You Won't Keep Your Current Insurance

In the 8/25/2011 Washington Examiner, Byron York warns Americans, "Plan to keep your health plan? Don't count on it".

In particular, he describes how government incentives will lead employers to drop their current coverage. In turn, this will push many Americans into government-sanctioned and government-subsidized plans which will foster more dependency on the government.

Once that happens, the only question is how long before the system turns into an explicit "single payer" plan.

Admin Note: Sporadic Blogging

FYI, blogging here may be a bit sporadic due to some personal medical issues. (I do have a few pre-scheduled posts that should be appearing over the next few days.

In the meantime, take a look at David Catron's latest in today's AmSpec, "Why Perry Can Beat Obama and Romney Can't".

The point-by-point comparison is interesting. (Disclaimer: I don't agree with Perry on a variety of issues but he's clearly better than Romney on health care.)

Quick Links: Candidates, Addiction, SCOTUS

Kaiser Health News summarizes, "GOP Presidential Hopefuls: Where They Stand On Health Care".

Dr. Alieta Eck of AAPS discusses how too many doctors and patients are, "Addicted to Government".

Jennifer Rubin discusses how quickly (or slowly) the US Supreme Court will decide to review ObamaCare at, "What about the Obamacare litigation?" (Via David Catron.)

Admin Note: DNS Problems Being Fixed

Some people have been having trouble accessing links to the FIRM blog and the main website.

Diana has tracked down the problem to some bad DNS data. That has already been fixed, although it may take a couple of days for the updated DNS information to propagate.

Thanks, Diana, for figuring this out! And thank you all for alerting us to the problem!

Do Not Disturb The Nurses

According to the 8/27/2011 UK Daily Mail, patients are upset at nurses wearing "Do Not Disturb" uniforms while administering medications:

A row has broken out over a hospital trust's decision to give nurses 'Do Not Disturb' uniforms to wear during routine ward duties to prevent patients from speaking to them.

When nurses are wearing the bright red tabards, patients have to address any concerns to care assistants, who do not have clinical qualifications.

The hospital says interruptions, such as patients asking questions about toilets and meal times, stop nurses from doing their jobs properly and could lead to patients being given the wrong medication.

(Read the full text of "Do Not Disturb: Fury over nurses' uniforms that ban patients from trying to speak to them".)

This is an interesting way of rationing care, by limiting when and how patients can interact with caregivers. It's not as overt as, say, capping the numbers of surgeries a hospital will perform each week or how many cardiology appointments patients can get in a year. But the hospital is still sending an implicit signal, "Don't expect too much from us".

(Via @MatthewBowdish.)

Quick Links: Government, Stagnation, Controls

Dr. Hal Scherz of Doc4PatientCare has a new OpEd at Fox News, "Think the Government Handled the Financial Crisis Badly? Just Wait, Because Health Care Is Next". He explains why, "'Stealth' rationing of care to Medicare patients is imminent."

Chief Executive reports, "Health Care Reform Keeping 72 Percent of CEOs from Hiring". (Via D4PC.)

As ObamaCare leads to greater consolidation of providers (including doctors selling their practices to hospital chains), Medscape Medical News notes, "Hospital-Employed Physicians May Drive Up Costs".

Of course, the supporters of government-run medicine will simply use this an excuse to impose yet more cost controls to "fix" the problems created by earlier government controls. (Via @MatthewBowdish.)

Thank You, Steve Jobs

This isn't directly related to health care, but American Thinker just published my short piece: "Thank You, Steve Jobs".

He became wealthy offering value for value. In the end, we and his customers (and his employees and the people who wrote iPad apps, etc.) all won. This is why free market capitalism is a wonderful, moral system.

On a related note, Glenn Reynolds of Instapundit has a nice interview with former BB&T CEO John Allison on how the government caused the financial crisis and why capitalism is the only moral economic system:

Waiting to Find a Family Doctor in Canada

In the 8/22/2011 Globe and Mail, Gloria Galloway reports on the "The soul-destroying search for a family doctor".

Basically, it took her years to find a primary care doctor who would accept her. And now she has a doctor, she will of course still have to deal with any waiting lists for complex care such as surgical procedures or MRI scans.

Again, "coverage" does not equal actual medical care...

(Via Carpe Diem and Kelly V.)

Wolf on Corporate Welfare

Although it's not directly related to health care, Dr. Milton Wolf has a nice new OpEd out in the 8/23/2011 Washington Times, "Energy Obamanomics: No green jobs and plenty of red ink".

The money quote:

It's time for downgraded America to demand that every business pay its own bills. Mr. Obama would like to end what he calls subsidies to oil companies. Fine. Let’s apply that evenly to all energy companies. In fact, let's apply it to all companies in America. No more bailouts, subsidies, targeted tax breaks, selective tariffs, mandates to purchase certain products or any other form of corporate welfare.

(Read the full text of "Energy Obamanomics: No green jobs and plenty of red ink".)

As a supporter of free markets, I am neither pro-business or pro-labor or pro-[any particular sector of business]. Instead, I am pro-capitalism, which means all economic enterprises should be free to compete for customers without special government handicaps -- or special favors. The only thing the government should do is to prevent the use of force or fraud, but otherwise get out of the way of the honest entrepreneurs who create value. The resultant economic boom could help make America great again!

Catron: Professor Obama Holds Forth on the Mandate

President Obama continues to insist that the individual mandate in ObamaCare is constitutional. In his latest AmSpec piece, David Catron rebuts those argument at, "Professor Obama Holds Forth on the Mandate".

In particular, Catron discusses the misanalogies to state-level requirements that drivers purchase automobile insurance and the claim the prior precedent supports the individual mandate.

(Read the full text of "Professor Obama Holds Forth on the Mandate".)

Massachusetts Update

The 8/16/2011 Washington Times reports that "Health coverage, rates rise in Massachusetts".

Although MA residents have theoretical "coverage", that does not necessarily mean they get actual medical care. Furthremore, "health care premiums continued to outpace inflation by rising an average of 5 percent to 10 percent each year".

The article notes that this will soon become a problem at the national level:

Reforming health care in Massachusetts -- and the challenges that came with it -- foreshadowed President Obama's health care initiative, which he signed into law last year. The Affordable Care Act closely mirrors Mr. Romney's overhaul, leaving in place the employer-coverage model but expanding subsidized coverage.

Both laws include mandates on individuals to purchase health insurance or pay a fine, and on businesses to offer insurance, though they exempt small firms. Both establish insurance exchanges that offer subsidized coverage to low-income individuals and families and ban insurance companies from rejecting individuals with pre-existing conditions.

Now, both plans face questions over how to pay for their reforms over the coming decades.

In Massachusetts, that problem is already acute...

The MA plan also relies heavily on expanding government-subsidized health programs such as MassHealth ("which includes Medicaid and the State Children's Health Insurance Program"). One of Romney's former health policy advisors acknowledges that this "does create problems for sustainability".

The article also noted that, "An extra $5.6 billion in Medicaid funding through the federal stimulus bill helped to pay for the program over the past two-plus years. As of this year, though, that assistance is gone."

In other words, the MA plan was kept partially afloat by the taxpayers of the other 49 states. But under the national ObamaCare plan, who will bail out the United States? I wouldn't count on Germany or China being eager to foot the bill!

(Read the full text of "Health coverage, rates rise in Massachusetts".)

For more information on how ObamaCare will harm the US economy, see this piece by US Rep. Darrell Issa (R-CA), "Health care law will deepen deficit".

How to Stop Doctors From "Going Galt"

Up to 40% of doctors have said they would retire early and/or quit clinical medicine due to ObamaCare.

But because of the recent stock market crash, many physicians now say "they will work longer until retirement because personal savings had been gutted or had not grown as rapidly as anticipated".

I have to give President Obama credit for this one -- downgrading the US economy is certainly one way to stop physicians from "going Galt". It all makes perfect sense now!

Quick Links: Snitching, Collectivism, Meaningful Use

The National Post reports how Ontario's health ministry has established a "snitch line" where people can report on doctors who engage in private-pay health care without government approval.

Dr. Rich Fogoros discusses the latest attempts to argue against direct-pay medicine on the grounds that "opting out" of the system increases the burdens on the rest of doctors and patients.

(Of course, those arguments omit the fact that those burdens are caused by government restrictions of the free market in the first place -- including licensing requirements for practitioners -- and would be easily alleviated by permitting a free market in health care services.)

Physician-blogger "NotDeadDinosaur" discusses how "Meaningful Use Requires Meaningless Data".

(The government will be requiring physicians to collect and submit data that doesn't have any relevance to their clinical practice -- but could be used in the future for political purposes. Via @rlbates and @sonodoc99.)

6 Types of Obamacare Waivers

To help you keep track, "6 Types of Obamacare Waivers":

1. MLR waiver for mini-med health insurance plans
2. Annual limit waiver
3. MLR waiver for States
4. State innovation waiver
5. ACO anti-trust waivers
6. Individual mandate waivers

More information on each type at the link.

(Via For Repeal.)

Just as a reminder, such waivers weren't in the original law.

Quick Links: Luck, Bureaucracy, Inflation, Exchanges

Dr. Milton Wolf channels Robert Heinlein on "bad luck".

Dr. Jay Parkinson describes the bureaucratic hassles he endured when he tried to introduce 21st century communications innovations into his practice: "What happens to doctors who think outside the box?"

Sally Pipes discusses, "Counting Up ObamaCare's Health Cost Inflation". (Via Dr. Richard Armstrong.)

Scott Gottleib explains that, "Health Insurance Exchanges: A Race To the Bottom". (Via Brian Schwartz.)

Scherz on IPAB

Dr. Hal Scherz of Docs4PatientCare had an OpEd in the 8/10/2011 Washington Times entitled, "A Trojan horse named IPAB".

He notes the following about IPAB (the Independent Payment Advisory Board authorized to cut Medicare spending):

Health and Human Services Secretary Kathleen Sebelius has been quoted as saying that the majority of IPAB members must not be medical practitioners. Though some doctors may be represented, it is unlikely that they will be actively practicing clinicians who care for patients directly. Instead, the board will be populated by economists and other bureaucrats - "bean counters" - who will be given the responsibility of deciding how doctors caring for Medicare patients will get paid. It is anticipated that IPAB will drive payments so low that many doctors will be unable to offer certain services to patients, resulting in rationing of health care, which the administration fervently denies....

IPAB has almost limitless power over Medicare spending. Written into the Affordable Care Act are provisions that essentially make its decisions exempt from congressional oversight and impervious to administrative or judicial review. It is a nearly autonomous agency operating as an arm of the executive branch. Conveniently, this does not occur until after the 2012 elections.

As if this weren't pernicious enough, President Obama thinks IPAB should have even more power -- that of "automatic sequester," which means it would be able to prevent Congress from appropriating any additional money for Medicare outside of its purview.

(Read the full text of "A Trojan horse named IPAB".)

Dr. Scherz also notes that many want to expand this government control from just Medicare to all nominally private health insurance.

In other words, unelected bureaucrats will make medical payment decisions that de facto limit services that doctors are able to offer to their patients. But we're not supposed to call it "rationing".

Wolf: Upgrading America

Dr. Milton Wolf has a new OpEd in the 8/15/2011 Washington Times, "Upgrading America".

A couple of key points:

More than half of Americans receive some form of government assistance. It's everywhere - hidden right before our eyes within massive programs such as Social Security and Medicare. Some of it is obvious: Medicaid, food stamps, unemployment benefits and a thousand other lofty-sounding programs. Let's call all of this what it is: welfare. If you take one dime more from the government than you pay in, you are receiving welfare and your neighbors are giving you handouts. Still more welfare is doled out to corporate America in the form of bailouts, subsidies, targeted tax breaks and the like...

We pay people not to work and then act surprised when they don't. We reward businesses for failing and then act surprised when they do.

Dr. Wolf also discusses how the ever increasing tax and regulatory burdens are strangling American prosperity and innovation.

His solution to our problems is simple:

It's time America reintroduce freedom back into the free market. Every government regulation is a limitation on free choice, and this ultimately destroys opportunities, jobs and wealth. Americans are not allowed to buy an incandescent light bulb, flush a toilet, start a lemonade stand or invest in a multibillion-dollar enterprise unless some all-powerful bureaucrat grants permission.

(Read the full text of "Upgrading America".)

Dr. Wolf's last point echoes a sentiment expressed by Ayn Rand in Atlas Shrugged:

When you see that in order to produce, you need to obtain permission from men who produce nothing -- when you see that money is flowing to those who deal, not in goods, but in favors -- when you see that men get richer by graft and by pull than by work, and your laws don't protect you against them, but protect them against you -- when you see corruption being rewarded and honesty becoming a self-sacrifice -- you may know that your society is doomed.

America is not doomed yet. But unless we make a 180-degree course correction, we will be soon. Fortunately, many Americans are starting to wake up to this fact.

Catron: Obamacare Loses Another One

David Catron's latest OpEd posted 8/15/2011 at AmSpec discusses the latest ruling from the 11th Circuit Court, "Obamacare Loses Another One".

One key point:

The importance of this ruling goes far beyond depriving the White House of a mere talking point, of course. It also provides a bipartisan argument against congressional overreach: "Few powers, if any, could be more attractive to Congress than compelling the purchase of certain products. Yet even if we focus on the modern era, when congressional power under the Commerce Clause has been at its height, Congress still has not asserted this authority."

They go on to point out that even during unambiguous crises like World War II, "Congress never sought to require the purchase of wheat or require every American to purchase a more fuel efficient vehicle." This reference to "fuel efficient vehicles" suggests that these two judges are concerned that the insurance mandate is an evil portent of things to come if it is allowed to stand.

(Read the full text of "Obamacare Loses Another One".)

Catron notes that the conflicting rulings between the 11th Circuit and the 6th Circuit makes it extremely likely that the US Supreme Court will have to weigh in on this issue.

And he also observes that the Obama Administration will almost certainly continue its delaying tactics to entrench the current law as much as possible before the Supreme Court rules on the case.

On a related point, law professor Ann Althouse points out that ObamaCare supporters should ask themselves, "Could Congress ban abortion using its commerce power?"

Stay tuned...

Learning From McDonald's

In the 8/12/2011 Canadian newspaper Globe and Mail, Andrew Steele wrote an interesting piece entitled, "What the health care system can learn from McDonald's".

Steele makes the point that innovations from the free market (such as the fast food industry) can also be applied to save money and improve quality in health care.

He notes that:

...[T]he Aravind Eye Care System has become the largest provider of eye care in the world. They perform hundreds of thousands of cataract surgeries a year, restoring sight to millions of people.

For the poorest of the poor, their services are the difference between starvation and a job, misery and dignity, death and life.

The inspiration of their model is not the Harvard Medical School or Johns Hopkins. It's McDonald's.

Steele's article also links to this TED talk about the Aravind Eye Care System:



Unfortunately, the article doesn't go far in enough in advocating privatization of Canada's current government-run system. In particular, if a government-run system attempted to create a network of such clinics, they would likely become ossified bureaucratic dinosaurs in short order -- precisely because the clinics would no longer have the freedom to innovate and respond to market forces in the same fashion as if they were privately owned.

But if the article gets people thinking more broadly about the merits of private-vs.-government health care, it will be a good start.

(Read the full text of "What the health care system can learn from McDonald's".  Link via R.B.)

Constitutional Battle Over ObamaCare Heats Up

The 11th Circuit Court's ruling yesterday striking down the ObamaCare individual mandate is obviously the big news story of the past day. A few relevant links:

Klein: "Why 11th Circuit struck down Obamacare's mandate"

Klein: "Lawyer who challenged Obamacare speaks"

Some noteworthy pre-ruling analysis of relevant issues includes:

Elizabeth Price Foley: "Limited government, federalism, and the Affordable Care Act".

Beard: "ObamaCare v. the Constitution" (The Objective Standard, Summer 2011)

Bowden: "How important is the Obamacare litigation?"

The latest ruling makes it much more likely that the US Supreme Court will eventually issue a ruling on this issue.

FWIW, law professor Orin Kerr predicts that SCOTUS will uphold the individual mandate by anywhere from 6-3 to 8-1.

Fogoros: An Epiphany On Direct-Pay Practices

Dr. Rich Fogoros discusses, "An Epiphany On Direct-Pay Practices".

In this post he makes several excellent points, including the fact that direct-pay health care preserves the doctor-patient relationship, thus allowing genuine ethical health care.

In contrast, supposedly noble government health systems have the opposite effect of causing an "unethical, demeaning, public-health-destroying style of practice".

The first system rewards the better doctors (thus benefitting patients). The second system drives the better doctors out of the profession.

Another good point:

It is important to note that any innovation that can potentially spare patients from some of the harm the healthcare system has in store for them will necessarily be applicable to only some patients at first. That's how disruptive processes work. They begin as niche products or services, attractive only to a few high-end users; too expensive or too marginal for the vast majority; ignored, ridiculed or castigated by current providers. But if at their core they're offering something fundamentally useful, they will slowly demonstrate their worth – and eventually all the potential users will see the light, and demand for the product will become explosive. When that happens, the means are found to make the new product affordable and available to meet the demand – often by making significant adjustments to the original concept, that nonetheless preserve the core benefits. And when that happens, the traditional providers (who never saw it coming) are suddenly out of business.

It may not be that direct-pay medicine plays the personal computer to the traditional healthcare system’s mainframe. But it is inarguable that what it offers to patients – at its core – is every bit as vital and every bit as indispensable. And if a critical mass of the public can be made to understand what is really being offered here, there will be no holding it back.

This is a typical pattern we take for granted in other sectors of the economy such as consumer goods. It's time to unleash similar free-market dynamics in American health care.

(Read the full text of "An Epiphany On Direct-Pay Practices".)

Amerling WSJ LTE On Mandates

The 8/11/2011 Wall Street Journal published this LTE by Dr. Richard Amerling of Association of American Physicians and Surgeons (AAPS) on the new mandated benefits under ObamaCare:

Where Will Pricey New Mandates End?

The federal government's announcement that it will require new health-insurance plans to offer contraceptive services without charging a co-payment ("Law Eases Availability of Birth Control," U.S. News, Aug. 2) should be chilling to all freedom-loving Americans. It is a vivid reminder of the dictatorial powers given the Department of Health and Human Services by ObamaCare.

Can anyone believe that private insurance companies will remain private, or solvent, under this law? Can anyone believe that such mandates will save money?

It is also now clear that the administration will use this new lever to implement social policy. With the stroke of a pen, taxpayers will now be directly subsidizing Planned Parenthood and others providing "contraceptive services."

Richard Amerling, M.D.
Association of American Physicians and Surgeons
New York

Quick Links: Congress, Administrative Costs

Now that the debt ceiling battle is over, FoxNews reports that the health care issue will heat up in Congress again.

John Goodman discusses the problems in attempting to classify expenditures as "administrative" (or not). He notes:

Think about a doctor's office and ask yourself what goes on there that you would be inclined to call "administration" or "overhead" and what you would call "medical care." Arguably, the physical facility, the equipment, and the utilities are all overhead. The personnel who admit you and discharge you are engaged in administration, are they not? Ditto for the taking of your medical history and your vitals -- and even ascertaining the nature of the complaint that brought you there. In fact, you could make a case that unless someone is actually drawing blood, giving you a shot or ordering a prescription, it's all overhead.

And if the definition of what counts as "overhead" makes a difference between turning a profit or enduring a loss, we can be sure than there will be intense political gamesmanship over how government defines "overhead" and "administrative" costs.

Hsieh PJM OpEd: Don’t Shoot the Downgrade Messenger

The 8/10/2011 PajamasMedia has just published my latest OpEd, "Don't Shoot the Downgrade Messenger".

My theme is that attacking S&P for the U.S. credit downgrade is like criticizing your doctor for diagnosing your cancer. Here is the opening:

Suppose you saw your doctor for a persistent headache. After performing a full battery of tests, he told you that your MRI scan showed a malignant brain tumor. Would you (1) work with him on a plan to treat your cancer, or (2) threaten the MRI manufacturer with a government investigation? Although most normal people would choose option 1, our government is responding to the news of the S&P credit downgrade with option 2.

The Senate Banking Committee has responded to S&P's downgrading of the U.S. government's credit rating by "gathering information" in preparation for possible formal hearings on S&P's action. Committee Chairman Tim Johnson (D-S.D.) called S&P’s move "irresponsible" because it would make it more difficult for cash-strapped state and local governments to borrow more money. In other words, the problem wasn't the fact that the federal, state, and local governments were borrowing money that might not ever get paid back. Rather, the problem was that S&P was pointing out that fact to the rest of the world.

Unfortunately, our government's tactic of blaming the messenger has been all too common these past few years...

(Read the full text of "Don't Shoot the Downgrade Messenger".)

The unrest in Great Britain and Greece are a wakeup call to America as to what to expect if we continue on our current unsustainable welfare-state spending spree. If America is to survive, programs like Medicare and Social Security will have to be phased out and eliminated.

Let's hope Americans take heed before it's too late.

Wolf: ObamaCare Or America?

In the 8/8/2011 Washington Times, Dr. Milton Wolf explains why we face a stark choice, "Obamacare or America?"

ObamaCare will turn our already precarious fiscal situation into a total nightmare. Here's an excerpt:

The $14.5 trillion debt monster has now grown larger the U.S. economy itself but, as evil as it is, it pales in comparison to the unfunded liability monster. It's time we wrap our minds around this beast. It is so massive that it simply cannot be accurately measured. The "Big Three" -- Social Security, Medicare and Medicaid - have underfunded promises several times the size of the national debt, according to Federal Reserve figures. One hundred and fifteen trillion dollars -- a cool million dollars for each taxpayer -- that's around eight times the total U.S. economy. These bills are quickly coming due.

President Obama's unbelievable solution is to turn the "Big Three" into the "Big Four" by adding his massive Obamacare entitlement to the mix. The same spender-in-chief who claimed that the nation is on the verge of default and grandma's Social Security checks can’t be guaranteed still wants to grow the welfare state even larger...

(Read the full text of "Obamacare or America?")

The rest of the piece cites yet more alarming numbers. And it shows that the biggest deficit coming out of Washington DC is not the economic deficit but the "reality deficit" -- i.e, the refusal to face the facts.

Ayn Rand once warned that people could evade reality, but they couldn't evade the consequences of that evasion. Unless America changes course soon, we're going to learn that lesson in spades.

Quick Links: Free Market, Spending, CO Symposium

Dr. Edwin Leap explains how, "The free market of smartphone apps can teach medicine a lesson". (Via @AAPSonline.)

Christopher Conover argues that "Government Share of Healthcare Is Far Bigger Than Advertised".

Grace-Marie Turner summarizes the recent debate over ObamaCare at the Colorado Health Symposium.

Catron: The One-Termer We've Been Waiting For

David Catron's latest OpEd at AmSpec covers President Obama, "The One-Termer We've Been Waiting For".

He discusses the economy-stifling results of ObamaCare, including stalled job creation, the job cuts at medical device companies like Boston Scientific, and job losses amongst health care workers due to hospital cutbacks.

One eye-opening excerpt:

Which bring us to the most galling irony of all -- the Obama administration has now admitted that PPACA won't reduce costs. Last month, the Centers for Medicare & Medicaid Services (CMS) issued a report showing that health care costs will rise faster with Obamacare in place than they would have in its absence: "CMS officials attributed the growth to an expansion of the insured population. Under the plan, an estimated 23 million Americans are expected to obtain insurance in 2014, largely through state-based exchanges and expanded Medicaid eligibility." In other words, the President's "signature achievement" actually exacerbates the main problem it was ostensibly designed to solve. Obamacare will "bend the cost curve" upward while expanding the unemployment rolls.

(Read the full text of "The One-Termer We've Been Waiting For".)

Given all this, it's no wonder that Americans have lost their enthusiasm for the President and his policies.

Wolf: Is The Problem The Man Or The Ideas?

In the 8/2/2011 Washington Times, Dr. Milton Wolf dissects the President's accomplishments (or lack thereof). Here are some points he covered in, "Liberals' unmaking of Barack Obama":

Two million-private sector jobs have been lost.

Unemployment jumped from 7.8 to 9.2 percent with a simply terrible 2011 first-quarter economic growth rate of just 0.4 percent.

A record 1 in 7 Americans is on food stamps.

Gasoline prices more than doubled, from $1.83 to $3.74 per gallon.

National debt increased 35 percent, to $14.5 trillion, or $137,000 for each taxpayer.

National unfunded liabilities increased 47 percent, to $114.9 trillion, or a cool $1 million for each taxpayer (and this does not yet include Obamacare).

America is on the verge of losing its AAA credit rating.

Some of the falsehoods related to Obama's health care legislation include:

Obamacare would create 4 million new jobs - 400,000 almost immediately.

You could keep your own doctor.

The president's mother was denied health insurance.

Given this abysmal track record, Obama's political and ideological supporters are now:

...[F]aced with an unthinkable dilemma: acknowledge the fundamental failure of his collectivist liberal philosophy, which tends toward socialism, or blame its failures on a single man whom, until just recently, the liberal deified.

Of course, they will be reluctant to admit that the fundamental ideas are flawed, so they will be tempted to blame poor execution or poor communications or poor management by the individual in charge.

Americans should not let them off the hook so easily. Instead, it's crucial to continue raising the point that statism and government control of health care (and the broader economy) as such are impractical and immoral regardless of who occupies the Oval Office.

We've seen the beginnings of this battle of ideas during the recent debt ceiling debate. Let's hope Americans continue this debate over the proper role of government in the lead-up to the 2012 election.

(Read the full text of "Liberals' unmaking of Barack Obama".)

Doctor Shortages

John Rossomando describes, "ObamaCare's Most Frightening Consequence: Not Enough Doctors".

In addition to financial pressures caused by decreased reimbursements, the article cites other factors:

Georgia GOP Rep. Tom Price, a fellow physician in the House Republican caucus, warns regulations will also cause doctors to change their minds about staying in medicine because they will make doctor-patient interactions more difficult.

"There will be limitations on medications that will be available, and shortages of medications through the FDA," Price said. "Surgeries will have to postponed because of a lack of medications needed to put patients to sleep, damaging the quality of the care that is received."

Price complains the regulations even come between patients and doctors when it comes to things as routine as how a doctor has to fill out paperwork to order oxygen tanks for patients who need them.

A November 2010 Physicians Foundation Survey underscored this when it found that 56% of doctors it surveyed anticipate the health care law will diminish the quality of care they can give their patients. A further 40% of physicians said they planned to retire, seek a nonclinical job in the health care field or leave the medical profession altogether.

A Galen Institute Study also found that ObamaCare's regulations likely would force countless aspiring doctors to forgo entering the profession at a time when demand for care is on the rise.

"PPACA [ObamaCare] will strip away physician autonomy, drown doctors in bureaucracy and drain job satisfaction," Dr. Jason Fodeman wrote in an April 2011 study for the Galen Institute. "As the profession deteriorates, older doctors will retire while younger doctors will look to switch careers.

"Many students considering a career in medicine will pursue other opportunities."

(Read the full text of "ObamaCare's Most Frightening Consequence: Not Enough Doctors".)

At the anecdotal level, I know doctors who are already planning exit strategies to leave medicine if/when the regulatory environment becomes too unbearable. This will make things harder on the good doctors who still try to stick it out and remain in practice. If enough good doctors decide to quit, it could lead to a "death spiral" for quality health care in America. And most Americans won't want to be treated by the other kind of doctor...

Should SCOTUS Hear The Thomas More Case?

In the 7/30/2011 Washington Examiner, Ken Klukowski of Liberty University argues that anti-ObamaCare activists should not want the US Supreme Court to hear the lawsuit by Thomas More Law Center challenging the individual mandate because it fails to properly address the severability issue.

Here's an excerpt from "Supreme Court should not take this Obamacare case":

The Thomas More Law Center filed one of the Obamacare cases, raising the sole issue of whether the individual mandate is unconstitutional. The case lost in the district court and again before the 6th Circuit federal appeals court. This week the TMLC petitioned the Supreme Court to take the case.

All the major lawsuits challenging Obamacare rightly argue that the individual mandate is unconstitutional. But the brass ring -- the ultimate prize -- is for the Supreme Court not only to strike down the mandate, but to also hold it non-severable from PPACA's other 2,700 pages.

Severability doctrine is how a court determines how much of a law to nullify. It's very rare for a court to strike down any part of a statute aside from the unconstitutional provision...

That's why the three most important lawsuits against Obamacare all raise severability. It's also why the federal judge in the biggest lawsuit (the multistate case from Florida) struck down the entire statute.

Striking down the individual mandate would be a great victory. Such a Supreme Court decision would delineate boundaries on federal power under the Constitution's Commerce Clause and the Necessary and Proper Clause.

The implications would be profound. It would be a shot of adrenaline for the cases challenging the Environmental Protection Agency's cap-and-trade rules, National Labor Relations Board's authoritarian rampage, the Federal Communications Commission's Internet power grab, among other lawsuits.

But, while TMLC's challenge is laudable, a lawsuit attacking Section 1501 but not raising severability doesn't go far enough. If only the individual mandate is struck down, it would immunize 99 percent of Obamacare from further legal challenges.

(Read the full text of "Supreme Court should not take this Obamacare case".)

If Klukowski is right, we should hope that the Supreme Court hears a case that maximizes the chance of striking down the entire ObamaCare law. (In theory, the SCOTUS could also choose to wait until other ObamaCare lower court cases reach them as well, then decide multiple issues at once.)

(Thanks to @Lucidicus for the pointer.)

Save Money On The OTHER Guy!

"Dr. Grumpy" points out how "People accuse doctors of not doing enough, or doing too much".

Basically, it's the medical equivalent of NIMBY (not in my backyard) -- i.e., save money on the other patient, but not me!

Minton: The Coming War on Vitamins

Michelle Minton of CEI (Competitive Enterprise Institute) has a new OpEd in the 7/28/2011 Washington Times, "The coming war on vitamins".

Minton describes the latest proposal by Senator Durbin (D-IL) which, in conjunction with other FDA regulations, would seriously hinder the ability of ordinary Americans to freely purchase many over-the-counter vitamins and dietary supplements. Many of these dietary supplements would have to go an onerous FDA approval process which would either drastically raise their prices or drive them off the store shelves completely.

I'm personally seeing more medically-savvy Baby Boomer patients taking ownership of their health and using these inexpensive supplements to protect against arthritis, digestive problems, etc. Hence, the Durbin proposal would significantly impair ordinary Americans' ability to act on their own best judgment for their best medical interests.

(Read the full text of "The coming war on vitamins".)

NewsMax has a related article drawing on Minton's analysis at, "Now Government Trying to Ban Sale of Your Supplements".

Americans need more health freedom, not more nanny-state regulations!