Avik Roy Profile picture
Sep 24, 2020 17 tweets 6 min read Read on X
So ⁦@realDonaldTrump⁩ is announcing his “America First Healthcare Plan” today in a spacious airplane hangar. Chairs spaced out to six feet. A lot of doctors in white coats in the room. I’ll tweet out some comments as POTUS makes his remarks. Image
Senior officials who are also appearing: @SecAzar, @SeemaCMS, @MarkMeadows.
One thing to keep an eye out for: how much of today’s discussion is about Trump’s health care policies to date (price transparency, reducing drug prices) vs. what he proposes to do in a second term.
As much as Trump is disliked by Dems, the stuff Trump has done through executive action in health care is broadly bipartisan in nature. Lots of people support price transparency, better negotiation of drug prices, etc.
Here’s how Trump’s proposals and actions on reducing drug prices line up with what @FREOPP has proposed: freopp.org/where-freopp-a…
Obviously the upcoming #SCOTUS appointment has a lot of people thinking about the Texas v. Azar Obamacare case. I seriously doubt that even with a 6-3 majority the Court’s conservatives will strike down the entirety of the ACA. I explain here: forbes.com/sites/theapoth…
In 2016, @realDonaldTrump promised “insurance for everybody.” What will he promise today? forbes.com/sites/theapoth…
Contrary to what a lot of people on the right and left believe, it is possible to achieve universal coverage with private insurance: freopp.org/key-findings-f…
Trump is highlighting Biden’s support for federally subsidized coverage for illegal immigrants. I wonder if this will come up in the first presidential debate...
“If we win,” Trump promises, we’ll have a plan that is less expensive that protects people with preexisting conditions. The exchanges are no longer “Obamacare” because the mandate was repealed.
Along with more choice, Trump talking up price transparency and the end of surprise billing as ways to lower costs. Transparency can lower costs but surprise billing reform done the wrong way can actually drive costs up.
Here is my explainer in surprise medical billing and the wrong way to reform the problem: forbes.com/sites/theapoth…
The most significant reforms Trump has proposed are the price transparency rules, which are now law, and his proposal to enact “most favored nation” pricing for Medicare drugs. I explain that policy here: forbes.com/sites/theapoth…
Trump now touting the ongoing negotiations between @MarkMeadows and the pharmaceutical industry to do something different than the executive order. Watering down the EO would be a mistake, because U.S. biologic drug prices are skyrocketing: freopp.org/the-growing-po…
Trump now highlighting another very important, bipartisan reform: site-neutral payment. Medicare overpays hospitals for services that can be delivered outside of hospitals for less. This is one of many provisions in Bruce a Westerman’s Fair Care Act: freopp.org/bruce-westerma…
Trump now talking about my favorite obscure wonky topic: the fact that Congress and President Clinton shut down the Puerto Rico pharmaceutical manufacturing industry beginning in 1996. Trump is noting that Biden supported the measure (as did many others). forbes.com/sites/theapoth…
That’s a wrap. On to #SCOTUS!

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More from @Avik

Dec 29, 2023
A week ago, popular Substacker @HC_Richardson reiterated the widely held—but factually flawed—view of most on the left that wealthy Americans don't pay their "fair share" of taxes, and that we can fix this problem by adopting European tax policies. (1/x) Image
@HC_Richardson (2/x) It's true that OECD countries generally have higher tax burdens than the U.S. does. But they don't do it by taxing the rich more—but by taxing the *middle class* more through payroll & consumption taxes. U.S. depends much *more* on progressive income taxes. Image
@HC_Richardson (3/x) In your typical EU country, the VAT tax (somewhat comparable to US sales taxes) is 21%. That's what pays for EU welfare states. The lowest standard VAT rate in Europe is Luxembourg's, at 16%. taxfoundation.org/data/all/globa…
Image
Read 7 tweets
Jul 13, 2023
THREAD: I'm honored to announce today the publication of the Freedom Conservatism Statement of Principles, signed by over 80 leaders of the liberty movement. Its core idea is this: the thing that has made America great is *freedom*. freedomconservatism.org/p/freedom-cons…
As you know, more and more people on the left and the right reject the importance of liberty. Some of these people call themselves "national conservatives" even though they reject the American political tradition in favor of...Hungary's? Forget that.
The Freedom Conservatism statement of takes inspiration from the Sharon Statement, signed by a group of young conservatives at the home of William F. Buckley, Jr., in 1960. (Buckley, the founder @NRO, built the postwar American conservative movement.) yaf.org/news/the-sharo…
Read 24 tweets
Sep 16, 2022
(1/x) Natcons claim to speak for The People™, and not the "cocktail-party class," on all issues but especially immigration. Strangely, however, the views expressed by natcons at cocktail parties don't reflect those of the American public, especially wrt legal immigration.
(2/x) Natcons are not only critics of illegal immigration, but of *legal* immigration, seeking "much more restrictive policies" and even a "moratorium." But only 33% of *Rs* support reducing legal immigration. 61% say it should stay the same or increase. pewresearch.org/politics/2018/…
(3/x) And, as a reminder, Republicans are a minority of the voting public. Overall, only 24% of Americans support reducing legal immigration. 32% support increasing it, and 38% want it to stay the same. Reducing legal immigration is, in fact, an anti-populist position.
Read 5 tweets
Aug 3, 2022
Climate & energy policy debates in the U.S. & elsewhere focus a lot on how to reduce & constrict U.S. energy use (because wind & solar can't meet current U.S. energy needs; in 2022, renewable capacity is 311 GW out of 1145 GW total).
But almost no one talks about how renewables alone are going to meet *future* U.S. energy demand. @EIAGov projects that by 2050, U.S. generating capacity will have to increase by 57% just to meet demand from population & economic growth, electric cars, etc.
In a new paper for @FREOPP, "The Urgency of Rethinking U.S. Nuclear Energy Regulation," @grantadever walks through why nuclear is the only path to a lower-carbon world with affordable, reliable, accessible energy. So what's the holdup? freopp.org/rethinking-u-s…
Read 6 tweets
Apr 15, 2022
According to my sources, the SEC/DOJ "investigation" of @ElonMusk is timed to thwart his bid for @Twitter. Normally, in the absence of a better offer, Twitter's board is effectively obligated by its fiduciary duty to shareholders to accept Musk's offer. If true, it's scandalous.
@elonmusk @Twitter (By "if true" I mean, if true that the investigation is an effort to thwart the acquisition.)
Elon has several options if the board uses the excuse of the SEC/DOJ investigation to reject his offer. For example, he can attempt to go directly to the shareholders (which, again, works in the absence of a better offer). Not sure whether he is willing to, though.
Read 6 tweets
Feb 4, 2022
This @bgmasters campaign ad pretty much crystallizes @FREOPP scholars' work on the rising cost of living: housing, healthcare, education are the biggest drivers.
@bgmasters @FREOPP All sorts of regulations—federal, state, and local—conspire to constrict the supply of housing. freopp.org/housing/home
Washington has put gasoline on the fire of rising costs in higher education, by letting colleges treat taxpayers like ATMs. freopp.org/college/home
Read 4 tweets

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