Thursday, July 27, 2017

The Macro View – Health, Financial And Political News Relevant To E-Health And The Health Sector In General.

July 27, 2017 Edition.
On the overseas front we now see President Trump wondering can he pardon all his staff (and himself maybe) to get round the concerns with the relations with President Putin and shut down his potential problems. Heavens we have now moved to fantasy concerns…
Additionally Trump is in awful trouble with his so called ‘health care reform’ legislation. This is looking like a problem that could really cause problems and we see the US moving towards being ungovernable.
This explains:
  • Jul 20 2017 at 9:43 AM

Donald Trump cannot make America govern itself again

by Edward Luce
Let us give Donald Trump a pass. The last time Congress enacted a serious law was more than seven years ago, which was well before he turned up.
That was Barack Obama's healthcare reform, which is turning into Mr Trump's nightmare. He just cannot get that law off the books.
Congress is a sausage factory that has forgotten how to make sausages. Now Mr Trump wants it to make the largest sausage imaginable: a big tax reform package. But what does Mr Trump know about sausages?The answer is little.
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In Australia we have a new mega ministry covering security and the Government suggesting that our economy is wonderful and growing well. Time will tell if that  is really true. Behind all this the Turnbull / Abbott imbroglio being ongoing. I wonder how this will turn out as well.
Here is the claim:

Economy on the rise, says Morrison

  • The Australian
  • 12:00AM July 20, 2017

David Uren

Scott Morrison will today launch a strident defence of the government’s fiscal strategy, warning that an earlier than planned return­ to budget surplus risks dampening an economy that is gathering momentum for the first time in ­almost a decade.
The Treasurer will tell the Melbourne Institute/The Australian Economic and Social Outlook Conference that the turnaround in economic momentum is evident in published financial data and in the increasing optimism about the outlook from the ­Reserve Bank and the Inter­national Monetary Fund.
“This is not some pipe dream or mirage on the horizon, but an emerging picture that can give us confidence,” he says.
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Here are a few other things I have noticed.
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National Budget Issues.

The signs stocks could be heading for a fresh crash

Tara Cunningham
Published: July 16 2017 - 12:15AM
The dizzying ascent of global stocks has unnerved analysts in recent months, as lofty valuations and the prospect of interest rate hikes threaten to spark a major sell-off.
The MSCI All-Country World Index, a gauge of global stocks, set a new peak last month.
The Dow Jones hit fresh highs on Friday, while London's benchmark FTSE 100 and the German DAX hit all-time highs in June.
Even disappointing macroeconomic data fails to deter the relentless drive higher in stock markets, as investors continue to pile into stocks with overstretched valuations.
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  • Updated Jul 16 2017 at 11:45 PM

Deloitte says rates won't rise until 2018 amid 'powder keg' property market

Interest rates won't rise until 2018 and even then increases will be slow and moderate because the Reserve Bank of Australia fears igniting the housing "powder keg", Deloitte Access Economics says.
The firm's latest business outlook acknowledges global momentum to lift rates but insists it will be some time yet before the RBA is comfortable enough to act here.
The report says the RBA central bank is particularly worried about the potentially destabilising effect of lifting mortgage costs, which would add to already high rates of household debt.
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House price growth to slow further but not crash: UBS

Clancy Yeates
Published: July 17 2017 - 5:56AM
Economists at investment bank UBS are increasingly confident a "correction" is taking place in residential construction, led by a slowdown in the apartment sector. But they argue house prices are set to grow more slowly, rather than drop, due to very low interest rates and growth in population.
Scott Haslem and George Tharenou cut their forecasts for dwelling commencements for this year and next in a report to clients last week, also arguing house price growth had been "unsustainable".
After "calling the top" in housing activity in April, the economists said they had "increased confidence that a correction is unfolding" in building activity. They noted official figures that last week showed a 19 per cent year-on-year slump in dwelling unit commencements in the March quarter.
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Treasurer Scott Morrison brings loans to masses with smaller lenders classed as banks

SHARRI MARKSON, The Daily Telegraph
July 17, 2017 12:00am
TREASURER Scott Morrison will pave the way for more than 50 smaller lenders to become banks, driving Australians away from the big four and helping families get a lower home loan rate.
In a bid to lessen the power of the big four banks, the government will remove restrictions on which lenders can call themselves banks, arguing it will ramp up competition and provide more options for customers.
Similar reforms in the United Kingdom has encouraged a flood of new lenders to enter the market — prompting the big banks to match their offerings with cheaper mortgages.
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Bank tax hasn't lifted wholesale funding costs

Clancy Yeates
Published: July 16 2017 - 10:46PM
Investors do not appear to be forcing the major banks to pay more for wholesale funding as a result of the federal bank tax, despite banks saying the levy threatens to undermine the confidence of funders of Australia's financial system.
When lobbying against the tax, some in the banking industry warned the levy could damage confidence in bond markets, where lenders raise more than $100 billion a year in funding.
However, market pricing trends show there has not been a spike the cost of debt for Australian banks affected by the tax since it was announced in May. This contrasts with the impact in equity markets, where the tax is blamed as one reason for the fall in bank shares.
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Govt wants all banks to be banks

July 17, 201710:47am
Colin Brinsden, AAP Economics Correspondent Australian Associated Press
All banks will be allowed to call themselves that no matter their size under eased federal government rules to broaden competition.
The Turnbull government has released draft legislation to allow any banking business with an authorised deposit-taking institution (ADI) licence to call itself a bank.
At present, only ADIs with capital greater than $50 million are permitted to use the term 'bank'.
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Why I love a Big Australia, and you should too

Jessica Irvine
Published: July 17 2017 - 12:33AM
Nineteen seventy-four was not a good year for the Australian economy.
Widespread strike action saw industrial disputes hit a record peak of 2.5 million working days lost in the first three months of the year.
The cost of living soared 16 per cent as workers demanded higher wages, which were, in turn, largely gobbled up by higher prices.
The golden era of jobs that had followed the end of World War II came to a shuddering halt, and Australia's jobless rate jumped from 2 per cent towards 5 per cent.
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The challenge to Liberals and Nationals is to unite and focus on winning

Nick Greiner
Published: July 16 2017 - 6:13PM
The mainstream centre-right party in the Australian political system naturally needs to govern in a way which provides an attractive umbrella for voters who believe in the core values of John Howard's "broad church" which explicitly and deliberately seeks to reconcile classical liberal and conservative streams of thought.
Some of those voters will see themselves as moderate, others as conservative, many will avoid any particular label but aspire to support the party delivering strong national security, sound economic management and opportunity and a fair go for all. More often than not the practical differences among this universe of voters depend on attitudes to social issues, which are seldom uppermost in choosing a government.
My motivation in accepting the presidency of the Liberal Party is not to promote particular views (or prejudices) but to provide the best possible platform to assist the re-election of the Coalition in 2019, because that represents easily the best and safest choice of national leadership, to promote the peace and prosperity of our nation.
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'Housing powder keg' to delay sharp RBA rate hikes: Deloitte

Clancy Yeates
Published: July 17 2017 - 11:19AM
The Reserve Bank will keep official interest rates unchanged until next year, and then only increase borrowing costs slowly, because record mortgage debt has created a "housing powder keg," Deloitte Access Economics says.
In a report that also says slowing in the housing market could drag on growth, the consultancy highlights how sensitive many households are to interest rate changes, which will limit sharp increases in the cash rate, now at 1.5 per cent.
Financial markets have in recent weeks questioned whether the Reserve Bank of Australia may follow the lead of foreign central banks such as Canada's and start to signal a return to more normal interest rates.
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Somebody's got it wrong on renewables

Mathew Dunckley
Published: July 18 2017 - 12:15AM
Businesses committed to buying renewable energy, and those with no intention of doing so, all believe their decision will save them money.
That conundrum is one of the standout findings in a survey of leading Australian companies and their approach to renewable energy by the Australian Renewable Energy Agency (ARENA).
ARENA, a federal government authority, talked to about 96 of Australia's largest public and private companies and found just under half of them (46) were actively using renewable energy.
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The superannuation lobby's field of straw men

John Daley
Published: July 18 2017 - 8:02AM
The Association of Superannuation Funds of Australia (ASFA) has accused the Grattan Institute of using flawed analysis about Australians' retirement incomes. It's just the latest example of the superannuation industry preferring its own straw men to some uncomfortable truths.
One uncomfortable truth is that ASFA's measure of a "comfortable" retirement supports an affluent lifestyle more luxurious than most Australians experience during their working lives. It is a better living standard than currently achieved by more than 80 per cent of single retirees, and two in three retired couples. ASFA's standard is misleading because it implies than anyone with less will be "uncomfortable" in retirement.
Another uncomfortable truth for the super lobby is that superannuation is no magic pudding: saving more for retirement inevitably means having less today. The average household can only reach ASFA's "comfortable" benchmark in retirement by being "uncomfortable" beforehand.
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Super industry defends 'comfortable' retirement

Martin Fahy
Published: July 14 2017 - 8:28AM
Australians need to make up their own minds about the standard of living they aspire to in retirement.
To do so they need information, which is why the Association of Superannuation Funds of Australia (ASFA) publishes definitions of a "modest" and "comfortable" living standard for retirees.
A recent article in Sunday Money  criticised the "comfortable" living standard, quoting panelists at two Fairfax subscriber events on retirement. 
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Census snapshot: One million homes left empty across Australia

Eryk Bagshaw
Published: July 17 2017 - 5:43PM
Australia has 200,000 more homes sitting empty than it had a decade ago, new figures show, despite the country grappling with a housing supply shortage that is pushing the cost of a first home beyond many of its residents.
The figures from the 2016 census have been described as "cruel and immoral" by leading UNSW urban policy expert Hal Pawson, who has warned the government must act to stem the growth in unoccupied housing.
"There is gross under-occupation across Australia," Mr Pawson said, adding that there were up to a million homes with three or more extra bedrooms than the owner required.
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  • Updated Jul 18 2017 at 11:30 PM

Malcolm Turnbull clashes with corporate Australia

The Turnbull government's strained relationship with corporate Australia has come under more duress following some heated exchanges between the Prime Minister and the nation's leading chief executives at a private dinner in Sydney on Monday night.
Multiple sources, all speaking on the condition of anonymity, have told The Australian Financial Review that while there was mutual recognition that both sides needed each other and a genuine desire to be constructive, Malcolm Turnbull upbraided the business leaders for not helping out more with donations and generally not being more vocal in advocating the government's agenda.
This invited complaints from the corporate leaders that much of the government's agenda was not friendly to them. One CEO listed as examples the imposition of the bank tax, the implementation of changes to section 46 of the Competition and Consumer Act, or an effects test, an ongoing aversion towards substantial industrial relations reform, and even the decision to phase in company tax cuts over 10 years, putting big business last.
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Major banks ordered to raise capital buffers to be 'unquestionably strong'

Clancy Yeates
Published: July 19 2017 - 8:54AM
The big four banks will need to increase their loss-absorbing financial buffers by billions of dollars under higher capital requirements set by the banking regulator.
The Australian Prudential Regulation Authority on Wednesday unveiled its long-awaited views on what banks must do to be considered "unquestionably strong," as recommended by the 2014 financial system inquiry.
It said the country's largest lenders would need to increase top tier capital by about 1 percentage point under the new regime to achieve a core equity tier one capital ratio of 10.5 per cent of assets by 2020 at the latest.
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  • Updated Jul 19 2017 at 11:00 PM

APRA's unquestionably average bank capital information paper

by Rodney Maddock
The recommendation of the Financial System Inquiry that Australia's major banks should be unquestionably strong was based on the premise that they needed to retain access to offshore funding markets even during a crisis. This is probably still true even though banks are much less reliant now on short-term wholesale funding than they were.
The key point, though, is that offshore markets need to understand the strength of the local banks. The Australian Prudential Regulation Authority's paper suggests increasing the level of equity funding of Australian banks will do this. Clearly more capital will help perceptions. The paper then goes through contortions proving to itself that its new rule will make banks unquestionably strong. The contortions are necessary because APRA has a whole series of opaque rules on how banks are managed which it needs to convert into foreign equivalents. Only once these adjustments are made, is it clear how well our banks stack up globally.
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Icarus trade continues, with the next global crisis further away than you think

Ambrose Evans-Pritchard
Published: July 20 2017 - 10:04PM
Global economic expansions do not die of old age. Outside war or violent energy shocks, they are invariably murdered by central banks fearing inflation.
The fact that the post-Lehman business cycle in the US is already the third longest since the mid-19th century tells us little. The more relevant point is that consumer price growth has been falling relentlessly this year and has dropped to 1.4 per cent.
The US future inflation gauge published by the Economic Cycle Research Institute has also rolled over, and this underlying indicator suggests that it will stay low for a long time. The US has turned Japanese.
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Bill Gross backs 'go-slow' policy shifts by central banks

John Gittelsohn
Published: July 21 2017 - 7:16AM
It won't take much for the Federal Reserve to raise short-term interest rates too far, triggering an economic reversal making indebted students, corporations and other borrowers unable to repay loans, according to billionaire bond manager Bill Gross.
"Central bankers and indeed investors should view additional tightening and 'normalising' of short-term rates with caution," Gross, who runs the $US2.1 billion Janus Henderson Global Unconstrained Bond Fund, said in an investment outlook published overnight.
The Fed has hiked its short-term funds rate four times since December 2015, including twice this year. The implied probability of another rate hike in 2017 was about 40 per cent as of late Wednesday, according to data compiled by Bloomberg. The median Fed target rate is 1.375 per cent this year, rising to 2.94 per cent in 2019.
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Rates will climb and borrowers should prepare, says Malcolm Turnbull

Peter Martin
Published: July 20 2017 - 4:38PM
Interest rate are set to rise, not immediately but soon, in the view of Prime Minister Malcolm Turnbull.
Speaking at the Melbourne Institute economic outlook conference, Mr Turnbull said his reading of statements from the Reserve Bank was that "rates are more likely to go up than down, clearly".
The Bank's cash rate has been 1.5 per cent since August, a record low.
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Reserve Bank deputy puts brakes on rate hike speculation

Eryk Bagshaw
Published: July 22 2017 - 12:01AM
Australians should not read too much into the Reserve Bank board's comments on a "neutral interest rate", deputy governor Guy Debelle says, after the minutes of Tuesday's meeting set markets into a flurry on speculation the central bank would eventually like to raise interest rates to 3.5 per cent.
The cash rate remains at the record low of 1.5 per cent, but the minutes fuelled predictions the next rate rise was likely to be up, sending a warning to thousands of highly indebted Australians who may struggle to meet their mortgage repayments if banks are forced to raise interest rates.
Prime Minister Malcolm Turnbull heeded the call on Thursday, telling the Melbourne Institute that high levels of indebtedness with low levels of interest rates "always pose a risk, particularly if there's an assumption of rising asset prices".
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Bill Shorten's hip-pocket pitch: the economy's not working

Mark Kenny
Published: July 22 2017 - 8:42AM
In some ways, the next election is shaping as a battle between head and heart.
Thanks to Bill Shorten's "scene-setter" speech in Melbourne on Friday, voters could face the starkest choice in decades - either to stick with the low-tax, pro-business, growth model despite its underperformance, or junk all that in favour of a strengthened social safety net funded by higher taxes on the wealthy and corporations.
Amid the torpor bedevilling the global economy, Malcolm Turnbull is searching for a consistent line, declaring himself an "optimist" while warning that household budgets could be further strained, meaning borrowers should be "prudent" about their indebtedness. 
Clearly, this sentiment is ill-suited to jolting a flat-lining economy into sudden and care-free effervescence. The personally comfortable Turnbull might call himself an optimist but his government's failure to prevent soaring household electricity prices and now, the threat of higher mortgage rates, will more likely entrench voters as pessimists. It is an incompatibility that favours Labor.
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Health Budget Issues.

Second-best in the world no guarantee of an equitable healthcare system

Kieran Gair
Published: July 16 2017 - 3:43PM
Britain has narrowly edged out Australia's healthcare system to take the coveted top spot in a global study which ranked the quality of healthcare systems based on 72 indicators.
The study, conducted by US think tank The Commonwealth Fund, compared the healthcare systems of 11 high-income countries to measure performance in five key domains: care process, access, administrative efficiency, equity and health care outcomes.
But experts warn a self-congratulatory pat on the back risks overlooking the reality faced by some of Australia's most vulnerable patients.
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Emergency meeting over federal government’s cancer treatment technology funding changes

ROSE BRENNAN, The Daily Telegraph
July 17, 2017 12:00am
CANCER sufferers across NSW could miss out on world-class treatments as funding cuts leave hospitals uncertain how they will afford key equipment.
The Daily Telegraph can reveal advisers to Health Minister Greg Hunt and the Royal Australian and New Zealand College of Radiologists held an emergency meeting last week over fears funding changes have cut $70 million from the system.
NSW Health Minister Brad Hazzard said he was worried “states and territories may not be able to afford new equipment”.
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  • Updated Jul 16 2017 at 11:00 PM

Medibank CEO Craig Drummond says health insurance at a 'critical juncture'

Medibank chief executive Craig Drummond has called on the $20 billion health insurance industry to work more closely with the federal government to head off an affordability crisis. He plans to further invest in home healthcare services to encourage more people to seek treatment outside the hospital system.
Mr Drummond, 56, used his first anniversary running one of the country's top health insurers to highlight the nation's soaring cost of living which he warned was contributing to the mass exodus of young people from private health insurance policies.
He said the industry must focus on working with the government to reduce healthcare costs, which would result in lower premiums, and said the country relied too heavily on unnecessary hospital treatment compared with other parts of the world.
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State income taxes and hospital co-payments proposed to tackle Medicare 'blight'

Adam Gartrell
Published: July 17 2017 - 12:15AM
State governments would reclaim their constitutional powers over income tax and introduce public hospital co-payments to free themselves from the "financial blight" of Medicare, under a think tank's radical plan for federation reform.
Researchers at the libertarian Centre for Independent Studies say that only through sweeping changes to the federation can state governments prevent the cost of public hospitals swamping their budgets in an ageing Australia.
Dr Jeremy Sammut and David Gadiel argue in their new report that the funding gaps around the Gonski school reforms and the National Disability Insurance Scheme pale in comparison to the looming costs of Medicare but states seem to be in denial.
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Medibank hits the PR trail to cover failures

Michael Pascoe
Published: July 17 2017 - 3:56PM
Three days after Choice slammed the private health insurance industry, a month before he's likely to report another fall in customer numbers and a year after promising to tackle "unsustainable" healthcare costs while enjoying a multimillion-dollar salary, Medibank's chief executive appears to be playing the PR game of blame-someone-else-for-your-challenges.
And never mind that Medibank, operating in capitalism's equivalent of a sheltered workshop, with the taxpayer doing most of its work for it, is outrageously profitable despite having the industry's highest number of customer complaints.
Forgive me being a little cynical about the piece on the front page of Monday's Australian Financial Review in which the Medibank boss, former banker Craig Drummond, all but cries for his poor customers – or perhaps former customers – suffering from "the nation's soaring cost of living, which he warned was contributing to the mass exodus of young people from private health insurance policies".
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Unhealthy diagnosis for Medibank as young baulk at insurance

  • The Australian
  • 12:00AM July 18, 2017

Bridget Carter

Scott Murdoch

Medibank Private’s share price has had a choppy run in the past few months and the volatility shows no signs of ending soon.
The health insurer’s stock was sold down by 3.7 per cent yesterday after Goldman Sachs slapped a fairly robust sell recommendation on the company.
Medibank stock had been trading above the $3 mark just two months ago and closed last night at $2.79.
Chief executive Craig Drummond has just returned from a tour of the European and US health systems — good coincidental timing with the northern summer — and said Australia was now at a critical juncture.
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Early warning system exposes the rise of the gonorrhoea 'super-superbug'

Kate Aubusson
Published: July 19 2017 - 8:32AM
A critically drug-resistant strain of gonorrhoea dubbed a "super-superbug" has been detected in every Australian state and territory by a new national surveillance system.
The National Alert System for Critical Antimicrobial Resistance (CARAlert) identified 1,064 bacteria highly resistant to last-line antibiotics between 17 March 2016 and 31 March 2017 across 73 laboratories.
"These are super-superbugs," said Professor John Turnidge senior medical advisor at the Australian Commission on Safety and Quality in Health Care, which oversees CARAlert. 
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Public hospital system savings deal on hold

  • The Australian
  • 10:51AM July 19, 2017

Sean Parnell

A bold plan to find savings in the public hospital system by having governments pay a package deal or bundled price for maternity services has been put on hold.
The Independent Hospital Pricing Authority has also warned that the problems identified with bundled pricing will affect similar changes in future.
The Australian revealed last year that the IHPA, a Rudd-era financing agency, was examining whether the next efficiency drive could be in maternity services.
Maternity services were chosen because service volumes and outcomes are relatively predictable and there is huge potential for savings: in 2014-15, more than 220,000 pregnant women were admitted to public hospitals, costing about $1.5 billion to deliver their babies.
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Private health insurance fix hurdle

  • The Australian
  • 2:13PM July 19, 2017

Sean Parnell

The reform committee set up by the Turnbull government to fix private health insurance has found the task of redesigning and categorising tens of thousands of policies harder than expected.
The lack of substantive progress has prompted the former head of the government’s insurance regulation agency to call for a Productivity Commission inquiry into the sector.
After the Coalition made a series of election promises aimed at addressing concerns over the complexity and cost of insurance, the Private Health Ministerial Advisory Committee was tasked with coming up with reforms.
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Calls for action on retirement villages grow louder

Adele Ferguson
Published: July 22 2017 - 12:25AM
In December 2014, Barry O'Farrell wrote to a group of residents at a retirement village telling them he "remained of the view that a parliamentary inquiry was required" into the multi-billion dollar retirement village sector.
The letter, sent months after he stepped down as Premier of NSW after being "Granged", said the issues and concerns, if not remedied, would affect more people in coming decades given current demographic projections.
He said a parliamentary inquiry was the best vehicle to investigate the sector as it would be public, involve MPs from various parties, under the Parliament's rules, and its recommendations would have to be publicly responded to by the government within three months.
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Medicare overhaul looming, health experts say

  • The Australian
  • 9:40PM July 21, 2017

Samantha Hutchinson

The rise of chronic illness and patients presenting with multiple, serious health problems will force a reimagining of Medicare with a renewed focus on preventative medicine, expert say.
A panel discussing the future of Medicare at the The Australian/Melbourne Institute Economic and Social Outlook Conference has heard payments to doctors and general practitioners in particular need to be reconfigured to reward long-term, preventative approaches to good health and treatment.
Medicare’s current payments system, which pays doctors per service, incentivises doctors to provide short-term treatment of acute issues, the panel said.
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International Issues.

Donald Trump tells Theresa May he wants 'better reception' in Britain

Gavin Cordon
Published: July 16 2017 - 2:52PM
London: US President Donald Trump told embattled British Prime Minister Theresa May he won't come to Britain for his controversial state visit until he is sure of getting a "better reception", it has been reported.
Mr Trump was said to have told Mrs May that he had not had "great coverage" in Britain and had urged her to "fix it for me", according to The Sun on Sunday.
It was originally reported last month that Mr Trump had informed Mrs May that he did not want to go ahead with the visit if there were likely to be large-scale protests.
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With approval rating falling further, Trump blames media for 'distorting democracy'

Scott Clement and Dan Balz
Published: July 17 2017 - 7:40AM
Washington: US President Donald Trump's standing with the American people has deteriorated since the northern spring, buffeted by perceptions of a decline in US leadership abroad, a stalled presidential agenda at home and an unpopular Republican healthcare bill, according to a new Washington Post-ABC News poll.
Approaching six months in office, Trump's overall approval rating has dropped to 36 per cent from 42 per cent in April.
His disapproval rating has risen five points to 58 per cent. Overall, 48 per cent say they "disapprove strongly" of Trump's performance in office, a level never reached by former presidents Bill Clinton and Barack Obama and reached only in the second term of George W Bush in Post-ABC polling.
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  • Updated Jul 17 2017 at 10:39 AM

Jamie Dimon is right. Donald Trump’s America has big problems

Wall Street's top banker, JPMorgan chief Jamie Dimon, on Friday ripped into Washington politicians for the persistent legislative gridlock that is "holding us back, and it is hurting the average American".
"It's almost embarrassing being an American citizen . . . and listening to the stupid s--- we have to deal with in this country," he said.
Dimon is dead right.
America has serious problems. The brazenly ideological political class is woefully failing ordinary Americans. It has been for near two decades.
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Trump healthcare bill vote delayed for John McCain health reasons

Paul McGeough
Published: July 17 2017 - 11:48AM
Washington: It's a hell of a gamble when you rely on a sick man. But Senate leader Mitch McConnell had no choice when Arizona Senator John McCain was laid low on Friday, with a blood clot over his eye. McConnell was forced to cancel a Senate vote scheduled for this week on the Republicans' increasingly unpopular makeover of Obamacare.
With two GOP senators committed to voting against the bill, the numbers are thought to be evenly divided – 50 for, 50 against. But there's no guarantee that McCain, when he's back on his feet, will support the bill.
McCain has only been critical of the terms of the makeover and the secretive process by which it was drafted. And his period of recuperation, initially thought to take a week, has been seized on by critics of the new healthcare laws, as an opportunity to browbeat an estimated eight or ten GOP senators who are said to be wobbling.
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Donald Trump now says 'let Obamacare fail' as healthcare overhaul collapses

Susan Cornwell
Published: July 19 2017 - 4:17AM
Washington: Republican efforts to overhaul or repeal Obamacare collapsed in the US Senate on Tuesday, dealing a sharp setback to President Donald Trump and the Republican Party's seven-year quest to kill President Barack Obama's signature healthcare law.
As I have always said, let ObamaCare fail and then come together and do a great healthcare plan. Stay tuned!
— Donald J. Trump (@realDonaldTrump) July 18, 2017
The disarray in the Republican-controlled Senate rattled financial markets and cast doubt on the chances for getting Mr Trump's other domestic policy priorities, such as tax reform, through a divided Congress.
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Trump's deeply worrisome New York Times interview reveals a lawless president

Greg Sargent
Published: July 21 2017 - 5:26AM
Washington: US President Donald Trump's extended, rambling new interview with the New York Times provides perhaps the clearest picture yet of his conviction that he is above the law - a conviction, crucially, that appears to be deeply felt on an instinctual level - and of his total lack of any clear conception of the basic obligations to the public he assumed upon taking office.
There are numerous worrisome moments in this interview, from his incoherence on the healthcare debate ("pre-existing conditions are a tough deal") to his odd asides about history (Napoleon "didn't go to Russia that night because he had extracurricular activities, and they froze to death"). But I wanted to highlight the sum total of the picture that results from three things Trump said.
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https://www.nytimes.com/2017/07/21/opinion/republicans-bills-fail.html

Republicans Can’t Pass Bills

David Brooks

In 1990, George H.W. Bush signed the Americans With Disabilities Act, which gave disabled people more freedom to move about society. In 1996, Republicans passed and Bill Clinton signed a welfare reform law that tied benefits to work requirements so that recipients would develop the skills they need to succeed in the labor force. In 2003, Republicans passed a law giving Americans a new prescription drug benefit, which used market mechanisms to give them more control over how to use it.
These legislative accomplishments were about using government in positive ways to widen people’s options. They aimed at many of the same goals as Democrats — broader health coverage, lower poverty rates — but relied on less top-down mechanisms to get there. 
Over the past few decades Republicans cast off the freedom-as-capacity tendency. They became, exclusively, the party of freedom as detachment. They became the Get Government Off My Back Party, the Leave Us Alone Coalition, the Drain the Swamp Party, the Don’t Tread on Me Party.
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http://www.smh.com.au/world/the-problem-with-donald-trump-giving-himself-a-pardon-over-mueller-findings-20170721-gxgff2.html

The problem with Donald Trump giving himself a 'pardon' over Mueller findings
James Hohmann 

Published: July 22 2017 - 3:18AM
Washington: "When the president does it, that means it is not illegal," Richard Nixon said during a televised interview in 1977. But Nixon understood that he could never pardon himself. President Trump may not.
Four of of the best-sourced journalists in Washington reported on Thursday night that "President Trump's lawyers are exploring ways to limit or undercut special counsel Robert Mueller's Russia investigation, building a case against what they allege are his conflicts of interest and discussing the president's authority to grant pardons, according to people familiar with the effort".
"Trump has asked his advisers about his power to pardon aides, family members and even himself in connection with the probe, according to one of those people," Carol Leonnig, Ashley Parker, Rosalind Helderman and Tom Hamburger wrote in The Washington Post reported.
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I look forward to comments on all this!
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David.