuesday at a private meeting with the panel's top Democrat, Patty Murray of Washington.

12 p.m.

The Senate's top Democrat says President Donald Trump's threats to block federal payments to insurers are "not frankly what an adult does" and would boost consumers' premiums.

Senate Minority Leader Chuck Schumer made the comments as Washington waits to see if Trump will halt the expenditures.

President Barack Obama's law requires insurers to lower out-of-pocket costs for millions of lower- and middle-income consumers. A court has ruled that Congress hasn't properly authorized the money. Trump has continued the payments until now.

Trump and Republicans call the expenditures bailouts for insurers.

The insurance industry notes they're legally required to reduce many customers' costs. It says blocking the federal payments would cause them to boost premiums by around 20 percent.

Schumer says Trump would be to blame if that happens.

3:30 a.m.

Top Senate Republicans think it's time to leave their derailed drive to scrap the Obama health care law behind them.

And they're tired of the White House prodding them to keep voting on it until they succeed.

Several GOP leaders say that at least for now, they see no clear route to the 50 votes they'd need to get something anything recasting President Barack Obama's health care statute through the Senate.

Their drive crashed last week. And their mood didn't improve after a weekend of tweets by President Donald Trump saying they "look like fools" and White House budget chief Mick Mulvaney using TV appearances to say they should continue voting.

No. 2 Senate Republican John Cornyn of Texas says Mulvaney should "let us do our jobs."

Read the rest here:

The Latest: States get involved in health care court case - ABC News

Presidential candidate Mirhossein Mousavi (R) and his his wife Zahra Rahnavard cast their ballots during the Iranian presidential election in southern Tehran June 12, 2009.

The former candidates, Mehdi Karroubi and Mir Hossein Mousavi, and Zahra Rahnavard, an author and activist who is Mousavis wife, have been under house arrest in Tehran since February 2011. Iranian authorities should immediately provide them with unrestricted access to adequate health care.

Iranian officials have deprived Mousavi, Karroubi, and Rahnavard of their most basic rights for more than six years, all without a judicial order or even the pretense of due process, said Sarah Leah Whitson, Middle East director at Human Rights Watch. Irans authorities should stop denying Mousavi and Karroubi the care they need, grant immediate access to a specialist medical facility, and end their house arrest.

On July 24, 2017, Mohammad Taghi Karroubi, Karroubis son, posted on Twitter that his father had been transferred to a hospital in Tehran after suffering an abnormally low heart rate. On July 28, Mohammad Taghi Karroubi confirmed in correspondence with Human Rights Watch that Intelligence Ministry officials had ordered Karroubis transfer back to his house the day before, against Karroubis doctors advice.

On July 28, Karroubis family wrote an open letter published in several Persian-language media outlets stating that Karroubi had suffered from a serious heart issue the day after he was moved back to his house. On July 30, Hossein Karroubi, another of Karroubis four sons, reported that authorities transferred his father back to a hospital in Tehran, where he is being treated.

Mohammad Taghi Karroubi told BBC Persian that the authorities treatment over the last several years has instilled fear among his family that the Ministry of Intelligence has appointed someone to the case who sees ending these detainees lives as his duty. The family has said they hold President Hassan Rouhani responsible for Karroubis wellbeing.

On July 26, the Kalameh, a pro-reform news website, reported that according to Mousavis daughters, Zahra and Narges, the former presidential candidate and prime minister is suffering from high blood pressure, dizziness, and chronic kidney problems. On July 27 and 28, Zahra and Narges Mousavi posted on their Twitter accounts that they have not been able to get any information on their fathers medical condition since their visit with him on July 25.

Several members of parliament, including Mahdmoudi Sadegh and Elias Hazari from Tehran, reported that they have tried to visit Karroubi in the hospital but that authorities have denied them permission.

Officials placed the two former presidential candidates and their wives, Zahra Rahnavard and Fatemeh Karroubi, under house arrest on February 14, 2011, in response to the opposition figures call for demonstrations in support of popular uprisings across the Middle East. While the authorities have released Fatemeh Karroubi, the other three remain detained. During six-and-a-half years of detention, officials have regularly deprived Mousavi and Karroubi from receiving the regular check-ups doctors had recommended for serious medical conditions.

Iranian officials, including Irans judiciary, have failed to provide any legal justification for the opposition figures continuing arbitrary detention. President Rouhani promised during his 2013 presidential campaign to lift the former candidates house arrest, but has not, and there is little available information about his efforts, if any, to free them.

Ali Motahari, a parliament member from Tehran who has repeatedly protested the house arrest in his speeches, said several times that the Supreme Leader, Ayatollah Ali Khamenei, is in favor of continuing the house arrest.

In August 2012, the United Nations Working Group on Arbitrary Detention, a body of five independent experts acting under the UN Human Rights Council, issued an opinion that the detentions are arbitrary (and thus prohibited), and recommended that the Iranian government release the detainees immediately and compensate them for their wrongful imprisonment.

Human Rights Watch has repeatedly called on Irans authorities, including Rouhani, to push for the release of the opposition figures and give them adequate access to medical care.

As President Rouhani begins his second term on August 5, he should demonstrate that he takes his promises to his fellow citizens for more rights and legal protections seriously, Whitson said. A good place to start would be to free Mehdi Karroubi, Mir Hossein, and Zahra Rahnavard from house arrest and to see that they get the health care they need.

More here:

Iran: Opposition Figures Denied Health Care - Human Rights Watch

Senate Homeland Security and Governmental Affairs Committee Chairman Ron Johnson speaks on Capitol Hill in 2016. Shawn Thew / EPA file

"Its something the president should do," Robert Moffit, a senior fellow at the Heritage Foundation who has tracked the issue, told NBC News. "Beyond the separation of powers question...they shouldnt be getting special advantages at the expense of the taxpayer."

Since members make too much money to qualify for Obamacare subsidies, theyd have to pay the full cost of the premiums, which would be a major increase.

Congress could pass legislation to grant themselves their current benefits, but theyd face taunts from Trump and other critics accusing them of voting to enrich themselves. Theres a reason they havent resolved the issue up to this point.

But its possible the move could come off as unnecessarily cruel. After all, it wouldnt just be elected officials with six-figure incomes who would be affected.

"While people are maybe not sympathetic to members of Congress, more would be sympathetic to the staff and it would be a far, far bigger deal for the staff," Len Nichols, Director of the Center for Health Policy Research and Ethics at George Mason University, told NBC news.

It could also backfire if Congressional Republicans resent the move and become less cooperative. Senators, in particular, have proven increasingly willing to buck the president and he cant afford to lose more support and follow through on his agenda.

Trump has said Congress should not vote on any other legislation until lawmakers pass health care.

This one is harder to pull off. The legislative branch sets its own rules, follows its own schedule, and its members can get prickly if they believe the executive branch is muscling in on its territory.

"He and his team have to understand that Congress is a co-equal branch of government," said Jim Manley, a former top aide to Senator Harry Reid. "They dont respond well to threats from any president of either party."

Trump couldn't stop Congress from voting on legislation. If he really wanted to, though, he could veto all bills until members caved.

He would be picking an especially dangerous time to issue a blanket veto threat. Over the next few weeks, Congress needs to pass legislation to fund the government or there will be a shutdown. It also needs to raise the debt limit or it risks setting off a financial crisis. Neither scenario would be a good look for the party with unified control of government.

Trump also cant keep up a blockade indefinitely without threatening the next item on his agenda: Taxes. The House and Senate are using this years budget reconciliation process to try and pass health care. But the fiscal year ends September 30, and once Congress passes a new budget, the legislation will expire. The new reconciliation bill is supposed to be the vehicle for tax reform, which promises to be a difficult fight as well.

For their part, members of Congress dont sound too intimidated so far.

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Health Care: President Trump's Triple Threat - NBCNews.com

Schumer said he was all for the concept of a bill advanced by Rep. Thomas Reed that would mandate roughly $7 billion in federal cost-sharing subsidies. | Getty

ALBANY, N.Y. Sen. Chuck Schumer said Monday he has heard from 10 of his Republican colleagues in response to his call for a bipartisan approach to health care legislation.

No one thought Obamacare was perfect it needs a lot of improvements, Schumer (D-N.Y.) said after an unrelated news conference at Albany Medical Center. Were willing to work in a bipartisan way to do it. What we objected to was just pulling the rug out from it and taking away the good things that it did: Medicaid coverage for people with parents in nursing homes, for opioid treatment, for kids with disabilities, pre-existing conditions.

Story Continued Below

The so-called skinny repeal bill, which would have removed some of Obamacares least popular provisions, failed early Friday in a 51-49 vote. According to The New York Times, Schumer told Sen. John McCain, a Republican from Arizona, that he was committed to a legislative effort in regular order to improve the health care system. McCain cast an unexpected and decisive "no" vote.

Schumer said he was all for the concept of a bill advanced by Rep. Thomas Reed (R-N.Y.) that would mandate roughly $7 billion in federal cost-sharing subsidies that reduce out-of-pocket costs for poor consumers. Schumer, the Senate's minority leader, said he wasnt sure whether legislation would emerge in a big bill or take several steps.

Well, well have to wait and see. The first step is to try and stabilize the system that means the cost-sharing which would reduce premiums and increase coverage. Both Democrats and Republicans Sens. [Tim] Kaine and [Tom] Carper and [Susan] Collins have talked about re-insurance plans, so the most severe cases go into a separate insurance fund, and that reduces costs, Schumer said. Those are immediate things, but in the longer term, Republicans have some ideas, we have some ideas, and well sit down and try to hash them out as Congress should do.

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Schumer: Republicans have been in touch about health care - Politico - Politico

Top Senate Republicans think it's time to leave their derailed drive to scrap the Obama health care law behind them. And they're tired of the White House prodding them to keep voting until they succeed.

Several GOP leaders said Monday that at least for now, they saw no clear route to the 50 votes they'd need to get something anything recasting President Barack Obama's health care statute through the Senate. Their drive crashed with three disastrous Senate votes last week, and their mood didn't improve after a weekend of tweets by President Donald Trump saying they "look like fools" and White House budget chief Mick Mulvaney using TV appearances to say they should continue voting.

Mulvaney has "got a big job, he ought to do that job and let us do our jobs," No. 2 Senate GOP John Cornyn of Texas said. He also said of the former House member, "I don't think he's got much experience in the Senate, as I recall."

"It's time to move onto something else, come back to health care when we've had more time to get beyond the moment we're in," said Sen. Roy Blunt of Missouri, another member of the GOP leadership. Asked about threats by conservative groups to attack GOP lawmakers who abandon the fight, Blunt said, "Lots of threats."

While the leaders stopped short of saying they were surrendering on an issue that's guided the party for seven years, their remarks underscored that Republicans have hit a wall when it comes to resolving internal battles over what their stance should be.

Yet even the White House's focus turned Monday to a new horizon: revamping the tax code.

White House legislative director Marc Short set an October goal for House passage of a tax overhaul that the Senate could approve the following month. Plans envision Trump barnstorming the country to rally support for the tax drive, buttressed by conservative activists and business groups heaping pressure on Congress to act.

On health care last week, Republican defections led to the Senate decisively rejecting one proposal to simply erase much of Obama's statute. A second amendment was defeated that would have scrapped it and substituted relaxed coverage rules for insurers, less generous tax subsidies for consumers and Medicaid cuts.

Finally, a bare-bones plan by Senate Majority Leader Mitch McConnell, R-Ky., rolling back a few pieces of Obama's law failed in a nail-biting 51-49 roll call. Three GOP senators joined all Democrats in rejecting McConnell's proposal, capped by a thumbs down by Sen. John McCain, R-Ariz.

Republican, Democratic and even bipartisan plans for reshaping parts of the Obama health care law are proliferating in Congress. They have iffy prospects at best.

Republicans can push something through the Senate with 50 votes because Vice President Mike Pence can cast a tie-breaking vote. But rather than resuming its health care debate, the Senate on Monday began considering a judicial nomination.

In the House, 43 Democratic and Republican moderates proposed a plan that includes continuing federal payments that help insurers contain expenses for lower-earning customers. It would also limit Obama's requirement that employers offer coverage to workers to companies with at least 500 workers, not just 50.

But movements by House centrists seldom bear fruit in the House, where the rules give the majority party ironclad control, and Speaker Paul Ryan, R-Wis., offered little encouragement.

"While the speaker appreciates members coming together to promote ideas, he remains focused on repealing and replacing Obamacare," said Ryan spokeswoman AshLee Strong.

Trump has threatened anew in recent days to cut off the payments to insurers, which total $7 billion this year and are helping trim out-of-pocket costs for 7 million people.

Those payments to insurers have some bipartisan support because many experts say failing to continue them or even the threat of doing so is prompting insurers to raise prices and abandon some markets.

Obama's statute requires that insurers reduce those costs for low-earning customers. Kristine Grow, spokeswoman for the insurance industry group America's Health Insurance Plans, said Monday that halting the federal payments would boost premiums for people buying individual policies by 20 percent.

"I'm hopeful the administration, president will keep making them," said No. 3 Senate Republican leader John Thune of South Dakota. "And if he doesn't, then I guess we'll have to figure out from a congressional standpoint what we do."

Senate health committee chairman Lamar Alexander, R-Tenn., said his panel will hold hearings in coming weeks about how to steady roiled health insurance markets.

Hoping to find some way forward, health secretary Tom Price met with governors and Louisiana Republican Sen. Bill Cassidy. Among those attending was Republican Arizona Gov. Doug Ducey, who's been trying to defend his state's expansion of Medicaid, the health insurance program for poor people, against proposed GOP cuts.

Cassidy and Sens. Lindsey Graham, R-S.C., and Dean Heller, R-Nev., have proposed converting the $110 billion they estimate Obama's law spends yearly for health insurance into broad grants to states.

Associated Press writer Bob Christie in Phoenix, Arizona, contributed to this report.

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Senate GOP sees no path on health care, despite Trump prods - ABC News

Billionaire Mark Cuban has proposed scrapping insurance companies from the U.S. health-care system and instead using federal funds to boost medical staff numbers and make care more widely accessible.

In a series of tweets late Sunday, which appeared to advocate parts of the U.K.'s National Health Service (NHS), the tech titan and philanthropist weighed in on President Donald Trump's beleaguered health-care reform agenda, saying that insurance companies were draining U.S. funds with "artificial" and inflated costs.

"Dear politicians. Let me ask a question. If every person in our country had health insurance, would we be any healthier?" Cuban posited in the first in a series of tweets.

He then went on to criticize the U.S. system, which relies on individual health insurance policies, and claimed that eradicating the role of private insurers could reduce costs by 50 percent or more. This would bring the U.S. system closer in line with the U.K.'s NHS or Australia's Medicare, which are largely state-funded.

"No chance a system where you give an ins (insurance) comp $, then beg them to spend it among limited options is the way to optimize our healthcare," Cuban insisted.

Cuban proposed that if he were in the president's shoes he would repeal Barack Obama-era insurance subsidies and instead use the funds to double medical school capacity and offer needs-based grants to increase staff numbers.

"Single Payer is not the solution," Cuban stated in his final tweet, saying that the current system feeds directly into the hands of inadequate insurance companies. Single-payer health insurance refers to a system in which a single public body organizes health-care financing, but the delivery of care remains mostly in private hands.

The U.K.'s NHS system, though widely commended, is not without its troubles, however, as it struggles to manage growing patient numbers with increasingly tight funding and falling staff numbers.

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Mark Cuban sees a model for fixing health care and he didn't find it in the United States - CNBC

1. President Trump President Donald Trump dictated a misleading statement for his son in response to a news report that Donald Trump Jr. hadmet with a Russian lawyer during the campaign,the Washington Post reported. Team Trump's original plan was to issue a truthful statement, but then Trump personally decided to have the statement say Trump Jr. had met with the lawyer, Natalia Veselnitskaya, to discuss the adoption of Russian children by Americans. White House press secretary Sarah Huckabee Sanders referred CNN to Trump's outside counsel for a response to the story. Attorney Jay Sekulow issued a statement, saying, "Apart from being of no consequence, the characterizations are misinformed, inaccurate and not pertinent." 2. White House The general is in -- and the Mooch is out. And so goes another zany day at the White House. Trump's new chief of staff, John Kelly, was sworn inMonday, and the retired US Marine Corps general made it clear bytossing out Communications Director Anthony Scaramuccithat he wants to run a tighter ship. Scaramucci blazed quite a trail during his 10 days on the job, engineering the ouster of former Chief of Staff Reince Priebus (whom he accused of leaking) and crudely taking on presidential advisor Steve Bannon in one of the most colorful interviews in White House history. Scaramucci leaves behind a small treasure trove of memorable lines (late night talk show hosts are devastated), but in the end, sources say, his profile was just getting too big for the Trump White House. CNN's Chris Cillizza says the way Kelly, who'd been Trump's secretary of homeland security,handled Scaramucci may mean he's more of a boss than we thought. The way the White House is now being restructured, everyone on staff will report to him, including Ivanka and Jared. 3. Venezuela A pair of leading opposition leaders have been rounded up in Venezuela. Leopoldo Lopez and Antonio Ledezma were taken from their homes, their families said on Twitter. Their removal follows Sunday's controversial election establishing a new legislative body made up entirely of President Nicolas Maduro's supporters. This new national assembly will have the power to rewrite the country's constitution. The election has been denounced worldwide, and the US Treasury Department hit Maduro with sanctions after the vote. 4. Climate change Two studies say the Earth is going to warm 2 degrees Celsius by the end of the century. If the studies' grim predictions are correct, we might not even recognize this planet by 2100. Rising sea levels, super droughts, mass extinctions, extreme weather and the melting of the Arctic would mean life as we know it would change dramatically. Researchers say the best way to avoid all of that is for governments to enact changes in public policy that lead to a serious reduction in greenhouse gas emissions. 5. Health care The GOP effort to kill Obamacare may be over, but there's still a desire to make improvements to our health care system. So lawmakers are looking at possible fixes to the health care law, and this time it's a bipartisan effort. About 40 House Republicans and Democrats -- who go by the very catchy name of the Problem Solvers Caucus -- have endorsed an outline of ideas aimed at making urgent fixes to Obamacare. Their ideas include mandatory funding for cost-sharing reduction payments, creating a stability fund, repealing the medical device tax and tweaking the employer mandate. None of this has been put into any bills yet, but it's a start. BREAKFAST BROWSE

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5 things for Tuesday, August 1: Trump, Scaramucci, Venezuela, climate, health care - CNN International