Some analysis of the "Health Care" Bill in the House

This came to my attention yesterday:

Yesterday President Obama responded to my statement that Democratic health care proposals would lead to rationed care; that the sick, the elderly, and the disabled would suffer the most under such rationing; and that under such a system these “unproductive” members of society could face the prospect of government bureaucrats determining whether they deserve health care.

The President made light of these concerns. He said:

“Let me just be specific about some things that I’ve been hearing lately that we just need to dispose of here. The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for death panels that will basically pull the plug on grandma because we’ve decided that we don’t, it’s too expensive to let her live anymore....It turns out that I guess this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, etc. So the intention of the members of Congress was to give people more information so that they could handle issues of end-of-life care when they’re ready on their own terms. It wasn’t forcing anybody to do anything.” [1]

The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation.” [2] With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.

Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often “if there is a significant change in the health condition of the individual ... or upon admission to a skilled nursing facility, a long-term care facility... or a hospice program." [3] During those consultations, practitioners must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services. [4]

Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” [5] Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care? As Charles Lane notes in the Washington Post, Section 1233 “addresses compassionate goals in disconcerting proximity to fiscal ones.... If it’s all about alleviating suffering, emotional or physical, what’s it doing in a measure to “bend the curve” on health-care costs?” [6]

As Lane also points out:

Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren’t quite “purely voluntary,” as Rep. Sander M. Levin (D-Mich.) asserts. To me, “purely voluntary” means “not unless the patient requests one.” Section 1233, however, lets doctors initiate the chat and gives them an incentive -- money -- to do so. Indeed, that’s an incentive to insist.

Patients may refuse without penalty, but many will bow to white-coated authority. Once they’re in the meeting, the bill does permit “formulation” of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would “place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign,” I don’t think he’s being realistic. [7]

Even columnist Eugene Robinson, a self-described “true believer” who “will almost certainly support” “whatever reform package finally emerges”, agrees that “If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending.” [8]

So are these usually friendly pundits wrong? Is this all just a “rumor” to be “disposed of”, as President Obama says? Not according to Democratic New York State Senator Ruben Diaz, Chairman of the New York State Senate Aging Committee, who writes:

Section 1233 of House Resolution 3200 puts our senior citizens on a slippery slope and may diminish respect for the inherent dignity of each of their lives.... It is egregious to consider that any senior citizen ... should be placed in a situation where he or she would feel pressured to save the government money by dying a little sooner than he or she otherwise would, be required to be counseled about the supposed benefits of killing oneself, or be encouraged to sign any end of life directives that they would not otherwise sign. [9]

Of course, it’s not just this one provision that presents a problem. My original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama and the brother of the President’s chief of staff. Dr. Emanuel has written that some medical services should not be guaranteed to those “who are irreversibly prevented from being or becoming participating citizens....An obvious example is not guaranteeing health services to patients with dementia.” [10] Dr. Emanuel has also advocated basing medical decisions on a system which “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.” [11]

President Obama can try to gloss over the effects of government authorized end-of-life consultations, but the views of one of his top health care advisors are clear enough. It’s all just more evidence that the Democratic legislative proposals will lead to health care rationing, and more evidence that the top-down plans of government bureaucrats will never result in real health care reform.

[1] See http://blogs.abcnews.com/politicalpunch/2009/08/president-obama-addresses-sarah-palin-death-panels-wild-representations.html.
[2] See http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
[3] See HR 3200 sec. 1233 (hhh)(1); Sec. 1233 (hhh)(3)(B)(1), above.
[4] See HR 3200 sec. 1233 (hhh)(1)(E), above.
[5] See http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
[6] See http://www.washingtonpost.com/wp-dyn/content/article/2009/08/07/AR2009080703043.html].
[7] Id.
[8] See http://www.washingtonpost.com/wp-dyn/content/article/2009/08/10/AR2009081002455.html].
[9] See http://www.nysenate.gov/press-release/letter-congressman-henry-waxman-re-section-1233-hr-3200.
[10] See http://www.ncpa.org/pdfs/Where_Civic_Republicanism_and_Deliberative_Democracy_Meet.pdf
[11] See http://www.scribd.com/doc/18280675/Principles-for-Allocation-of-Scarce-Medical-Interventions.

This was from SarahPac on Facebook.

"You are sucking at the hind teat of a dead cow..."

With few exceptions (specifically the abolishment of the Electoral College (4:18) and Universal Service (4:26)), this guy makes sense...

Thoughts on the Mark Sanford Scandal

I have to say I do not agree with much of what has been said of Governor Sanford of South Carolina by many in the Conservative movement. Glenn Beck this morning said:

We got plenty of dirtbags. We got plenty of people we can't trust. May I just beg the audience to please tell me that character does matter, please?

Yes, Glenn, character does matter...but what you and many others seem to be forgetting is that we are all dirtbags!

Remember...all have sinned and fall short of the glory of God (Romans 3:23).

Are we any better? Not at all! We have already made the charge that Jews and Gentiles alike are all under sin. As it is written: "There is no one righteous, not even one..." (Romans 3: 9-10)

To suggest that we as conservatives must demand righteousness misses the most important part of our human nature, that we are convicted in the Law and cannot by our own means ever be righteous and right with God. It is for this reason Jesus came to be the sin offering for us. This does not mean that we no longer sin...we are human and sin always--it is our nature!

Paul said the following when describing the human condition: "I do not understand what I do. For what I want to do I do not do, but what I hate I do....I know that nothing good lives in me, that is, in my sinful nature. For I have the desire to do what is good, but I cannot carry it out. For what I do is not the good I want to do; no, the evil I do not want to do—this I keep on doing." (Romans 7: 15, 18-19)

Yes, if one lives in the Spirit, one dies to his flesh...and it is only through the Spirit and by God's grace that we can live in righteousness...but I do not believe that this precludes us from falling again into sin--we are at war with one who will sorely tempt us and if we have not submitted fully to God, if we struggle to hold our own faith with our own will, we fall yet again because our will is human--weak, frail, unreliable, and sinful.

Does character count? ABSOLUTELY! Do we need people in office that have unquestionable character? NO! All of us have character flaws through our sinful state--every man's character is questionable. It is the admission of this and the steps one takes to deal with these flaws that should count for the most.

Finally, I was extremely moved by Jenny Sanford's statement. In it I found a quiet and contemplative faith and the seeds to Governor Sanford's redemption:

I would like to start by saying I love my husband and I believe I have put forth every effort possible to be the best wife I can be during our almost twenty years of marriage. As well, for the last fifteen years my husband has been fully engaged in public service to the citizens and taxpayers of this state and I have faithfully supported him in those efforts to the best of my ability. I have been and remain proud of his accomplishments and his service to this state.

I personally believe that the greatest legacy I will leave behind in this world is not the job I held on Wall Street, or the campaigns I managed for Mark, or the work I have done as First Lady or even the philanthropic activities in which I have been routinely engaged. Instead, the greatest legacy I will leave in this world is the character of the children I, or we, leave behind. It is for that reason that I deeply regret the recent actions of my husband Mark, and their potential damage to our children.

I believe wholeheartedly in the sanctity, dignity and importance of the institution of marriage. I believe that has been consistently reflected in my actions. When I found out about my husband's infidelity I worked immediately to first seek reconciliation through forgiveness, and then to work diligently to repair our marriage. We reached a point where I felt it was important to look my sons in the eyes and maintain my dignity, self-respect, and my basic sense of right and wrong. I therefore asked my husband to leave two weeks ago.

This trial separation was agreed to with the goal of ultimately strengthening our marriage. During this short separation it was agreed that Mark would not contact us. I kept this separation quiet out of respect of his public office and reputation, and in hopes of keeping our children from just this type of public exposure. Because of this separation, I did not know where he was in the past week.

I believe enduring love is primarily a commitment and an act of will, and for a marriage to be successful, that commitment must be reciprocal. I believe Mark has earned a chance to resurrect our marriage.

Psalm 127 states that sons are a gift from the Lord and children a reward from Him. I will continue to pour my energy into raising our sons to be honorable young men. I remain willing to forgive Mark completely for his indiscretions and to welcome him back, in time, if he continues to work toward reconciliation with a true spirit of humility and repentance.

This is a very painful time for us and I would humbly request now that members of the media respect the privacy of my boys and me as we struggle together to continue on with our lives and as I seek the wisdom of Solomon, the strength and patience of Job and the grace of God in helping to heal my family.

For my part, I am praying for the Sanfords.

We should have adopted this after 9/11

I am sure all of you witnessed the collective shift to patriotic pride after the devastating attacks on September 11. I always thought that "God Bless America" was overdone (my apologies to Irving Berlin). Don't get me wrong...I love the song...but it is a little ditty written by a brilliant musical theater composer.

I thought it would have been better if we had just adopted singing the fourth verse of Key's Star Spangled Banner...after all, it is our national anthem:

O, thus be it ever when freemen shall stand,
Between their lov'd homes and the war's desolation;
Blest with vict'ry and peace, may the heav'n-rescued land
Praise the Pow'r that hath made and preserv'd us a nation!
Then conquer we must, when our cause is just,
And this be our motto: "In God is our trust"
And the star-spangled banner in triumph shall wave
O'er the land of the free and the home of the brave!

Thoughts?

California Supreme Court Decides Correctly (for the most part)

As reported by Brietbart.com:

SAN FRANCISCO (AP) - The California Supreme Court upheld a voter-approved ban on same-sex marriage Tuesday, but it also decided that the estimated 18,000 gay couples who tied the knot before the law took effect will stay wed.

The 6-1 decision written by Chief Justice Ron George rejected an argument by gay rights activists that the ban revised the California constitution's equal protection clause to such a dramatic degree that it first needed the Legislature's approval.

The court said the people have a right, through the ballot box, to change their constitution. "In a sense, petitioners' and the attorney general's complaint is that it is just too easy to amend the California constitution through the initiative process. But it is not a proper function of this court to curtail that process; we are constitutionally bound to uphold it," the ruling said.

Who would have guessed that a court in California would actually be limited to its "proper function?" There may be hope after all

$1,840,000,000,000.00

From Blomberg: "Obama Says U.S. Long-Term Debt Load ‘Unsustainable’"

Ummm...really, Mr. President??

Interesting you are saying this now after presiding over the '09 budget with a deficit of $1.84 TRILLION. That is the ONE-YEAR DEFICIT is projected to by $1.84 trillion in '09.

This is more than the ENTIRE US DEBT in 1985 ($1.82 trillion according to Treasury)

This is more than the ENTIRE AMOUNT OF US BUDGET SPENDING in 2003--ONLY 6 YEARS AGO ($1.80 trillion according to OMB--Table 1.1, page 22)

This is more than the ENTIRE US GOVERNMENT SPENDING (on- and off-budget) in 2000--ONLY 9 YEARS AGO ($1.79 trillion according to OMB on same table above)

This is more than the ENTIRE GDP OF THE UNITED STATES (the value of all goods and services produced in the US) in 1976 ($1.83 trillion according to the Bureau of Economic Analysis)

This is more than the ENTIRE AMOUNT OF PERSONAL SPENDING IN THE US BY EVERY MAN, WOMAN, AND CHILD in 1980 ($1.76 trillion according to the BEA on same table above)

This is more than the ENTIRE GDP OF EVERY SINGLE COUNTRY except the US, Japan, China, Germany, France, UK, and Italy in 2008 (according to the CIA World Factbook)

President Obama would like you to believe that this in not his budget...however, as my friend DJ points out in his blog (emphasis added):

Usually, the budget of the first fiscal year of an administration is set by the previous president and Congress (fiscal years run from October to September, thus FY09 began in October of 2008).

Note that I said “usually,” because this time, Congress refused to pass a budget during and after the election campaign. The government survived on continuing resolutions (Washington-speak for month-to-month spending) because Pelosi, Reid, et al wanted to let Obama write the FY09 budget, which he did. Of course, one of the bigger impacts on this year’s deficit (but far from the biggest) is the TARP fiasco, which Obama did not implement. However, he did support it wholeheartedly – in the campaign and on the Senate floor – so he can’t escape responsibility for that one either (had he, the Democratic nominee for President, refused to support it, odds are the Democratic majorities in Congress would have shot it down).

So unlike previous presidents, Obama must accept responsibility for this budget imbalance. This deficit is on him.

Mr. Obama, you are largely responsible for this budget, this deficit, and this out-of-control spending. You are responsible for the overwhelming burden of this debt on my children and theirs. DO NOT think that we cannot see that the EMPEROR HAS NO CLOTHES!!!

Are We Seeing the Beginning of the End??

Dateline: April 9, 2009, Austin, Texas

Gov. Rick Perry today joined state Rep. Brandon Creighton and sponsors of House Concurrent Resolution (HCR) 50 in support of states’ rights under the 10th Amendment to the U.S. Constitution.

“I believe that our federal government has become oppressive in its size, its intrusion into the lives of our citizens, and its interference with the affairs of our state,” Gov. Perry said. “That is why I am here today to express my unwavering support for efforts all across our country to reaffirm the states’ rights affirmed by the Tenth Amendment to the U.S. Constitution. I believe that returning to the letter and spirit of the U.S. Constitution and its essential 10th Amendment will free our state from undue regulations, and ultimately strengthen our Union.”

Jump to the "Teaparties" of April 15 (from a FoxNews report):

An animated Perry told the crowd at Austin City Hall -- one of three tea parties he was attending across the state -- that officials in Washington have abandoned the country's founding principles of limited government. He said the federal government is strangling Americans with taxation, spending and debt.

Perry repeated his running theme that Texas' economy is in relatively good shape compared with other states and with the "federal budget mess." Many in the crowd held signs deriding President Barack Obama and the $786 billion federal economic stimulus package.

Later, answering news reporters' questions, Perry suggested Texans might at some point get so fed up they would want to secede from the union, though he said he sees no reason why Texas should do that.

"There's a lot of different scenarios," Perry said. "We've got a great union. There's absolutely no reason to dissolve it. But if Washington continues to thumb their nose at the American people, you know, who knows what might come out of that. But Texas is a very unique place, and we're a pretty independent lot to boot."

DATELINE: March 5, 2009, Pierre, South Dakota

South Dakota Resolution Passes

NOW, THEREFORE, BE IT RESOLVED, by the House of Representatives of the Eighty-fourth Legislature of the State of South Dakota, the Senate concurring
therein, that the State of South Dakota hereby reasserts sovereignty under the
Tenth Amendment to the Constitution of the United States over all powers not otherwise enumerated and granted to the federal government by the Constitution
of the United States; and

BE IT FURTHER RESOLVED, that all compulsory federal legislation that directs states to comply under threat of civil or criminal penalties or sanctions or requires states to pass legislation or lose federal funding be prohibited or repealed; and

BE IT FURTHER RESOLVED, that this concurrent resolution serve as Notice and Demand to the federal government, as our agent, to cease and desist, effective immediately, mandates that are beyond the scope of these constitutionally delegated powers.

DATELINE: April 27, 2009, Bismark, North Dakota

North Dakota Sovereignty Declaration Final As Passed

NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES
OF NORTH DAKOTA, THE SENATE CONCURRING THEREIN:

That the Sixty-first Legislative Assembly affirms this state's sovereignty under the
10th Amendment to the Constitution of the United States over all powers not otherwise enumerated and granted to the federal government by the Constitution of the United States and demands the federal government halt its practice of assuming powers and imposing mandates upon the states for purposes not enumerated in the Constitution of the United States; and

BE IT FURTHER RESOLVED, that this resolution serves as notice and demand to the federal government to cease and desist, effective immediately, mandates that are beyond the scope of constitutionally delegated powers; and

BE IT FURTHER RESOLVED, that all compulsory federal legislation that directs states to comply under threat of civil or criminal penalties or sanctions or requires states to pass legislation or lose federal funding be prohibited or repealed

DATELINE: May 4, 2009, Oklahoma City, Oklahoma (from the Oklahoman):

House bypasses governor’s veto to claim Oklahoma’s sovereignty

Although Gov. Brad Henry vetoed similar legislation 10 days earlier, House members Monday again approved a resolution claiming Oklahoma’s sovereignty.

Unlike House Joint Resolution 1003, House Concurrent Resolution 1028 does not need the governor’s approval.

The House passed the measure 73-22. It now goes to the Senate.

Key said he expects HCR 1028 will pass in the Senate. HJR 1003 earlier passed the House 83-18 and won approval in the Senate 29-18.

Henry vetoed HJR 1003 because he said it suggested, among other things, that Oklahoma should return federal tax dollars.

Key said HCR 1028, which, if passed, would be sent to Democratic President Barack Obama and the Democratic-controlled Congress, would not jeopardize federal funds but would tell Congress to "get back into their proper constitutional role.” The resolution states the federal government should "cease and desist” mandates that are beyond the scope of its powers.

Key said many federal laws violate the 10th Amendment, which says powers not delegated to the U.S. government "are reserved to the states respectively, or to the people.” The Constitution lists about 20 duties required of the U.S. government, he said.

Other States with active 10th Amendment Resolutions in their respective legislatures (see this link):

• Louisiana--2009 Senate Concurrent Resolution 2 (as of 5/6 has been reported out of the Senate and Governmental Affairs Committee favorably)
• Wisconsin--2009 Senate Resolution 6 (as of 4/9 has been referred to the Committee on Ethics, Reform, and Government Operations)
• Illinois--2009 Senate Resolution 0181 (as of 3/31 referred to Assignments Committee)
• West Virginia--2009 House Concurrent Resolution 49 (as of 3/27 referred to House Rules Committee)
• North Carolina--2009 House Resolution 849 (as of 3/30 referred to Committee On Rules, Calendar, and Operations of the House)
• Ohio--2009 House Concurrent Resolution 11 (introduced)
• Oregon--2009 House Joint Memorial 17
• Alabama--2009 House Joint Resolution 403 (introduced 3/24)
• Mississippi--2009 House Concurrent Resolution 69 (passed committee on 5/6--scheduled for vote); 2009 Senate Concurrent Resolution 630 (introduced 3/10--referred to Rules Committee)
• Kentucky--2009 House Concurrent Resolution 169 (introduced 2/24--posted to Committee on Elections, Constitutional Amendments & Intergovernmental Affairs on 2/26)
• Alaska--2009 House Joint Resolution 27 (passed House 4/6, passed Senate 4/19, awaiting transmittal to Governor Palin)
• Indiana--2009 Senate Resolution 0042 (passed Senate 4/9, awaiting transmittal to House)
• Tennessee--2009 Senate Joint Resolution 0311 (passed Senate 5/4, awaiting transmittal to House)
• Minnestota--2009 HF 997 (sent to Committee on State and Local Government Operations Reform, Technology and Elections 2/19)
• South Carolina--2009 House Concurrent Resolution 3509 (passed House 2/26, in the Senate Committee on Judiciary 3/3)
• Georgia--2009 Senate Resolution 632 (passed 4/1); 2009 House Resolution 280 (in House Committee on Judiciary)
• Kansas--2009 Senate Concurrent Resolution 1609 (referred to the Senate Judiciary Committee on 2/12)
• Texas--2009 House Concurrent Resolution 50 (reported favorably out of Committee--awaiting scheduling of vote 4/27)
• Missouri--2009 House Concurrent Resolution 13 (passed House 3/23, referred to Committee on Rules, Joint Rules, Resolutions and Ethics 3/24...public hearings held 4/7)
• Iowa--2009 Senate Concurrent Resolution 1 (intoduced 1/27)
• Michigan--2009 House Concurrent Resolution 0004 (introduced 1/22--Committee on Government Operations); 2009 Senate Concurrent Resolution 1 (intoduced 3/3--Committee on Judiciary)
• Arizona--2009 House Concurrent Resolution 2024 (reported out of committee favorably 4/14)
• Washington--2009 House Joint Memorial 4009 (introduced 1/30--referred to Committee on State Government & Tribal Affairs)

REMEMBER--THE FIRST STEP OF THE AMERICAN REVOLUTION WAS THE ATTEMPT TO REDRESS THE ISSUES THE COLONIES HAD WITH THE CROWN (SEVERAL TIMES). THE DECLARATION WAS THE OUTCOME OF THE REFUSAL OF THE CROWN TO REDRESS THE ISSUES OF TYRANNY...