Category Archives: Obamacare

Obamacare Rising Costs Here and Details of New Proposal

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Brady: “Obamacare is imploding, and we’re just seeing prices skyrocket”

Our health care system continues to deteriorate under Obamacare. Americans are facing fewer choices, higher costs, and less access to the care they need. Just look at the news from last week:

  • Premiums have more than doubled under Obamacare. According to data from the previous Administration, millions of Americans are now paying twice as much—on average $3,000 more—for insurance on the individual marketplaces than they were in 2013.
  • 25 more counties will have zero Obamacare insurance options. The last Obamacare insurer in parts of Missouri, Blue Cross Blue Shield of Kansas City, announced its decision to withdraw from Obamacare’s individual marketplace in 2018. That leaves hundreds of thousands more Americans with few, if any, places to turn for coverage.

Describing the urgent need to repeal and replace Obamacare, economist Stephen Moore wrote in The Washington Times:

“If we stay with Obamacare, within a few years tens of millions will have no insurance at all that is even remotely affordable. Aetna, Humana, and other major insurers in just recent months have fled Obamacare. The Titanic has hit the iceberg and it is rapidly sinking … Here’s a prediction: by the end of the year we could have nearly half the country without insurers if this spiral continues.”

House Republicans took action to rescue the American people from this failing law by passing the American Health Care Act, which the Congressional Budget Office confirmed:

  • Lowers average premiums in the individual marketplace by 4 to 30 percent or more, depending on the state.
  • Delivers nearly $1 trillion of relief from Obamacare taxes. 

  • Provides individuals and families freedom to choose a health care plan that is right for them.Obamacare keeps wreaking havoc across the country:
    • Major insurers continue to abandon the individual insurance market in different states, making it more difficult for Americans to access coverage.
    • Humana and Aetna announced they would withdraw from Obamacare’s individual exchanges entirely in 2018.
    • The last remaining insurer in Iowa could exit the exchanges next year—leaving families in 94 out of 99 counties without a single insurer to turn to for their coverage.
    • Connecticut, Maryland, New York, Oregon, and Virginia have already projected double-digit premium rate increases for next year.

    As Ways and Means Republicans explain, Obamacare’s latest failures underscore the urgent need for the American Health Care Act—legislation passed by the House to fix our broken health care system:

    On Delivering Relief from Obamacare

    Rep. Diane Black (R-TN), Budget Committee Chairman, in RealClearPolitics: “Obamacare is a disaster, and in Tennessee, its collapse is creating dire circumstances for our citizens. Massive premium increases are making insurance unaffordable for more and more Tennesseans and rising deductibles are making it harder to get health care, even for those who have insurance. Doing nothing is not an option. Congress has taken the first step to keep our promise of repealing and replacing Obamacare.” 

    Rep. Kevin Brady (R-TX), Ways and Means Committee Chairman, in the Conroe Courier: “Although this is just the first step, it is a giant pivot in the right direction so that Americans no longer have to struggle under the $1 trillion in tax hikes brought on by Obamacare. Under the bill, Americans, especially small businesses, will no longer be forced to buy healthcare they do not want or cannot afford.” 

    Rep. Jackie Walorski (R-IN) in the South Bend Tribune: “Obamacare came with a lot of promises. But these promises were broken, and now many Hoosiers face higher premiums, fewer options, and a collapsing system … [AHCA] rescues Americans from the instability of Obamacare and begins a stable transition to a better system. It will lower premiums and strengthen markets so patients have real options they can actually afford. It will empower patients, not bureaucrats, to make health care decisions.”

    On Protecting Patients with Pre-Existing Conditions

    Rep. Erik Paulsen (R-MN) in the Minneapolis Star Tribune: “Nothing in this bill would allow an insurance company to deny someone coverage, including to those with a preexisting condition. Nothing would allow an insurance company to cancel someone’s insurance policy should they become sick. Despite claims from opponents, the bill does not classify sexual assault as a preexisting condition. For those who maintain continuous coverage, the bill does not allow insurance companies to charge an individual more simply because they have a preexisting condition. It’s also worth noting that this bill includes $138 billion to assist states in making sure everyone, including those with preexisting conditions, has access to high-quality, affordable health care.” 

    Rep. Adrian Smith (R-NE) in the Grand Island Independent: “I firmly believe we can protect access to care for those with preexisting conditions while lowering costs for the millions of Americans currently facing premiums and deductibles they cannot afford. Passing the American Health Care Act in the House was the first step, and we will continue our work in Congress to revive the health care marketplace.”

    Rep. Jackie Walorski (R-IN) in the South Bend Tribune: “This bill maintains critical protections for patients with pre-existing conditions. I have always said any replacement must protect these patients, and we make sure no one can be denied coverage due to a pre-existing condition. States can obtain a waiver of some individual and small group insurance regulations to help lower premiums or increase the number of people with coverage, as long as they implement plans—such as high risk pools—to ensure affordable coverage for those with costly medical conditions. Under these waivers, insurers can only charge high-risk patients more if they have a two-month lapse in coverage, and the bill dedicates $8 billion to help patients in such situations.” 

    On Putting the American People Back in Control of Their Care

    Rep. Carlos Curbelo (R-FL) in the Miami Herald: “I made a promise that I would fight for better healthcare for our country, for a market-based system where Americans, not special interests, are in control and can make the best healthcare choices for themselves and their families. The legislation before Congress today gets us closer to such a system.”

    Rep. Erik Paulsen (R-MN) in the Minneapolis Star Tribune: “[This debate] is about Nyla, a recently widowed mother of four who saw her premiums jump to $1,000 per month with a $13,000 deductible… this debate is about Taryn, who, after being diagnosed with a brain tumor, suddenly had her plan canceled when her insurer pulled out of the market … [AHCA] is aimed at addressing many of the shortcomings of the ACA by stabilizing insurance markets and beginning to bring down premiums. Rather than the one-size-fits-all Washington approach, we can empower states and consumers to take control of their own health care outcomes.”

    CLICK HERE to read Ways and Means Committee Chairman Brady’s statement on the AHCA.

    CLICK HERE to read a summary of the AHCA.

    CLICK HERE to read the section-by-section description of the AHCA.

Govt in Healthcare Causing Critical Doctor Shortage

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Affording medical school, impossible, paying back college loans, impossible, paying all the administrative/paperwork labor costs in practice, impossible, relying on prompt payments from government on Medicare, impossible, care by government compliance standards, impossible.

Burnout = Probable

Image result for obamacare doctor shortage

Blame Obamacare and Congress for the coming drought of doctors

When you go to the Internet or phone book today, there are hundreds of physicians listed in most urban areas. But in the next two decades, you can expect more difficulty finding a physician in your hometown — a major physician shortage is looming, thanks to Obamacare and Congress.

In the last year, I have seen many mid-career physicians leaving the practice of medicine. While the growth of mid-level hospital administrators has ballooned by nearly 3,000 percent in the last 30 years, fewer students are entering medical school. In fact, according to Compdata surveys, hospital administrators now account for a large proportion of the costs of healthcare.

The pending physician shortage will affect both primary care as well as numerous essential subspecialties. When I was in medical school, I was told that specialists, such as cardiologists, would be in abundance and I would not be able to get a job. My classmates and I were pushed towards jobs in primary care.

However, many of us chose to pursue our passions — for me, it was cardiovascular medicine. I have been a practicing cardiologist for almost 17 years now — I never had any issue with finding a job in my chosen field.

Based on a new report from the Association of American Medical Colleges, it is expected that we will see a shortfall of nearly 100,000 doctors by the year 2030. A closer look at the predictions show that we will have a shortage of 40,000 primary care physicians, as well as a shortage of nearly 60,000 physicians in specialties such as allergy and immunology, cardiology, gastroenterology, and infectious disease. In general surgery, the report predicts that there will be 30,000 fewer surgeons than are needed to provide care to those who need it.

Why Are Doctors Leaving Medicine?

A 2016 report from the Physicians Foundation found an alarming growth in burnout and dissatisfaction among practicing physicians — 47 percent of respondents in the survey indicated plans to “accelerate” their retirement and move into areas outside of clinical medicine.

The most common reason for leaving medicine included regulatory burdens and electronic health records. Nearly 63 percent indicated that they have negative feelings about the future of healthcare and only half of all physicians would actually recommend a career in medicine to their children. Many of my colleagues feel they have no voice and have no way to impact healthcare policy — even in their own institution.

As regulatory requirements and non-clinical tasks continue to mount, physicians are finding themselves spending less and less time with patients. According to 2016 research from the Annals of Internal Medicine, most doctors only spend 25 percent of their day engaging with patients — the bulk of the time is spent on non-clinical electronic and regulatory paperwork. In fact, for every hour of direct patient contact, physicians have an additional 2 hours of electronic paperwork.

Most of this is due to either mandatory electronic medical record coding (to help the hospital systems bill at the maximal levels) or due to government-mandated documentation (such as asking about gun use during office visits — most of which has never shown a survival or outcome benefit).

What Is the Solution?

These statistics should be incredibly troubling for all Americans seeking healthcare. With access already an issue in the healthcare system for many and more reforms on the way, we must do more to entice bright young minds to medicine—and retain those that are currently delivering care to millions of patients.

While the AAMC argues that the answer to averting a shortage lies in creating more training spots and allowing advanced practice nurses and physician assistants to do the work of trained physicians, the real answer to the pending crisis lies in Washington.

Congress must act to save healthcare. Years of Obamacare and the resulting increase in regulations applied to physicians have begun to erode the very core of medical care — the doctor-patient relationship. Physicians are now tasked with checking boxes and filling out forms rather than bonding with patients.

Congress has spent the first 6 months of this year simply posturing and grandstanding about healthcare rather than actually working on meaningful reform. Once again, no real physician input into the creation of a workable healthcare reform bill has been sought by those in Washington (reminiscent of how Obamacare was created). Those in Congress must listen and act now:

1. Limit Meaningless Electronic Paperwork

Currently doctors spend far too much time with electronic medical records. Electronic records, while touted to be a patient safety tool, are nothing more than a way for hospitals and healthcare systems to ensure that they are billing patients at the highest levels — capturing all possible charges. Physicians are forced to click through myriad pathways in the record in order to document their care and work and all of these pathways are carefully designed to maximize billing codes. Most doctors take home two or more hours of electronic documentation nightly in order to keep up with patient care loads.

We must streamline paperwork and balance documentation with patient care. Doctors should not be billers and coders for the healthcare system.

2. Remove Hospital Administrators from the Care Equation

In some institutions, there are more mid-level managers than physicians. These executives are not physicians and are not trained in the practice of medicine. Their primary focus is to increase market share for the healthcare system and to “manage” healthcare professionals by creating algorithms of care and regulations. Administrators will claim that their activities will help with quality improvement and patient safety. However, most of these individuals are highly compensated and I am not aware of any data that suggests their activities have ever been shown to improve patient outcomes. For most physicians, administrators are a mechanism for increasing cost of care.

Physicians should be part of the decision-making process in any healthcare system and should have a voice — currently there are very few physicians in the C-suite.

3. Remove Barriers to Patient Care

Nothing frustrates doctors more than not being able to provide care to patients. We must make healthcare more accessible and provide physicians with the resources they need to efficiently provide high-quality affordable care. We must promote the use of telemedicine and digital tools to enhance the doctor-patient interaction.

We must allow physicians and patients to build long term relationships and facilitate and promote engagement. No longer can we allow networks and insurers to dictate which doctor a patient can see — “If you like your doctor, you can keep your doctor.”

4. No Longer Allow Insurance Companies to Dictate Care

As a practicing physician, I spend a great deal of time battling with insurance companies over appropriate care for my patients. I find myself spending hours each week on the phone with an insurance company bureaucrat arguing that a particular test or therapy is indicated (even though these are supported by clinical guidelines) rather than caring for patients. We must not allow insurers to dictate how highly-trained physicians should care for their patients.

Insurers must abide by the practice guidelines and indications for tests and procedures that have been approved by major national organizations, such as the American College of Cardiology, for example.

 

 

 

United Healthcare and the Billion Dollar Fraud

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Image result for medicare

Primer:

The FBI is the primary agency for exposing and investigating health care fraud, with jurisdiction over both federal and private insurance programs. Health care fraud investigations are considered a high priority within the Complex Financial Crime Program, and each of the FBI’s 56 field offices has personnel assigned specifically to investigate health care fraud matters. Our field offices proactively target fraud through coordinated initiatives, task forces and strike teams, and undercover operations.

The Bureau seeks to identify and pursue investigations against the most egregious offenders involved in health care fraud through investigative partnerships with other federal agencies, such as Health and Human Services-Office of Inspector General (HHS-OIG), Food and Drug Administration (FDA), Drug Enforcement Administration (DEA), Defense Criminal Investigative Service (DCIS), Office of Personnel Management-Office of Inspector General (OPM-OIG), and Internal Revenue Service-Criminal Investigation (IRS-CI), along with various state Medicaid Fraud Control Units and other state and local agencies. On the private side, the FBI is actively involved in the Healthcare Fraud Prevention Partnership, an effort to exchange facts and information between the public and private sectors in order to reduce the prevalence of health care fraud. The Bureau also maintains significant liaison with private insurance national groups, such as the National Health Care Anti-Fraud Association, the National Insurance Crime Bureau, and private insurance investigative units.

UnitedHealth fudged Medicare claims, overbilled by $1 billion, feds say

Company denies wrongdoing, claims Justice Department ‘fundamentally misunderstands’ how Medicare Advantage program works

This story is a collaboration between Kaiser Health News and the Center for Public Integrity.

The Justice Department has accused insurance giant  UnitedHealth Group of overcharging the federal government by more than $1 billion through its Medicare Advantage plans.

In a 79-page lawsuit filed late Tuesday in Los Angeles, the Justice Department alleged that the insurer made patients appear sicker than they actually were in order to collect higher Medicare payments than the company deserved. The government said it had “conservatively estimated” that the company “knowingly and improperly avoided repaying Medicare” for more than a billion dollars over the course of the alleged decade-long scheme.

“To ensure that the program remains viable for all beneficiaries, the Justice Department remains tireless in its pursuit of Medicare fraud perpetrated by health care providers and insurers,” said acting U.S. Attorney Sandra R. Brown for the Central District of California, in a statement announcing the suit. “The primary goal of publicly funded healthcare programs like Medicare is to provide high-quality medical services to those in need — not to line the pockets of participants willing to abuse the system.”

UnitedHealth denied the allegations.

Tuesday’s filing marks the second time that the Justice Department has intervened to support a whistleblower suing UnitedHealth under the federal False Claims Act. Earlier this month, the government joined a similar case brought by California whistleblower James Swoben in 2009. Swoben, a medical data consultant, also alleges that UnitedHealth overbilled Medicare.

The case that the feds effectively joined on Tuesday was first filed in 2011 by Benjamin Poehling, a former finance director for the UnitedHealth division that oversees Medicare Advantage Plans. Under the False Claims Act, private parties can sue on behalf of the federal government and receive a share of any money recovered.

UnitedHealth is the nation’s biggest operator of Medicare Advantage plans, covering about 3.6 million patients in 2016, when Medicare paid the company $56 billion, according to the complaint.

Medicare Advantage plans are private insurance plans offered as an alternative to Medicare’s traditional fee-for-service option.

Medicare pays the private health plans using a complex formula called a risk score, which is supposed to pay higher rates for sicker patients than for those in good health. But waste and overspending tied to inflated risk scores has repeatedly been cited by government auditors, including the Government Accountability Office. A series of articles published in 2014 by the Center for Public Integrity concluded that improper payments linked to jacked-up risk scores have cost taxpayers tens of billions of dollars.

Tuesday’s court filing argues that UnitedHealth repeatedly ignored findings from its own auditors that risk scores were often inflated, as well as warnings by officials from the Centers for Medicare & Medicaid Services (CMS) that the firm was responsible for ensuring the billings it submitted were accurate.

UnitedHealth argued that it had done nothing wrong, and said it would aggressively contest the case.

“We are confident our company and our employees complied with the government’s Medicare Advantage program rules, and we have been transparent with CMS about our approach under its unclear policies,” UnitedHealth spokesman Matt Burns said in a statement.

Burns went on to say that the Justice Department “fundamentally misunderstands or is deliberately ignoring how the Medicare Advantage program works. We reject these claims and will contest them vigorously.”

A spokesman for CMS, which has recently faced congressional criticism for lax oversight of the program, declined comment.

Central to the government’s case is UnitedHealth’s aggressive effort, starting in 2005, to review millions of patient records to search for missed revenue. These reviews often uncovered payment errors, sometimes too much and sometimes too little. The Justice Department contends that UnitedHealth typically notified Medicare only when it was owed money.

UnitedHealth “turned a blind eye to the negative results of those reviews showing hundreds of thousands of unsupported diagnoses that it had previously submitted to Medicare,” according to the suit.

Justice lawyers also argue that UnitedHealth executives knew as far back as 2007 that they could not produce medical records to validate about one in three medical conditions Medicare paid UnitedHealth’s California plans to cover. In 2009, federal auditors found about half the diagnoses were invalid at one of its plans.

The lawsuit cites more than a dozen examples of undocumented medical conditions, from chronic hepatitis to spinal cord injuries. At one medical group, auditors reviewed records of 126 patients diagnosed with spinal injuries. Only two were verified, according to the complaint.

The Justice Department contends that invalid diagnoses can cause huge losses to Medicare. For instance, UnitedHealth allegedly failed to notify the government of at least 100,000 diagnoses it knew were unsupported based on reviews in 2011 and 2012. Those cases alone generated $190 million in overpayments, according to the suit.

While Medicare Advantage has grown in popularity and now treats nearly 1 in 3 elderly and disabled Medicare patients, its inner workings have remained largely opaque.

CMS officials for years have refused to make public financial audits of Medicare Advantage insurers, even as they have released similar reviews of payments made to doctors, hospitals and other medical suppliers participating in traditional Medicare.

But Medicare Advantage audits obtained by the Center for Public Integrity through a court order in a Freedom of Information Act lawsuit show that payment errors — typically overpayments — are common.

All but two of 37 Medicare Advantage plans examined in a 2007 audit were overpaid — often by thousands of dollars per patient. Overall, just 60 percent of the medical conditions health plans were paid to cover could be verified. The 2007 audits are the only ones that have been made public.

CMS officials are conducting more of these audits, called Risk Adjustment Data Validation, or RADV. But results are years overdue.

IG Report: Improper Accounting at HUD, $516 Billion

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What We Found  Full 126 page Inspector General Report is here.

Image result for julian castro hud

Of note, Speaker Boehner hired a law, Jonathan Turley to represent the House in a lawsuit, where Treasury under Barack Obama was ordered to take monies from other agencies to fund Obamacare and pay insurers. That lawsuit case is found here. Where is the case now? In May 2016, Collyer ruled that the payments were illegal. The case is already on appeal to the D.C. Circuit and will probably be argued in early 2017.

Meanwhile, how about fraud at HUD, where Julian Castro was Secretary? Julian is a radical and a LaRaza advocate. Further, Politico reported that Julian Castro’s name was floated early as a Hillary running mate.

Image result for julian castro hillary clinton   Back to the half a trillion dollars….

The total amounts of errors corrected in HUD’s notes and consolidated financial statements were

$516.4 billion and $3.4 billion, respectively. There were several other unresolved audit matters,

which restricted our ability to obtain sufficient, appropriate evidence to express an opinion.

These unresolved audit matters relate to (1) the Office of General Counsel’s refusal to sign the

management representation letter, (2) HUD’s improper use of cumulative and first-in, first-out

budgetary accounting methods of disbursing community planning and development program

funds, (3) the $4.2 billion in nonpooled loan assets from Ginnie Mae’s stand-alone financial

statements that we could not audit due to inadequate support, (4) the improper accounting for

certain HUD assets and liabilities, and (5) material differences between HUD’s subledger and

general ledger accounts. This audit report contains 11 material weaknesses, 7 significant

deficiencies, and 5 instances of noncompliance with applicable laws and regulations.

What We Recommend

In addition to recommendations made in audit reports 2017-FO-0001, 2017-FO-0002, and 2017-

FO-0003, we recommend that HUD (1) reassess its current consolidated financial statement and

notes review process to ensure that sufficient internal controls are in place to prevent and detect

errors, (2) evaluate the current content of HUD’s consolidated note disclosures to ensure

compliance with regulations and GAAP, and (3) develop a plan to ensure that restatements are

properly reflected in all notes impacted.

On November 15, 2016, we issued an independent auditor’s report1 stating that the U.S.

Department of Housing and Urban Development (HUD) was unable to provide final fiscal years

2016 and 2015 consolidated financial statements and accompanying notes in a timeframe that

would allow us to obtain sufficient, appropriate evidence to determine whether they were free

from material misstatement. We also reported on the delays encountered in the material

weakness, Weak Internal Controls Over Financial Reporting Led to Errors and Delays in the

Preparation of Financial Statements and Notes.2

The delays were due to insufficiently designed and implemented financial reporting processes

and internal controls that were put into place because of HUD’s transition of its core financial

system to a Federal shared service provider (FSSP). HUD inadequately planned and tested the

changes to HUD’s financial reporting process before the transition. Additionally, late

restatements performed by HUD’s component entities, the Government National Mortgage

Association (Ginnie Mae) and Federal Housing Administration (FHA), contributed to the delay

in providing final consolidated financial statements.3 As a result, we were unable to provide an

opinion on HUD’s fiscal years 2016 and 2015 financial statements. While there were other

material matters that supported our basis for disclaimer, this was the primary reason for our

disclaimer of opinion.

Proposed Trump Budget, Chain Saw or Scalpel?

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Back in January, The Hill reported on early meetings the Trump team was having to address the proposed governmental budget. Yippee…finally. However, are all the proposals a good thing once they are introduced? Trump’s White House wants to cut $10.5 TRILLION in 10 years. He is working to increase Pentagon spending by $54 billion.

***

Staffers for the Trump transition team have been meeting with career staff at the White House ahead of Friday’s presidential inauguration to outline their plans for shrinking the federal bureaucracy, The Hill has learned. The changes they propose are dramatic.

The departments of Commerce and Energy would see major reductions in funding, with programs under their jurisdiction either being eliminated or transferred to other agencies. The departments of Transportation, Justice and State would see significant cuts and program eliminations.

The Corporation for Public Broadcasting would be privatized, while the National Endowment for the Arts and National Endowment for the Humanities would be eliminated entirely.
Overall, the blueprint being used by Trump’s team would reduce federal spending by $10.5 trillion over 10 years.

*** So far, so good.

Okay, there are more clues, and you can decide for yourself.

The White House is proposing a 17% cut to the nation’s top weather and climate agency, the National Oceanic and Atmospheric Administration (NOAA).

A $1.3 Billion cut to the Coast Guard.

There are other agencies that will be affected and they can lobby their case for more funding once the budget is presented, reviewed and accepted.

The budget plans that the White House is expected to send to departments and agencies on Monday are just one stage in a lengthy process.

The agencies can argue for more funding, and final spending plans must be approved by the U.S. Congress.

Trump’s budget assumes annual economic growth of 2.4 percent, the second official said. While campaigning for the presidency last year, Trump called for a “national goal” of 4 percent economic growth.

Treasury Secretary Steven Mnuchin, speaking on Fox News earlier on Sunday, said Trump’s budget would not seek cuts in federal social programs such as Social Security and Medicare. More from Reuters.

Anyone remember the old discussion of balancing the budget? The Heritage Foundation has a money wing that has studied and examined all government agencies and has proposed the blueprint. It would be well for voters and those concerned with government budgets and spending to examine this blueprint and as such the Trump White House should do the same. The full blueprint is here and it is a stellar piece of work.

First up that must be scrutinized is ‘entitlements’. Just exactly where did that term come from anyway? Who is entitled to anything and why? If you can stomach entitlement spending and the associated charts, click here.

There are also federal government grant programs and the Trump White House has not mentioned these. The U.S. State Department is a major grant operation for non-government agencies (NGO) and click here for those details.

The Department of Justice provides grants and much of those dollars go to cities for sanctuary cities.

Then there is the Department of Agriculture with a grant program. In fact every agency has a grant operation and we have not mentioned subsidies. Whoa, that one will light your hair on fire.

As noted by the Daily Caller in 2015:

The federal government spends billions of dollars each year on business subsidies and tax credits, with most of the money accruing to large corporations, a new database reveals.

The database released Tuesday by the government accountability group Good Jobs First, called Subsidy Tracker 3.0, represents the first-ever comprehensive listing of federal economic development programs, expanding on the group’s existing database of state and local subsidies.

According to an accompanying report put out by the group, “two-thirds of the $68 billion in business grants and special tax credits awarded by the federal government over the past 15 years have gone to large corporations,” including numerous foreign firms.

C’mon White House, how about addressing the grants/subsidies/loan guarantee/pledges and types of aid to foreign countries that hate us.

First on the list is the money that should be terminated that the United States pays to UNRWA.

U.S. Funding for the Palestinian Authority and UNRWA

The Palestinian Authority is hugely dependent upon foreign assistance, which accounts for about 66 percent of its annual budget. European Union funding for the PA amounted to $600 million in 2005.[2] The United States gives $70 million directly to the PA each year, as well as $225 million for humanitarian projects through the U.S. Agency for International Development (USAID).[3] Between 1993 and 2004, the Palestinian Authority received $6.93 billion in aid from the international community.[4]

What do you want Trump to cut? Education? EPA? Section 8 Housing? United Nations? Ransom money to rogue nations? How about the waste, fraud and collusion of members of Congress? How about stopping ridiculous travel by federal government employees?

Maybe we need to look carefully too at what we NEED to be spending quality money on.

Leave your thoughts in the comments section. Thanks as it is going to be a wild ride to stop spending and reforming the tax code.