ObamaCare and the Deficit

At Forbes.com, Avik Roy explains "Why Repealing Obamacare Will Reduce the Deficit".

His key points include:

1. CBO does not take into account PPACA’s impact on discretionary spending
2. PPACA includes an unrelated takeover of student loans, which will lead to more loan defaults
3. The CLASS Act generates some near-term revenue at the expense of massive long-term expenditures
4. CBO estimates are highly sensitive to errors in the projected growth of government subsidies
5. PPACA incentivizes employers to dump their employees onto the subsidized exchange, something CBO does not anticipate

(Read the full text of "Why Repealing Obamacare Will Reduce the Deficit".)

These sorts of economic arguments are excellent adjuncts to arguments on the broader philosophical and moral arguments against ObamaCare.

Wolf On Wisconsin Doctors

In the February 25, 2011 Washington Times, Dr. Milton Wolf discusses with Wisconsin doctors unprofessional behavior. Here's the opening of his piece, "Organized medical fraud in Wisconsin":

"Primum nil nocere." First, do no harm. This bedrock principle in medicine is a foreign language to most politicians and, sadly, to some Wisconsin doctors, who have violated their oath and the public trust as they have defrauded Wisconsin taxpayers.

Several University of Wisconsin family physicians donned their sacred white coats and were caught distributing fraudulent "sick notes" free for the asking quite literally by the boxful -- I wonder who paid for that printing -- to teachers and others who skipped work to engage in political protest at the state Capitol in Madison. Whatever the merits of the teachers' protest, there's a word for what these doctors and teachers are perpetrating: fraud.

An army of citizen-journalist bloggers, including Tim Daniels of Left Coast Rebel and Ann Althouse, captured and publicized photographs and video allegedly of publicly funded University of Wisconsin doctors... as they disseminated these fraudulent notes to Wisconsin's publicly funded teachers so the teachers could have a publicly funded day off...

(Read the full text of "Organized medical fraud in Wisconsin")

As Dr. Wolf notes, this reported behavior runs contrary to the core principles of the Hippocratic Oath. But at least the wheels of justice appear to be in motion now.

(And thank you, Dr. Wolf, for mentioning my earlier PajamasMedia piece, "The Wisconsin Protests and the New Medical Ethics", and FIRM in your OpEd!)

Schwarz PJM OpEd: How to Insure Americans with Pre-Existing Conditions

Congratulations to Brian Schwartz for his latest OpEd in PajamasMedia, "How to Insure Americans with Pre-Existing Conditions".

Here is the opening:

You might believe the ObamaCare offers the only way to cover people with pre-existing conditions -- if you read only Colorado Public News’s misleading "fact check" on Colorado representatives and the contested health care bill. Actually, ObamaCare makes things worse, not better, for people with pre-existing conditions. Our representatives should support better alternatives.

ObamaCare requires insurers to offer a policy to any applicant, at pretty much the same price regardless of the applicant's health or expected medical expenses. If such price controls sound wise, imagine if restaurants had to charge the same price for steaks and burgers...

(Read the full text of "How to Insure Americans with Pre-Existing Conditions".)

As Schwartz notes, it is bad government policies (especially the tax laws favoring employer-based health insurance thus destroying portability) in conjunction with numerous mandates specifying prices and benefits that destroy the market for those with pre-existing conditions. The problem would essentially evaporate in a free market.

In a free society, only a very tiny minority would be "uninsurable". Anyone who wished to contribute to private charity to pay for their medical expenses would be free to do so without government-compelled mandates or subsidies.

As always, we don't need more bad government policies (like ObamaCare) to "fix" problems caused by earlier bad government policies. Thank you, Brian, for pointing out some positive alternatives to ObamaCare.

Regulating Your Thinking

The latest pro-ObamaCare court ruling has come down, with the stunning claim that the government should be able to regulate your "mental activity". Here are two analyses:

William Jacobson (law professor at Cornell), "All Your Thoughts Are Belong To U.S.".

Jacobson notes: "Our thoughts are now actions. There literally is nothing the federal government cannot regulate provided there is even a hypothetical connection to the economy, even if the connection at most is in the future."

Avik Roy, Forbes, "Federal Judge: Obamacare Allows Congress to Regulate 'Mental Activity'"

Roy notes: "On page 45, Judge Kessler argues that the Commerce Clause of the Constitution allows Congress to regulate 'mental activity'"

Let's hope the US Supreme Court overturns this idea once and for all.

UK Patients On The NHS

So what do UK patients think of the government-run National Health Service (NHS)? This recent survey confirms years of anecdotal reports.

Some key findings include:

Patient reported a high frequencey of "insufficient care and compassion".

"Choice of providers, dignity, and inclusivity" were ranked "low".

Cleanliness was a problem at many facilities

Read the full report, "What Patients Think About Our NHS" (PDF).

Will this be America's health care future?

(Via Kelly V.)

Wolf and Wilkinson On Wisconsin

In the 2/24/2011 Washington Times, Dr. Milton Wolf discusses the recent Wisconsin protests. Here's the opening of his piece, "Wisconsin Strikes Set An Example":

Welcome to President Obama's bizarro-world America, where public servants are quickly becoming our public masters. Wisconsin public school teachers have effectively declared a strike against the taxpayers and their own students, demanding benefits that most of the public they profess to serve are not afforded.

These teachers, many of whom fraudulently claimed a sick day on the taxpayers' dime to protest Wisconsin Gov. Scott Walker's efforts to balance the state budget, effectively declared a strike that forced the closure of several schools. Not only did they abandon their students - except those poor kids they rounded up as pawns in their protest -- they also abandoned any claims that their motivation is "for the children"...

(Read the full text of "Wisconsin Strikes Set An Example".)

In the Economist post "Government workers don't need unions", Will Wilkinson makes a very similar point:

The thing is, public-sector unions don't work like this. They aren't bargaining against capitalists for a fair cut of the cooperative surplus. They're bargaining against everybody who pays taxes and/or benefits from government spending. The question of distribution in democratic politics isn't about splitting up jointly-produced profits. It's about interest groups fighting to grab a bigger share of government revenue while sticking competing groups with the tax bill.

Because of the sheer size and relatively uniform interests of the group, public employees constitute a politically powerful bloc with or without unions. As the percentage of the labour force employed by the government rises, the heft of this group only increases. Public-employee unions simply consolidate an already impressive concentration of political bargaining power...

(Read the full text of "Government workers don't need unions".)

When government employees are able to "bargain" with the power of the government behind them, the rest of Americans end up on the short end. Americans should think long and hard before we turn over any more of our economy (let alone our health care!) to these people.

Quick Links: Innovation, Retail Clinics, Defunding, Alaska

Fred Sauer explains, "How ObamaCare Kills Medical Innovation".

Paul Howard discusses how "retail health clinics" can help patients receive quality care at lower prices. Unfortunately, state regulations often prevent their wider adoption.

The House continues to defund portions of ObamaCare. Faster, please!

Some states are fighting back as, "Alaska Governor Refuses to Enact Health-Care Law".

Wisconsin Updates

University of Wisconsin says it will launch an investigation of alleged physician misconduct.

Ford Vox of The Atlantic notes that the WI physicians have "managed to belittle a public trust between physicians, employers and patients." Read the full piece.

(Via HotAir, who also linked to my PajamasMedia piece -- thank you!)

Hsieh PJM OpEd: "The Wisconsin Protests and the New Medical Ethics"

PajamasMedia has just published my latest OpEd, "The Wisconsin Protests and the New Medical Ethics". Here is an excerpt:

During the recent Wisconsin protests pitting the public-sector teachers' union against a governor attempting to rein in their overly generous benefits, several doctors were caught on camera apparently handing out fake work excuses to the protesters.

Although this might seem an outrageous breach of professional ethics, it is actually entirely consistent with the new brand of "progressive" medical ethics currently taught to medical students. And these apparent breaches of professional ethics displayed in Wisconsin may be an ominous foretaste of future problems Americans can expect under ObamaCare...

In traditional medical ethics, a doctor's primary responsibility is to tell his patients the truth and to treat his patients according to his best honest judgment, skill, and ability.

But a new form of medical ethics is being taught in medical schools that tells doctors to place the needs of "society" ahead of individual patients. At best, it forces doctors to juggle the truth and the interests of their patients alongside "social" considerations. At worst, it will give them license to sacrifice their professional integrity (and their patients' interests) in the name of "society"...

(Read the full text of "The Wisconsin Protests and the New Medical Ethics".)

For more on this topic, I recommend "Social Justice and Medical Ethics" by Dr. Beth Haynes of the Black Ribbon Project.

Another good resource is this series of blog posts on the New Medical Ethics by Dr. Richard Fogoros of The Covert Rationing Blog.

Update: Thank you, Instapundit, for the link!

And thank you, HotAir, for the link!

Catron: Dr. Berwick and Mr. Hide

David Catron dissects the recent testimony given by Dr. Donald Berwick to the House Ways and Means Committee in his latest AmSpec piece, "Dr. Berwick and Mr. Hide".

In particular, Catron notes:

His disingenuous opening remarks, evasive answers, and transparent contempt for congressional oversight revealed Obama's recess-appointed administrator of the Centers for Medicare & Medicaid (CMS) as a grotesque changeling. Gone were the bold statements about rationing, Britain's socialized medical system, and the perils of the market. The celebrated visionary, Dr. Donald Berwick, has been completely subsumed in the sly apparatchik, Mr. Hide.

(Read the full text of "Dr. Berwick and Mr. Hide".)

Fortunately, in the age of the internet, Americans can look back on Berwick's record and decide for themselves whether he's trying to soft-pedal his earlier views. Berwick can run from his past remarks, but he can't hide. Too many people are now onto him now -- thanks to watchdogs like Catron.

Universal Health Care in Colorado?

According to the 2/15/2011 Denver Daily News, Colorado Democrats are still pushing for "universal health care" in the state.

Here is an excerpt from, "Universal Health for Colorado?":

Sen. Irene Aguilar, D-Denver, a doctor, introduced Senate Bill 168 yesterday, arguing that a Colorado-specific health care cooperative is necessary to address the needs of 258,000 Coloradans who are uninsured and won’t have their needs met by the federally mandated health insurance exchange, currently being challenged in the courts.

...SB 168 would create a board of health care and policy experts to develop details for implementing a health care cooperative that would include all Coloradans as members.

The plan would be referred to Colorado voters in 2013.

The cooperative is being called "nongovernmental" because it would be governed by a member-elected board, though critics argue that the cooperative is governmental in nature.

The "universal" concept is already raising red flags. Critics object to residents being required to divert their private premium payments to public taxes in order to pay for the system.

(Read the full text of "Universal Health for Colorado?".)

If all CO residents are required by law to pay into this "cooperative", then it's hardly "nongovernmental"!

Conversely, if individuals wish to voluntarily join any form of "co-operative" or mutual assistance contract, they should be free to do so. In that case, the only obstacle is the government, in the form of state insurance laws which typically treat such cooperatives as "insurance companies" and thus subject to numerous state mandates. But if the government would get out of the way, individuals would be free to form any cooperatives they wished according to their best rational judgment.

But Senator Aguilar is not proposing a voluntary cooperative, but rather a mandatory system which is just another form of redistributing wealth.

Fortunately, her bill is unlikely to become law this session. But the underlying idea behind it is still very much alive, and therefore likely to proposed again and again in the future -- unless voters firmly reject the underlying mistaken notion that there is some "right" to health care.

Brian Schwartz has more analysis in his blog post, "The health care Authority will enforce your 'cooperation'".

(Denver Daily link via Ari Armstrong.)

NYT: Concierge Medical Care With a Smaller Price Tag

The January 31, 2011 New York Times has an interesting article, "Concierge Medical Care With a Smaller Price Tag".

What's especially interesting is that the profiled One Medical Group practice offers reasonably-priced high-quality care which takes into account the whole patient. In other words, it is the "integrated care" that government programs like "medical homes" and "Accountable Care Organizations" are striving for. But in this case, it is achieved by physicians adopting innovative practice models in a private setting -- not via government mandate.

The innovations that One Medical Group are making are possible only because the government does not dictate to them what sort of "practice guidelines" they must adhere to, how they must document their care, etc. Instead, the physicians are left free to follow their best rational judgment to provide the best care for their patients. Such innovations can and should be the norm in a private health care economy, where multiple groups could arise and compete for patient business.

Under the coming government-imposed models of giant ACOs and "medical homes", small and nimble private innovators such as One Medical Group will become increasingly hard to find -- or may be driven out of business altogether. In many ways, it will be analogous to the Eastern bloc countries forcibly replacing small private farms with the large inefficient state-run "collective farms".

Those socialist collective farms were an abject failure and couldn't feed the population of the USSR.

There's no reason to think that state-run medical ACOs will serve the health needs of Americans any better.

Wolf: In Contempt of Court and Common Sense

Dr. Milton Wolf has a new OpEd in the 2/16/2011 Washington Times, "In contempt of court and common sense".

In particular, he notes that the Obama administration piously talks about "respecting the Constitution" when they can score political points against their opponents -- but they conveniently forget about constitutionality when it works against them. The trend is much broader than health care, as Dr. Wolf documents.

In other words, the rule of law is just another "inconvenient truth" for them.

The big question is whether the Congressional Republicans will step up and defund ObamaCare, as they should -- or if they'll compromise, as they've done far too often in the past.

(Victor Davis Hanson makes some similar points about the convenient amnesia of the Left in his 2/13/2011 PJM piece, "Goodbye to All That -- 2004-2007".)

Hsieh LIJ OpEd: What Kind of Healthcare Competition Do We Want?

The February 2011 issue of the Colorado-based publication Liberty Ink Journal has published my piece, "What Kind of Healthcare Competition Do We Want?"

The theme of their February 2011 issue was competition (in culture, economics, sports, etc.)

I'd like to thank editor-in-chief Stephanie Anderson and managing editor Tobin Spratte for inviting me to contribute a "Special Feature" on the theme of competition and health care to LIJ.

(This piece has a similar theme as my earlier Washington Times piece, "The Best Health Care Political Pull Can Buy".)

Majumder: Let's Compensate Bone Marrow Donors

In the 2/9/2011 USA Today, Kumud Majumder tells America, "Let's compensate bone marrow donors".

Here is the opening:

My 11-year-old son, Arya, was an angel who transformed my life. His death from leukemia last April took away not just my only child, it also took away my very heart and soul, and triggered the collapse of my 23-year marriage.

Arya's tragedy happened in part because of a lack of bone marrow donors. Each year, as many as 3,000 people in the U.S. die waiting for a bone marrow donor match. A significantly higher number of people die from complications arising from partially matched donors. This is largely avoidable, and the shortage of donors is made worse by a federal law that I and other families of cancer patients are fighting in federal court. On Tuesday, the U.S. Court of Appeals in Pasadena, Calif., will hear arguments in our constitutional challenge against the U.S. attorney general.

Our suit contests the part of the National Organ Transplant Act that bans families like ours from setting up a pilot program to offer modest compensation to donors with the most needed bone marrow and thus save more lives. The law makes offering any compensation -- such as a housing allowance -- a federal crime that could land everyone involved (from the doctor to the donor to the patient) in jail. In our view, the Constitution does not allow the government to imprison people for doing no harm while saving lives...

(Read the full text of "Let's compensate bone marrow donors".)

The government currently forbids would-be bone marrow donors from receiving compensation from the potential recipients. By forbidding consenting adults from trading value-for-value, this results in an artificial shortage of marrow -- and costs lives. Allowing these exchanges would be a win-win for all parties.

For more on this, see the Institute for Justice webpage on this topic.

Rhoads: Behold the 1099-Romney

Jared Rhoads of the Lucidicus Project explains what sort of additional paperwork he has to file at tax time because of the Massachusetts individual mandate.

Here is the introduction of his post, "Behold the 1099-Romney":

It's tax preparation time again. Among other things, that means gathering up the W-2s, the brokerage statements for Schedule D, the receipts from charitable organizations to which I donated, and the 1099-DIV I received for earning four dollars in bank interest last year.

Am I forgetting anything? I'll give you a hint: I live in Massachusetts.

That's right, I need my 1099-HC.

For the uninitiated living in the 49 less "progressive" states, the 1099-HC is the form needed by each Massachusetts resident in order to prove to the government that he had continuous health insurance throughout the prior taxable year. The "HC" in the name of the form stands for either "health care" or "health coverage." I'm not sure which it is; I just call it the 1099-Romney...

(Read the full text of "Behold the 1099-Romney".)

Unless ObamaCare is repealed (or struck down by the U.S. Supreme Court), Americans in the other 49 states will soon experience something similar -- enforced by the ever-reasonable bureaucrats of the IRS.

Between A Rock and a Hard Place

Contradictory government demands are putting doctors and hospitals in a bind, according to a recent article in the February 8, 2011 New York Times, "Health Law Provision Raises Antitrust Concern".

ObamaCare rules are "encouraging" doctors and hospitals to form large entities known as "Accountable Care Organizations" (ACOs). In theory these integrated care models are supposed to allow providers to exchange information and achieve efficiencies of scale. So ACOs are being fostered via a variety of financial carrots and sticks by the Department of Health and Human Services (HHS) and reportedly supported by the Department of Justice.

However, a senior member of the Federal Trade Commission is also warning doctors and hospitals not to get too "integrated" -- lest they be charged with violating anti-trust laws. In other words, too much cooperation between providers will be viewed as "anti-competitive" -- and punished by the federal government.

So how is a doctor or a hospital supposed to know whether they will run afoul of a government regulator? The short answer is, they don't.

Doctors and hospitals have to somehow please simultaneous (and sometimes inconsistent) rules set by the FTC and the Department of Justice, both of which have jurisdiction over Accountable Care Organizations. As the NYT notes:

In discussions between the two agencies, Mr. Rosch [of the FTC] said, the department has taken the position that health care providers should be free to choose which agency would review their plans. Such an arrangement, he said, could lead to "a lack of regulatory consistency," with the two agencies applying different standards. Justice Department officials declined to comment.

When non-objective laws are the norm, it's no longer possible to have rule of law.

Instead, all we are left with is rule of men -- something we've already seen with the hundreds of discretionary ObamaCare waivers granted by the HHS.

In this new battle, doctors, hospitals, and patients will find themselves at the mercy of competing bureaucracies seeking to assert their jurisdictional dominance over each other -- and over us.

Talk about being caught between a rock and a hard place...

ObamaCare Comics

ObamaCare is so unpopular, that leading supporter (and MIT economist) Jon Gruber is going to write a comic book (aka "graphic novel") to persuade Americans of its merits.



More information at the 2/8/2011 Boston Herald story, "Comic treatment for health plan".

(Via Scott K.)

Ralston: Constitution Or ObamaCare

In the February 4, 2011 Orange County Registr, Richard Ralston of AFCM notes that our choice is, "Constitution or Obamacare -- Not Both".

Here is the opening:

Court challenges to the constitutionality of Obamacare have exposed the broader agenda of those who are committed to the permanent expansion of government power which that legislation represents. The specific legal issues are almost irrelevant because Obamacare is so clearly outside the scope of limited, constitutional government. This has made it necessary for the advocates of unrestrained government power to attack either the Constitution itself or the very concept of constitutional limits on the tyranny of the majority or of a ruthless minority elite.

Some try to sidestep the attack on the Constitution by substituting a war on English. They claim to support the Constitution but deny that words have any objective meaning. Supposedly we do not know and cannot know what the writers of the Constitution, or even of recent amendments, intended to say. Everything is a matter of interpretation, and the words mean whatever anyone wants them to mean. Of course, that is arbitrary, and unless we abandon reason and reality completely, the Constitution cannot mean thousands of mutually exclusive things...

(Read the full text of "Constitution or Obamacare -- Not Both".)

The health care debate has forced America to revisit some basic issues about the proper role of government, rule of law, and the importance of freedom in human survival and prosperity. The fight is a long ways from over; but at least it's being fought on the right battlefield.

Catron: Desperately Seeking Solace

In his latest AmSpec essay, David Catron covers some of the legal and linguistic contortions various ObamaCare supporters are utilizing in order to preserve the individual mandate. Here's an excerpt from "Desperately Seeking Solace":

For nearly a year [pundits on the Left] have been writing smug opinion pieces and snide blog posts about Florida's "frivolous" lawsuit, assuring their readers that such a ruling was a virtual impossibility. Now, their attempts to explain away the obvious implications of Judge Vinson's decision manifestly fail to pass the laugh test.

The most hilarious of these involves the "musket mandate"...

(Read the full text of "Desperately Seeking Solace".)

During the 2010 health care debates, the ObamaCare supporters worked hard to portray the plan as a "done deal", especially after it cleared the Congress. Fortunately, Americans did not just take that lying down, but decided to fight back through politics and through the legal process -- with astonishing successes. And once the aura of inevitability began to crumble around ObamaCare, that took away one of its chief political advantages.

ObamaCare supporters are now (rightfully) a little nervous. In contrast, ObamaCare opponents fighting for health care freedom are now feeling a little bit of "hope and change". It's about time...

Rich On Clinical Guidelines

Physician-blogger "Dr. Rich" makes some rather pointed observations in his post, "Who Writes Those Clinical Guidelines, Anyway?"

Some excerpts:

...[T]he act of creating clinical guidelines is not inherently evil, and indeed, back in the day when guidelines were merely guidelines (instead of edicts or directives that must be obeyed to the last letter), creating clinical guidelines was a rather noble thing to do.

But today, we have physicians clamoring to become GOD panelists (Government Operatives Deliberating). These aristocrats of medicine will render the rules by which their more inferior fellow physicians, the ones who have actual contact with patients, will live or die.

Although (by his own admission) he engages in some pretty broad generalizations about physician personality types, he does put his finger on a central premise driving many of these would-be guideline-writers -- namely, they know best.

In other words, they know how medicine should best be practiced -- and their judgment should overrule that of the actual physician taking care of the actual patient juggling many complex factors specific to the individual case. The current government-endorsed "clinical guidelines" approach is merely a variant of the "central planning" fallacy that failed so miserably in the socialist Eastern bloc economies.

Of course, not every doctor enamoured of central planning is necessarily clinically inept. But many of them place too much faith in the power of central government -- and have too little respect for the rationality and integrity of ordinary physicians "in the trenches".

(Read the full text of "Who Writes Those Clinical Guidelines, Anyway?")

Forbes: How the FDA May Kill Millions Of Us

Steve Forbes warns us about how government policies are slowing drug development in his latest OpEd, "How the FDA May Kill Millions Of Us".

Here's an excerpt:

The pipeline for new antibiotics is drying up. Since the 1940s the miracle of penicillin and its relatives has saved tens of millions of lives. Antibiotics easily conquered such illnesses as pneumonia and tuberculosis, which routinely killed countless numbers of people each year. Bacteria, of course, can become drug-resistant, but for decades pharmaceutical companies, especially in the U.S., routinely came up with new antibiotics to fell new killer germs. Now, however, the flow of new stuff has dried to a trickle.

Authorities are taking note of all this, as is the U.S. Congress. Henry Waxman has declared that the pharmaceutical industry's failure to develop a reliable new class of antibiotics is an example of "market failure." No it isn't, Henry; it's a failure of government regulation. The FDA has made clinical trials cost-prohibitive.

(Read the full text of "How the FDA May Kill Millions Of Us")

I'm glad this issue is getting more national attention. In particular, deaths caused by regulatory agencies like the FDA represent a classic example of Frederic Bastiat's principle of "the seen vs. the unseen".

We'll never know what drugs would have already been developed had it not been for FDA interference. And we'll never know which of the many patient deaths that occurred could have been prevented if those drugs had been developed.

And I'm especially glad that Steve Forbes is putting the blame where it belongs -- on the government, not the free market. Let's hope people listen to Forbes on this issue.

(For more on this, see Stella Daily Zawistoski article "How the FDA Violates Rights and Hinders Health" and my recent PajamasMedia piece, America's Other Drug Problem".)

Hsieh PJM OpEd: "America's Other Drug Problem"

The February 5, 2011 PajamasMedia published my latest OpEd, "America's Other Drug Problem".

My theme is that the current critical shortage of many life-saving legal drugs should be solved not by yet another new government program (as the Obama Administration is planning), but by getting government out of the way.

Here is the introduction:

America has a serious drug problem, but it's not one most Americans have heard of. The problem is not illegal drugs, but rather a critical shortage of many life-saving legal drugs. And the federal government is about to make things worse.

During the past year, medical professionals have received alarming reports about critical shortages of important drugs. These drugs aren't the common over-the-counter medications that consumers purchase in their local drugstores. Rather, the shortages are in various injectable drugs typically administered to seriously ill patients in hospitals...

(Read the full text of "America's Other Drug Problem".)

For this piece, I drew heavily on (and linked to) the excellent article by Stella Daily Zawistoski in the Fall 2008 issue of The Objective Standard on "How the FDA Violates Rights and Hinders Health". If you're interested in this topic, I highly recommend reading her more detailed article.

Update: Thank you, Instapundit, for the link!

Wolf: USS Obamacare Takes On More Water

Dr. Milton Wolf has a new piece in the February 4, 2011 Washington Times, "USS Obamacare takes on more water".

He details how ObamaCare is taking hits on multiple fronts now -- legal, political, and popular. The breadth and depth of opposition to ObamaCare is stunning, and is continuing the snowball. If you value freedom, read the full text of his OpEd for some encouraging news.

ObamaCare is not dead yet. Rather, it is a wounded beast -- and still very dangerous. It's up to Americans to finish the job over the next 2 years and kill it once and for all.

For one legislative strategy on how to proceed, see Keith Hennessey's 2/2/2011 post, "How to Repeal ObamaCare". But this must be accompanied by ongoing grass-roots discussion and activism to keep Americans informed on this issue -- and to keep holding our politicians' feet to the fire. Fortunately, men like Dr. Wolf are doing their part to help.

Quick Links: Drug Shortages, Free Riders, Repeal

The 2/1/2011 Wall Street Journal gives more details on how "Drug Shortages Distress Hospitals".

In the 2/2/2011 Forbes.com, Avik Roy discusses the "Myths of the 'Free Rider' Health Care Problem".

In the 2/3/2011 Washington Post, Jennifer Rubin discusses "Losing a repeal vote, but winning the war against ObamaCare".

Quick Links: Barnett, Scherz, Carney

In the 2/2/2011 Wall Street Journal, Randy Barnett and Elizabeth Foley cover "The Nuts and Bolts of the ObamaCare Ruling".

Dr. Hal Scherz of Docs4PatientCare explains that, "The Healthcare Debate is Far From Over".

John Carney at CNBC points out that ObamaCare is now operating outside the rule of law.

How The Rationing Will Occur

In the 1/27/2011 Daily Caller, Heather Smith explains that "The Obamacare rationing is beginning".

Here's how the rationing will occur:

The government isn't going to say, "We won't treat you for condition X" -- the public outcry would be too great. No, they have learned from other nations that have government health care that that would mean disaster. What they do is much more subtle -- they simply limit options in the hope that patients won’t realize that care is being rationed.

For most diseases, there are several options for treatment and the treatment regimen is based upon the individual patient's history and advice from their doctor. If the government refuses to pay for a particular type of treatment, that arrow is simply removed from the doctor's quiver and the patient will most likely never be made aware of it.

However, sometimes there is a period between the government deciding a treatment is no longer cost effective and when some patients are receiving it. This is the rare time when people can see how their options are being limited and actually stand a chance to do something about it...

(Read the full text of "The Obamacare rationing is beginning".)

Furthermore, as I noted in an an earlier PajamasMedia piece from last year, doctors will be co-opted into participating in this silent rationing -- as has already occurred in the UK:

...[N]early one in four British oncologists admitted to deliberately withholding information from their patients about treatments widely available in other European countries, but not allowed under the NHS system due to cost. These oncologists argued that "there was 'no point' in discussing treatments their patients could not have" and that such a discussions might "distress, upset or confuse" their patients.

But patients rely on their physicians for information about treatment options -- including an honest appraisal of all the risks, benefits, and alternatives -- so they can make fully-informed decisions about their lives. Failure to disclose such information is a serious breach of a doctor's Hippocratic Oath.

Hence, the importance of repealing ObamaCare.

We have been warned...

Catron on Vinson

David Catron has a nice discussion of yesterday's Vinson ruling. Here's the introduction to his latest AmSpec piece, "Roger That!":

Ian Gershengorn, the government lawyer charged with defending ObamaCare in State of Florida v. U.S. Department Health and Human Services, probably knew he was in for a shellacking when in a December hearing Judge Roger Vinson started talking about broccoli. The basis of Florida's challenge to ObamaCare is its claim that the law's requirement that all Americans buy health insurance is unconstitutional because Congress has no legitimate power to impose such a mandate.

Revealing some sympathy with this position, Judge Vinson asked the hapless DOJ attorney, "If they decided everybody needs to eat broccoli because broccoli makes us healthy, they could mandate that everybody has to eat broccoli each week?" Gershengorn lamely responded that the health care market has unique qualities that necessitate the mandate. "It is not shoes, it is not cars, it is not broccoli."

This answer was obviously not very convincing to the Judge...

(Read the full text of "Roger That!")

In particular, he highlights some important differences between the Vinson ruling and the earlier Hudson ruling, such as Vinson's decision that "the entire act must be declared void" because of the lack of severability.

As others have correctly noted, this isn't the end of ObamaCare. But it may be a critical turning point.

The Vinson Ruling

The big news from yesterday is, of course, the ruling from federal judge Roger Vinson that ObamaCare is unconstitutional.

Readers can find the full 78-page ruling here (also mirrored at the end of this blog post).

David Kopel of the Independent Institute summarizes and analyzes some of the major points here.

So does Cornell law professor William Jacobson.

As with the Hudson ruling, there will undoubtedly be tons more commentary in the next few days about the legal, political, and philosophical significance. But for now, I wanted to highlight a few passages:

From page 75: "Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void."

And from page 42:

It is difficult to imagine that a nation which began, at least in part, as the result of opposition to a British mandate giving the East India Company a monopoly and imposing a nominal tax on all tea sold in America would have set out to create a government with the power to force people to buy tea in the first place.

(Hat tip to Dr. Matthew Bowdish.)

And from footnote 30, page 76:

I note that in 2008, then-Senator Obama supported a health care reform proposal that did not include an individual mandate because he was at that time strongly opposed to the idea, stating that "if a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house."

The US Supreme Court will have the final say on this matter.

But for now, America still has a chance...

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