U.S. Health Care Under Trump: Former Medicaid/Medicare Chiefs Square Off

https://www.commonwealthclub.org/events/2017-06-27/us-health-care-under-trump-former-medicaidmedicare-chiefs-square

Image - U.S. Health Care

Tue, Jun 27 2017 – 6:30pm

Gail Wilensky, Ph.D., Senior Fellow, Project HOPE; Former Administrator Under President George H.W. Bush, Health Care Financing Administration
Andy Slavitt, Senior Advisor, Bipartisan Policy Center; Former Acting Administrator President Barack Obama, Centers for Medicare and Medicaid Services
Mark Zitter, Chair, the Zetema Project—Moderator

Where is health care in the U.S. headed under the Trump administration? What do recent changes mean, and how will they affect consumers? Where should we be heading and why?

Now that the American Health Care Act (AHCA) has passed in the House, health care reform remains a hotter topic than ever. House Speaker Paul Ryan (R-WI) has proposed turning Medicare into a voucher program and funding Medicaid through block grants to states. Congress continues to discuss eliminating the individual mandate and providing more flexibility in terms of which benefits insurers must offer. Conservatives claim these changes would provide greater choice to consumers and more value to the federal budget, while progressives argue that these changes would reduce access to care and worsen health outcomes.

We’ll hear from two former senior officials on the ongoing efforts to repeal or repair the Affordable Care Act (ACA). Andy Slavitt recently stepped down as acting administrator for the Center for Medicare and Medicaid Services under President Barack Obama. Gail Wilensky held the same post under President George H.W. Bush. Both experts continue to speak out from differing perspectives on Medicare and Medicaid as well as broader reform issues. Join us for a spirited discussion on the problems and prospects of U.S. health care.

Location: 555 Post St., San Francisco
Time: 5:30 p.m. check-in, 6:30 p.m. program
Notes: 
In association with the Zetema Project

Why Expertise Matters

http://www.npr.org/sections/13.7/2017/04/07/522992390/why-expertise-matters?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=20170407

It's important for everyone to realize and acknowledge that there are experts who really do know more than the rest of us on certain topics, says Adam Frank.

I am an expert — a card-carrying, credential-bearing expert.

Of course, there are only a few hundred people on the planet who care about the thing I’m an expert on: the death of stars like the sun. But, nonetheless, if the death of stars like the sun is something you want to know about, I’m one of the folks to call. I tell you this not to brag or make my mom proud, but because expertise has been getting a bad rap lately. It’s worth a moment of our time to understand exactly why this “death of expertise” is happening — and what it means for the world.

The attack on expertise was given its most visceral form by British politician Michael Gove during the Brexit campaign last year when he famously claimed, “people in this country have had enough of experts.” The same kinds of issues, however, are also at stake here in the U.S. in our discussions about “alternative facts,” “fake news” and “denial” of various kinds. That issue can be put as a simple question: When does one opinion count more than another?

By definition, an expert is someone whose learning and experience lets them understand a subject deeper than you or I do (assuming we’re not an expert in that subject, too). The weird thing about having to write this essay at all is this: Who would have a problem with that? Doesn’t everyone want their brain surgery done by an expert surgeon rather than the guy who fixes their brakes? On the other hand, doesn’t everyone want their brakes fixed by an expert auto mechanic rather than a brain surgeon who has never fixed a flat?

But Nichols is profoundly troubled by the willful “know-nothing-ism” he sees around him. Its principle cause, he argues, are the new mechanisms that shape our discussions (i.e. the Internet and social media). He writes:

“There was once a time when participation in public debate, even in the pages of the local newspaper, required submission of a letter or an article, and that submission had to be written intelligently, pass editorial review, and stand with the author’s name attached… Now, anyone can bum rush the comments section of any major publication. Sometimes, that results in a free-for-all that spurs better thinking. Most of the time, however, it means that anyone can post anything they want, under any anonymous cover, and never have to defend their views or get called out for being wrong.”

Nichols also points to excesses of partisanship in politics, the weakening of expectations in schools and, finally, to human nature. The last cause, he says, is particularly troubling. As he puts it:

“Its called the Dunning-Kruger effect, which says, in sum, that the dumber you are, the more confident you are that you’re not actually dumb. And when you get invested in being aggressively dumb…well, the last thing you want to encounter are experts who disagree with you, and so you dismiss them in order to maintain your unreasonably high opinion of yourself.”

Part of the problem, says Nichols, is that while the democratization of knowledge is great, it’s threatened by the strange insistence that every opinion has equal weight. That’s an idea, he rightly says, that has nothing to do with democracy:

“Having equal rights does not mean having equal talents, equal abilities, or equal knowledge. It assuredly does not mean that ‘everyone’s opinion about anything is as good as anyone else’s.’ And yet, this is now enshrined as the credo of a fair number of people despite being obvious nonsense.”