Obamacare

Why Georgia matters

Even failed “progressive” actions by US legislators are rarely, if ever, reversed. Often, they enable broader progressive changes.

As I write this, it’s nine days after the 2020 election and we still don’t know who will be inaugurated as President of the United States. In spite of the precipitous “calling” of the election by the AP an other media for Joe Biden, the actual result is not a given due to close votes in several States. Lawsuits and recounts will likely play out at least until the day of the Electoral College vote, December 14, 2020, if not beyond.

Georgia officials have announced that they will conduct a recount and audit of the vote in that State because the difference in the Presidential election votes is about 0.2%. There’s a chance that the State will determine who will be sworn in on January 20, 2021.

But the biggest impact for the State may be as a result of another election. (Or, technically, two elections.)

On January 5, 2021, the State of Georgia will hold a run off election to determine both of their Senators. Currently, it appears that both races can be handily won by the Republicans if they turn out as they did on November 3, 2020.

(Each race had several candidates and Georgia requires a majority to win. Republican John Purdue beat Democrat Jon Ossof 49.7% to 48%.

While Republican Kelly Loeffler only received 25.9% of the vote in the Special Election compared to the 39.2% won by Democrat Raphael Warnock, the other Republicans in the race bled off Loeffler’s votes have endorsed her, including Doug Collins, who had 19.9% of the vote.)

In the event that Joe Biden wins the Presidential election each of us, regardless of Party affiliation, should ask ourselves whether the current crop of Democrats can govern without turning our Nation over to the chaos that is the status quo in many of the cities they already govern.

In addition, it’s imperative to remember the consequences of compromises and the influence of the Left on policies of the future.

Take an example from my profession: 1993’s “HillaryCare” debacle. Hillary Clinton’s plan to centralize health care to impose universal, single-payer government financed health insurance failed due to closed door meetings and a chaotic lack of political planning. It still resulted in SCHIP, HIPAA, the Balanced Budget Act of 1997 that removed all privacy from medical records and forced utilization of mid-level medical personnel as employees of “providers,” the ridiculous idea that cutting numbers of physicians by restrictions on funding for residencies would save money for Medicare, and ultimately, ObamaCare.

The Republicans have already won 50 seats, at least, but that is no majority and ties would be settled by the vote of the “President of the Senate,” the Vice President of the United States. In the event that Biden is the final winner of the Presidency, those ties would go to Kamala Harris – or her VP after Joe resigns or is unseated.

It’s a cliché that we’re likely to hear slot in the next 2 months, but do keep Georgia on your mind.

Health care poll

Today, I came across a poll of likely Texas voters, conducted by the University of Texas and Texas Tribune that said that for Texans, health care is a distant third in importance, behind border security and immigration. This was in contrast with frequent news reports in the last week that an unnamed “recent poll” had found that health care is the number one issue in the 2018 election for voters. That first, UT/TT, poll was more consistent with other recent news coverage and the issues that I keep seeing pop up on Twitter and Facebook.

So I did some research….

It turns out that the first poll (“KFF,” download pdf file,with results) was conducted by the Kaiser Family Foundation, a nonprofit based in San Francisco, California. In fact, approximately 30% of the respondents listed health care as their number one issue and were designated “Health Care Voters” by pollsters. 70%, designated “non-Health Care Voters,” chose other issues, including the economy and jobs (21%).

The demographics of those polled were heavily slanted toward Democrats, with registered Democrats and “Independents” who are identified as “Independent Lean Democrat” adding up to 68% of the “Healthcare Voters.” “Non-Health Care Voters” came in at 49% Republican or “Independent Leans Republican.”

While KFF is considered one of the “Least Biased” polling bodies, they are still subject to sampling errors. It appears that this might be one of those times.

Comments are disabled. Comment on my Facebook page, please.

Health Insurance Choice Is Bad?

Health insurance choice is bad?

The San Antonio Express News picked up a Washington Post op ed on those big, bad Republican plans to repeal Obamacare. Originally titled, “The reason Republican Republican health-care plans are doomed to fail,” by the editorial board that declared, “There’s no way to replace Planned Parenthood.”

And it’s bunk, even as prudently renamed and appropriately filed in the Opinion section.

What we are *actually *seeing *today is that costs are rising and insurers are withdrawing from States. Choices are certainly limited if there’s only one insurance company on the exchange and routine screening costs are “free” — But the care for treatment discovered at screenings is subject to high deductibles.

Limited coverage plans with major medical for extraordinary costs – rather than a wish list covered with other people’s money from first dollar – encourages personal responsibility and will cut costs. It would also allow people to own their insurance, rather than have it controlled and limited by current employers.

Pay attention: it’s policy, not bias

The consensus of media pundits and bloggers, as well as quite a few liberal and even Conservative op-ed authors, is that Donald J.Trump was elected President out of some misguided national populism and anger at Congress, fueled with a lot of racism, misogyny and hate. The fact that those same voters elected a Republican majority in the House and Senate  – sending virtually every eligible Republican incumbent back to DC – is glossed over.

The idea that Conservatives really believe in small government and equal opportunity supported by personal responsibility is rarely voiced. That we might actually vote, not only for President but consistently down ballot, in order to defend the Bill of Rights and the right to life is ignored while we are accused of xeno-, homo-, and poly-whatever-phobia. I read that I am “afraid” of other lifestyles, religions, and losing my “privilege” based on being a White Christian.

Personally, I approve of most of the Republican Platform, especially where it addresses core Conservative issues, such as low taxes and equal treatment under the law. I want a Legislature that will uphold the Constitution as it’s written and defend against the infringement of inalienable rights. I don’t want activist judges nominated or confirmed at any level of the Federal Court system, especially the Supreme Court. I hope President Trump and the Republican Congress majority will decrease the hassle factors and threats placed on the practice of medicine and business in general by an overreaching Federal bureaucracy.

And, yes, my sense of fairness hopes that our existing immigration laws will finally be enforced, as an outcome of the”equal treatment under the law.”

Instead of facile clichés fed by cherry-picked sound bites and the latest talking points from the Left, try looking at and listening to the 59 Million voters across the country who elected a Republican candidate for President, and ensured a Republican majority including all those “establishment” candidates in both the House and Senate. 

It’s the Republican platform and Conservative policy that we Conservatives voted for, not one man.

I hope you can recall this

The future includes so much more than a 10 year old video, for people who don’t have memory problems.

Forget the Clinton’s sale of nights in the Lincoln Bedroom and misplaced furnishings from the White House and, later, the State Department offices. Go ahead, laugh at the “Reset button.”

But don’t forget the pay-for-access that continues to this day. Please don’t dismiss Clinton’s complicity with the sale of US uranium and her own dismissal of the deaths of four Americans at Benghazi or of “our posterity” in the case of the unborn children whose lives are ended by elective, intentional abortion.

These recollections make a difference today and for the future.

What place will there be in a Clinton II Administration for people who oppose abortion or who prefer to continue to include “under God” in the Pledge of Allegiance? Can we tolerate another 4 years of IRS discrimination against conservative non-profits? Do we need to have more lawsuits against nuns or regulations forbidding Christians from praying in the name of Jesus?

We certainly won’t be invited to any closed door meetings on HillaryCare. And there’s no telling how many boxes of FBI files and billing records will disappear never to be “recalled” if Clinton gets another shot at the White House.

I would much rather hold Donald Trump to his promises than watch Hillary Clinton keep hers.

Beverly B Nuckols, MD

Obama’s Abortion Cronyism 

Obama’s new Health and Human Services regulations will prohibit consideration of whether a provider does abortions – or sells body parts – or not.

Kansas and Texas, among other States, attempted to prioritize their limited tax dollars, preferring to steer money – and patients – toward continuing and comprehensive caregivers – primary care providers- over  reproductive health “boutiques:”

When PP sued, they lost. But Obama arbitrarily stripped the State’s Title X funds and gave the money to PP, anyway.

The “most transparent Administration ever” went further:

 In New Hampshire, the administration even refused to disclose information about its direct Planned Parenthood grant, claiming disclosure would harm the nonprofit’s “competitive position.”””

What competition??? That’s pure cronyism and blatant support of the Democrat’s  – and Obama’s – pro-abortion political ideology.

Edited 11/12/16: misspelling of Services in first sentence BBB

Corker’s “Iran S.Amdt.1140 to H.R.1191” (text)

“Is not this a lamentable thing, that of the skin of an innocent lamb should be made parchment?” (William Shakespeare, Henry VI, Part 2, just after the more famous, “The first thing we do, let’s kill all the lawyers.)  

The Senate took a House Bill, H.R. 1191, that originally amended ObamaCare  (so that the IRS would know for certain that volunteer firefighters, paramedics, and other emergency personnel aren’t counted as employees) and changed it completely in order give birth to the  “Iran Nuclear Agreement Review Act of 2015.”

It’s appropriate that a bill that originally amended ObamaCare was changed this way, since ObamaCare was passed in the first place by Harry Reid’s Senate amendment to a bill that as originally titled, “Service Members Home Ownership Tax Act of 2009.”

From the Senate record:

SA 1140. Mr. CORKER (for himself and Mr. Cardin) proposed an
amendment to the bill H.R. 1191, to amend the Internal Revenue Code of
1986 to ensure that emergency services volunteers are not taken into
account as employees under the shared responsibility requirements
contained in the Patient Protection and Affordable Care Act; as
follows:

Strike all after the enacting clause and insert the
following:

SECTION 1. SHORT TITLE.

This Act may be cited as the “Iran Nuclear Agreement
Review Act of 2015”.

SEC. 2. CONGRESSIONAL REVIEW AND OVERSIGHT OF AGREEMENTS WITH
IRAN RELATING TO THE NUCLEAR PROGRAM OF IRAN.

The Atomic Energy Act of 1954 (42 U.S.C. 2011 et seq.) is
amended by inserting after section 134 the following new
section:

“SEC. 135. CONGRESSIONAL REVIEW AND OVERSIGHT OF AGREEMENTS
WITH IRAN.

“(a) Transmission to Congress of Nuclear Agreements With
Iran and Verification Assessment With Respect to Such
Agreements.–
“(1) Transmission of agreements.–Not later than 5
calendar days after reaching an agreement with Iran relating
to the nuclear program of Iran, the President shall transmit
to the appropriate congressional committees and leadership–
“(A) the agreement, as defined in subsection (h)(1),
including all related materials and annexes;
“(B) a verification assessment report of the Secretary of
State prepared under paragraph (2) with respect to the
agreement; and
“(C) a certification that–
“(i) the agreement includes the appropriate terms,
conditions, and duration of the agreement’s requirements with
respect to Iran’s nuclear activities and provisions
describing any sanctions to be waived, suspended, or
otherwise reduced by the United States, and any other nation
or entity, including the United Nations; and
“(ii) the President determines the agreement meets United
States non-proliferation objectives, does not jeopardize the
common defense and security, provides an adequate framework
to ensure that Iran’s nuclear activities permitted thereunder
will not be inimical to or constitute an unreasonable risk to
the common defense and security, and ensures that Iran’s
nuclear activities permitted thereunder will not be used to
further any nuclear-related military or nuclear explosive
purpose, including for any research on or development of any
nuclear explosive device or any other nuclear-related
military purpose.
“(2) Verification assessment report.–
“(A) In general.–The Secretary of State shall prepare,
with respect to an agreement described in paragraph (1), a
report assessing–
“(i) the extent to which the Secretary will be able to
verify that Iran is complying with its obligations and
commitments under the agreement;
“(ii) the adequacy of the safeguards and other control
mechanisms and other assurances contained in the agreement
with respect to Iran’s nuclear program to ensure Iran’s
activities permitted thereunder will not be used to further
any nuclear-related military or nuclear explosive purpose,
including for any research on or development of any nuclear
explosive device or any other nuclear-related military
purpose; and
“(iii) the capacity and capability of the International
Atomic Energy Agency to effectively implement the
verification regime required by or related to the agreement,
including whether the International Atomic Energy Agency will
have sufficient access to investigate suspicious sites or
allegations of covert nuclear-related activities and whether
it has the required funding, manpower, and authority to
undertake the verification regime required by or related to
the agreement.
“(B) Assumptions.–In preparing a report under
subparagraph (A) with respect to an agreement described in
paragraph (1), the Secretary shall assume that Iran could–
“(i) use all measures not expressly prohibited by the
agreement to conceal activities that violate its obligations
and commitments under the agreement; and
“(ii) alter or deviate from standard practices in order to
impede efforts to verify that Iran is complying with those
obligations and commitments.
“(C) Classified annex.–A report under subparagraph (A)
shall be transmitted in unclassified form, but shall include
a classified annex prepared in consultation with the Director
of National Intelligence, summarizing relevant classified
information.
“(3) Exception.–
“(A) In general.–Neither the requirements of
subparagraphs (B) and (C) of paragraph (1), nor subsections
(b) through (g) of this section, shall apply to an agreement
described in subsection (h)(5) or to the EU-Iran Joint
Statement made on April 2, 2015.
“(B) Additional requirement.–Notwithstanding subparagraph
(A), any agreement as defined in subsection (h)(1) and any
related materials, whether concluded before or after the date
of the enactment of this section, shall not be subject to the
exception in subparagraph (A).
“(b) Period for Review by Congress of Nuclear Agreements
With Iran.–
“(1) In general.–During the 30-calendar day period
following transmittal by the President of an agreement
pursuant to subsection (a), the Committee on Foreign
Relations of the Senate and the Committee on Foreign Affairs
of the House of Representatives shall, as appropriate, hold
hearings and briefings and otherwise obtain information in
order to fully review such agreement.
“(2) Exception.–The period for congressional review under
paragraph (1) shall be 60 calendar days if an agreement,
including all materials required to be transmitted to
Congress pursuant to subsection (a)(1), is transmitted
pursuant to subsection (a) between July 10, 2015, and
September 7, 2015.
“(3) Limitation on actions during initial congressional
review period.–Notwithstanding any other provision of law,
except as provided in paragraph (6), prior to and during the
period for transmission of an agreement in subsection (a)(1)
and during the period for congressional review provided in
paragraph (1), including any additional period as applicable
under the exception provided in paragraph (2), the President
may not waive, suspend, reduce, provide relief from, or
otherwise limit the application of statutory sanctions with
respect to Iran under any provision of law or refrain from
applying any such sanctions pursuant to an agreement
described in subsection (a).
“(4) Limitation on actions during presidential
consideration of a joint resolution of disapproval.–
Notwithstanding any other provision of law, except as
provided in paragraph (6), if a joint resolution of
disapproval described in subsection (c)(2)(B) passes the
Congress, the President may not waive, suspend, reduce,
provide relief from, or otherwise limit the application of
statutory sanctions with respect to Iran under any provision
of law or refrain from applying any such sanctions pursuant
to an agreement described in subsection (a) for a period of
12 calendar days following the date of passage of the joint
resolution of disapproval.
“(5) Limitation on actions during congressional
reconsideration of a joint resolution of disapproval.–
Notwithstanding any other provision of law, except as
provided in paragraph (6), if a joint resolution of
disapproval described in subsection (c)(2)(B) passes the
Congress, and the President vetoes such joint resolution, the
President may not waive, suspend, reduce, provide relief
from, or otherwise limit the application of statutory
sanctions with respect to Iran under any provision of law or
refrain from applying any such sanctions pursuant to an
agreement described in subsection (a) for a period of 10
calendar days following the date of the President’s veto.
“(6) Exception.–The prohibitions under paragraphs (3)
through (5) do not apply to any new deferral, waiver, or
other suspension of statutory sanctions pursuant to the Joint
Plan of Action if that deferral, waiver, or other suspension
is made–
“(A) consistent with the law in effect on the date of the
enactment of the Iran Nuclear Agreement Review Act of 2015;
and
“(B) not later than 45 calendar days before the
transmission by the President of an agreement, assessment
report, and certification under subsection (a).
“(c) Effect of Congressional Action With Respect to
Nuclear Agreements With Iran.–
“(1) Sense of congress.–It is the sense of Congress
that–
“(A) the sanctions regime imposed on Iran by Congress is
primarily responsible for bringing Iran to the table to
negotiate on its nuclear program;
“(B) these negotiations are a critically important matter
of national security and foreign policy for the United States
and its closest allies;
“(C) this section does not require a vote by Congress for
the agreement to commence;
“(D) this section provides for congressional review,
including, as appropriate, for approval, disapproval, or no
action on statutory sanctions relief under an agreement; and
“(E) even though the agreement may commence, because the
sanctions regime was imposed by Congress and only Congress
can permanently modify or eliminate that regime, it is
critically important that Congress have the opportunity, in
an orderly and deliberative manner, to consider and, as
appropriate, take action affecting the statutory sanctions
regime imposed by Congress.
“(2) In general.–Notwithstanding any other provision of
law, action involving any measure of statutory sanctions
relief by the United States pursuant to an agreement subject
to subsection (a) or the Joint Plan of Action–
“(A) may be taken, consistent with existing statutory
requirements for such action, if, during the period for
review provided in subsection (b), the Congress adopts, and
there is enacted, a joint resolution stating in substance
that the Congress does favor the agreement;
“(B) may not be taken if, during the period for review
provided in subsection (b), the Congress adopts, and there is
enacted, a joint

[[Page S2410]]

resolution stating in substance that the Congress does not
favor the agreement; or
“(C) may be taken, consistent with existing statutory
requirements for such action, if, following the period for
review provided in subsection (b), there is not enacted any
such joint resolution.
“(3) Definition.–For the purposes of this subsection, the
phrase `action involving any measure of statutory sanctions
relief by the United States’ shall include waiver,
suspension, reduction, or other effort to provide relief
from, or otherwise limit the application of statutory
sanctions with respect to, Iran under any provision of law or
any other effort to refrain from applying any such sanctions.
“(d) Congressional Oversight of Iranian Compliance With
Nuclear Agreements.–
“(1) In general.–The President shall keep the appropriate
congressional committees and leadership fully and currently
informed of all aspects of Iranian compliance with respect to
an agreement subject to subsection (a).
“(2) Potentially significant breaches and compliance
incidents.–The President shall, within 10 calendar days of
receiving credible and accurate information relating to a
potentially significant breach or compliance incident by Iran
with respect to an agreement subject to subsection (a),
submit such information to the appropriate congressional
committees and leadership.
“(3) Material breach report.–Not later than 30 calendar
days after submitting information about a potentially
significant breach or compliance incident pursuant to
paragraph (2), the President shall make a determination
whether such potentially significant breach or compliance
issue constitutes a material breach and, if there is such a
material breach, whether Iran has cured such material breach,
and shall submit to the appropriate congressional committees
and leadership such determination, accompanied by, as
appropriate, a report on the action or failure to act by Iran
that led to the material breach, actions necessary for Iran
to cure the breach, and the status of Iran’s efforts to cure
the breach.
“(4) Semi-annual report.–Not later than 180 calendar days
after entering into an agreement described in subsection (a),
and not less frequently than once every 180 calendar days
thereafter, the President shall submit to the appropriate
congressional committees and leadership a report on Iran’s
nuclear program and the compliance of Iran with the agreement
during the period covered by the report, including the
following elements:
“(A) Any action or failure to act by Iran that breached
the agreement or is in noncompliance with the terms of the
agreement.
“(B) Any delay by Iran of more than one week in providing
inspectors access to facilities, people, and documents in
Iran as required by the agreement.
“(C) Any progress made by Iran to resolve concerns by the
International Atomic Energy Agency about possible military
dimensions of Iran’s nuclear program.
“(D) Any procurement by Iran of materials in violation of
the agreement or which could otherwise significantly advance
Iran’s ability to obtain a nuclear weapon.
“(E) Any centrifuge research and development conducted by
Iran that–
“(i) is not in compliance with the agreement; or
“(ii) may substantially enhance the breakout time of
acquisition of a nuclear weapon by Iran, if deployed.
“(F) Any diversion by Iran of uranium, carbon-fiber, or
other materials for use in Iran’s nuclear program in
violation of the agreement.
“(G) Any covert nuclear activities undertaken by Iran,
including any covert nuclear weapons-related or covert
fissile material activities or research and development.
“(H) An assessment of whether any Iranian financial
institutions are engaged in money laundering or terrorist
finance activities, including names of specific financial
institutions if applicable.
“(I) Iran’s advances in its ballistic missile program,
including developments related to its long-range and inter-
continental ballistic missile programs.
“(J) An assessment of–
“(i) whether Iran directly supported, financed, planned,
or carried out an act of terrorism against the United States
or a United States person anywhere in the world;
“(ii) whether, and the extent to which, Iran supported
acts of terrorism, including acts of terrorism against the
United States or a United States person anywhere in the
world;
“(iii) all actions, including in international fora, being
taken by the United States to stop, counter, and condemn acts
by Iran to directly or indirectly carry out acts of terrorism
against the United States and United States persons;
“(iv) the impact on the national security of the United
States and the safety of United States citizens as a result
of any Iranian actions reported under this paragraph; and
“(v) all of the sanctions relief provided to Iran,
pursuant to the agreement, and a description of the
relationship between each sanction waived, suspended, or
deferred and Iran’s nuclear weapon’s program.
“(K) An assessment of whether violations of
internationally recognized human rights in Iran have changed,
increased, or decreased, as compared to the prior 180-day
period.
“(5) Additional reports and information.–
“(A) Agency reports.–Following submission of an agreement
pursuant to subsection (a) to the appropriate congressional
committees and leadership, the Department of State, the
Department of Energy, and the Department of Defense shall,
upon the request of any of those committees or leadership,
promptly furnish to those committees or leadership their
views as to whether the safeguards and other controls
contained in the agreement with respect to Iran’s nuclear
program provide an adequate framework to ensure that Iran’s
activities permitted thereunder will not be inimical to or
constitute an unreasonable risk to the common defense and
security.
“(B) Provision of information on nuclear initiatives with
iran.–The President shall keep the appropriate congressional
committees and leadership fully and currently informed of any
initiative or negotiations with Iran relating to Iran’s
nuclear program, including any new or amended agreement.
“(6) Compliance certification.–After the review period
provided in subsection (b), the President shall, not less
than every 90 calendar days–
“(A) determine whether the President is able to certify
that–
“(i) Iran is transparently, verifiably, and fully
implementing the agreement, including all related technical
or additional agreements;
“(ii) Iran has not committed a material breach with
respect to the agreement or, if Iran has committed a material
breach, Iran has cured the material breach;
“(iii) Iran has not taken any action, including covert
action, that could significantly advance its nuclear weapons
program; and
“(iv) suspension of sanctions related to Iran pursuant to
the agreement is–

“(I) appropriate and proportionate to the specific and
verifiable measures taken by Iran with respect to terminating
its illicit nuclear program; and
“(II) vital to the national security interests of the
United States; and

“(B) if the President determines he is able to make the
certification described in subparagraph (A), make such
certification to the appropriate congressional committees and
leadership.
“(7) Sense of congress.–It is the sense of Congress
that–
“(A) United States sanctions on Iran for terrorism, human
rights abuses, and ballistic missiles will remain in place
under an agreement, as defined in subsection (h)(1);
“(B) issues not addressed by an agreement on the nuclear
program of Iran, including fair and appropriate compensation
for Americans who were terrorized and subjected to torture
while held in captivity for 444 days after the seizure of the
United States Embassy in Tehran, Iran, in 1979 and their
families, the freedom of Americans held in Iran, the human
rights abuses of the Government of Iran against its own
people, and the continued support of terrorism worldwide by
the Government of Iran, are matters critical to ensure
justice and the national security of the United States, and
should be expeditiously addressed;
“(C) the President should determine the agreement in no
way compromises the commitment of the United States to
Israel’s security, nor its support for Israel’s right to
exist; and
“(D) in order to responsibly implement any long-term
agreement reached between the P5+1 countries and Iran, it is
critically important that Congress have the opportunity to
review any agreement and, as necessary, take action to modify
the statutory sanctions regime imposed by Congress.
“(e) Expedited Consideration of Legislation.–
“(1) In general.–In the event the President does not
submit a certification pursuant to subsection (d)(6) or has
determined pursuant to subsection (d)(3) that Iran has
materially breached an agreement subject to subsection (a)
and the material breach has not been cured, Congress may
initiate within 60 calendar days expedited consideration of
qualifying legislation pursuant to this subsection.
“(2) Qualifying legislation defined.–For purposes of this
subsection, the term `qualifying legislation’ means only a
bill of either House of Congress–
“(A) the title of which is as follows: `A bill reinstating
statutory sanctions imposed with respect to Iran.’; and
“(B) the matter after the enacting clause of which is:
`Any statutory sanctions imposed with respect to Iran
pursuant to ______ that were waived, suspended, reduced, or
otherwise relieved pursuant to an agreement submitted
pursuant to section 135(a) of the Atomic Energy Act of 1954
are hereby reinstated and any action by the United States
Government to facilitate the release of funds or assets to
Iran pursuant to such agreement, or provide any further
waiver, suspension, reduction, or other relief pursuant to
such agreement is hereby prohibited.’, with the blank space
being filled in with the law or laws under which sanctions
are to be reinstated.
“(3) Introduction.–During the 60-calendar day period
provided for in paragraph (1), qualifying legislation may be
introduced–
“(A) in the House of Representatives, by the majority
leader or the minority leader; and

[[Page S2411]]

“(B) in the Senate, by the majority leader (or the
majority leader’s designee) or the minority leader (or the
minority leader’s designee).
“(4) Floor consideration in house of representatives.–
“(A) Reporting and discharge.–If a committee of the House
to which qualifying legislation has been referred has not
reported such qualifying legislation within 10 legislative
days after the date of referral, that committee shall be
discharged from further consideration thereof.
“(B) Proceeding to consideration.–Beginning on the third
legislative day after each committee to which qualifying
legislation has been referred reports it to the House or has
been discharged from further consideration thereof, it shall
be in order to move to proceed to consider the qualifying
legislation in the House. All points of order against the
motion are waived. Such a motion shall not be in order after
the House has disposed of a motion to proceed on the
qualifying legislation with regard to the same agreement. The
previous question shall be considered as ordered on the
motion to its adoption without intervening motion. The motion
shall not be debatable. A motion to reconsider the vote by
which the motion is disposed of shall not be in order.
“(C) Consideration.–The qualifying legislation shall be
considered as read. All points of order against the
qualifying legislation and against its consideration are
waived. The previous question shall be considered as ordered
on the qualifying legislation to final passage without
intervening motion except two hours of debate equally divided
and controlled by the sponsor of the qualifying legislation
(or a designee) and an opponent. A motion to reconsider the
vote on passage of the qualifying legislation shall not be in
order.
“(5) Consideration in the senate.–
“(A) Committee referral.–Qualifying legislation
introduced in the Senate shall be referred to the Committee
on Foreign Relations.
“(B) Reporting and discharge.–If the Committee on Foreign
Relations has not reported such qualifying legislation within
10 session days after the date of referral of such
legislation, that committee shall be discharged from further
consideration of such legislation and the qualifying
legislation shall be placed on the appropriate calendar.
“(C) Proceeding to consideration.–Notwithstanding Rule
XXII of the Standing Rules of the Senate, it is in order at
any time after the committee authorized to consider
qualifying legislation reports it to the Senate or has been
discharged from its consideration (even though a previous
motion to the same effect has been disagreed to) to move to
proceed to the consideration of qualifying legislation, and
all points of order against qualifying legislation (and
against consideration of the qualifying legislation) are
waived. The motion to proceed is not debatable. The motion is
not subject to a motion to postpone. A motion to reconsider
the vote by which the motion is agreed to or disagreed to
shall not be in order. If a motion to proceed to the
consideration of the qualifying legislation is agreed to, the
qualifying legislation shall remain the unfinished business
until disposed of.
“(D) Debate.–Debate on qualifying legislation, and on all
debatable motions and appeals in connection therewith, shall
be limited to not more than 10 hours, which shall be divided
equally between the majority and minority leaders or their
designees. A motion to further limit debate is in order and
not debatable. An amendment to, or a motion to postpone, or a
motion to proceed to the consideration of other business, or
a motion to recommit the qualifying legislation is not in
order.
“(E) Vote on passage.–The vote on passage shall occur
immediately following the conclusion of the debate on the
qualifying legislation and a single quorum call at the
conclusion of the debate, if requested in accordance with the
rules of the Senate.
“(F) Rulings of the chair on procedure.–Appeals from the
decisions of the Chair relating to the application of the
rules of the Senate, as the case may be, to the procedure
relating to qualifying legislation shall be decided without
debate.
“(G) Consideration of veto messages.–Debate in the Senate
of any veto message with respect to qualifying legislation,
including all debatable motions and appeals in connection
with such qualifying legislation, shall be limited to 10
hours, to be equally divided between, and controlled by, the
majority leader and the minority leader or their designees.
“(6) Rules relating to senate and house of
representatives.–
“(A) Coordination with action by other house.–If, before
the passage by one House of qualifying legislation of that
House, that House receives qualifying legislation from the
other House, then the following procedures shall apply:
“(i) The qualifying legislation of the other House shall
not be referred to a committee.
“(ii) With respect to qualifying legislation of the House
receiving the legislation–

“(I) the procedure in that House shall be the same as if
no qualifying legislation had been received from the other
House; but
“(II) the vote on passage shall be on the qualifying
legislation of the other House.

“(B) Treatment of a bill of other house.–If one House
fails to introduce qualifying legislation under this section,
the qualifying legislation of the other House shall be
entitled to expedited floor procedures under this section.
“(C) Treatment of companion measures.–If, following
passage of the qualifying legislation in the Senate, the
Senate then receives a companion measure from the House of
Representatives, the companion measure shall not be
debatable.
“(D) Application to revenue measures.–The provisions of
this paragraph shall not apply in the House of
Representatives to qualifying legislation which is a revenue
measure.
“(f) Rules of House of Representatives and Senate.–
Subsection (e) is enacted by Congress–
“(1) as an exercise of the rulemaking power of the Senate
and the House of Representatives, respectively, and as such
are deemed a part of the rules of each House, respectively,
but applicable only with respect to the procedure to be
followed in that House in the case of legislation described
in those sections, and supersede other rules only to the
extent that they are inconsistent with such rules; and
“(2) with full recognition of the constitutional right of
either House to change the rules (so far as relating to the
procedure of that House) at any time, in the same manner, and
to the same extent as in the case of any other rule of that
House.
“(g) Rules of Construction.–Nothing in the section shall
be construed as–
“(1) modifying, or having any other impact on, the
President’s authority to negotiate, enter into, or implement
appropriate executive agreements, other than the restrictions
on implementation of the agreements specifically covered by
this section;
“(2) allowing any new waiver, suspension, reduction, or
other relief from statutory sanctions with respect to Iran
under any provision of law, or allowing the President to
refrain from applying any such sanctions pursuant to an
agreement described in subsection (a) during the period for
review provided in subsection (b);
“(3) revoking or terminating any statutory sanctions
imposed on Iran; or
“(4) authorizing the use of military force against Iran.
“(h) Definitions.–In this section:
“(1) Agreement.–The term `agreement’ means an agreement
related to the nuclear program of Iran that includes the
United States, commits the United States to take action, or
pursuant to which the United States commits or otherwise
agrees to take action, regardless of the form it takes,
whether a political commitment or otherwise, and regardless
of whether it is legally binding or not, including any joint
comprehensive plan of action entered into or made between
Iran and any other parties, and any additional materials
related thereto, including annexes, appendices, codicils,
side agreements, implementing materials, documents, and
guidance, technical or other understandings, and any related
agreements, whether entered into or implemented prior to the
agreement or to be entered into or implemented in the future.
“(2) Appropriate congressional committees.–The term
`appropriate congressional committees’ means the Committee on
Finance, the Committee on Banking, Housing, and Urban
Affairs, the Select Committee on Intelligence, and the
Committee on Foreign Relations of the Senate and the
Committee on Ways and Means, the Committee on Financial
Services, the Permanent Select Committee on Intelligence, and
the Committee on Foreign Affairs of the House of
Representatives.
“(3) Appropriate congressional committees and
leadership.–The term `appropriate congressional committees
and leadership’ means the Committee on Finance, the Committee
on Banking, Housing, and Urban Affairs, the Select Committee
on Intelligence, and the Committee on Foreign Relations, and
the Majority and Minority Leaders of the Senate and the
Committee on Ways and Means, the Committee on Financial
Services, the Permanent Select Committee on Intelligence, and
the Committee on Foreign Affairs, and the Speaker, Majority
Leader, and Minority Leader of the House of Representatives.
“(4) Iranian financial institution.–The term `Iranian
financial institution’ has the meaning given the term in
section 104A(d) of the Comprehensive Iran Sanctions,
Accountability, and Divestment Act of 2010 (22 U.S.C.
8513b(d)).
“(5) Joint plan of action.–The term `Joint Plan of
Action’ means the Joint Plan of Action, signed at Geneva
November 24, 2013, by Iran and by France, Germany, the
Russian Federation, the People’s Republic of China, the
United Kingdom, and the United States, and all implementing
materials and agreements related to the Joint Plan of Action,
including the technical understandings reached on January 12,
2014, the extension thereto agreed to on July 18, 2014, the
extension agreed to on November 24, 2014, and any materially
identical extension that is agreed to on or after the date of
the enactment of the Iran Nuclear Agreement Review Act of
2015.
“(6) EU-iran joint statement.–The term `EU-Iran Joint
Statement’ means only the Joint Statement by EU High
Representative Federica Mogherini and Iranian Foreign
Minister Javad Zarif made on April 2, 2015, at Lausanne,
Switzerland.
“(7) Material breach.–The term `material breach’ means,
with respect to an agreement described in subsection (a), any
breach

[[Page S2412]]

of the agreement, or in the case of non-binding commitments,
any failure to perform those commitments, that
substantially–
“(A) benefits Iran’s nuclear program;
“(B) decreases the amount of time required by Iran to
achieve a nuclear weapon; or
“(C) deviates from or undermines the purposes of such
agreement.
“(8) Noncompliance defined.–The term `noncompliance’
means any departure from the terms of an agreement described
in subsection (a) that is not a material breach.
“(9) P5+1 countries.–The term `P5+1 countries’ means the
United States, France, the Russian Federation, the People’s
Republic of China, the United Kingdom, and Germany.
“(10) United states person.–The term `United States
person’ has the meaning given that term in section 101 of the
Comprehensive Iran Sanctions, Accountability, and Divestment
Act of 2010 (22 U.S.C. 8511).”.
______

via S.Amdt.1140 to H.R.1191 – 114th Congress (2015-2016) – Amendment Text | Congress.gov | Library of Congress.

“How Government Killed the Medical Profession”

Contrast the Hippocratic ethic in which a physician recommends treatment to his patient, based on his best medical judgement in the patient’s interest, with that of the “veterinary ethic,” where decisions are made by the “payor” — or owner. Now, consider the effect of Government regulations which arbitrarily force doctors to learn protocols and guidelines (rather than adjust to the patient’s course of illness), to fit a patient’s illness into International Clinical Diagnoses (out to the nth decimal place) and which withhold payment when a patient becomes ill enough to need readmission to the hospital within 30 days of the last admission.

In an article published online by Cato, Dr. Jeffery Singer lays out the history of the destruction of Medicine as  a profession. In the past, Dr. Singer described the ethical transition toward the “veterinary ethic.”

Each of these articles is worth your time and consideration. The first article gives one of the best explanations of the Government move to “coding” of medical diagnoses in exchange for payment “reimbursement,” on through the forced move to Electronic Medical Records without evidence that patients will benefit and Accountable Care Organizations which assign patients to employee “providers.” The second, earlier article, reviewed the necessary change in medical ethics to allow doctors to practice without – or in contradiction to – their conscience.

Forget patient autonomy, long elevated by the lawmakers, lawyers and  Ph.D’s (in the name of “Bioethics”) above the traditional physician Hippocratic values of beneficence and its foundation, non-maleficence. In the world of Government medicine, your life is in the hands of the “payor:” the Golden Rule of “He who has the gold makes the rules.”

NEJM admits “ObamaCare” isn’t “Affordable” without subsidies

The New England Journal of Medicine has some free articles you might want to read this week. (I’m afraid you will have to register – will you let me know if you do?)
The first asserts that we’re stuck with ObamaCare – but it calls ObamaCare, “ObamaCare.” The author, Jonathan Oberlander, Ph.D, also acknowledges that the only way the ACA (the Affordable Care Act) is “Affordable” is if the Federal government hands out cash subsidies. In fact, if the Supreme Court rules that the language of the law forbids subsidies in States that don’t have their own exchanges,

Here’s an excerpt:
“The calendar cannot be turned back to 2009. The ACA has made some irreversible changes in U.S. health care.

“Even if they have unified control of the federal government in 2017, Republicans will confront the reality that Obamacare has redefined U.S. health policy and the terms of the debate. In practice, future repeal legislation would probably not scrap the whole ACA, but rather remove specific provisions and remake other policies to conform to a more conservative vision. A Republican President could, through waivers and other means, undermine Obamacare in important ways, but he or she could not eliminate it.

“The Supreme Court’s decision to hear a case (King v. Burwell) challenging the legality of providing premium subsidies in federal exchanges is crucial to the GOP precisely because the chances for legislative repeal of Obamacare are so remote. The Court can seriously damage the ACA in a way that congressional Republicans cannot. A decision to prohibit subsidies for helping the uninsured to purchase coverage in the 34 states that have federally run exchanges would destabilize the health insurance marketplaces and unravel the individual and employer mandates in those states, exacerbating the already large disparities in insurance coverage among states. It would cause both a sizable increase in the uninsured population and sizable losses for the insurance industry and medical care providers as millions of Americans lost their health coverage.  Such a ruling could, in turn, produce enormous pressures on affected states and Congress to adopt measures to stave off those outcomes. Yet the ACA’s shaky political foundations would complicate policymakers’ responses, and Obamacare’s opponents would be emboldened to resist any fixes. A ruling against federal subsidies could have a spillover effect, dampening the chances for Medicaid expansion in some states.“ (Emphasis mine)

 

The ACA appears to be on track to destroy the financing of health care in our country, whether or not it is fully implemented.

Dreams of 2017

What “executive priorities” would you like to see implemented by Executive Order of the new Republican President, beginning January 20, 2017?

Even as a “dream,” it’s not easy to write all this. It’s easy to see the objections and possible pitfalls. I need help. I suggest not enforcing any law that can’t be justified in 2 to 3  sentences, using “Life, liberty and the pursuit of happiness” and a plain reading of the Constitution and the Bill of Rights. No “penumbras,” no nuances. Make it plain and transparent enough that even Gruber’s criteria of  “the stupidity of the American voters” is met.

Same 90 day deadline Obama set for his immigration fiat?

Here’s a short list:

• Close the border.  Should we deport the “over-stayers” and those on Obama’s “deferment” lists?
• The IRS should phase out, shut down, beginning with Obamacare enforcement.
• The Secret Service will limit it’s scope to protection of dignitaries.
• Tell the EPA, OSHA, EEOC, HHS, Education Energy and others to plan on shutting down as States take over their functions – the way the States want to do those functions.
• Foreign aid should be held until Congress makes new, individual appropriations.
• Any aide that goes to abortion-favorable services stops immediately.
• ?????

The Insider – FeatureID 383

Read this article for a history (you probably don’t know about)  of the many attempts and failures in healthcare reform over the last 20+ years.

In 2001, Rep. Bill Thomas (R-Calif.), chair of the House Ways and Means Committee, brought a tax credit bill to the House floor and passed it over objections of congressional liberals favoring Medicaid expansion. In the Senate, however, Majority Leader Tom Daschle (D-S.D.) blocked the tax credit bill twice. Nonetheless, as a political matter, conservatives were playing offense on health care policy for the first time in memory. While small, the proposal was a psychological victory for those who wanted to fix health care with more free markets.

via The Insider – FeatureID 383.

I say “fertilization,” you say “conception”

Forty years ago the words “fertilization” and “conception” meant the same thing to doctors, lawyers, and embryologists alike: the joining of the 23 chromosomes in the sperm with the 23 chromosomes in the oocyte (“egg”) to form a new complete, unique human organism. “Contraception” was defined as any method that worked before the existence of the embryo by preventing fertilization. These were the hormonal treatments and devices that prevent ovulation of the egg and condoms, diaphragms and sterilization that serve as “barriers” between the sperm and egg.   Drugs and devices that may or may not end the life of the embryo after fertilization were legally and correctly called “abortifacients.”

However, legalized abortion and the ability to accomplish fertilization through in vitro methods led to new legal definitions of “pregnancy” and “conception” as beginning at implantation rather than fertilization.   Even in vivo, healthy human embryos in healthy mothers were deprived of legal protection as human beings for at least the first 5 – 10 days of their lives, the window of opportunity for implantation when the developing embryo grows to hundreds of cells organized in 2 or 3 recognizable tissue layers and interact with the mother’s body in ways that may affect the timing of birth or risk of diabetes and other health concerns. Possible abortifacients that work after fertilization but before implantation were redefined as “emergency contraception.”

In spite of what you may have heard on the news, the June 30, 2014 Burwell v. Hobby Lobby decision by the Supreme Court of the United States (SCOTUS) didn’t deny birth control for anyone. Everyone may still purchase his or her own FDA-approved birth control.  SCOTUS simply ruled that the government can’t force some employers to buy things that they believe are immoral.

In fact, Hobby Lobby only asked to be exempt from purchasing insurance plans that paid for specific drugs and devices used for “emergency contraception.” Before the passage of the Affordable Care Act (“ObamaCare” or ACA), the company purchased insurance that included true forms of contraception, including,

• Those that prevent ovulation by preventing the normal ups and downs of the hormones estrogen and progesterone, such asBirth-control pills with estrogen and progestin (“Combined Pill”),Birth-control pills with progestin alone (“The Mini Pill”),Birth control pills (extended/continuous use), Contraceptive patches, Contraceptive rings,Progestin injections, andImplantable rods

and

• Those that act as “barriers” to fertilization by preventing the union of sperm and egg: Male condoms, Female condoms, Diaphragms with spermicide, Sponges with spermicide, Cervical caps with spermicide, Spermicide alone, Vasectomies, Female sterilization surgeries, and Female sterilization implants.

The problem is that regulations written by the Obama Administration mandated that all insurances pay for all pregnancy “preventatives” approved by the FDA, including drugs and devices that may function after fertilization to end the life of the new human embryo:

• Pills that mainly delay ovulation but may impair implantation and development of the placenta if fertilization takes place, such as over-the-counter Plan B and generic levonorgestrel tablets, and ella, which requires a prescription, and
• Devices that mechanically and hormonally make the uterus inhospitable to implantation by the embryo, such as intrauterine devices like the copper-T, Mirena, and ParaGuard. These are inserted up to 5 days after unprotected intercourse to prevent implantation and then left in place to prevent fertilization and implantation for as long as 5-10 years.

Although the words we use do not change the fact that the human embryo is the same human life before implantation as after, they can change his or her legal status.

Understanding Supreme Court Decisions: Hobby Lobby

For questions about the decision and history behind it, read this!

Understanding Supreme Court Decisions: Hobby Lobby.

Wider impact of Hobby Lobby ruling? : SCOTUSblog

Remember, no one is forbidden to buy anything.  However, the US Government will not force people or their companies to pay for devices and drugs they believe are immoral.

 

The Affordable Care Act regulations issued by the federal government, however, required twenty different preventive methods or services, including sterilization and pregnancy counseling. Depending upon how lower courts now interpret the Hobby Lobby decision, companies that fit within the Court’s “closely held company” bracket and offer religious objections could be spared from having to provide any of those services through their employee health plans.

In three cases in which a federal appeals court had rejected the challenges to the mandate, the new Supreme Court orders told those courts to reconsider, applying Monday’s decision. The companies or their owners had taken those petitions to the Court.

On three petitions filed by the federal government, involving appeals court rulings rejecting the challenges by corporations. their owners, or both, the Justices simply denied review.

via Wider impact of Hobby Lobby ruling? : SCOTUSblog.

Protect the Privacy of Your Medical Records |

I’ve had privately insured and Medicare patients – and at least two families visiting our town from Canada – ask me to keep records about one or another history or ailment. I told them I’d do my best, but explained the legal problems with Medicare laws. Since 1997, doctors have been prosecuted for refusing to allow Medicare auditors to see everything in the office. One woman doctor was arrested for refusing to unlock a drawer in her (private?) desk.

And now, the IRS wants control of your medical care.

 

The confidentiality of the medical relationship and records has to be maintained or patients will not disclose the true nature of their problems. This results in harm to the patient and prevents the physician from truly helping the patient.

via Protect the Privacy of Your Medical Records |.

Medicaid backlog creates payment hassles for physicians | Medical Economics

And the docs will pay if the patient doesn’t qualify . . .

 

Though 6 million new patients have enrolled for Medicaid coverage due to expansion of the program, media reports say that nearly half of those enrollment applications have yet to be processed.

Because of the bureaucratic backlog, physicians might get stuck waiting even longer on Medicaid reimbursements for patients who have yet to receive authorization. In addition, practices may incur costs from patients who signed up for but were denied Medicaid coverage.

via Medicaid backlog creates payment hassles for physicians | Medical Economics.

American Academy of Family Physicians resignation

I wrote a very difficult letter today. I  resigned from the organization that is supposed to support Family Physicians in our education, practice management and good medical care of our patients. Instead, the American  Academy of Family Physicians too often strays toward forcing its members to be complicit with controversial policies such as condoning gun control and over-the-counter contraceptive drugs, and condemnation of “reparative therapy” for homosexual patients, even when those patients are unhappy with their sexuality. I write about my main conflicts and the “final straw” in the letter:

 

It is with great regret that I write this letter as notice that I have decided not to renew either my Texas or American Academy of Family Practice membership. While I am still a family doctor, neither the Texas Academy of Family Practice (TAFP) nor the American Academy of Family Practice (AAFP) represent my political or ethical views.

The political, social and ethical controversies were the main reason I remained in the Academy for the last few years since I left full time practice. I hoped that I could make a difference by volunteering my time and money as an active participant in the Texas Academy, the National Conference of Special Constituencies, the AAFP list serves, the Academy Legislative meetings in DC and our annual AAFP Congress of Delegates.

From the time of Hillary Clinton’s closed meetings on healthcare to the endorsement of the passage of the ACA before it was written, the political actions of the AAFP leaders has disappointed me in Washington, DC. Our practice hassle factors have grown and grown, too often with the blessings of – and sometimes due to the experiments with alternative methods of practice by – the Academy.

The AAFP advocated for elective abortion before I joined as a Student member and I accepted that the burden of persuasion was on those of us who disagreed.

However, the Academy’s decision to advocate for the redefinition of marriage in 2012 and the refusal to reconsider the extracted Resolution on marriage neutrality at the 2013 Congress of Delegates in San Diego were the final proof that there’s no tolerance for family doctors who hold conservative politics or traditional ethics in the Academy.

Unfortunately, our TAFP spokesperson to the 2013 AAFP Reference Committee on Advocacy misrepresented the Texas Delegation’s instructions from the Directors on marriage. As I remember the discussion and vote, the intention was to allow the Texas delegates wide latitude in voting on any final form of the Resolution.

I hereby resign from the Texas Academy of Family Physicians, the American Academy of Family Physicians and as a Fellow of the AAFP.

 

I waited to resign after nearly 30-year membership until the last minute before being dropped (for lack of paying my annual dues). There were several reasons for my hesitancy. For one thing, I didn’t want to be an undue influence on other members when they considered whether or not to write that hefty annual check to the Academy. For another, while I will continue to work with the AAFP and the Christian Medical and Dental Association to protect the right to life, marriage, the conscience rights of doctors within the profession of medicine and the specialty of Family Medicine, I do believe that it is important to work to persuade from within the organization. The biggest problem with finally writing the letter was that I was looking for a way to somehow keep my integrity while allowing the Academy to claim to represent me.

However, now that I’ve resigned, please consider sharing my letter with your family doctor. Many of them are unaware of the policies that our professional organizations push on good doctors of today and the students and residents who will be our doctors of tomorrow.

Hobby Lobby isn’t today’s most important case: Column | News-Herald Media | marshfieldnewsherald.com

Make them follow the law as written!

The issues in Halbig are simple.

Obamacare authorizes the IRS to provide health-insurance subsidies (nominally, tax credits) to consumers who purchase health insurance “through an Exchange established by the State.” That’s not a drafting error. The subsidy-eligibility rules employ that language a total of nine times, without deviation. The rest of the statue is fully compatible with this language.

The statute is therefore clear and unambiguous: the IRS may issue subsidies in the 14 states that established an exchange, but not in the 34 states that left the job of establishing and operating their state’s exchange to the federal government. Congress’ purpose is likewise clear. It wanted states to operate the exchanges, so it conditioned subsidies on state cooperation. Medicaid and countless other federal programs do the same.

The IRS’s philosopher-kings have decided to issue subsidies in those 34 states anyway.

The Obama administration has acquired a reputation for unilaterally rewriting laws (to say nothing of abusing the IRS’s powers) for political purposes, but this one takes the cake.

via Hobby Lobby isn’t today’s most important case: Column | News-Herald Media | marshfieldnewsherald.com.

The battle over Medicaid expansion

When people have the facts, they oppose ObamaCare and Medicaid expansion.

When Virginia voters learn that ObamaCare’s Medicaid expansion slashes seniors’ Medicare, gives taxpayer-funded Medicaid coverage to former prison inmates and could deplete funding for critical state priorities, their support for ObamaCare’s Medicaid expansion plummets; this according to a new poll released today by the Foundation for Government Accountability (FGA), a multi-state free-market think tank based in Florida.

The 10-question poll was conducted between March 7 and March 9, 2014, with 469 likely Virginia voters responding to all 10 questions.

via The battle over Medicaid expansion.

Drs discover that sick people use health care!

Ezekial Emanuel is Rahm’s brother. He has been one of the Obamacare pushers for years.

The new goal, according to Emanuel, should be per-capita annual health care costs by 2020 that increase no more than the annual gross domestic product.

“It’s clear and easily measured,” he said. “But it’s not going to happen overnight.”

It would require a “renewed, systemwide focus on transforming the delivery system to improve the way we care for the chronically ill,” said Emanuel, because 10% of the population with chronic illnesses now consumes nearly two-thirds of health care dollars.

Another recipe for reform was offered by Joanne Lynn, MD, of the Center for Elder Care and Advanced Illness, Altarum Institute, Washington.

“We almost all get to grow old; it’s the terrific success of modern medicine,” she said, but the system hasn’t evolved to cope with this reality.

via Physicians outline critical issues facing US health care | Healio.

Untested Waters (TMA on ObamaCare)

From the Texas Medical Association website:

Both Texas Oncology and ARC, for example, already participated in most major health plans in Texas before the launch of the exchange. Because not all of those insurers explicitly invited Texas Oncology to join their new marketplace networks, the group was combing through its contracts and contacting carriers to find out how to opt out of the exchange plans. All of ARC\’s existing contracts require insurers to renegotiate with the group before including it in any new products or networks. Some payers never approached the group; others came back with lower fee schedules, which ARC declined. On the other hand, 27 percent of respondents in the MGMA survey said they are participating in the exchange because their existing contract terms required them to participate in all of an insurers\’ products under so-called \”all products\” clauses.

Because a number of Dr. Buckingham\’s contracts include such clauses, the six-physician practice, Eye Physicians of Austin, faces the prospect of renegotiation in order to opt out of certain exchange plans.

\”To me, my hands are tied, and they are making me jump off of a plank I don\’t want to jump off of. And it\’s an expensive process, and it interrupts patient care,\” she said.

via Untested Waters.

You say “Mispoke,” I say “Lie” – NYTimes.com

“That, they say, violates President Obama’s pledge that if you like the insurance you have, you can keep it.

“Mr. Obama clearly misspoke when he said that.”

via Insurance Policies Not Worth Keeping – NYTimes.com.

#Stand4Life Victories: Texas’ law upheld, ObamaCare contraception mandate struck

Victory on two levels! Many of Texas’ abortion facilities are closed today because they don’t have doctors with hospital privileges and today, the DC Court of Appeals ruled in favor of religious conscience rights, even for people who own businesses!

From The Hill, a blog out of Washington, DC:

A federal appeals court on Friday struck down the birth control mandate in ObamaCare, concluding the requirement trammels religious freedom.

The D.C. Circuit Court of Appeals — the second most influential bench in the land behind the Supreme Court — ruled 2-1 in favor of business owners who are fighting the requirement that they provide their employees with health insurance that covers birth control.

Requiring companies to cover their employees’ contraception, the court ruled, is unduly burdensome for business owners who oppose birth control on religious grounds, even if they are not purchasing the contraception directly.

“The burden on religious exercise does not occur at the point of contraceptive purchase; instead, it occurs when a company’s owners fill the basket of goods and services that constitute a healthcare plan,” Judge Janice Rogers Brown wrote on behalf of the court.

via Court strikes down mandate for birth control in ObamaCare | TheHill.

Unions to win delay of ObamaCare tax (Not the rest of us, tho’)

Labor unions are poised to score the delay of an ObamaCare tax in the bipartisan budget deal emerging in the Senate.

The bargain under negotiation would make small adjustments to the healthcare law, including delaying the law\’s reinsurance fee for one year. The three-year tax is meant to generate revenue that will stabilize premiums on the individual market as sick patients enter the risk pool.

via Unions poised to win delay of ObamaCare tax in budget deal – The Hill’s Healthwatch.

“Welcome to the Party, Pal” | The Northern Right

Amen to this:

“So what do we Americans do with a feral, out of control administration, misusing and abusing their authority? Well, we can start transferring power and authority out of Washington DC back to the many states. Doing this with all public lands, National Parks, National Forests, Wilderness Areas, National Monuments and everything else the feds own and operate would be a good first start. Follow it up with moving all licensing and permitting back to the states.”

“Welcome to the Party, Pal” | The Northern Right.

A tax for doing nothing

From a blurb on Taranto’s The Best of the Web Today, today:

After the court’s ruling in NFIB v. Sebelius, the mandate, of course, is not an actual legal command, but, as Chief Justice John Roberts put it, merely the establishment of a “a condition–not owning health insurance–that triggers a tax–the required payment to the IRS.”

Every time I think of Justice John Robert’s declaration that the ObamaCare individual mandate is does not carry an individual penalty, but rather, a tax, I become angry. It makes as much sense as his messing up the Oath of Office on January 20, 2009 followed a day later with the “real” oath.

I still don’t get Robert’s logic. It’s a tax, because you only pay fines when you commit an act. Or is it a tax because you pay the IRS?   Whatever, in order to not pay, you have to sign up for the exchanges, which then “ping” the IRS to find out about your income.

Luckily, I have a bit of an attention deficit.*  So, then I start thinking about how much Congress should owe the rest of us because they do nothing – or at least not what we want. The motto ought to be, “It ain’t fine!”

* (: It’s not a disorder if it helps you get through the day.)

UnitedHealthcare drops physicians from Medicare plan – Financial Mines

“Keep your doctor?” NOT!

Physicians across the state are reeling after they were informed that they will no longer be participants in a popular Medicare program.

UnitedHealthcare sent a letter dated Oct. 2 to 810 primary care physicians and 1,440 physician specialists, telling them that the separation from its Medicare Advantage network would be effective Feb. 1, 2014.

The business, a unit of Minnetonka, Minn.-based UnitedHealth Group, said affected physicians have the right to appeal and told them that their agreements for other UnitedHealthcare networks will not be impacted.

The notification came as a surprise to the Fairfield Medical Association, which counts 1,499 physicians in its ranks.

“They’re letting 19 percent of the physicians in the network go,” said Mark Thompson, executive director of the association. “This is where insurance companies are using insurance contracts to interfere with the doctor-patient relationship.”

via UnitedHealthcare drops physicians from Medicare plan – Financial Mines.

ObamaCare begins to “Ping” the IRS for information

What might have been missed in all the emotional media coverage about the troubles people are having with the ObamaCare exchanges and the news that the IRS official shared tax information with the WhiteHouse:

Hall Ingram said a key piece of the healthcare law’s new infrastructure — the federal “data hub” — is working well.

When consumers apply for insurance and tax subsidies through an exchange, the exchange uses the data hub to draw information from several state and federal agencies to confirm applicants’ identity and calculate the subsidies they can receive.

Exchanges have successfully pinged the IRS’s servers to request income information about applicants, and the IRS has been able to respond, she said.

“As far as we can tell, and we are looking on a daily basis, it\’s operating well,” Hall Ingram said.

via GOP grills IRS’s ObamaCare chief – The Hill’s Healthwatch.

Obama Stumbles Despite Friendly Press « Commentary Magazine

After explaining his “history,” of posturing and hiding unpopular legislation by attaching it to another Bill, President Obama truly stumbles:

“And you know, we don’t get to select which programs we implement or not.”

via Obama Stumbles Despite Friendly Press « Commentary Magazine.

Iguess it depends on the meaning of “select,” because as the article notes,

“Obama chooses which parts of which laws he wants to implement and enforce at will, as if Congress were a supercommittee brainstorming ideas rather than a coequal branch passing laws . . “

‘Gestapo’ tactics meet senior citizens at Yellowstone » Local News » NewburyportNews.com, Newburyport, MA

Not even allowed to take pictures!

Rangers systematically sent visitors out of the park, though some groups that had hotel reservations — such as Vaillancourt’s — were allowed to stay for two days. Those two days started out on a sour note, she said.

The bus stopped along a road when a large herd of bison passed nearby, and seniors filed out to take photos. Almost immediately, an armed ranger came by and ordered them to get back in, saying they couldn’t “recreate.” The tour guide, who had paid a $300 fee the day before to bring the group into the park, argued that the seniors weren’t “recreating,” just taking photos.

“She responded and said, ‘Sir, you are recreating,’ and her tone became very aggressive,” Vaillancourt said.

The seniors quickly filed back onboard and the bus went to the Old Faithful Inn, the park’s premier lodge located adjacent to the park’s most famous site, Old Faithful geyser. That was as close as they could get to the famous site — barricades were erected around Old Faithful, and the seniors were locked inside the hotel, where armed rangers stayed at the door.

“They looked like Hulk Hogans, armed. They told us you can’t go outside,” she said. “Some of the Asians who were on the tour said, ‘Oh my God, are we under arrest?’ They felt like they were criminals.”

via ‘Gestapo’ tactics meet senior citizens at Yellowstone » Local News » NewburyportNews.com, Newburyport, MA.