Last night, the second or third instance of a new tweet chat
about the American Health Care Act (AHCA) – increasingly known as ‘Trump Care’
took place. This chat was ‘sponsored’ by @physicianswkly and largely moderated
by Dr. Linda Girgis (@drlindamd) a Family Medicine expert, clinical assistant
professor at Rutgers Medical School (@RWJMS) and popular healthcare social media personality.
In spite of some fairly widespread confusion about the
hashtag associated with the chat – the correct hashtag being #TrumpHealthCare –
the chat did take place with 145 participants sharing 296 tweets for a total of3.7M impressions. See my commentary on these stats at the end of this post.
Since I was unable to participate in the chat, I’ve
summarized what transpired based on the tweets I was able to obtain from
@Symplur. I'e also added a few comments on certain tweets.
Here are the topics and associated contributions from chat participants:
Here are the topics and associated contributions from chat participants:
Handle
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Tweet
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@physicianswkly
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Please keep it civil & focused on policy & facts. Please
no Trump rallying or bashing. Thanks for joining. Let's go!
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@physicianswkly
|
15 MINUTE WARNING! let's stick to just the facts please. No
Trump bashing or rallying! Trolls will be ignored.…
|
Topic #1: Do you think the #ACHA / #TrumpCare will be an
improvement on the #ACA / #ObamaCare? Why/why not?
|
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@drlindamd
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Not much will change. I think the problems in the system have
been getting worse and this will just continue.
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@dfisher_p2
|
If 24 million people were to be uninsured under #AHCA, not sure
how that is an improvement
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@drlindamd
|
Not in its current form. Mandate is still there except worse in
that 30% penalty goes to ins cos!
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@idpharmacist
|
Not if this data are true: Many Trump voters would pay more #TrumpHealthcare
bill
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@misterchambo
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Not in its current form. Mandate is still there except worse in
that 30% penalty goes to ins cos!
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@dfisher_p2
|
It's estimated that 79% of the tax breaks under the #AHCA would
go to millionaires, that is not helpful to the masses
|
@ShimCode Comment: I agree with
@misterchambo and @jorient: The estimates from the CBO can be very un-reliable. And
it’s not their fault, projections and estimates are just that: projections
and estimates.
|
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@mloxton
|
No. KHN and CBO pretty much show that it serves fewer, and
reduces care. Cost savings at the expense of coverage
|
@misterchambo
|
Don’t trust the CBO! Makes as much sense as having Zeke Emanuel
advise the President.
|
@jorient
|
What has the CBO ever gotten right? ACA enrollment?! A
weatherman that bad would be fired
|
@lorenaolsonmd
|
Even if they're close, it is a total disaster!
|
@dfisher_p2
|
The manager's amendment included the increase of the inflator
used for per-capita Medicaid inflation +1%
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@misterchambo
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Solutions for healthcare include: expanded HSAs, Price
transparency, HD catastrophic policies and DPC. Will reduce cost.
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@misterchambo
|
Or, more succinctly put, get insurance companies and government
out of healthcare! Funding yes, medical direction no.
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@drlindamd
|
Great points! I agree and I honestly think they are no solution
to most people.
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@dfisher_p2
|
But, block grants would not be available for the elderly and
disabled.
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@dfisher_p2
|
Managers amendment also accelerates the repeal of all other ACA
taxes from 2018 to 2017
|
@drlindamd
|
Do you think this will have a big impact?
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@dfisher_p2
|
Still no help for the low-income, elderly (or nearly elderly)
individuals
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@drlindamd
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I think if this happens, we are going to see the frailest left
with minimal coverage.
|
Topic #2: What’s the most impactful change in “manager’s
amendment” to #AHCA made by House Republican leaders late Monday night?
|
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@rogerbeauchamp
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Correct! And 3rd party keeps 25 to 31 percent of the premium
dollars, even those spent for primary care
@ShimCode Comment: IMO and that of
many others, the above comment is ignorant of reality and history. And also
ignorant of the key Medical Loss Ratio mandate passed in the ACA.
|
@jorient
|
Maybe >50% of $3 trillion goes to something that provides no
medical goods or service to actual person
|
@misterchambo
|
Agree on exec salaries. Much better results with waste, fraud
and abuse. Get middlemen out of the equation.
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@jorient
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Problem is 90% of expenditures go thru 3rd party. Drain the
swamp!
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@jorient
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Tax credits should go to taxpayers, not insurance companies
@ShimCode Comment: A generally bad idea! Many people may keep
the money and not pay their insurance premiums.
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@drlindamd
|
Excellent point! But no one is looking at these 3rd parties too
much: insurance cos., big pharma.....
|
Medicaid Block Grants & Giving Power Back to the States |
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@drlindamd
|
States would be allowed to choose a block grant rather than a
per capita cap.
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@dfisher_p2
|
States would be able to choose a block grant rather than a per
capita cap to fund their adult and children populations
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@dfisher_p2
|
Manager’s amendment takes $1B to fund the administration of the
Medicaid per capita cap/Patient State Stability Fund
|
@mloxton
|
Selling insurance across state lines is fine by me so long as
they meet the higher of state and federal specs
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@drlindamd
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Agree. But I still don't think it will help the people who can't
afford it too much.
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@mloxton
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Interesting that the "sell across states" thing may
create a gap for telehealth to grow
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@jorient
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Avoiding state mandates is whole point of cross-state purchase.
Guaranteed issue (pre-existing’s) kills individual market
|
@jorient
|
Redistributing exec salaries: a drop in the bucket. Only a small
piece of losses to the Swamp
|
@bburtcpa
|
I’m not for this Trump law, but this is wrong headed logic. The
taxes were an abomination to begin with to introduce failed Socialist policy.
|
Topic #3: What will result, good & bad, from @SpeakerRyan’s
plan to eliminate payroll taxes that help pay for #Medicare?
|
|
@mloxton
|
I think the HSAs tie up money, block grants are a sneaky way to
throw people of insurance, and caps are just cruel
|
@mloxton
|
Unclear, but likely to be a logistical and HR nightmare
|
@drlindamd
|
Medicare will not be able to continue. It needs to be funded
somehow.
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@jorient
|
All Ponzi schemes die. Medicare is in deficit financing
situation.
|
@jorient
|
Medicare promised it was only about funding. Whose bread I eat
his song I must sing
|
Topic #4: @cynthiaccox of @KaiserFamFound posted this chart to
show what happens w/ #AHCA tax credits. What do you make of it?
|
|
@dfisher_p2
|
I'll see your chart and raise you this one https://t.co/cvRsY2sRFo
|
@drlindamd
|
Tax credits will help people pay for coverage. However, premiums
are rising.
|
@drlindamd
|
Tax credits will not fix rising premiums/deductibles. Health
insurance still unaffordable for many.
|
Direct Primary Care and Insurance Companies
|
|
@jorient
|
Cheaper and better to buy care directly for needy. Why should
managed-care cartel get even 15%?
|
@misterchambo
|
Agreed 100% on direct purchase for needy! Two Medicaid DPC
pilots being worked on right now w/a possible third!
|
@jorient
|
Why is insurance a Holy Grail? It profits from selling something
people can't or don't use.
|
@laughinhart
|
Insurance used to be helpful until Government got into
healthcare.
|
@mloxton
|
Because it's "the market" and Wall St loves loves
loves it. From any other perspective, it's just waste, adds no value
|
@jorient
|
Why not mandate as condition of employer tax exclusion that
workers could take insurance value of health plan in cash?
|
@mloxton
|
From a value chain pov, health insurance has almost zero value
add. In QI terms "Muda" that should be eliminated :)
|
@physicianswkly
|
But isn't #AHCA for people without insurance through work?
|
Topic #5: As a provider only, not based on political view, what
is your take on the proposed defunding of #PlannedParenthood?
|
|
@drlindamd
|
Many girls and women go there for annual gyn exams and birth
control. Teenage pregnancy/STDs will increase.
|
@drlindamd
|
For many women/girls, this is the only healthcare that they
receive.
|
@mloxton
|
As an analyst and one time EMT, a cruel disaster that worsens
everything it claims to seek. It makes no medical sense
|
@dfisher_p2
|
21% of counties have no safety-net family planning alternative
should their local Planned Parenthood close
|
@dfisher_p2
|
Planned Parenthood is the nation’s leading reproductive health
care provider and advocate
|
@physicianswkly
|
Thoughts on proposal to phase out #Medicaid expansions in 2020
& restructure of funding into lump sum for each state?
|
@mloxton
|
V shortsighted except for states with dwindling population. For rest,
it's a massive time bomb that kills low SES ppl
|
@drlindamd
|
We need to make sure patients don't get hurt by this. We need to
make sure those covered are truly eligible.
|
@drlindamd
|
Many people are gaming the system. Need to eliminate fraud and
waste while not harming any patients.
|
@drlindamd
|
States will have a harder time budgeting for Medicaid.
|
Didn’t see any Trump Fans – But Several Bashers. Surprise!
|
|
@antisocial1972
|
@realDonaldTrump and why, look at his new #trumphealthcare, its
shows he #HATES WOMEN, THE POOR, PPL SUFFERING FRM MENTAL ISSUES
|
@joyouswarrior
|
@realDonaldTrump This #PresidencyThing doesn't seem to be
working out, Donnie. #UTTERFAILURE
|
Confusion about the Hashtag
There was a LOT of confusion about the hashtag associated
with the tweetchat which I believe was due to two primary reasons:
1. Was it #TrumpHealthCare or #TrumpCare?
The #trumphealthcare tag too closely resembled the politically charged
#trumpcare tag. Realistically, a more accurate hashtag would be #RyanCare. I
suggest that if @physicianswkly intends to continue these chats, that an alternate tag be
selected.
Handle
|
Tweet
|
@mandibpro
|
Linda, do we have topics, or free-flow?
|
@mloxton
|
Not seeing questions, am I missing something?
|
@physicianswkly
|
Really? they've all got the #TrumpHealthcare hashtag...
|
@drlindamd
|
Weird, I am not seeing all the tweets either even with the
hashtag.....
|
@physicianswkly
|
Is big gov't blocking us?
|
@physicianswkly
|
Are people seeing these questions?
|
@idpharmacist
|
Only if I go to your specific feed @physicianswkly - even if
checking "latest" tweets not visible? Not sure why...
|
@physicianswkly
|
Thanks! Not sure what's going on here
|
@physicianswkly
|
Gonna try retweeting the questions, b/c that seems to allow
people to see them... let us know
|
@drlindamd
|
We are using #Trumphealthcare. Not many were using it before our
first chat. Definitely will look at it before next chat
|
@physicianswkly
|
The tweetchat hashtag is #TrumpHealthcare. Just mentioned
#TrumpCare b/c that's a popular hashtag that the use of could pull more
people in
|
@physicianswkly
|
Thanks for taking over the question-asking @DrLindaMD since our
questions/tweets weren't being seen. Hope yours are!
|
2. Confusing Promotion
The chat was promoted with the #TrumpCare tag. For instance:
5 MINUTE WARNING!— Physician's Weekly (@physicianswkly) March 23, 2017
Join our tweetchat & make your voice heard on #TrumpCare / #AHCA.
Search #TrumpHealthcare & click Latest to follow along pic.twitter.com/y55aOLWQYo
The participant would have to review the above image to actually learn that the proper hashtag was #TrumpHealthCare.
Update: I stand somewhat corrected based on comment from 'anonymous.' And see my response to anonymous.
Comments on The Chat's Stats
Update: I stand somewhat corrected based on comment from 'anonymous.' And see my response to anonymous.
Comments on The Chat's Stats
Based on the generally controversial nature of healthcare
and healthcare reform in the United States, the Donald Trump presidency and the
fact that there was clear confusion as to the hashtag associated with the tweetchat,
the stats for last night's #TrumpHealthCare tweet chat should be taken with a grain of
salt. I suspect that many of the tweets intended for this chat were coded with #trumpcare and ended up not being seen - or counted in the Symplur numbers.
As a veteran of many healthcare tweetchats, I will share that 145 participants are very high number of participants for a chat; especially given there were only 296 total tweets from all those participants. Out of those 296 tweets, I filtered out over 200 as retweets and tweets that were clearly off-topic.
You can find the entire list of tweets from this chat here.
If you're interested in healthcare, healthcare reform, and healthcare data, technology and services topics, consider following me on Twitter where I share as @ShimCode.
As a veteran of many healthcare tweetchats, I will share that 145 participants are very high number of participants for a chat; especially given there were only 296 total tweets from all those participants. Out of those 296 tweets, I filtered out over 200 as retweets and tweets that were clearly off-topic.
You can find the entire list of tweets from this chat here.
If you're interested in healthcare, healthcare reform, and healthcare data, technology and services topics, consider following me on Twitter where I share as @ShimCode.
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