DL Open Thread: Monday, March 16, 2026
ChristianaCare Gears Up To Fight Healthcare Cost Containment Bill:
Delawareans with private insurance pay some of the highest prices in the nation for hospital services. Research also shows the state’s hospitals generally have higher profits than the national average.
New legislation sponsored by Senate Majority leader Bryan Townsend, D-Newark, aims to invest more in primary care and reduce hospital spending. But the powerful health care lobby fiercely opposes the bill.
Both sides agree that if the measure became law, it could save more than $400 million annually. But while supporters say that will save Delawareans money on their insurance premiums, hospitals say it would cripple their ability to care for patients. The last time lawmakers passed budget controls to reduce hospital spending, the state’s largest health care system, Christianacare Care sued to stop its implementation.
Senate BIll 1 aims to bolster the number of primary care doctors in the state while also capping the percentage hospital charge relative to the Medicare reimbursement rate. The state’s current primary care framework sunsets at the beginning of next year.
Insurance carriers would be required to spend at least 11.5% of their total medical costs on primary care, starting this year. It would mandate that carriers allow providers to participate in value-based care payment models. The traditional fee for service model pays medical staff by the volume of tests, procedures or visits. Value-based structures are based on patient outcomes, quality of care and spending efficiencies.
Under the measure, prices for hospital services may not exceed 250% of Medicare reimbursement rates unless the hospital or health care system is in a state global budget, which means they have a predetermined, fixed annual budget to care for their patient population.
Brian Frazee, president of the Delaware Healthcare Association, predicts devastation for state hospitals, including cuts to care and jobs.
“We need more health care here, not less,” he said. “We’re the fifth-oldest state in the country. We’re the sixth-fastest growing state. We have a generally unhealthier population than other states, especially as it relates to cancer, diabetes and obesity.”
Frazee also argued that current state hospital pricing is reasonable because Medicare reimbursement rates are substantially lower than the actual cost of care.
But researchers dispute that. RAND’s pricing transparency report tested the theory that hospitals need to charge commercial payers higher prices to offset underpayments by public payers and losses because of uncompensated care, but did not find a strong correlation between the two.
“If hospitals needed higher prices from commercial payers to compensate for low payments from Medicare, Medicaid and other low paying patients, then we would expect to see hospitals that have a really high share of Medicare, Medicaid and no-pay patients to have the highest commercial prices,” said Roz Murray, an assistant professor of health services, policy and practice at the Brown University School of Public Health. “And that relationship is just not true.”
Murray said hospital market consolidation since the 1990s has also led to higher prices. (Dingdingding.)
Supporters of the legislation argue that the hundreds of millions of anticipated savings by capping prices to 250% of Medicare or through a global budget arrangement would lower insurance premiums and out-of-pocket costs for employees. They point to Oregon, which capped prices at 200% of Medicare for state employees and teachers, as a success story.
Still, even if the bill, which will be heard in committee for the first time on March 18, sails through the General Assembly, it would still face a possible legal challenge. A request for comment about the legislation to Gov. Matt Meyer’s office received no response. (Does this mean that Matt Meyer’s wife will have the final say on whether this bill becomes law?)
First committee hearing is on Wednesday,
Trump Already Won. I agree with this, although we’re not talking ‘won’ in the traditional sense. Did Hegel figure it out 200 years ago? A highly-recommended read:
“House Democrats are on the verge of a takeover,” Minority Leader Hakeem Jeffries predicted last month. And while he is obligated to sound optimistic, he is not wrong. The war in Iran is highly unpopular. Gas prices are about to go through the roof. Democrats might well take back the House in November. They might even be in strong position to take back the White House in 2028. On our current trajectory, it seems quite possible, even likely, that Trump will end his second presidency unpopular, ineffective and roundly repudiated by voters.
But too many Democrats are missing the forest for the trees. Yes, Trump himself may soon be disgraced, but he and his administration have set in motion long-term changes that are going to be with us for the foreseeable future. Trump, it is increasingly clear, is a figure of enormous historical significance who is reshaping America and the globe in ways that will not easily be undone by Democratic wins in future elections.
Liberals, naturally, would like to believe the opposite: that once they triumph at the ballot box, all can go back to normal. “Time will show the Trump era to be less turning point, more freakish aberration,” Simon Tisdall, a foreign affairs columnist for The Guardian, wrote in December. “In history’s bigger picture, Trump is a blotch, an unsightly smear on the canvas.”
This could not be more wrong. And the ill-conceived but also era-defining war in Iran — the seventh country that Trump has attacked in his second term — is just the latest manifestation of how Trump is irrevocably changing our world.
My confidence in this prediction derives from an unlikely source. To try to make sense of Trump’s presidency, I recently returned to G.W.F. Hegel’s “Lectures on the Philosophy of History,” which I had read many years ago when I was trying to understand his influence on Marxism. This may seem to be an unnecessary diversion — like studying quantum mechanics in order to repair a car — but Hegel’s theory of history maps remarkably well onto our current situation.
Hegel viewed history as consisting of stages punctuated by times of upheaval. He assigned to what he called “world-historical individuals” a special role in spurring the transition from one era to another. These individuals didn’t necessarily grasp the full import of what they were doing, and their actions, while transformative, didn’t necessarily result in the outcomes they intended. Trump, I have come to believe, is exactly such an individual: He is speeding the transition from one historical era to another. The ultimate results are very unlikely to line up with his exact ideological aims, but they will be profound. And the world is never going back to what it was.
I’ll leave it to you to read through Hegel’s view of situations like that which currently concerns us. However:
These leaders often leave death and destruction in their wake. To achieve their results, Hegel writes, “They must trample down many an innocent flower, crush to pieces many an object in its path.” To many of their contemporaries, they may seem to be monsters. They “appear to have done everything under the impulse of some passion, more grand — some morbid craving — and on account of these passions and cravings to have not been moral men.”
Hegel saw the stages of history as naturally progressing in a positive direction. But shorn of that Enlightenment optimism, the parallels to today are considerable. When Trump burst onto the political scene in 2015, he entered a world where a consensus that had prevailed for decades was rapidly breaking down. The consensus had several names and overlapping premises. The economic component went by “neoliberalism” or “market liberalism” and consisted of a belief that the U.S. and the rest of world could achieve peace and prosperity through the free flow of goods, capital, currency and labor. Its crowning achievement was the World Trade Organization, which began in 1995.
In the early 2000s, this consensus fell victim to a series of historical fiascoes. American invasions failed in Iraq and Afghanistan. The Great Recession cast doubt on the reliability of free markets. Porous borders led to soaring illegal immigration in the U.S. and Europe. The fear of migrants became fused with the fear of Islamist terrorist attacks. NATO expansion plans provoked Russia into war in Georgia and Ukraine. China’s entrance into the WTO caused a massive loss of factory jobs in the U.S. and Western Europe. And far from becoming a liberal democracy, Beijing remained a dictatorship, one that threatened its neighbors.
When established political leaders failed to recognize that the old order was disintegrating, politicians and populist movements sprung up on the left and right that did. And the most important of these was Trump and his MAGA movement.
This entire piece is well worth reading. Cut to the chase:
Even if Democrats win in 2026 or 2028, it is increasingly difficult to imagine important parts of Trump’s legacy being reversed. Given recurring imbalances in the international economy, could any future president really resurrect the old dream of free trade? Remember that Joe Biden retained Trump’s tariffs from his first term. Going forward, countries are likely to emphasize bilateral and regional trade agreements, as well as government policy aimed at protecting key industries. Trade may begin to look more like it did 100 years ago, between the world wars.
Trump has also likely dealt a death blow to numerous international institutions. His Board of Peace, dominated by illiberal democracies and autocracies, is unlikely to last, but it has still exposed the impotency of the U.N. and its Security Council. He has undermined, perhaps fatally, the trust that held together America’s post-World War II alliances. NATO temporarily lost its rationale after the Cold War ended, but it appeared to revive in response to Russia’s invasion of Ukraine. After a lame attempt to reach an agreement between the warring parties, Trump has largely withdrawn from the conflict. By the time Trump leaves office, the defense of Ukraine may have become a lost cause — and with it, the bond between the United States and its erstwhile NATO allies. To make matters worse, Trump has sent mixed signals about his commitment to Article 5, which requires NATO countries to come to the aid of any members who are attacked. America’s Asian allies, which depend on our nuclear umbrella, have taken note.
You get the picture.
Yet One More Bizarro Trump Appointee:
Brendan Carr, the chairman of the Federal Communications Commission, threatened on Saturday to revoke broadcasters’ licenses over their coverage of the war with Iran, his latest move in a campaign to stomp out what he sees as liberal bias in broadcasts.
As the war entered its third week, Mr. Carr accused broadcasters of “running hoaxes and news distortions” in a social media post and warned them to “correct course before their license renewals come up.”
“Broadcasters must operate in the public interest, and they will lose their licenses if they do not,” he said.
Mr. Carr shared a Truth Social post by President Trump that criticized the news media for its coverage of the war with Iran. Mr. Trump referred to a story published by The Wall Street Journal that reported five American refueling planes had been struck in Saudi Arabia, claiming its headline was “intentionally misleading.” He accused the news media of wanting the United States to lose the war.
Carr’s a real piece of excrement:
Carr became chairman after the Trump’s second inauguration on January 20, 2025, although he lacked a Republican majority, pending the confirmation of Olivia Trusty. That month, Carr ordered an investigation into NPR and PBS sponsorships as a violation of commercial advertising regulations and stated that he did not believe Congress should continue to fund both organizations. The following day, he requested a transcript of vice president Kamala Harris’s interview on 60 Minutes;[42] the FCC released the transcript in February. Earlier in January, Carr reopened a complaint against WPVI-TV that had been dismissed by his predecessor as FCC chair, over ABC’s moderation of the September 2024 presidential debate between Trump and Harris.
Carr heralded a shift in the FCC’s purpose towards leveraging the bully pulpit against opponents of Trump’s ideology. An ally of Musk he awarded Musk’s SpaceX federal radio spectrum, In April, Carr urged European countries to sign contracts with SpaceX over Chinese competitors.
There’s so much more including, but not limited to, Jimmy Kimmel. Like virtually all of Trump’s second-term appointees, he is perverting the purpose of the agency he heads.
Trump ‘Demands’ That Other Countries Reopen The Strait Of Hormuz. He has officially become a tinhorn dictator:
“I’m demanding that these countries come in and protect their own territory, because it is their territory. It’s the place from which they get their energy. And they should come and they should help us protect it,” Trump said.
“Why are we maintaining the Hormuz Strait when it’s really there for China and many other countries? Why aren’t they doing it?”
I’ll hazard a guess. Could it be because we started a war there that led to the closing of the Strait? There’s more:
With the Iran war entering a third week and the price of oil reaching nearly $105 a barrel on Monday, President Trump again urged NATO countries and China to help the U.S. secure the vital Strait of Hormuz.
None of the countries have publicly committed to Trump’s request, and the president upped the ante in an interview with The Financial Times late Sunday, saying their failure to do so would “be very bad for the future of NATO.”
He broke it, he bought it.
What do you want to talk about?
