Shawn F. Gremminger Profile Banner
Shawn F. Gremminger Profile
Shawn F. Gremminger

@sgremminger

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Health Policy Guy. Tweets are my own opinions. The world is gray. There is no panacea. Every decision involves tradeoffs.

Washington, DC
Joined February 2010
Don't wanna be here? Send us removal request.
@sgremminger
Shawn F. Gremminger
5 months
I'm at the pediatrician office for a well child visit with my daughter. Appointment was 9:20. Vitals taken and paperwork filled out, but still waiting to see a doctor. Reason #30584 of why healthcare in the US sucks. Why can every other sector keep appts, but physicians can't?
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@sgremminger
Shawn F. Gremminger
2 years
If it actually was an open border... ...then they wouldn't have been hiding in the back of a truck.
@GregAbbott_TX
Greg Abbott
2 years
At Least 42 People Found Dead Inside Truck Carrying Migrants In Texas. These deaths are on Biden. They are a result of his deadly open border policies. They show the deadly consequences of his refusal to enforce the law.
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@sgremminger
Shawn F. Gremminger
2 years
@tylerbowyer Lemme stop you right there. This isn't a "very conservative" community. By your own hypothetical reckoning, fully 59 percent of the community isn't very conservative. The ideological midpoint of the community is somewhere just left of center, in the moderate Republican camp.
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@sgremminger
Shawn F. Gremminger
1 year
@TrevorSutcliffe Native born Americans kill people at a far higher rate than immigrants. But don't let that stop you from being who you are.
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@sgremminger
Shawn F. Gremminger
5 months
@_Dehra Then schedule fewer appointments.
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@sgremminger
Shawn F. Gremminger
5 months
@TakeWeightOffMD Most other industries have managed to deal with administrative headaches while running efficient enterprises. Why can't doctor's offices?
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@sgremminger
Shawn F. Gremminger
2 years
@the_transit_guy You're saying cars don't deserve someplace beautiful to park?
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@sgremminger
Shawn F. Gremminger
2 years
The crudité is too damn high.
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@sgremminger
Shawn F. Gremminger
1 year
Do Medicaid work requirements work? It depends on what you mean. If by "work" you mean successfully kick a lot of people off coverage, thus saving states money, yes. If by "work" you mean actually increasing the number of beneficiaries who have jobs, unequivocally, no.
@JoanAlker1
Joan Alker
1 year
Reading closely text of Medicaid work requirement in McCarthy bill and this is kind of shocking: it applies to the entire Medicaid program ie c. 90 million people. States have to check everyone and explicitly exempt them. It is NOT limited to the Medicaid expansion group.
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@sgremminger
Shawn F. Gremminger
5 months
@MrFPastPuff So everyone else in the world can plan for and manage uncertainty, but physician's offices can't?
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@sgremminger
Shawn F. Gremminger
2 years
One common argument against #Medicaid expansion: You can't trust the federal government to hold up its end of the bargain - maintaining 90% match for expansion populations. FUN FACT: In Medicaid's 57 year history, the federal government has NEVER reduced federal match. (1/2)
@NabilahIslam
Nabilah Islam Parkes
2 years
Expanding Medicaid is a bi-partisan issue. When I’m in the state Senate, I’d be more than happy to work w/ my GOP colleagues to pass legislation that expands Medicaid coverage to 500k Georgians, provides funding to rural hospitals & boosts our economy.
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@sgremminger
Shawn F. Gremminger
1 year
@DMaxMTL @USConst_Amend_I Freedom of speech is...outdated?
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@sgremminger
Shawn F. Gremminger
1 year
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@sgremminger
Shawn F. Gremminger
2 years
Having been deeply involved in both these issues (No Surprises Act and hospital transparency)... this hits. I'm both proud to have helped this stuff happen...and embarrassed that, yeah, it is what it is.
@planetmoney
NPR's Planet Money
2 years
No Surprises
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@sgremminger
Shawn F. Gremminger
4 months
@sdixitmd @MrFPastPuff No, both. We should pay primary care clinicians more. Make it a more attractive field and let them have the time they need to do their jobs. But to say "I expect you to be on time but I can be late because my job is complicated" is insulting to patients.
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@sgremminger
Shawn F. Gremminger
1 year
@SteveGuest Who paid for RBG and Breyer's trips? Kind of feels like that is the point.
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@sgremminger
Shawn F. Gremminger
2 years
These reports are deeply frustrating for those of us who worked hard on the hospital transparency requirements.
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@sgremminger
Shawn F. Gremminger
1 year
@PeterSchiff @POTUS Why should the government tell private investment managers how to invest private people's money? If I don't want my money invested using ESG as a factor, shouldn't I have the freedom to choose another manager? When did you stop caring about the market?
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@sgremminger
Shawn F. Gremminger
2 years
Build it.
@UrbanistOrg
The Urbanist
2 years
In Seattle's Central Business District, a land use application for a 100-story apartment building with 1,020 homes, office, and retail has been re-noticed. The project is a half-block from the subway station. Comments accepted through March 8th:
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@sgremminger
Shawn F. Gremminger
2 years
@WarrenKinghorn @UMich @KristinCollie20 Free speech works both ways. The students who walked out didn't prevent Dr. Collier from speaking. But they used their silent speech to show their profound disagreement.
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@sgremminger
Shawn F. Gremminger
9 months
Using only a restaurant, tell us where you went to college.
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@mattyglesias
Matthew Yglesias
9 months
Using only a restaurant, tell us where you went to college
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@sgremminger
Shawn F. Gremminger
4 months
Unlike the physician twitterati, which would rather blame everyone else for long wait times, credit to the @aafp for developing good tools to help practices improve efficiency:
@sgremminger
Shawn F. Gremminger
5 months
I'm at the pediatrician office for a well child visit with my daughter. Appointment was 9:20. Vitals taken and paperwork filled out, but still waiting to see a doctor. Reason #30584 of why healthcare in the US sucks. Why can every other sector keep appts, but physicians can't?
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@sgremminger
Shawn F. Gremminger
5 months
@caseyadams360 But again, why are they shocked every day when they have mounds of paperwork? Why don't they schedule knowing that that is their reality?
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@sgremminger
Shawn F. Gremminger
5 months
@ElinWaring Right. But that happens every day. So why are physician offices incapable of planning for that?
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@sgremminger
Shawn F. Gremminger
1 year
@jonostrower Not going to disagree with the analysis, but starting with 100 CO2 per passenger as the base creates an unnecessarily distorted graphic.
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@sgremminger
Shawn F. Gremminger
7 months
Its almost like we (Ben, me, thousands of other people) told the Hill and the Admin that this is exactly what would happen if you let the providers have their way. And here we are.
@ben_ippolito
Ben Ippolito
7 months
Looks like over 75% of surprise billing arbitration decisions resulted in prices over median in-network rates (the QPA). Patients may not get surprise bills, but it's unclear that this system will actually save any money. A snippet from 2023:
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@sgremminger
Shawn F. Gremminger
1 year
@GregAbbott_TX Then why is GDP per capita so much higher I'm CA and the northeast?
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@sgremminger
Shawn F. Gremminger
2 years
@TheVandenHeuvel @spargles This is actually the best take so far. Bot because you recognize "southernness" doesn't neatly align with state borders and because these look close to right (based on my vibes). I'd quibble a little with the definitions near DC and Houston, but reasonable people can disagree.
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@sgremminger
Shawn F. Gremminger
1 year
@Tyler_The_Wise This is more complicated than it first appears and is mostly a good thing. B/w better diagnosis and better medicines, people that were once confined to psych wards are now living productive lives. But obviously we have too many ppl who need real psych help living on the streets.
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@sgremminger
Shawn F. Gremminger
5 months
@TakeWeightOffMD Right. But prior auth has been around for years. How is it that every morning physicians are surprised by having to make prior auth calls? Why is it that they schedule as if they won't have to do it and then are shocked when they do?
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@sgremminger
Shawn F. Gremminger
2 years
@nypost Tough. The Bluejays are in the playoff hunt and it isn't their job to help Aaron Judge or make his mom proud.
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@sgremminger
Shawn F. Gremminger
1 year
@ctoLarsson Okay, but crypto's still risky, though.
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@sgremminger
Shawn F. Gremminger
5 months
@CarolynMcC Once again, customers expect on-time delivery and service in every other industry, but somehow are expected to make exceptions for health care providers as if they're the only ones that have to deal with complications and circumstances out of their control.
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@sgremminger
Shawn F. Gremminger
2 years
@Alain_Mower My stock answer when someone asks "Should we ask Legal?" Only if you want to be told "no."
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@sgremminger
Shawn F. Gremminger
1 year
@DavidZipper Seems like there's a market opening for any carmakers willing to try.
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@sgremminger
Shawn F. Gremminger
2 years
Say what you want - and many people have said many things - but even the most ardent Republicans will admit (in private) that she's the most effective speaker in our lifetime.
@chrisjollyhale
Christopher Hale
2 years
We don’t say it enough — Nancy Pelosi has been one of the best speakers of the House in American history.
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@sgremminger
Shawn F. Gremminger
1 year
@APKramar @judgeglock I've thought about it for more than five seconds. I've even studied it and read the arguments for the other side. It's still a good idea and all the counter arguments are red herrings.
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@sgremminger
Shawn F. Gremminger
1 year
#340B hospitals and clinics shouldn't be allowed to buy drugs at a government-mandated discount and then mark them up for 400%.
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@sgremminger
Shawn F. Gremminger
2 years
Just got back from vacation...what'd I miss?
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@sgremminger
Shawn F. Gremminger
1 year
@RepJasonSmith In fairness, big tax increases aren't inflationary.
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@sgremminger
Shawn F. Gremminger
1 year
@Brian_Riedl One of the first truisms I learned about politics (high school) is that Presidents yet far too much credit for a strong economy and far too much blame for a weak one. Still rings true 25 years later.
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@sgremminger
Shawn F. Gremminger
2 years
@MickMulvaney I vaguely remember watching you spending a lot of time behind a podium talking to reporters. Like a lot a lot.
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@sgremminger
Shawn F. Gremminger
2 years
@JSS779 You'll keep getting messages until you go back to Pondicherri and ride in their darn taxi. Might as well start planning your next trip.
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@sgremminger
Shawn F. Gremminger
2 years
THE IFR BASICALLY SAID THE ARBITRATOR SHOULD ASSUME THE QPA IS CORRECT BARRING SIGNIFICANT OTHER FACTORS. THE NEW RULE SAYS THE ARBITRATOR MUST LOOK AT THE QPA FIRST, BUT USE OTHER FACTORS TO DETERMINE WHICH OFFER BEST REPRESENTS THE VALUE OF THE SERVICE. #surprisebilling
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@sgremminger
Shawn F. Gremminger
1 year
@AirlineFlyer My (only half joking) thought on their strategy thinking is: "Look, we are having a hard enough time building the planes we have on backlog now, let's not do something crazy like building innovative products or beating our rivals...then we'd be really screwed."
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@sgremminger
Shawn F. Gremminger
2 years
@fatsnowcat @asminnow "It's getting hot in herre. So take off all your cowling... I am getting so hot, I wanna take my cowling off." -- Nelly, possibly
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@sgremminger
Shawn F. Gremminger
1 year
@Josh20Left Love the majority of IR students, who are basically like: "Well, what kind of socialism are we talking about here?" Because unlike the other majors, they actually understand the various ways socialism has been implemented in practice.
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@sgremminger
Shawn F. Gremminger
2 years
@JasonSCampbell 55% of self-identified Republicans support legal same-sex marriage. Is this a hill elected Republicans want to die on?
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@sgremminger
Shawn F. Gremminger
2 years
The administration can rightfully exercise discretion on partially-compliant systems, but there's no reason that non-compliant systems shouldn't be fined NOW, with fines retroactive to when the rules went into effect. It's been more than two years... this is unacceptable.
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@sgremminger
Shawn F. Gremminger
2 years
Reminder: Providence is a "non-profit" hospital system that makes so much money they started their own private equity wing. And they're sending Medicaid patients to collections.
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@sgremminger
Shawn F. Gremminger
1 year
@SteveStaeger @denverparksrec Imagine banning a healthy, pro-social activity in neighborhoods because it is occasionally as loud as a typical washing machine.
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@sgremminger
Shawn F. Gremminger
4 months
A worthwhile read from the always brilliant @GeBaiDC . The money quote: "...financial interests are not well aligned between insurance companies and plan sponsors. It’s no surprise that [insurers] often negotiate uncompetitive prices, leaving plan sponsors’ money on the table."
@GeBaiDC
Ge Bai
4 months
My latest @Forbes : Why Are Cash Prices Lower Than Health Insurance Negotiated Prices? @JHUCarey @JohnsHopkinsSPH @BSPH_HPM
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@sgremminger
Shawn F. Gremminger
2 years
@LorenCrowe @danielsgoldman If any of the progressives in the race had any integrity, they would have dropped out and this wouldn't have happened. Progressives in the district have no one to blame but themselves.
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@sgremminger
Shawn F. Gremminger
4 months
When the argument is always "No margin, no mission" there is no limiting factor on what profit-seeking behavior tax-exempt hospitals will engage in. Open a private equity subsidiary? 340B at a clinic in Bevery Hills? Garnish wages for unpaid bills? "No margin, no mission!"
@GeBaiDC
Ge Bai
4 months
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@sgremminger
Shawn F. Gremminger
1 year
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@sgremminger
Shawn F. Gremminger
2 years
In the year of our lord two thousand and twenty two, the folks at @IDOT_Illinois created a name, logo, website, and twitter handle for an interchange. An interchange. In 2022. As if the last 50 years of urban development policy never happened. Folks...
@Thejanebyrne
Jane Byrne Interchange
2 years
Move over Chicago, there’s a new interchange in town. 😎 #JBI #MidCenturyModern #Meets21stCentury #IDOT
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@sgremminger
Shawn F. Gremminger
1 year
@Tyler_The_Wise Everyone hates tourists...until tourists stop showing up and the tourist economy goes bust.
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@sgremminger
Shawn F. Gremminger
1 year
Is there a TURBO #chemtrails button on the 787? 😂 Asking for a friend. cc: @JTTsteve @OMD_SkyDog
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@sgremminger
Shawn F. Gremminger
2 years
"skin in the game."
@GraceCordovano
Enlightening Results 💡
2 years
The secret to transforming #healthcare is _______________ (wrong answers only).
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@sgremminger
Shawn F. Gremminger
2 years
@Cobylefko A lot of people are responding by blaming cars. They aren't wrong that cars have forever altered urban design, but we stopped building cities that way long before cars. Better public transportation (incl. horsecars) meant wider streets and people living further from work.
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@sgremminger
Shawn F. Gremminger
2 years
@AsInMarx This is the kicker...🙄
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@sgremminger
Shawn F. Gremminger
2 years
@leokitty ¿QUATRO leches? ¿En esta economía?
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@sgremminger
Shawn F. Gremminger
11 months
@_cingraham Patrick McHenry is 50 years old. Always has been, always will be.
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@sgremminger
Shawn F. Gremminger
1 year
Now do childbirth.
@CawthornforNC
Madison Cawthorn
1 year
Unless a politician can handle a firearm, they shouldn't be allowed to make laws banning firearms.
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@sgremminger
Shawn F. Gremminger
1 year
This may be the perfect tweet.
@LarrySabato
Larry Sabato
1 year
So far Ron DeSantis has run a failing campaign. But here’s the good news: DeSantis has developed skills which, in some instances, can be applied for his personal benefit.
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@sgremminger
Shawn F. Gremminger
1 year
@_fat_ugly_rat_ Ironically, one of the oldest cities in the world. (Short answer is lots of sun plus lots of water equals lots of food in an era where food was scarce most other places.)
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@sgremminger
Shawn F. Gremminger
1 year
@LeeCEldridge @politicalmath Roe v. Wade WAS the compromise. Per Roe: * Women have the right to abort pre-viability without undue interference from the state * The state may restrict abortion post-viability * The state has a legitimate interest in protecting woman’s health and life of the fetus
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@sgremminger
Shawn F. Gremminger
2 years
Honestly, I'm fine with this, if the law is equally applied to all religious traditions. Looking forward to the State of Alabama providing public tuition assistance to Muslim schools.
@SCOTUSblog
SCOTUSblog
2 years
The Supreme Court STRIKES DOWN a Maine education program that provides tuition assistance for students to attend some private schools but excludes schools that provide religious instruction. SCOTUS says the exclusion of religious schools is unconstitutional.
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@sgremminger
Shawn F. Gremminger
1 year
@JoshEakle I don't think anyone takes nick Fuentes seriously.
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@sgremminger
Shawn F. Gremminger
2 years
If the Administration thought they were buying themselves some peace by backing off on some of the stronger #SurpriseBilling regs...well, they were wrong. Hard to imagine providers agreeing to any policy that reduces their ability to charge whatever they want for OON care.
@bobjherman
Bob Herman
2 years
The AHA and AMA are *dismissing* their lawsuit over the surprise bill law, ahead of a status hearing tomorrow. But it sounds like the hospital and doctor groups ... are just going to sue again.
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@sgremminger
Shawn F. Gremminger
1 year
@pmcondon2 @Lanefab Feels like it has more to do with physical geography and economics than building codes. To wit: what do Hong Kong, San Francisco, and Vancouver all have in common? Lots of high income earners and limited land. Now do Omaha, Houston, and Cleveland.
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@sgremminger
Shawn F. Gremminger
2 years
@Cobylefko Urban design changed radically in the 19th century. In part because of better transportation options, but also public health. Those winding medieval streets may be beautiful now, but they were the perfect breeding ground for communicable diseases, like... you know, the plague.
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@sgremminger
Shawn F. Gremminger
2 years
Don't threaten me with a good time.
@Acyn
Acyn
2 years
Kevin Brady (R-TX) warns that releasing Trump’s tax returns could lead to the release of tax returns of Supreme Court Justices
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@sgremminger
Shawn F. Gremminger
1 year
@samjcohn @smith_jsbe8786 Not true...there is strong evidence base for chiropractic for many conditions - though by no means all that some chiropractors claim they can fix / improve. Also, the incidence of traumatic injury associated with chiropractic is low:
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@sgremminger
Shawn F. Gremminger
1 year
When I was lobbying on #SurpriseBilling in previous jobs, we made the claim that surprise billing wasn't just something that some people did sometimes. It was an intentional business practice by #PrivateEquity backed physician groups. Some people scoffed.
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@sgremminger
Shawn F. Gremminger
1 year
Based @CatoHealth . Good for you, @dr4liberty .
@RepMattGaetz
Rep. Matt Gaetz
2 years
UNBELIEVABLE: Senior Fellow at @CatoHealth Dr. Jeffrey A. Singer says borders are for GOVERNMENTS and not PEOPLE! Gaetz: “Do you think everybody in the world has freedom of movement across our border?” Dr. Singer: “Unfortunately, no.”
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@sgremminger
Shawn F. Gremminger
1 year
@tontonlove @LokayFOX5 I drive in DC. The cameras are frustrating, but in all the years they've been around I have 1 speeding ticket (36 mph in K street tunnel) and 1 running a red light (stuck in intersection on Constitution during rush hour). That many tickets in 6 months is a major red flag.
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@sgremminger
Shawn F. Gremminger
2 years
Pundit 1: "We haven't blamed millennials for anything in a while. Feels like we should do that. What've we got? Pundit 2: "Inflation's a problem. Maybe that?" Pundit 1: "Inflation it is. Write it up!"
@CNBC
CNBC
2 years
Millennials are to blame for sky-high inflation, strategist says
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@sgremminger
Shawn F. Gremminger
2 years
@pruett_collin @allen_drewe Collin, the explanation for why college students are overwhelmingly voting D isn't complicated...
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@sgremminger
Shawn F. Gremminger
2 years
No that anyone remembers (and I don't blame them for not remembering random tweet threads from me from many months ago), but I predicted this. So there, I guess.
@JamesGLeckie
James Leckie
2 years
There are sign of life for Medicaid Expansion in Wyoming, South Dakota, North Carolina, Alabama, Georgia, and even Texas...
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@sgremminger
Shawn F. Gremminger
2 years
Idea: For Catholic hospitals, require at least 51% of board members to be nuns. I guarantee you will see a near immediate change in how large Catholic systems weigh mission vs. profit.
@suhas_gondi
Suhas Gondi
2 years
9/9 Curious for other thoughts and interpretations of these data. Lucky to co-lead this project with the inimitable @sanjaykishore31 and grateful for wisdom and clarity from @JMichaelMcW
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@sgremminger
Shawn F. Gremminger
10 months
@webflite P-51 in a heartbeat.
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@sgremminger
Shawn F. Gremminger
6 months
This event it going to be LIT! Ok, maybe not as lit as the Foo Fighters on Tuesday night, but still informational and interesting. A preview of my comments...the No Surprises Act has been a godsend for patients. Not so much for employers.
@SabrinaCorlette
Sabrina Corlette
6 months
Join @Julie_Appleby of @KFFHealthNews , @MattAFiedler , @sgremminger , and more for a policy briefing (and free breakfast!) on the impact of the No Surprises Act, Thursday, March. 7 Register here to save your spot:
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@sgremminger
Shawn F. Gremminger
2 years
@DailyCaller Constitutionally, all three have a responsibility to keep the others in check.
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@sgremminger
Shawn F. Gremminger
2 years
@atrupar "Clay Higgins turned the ____ hearing into a circus" is pretty much an evergreen tweet.
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@sgremminger
Shawn F. Gremminger
2 years
There is literally no amount of money you could pay me to live in The Villages. I'd rather live under a bridge. I'm 100% serious.
@SteveKornacki
Steve Kornacki
2 years
In FL-11, Laura Loomer trails Rep. Dan Webster 51-44% in the GOP primary. She actually leads by 4 in Sumter (The Villages) with just about all the votes in there, but Webster is crushing her in Orange County and ahead in Lake. Small slice of Polk in district too w/ no votes yet
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@sgremminger
Shawn F. Gremminger
1 year
@cjscalia The Supreme Court is doing a fine job delegitimizing themselves.
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@sgremminger
Shawn F. Gremminger
2 years
This is why I love @mfcannon . Troll says nasty (and untrue!) stuff about Cato. Michael responds in the most pedantic and hilarious way possible.
@mfcannon
Michael F. Cannon 🇮🇪🇺🇸
2 years
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Shawn F. Gremminger
2 years
She's not a very good hunter, evidently.
@RepMTG
Rep. Marjorie Taylor Greene🇺🇸
2 years
AR-15 is my favorite hunting rifle.
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@sgremminger
Shawn F. Gremminger
1 year
@CMichaelGibson I have an android and have never bought an apple project for my own use in my entire life. So yeah, give me $10k.
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@sgremminger
Shawn F. Gremminger
1 year
I try to avoid schadenfreude as much as I can, but there is no other way to view the literal bankruptcy of this company as anything other than poetic justice for a company that was morally bankrupt in every way.
@B_Madden4
Blake Madden 🏥
1 year
If you want some fun healthcare Sunday reading, I wrote about the rise and fall of Envision Healthcare. A classic case study in financial engineering in healthcare rather than providing any sort of real value. Read it here!
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@sgremminger
Shawn F. Gremminger
1 year
@BankerWeimar We need to have a conversation about your diet.
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@sgremminger
Shawn F. Gremminger
4 months
@813JAFERD @aafp You may be surprised to find I agree with you 100%. Primary care docs should be getting a lot more money.
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@sgremminger
Shawn F. Gremminger
1 year
@mfcannon Good point. I'd be interested in seeing the data for the decade before the ACA. I haven't studied insurer consolidation as much as provider consolidation, but the latter has been going on since the 90s. ACA didn't help, but is probably not the main cause of provider mergers.
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@sgremminger
Shawn F. Gremminger
2 years
@VPrasadMDMPH So if masks don't work and boosting doesn't work. And quarantines don't work. You're and MD and MPH...what works?
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@sgremminger
Shawn F. Gremminger
1 year
"Did you hear so-and-so left the Hill?" "No, where did she land!?!" "Well she chatted with Glover Park and Akin Gump, but the Wagner Group just lost their Ways and Means Republican, so she ended up there." "Solid move. I'll have to reach out to get coffee with her."
@jessiehellmann
Jessie Hellmann
1 year
Why is called the Wagner Group like it’s a law firm or consulting group
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