Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Thursday, December 07, 2017

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

December 07, 2017 Edition.
Two huge things are going on around the Trump Administration at present.

First Michael Flynn – his recent short lived National Security Adviser has pleaded guilty to misleading the FBI on his dealings with Russia sucking other members of the Administration closer to the flame. This could all go very badly.

Secondly the Senate Tax Cut Bill has be passed and lead to spectacular changes in the US Tax code if reconciled with the House Bill. It is suggested this might also lead to all sorts of problems and that it will be unimaginably expensive. We shall see.

And as a wild card late in the week - we have seen Trump recognise Jerusalem as the capital of Israel - causing almost universal anger!

Elsewhere to Pope has finally spoken out on the part of the Myanmar refugees and Brexit seems to be coming closer, and we have seen an assassination attempt on the British PM.


In Australia we have Parliament (the Reps) sitting! Last week chaos reigned and the we have a Royal Commission into the Financial System underway and Turnbull looking like he is for the chop with the Nats having gone rogue.

The SSM Bill awaits the finality also, but Barnaby is now back in the House!

Last – Labor has been returned in Qld.
Here are a few other things I have noticed.

Major Issues.

New bank accountability laws should be extended: inquiry

Ruth Williams
Published: November 24 2017 - 5:14PM
 New laws holding bank executives to greater account for scandals and misconduct should be broadened to cover other financial services operators, as well as to conduct causing harm to consumers, a senate committee has urged.
And the cross-party committee has called on the government to push back the rollout of the Banking Executive Accountability Regime (BEAR) laws by at least six months, after complaints by the banks and comments by the prudential regulator that the current July 1, 2018, launch date would be "challenging" to implement.
Labor and Greens senators also cautioned that, while their parties would not try to block the new laws in parliament, the BEAR bill did not reduce the need for a royal commission into the scandal-plagued banking sector.

What the world's central banks are saying about cryptocurrencies

Eric Lam
Published: November 27 2017 - 10:29AM
Eight years since the birth of bitcoin, central banks around the world are increasingly recognising the potential upsides and downsides of digital currencies.
The guardians of the global economy have two sets of issues to address. First, what to do, if anything, with the emergence and growth of private cryptocurrencies. Second, whether to issue official versions.
Following is an overview of how the world's largest central banks (and some smaller ones) are approaching the subject:

Australia's conservatives post-Queensland: the only hope is hope

Tom Switzer
Published: November 26 2017 - 2:33PM
Can the crisis of Australian conservatism get any worse? If Annastacia Palaszczuk's Queensland government is returned – and, at this stage, Labor is the favourite to win a majority – LNP rumblings will grow louder. And if the Liberals cop a massive 10 per cent swing to lose the December 16 federal byelection for the seat of Bennelong – which polls show is conceivable – the venom will fracture the Liberal movement, perhaps fatally. 
Malcolm Turnbull would need a miracle to win the next election, and you might think we're reliving history.
Go back to early 2001: Peter Beattie's Labor government was re-elected. Pauline Hanson's One Nation split the Coalition vote. A few weeks later  the Liberals lost unexpectedly the safe federal seat of Ryan with a savage 10 per cent swing. The then-Liberal prime minister, John Howard, was written off as yesterday's man. On February 19, after Labor's Queensland election victory, The Australian's front page splashed: "Howard needs a miracle."

Banking inquiry: why the big four still have a stranglehold post GFC

Jessica Irvine
Published: November 26 2017 - 8:22PM
Nobody likes it when the lawyers win.
An inquiry into Australia's banking sector would unleash a fee feeding frenzy for the silks of Sydney and Melbourne.
The substantial cost to taxpayers of a year-long inquiry - be it a royal commission reporting to government as proposed by Labor, or a commission of inquiry reporting to parliament as proposed by rogue Nationals Senator Barry O'Sullivan - would be dwarfed by the costs run up by the big banks themselves to retain an army of barristers and solicitors.
Make no mistake: it's bank customers and shareholders who will ultimately wear those costs through higher fees, or lower returns.

Australia now has 1.16m millionaires, according to Credit Suisse's Global Wealth Report

Chris Pash
Published: November 27 2017 - 10:02AM
The number of millionaires grew by 200,000 to 1.16 million in Australia over the 12 months to mid-2017, according to research by Credit Suisse.
And the number of ultra-high-net-worth (UHNW) individuals in Australia — those with a net worth of $US50 million ($65.5 million) — jumped by 30 per cent to almost 3000, according to the latest edition the Global Wealth Report.
"No other part of the wealth pyramid has been transformed as much since 2000 as the millionaire and ultra-high-net-worth individual segments," says Alex Wade, the head of Australia, and developed and emerging asia, private banking, Credit Suisse.

Health checks for older doctors to prove they're fit to practise

Aisha Dow
Published: November 28 2017 - 5:59PM
All Australian doctors aged 70 or over will have to undergo regular health checks to prove they are fit to practise, as part of a new plan to weed out dangerous medical professionals.
Those who work in isolation, such as solo GPs, will also face additional scrutiny, as will those who have received multiple proven complaints against them.
But doctors will not have to resit their exams every five years.

Medical Board reforms include fitness tests for older doctors

  • The Australian
  • 12:00AM November 29, 2017

Sean Parnell

Doctors aged 70 and over will have to prove they are fit to keep treating patients while medical students and junior medicos will be monitored for possible integrity issues under reforms proposed by the Medical Board of Australia.
After five years of development, likely to require several more years to implement, the reforms in the Professional Performance Framework were released yesterday for further consultation.
The framework proposes registered doctors take part in at least 50 hours of continuing professional development (CPD) every year to review their performance, measure their outcomes and update their education.

How evil is tech?

David Brooks
Published: November 29 2017 - 5:34AM
Not long ago, tech was the coolest industry. Everybody wanted to work at Google, Facebook and Apple. But over the past year the mood has shifted.
Some now believe tech is like the tobacco industry -- corporations that make billions of dollars peddling a destructive addiction. Some believe it is like American gridiron - something millions of people love, but which everybody knows leaves a trail of human wreckage in its wake.
Surely the people in tech -- who generally want to make the world a better place -- don't want to go down this road. It will be interesting to see if they can take the actions necessary to prevent their companies from becoming social pariahs.

OECD predicts robust Australian growth

The OECD predicts Australia should enjoy a period of robust economic growth and a further strengthening in the jobs market.
Source: AAP
29 November, 2017
A new report has brought some good news for Treasurer Scott Morrison as he puts together the mid-year budget review.
The Organisation for Economic Cooperation and Development expects the Australian economy will continue to grow at a robust pace, with the jobs market strengthening further.
In its latest economic outlook, the OECD expects business investment outside of the housing and mining sectors to pick up, with exports boosted by new LNG production.
  • Updated Nov 28 2017 at 7:17 PM

Why real wages are falling and the RBA doesn't know what to do

by P.D. Jonson
Slow wages growth is a global issue. The Reserve Bank of Australia is predicting that these wages will rise. But recent RBA predictions have been spectacularly wrong, leading successive Australian governments to gild the lily and pretend that our economic situation is easier to fix than it really is.
For decades, new workers have entered global labour markets in China, India, south-east Asia and other developing nations. These new workers bring competitive pressures on to developed nation workers. Slow growth since the global financial crisis has also weakened recovery and the bargaining power of workers. Economic 'headwinds' abound and are stalling growth.

An industry in need to help: marriage slides to an all-time low

Peter Martin
Published: November 29 2017 - 9:23AM
Same-sex marriage could be just the boost the industry needs.
Official figures released on Tuesday show Australians marrying less than at any time since Federation.
Only 4.9 marriages per 1000 Australians were registered in 2016, down from 5.8 in the 1990s, 8.0 in the 1970s and 7.0 at the turn of the 1990s.
And the Australian Bureau of Statistics believes 4.9 might be an overestimate of the marriage rate. "A larger than usual number of 2015 marriage registrations have been delayed until 2016," it reported, meaning that the total included an unusual number of marriages that took place the previous year.

Low wages growth is the real reason you are feeling the cost-of-living pinch

Ross Gittins
Published: November 29 2017 - 1:09AM
Maybe it's just me, but these days the more politics I hear on TV or radio, the less time it takes for my blood to boil. Just ask my gym buddies. "No point shouting at the radio, Ross, they can't hear you."
Last week, for instance, I heard the erstwhile Queensland leader of One Nation carrying on about what a big election issue the rising cost of living was. There was the cost of electricity ... but he ran out of examples.
High on my list of things I hate about modern pollies is the way they tell us what they think we want to hear, not what we need to know. Then they wonder why voters think they're phoneys.
  • Nov 29 2017 at 4:37 PM

Why Wilson Asset Management's chairman says it looks like 2008

There's so much bad publicity for shares and financial markets these days that there's a new theory going around as to why, despite it all, stockmarkets keep rising.
There is, quite simply, too much doom and gloom around and the shorters are getting squeezed all the time.
Despite the scary headlines of rising rates, there's just too many investors convinced they won't rise that much and too many gripped by good earnings, the upbeat global economic outlook, and of course the prospect of tax reform in the US.

Labor tax plan’s ‘$164bn burden on economy’, says Scott Morrison

  • The Australian
  • 12:00AM November 30, 2017

David Uren

Scott Morrison has commissioned extraordinary Treasury costings of Labor’s tax policies which he says would impose a “crushing” $164 billion burden on an economy that is just getting back on to its feet.
The Treasurer revealed details of the Treasury modelling in a plea to business not to forsake the ­Coalition government, declaring “Labor is not a benign option” for the economy.
“Just in case some people think they can risk their business with Bill Shorten becoming prime minister, allow me to provide a gentle and respectful warning,” Mr Morrison told the annual dinner of the Australian Chamber of Commerce and Industry last night.

PM Malcolm Turnbull announces royal commission into banking sector

Adam Gartrell, Eryk Bagshaw
Published: November 30 2017 - 11:18AM
The Turnbull government will establish a royal commission into misconduct in Australia's banking and financial services sector.
Prime Minister Malcolm Turnbull announced the stunning backflip on Thursday after bank CEOs called on the government to establish an inquiry in a bid to end the uncertainty plaguing the sector.
"The speculation about an inquiry cannot go on," Mr Turnbull said.

Scott Morrison has 'surrendered' to inequality, global think tanks say

Latika Bourke
Published: December 1 2017 - 12:06AM
London: Malcolm Turnbull and Scott Morrison's first budget "surrendered" to the politics of inequality and "retreated" from reducing government spending to balance the budget, says an essay published by Canadian think tank.
In a global collaboration, five think tanks representing the Anglosphere including Australia's Centre for Independent Studies, London's Policy Exchange, the American Enterprise Institute (AEI) and the New Zealand Initiative contributed to the Canadian Macdonald-Laurier Institute's (MLI) project on lessons on austerity for US President Donald Trump. 
The MLI cites Australia's experience in the 80s and 90s - when voters were persuaded of the need to pursue tough economic reforms to pay off the deficit and liberalise the markets - as an example of what the US should mimic in trying to reform it's own economy. 

Leadership instability and expense scandals fuel Australia's falling prosperity

Latika Bourke
Published: December 1 2017 - 4:39AM
London: A decade ago John Howard's four-term government came to an end. When the Liberal leader was booted out of office in the Kevin 07 Ruddslide, Australia was the envy of other nations, ranking as the world's most prosperous country. 
Ten years later, post the financial crisis and the seven years of political instability that began when Julia Gillard ousted Kevin Rudd, Australia just scraped into the top ten of the Legatum Institute's Prosperity Index. 
It is the country's worst performance in the annual survey since the London-based think tank began measuring prosperity across the world in 2006. New Zealand, which ranked first last year, also went backwards, losing the top spot to Norway.

Australia must wake up as world sleepwalks to war

Catherine McGregor
Published: December 1 2017 - 12:05AM
Speaking at a leadership retreat on the Gold Coast, in May this year, the former Chief of the Defence Staff Chris Barrie observed that the world was "sleepwalking" towards a global conflagration, similar to that of 1914. Having spent the better part of four decades in the Australian Defence Force I have a propensity towards realism, manifested as pessimism about the state of global affairs.
To paraphrase the Life of Brian, I always look on the dark side of life. Of course, it is the peculiar vanity of human beings to consider the era through which we are living to be of unprecedented challenges and threats.
Yet, even by my pessimistic standards, I believe that the global situation is extremely parlous, and it is deteriorating. For the first time since the Cold War, there is real risk of nuclear exchanges between major powers. Readers may be surprised that I consider the risk of a nuclear exchange between the United States and North Korea among the least likely threats of nuclear war facing the world currently.

We might have just seen an end to age of bizonomics

Ross Gittins
Published: December 2 2017 - 1:17AM
The banks and other opponents of a royal commission into banking told us it would generate a lot of noise and expense without achieving anything of value. They'll probably still be claiming that when the just-announced inquiry has reported.
Well, maybe. By contrast, I think there's a good chance the commission's establishment will be seen as the most visible marker of the time when the two sides of politics turned their backs on the era of bizonomics – the doctrine that what's good for big business is good for the economy and the punters who make it up.
The litany of misconduct by the big four banks – the unscrupulous investment advice given, the mistreatment of people with legitimate life insurance claims, the charges that the bank-bill swap rate was being rigged, and allegations of extensive use of bank facilities for money laundering – has driven the public's growing insistence that the banks be brought to account.

Australians hate hypocrites, as the Coalition and big business are finding out

Richard Denniss
Published: December 2 2017 - 12:15AM
Schadenfreude is the German word for the joy you take in the misfortune of others. It doesn't have a simple English translation, but we've all felt the joy of watching an office bully come unstuck.
In Australian politics, there is plenty of schadenfreude on offer for those who think that conservative political and business leaders have lorded it over the rest of us for a while. Take the Nationals, for example.
Most people in National Party electorates support same-sex marriage, oppose subsidies for new coal mines and want Australia to have a much bigger renewable energy target. It's not One Nation that's a threat to the Nationals; it's Nationals MPs' determination to push for deeply unpopular popicies.

National Budget Issues.

Tax cuts: lies, damn lies and bracket creep

Ross Gittins
Published: November 27 2017 - 12:15AM
If Malcolm Turnbull's promised tax cuts ever eventuate, we can be sure they'll be justified in the name of redressing terrible "bracket creep". But there are few aspects of taxation that involve more deception.
Treasury has been overselling the bracket creep story since the arrival of the Abbott government, while the Turnbull government has been exaggerating how much of it there's likely to be, so as to prop up its claim it's still on track to return the budget to surplus in 2020-21.
Every politician with their head screwed on loves bracket creep. When pressed, however, all profess to think it a bad thing. The punters think they disapprove of it, but their "revealed preference", as economists say (what they do rather than what they say), tells us they prefer it to the alternative.

Malcolm Turnbull’s tax delusion will cost all Australians

Shane Wright, Economics Editor
Monday, 27 November 2017 9:38AM
The Budget is deeply in the red. Wages growth, according to some measures, is at its slowest since the 1960s.
And for many people, either they haven’t seen a wage increase in years or have been forced into work that pays less than they were earning.
Yet Malcolm Turnbull — in one of the most blatant political diversions of recent years — has opened the door to personal income tax cuts sometime between now and next May’s Budget.

Reading between the cargo cult policy lines: screams and tears

Michael Pascoe
Published: November 29 2017 - 12:15AM
These are indeed challenging times for public policy. Listening to the federal Treasurer and reading the Business Council of Australia chief executive, I'm getting flashes of Fantasy Island.
"Ze plane! Ze plane!" Tattoo would exclaim to start the TV show.
"Ze modelling! Ze modelling!" the Treasurer and BCA incant in desperate attempts to breathe life into their centrepiece reform policy – maybe their only reform policy – tax cuts for big business.

Health Budget Issues.

Spike in Medicare bulk-billing numbers as Aussies see GPs for free

November 27, 2017 1:00am
THE number of Australians seeing their doctor without paying anything is reaching its highest levels on record.
New Medicare figures, to be released today, reveal GP bulk-billing numbers rose by 0.5 per cent to 85.9 per cent for the three months to September.
It is the highest number for the September quarter since Medicare began more than three decades ago.

Poorest 10 million Australians far more likely to die of preventable illness, rich more likely to booze dangerously

Aisha Dow
Published: November 28 2017 - 12:15AM
The often stark divide between the "haves and have nots" has been highlighted in new research showing the poorest 10 million Australians are far more likely to die of preventable illnesses, while many of the country's most affluent are more likely to engage in risky drinking.
A report from the Australian Health Policy Collaboration at Victoria University has shown that a huge proportion of the population is at high risk of dying early from chronic diseases and other often-preventable conditions.
These most disadvantaged Australians (representing 4 in every 10 people) are almost three times more likely to die of diabetes, almost 40 per cent more likely to die of cancer and more than twice are likely to die of respiratory or cardiovascular disease, compared to richer sections of the population.
November 27 2017 - 6:43PM

PM's gambit puts access to life-saving drugs at risk

·         Adam Gartrell, Health Correspondent
A plan to give seriously ill Australians faster access to potentially life-saving drugs could be delayed because of Prime Minister Malcolm Turnbull's decision to cancel a week of lower house sittings.
The government has promised to introduce a fast track for drug approvals that would give patients access to promising new prescription medicines up to two years earlier than under the current system.
The new "provisional pathway" system is due to begin on January 1 next year - but that timetable depends on Parliament's approval.

Commonwealth to cut funding for botched operations

  • The Australian
  • 12:00AM November 28, 2017

Sean Parnell

Public hospitals will no longer ­receive commonwealth funding for avoidable complications such as pressure injuries, infections and falls under a landmark bid to ­improve the standard and cost of acute care in Australia.
Under activity-based funding, public hospitals, and through them clinicians, receive money for services delivered, including those that have been botched or could have been avoided. Only since July have hospitals not been funded for the most serious mistakes.
From July 1 next year, under a decision announced by the Independent Hospital Pricing Auth­ority yesterday, public hospitals will have to absorb the cost of treating patients with certain “hospital acquired complications”. Without that funding, managers and clinicians will have another reason to improve their performance.

Rethink pregnancy cover in private health insurance – even if you want to start a family

Caitlin Fitzsimmons
Published: December 3 2017 - 12:15AM
One of the many cons to convince young people to take private health insurance is to exploit their natural anxiety around pregnancy and childbirth.
If young people weren't fooled by the ads exhorting them to take out insurance before their 30th birthday, a topic I've written on previously, they'll often decide it's necessary when they're planning to start a family.
I'd like to challenge that. Pregnancy cover adds hugely to the cost of a health insurance policy and leaves people thousands of dollars out of pocket for the delivery – for care that is probably just as good in the public system.

International Issues.

To the world, they are Muslims. To Islamic State, Sufis are heretics

Rukmini Callimachi
Published: November 26 2017 - 4:22PM
The suicide bomber who stepped inside the gold-domed shrine in southern Pakistan in February was wearing a vest packed with ball bearings, bolts and screws. When he hit the detonator, he killed more than 80 people.
To the world, they were Muslims.
But to the Islamic State, which quickly claimed credit for the attack, they were something else: Mushrikin, an Arabic word meaning polytheists.

The surprising way the Chinese Communist Party keeps power

Peter Hartcher
Published: November 28 2017 - 12:05AM
 How has China managed to become the world's most durable autocracy? An intriguing new book by an Australian academic argues that it's because it's not really an autocracy at all.
The collapse of the Chinese Communist Party has been predicted year in and year out for decades. Yet its grip on the world's most populous country has been unbroken now for 68 years. "Yes, my prediction was wrong," wrote prominent American sinologist Gordon Chang when the party outlived the prediction in his 2001 book that it would fall within 10 years. "Instead of 2011, the mighty Communist Party of China will fall in 2012. Bet on it."
Australian academic John Lee made a career out of arguing for the forthcoming collapse of China until he finally went to work for Foreign Affairs Minister Julie Bishop as an adviser last year. Judging by the government's new white paper on foreign policy, Lee has changed his mind or been overruled.

North Korea test fires ballistic missile, in further challenge to Trump

Published: November 29 2017 - 6:20AM
Seoul: North Korea fired a ballistic missile Wednesday morning for the first time in more than two months, defying demands from President Donald Trump to halt its weapons programs and raising the stakes in an increasingly tense standoff with the United States and its allies.
"North Korea launched an unidentified ballistic missile eastward from the vicinity of Pyongsong​, South Pyongan​ province, at dawn today," the South Korean Joint Chiefs of Staff said in a statement. Pyongsong, in western North Korea, is about 32 kilometres north-east of Pyongyang, the capital.
The launch was also confirmed by the Japanese prime minister's office.

White House Weighs Replacing Tillerson With Pompeo

By Jennifer Jacobs and Nick Wadhams
December 1, 2017, 3:12 AM GMT+11 Updated on December 1, 2017, 8:33 AM GMT+11
  • CIA Director Mike Pompeo may replace secretary of State
  • Trump has said Tillerson may leave by the end of the year
The White House is weighing a plan to replace Secretary of State Rex Tillerson with CIA Director Mike Pompeo, three administration officials said, amid frustration with the top diplomat’s slow pace of hiring and repeated clashes with President Donald Trump.
Trump’s staff have been debating the shakeup since at least September, according to one of the officials. Relations between White House staff and Tillerson’s inner circle have been broken since summer, when the two sides all but stopped talking, the official said.
Administration spokeswomen declined to rule out reports that Tillerson is on the way out or say that Trump has full confidence in his top diplomat. White House press secretary Sarah Sanders told reporters Thursday that “when the president loses confidence in somebody, they’ll no longer be here,” adding only that Tillerson’s “future right now is to continue working hard as secretary of state.”

North Korea reveals images of new ballistic missile - it's a monster

Jane Onyanga-Omara
Published: December 1 2017 - 5:37AM
North Korea released numerous images Thursday that it says are of the new intercontinental ballistic missile it claims is capable of striking "the whole mainland of the US."
Dozens of photos of the Hwasong-15 missile were published in state media. North Korea claims to have achieved its goal of becoming a nuclear state with the missile launch Wednesday.
Michael Duitsman, a researcher at the Centre for Nonproliferation Studies in Monterey, California, tweeted soon after the photos were published: "This is very big missile ... And I don't mean 'Big for North Korea.' Only a few countries can produce missiles of this size, and North Korea just joined the club."

Despite condemnations, Donald Trump is impervious to the uproar he causes

Philip Rucker, Ashley Parker
Published: December 1 2017 - 6:04PM
Washington: US President Donald Trump this week disseminated on social media three inflammatory and unverified anti-Muslim videos, took glee in the firing of a news anchor for sexual harassment despite facing more than a dozen of his own accusers, and used a ceremony honouring Navajo war heroes to malign a senator with a derogatory slur, "Pocahontas".
Again and again, Trump veered far past the guardrails of presidential behaviour. But despite the now-routine condemnations, the President is acting emboldened, as if he were impervious to the uproar he causes.
If there are consequences for his actions, Trump does not seem to feel their burden personally. The Republican tax bill appears on track for passage, putting the President on the cusp of his first major legislative achievement. Trump himself remains the highest-profile man accused of sexual improprieties to keep his job with no repercussions.

Former Trump adviser Michael Flynn charged with lying to the FBI

Published: December 2 2017 - 6:02AM
US President Donald Trump's former national security adviser has pleaded guilty to lying to the FBI's probe into Russian electoral meddling.
Charges against Michael Flynn were unsealed on Friday morning, local time, and he entered a guilty plea at a hearing in a Washington court hours later.
He is the fourth person connected to the Trump campaign to be charged as part of Special Prosecutor Robert Mueller's probe into Russian interference in the 2016 US presidential election.

Michael Flynn's guilty plea is an ominous sign for the White House

Published: December 2 2017 - 9:22AM
Washington: Donald Trump's former national security adviser Michael Flynn is now cooperating with investigators looking into Russian election meddling - an ominous sign that the president could be implicated in the ongoing probe.
Flynn, a former army general, pleaded guilty on Friday to lying to the FBI about conversations he had with Russian ambassador Sergey Kislyak, one of which occurred at Trump Tower in December, 2016, with Trump's son-in-law and adviser Jared Kushner.
Court papers indicate that Flynn said he was acting under instructions from senior Trump officials when he met with Kislyak to discuss sanctions imposed by President Barack Obama in retaliation for Russia's election meddling.
  • Dec 2 2017 at 6:23 PM

US Senate passes sweeping tax reforms

by Laura Litvan
Senate Republicans narrowly approved the most sweeping rewrite of the US tax code in three decades, slashing the corporate tax rate and providing temporary tax-rate cuts for most Americans.
The 51-49 vote – achieved only after closed-door deal-making with dissident senators – brings the GOP close to delivering a much-needed policy win for their party and President Donald Trump. Trump has promised to sign tax-cut legislation before the end of 2017.
Before any bill goes to Trump, lawmakers will have to resolve differences between the Senate bill and one the House passed last month, a process that could begin Monday. Although both versions share common topline elements, negotiations on individual provisions inserted to win votes, particularly in the Senate, may be protracted and difficult. The final product will end up being a central issue in the 2018 elections that will determine control of Congress.
I look forward to comments on all this!

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