Go ahead, Try to make a wise prediction. Can't happen.

Predictability. Stability. These are two critical keys to success for any family, business, or government. Neither exist in our present day politics or economy.

Who among us can predict our health care or economic future? Not one of us. All we can do is guess, and guessing is the wrong way to build anything that will last.

The Good Book asks the question, “What person who is about to build a tower doesn’t first sit down and count the cost?” But how can anyone count the cost when the rules change almost daily?

A Washington Post article promoted the idea that President Obama might be open to giving states flexibility on Medicaid mandates. He might even grant states some leeway in the implementation of health benefit insurance exchanges. The test? Any flexible plans must meet the intent of the ACA? What does that mean? What flexibility? What, pray tell, is the intent of the ACA?

The Secretary of Health and Human Services has been woefully lax in issuing ObamaCare rules, and now President Obama suggests the rules that are not yet rules may change – if the federal government deems that states mean to do what the Affordable Care Act requires; as if anyone can figure out exactly what that means.

We await the ruling of the Supreme Court about the ACA. Will it overturn all of it, just the mandate, or let it stand? Which is worse?

 

 If it lets the ACA stand, then we face years of rules that are not rules, waivers that are not waivers, and endless political bickering. If the Court overturns the individual mandate, and lets everything else stand, we face the end of insurance companies (some would cheer this, but not stockholders). If the Court overturns everything, we face chaos.

Right now, today, someone somewhere is creating the next miracle medical device, discovering a new surgical procedure, harnessing some unknown element of creation that will revolutionize medical care. Why would anyone invest in the entrepreneur’s idea, when the investor knows that the rules will change?

Right now, today, banks and venture capitalists are pondering how to grow their money. The safest bet is not to bet on stability and predictability, because there is none. Keep the money in the vaults until America decides who and what it is. Speculate on the stock market, but avoid new ventures. For certain, keep your money far from Solyndra projects, because when the clouds carrying financial collapse produce economic thunderstorms, and America is caught up in a flood of bankruptcies, no one will worry about green energy. 

Or, maybe the rules will change and none of this will happen.

The greatest damage President Obama has done to America is to leave us without any sense of stability, or ability to predict with some rational certainty, where we are headed. On the other hand, it is possible to rationally predict that we are headed for a financial disaster. 

One other prediction: The election of 2012 will determine our survival as a nation of free people. That prediction you can take to the bank.

Health Care Threatens Your Liberty

Take a few minutes to view this YouTube speech. It's one I gave to the Association of American Physicians and Surgeons, on January 20, 2012, at a Las Vegas meeting.

Private behavior has a public cost: We all will spend more

Cigarette smokers have taught us that private behavior has a great public cost. Governments have no problem imputing large taxes on smokers and shaming them through tax-supported public service announcements. When it comes to smoking, we get it. But, when it comes to sex, not so much.

“Don’t impose your morals on me,” is the common cry of not just libertines, but all of us. The idea here is that private behavior is private and, as long as it does not affect others, people should be left to their own wills. This worked well when society expected people to exercise personal restraint. It was enough that public consensus kept people in line; few government sanctions were necessary. Healthcare reform, however, is exposing flaws in that argument as it applies today.

The Federal Secretary of Health and Human Services, under the authority granted by the Affordable Care Act of 2010 (ACA), recently issued eight mandates on private health insurance. The Secretary’s order means that in the future, health insurance must pay 100 percent of the cost of preventive care for these eight mandated categories. At least five of these mandates are directly related to sexual promiscuity. We will all pay the cost in higher insurance premiums.

Specifically, the new Federal guidelines require that all Health Insurance policies must cover preventive care for these five behavior-oriented conditions:   

• Human papillomavirus (HPV) DNA testing for women 30 years and older;
•  Sexually-transmitted infection counseling;          
• Human immunodeficiency virus (HIV) screening and counseling;  
• FDA-approved contraception methods and contraceptive counseling; 
•  Domestic violence screening and counseling.

Before moving on, read the list again. It is true, of course, that even the most careful, pious person or monogamous married couple could conceivably suffer from one or more of these conditions: but the incidence of such is certainly low enough not to allow a federal official to order preventive healthcare payments for medical tests related to these behaviors.

HPV, STDs, and HIV, for the most part, are diseases resulting from promiscuous sexual behavior. American society has, for the most part, considered medicinal contraception acceptable, although tens of millions reject it on religious grounds. No one that I know of considers domestic violence acceptable behavior; about this, society continues to impose moral and legal strictures.

Physicians are expected to withhold moral judgment while deciding whether to treat an individual. No matter the cause, a hurting or ill person needs medical attention. The man infected with HIV or AIDS should get medical care. The woman suffering from STDs or cervical cancer should get medical care. Despite potential medical, emotional, and psychological dangers, we do not withhold medicinal contraceptives from single or married women who desire to prevent pregnancy. We tolerate cohabitating partners as a price we pay to keep government out of private lives (and we celebrate it in our popular culture). These all come with a price tag, and now, the Secretary has increased it for everyone.

You see, there really is a financial cost to all of us for not embracing the “old” morality, the morality that reserved sexual intimacy for marriage between a man and woman. We have fallen so far from this higher moral standard that today, a Federal official orders that everyone must pay more just to screen for diseases that naturally follow promiscuous behavior.

“We cannot put enough policemen on the street if there is no policeman in the heart,” to paraphrase Alan Keyes, who has sent this on numerous occasions. Public morality flows from private morality, and a lack of it costs all of us.

We do not want government to impose morals on us, but we should not want government to order us to pay for the results of immorality.

“Mandatory Life Insurance,” Cries California Congress Person

Perfect Match for Health Insurance Exchanges

BROADMOOR, CA. June 29, 2011: “Tomorrow I plan to introduce the Affordable Life Insurance Empowerment Act in Congress,” said Arly Esperson, Congressperson from California’s 54^th Congressional District. “Now that the Sixth Circuit Court of Appeals has ruled the health insurance mandate is constitutional, I think it’s time we take the next step.”

Today, a three-judge federal appeals court in the Sixth District upheld the cornerstone of the Affordable Care Act of 2010. “The progressives in Congress wanted to be sure the court upheld the mandate before we started moving ahead with the rest of our agenda,” Esperson explained. Esperson spoke about the controversial ACA provision known as the individual mandate that will require every American resident to enroll in a health insurance plan by 2014.

Progressives breathed  a sigh of relief over the decision, Esperson said. Esperson leads the Latte Party Caucus in Congress, a group of lawmakers who believe government needs to do more for “working people. And that’s why I am moving ahead with this new bill.”

The Affordable Life Insurance Empowerment Act (ALIE), Esperson explained, would require all United States’ residents to purchase a minimum of $10,000 in what Esperson called “lifetime coverage.” Ron Kelly, a spokesman for New Mexico Life Insurance clarified the term: “Esperson means whole life or cash value insurance, and it lasts a lifetime, or, well, until death.”

Esperson’s bill would go farther and require everyone older than 35 to own a minimum of $250,000 in term life insurance in addition to the $10,000 whole life policy.  “This will do several things for working people,” Esperson explained. “First, there will be money for burial cost. Second, it will help settle estates. And third, and just as important, the federal tax of 25 percent on the death benefit will help to reduce the national debt.”

ALIE overcomes two hurdles that might otherwise doom the bill: premium cost for low-income people, and accessibility coverage. 

First, Esperson explained that low-income people – the threshold is set at family income of less than $50,000 a year – will receive help paying their mandatory life insurance premiums. “America’s richest individuals often use life insurance to dodge paying estate taxes,” Esperson said. “We will levy a 35 percent tax on the life insurance proceeds of all plans that exceed $500,000.” In this manner, “we will make sure the rich pay their fair share.”

Second, Esperson plans to fold enrollment in mandatory life insurance plans in the Health Insurance Exchanges required by the ACA. “Hey, every state must have the Exchanges, and it would be nothing for Exchange enrollers to fill out life insurance applications.” 

Under ALIE, insurance companies will have to issue life insurance to anyone, regardless of their medical condition or age. “That’s why we mandate ownership,” Esperson explained, “to eliminate cherry picking of insured people, as the life insurance companies do now.”

The other ALIE key feature will help keep the premiums low for everyone, according to Esperson. “We will limit the premium rates on a three to one ratio, so that the younger people will not get stuck paying too high of premiums.” People under 33, according to ALIE, would pay one-third as much as people older than 65.

“This is the perfect adjunct to the Affordable Care Act,” Esperson said. “For the first time in our nation’s history, everyone will have health and life insurance.”

President Obama has remained silent on ALIE.

We elected Sue Johnson as President proving girls can govern

Cong. Michelle Bachmann

Michelle Bachmann wants to be President of the United States. She’s a girl. I can attest to this because I have met her personally. You can take my word for it.

But can a girl win the presidency? Yes, and on this you can also take my word for it.

In 1961, Sue Johnson defeated me, Dave Racer, for the Presidency of Dr. James Phillips’ Ninth Grade Core Class. Sue served admirably. I think I became secretary of something.

Alright, running a Ninth Grade class isn’t exactly like being The Most Powerful Leader in the World. I grant you that.

But what makes a good U.S. President? It depends on the times and the challenges.

For my money, the next president have a demonstrable record of commitment to solid principles of faith, family, thrift, limited government, and understand that we are going broke. In my family, it’s the girl that worries most about budget – and not overspending.

Okay. I am convinced that Michelle Bachmann is qualified to be President of the United States for the times in which we live. She may not be the only candidate so qualified, but she is the Real Thing.

In fact, I am willing to say it straight: If any one of the GOP boys want to be President, they should quickly adopt Bachmann’s convictions. I’m pretty sure that Mitt Romney can’t do it, and I wonder about Newt Gingrich. Ron Paul has convictions, but not for these times (he is either two centuries too late or 10 years too soon).

I see Tim Pawlenty, my governor, as an enigma. This is because I am not a pragmatist, and because I am an idealist. Pawlenty governed exceptionally well, but faced a Democrat legislature most of the time. Pawlenty also had to deal with Minnesota’s GOP “conservatives,” many  of whom are to the left of a Missouri Democrat. Clearly, he can do the job, but he also knows how to cut a deal – and I’m thinking this is not the era where we need deal-cutters.

But I got off course. My purpose in this odd piece is to demonstrate that the problems we face in the United States are so ponderous that we have to throw aside the trivial arguments about race and gender, and find someone to bring about a change in course. The change, of course, is to give Barrack Obama the chance to play golf everyday – even twice daily if he wishes, and keep him away from the White House.

Don’t carp at me that Michelle Bachmann kissed George Bush, or said something silly about Paul Revere. Every politician is flawed. This is because they are human beings. Even Sue Johnson had flaws, but far fewer than mine. 

If you don’t want a girl to be president (or at least the girl named Bachmann) then lean on the boys to prove they can do it.

Resisting Federal Encroachments: Founders v. Today

“Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shown, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security…”

The Declaration of Independence – 1776

Why not read those words again before you move ahead with this blog. Do they sound extreme to you? I mean, “throw off such government;” that certainly sounds extreme, doesn’t it? Or does it?

Throwing off the chains of oppressive government meant taking up arms to the Founders. They did not have the protection of a Constitution they had dutifully adopted, endorsed, and wished to defend.

The Founders cited the primary reason for establishing government to be to “secure these [unalienable] rights,” the God-given rights to life, liberty and the pursuit of happiness (translated in the Bill of Rights and the Fourteenth Amendment to mean, the right to own property). Simply, a government that no longer defends life, liberty, and property, said the Founders, must be thrown off.

“The individual mandate is outside Congress’ Commerce Clause power, and it cannot be otherwise authorized by an assertion of power under the Necessary and Proper Clause. It is not Constitutional,” [i] wrote Federal Judge Roger Vinson. (Vinson ruled on the individual mandate to purchase health insurance required by the Affordable Care Act of 2010, passed by Democrats in Congress, and signed by President Obama.) Other judges have disagreed with Vinson, and the Supreme Court will ultimately decide.

When Congress acts in such a manner so as to attack liberty and property, as Vinson stated clearly in his ruling, what should we as citizens do? Well, if we agree that no one should be coerced by government to purchase something they may not want (in this case, health insurance), maybe we should resist? Sam Adams and the other Declaration signers would cheer us on.

Has the time come to resist?

The Declaration speaks of “a long train of abuses and usurpations” as a critical element in deciding whether to “throw off such government…” Judge Vinson’s decision looked back at how Congress has butchered, sliced, and diced the enumerated powers of the Commerce Clause; mostly since the 1930s. Vinson identified a train of ever-increasing, ever-broadening Congressional encroachments on private commerce. He quoted the Congressional Research Service and the Congressional Budget Office, both of which stated the individual mandate is an unprecedented expansion of the reach of the Commerce Clause.

When Congress decides to tell us that we must purchase health insurance has their action crossed the line into tyranny, or is that too strong of word? Would you supply me with an alternative? And is this a one-time assertion of power, or evidence that Congress intends to continue a long train of usurpations?

When you view the growth of government under the light of the Founders’ reasoning, and then under the scrutiny of history (including recent history), you see the “long train of abuses and usurpations” upon which the Founders based their claim to independence. The Founders chose to fight a hot war of rebellion as their answer, but resistance can take many other forms long before war becomes the only option. This is one of the chief blessings of our United States Constitutions.

What methods of resistance?

We express resistance to tyranny at the ballot box. We elect individuals to represent our views. If our view is that Congress does not have the power to force someone to purchase health insurance, we will resist Congressional tyranny by electing a different Congress. In fact, we started that process through the 2010 election, and hopefully, will continue it in 2012. So elections are an alternative to taking up arms, as an expression of resistance – God be praised.

Are there other ways to resist tyranny beyond the next election?

Lawsuits, such as the one Judge Vinson ruled upon, are one way to resist. Another is to ask state and federal lawmakers that are currently serving to use every possible legal scheme of which they can conceive to resist all federal encroachments on liberty. It means asking lawmakers to scrutinize all legislation related to the Affordable Care Act of 2010, searching for any instance in which they dare to challenge the federal government by taking no action, or taking adverse action.

There is an ultimate form of resistance to tyranny that falls short of the Founders’ resort to arms: If millions of Americans choose en masse to resist laws that threaten unalienable rights to life, liberty, and property, Congress and the Courts will notice. Perhaps, if the individual mandate stands, we should incite millions of Americans to drop health insurance coverage as a form of civil disobedience; sort of like dumping tea into Boston Harbor.
On the other hand, millions of Americans may remain indifferent. Today’s elected state lawmakers may choose, instead, to capitulate to Congress. If so, James Carville may prove to be right when he said recently, “…we’re going to start to see civil unrest in this country. I hate to say that, but I think it’s imminently possible.”[ii]

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[i] Case No.: 3:10-cv-91-RV/EMT - State of Florida v. United States Department of Health and Human Services

2011        Federal Court, Florida District: Florida. P 56.

[ii] Carville, J. (2011) “Carville: There Will be Civil Unrest—Over Economy.” Newsmax.com. June 6, 2011. http://www.newsmax.com/InsideCover/Carville-Obama-Clinton-civilunrest/2011/06/06/id/398990. Retrieved June 8, 2011.

Who should ration health care?

“Racer,” you may have already said, “why resort to false, emotional words like ‘ration’ when what we need is a serious discussion about health care reform?”

Easy. Rationing is an essential element of the ACA way. 

Fifteen commissioners, each earning $165,000 a year, will do the rationing. They are called the Independent Payment Advisory Board, and are foundational to how ObamaCare will function.

President Obama and the Democratic members of Congress, in passing the misnamed Affordable Care Act of 2010 (ACA), took $500 billion away from future Medicare payments. They did this knowing that more than 78 million Americans are beginning to qualify to enroll in Medicare. What happens when less money is available for more people? You choose your favorite term: I use the appropriate one: It’s called rationing.

Make no mistake about it. Rationing will happen as  revenue fails to keep up with cost of care. 

Medicare Revenue is directly linked to the expansion (or retraction) of the economy, except that President Obama does not believe this. Instead, he believe there is a finite amount of money, and the role of politicians is to divide it up.

The way to divide up a finite amount of money in Medicare is to ration care. The instrument to accomplish this is the Independent Payment Advisory Board (IPAB). This 15-member board, set up under the ACA, will decide what care will be allowed to be provided to Medicare enrollees, and what will be denied. Denial of care is called rationing.

It is true that there are other forms of rationing. If a person has no money, and there are not medical providers willing to care for that person, it is called rationing. But the Affordable Care Act will create more of this type of rationing, not less. Why? Because the ACA discourages individuals from becoming physicians. If there are no doctors, there is no health care – well, professional health care.

If a person has prepaid health coverage (some call it insurance), and the insurance company or Health Maintenance Organization (HMO) is in charge of deciding who gets what coverage, that is a form of rationing. But it is far different from the way the IPAB functions. There is at least some competition among health care insurance companies to provide coverage for individuals. If there would be only one insurance company, it could dictate – yes, dictate – who will get what care, when, where, and under what conditions. This is precisely what the IPAB will be able to do, because Medicare is single payer, government-run health care – it has no competitor. 

Repeat it. Tell the truth. ObamaCare, the ACA, is the process to ration health care. First, to senior citizens on Medicare, and then to the rest of society (as Exchanges give way to single payer systems, and as Accountable Care Organizations submit to the federal paymaster).

We start to fix this by repealing the IPAB. And the requirement for Exchanges. And the individual mandates. We fix it by expanding access to consumer-directed health care, Health Savings Accounts, and medical entrepreneurism. 

We cannot, absolutely cannot waste our time trying to fix the ACA. It cannot be fixed. It must be rationed out of existence.

Health care  decisions are the realm of patients, their families, and doctors. Communities join this process voluntarily. This is the way to pursue rational decisions about health care.