This is a non-healthcare post.

The GOP tax bill is a mess, riddled with math errors, contradictory language, and un-implementable directives.

One  is a huge and possibly un-fixable problem for the GOP – unfixable without ignoring requirements to keep the deficit-increasing impact of the bill within strict limits..

Late Monday night, the news that drafters made a $289 billion mistake hit the wires, infuriating the very corporate bigwigs the bill was supposed to reward.

Without getting too far into the weeds, a last-minute addition to the bill in the Senate added the Corporate Minimum Tax back to the bill, which effectively killed a bunch of other incredibly popular tax breaks – like the Research and Development credit. That will raise costs by perhaps $289 billion.

Here’s what one totally pissed off Republican CEO said:

Robert Murray,C.E.O. of Murray Energy Corp., angrily estimated that his company’s tax bill would increase by $60 million. “What the Senate did, in their befuddled mess, is drove me out of business and then bragged about the fact that they got some tax reform passed,” Mr. Murray said in an interview. “This is not job creation. This is not stimulating income. This is driving a whole sector of our community into nonexistence.”

But both the House and Senate have passed the bill, you say, so they’ll figure it out in the Conference Committee.

Not so fast.

To “fix this”, conferees will have to find the same amount of revenue from other sources. So, other taxes are going to go up – a lot. Or the AMT for companies will have to disappear. And given the very tight timeline to get this done, and the intransigence of the “freedom caucus”, and the furor over many other provisions, the longer this thing is in the public’s eye, the less chance it has of becoming law.

And the less damage it does to health insurance companies, Medicare recipients, doctors and hospitals.

Which is a very good thing.

Folks, this stuff is complicated. We live in a very, very complex world, and there are NO simple solutions to the really knotty problems we have. It’s time to take a set aside the sound bites and get to governing.

Got in yesterday, and the whirlwind started. Initial takes…

Thanks to the wonderful folks at myMatrixx for carting me and pretty much everyone else from the airport to our hotels.

The Mitchell last night event was very well attended; it was going strong well into the night.

Telemedicine is the next big thing – there are at least a half-dozen companies focusing on this, with many more touting their adoption of pieces and parts of telemedicine. Like anything else, there’s going to be a shakeout – more on this next week.
But make no mistake, unlike many flashes-in-the-work-comp-services pan, telemedicine (or whatever term you use) is going to be a big, big deal.

The CVS acquisition of Aetna will have zero effect on Coventry. Or maybe even less. The new company’s revenues are almost a quarter-trillion dollars; Coventry work comp’s annual take is less than a quarter of one percent of that.

A couple folks aren’t here this year. Bill Block is one. Bill passed away this year; universally liked, Bill was just a good guy, a relationship guy who knew everyone and had a good word for all. He’d been in the business for decades, working for several different companies, bringing his smile and good cheer wherever he went. Bill will be missed.

Funally, confession time. I have a horrible memory for names and faces. And most other important things. Please accept my heartfelt apologies!

Here’s a few pointers for those in or heading to the NWCDC confab in Vegas.

1.  Realize you can’t be everywhere and do everything. Prioritize.

2.  Leave time for last-minute meetings and the inevitable chance meetings with old friends and colleagues.

3.  Unless you have a photographic memory, use your smartphone to take voice notes from each meeting – right after you’re done.  Otherwise they’ll all run together and you’ll never remember what you committed to.

4.  Get the NWCDC app for your Droid or iPhone – there’s a web-based version too for tablets.  It has the schedule, exhibit hall layout, local map, and a bunch of other handy information and tools.

5.  Introduce yourself to a dozen people you’ve never met.  This business is all about relationships and networking, and no better place to do that than this conference.

6.  Wear comfortable shoes, get your exercise in, and be professional and polished.  It’s a long three days, and you’re always ‘on’.

Finally, I’ll echo one of Sandy Blunt’s points – in these day of YouTube, phone cameras, Twitter and Google+, what you do is public knowledge.  That slick dance move or intense conversation with a private equity exec just might re-appear – to your dismay.

From covering our generally-mediocre-but-hugely-expensive healthcare “system” to the use of blockchain in clinical trials to why adding $ to fund healthcare subsidies would drive UP premiums, it’s all here in Andrew Sprung’s edition.

If you want to stay up to date on the healthcare stuff that will affect your business – HealthWonk Review is the best way to do just that.

This biweek’s edition of Health Wonk Review comes to us courtesy of Jason Shafrin PhD…Jason ties each entry to a quote.

Somehow he’s able to channel Mahatma Gandhi, Churchill, and a host of other luminaries to health care. Impressive indeed – head on over for a read!

As many readers know, I have been running for County Legislator here in Onondaga County New York – yesterday was election day, and I lost.

Results are here.

In the immortal words of Yoda, “there is no try, there is only do.”

Despite a lot of support from friends and colleagues, a massive amount of work, a very, very good campaign manager and staff, and a good message, I lost.

The regret I have is not for the hundreds of hours I put in, or the fun forgone when I knocked on doors instead of visiting with family and friends, rowing or riding my bike. The regret is many of you supported our campaign in many ways, and I did not deliver the win. This campaign was never about me, it was about making a difference for the people here, and many of you bought into that and pitched in.

I deeply appreciate your support and encouragement, kind words expertise and advice. I cannot tell you how much that meant and means to me, and I am profoundly grateful.

For now, the Paduda family is headed to Sedona Arizona for a week of family time, mountain biking, hiking, too much good wine and lots of reading the stuff that’s been piling up on the nightstand for the last nine months.

Looking forward to seeing you in Las Vegas – and thanks.

The death rate for drug overdoses climbed 17 percent last year, killing more than 64,000 people in 2016

‘We have roughly two groups of Americans that are getting addicted,” Dr. [Andrew] Kolodny said. “We have an older group that is overdosing on pain medicine, and we have a younger group that is overdosing on black market opioids.”

For those interested in why this is happening, I urge you to read a “biography’ of the Sackler family, owners of Purdue Pharma of Oxycontin fame.

Here is one chilling excerpt:

[Sam Quinones, author of a book on the crisis talking about the] similarities he finds between the tactics of the unassuming, business-minded Mexican heroin peddlers, the so-called Xalisco boys, and the slick corporate sales force of Purdue. When the Xalisco boys arrived in a new town, they identified their market by seeking out the local methadone clinic. Purdue, using I.M.S. data, similarly targeted populations that were susceptible to its product.

My take is this just one of the many similarities between Purdue and the drug cartels – the one chief difference is Purdue et al dosen’t have to worry about law enforcement.

At least not so far.