Medicine Archives

Candidate Obama vs. President Obama

Those campaign promises are reaching their expiration dates quite quickly.  Back during the campaign, Obama ran hard against Hillary Clinton’s mandatory health insurance. has the quotes.

"Hillary Clinton’s attacking, but what’s she not telling you about her health care plan? It forces everyone to buy insurance, even if you can’t afford it, and you pay a penalty if you don’t," said one of his television ads .

His mailings made similar claims, which we rated Half True . At one campaign stop, Clinton waived the mailers and declared, "Shame on you, Barack Obama!"

"Meet me in Ohio," she added. "Let’s have a debate about your tactics and your behavior in this campaign."

Obama was vigorous in his attacks on Clinton for including an indvidual [sic] mandate in her plan. Now that the Democrats in the House have included a mandate in health reform legislation, he’s fine with it. He admitted he changed position in the interview with CBS. Full Flop!

All that talk of Hope and Change is really just subject to political expediency.  If you believed what he said, what you need to hope for is that he doesn’t change.  (If you didn’t, well then, this is not a real surprise.)

Restructuring the Economy; What Do You Call It?

TigerHawk has an eye-opening blog post about how much of the economy the Obama administration wants to restructure. 

Perhaps a number will help: 35%. That is the aggregate percentage of United States GDP produced by the three industries that the Democrats hope to restructure from the top down: Health care (17% of GDP), energy (9.8% of GDP), and financial services (8% of GDP). Think about that.

And it has to be done now, now, now!  Don’t read the bills, and don’t let the public scrutinize them; just vote on them!

And if you act now, we’ll throw in the automotive sector (4% of GDP)!  (Sorry, channeling Billy Mays for a second there.)

So then, if the government gets to get its hands into more than 1/3rd of the economy, with a controlling interest never before given to it, would you still call that capitalism? 

Paging Dr. Krugman

John Stossel has a nice takedown of your most recent article on universal health care.  No, it’s not better in France, and it’s going to cost way more than any estimate.

It’s short, so you can indeed Read the Whole Thing(tm).

Will Obamacare End Roe v. Wade?

At least according to this article in The American Spectator, the answer is yes:

Stated or unstated, a driving force behind modern liberalism takes root in the 1973 Supreme Court decision Roe v. Wade, in which abortion was legalized. The Court found a “right to privacy” guaranteed by the due process clause of the 14th Amendment, saying that a woman had a constitutional right to abort her child up until the “point at which the fetus becomes viable.” The Court quite specifically defined viability as the point at which a fetus is “potentially able to live outside the mother’s womb, albeit with artificial aid. Viability is usually placed at about seven months (28 weeks) but may occur earlier, even at 24 weeks.”

Quite aside from the political acrimony the Roe decision has generated from the day it was issued, the hot debate over President Obama’s health care proposal alters the abortion debate in a fashion quite unintended. If passed, ObamaCare could instantly set up a legal confrontation between the principle behind President’s health care system — and the principle undergirding Roe v. Wade. Which in turn would launch a political battle royal between proponents of government health care and abortion rights.


A reading of the Roe decision leaves no doubt whatsoever of what abortion advocates have claimed ever since the opinion was handed down. To quote the Supreme Court decision directly:

We repeat, however, that the State does have an important and legitimate interest in preserving and protecting the health of the pregnant woman, whether she be a resident of the State or a nonresident who seeks medical consultation and treatment there, and that it has still another important and legitimate interest in protecting the potentiality of human life.

If, as Roe clearly states, “the State does have an important and legitimate interest in preserving and protecting the health [emphasis mine] of the pregnant woman” — why doesn’t it have “an important and legitimate interest” in protecting the health of the rest us?

The article goes on to point out that the fundamental premise behind universal health care is that the government could be deciding who gets what medical care thus taking the decision-making process out of the hands of the patient and putting into the hands of bureaucrats. If that’s so, you can be sure that abortion advocates will be at odds with those who want a single-payor health system.

Dying to Cut Costs

Don’t you just hate it when it’s the insurance company making your healthcare decisions rather than you or your doctor?  Well, when it’s the government insuring you, this is what you can expect.

President Obama suggested at a town hall event Wednesday night that one way to shave medical costs is to stop expensive and ultimately futile procedures performed on people who are about to die and don’t stand to gain from the extra care.

In a nationally televised event at the White House, Obama said families need better information so they don’t unthinkingly approve "additional tests or additional drugs that the evidence shows is not necessarily going to improve care."

He added: "Maybe you’re better off not having the surgery, but taking the painkiller."

Obama advertises that you’ll be able to choose your own doctor, but if neither of you have a say in your healthcare that’s just a bunch of misdirection.  Indeed, sometimes that happens even now, but if you think that the government option will somehow be fundamentally different, you’re gravely mistaken. 

And after the trillions spent on providing this, the desire to cut costs will be great.

Link Catch-up

I haven’t posted as much recently.  I thought summer would slow things down, but apparently not so much around our house.  I’ve been collecting things to write on, but they’re starting to get stale, so before they’re completely irrelevant, here are a few quick hits to start the week.

Economy: Never mind whether or not you got TARP funds, the Obama administration may be looking to cap your executive’s pay.

Gene Sperling, a top counselor to Treasury Secretary Timothy Geithner, conceded to a congressional committee that imposing compensation caps on companies could lead to a flight of talent.

“I can say with certainty that nobody in the Obama administration is proposing such a thing,” he said.

Yet, at the same time, he and officials with the Federal Reserve and the Securities and Exchange Commission laid out a case for how payment structures rewarded short-term gains at the expense of long-term performance and contributed to the nation’s financial crisis.

The administration plans to seek legislation that would try to rein in compensation at publicly traded companies through nonbinding shareholder votes and by decreasing management influence on pay decisions.

No mention of how incentivizing the giving loans to people who couldn’t afford them contributed to the nation’s financial crisis, nor any talk of reining that in.

Abortion: Warner Todd Hudson asks and answers, “Why is Killing Abortionists Wrong? Because it is Un-Christian, That’s Why!” He uses logic and scripture to back up his position.  The key paragraphs:

The final word here is that a Christian ethic posits that men are subject to man’s laws and willfully violating them is not a Christian thing to do — but for extreme cases, and then in a more passive manner than not. Additionally man’s duly constituted law is the sword of punishment and punishment should not be carried out by the individual going off on his own hook. Christians do not take the law into their own hands.

So, in answer to Jacob Sullum’s tough question, killing abortionists IS wrong. It is also quite in keeping with Christian practice to suffer under pro-abortion laws without taking the law into one’s own hands to end the life of a doctor committing abortions. The law says that abortion is legal, only the law may impose the sentence of death, and the individual is bound by those facts under a Christian worldview.

Definitely worth a read.

Health Care: So will all those saving we’re supposed to come from health care reform going to come after the trillion dollar cost is recouped?

Health-care overhaul legislation being drafted by House Democrats will include $600 billion in tax increases and $400 billion in cuts to Medicare and Medicaid, Ways and Means Committee Chairman Charles Rangel said.

Democrats will work on the bill’s details next week as they struggle through “what kind of heartburn” it will cause to agree on how to pay for revamping the health-care system, Rangel, a New York Democrat, said today. The measure’s cost is reaching well beyond the $634 billion President Barack Obama proposed in his budget request to Congress as a 10-year down payment for the policy changes.

Asked whether the cost of a health-care overhaul would be more than $1 trillion over a decade, Rangel said, “the answer is yes.” Some Senate Republicans, including Senator Orrin Hatch of Utah, say the costs will likely exceed $1.5 trillion.

And, as we all know, government estimates of the cost of a government program are a low end guess.  Somehow, I think that net tax decrease that Obama promised was never going to materialize anyway.

Deckchairs on the Titanic

Mr Obama and those in his coterie want to press for a major shift in our healthcare system to one which far more strictly controlled by the government. I think Mr Obama’s interest in healthcare in this manner is likely a charitable impulse for the 10% at the bottom combined alas with a disregard for the state of the middle 85% which will likely be substantially harmed by this shift and the realization that those at the very top (of which he is one) will be unaffected. The question for future elections will be how well will the Democratic party be able to re-write history and shift blame for the disaster that this will become. For if they fail that project then their predicted demographic demise of the GOP will not occur, but that a decade from now the two-party system which naturally arises in the American project will not include one which coins itself the “Democratic party”.

In the interest of completeness, is should be pointed out that the AMA hawking for market control of healthcare is a somewhat disingenuous plea. The AMA strictly controls their medical school graduating population into the various specializations in a centralized manner attempting to predict and fix the markets and quantities of various specialty (and generalist) numbers. Their plea for market forces is more in the nature of a complaint that power which had been theirs might be lost.

Today it was noted (by a liberal blogger no less) that approximately 10% of medical expenses go the mostly loudly demonized portion of the industry, i.e., the pharmaceutical companies. Given the effects of the advances that internal medicine has been able to achieve in the last few decades if that the result of 10% of our expenditure … there should be no grounds for complaints. Those touting “gains” in efficiencies of the proposed system fail to recognized the following (or at least have failed to counter them in anything I’ve read):

  • To get a drastic gain in efficiency has to mean that today there are drastic inefficiencies. To this matter, a question should be asked. In your visits in hospitals and doctors offices do you see Doctors the nursing staff just doing busy work? Or are they at at task dealing with patients? In my experiences with medical staff, one sees busy doctors and the industry standard “waiting room” time is on account of emergency and other over-booking and under estimates of the time it takes to deal with individual patients. The point is, if doctors and nurses and other practitioners don’t have idle time and are actually working close to capacity … where’s this big gain in medical capacity going to come from?
  • It is claimed that government involvement will streamline and make the paper work and billing matters more efficient and more streamlined. Why just stating this doesn’t cause those touting this notion’s head to explode with the cognitive dissonance is beyond me. Government. Increased efficiency. Aren’t those antithetical concepts? There is no project, no task, no aspect of life in the past 2000 years that government bureaucracy has added efficiency and smoothed out the wrinkles. Less paperwork and lower costs with more government involvement. Riiiight. Name just one time in the past where that transpired.
  • If improvements in medical costs and quality of care are to be actually realized, it’s going to be when more and more of your medical interactions are in the form of something more like a internet subscription service, i.e., far fewer doctors managing a largely automated network. It’s going to take real innovation and paradigm shifts in how medicine is done. So let me ask, will entrenching our medical culture and industrial complex into a large government beaurocracy will make things more or less amenable to large changes? Less likely seems the realistic answer. If you think the answer is “more likely” … again I’ve failed to even see this issue addressed anywhere … so what is the argument to that.
  • Finally, the insistence that increased administrative efficiency and methodology is where the solution to the so-called healthcare problem is to be found is harmful in that it causes thousands if not millions of people to be looking for the solutions in the wrong place.

Here are three fatal flaws with every “unified government run” healthcare proposal such as the ones that the Democrats are pushing.

Political Cartoon: A Big Pill to Swallow

From Chuck Asay:

(Click on the cartoon for a larger version.)

He’s just going to introduce efficiencies into the system, that’s all.  No, really.

A Prediction: 1,000 Swine Flu cases in U.S. by May 18, 2009

So say the “worst case” statistical models at Indiana University.

However, researchers state that time is of the essence and that models could change every 12 to 24 hours, depending on how quickly various governments react to the threat.

So… what’s your wager?

Rushing Things … Again.

Health care and any overhauling thereof should not be done lightly.  It should not be rushed through Congress, like, say, the TARP bill was.  This is a big deal.

Well, apparently Obama thinks it’s too big to fail.

President Obama and his Democratic allies in Congress are poised to trample Republican opposition to his health care bill with a controversial legislative tactic known as reconciliation.

The fast-track process would protect Obama’s ambitious plan to overhaul the U.S. health care system from a potential GOP filibuster and limit the Republicans’ ability to get concessions. It also would give Democrats far more control over the specifics of the health care legislation.

Under typical Senate rules, 60 votes are needed to advance a bill, but reconciliation would enable Democrats to enact the health care plan with just a simple majority and only 20 hours of debate.

Democrats hold 56 seats in the Senate, and two independents typically vote with the party. Republicans have 41 seats, and there is one vacancy.

Republicans have complained furiously about the prospect of health care reform passing under fast-track rules. But they’re not planning to go down without a fight.

And that’s not the only ill-considered option not being properly considered.

But Democrats aren’t stopping at health care. Obama’s plan to cut private banks and other lending institutions out of the market for student loans would also move on a filibuster-free path.

Senate Majority Leader Harry Reid, D-Nev., said Friday that most House and Senate negotiators have resolved most of their differences over a congressional budget blueprint designed to advance Obama’s agenda through Congress. The measure will set the rules on how Congress considers Obama’s agenda for the rest of the year.

Lawmakers are rushing to agree on the budget framework in time to give Obama a victory within his first 100 days in office.

The negotiations have centered on the annual congressional budget resolution, which sets the parameters for the legislation that follows. Congressional votes next week would provide a symbolic victory for Obama’s sweeping agenda to enact a universal health care system, invest in education and clean energy and cut the exploding budget deficit to manageable levels.

Obama marks his 100th day in office on Wednesday.

This is big government run amok.  All Republicans can do at this point is try to get in amendments to ameliorate the damage.  Some Congressman, and many constituents, including those at the recent Tea Parties, complain that far too many legislators didn’t actually read the bill or know what was in it.  And yet they’re going to do it again; make the same mistake twice, very deliberately.

A government big enough to make these sweeping changes in the blink of an eye is big enough to foul it up in a big way.  And there’s a better than even chance it will be fouled up the faster it’s done and the less debate there is.

Single Payer? Them’s Fighting Words … Or
Liberty or Death — Pick One

Today’s links started a short discussion on healthcare. The Liberal/Progressive left see universal health insurance (one insurance provider) as a way to ensure the “right” that they believe every American has to good healthcare. Now, I don’t think healthcare is a “right” but then again I’m admittedly quite shaky when it comes what the word “right” (with or without scare quotes) might mean and think that by and large think that we don’t have what is meant commonly by that word, especially for healthcare. But I digress, for the point of this essay is to establish a few “talking points” regarding healthcare from a policy standpoint.

I’ll begin with noting a few flaws with universal coverage.

  • One of the primary problems with universal coverage/one provider for insurance is structural. Representational government, involving elected officials, is particularly poorly suited to handle actuarial matters. Politicians like to promise, and very often promise short term gains ignoring long term costs, e.g., flood insurance rates set by the State is traditionally far below what reasonable actuarial calculations will provide. The representitive banks on the “payback” or disaster which is being insured against will not occur in his/her lifetime.
  • Good actuarial calculations demand an eye to the cost, to the bottom line. That future cost is the future of the company and cannot be overlooked, unlike it can in a politician’s rhetoric.
  • Insurance-as-business has a short term interest in cutting costs, but a long term interest in them going up. That is to say, in the short term a medical insurance provider benefits from cutting health care costs. If a medical procedure costs less, it costs them less and they don’t have to pay as much to provide a given benefit. On the other hand in the long term, their rates and profit are based on a percentage of average costs … which if they go up, then aggregate profits go up as well. One might suspect that the cost/benefit analysis works differently for a government run agency, but this is not likely the case as power as well as profit goes into the government’s payback.

Now some thoughts on healthcare in general.

  • Why is healthcare expensive today? The reason shirts, food, shoes, and toasters are cheap today is because of two factors. Mechanization allows for multiplication of human labor involved in their production and the availability of cheap power. If a skilled or unskilled laborer can produce 10,000 widgets a day with a machine where he can only make one per day by hand, then the price of the widget being sold can drop by orders of magnitude. Unless we increase greatly the number of health care workers and pay them slave wages the price of healthcare is going to stay prohibitively high. Humans, especially skilled humans, cost money (they need to get paid). Ultimately the only way to make healthcare available and cheap for everyone is to get the humans efforts multiplied by technological means. If a doctor today sees 40 patients a day, the only way to reduce health care costs by orders of magnitude is to increase the number of patients he can minister to in a day the same orders of magnitude. This is not as impossible as it sounds. The average village pediatrician sees childhood diseases in waves. When a flu sweeps through the town, he gets hit with hundreds of kids with identical symptoms. Does he need to give the same diagnostic care to all? Couldn’t some intelligent automation and cheap intelligent diagnostic tools multiply his effectiveness?
  • Another reason is regulation. FDA regulation is very expensive, and largely useless from the point of view of the manufacturer. FDA approval does not indemnify a manufacturer from fault. After going through extensive and expensive tests a drug is approved. If later it is found harmful, the manufacturer is still liable even though they got certification. FDA approval is not necessarily a bad thing, but it has cost. That cost should be an option not a requirement and should indemnify the manufacturer from fault. If the FDA approves thalidomide for pre-natal maternal care then there should be no way to bring suit in case harmful effects are discovered later unless the manufacturer fudged or falsified the certification procedure. Requiring FDA approval is likely the single biggest roadblock to innovation in the healthcare industry in the US today. I’m not suggesting it be eliminated, in fact by indemnifying a manufacturer upon gaining FDA certification it is instead strengthened. The other side of that coin is that FDA approval for drugs and health care products should be optional.
  • Univeral/single payer plans miss out on the goal. The goal for government policy should not be to bring equal health care to everyone but to provide a path to better, cheaper, and more effective future health care for all of us. Government driven policy and insurance is not the way to innovate.

Look at an example noted in Monday’s highlight’s comments:

A down to earth example might be the law student whose letter Andrew Sullivan published recently. He has asthma but no coverage since he is in school. He has to basically get his friends mom to swipe samples of the drug he needs. He was jogging on a treadmill and got a sudden pain in his foot. He stayed off of it for several months. In the meantime someone with good coverage will get regular checkups for a $20 co-pay and maybe spend $100 for an emergancy x-ray if they got that mysterious pain in their foot. This type of ‘rationing’ does not seem very efficient or fair.

How might this end up in a “mechanized” health care environment? Today we have many categories of “prescription” drugs and over the counter drug and as well we have protected and generic drugs. My suggestions would severely limit the first category opening up the number of drugs available over the counter, which would almost certainly include asthma inhalants. And as well to the “protected” and “generic” classifications of drugs, other approval schemes would be available besides FDA approved medications. Other independent certifications (or no certification at all) would be available to drug manufacturers. That would leave a larger array of price points for the albuterol this young student needs. In the second case, the student could go to a semi-automated (think Kinko’s) medical diagnostic clinic, rent some scan time with a automated scanner (x-ray or ultra-sound likely) and have the pain in his foot examined. He could have an automated result from an expert system tell him what therapeutic options would be best in his case and the an estimate of accuracy of diagnoses which he could use to decide if he needed his pictures to be examined by a human expert. The clinic would be making money by providing this machine for likely less than that $20 co-pay. Note that in my “plan” anti-plan no insurance is needed. In fact, the existence of insurance would mean that the things needed to give control back to the patient and provide for more health care “product” to be consumed by the population would not be occuring. Single payer or universal health care is exactly the wrong way to get to where we need to go. It is moving to a more covered, more controlled and less effective health care industry, which gets it exactly backwards.

Consider 400 years ago, I’d bet that over 60% of the population farmed. Consider food as analogous to health care. Single payer is a plan to provide “fairer distribution” (an arguable point) and redistribute and control what food is produced. That sounds like a move to the collective farming of peasants who stay with non-mechanized labor for production. But history has shown, a more effective way to provide inexpensive food is to bring in harvesters, trucks, fertilizer, refrigeration, super-markets, and other (farmers, ethnic, health) markets into the equation. Single payer supporters are the ones fighting for staying with the horse drawn solutions on collectivized farms at the same time as a better solution. Today a small fraction of the population farms … and obesity because, in part, of cheap available food is the problem.

So essentially the single-payer supporter is campaigning for the five-year plans of the Soviet era and the failed farm collectivization projects of Lenin and Stalin which caused mass starvation and shortages. So when looked at from a practical standpoint, single-payer healthcare might have pretty poetic stories and market jingles to push its agenda forward. But to put it bluntly, one might ask the supporters single payer, “So which is it are you stupid or evil?” ‘Cause it seems like those are only the two alternatives that remain.

Are Democrats Really Against Following Your Conscience?

Last December, the Bush administration granted protection to health care workers who refused to perform certain procedures on moral grounds.  If a hospital, health plan or clinic didn’t accommodate the consciences of their employees, they’d lose federal funding.  Abortion rights activists proceeded to take the low road.

But women’s health advocates, family planning proponents, abortion rights activists and some members of Congress condemned the regulation, saying it will be a major obstacle to providing many health services, including abortion, family planning, infertility treatment, and end-of-life care, as well as possibly a wide range of scientific research.

Never mind moral issues, and never mind that plenty of people who have no problem with performing these procedures exist, there must not even be the slightest impediment to these procedures.  Guess we know where their priorities lie.

As well as the priorities of some Democrats in Congress.

Sen. Patty Murray (D-Wash.), who with Sen. Hillary Rodham Clinton (D-N.Y.) introduced a bill last month to repeal the rule, said: "We will not allow this rule to stand. It threatens the health and well-being of women and the rights of patients across the country." Similar legislation is pending in the House.

No, it does not threaten anyone’s health or well-being.  Allowing an employee to follow their conscience simply means finding someone who’s ethics aren’t similarly bothered.

In spite of these overwrought pronouncements, the rule was put in place.

That was then, this is now.

Taking another step into the abortion debate, the Obama administration Friday will move to rescind a controversial rule that allows health-care workers to deny abortion counseling or other family-planning services if doing so would violate their moral beliefs, according to administration officials.

The rollback of the "conscience rule" comes just two months after the Bush administration announced it last year in one of its final policy initiatives.

This rule is important, mostly to protect health care workers from losing their jobs over their personal beliefs.  They weren’t supposed to be able to lose it, but that didn’t stop the health care industry.

For more than 30 years, federal law has allowed doctors and nurses to decline to provide abortion services as a matter of conscience, a protection that is not subject to rulemaking.

In promulgating the new rule last year, Health and Human Services Secretary Mike Leavitt said it was necessary to address discrimination in the medical field.

He criticized "an environment in the health-care field that is intolerant of individual conscience, certain religious beliefs, ethnic and cultural traditions and moral convictions."

Doctors have been successfully sued for not performing procedures they objected to, so the rule is necessary to give this same protection to other, non-abortion-related procedures. 

The Obama administration claims:

Officials said the administration will consider drafting a new rule to clarify what health-care workers can reasonably refuse for patients.

How about we find out what the administration considers "reasonable" before doing away with this valuable protection?  Or is conscience not that big a deal to Barack Obama?  It doesn’t sound like it.

Unintended Consequences; Removing Morality from Sexuality

Melanie Phillips in the London Daily Mail observes:

The story of 13-year-old Alfie, who reportedly has become a father by 15-year-old Chantelle, is a fable for our tragically degraded times.

Most of the attention has focused upon Alfie, who looks about eight and doesn’t even understand the word ‘financial’. But while Alfie’s youth is exceptional, this situation is not.

Whether or not Alfie is the father of baby Maisie or whether that honour goes to one of Chantelle’s reputed other boyfriends, the fact is that the length and breadth of this country there are many Chantelles, having sex and often getting pregnant while under age.

Phillips points out what has long been a refrain in societies where liberal programs have taken hold; the unintended consequences of government intervention.

There has been a profound loss of the very notions of self-restraint and boundaries of behaviour, promoted from the top by narcissistic liberals and funded at the bottom by welfare benefits which cushion people from the consequences of their actions.

The liberal intelligentsia pushed the idea that the worst things in the world were stigma and shame. Illegitimacy was accordingly abolished, lone mothers provided with welfare benefits and any talk about the advantages to children from marriage and sexual continence was to be banned as ‘judgmental’.

With all constraints on behaviour vilified as ‘moralising’, sex became treated merely as a pleasurable pastime devoid of any spiritual dimension.

As parents careered through serial sexual partnerships, putting their own short-term desires first and effectively behaving like children, they no longer wanted to be bothered with taking responsibility for their own offspring and so started treating them as if they were grown-up.

This was massively reinforced by the approach to sex education and contraception by schools and public health professionals, who treated children as quasi-adults capable of making their own life choices.

What they actually needed, as all children do, was firm and consistent boundaries which taught them that sex was properly an adult activity.

Instead, they were taught to treat sex a bit like bungee-jumping or paragliding – to have fun doing it, but to take precautions to avoid getting hurt.

And, she notes, the only definition of "hurt" was "getting pregnant".  Never mind the emotional or psychological harm that might be involved.

Read the whole thing.  Seems the more sex education we have and the earlier it starts, the more stories like this that we get.  Phillips’ article is a strong argument for the teaching of responsibility and its consequences rather than covering the world in bubble wrap. 

Democrats Against Religious Freedom

Congressman Chris Murphy (D-CT) is championing his support of what’s called the Protecting Patient and Health Care Act of 2009.  From his website:

WASHINGTON, D.C. – With the clock ticking down on the implementation of a sweeping Bush Administration rule that will deny vital health services to Americans, today Congressman Chris Murphy (CT-5) joined a group of colleagues to introduce the Protecting Patient and Health Care Act of 2009 to stop it.

In late December, the Bush Administration finalized the "refusal clause", which would cut off federal funding for any state or local government, hospital, health plan, clinic, or other entity that does not accommodate employees who refuse to participate in care that they find ethically, morally, or religiously objectionable. Set to take affect on Sunday, this sweeping change in access to vital health services, including birth control, abortion, HIV and STI testing, end of life care, and fertilization treatments, trumps current practices that accommodate health care providers’ religious beliefs while also providing their patients with access to care. It even goes as far as to allow whole hospitals or health plans to refuse services even if individual doctors and providers are willing to perform them.

What’s missing in this description is the reason the "refusal clause" was needed.  It’s really only emphasizing how the law currently is, because a number of court cases, and the judges of those cases, have shown that apparently the judicial system doesn’t quite understand the concept. 

I’ve touched on one example last August where a pair of doctors in California were sued successfully when they declined to give their services to a lesbian couple.  (Actually, they did everything but the physical insemination, which is all they declined to do.)  Acting as though they were the only option in the state, the couple took the case all the way to the State Supreme Court and won.  This was an elective procedure, and the State Supreme Court seemed to think they were obligated to do it if asked.  (And as noted in the original post, the CA Medical Association was on the side of the doctors until they got bullied by the gay-rights community, and they caved.)

So the action by the Bush administration was simply to reiterate that this refusal is legal, and put some oomph behind it.  The whole idea the people have no where else to go for these treatments, elective or otherwise, is absurd, but the danger to a guaranteed constitutional right is real. 

But Democrats, who insist that they’re just as concerned about religious freedom as anyone, put the lie to that by making the First Amendment a second-class citizen.


With all the promises of change that Barack Obama got his supporters to believe, we’re now finding out that "promises" are more like "goals".  Or perhaps "hopes".

Close Gitmo on the first day in office?  First week?  First 100 days?  Well, technically, he may only issue an order to do it soon, but it’s "a challenge" to even close it within the first 100 days.  The ACLU wants a timetable.  Good luck with that.

"That’s a challenge," Obama said on ABC’s "This Week." "I think it’s going to take some time and our legal teams are working in consultation with our national security apparatus as we speak to help design exactly what we need to do."

It’s not as easy as some on the Left expected it would be.  The "Reality-based community" finds that facing reality isn’t what they thought it would be.

Iraq withdrawal within 16 months?  Well, Biden has said that they’re going to follow the Bush plan instead.  Additional take on this and all the Iraq issues at RedState.

Universal Health Care is being back-burnered.  Indeed, the economic crisis should be one of the top priorities, but I thought this whole scheme was supposed to save us all money.  If it’s such a win-win for the economy and health care, why delay?  Hmmm.  (Perhaps it has something to do with how poorly UHC is working in places like Massachusetts?)

No lobbyists serving in policy areas they have worked to influence in the past year.  So then, September 2008 is technically last year.

Interrogation techniques that Obama campaigned against may actually get a new lease on life.  Newsweek tells us:

Dick Cheney, who will step down as vice president on Jan. 20, has been widely portrayed as a creature of the dark side, a monstrous figure who trampled on the Constitution to wage war against all foes, real and imagined. Barack Obama was elected partly to cleanse the temple of the Bush-Cheney stain, and in his campaign speeches he promised to reverse Cheney’s efforts to seize power for the White House in the war on terror.

It may not be so simple

This could be another entry in my "New They Tell Us" category.  This was so simple during the campaign, but now they tell us it’s complex.  Nuance, anyone?

All this added to Obama’s waffling on tax cuts, windfall profits taxes on Big Oil, and FISA.  Now, I have no illusion that Obama has become some sort of bedrock conservative (though he’s been seen in the company of some), and we’re still likely to see many a liberal policy enacted.  However, underneath all this complaining by the Left that the new boss seems the same as the old boss is one thought; maybe the old boss got some things right.

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