8/21/2018

My Dear Friend and President, DJT,

You are getting busy again! Today you've got some meetings and then a trip to WV. You might as well buy a place in WV. Housing prices are quite affordable so you could get something really nice for a low price. Then you could spend more time there. 

Are you sure you want to invest so much energy into Patrick Morrisey's Senate race against Joe Manchin? Joe was born and raised in WV. He served as governor. He's got kids and grandkids there. Patrick showed up there in 2006 after being a lobbyist in DC. His biggest campaign promise is that he'll do what you tell him. Don't you think that folks in WV want more than that? I have a feeling they are more inclined to trust the hometown guy. Joe has supported some of your nominees. He's supported your immigration plan. He even clapped for you at the State of the Union Address. Are you sure you want to keep slinging mud at him?

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I am curious to learn what you and the union leaders will be talking about in your 20-minute meeting this afternoon. I understand that they don't like a provision in the Opioid Crisis Response Act that's up for a vote in the Senate because it changes the period of time that private payers have to foot the bill for dialysis from 30 months to 33 months. Apparently, dialysis providers make big bucks from those private insurance companies that have to pay $88,000 a year to keep folks alive. According to NEJM, dialysis patients in the US have a high mortality rate so we are paying too much for substandard care. Since it's 8% of the Medicare cost, I think you need to hire some scientists to get to work on improving that system. You'll probably have to figure out another way to pay for the opioid crisis. Maybe taxing your wealthy buddies would be a better idea. 

So many complicated problems! Are you sure you want to keep doing this job?

Have a great day,

RCA

8/22/2018

8/20/2018