Health Care

Why Obamacare is worse than understood by most and must be stopped.

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The Supreme Court will rule on the constitutionality of Obamacare this year. The arguments and the issue which got the most publicity was the individual mandate. I don’t actually care much about this although it may well violate the Constitution. There are far worse things in the legislation and they should be emphatically rejected by the Supreme Court. The worst of the issues is discussed in detail here. This is a really frightening piece of legislation and I cannot imagine that the Court will let it stand. Of course, given the absence of argument, the Court will have to find this hidden provision itself.

Perhaps nothing in the Obamacare legislation embodies the top-down, command-and-control nature of Progressive healthcare more than the Independent Payment Advisory Board (IPAB), a 15-member panel of “experts” to be appointed by the President. There are three particular features of the IPAB that illustrate this fact: The IPAB will control all healthcare spending, public and private. The IPAB has been awarded near-dictatorial power. And the IPAB is designed to be a nearly immutable entity.

How is this accomplished ?

Specifically, Section 10320 (in the Managers’ Amendments portion of the legislation) grants the IPAB, beginning in 2015, the authority to limit all healthcare expenditures, that is, all healthcare expenditures, and not just expenditures by Medicare or government-run programs.

To emphasize this expanded authority, Section 10320 changes the name of the “Independent Medicare Advisory Board” to the “Independent Payment Advisory Board.” It directs the IPAB, at least every two years, to “submit to Congress and the President recommendations to slow the growth in national health expenditures” for private healthcare programs. Furthermore, it designates that these “recommendations” may be implemented by the Secretary of HHS or other Federal agencies “administratively” (that is, without any action by Congress).

Thus the federal government can control, under penalty of criminal prosecution of doctors, private health care spending ! This goes well beyond Medicare and Medicaid. It will prevent, unless stopped, people from spending their own money on health care.

That is not the worst of it. The IPAB cannot be changed or repealed by Congress. This is unprecedented in US law. Even the ill-advised Prohibition Amendment, promoted as another moral obligation by progressives after World War I, could be repealed by another constitutional amendment.

A quick reading of Section 3403 might leave one with the impression that the IPAB is a sort of Mr. Rogers of healthcare a mild-mannered, friendly, always-helpful, but ultimately undemanding agent for good. This is the impression imparted by the first few paragraphs of the Section, which paint the new entity as an “advisory” board, whose main task is to develop “proposals” and “advisory reports,” which “proposals” and “advisory reports” would solely consist of various “recommendations,” that ought to be “considered” for the purpose of cost reduction.

Nothing could be further from the truth. This language is simply another example of supplying a new law, which is far more radical than the authors would like people to know, with a soothingly misleading introductory paragraph. The IPAB is actually designed to be as all-powerful as it’s possible to be.

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Global Warming and acupuncture

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It looks as though the sun is entering a new dormant period, similar to the Maunder Minimum which led to the Little Ice Age.

This will almost certainly end the global warming hysteria in a few years. The people who continue to cling to this sort of hoax, will be looking for the Next Big Thing. I don’t mean to imply that the earth did not warm over the past century. The Little Ice Age ended about 1850 so a warming trend is expected following such an event. The hoax is the contrived evidence that humans are responsible. I was skeptical about that from the first. The forces involved are too large. If humans affected climate, it probably began with the development of agriculture. Perhaps we have had no ice age in the past 10,000 years because of the effects of agriculture and forest changes. I have previously discussed this and nothing has changed my mind.

The next question is what will replace global warming as the religion of the bored classes ? There are signs that it may be “New Age” medicine. This sort of thing is common in certain circles and has considerable similarity to the global warming arguments.

The Center for Integrative Medicine, Berman’s clinic, is focused on alternative medicine, sometimes known as “complementary” or “holistic” medicine. There’s no official list of what alternative medicine actually comprises, but treatments falling under the umbrella typically include acupuncture, homeopathy (the administration of a glass of water supposedly containing the undetectable remnants of various semi-toxic substances), chiropractic, herbal medicine, Reiki (“laying on of hands,” or “energy therapy”), meditation (now often called “mindfulness”), massage, aromatherapy, hypnosis, Ayurveda (a traditional medical practice originating in India), and several other treatments not normally prescribed by mainstream doctors. The term integrative medicine refers to the conjunction of these practices with mainstream medical care.

Here we have what may become the replacement for AGW in the minds of the exquisite privileged class. It has all the requirements.

1. America is corrupt and inferior ? Yes. (See the comments)

2. Capitalism is corrupt and inferior ? Yes

3. Only the truly intelligent and sensitive can appreciate it ? Well.

You might think the weight of the clinical evidence would close the case on alternative medicine, at least in the eyes of mainstream physicians and scientists who aren’t in a position to make a buck on it. Yet many extremely well-credentialed scientists and physicians with no skin in the game take issue with the black-and-white view espoused by Salzberg and other critics. And on balance, the medical community seems to be growing more open to alternative medicine’s possibilities, not less.

That’s in large part because mainstream medicine itself is failing. “Modern medicine was formed around successes in fighting infectious disease,” says Elizabeth Blackburn, a biologist at the University of California at San Francisco and a Nobel laureate. “Infectious agents were the big sources of disease and mortality, up until the last century. We could find out what the agent was in a sick patient and attack the agent medically.” To a large degree, the medical infrastructure we have today was designed with infectious agents in mind. Physician training and practices, hospitals, the pharmaceutical industry, and health insurance all were built around the model of running tests on sick patients to determine which drug or surgical procedure would best deal with some discrete offending agent. The system works very well for that original purpose, against even the most challenging of these agents—as the taming of the AIDS virus attests.

But medicine’s triumph over infectious disease brought to the fore the so-called chronic, complex diseases—heart disease, cancer, diabetes, Alzheimer’s, and other illnesses without a clear causal agent. Now that we live longer, these typically late-developing diseases have become by far our biggest killers. Heart disease, prostate cancer, breast cancer, diabetes, obesity, and other chronic diseases now account for three-quarters of our health-care spending. “We face an entirely different set of big medical challenges today,” says Blackburn. “But we haven’t rethought the way we fight illness.” That is, the medical establishment still waits for us to develop some sign of one of these illnesses, then seeks to treat us with drugs and surgery.

No doubt the author would prefer that people died too young for chronic disease to affect them.

A well-known science blog states the case for scientific medicine.

Speaking of bad ideas, in contrast to his previous article, in which he managed at least to get the gist of what Ioannidis teaches but merely spun it in what I considered to be an annoying fashion, the entire idea behind Freedman’s new article channels the worst fallacies of apologists for alternative medicine. The whole idea behind the article appears to be that, even if most of alternative medicine is quackery (which it is, by the way), it’s making patients better because its practitioners take the time to talk to patients and doctors do not. In other words, it’s a massive “What’s the harm?” argument. Yes, that’s basically the entire idea of the article boiled down into a couple of sentences. Deepak Chopra couldn’t have said it better. Tacked on to that bad idea is a massive argumentum ad populum that portrays alternative medicine (or, as purveyors of quackademic medicine like to call it, “complementary and alternative medicine” or “integrative medicine”) as the wave of the future, a wave that’s washing over medicine and teaching us cold, reductionistic doctors to care again about patients and thus make them better. Freedman even contrasts this to what he calls the “failure” of scientific medicine. I kid you not. Worse, Freedman makes this argument after having actually interviewed some prominent skeptics, including Steve Salzberg and Steve Novella, in essence, missing the point.

I expect to see more and more of “alternative medicine” because it appeals to the scientific illiterate and it damns another traditional source of authority, scientific medicine. Global warming hysteria attacks capitalism and prosperity. Alternative medicine is also going to be useful to Obamacare as a way of cutting reimbursement for traditional care. There are assumptions that it is cheaper. It may be cheaper per session, although is also uncertain, but there is no end point to such treatment. Who can say when the treatment is enough if it cannot be measured ? The theory that it is cheaper will be a powerful wind behind it. Watch for more and more about it in the left leaning media.

Harding and Coolidge

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The Republican convention of 1920 knew that the party was heavily favored to win the fall election. Wilson was forlornly hoping for third term nomination in spite of his crippled state as a result of the stroke. Teddy Roosevelt had died in 1919 at the age of 60. The contenders on the Republican side included Illinois Governor Frank Lowden whose only major handicap with the voters was the fact the he had married the daughter of George Pullman, the railroad tycoon, and was rather ostentatious in displaying his wealth. He had, however, been a reform governor of Illinois. General Leonard Wood, who had been a medical officer commissioned into the regular army in 1886 as a line officer, was another. He had been the senior officer of the US Army in 1917, yet President Wilson had appointed John J. Pershing, junior to Wood, to the European command. Wilson considered Wood a potential political rival, somewhat like Harry Truman and Franklin Roosevelt considered General MacArthur.

The third contender was Hiram Johnson, who had run as Teddy Roosevelt’s VP candidate on the Progressive ticket in 1912. There was little enthusiasm for him except among former Progressives who had returned to the party for 1920. Warren Harding is often described as a dark horse who was selected by party bosses after the leaders had exhausted each other. In fact, he was always in the top four and his selection was not a surprise to the convention.

The huge surprise was the nomination of Coolidge for Vice-President. He did not seek the nomination and was not interested after his experience as lieutenant governor of Massachusetts. After the Boston Police Strike, his name was familiar to the nation and in a favorable way. A big issue was the League of Nations and Coolidge favored membership, although with the Lodge reservations. Senator Lodge, no ally of Coolidge, exchanged letters with him on the League and agreed to disagree. Nevertheless, Lodge offered to place Coolidge’s name in nomination for President. Why he made the offer is not know. After several very favorable newspaper profiles appeared in early 1920, Coolidge made another statement that he was not a candidate for President. Frank Stearns and Lodge tried to bring a Coolidge delegation to the convention but Wood lived in Massachusetts and the delegation split. His interest in the nomination was further diminished by the death of his beloved step-mother, Carrie in May 1920.

Lowden’s handlers favored Coolidge as a VP candidate as he and the governor were from different parts of the country. Lowden’s biggest problem with the bosses was his reputation as incorruptible. The Illinois party bosses distrusted him. They feared he couldn’t be bought, or if so, wouldn’t stay bought. Robert Sobel, in his biography of Coolidge, says that Lowden was probably the best qualified Republican of the 1920s. One of the party bosses, Boies Penrose, asked Harding if he wanted to be president. Harding liked being a Senator and declined, leading Penrose to look elsewhere. By the time of the convention, Penrose was fatally ill, although his reputation was still powerful. He awakened from a coma during the convention, asked about the voting and suggested they choose Harding. Then, he lapsed into the coma again.

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Why this is life and death for the unions

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In reading about the Wisconsin stand-off, I ran across this thread at Newsbusters . The last comment is so important, it deserves a post, I think. I can’t verify this story but I have spent some time with union health plan administrators.

Would someone please note that Unions make the great lion’s share of their $ from negotiating “benefits”, not salaries… or collection of dues.

This is why the decoupling of the Salaries and Benefits is so important to Unions in Wisconsin. And why the Union’s have countered the way they have. They’ll give up Salary and Jobs for Teachers in a second, but they will fight to death for the Benefit negotiation position. In another life as an executive in CA, I used to do administration for two Teamster’s “Health and Welfare” benefit packages. Do your research, but you’ll find I’m correct about motivation of Unions. I also believe that the amount of money kept by Unions will be very interesting to both your viewers, and the tax payers of the US of A. The way it works is that the Unions negotiate with the “Employer” regarding how much money per member/per month they will need to support the benefit options required in Union contract. In the case of WI, they negotiate with each of the 77 counties. Then the Unions negotiate the terms of benefits with “providers”/Ins Co’s, etc. They make the lion’s share of their money off of what is called the “breakage” created by Employees choosing between plan options, and the administration of the programs.

Let me explain with an example: A Union begins by negotiating with the Employer/State. They’ll claim their buying leverage will afford Employer significant savings. They’ll end up with a 3-tiered cost structure which allows the Union a profit even with the highest benefit option available as Union already has a very good idea about what Providers will be charging. But it gets even more lucrative for Unions at this point. Let’s say high-end Blue Cross PPO coverage costs $400 for the Family tier. What a Union will do is require $425 from Employer, plus a loaded in admin fee, as a charge for all Families in the employer group. So far, so fair? But, the Union will also offer a few other plans for Employees to choose from. The Union will also have developed relationships with a few cheaper HMO plans, and lesser PPO benefit structure plans that charge, as an example, $325 and $375, respectively.

At an Open House, employees will choose what fits their needs and the Union is in line for the “breakage”. The left over breakage is then, to my experience, placed in a fund where only the Union has the checkbook. Cars, Vacations and Condo’s, oh my. The Union also makes a “commission” off of things like Pre Legal, Dental and Term Life. As another profit source, the Union also leans on the Administrator for favors I’d rather not list, but usually involving idiocy like buying thousands of dollars of “raffle tickets” and leasing cars for the Union’s Business Agents, not entirely above board. Of course, I am relating my experience, and what little I know of others who also did Union administration. I’d expect any simple research by an actual reporter would open up a Pandora’s box of Slush in the Badger State.

Very revealing comment. This is why “benefits” is such a life and death issue for the unions.

The Shooting in Tucson

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I have had a house in Tucson for the past five or six years. It is in Gabriel Gifford’s Congressional district. I know the corner of Ina Road and Oracle Road where the shooting occurred. I know and like Tucson and Arizona. I would rather be living there than here because I have serious fears about California’s future while I think Arizona is now in pretty good hands. They had a housing bubble but they have more sensible people in that state government.

Gabriel Gifford’s district includes some of the most affluent areas of Tucson. To be re-elected, she had to be a “blue dog” Democrat. She has an appealing personal story. Her father is a sheriff of a neighboring county and her husband is an astronaut. I would not have voted for her because she had a very attractive opponent but there was very little of the animosity in that election that there was in other district races. Some of her constituents were unhappy about her healthcare vote. She had gotten the message and voted against Nancy Pelosi for minority leader of the Democrats, one of 17 Democrats to do so.

The press conference by the Pima County sheriff yesterday was disgraceful. I watched the whole thing. He went over and over his theories that harsh political discourse was somehow a cause of the shooting. He repeated the whole mantra three times by my count. Other than that, he provided very little information, for example, declining to give the suspect’s name when everyone with an internet connection knew what it was. I think he may have been reacting to personal distress as he probably knows Ms Gifford’s father and has known her for a long time. I also suspect he is a Democrat as Tucson is a rather left wing city being the site of the University of Arizona. The City Council has been very left wing and several members were defeated in the previous election as they had spent far too much money on frivolous projects, some of which had never been completed.

There is a lot of wild talk on left wing web sites, some of which is being rolled back as Daily Kos and the DNC scrub web sites of similar images and rhetoric as conservative sites and people they are attacking. A lot of it has been scrubbed but some people have found Google caches.

Like this DLC “targeting map.”

There has been a lot of talk about how “angry” Arizona people are. Well, maybe they have reason to be angry. The Obama administration has sued the state to try to stop an Arizona law that merely enforces a federal law that Obama seems disinterested in enforcing. Arizona is overrun with illegals immigrants, drug violence is 60 miles away in Mexico and auto insurance rates are sky high because of car theft. Someone I know had a LoJack system installed in his car. When he realized the car was stolen, the police activated the locator and the car was already 60 miles into Mexico.

Some of the angry rhetoric comes from a sense that the people have lost control of the government since Obama was elected. The health care bill was opposed in every poll of public opinion. The Republican minority was completely opposed. Yet, the bill was passed by procedural maneuvers never before used to pass legislation of this magnitude. As the people have learned more about the bill, they like it less. Nancy Pelosi told us they have to pass it so we can find out what is in it. Yes, the people of Arizona are angry. But it had nothing to do with yesterday’s shooting.

The young man is obviously a paranoid schizophrenic. His ramblings on a You Tube video contain the typical delusions of schizophrenics. He goes on about the government controlling minds through grammar. He appears to be obsessed with grammar and goes on about introducing a new currency for which he will be the Treasurer. These are the delusional ravings of a psychotic. There appears to be some level of disappointment that he is not associated with a political ideology, especially the tea party. There are already think pieces about “violence”, by which they mean talk radio and Fox News, just as Clinton did after the McVeigh bombing in Oklahoma.

By day’s end, the argument that the political right—fueled by anti-government, and anti-immigrant passions that run especially strong in Arizona—is culpable for the Tucson massacre, even if by indirect association, seemed to be validated by the top local law enforcement official investigating the shooting of Rep. Gabrielle Giffords (D).

This refers to that disgusting press conference by the Pima County sheriff. They even have a video of his rant.

Pima County Sheriff Clarence Dupnik, an elected Democrat, at a news conference Saturday evening.

Yup, I guessed right.

One veteran Democratic operative, who blames overheated rhetoric for the shooting, said President Barack Obama should carefully but forcefully do what his predecessor did.

“They need to deftly pin this on the tea partiers,” said the Democrat. “Just like the Clinton White House deftly pinned the Oklahoma City bombing on the militia and anti-government people.”

Another Democratic strategist said the similarity is that Tucson and Oklahoma City both “take place in a climate of bitter and virulent rhetoric against the government and Democrats.”

Isn’t it odd that movies about the assassination of George Bush are not considered too extreme ?

I think Representative Gifford will recover as the gunshot wound track passed from her temple out her forehead, probably missing her brain. A family friend said she is now in induced coma, no doubt to minimize cerebral edema from the contusion to the brain from the shock wave. I don’t know if the Democratic party will recover from its disinterest in debate and its tendency to try to demonize its opponents instead of argue with them.