#GOP2012 Platform Ideas #TxGOP #

My idea for “Constitutional Solutions” for health care is up on the site. Take a look and second it, here.

Another place to read is under the Family Values and Faith-based Issues subheadings of Marriage and Family Values and Sanctity of Life. It seems the site is being bombarded by “Republicans” who want to get rid of these planks in our Platform. Please comment on the “ideas” that want to approve same sex marriage and get “pro-life” completely out of our Platform.

I wrote one of my (long) posts in response to “Remove Pro-life from the Party Platform,” here:

This idea can’t be considered by the Republican Party. The major difference between our Party and all others is the basic belief in and defense of the ideals embodied in the Declaration of Independence as well as the Constitution. In fact, the Constitution means nothing without the right to life. The freedom from tyranny that the Constitution preserves is nothing without the security “that all men are created equal and endowed by God with *unalienable* rights, …Life, Liberty and the Pursuit of Happiness.” The definition of human being is scientific, it’s not arbitrary or dependent on stage of life or geography. Once we stop assuming that all human individuals are endowed with these rights and allow the government to decide which humans are human enough to have these inalienable rights protected by the force of law, we all become slaves to the majority, whether that majority is in numbers or the power of the biggest guns. We are the only species having this conversation.

Texas Womens Health Program update

Texas Alliance for Life has sent out a notice of a hearing Monday, August 8th, on the TWHP. (Sorry for the formatting, I’m traveling, so limited access to the Internet.)

* * * URGENT LEGISLATIVE ALERT 8/3/12 * * *

Please Contact the Texas Department of State Health Services to Register Your Opposition to Tax Funding for Planned Parenthood!

Deadline on MONDAY

Please immediately contact the Texas Department of State Health Services (DSHS) and register your opposition to tax funding for Planned Parenthood in a new state health program.

DSHS is creating a new state-funded program, called the Texas Women’s Health Program (TWHP), to provide preventative health care for low-income women. The services will including some STD screening and treatments, screening for breast and cervical cancer, and contraceptives. The new state program will replace the Medicaid Women’s Health Program, which is expected to come to an end in October. The new TWHP will provide the same or more services as the Medicaid program it replaces.
See a sample message and contact information below. Comments must be received by Monday, August 6.

The Obama Administration is killing the Medicaid Women’s Health Program in Texas because Governor Perry and the Legislature refuse to fund Planned Parenthood. Senate Bill 7, passed by the Legislature and signed by Governor Perry last year with Texas Alliance for Life’s strong endorsement, explicitly excludes organizations that provide or promote elective abortion, like Planned Parenthood. Without Senate Bill 7, there would be no statutory basis for excluding Planned Parenthood from the Medicaid Women’s Health Program and from the Texas Women’s Health Program.

SAMPLE MESSAGE: Please call, email, or mail a message in your own words by Monday, August 6.Phone — 800.322.1305 (during business hours):

Email — click here to email to CHSS@dshs.state.tx.us.
“Dear Ms. Garcia,
“This is a comment regarding the proposed rules for the Texas Women’s Health Program published in the Texas Register on July 6, 2012.
“Please assure that Planned Parenthood and other organizations that provide or promote elective abortion are not eligible for public funding under the Texas Women’s Health Program. Planned Parenthood runs 14 abortion facilities in Texas, and they promote elective abortion at every one of its sites in Texas even where they do not perform abortion. I do not want my tax dollars to go to organizations that perform or promote abortions as a method of family planning”
“—–Your name and address

Mail: Imelda M. Garcia, Department of State Health Services, Division of Family and Community Health Services, Community Health Services Section, Mail Code 1923, P.O. Box 149347, Austin, Texas 78714-9347,

Deadline: Monday, August 6, 2012.
Please let us know you’ve made your contact. Simply send comments to info@texasallianceforlife.org.

BACKGROUND

For more information, visit Governor Rick Perry’s website, Fighting for Women’s Health: http://governor.state.tx.us/initiatives/womens_health/.

Here’s a (YouTube) video of Texas Alliance for Life’s executive director, Joe Pojman, Ph.D.: Joe Pojman, Ph.D., Executive Director. This video interviews Texas Alliance for Life’s board member, Dr. Beverly Nuckols: Beverly Nuckols MD, FAAFP, Family Physician 

Texas Alliance for Life (TAL) is a non-sectarian, non-partisan, pro-life organization of people committed to protecting innocent human lives from conception through natural death through peaceful, legal means. TAL is a statewide organization based in the Texas capital.

www.TexasAllianceforLife.org    512.477.1244

twitter.com @TXAlliance4Life     facebook.com/TexasAllianceforLife

Family Doctor or Family Nurse? Pay now or Pay Later?

We docs often hear that advance practice nurses could do 80% of what Family docs, pediatricians and internist do. But, it’s knowing the difference between that 80% and 20% that will kill you!

I’m printing the whole of this letter from Dr. Valenti published by the Texas Medical Association, because it says so much that we doctors are saying these days. Here’s more about the crisis among Texas Doctors who still see the poorest elderly in Texas.

Money is vital to keep practices open, but what’s scary is that there’s a move to allow “mid-levels” to do more. Specifically, Dr. Valenti objects to an opinion piece in the DMN that includes this statement: “Hardly anyone doubts that most veteran registered nurses, with a little more training, could do a fine job setting broken bones, stitching wounds and even dispensing drugs for common ailments.”

Tuesday, July 31, 2012
Setting the Record Straight on Doctor Pay
The following is a response by Joseph Valenti, MD, to commentary published Friday in the Dallas Morning News by Eli Lehrer, president of R Street. In the article, Mr. Lehrer claims U.S. physicians and health care workers make too much money and are responsible for the high cost of medical care in America.

Dear Sir:

I am a physician in Denton, Texas. This morning, I sat and read your article in The Dallas Morning News titled “Your Doctor’s Big Fat Paycheck.” Frankly, I am in awe of the breadth of your ignorance.

Fact: Of the health care dollars spent in this country, physician salaries make up about 8.5 percent. That is one of the lowest percentages in the industrialized world. Germany, by contrast, is at 15 percent.

Fact: The graduate level course of study for nurse practitioners (NPs) and nurses is not even close to that of physicians — we have a little something called residency. Perhaps you’ve heard of it. When I did mine in OB-Gyn from 1994 to1998, it was 90-100 hours a week for four years with a take home pay of $20,000. I was raising a family on that, as my wife had to stay home to take care of premature twins. NPs and nurses do none of that.

Fact: Private insurers are already too strong. “Weak bargaining position”? If you don’t like the contract they offer, they tell you to take a hike. Doctors are the ones with no bargaining position. I haven’t had an increase from United Healthcare for 54 months. Meanwhile, it paid its shareholders an 11-percent dividend last year. And regarding your comment about how individual plans rarely cover one-half an area — do your homework! States like Alabama have Blue Cross and Blue Shield covering 90 percent of insured lives! In any other industry, this would constitute a monopoly.

Fact: Medicare increases have been had by every segment of the health care industry except doctors. (See the charts.)

Fact: Pilots may make less than doctors. They also belong to unions and walk out when they don’t get what they want. Doctors never walk out, and the pro bono and free care we hand out can’t even be deducted from our federal taxes as charity. Then try breaking it down per hour. Pilots fly about 60 hours/month. Doctors work in the office and hospital about 60 hours/week. And that doesn’t take into account nights and weekends on call. Don’t get me wrong — pilots are vital and do a great job. But on a per-hour basis, they are clearly ahead. By the way, I don’t know a single primary care doctor who makes $200,000 a year. Most of the ones I know are barely getting by, and many are closing their practices or selling them to hospitals.

A huge doctor shortage is looming. We cannot and will not attract our best and brightest students to medicine unless their pay is commensurate with the level and intensity of work and commitment needed to fund a modern medical education. The student loan burden alone, which is now often exceeding $200,000, keeps many away.

The huge amount we spend in this country for health care has far less to do with medical professionals’ salaries than it does with the cost of almost everything else. Case in point: The same Mirena IUD, from the same single factory that Bayer uses in Finland, costs $700 in the United States but costs $250 in Canada. Really? That same case can be made for tens of thousands of drugs and medical products here.

Medicine is one of the only businesses I know of where the increasing cost of doing business can’t be passed on to the customer. Every year, the cost of running my office and paying my employees goes up, while insurance payments stay the same or go down. I am left to eat the difference. My salary the last three years is less than I made 14 years ago when I started in private practice. Hardly a source of bankrupting the health care system.

Shakespeare said that the eye sees what the mind knows. With that in mind, ask yourself if you would feel comfortable entrusting your care or that of your family to someone with less training, less knowledge, and less expertise. Would you? I think not. Now ask yourself how happy one of us would be treating someone like you, who wrote an article that is so misleading about us and who we really are and what we really have done to become really good at taking care of patients. Surprise. We would love to take of you. Why? Because that is what we took a vow to do, a vow that doesn’t allow us the luxury of being judgmental. So the next time you are lying in bed needing emergency surgery, remember this — we will be there. Pay or no pay. Assign a value to that ideal, and then consider whether or not we are “overpaid.”

Sincerely,
Joseph S. Valenti, MD, FACOG

Medicaid Expansion Would Cost Everyone

Bravo to Governor Rick Perry for refusing to move ahead on the Medicaid expansion requirements in the misnamed “Affordable Care Act,” AKA “ObamaCare.”

According to the Texas Public Policy Foundation, of the 6.5 million uninsured in Texas, fewer than 10% of Texas’ uninsured would benefit from expanding Medicaid to everyone at 133% of the Federal poverty guidelines. ObamaCare has no requirements other than annual income.  The law won’t allow asset verification or take into account beneficiaries’ willingness and ability to work.

Texas uninsured numbers include Nearly 1/3 that are illegal aliens, about 40% who earn more than $50,000 a year, and about 1/4 who are already eligible under Medicaid and CHIP. None of these people  would be eligible under the expansion. Many are young and healthy, not convinced they need to spend their money on insurance, anyway.

The cost of expanded Medicaid, much less the rest of Obamacare, would require increased taxes, overt and hidden, on everyone. Sure, for two years, the Federal government is supposed to “pay” for the 10% of Texas’ uninsured added to the expanded Medicaid. But it won’t pay for that 25% of uninsured that are already eligible and it won’t cover illegal aliens or “the working poor.” And after 2 years, the Federal money goes away, leaving Texas with the bill.

Even though Washington can print paper money, the government doesn’t have any money that it doesn’t take in taxes. The cost is not just what is collected by the IRS, it comes in the loss of value of the money and assets we earn or already have.  Obamacare, and the Stimulus before it,  are sold by the Left as a classic take-from-the-rich “redistribution of the wealth.”  However, hey also cost non-taxpayers and the working poor and middle class by the harm they do to our economy and the increase in cost of necessities. As well as inevitably rewarding those who are unwilling to fend for themselves, they punish everyone who lives pay check to paycheck as well as the “wealthy.”

Governor Rick Perry tells Obama Admin, “No!” #TxSen @GovernorPerry

Governor Rick Perry has made it official: Texas won’t expand our Medicaid to cover all adults up to 133% of the Federal Poverty level. The ACA Medicaid expansion does not allow any requirements other than income. No need to work, no asset limits, no medical need or other hardship.

Here’s the Press Release from the Governor:

July 9, 2012

Gov. Rick Perry, in a letter to U.S. Health and Human Services Secretary Kathleen Sebelius, today confirmed that Texas has no intention of implementing a state insurance exchange or expanding Medicaid as part of Obamacare. Any state exchange must be approved by the Obama Administration and operate under specific federally mandated rules, many of which have yet to be established. Expanding Medicaid would mandate the admission of millions of additional Texans into the already unsustainable Medicaid program, at a potential cost of billions to Texas taxpayers.

“If anyone was in doubt, we in Texas have no intention to implement so-called state exchanges or to expand Medicaid under Obamacare,” Gov. Perry said. “I will not be party to socializing healthcare and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government.

“I stand proudly with the growing chorus of governors who reject the Obamacare power grab. Neither a “state” exchange nor the expansion of Medicaid under this program would result in better “patient protection” or in more “affordable care.” They would only make Texas a mere appendage of the federal government when it comes to health care.”

Gov. Perry has frequently called for the allocation of Medicaid funding in block grants so each state can tailor the program to specifically serve the needs of its unique challenges. As a common sense alternative, Gov. Perry has conveyed a vision to transform Medicaid into a system that reinforces individual responsibility, eliminates fragmentation and duplication, controls costs and focuses on quality health outcomes. This would include establishing reasonable benefits, personal accountability, and limits on services in Medicaid. It would also allow co-pays or cost sharing that apply to all Medicaid eligible groups – not just optional Medicaid populations – and tailor benefits to needs of the individual rather than a blanket entitlement.

Gov. Perry has consistently rejected federal funding when strings are attached that impose long-term financial burdens on Texans, or cede state control of state issues to the federal government. In 2009, Texas rejected Washington funding for the state’s Unemployment Insurance program because it would have required the state to vastly expand the number of workers entitled to draw unemployment benefits, leading to higher UI taxes later.

In 2010, Gov. Perry declined “Race to the Top” dollars, which would have provided some up-front federal education funding if Texas disposed of state standards and adopted national standards and testing.

To view the governor’s letter to Secretary Sebelius, please visithttp://governor.state.tx.us/files/press-office/O-SebeliusKathleen201207090024.pdf.

A Fourth of July Comment on ObamaCare (revised)

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.–That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, –That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness.”

The discussion about reversing the trend from collecting taxes that are spent on individuals, rather than on common use, is considered by some as revolutionary as the July 4, 1776 Declaration of Independence. Along with everyone else, I’ve been giving a lot of thought to this in light of last week’s  Supreme Court decision on the Affordable Care Act, or Obamacare. As with any law or tax, the conversation about “ObamaCare” must begin with the basics of the Declaration of Independence and the Constitution of the United States.

A decade after the Declaration of Independence, the Founding Fathers wrote the Constitution of the US to “secure” the inalienable rights of the people from infringement by the government and to prevent the growth of interference by government except where necessary to prevent or punish the infringement of inalienable rights. The Constitution included a way to make changes that the People find necessary through the Amendment process. We can’t allow anyone, whether the United Nations, the World Health Organization, or “progressives” to fundamentally alter our Constitution by law, legal ruling, or bureaucratic regulations without going through the proper, Constitutional, amendment process.

The inalienable rights to life, liberty and the pursuit of happiness carry through to all aspects of life, whether it’s working for day to day expenses, saving for the future, or making choices of foods to eat and entertainment. Rights create a non-delegable duty of personal responsibility, which means that each of us must pursue happiness for ourselves without infringing on anyone else’s rights. We cannot kill, enslave or limit others’ pursuit of happiness by forcing them to do our will or give us their property. This is true even when we face consequences that aren’t the result of our choices: accidents, natural catastrophes, bad luck or bad genes. If it makes you happy, you can freely give what you want to charity or service for the benefit of others, but even this is limited by the fact that your rights are inalienable: i.e., you can’t give away or sell your right to life or liberty.

One way that people exercise personal responsibility is to purchase insurance. Traditionally, insurance covered unexpected or catastrophic costs. There is no Constitutional justification – and certainly no economic justification – for the Federal government to turn health insurance into tax funded pre-paid “health care coverage” to pay for everything from first dollar.

When the People agree that a given purpose will secure what the Constitution calls our “Safety and Happiness,” we have allowed our governments to tax us for “public goods,” like roads, education, and defense. Social Security and Medicare are different, in that individuals were taxed and told that the money would be used for their own and their family’s future needs, rather than for common use.

After the passage of the Social Security Act in 1935 precipitated a near-Constitutional crisis, these funds were spent over the years by subsequent Congresses. They were also used to justify more taxes and spending for other people and purposes; what we now call “redistribution of wealth”. Bit by bit, good-hearted Americans have allowed the scope of both State and Federal entitlements to grow until more than half of our population receives tax funds paid by other people for food, housing, healthcare and even free cellular phones. And then came the Affordable Care Act or “ObamaCare,” which will “tax” or penalize every American if they don’t purchase government approved health insurance.

Obviously, our Nation shouldn’t break the contract with all of the people whose payroll taxes were collected over the years for Social Security and Medicare. However, the Accountable Care Act is the latest step toward the unconstitutional federalization of an industry in a way that wasn’t envisioned by the Founders of our Nation for ANY industry. What better time to evaluate Constitutional taxes and spending than  Independence Day ?

Medicine vs. “Health”

Medicine is the diagnosis and treatment of disease and injury, while the World Health Organization defines “health” as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

Doctors practice medicine, but is “health” even possible?

The hassle factor in “health care” costs

Most docs know the history of medical finance and the creep of health care payments with tax dollars. We know that the costs of chronic, much less catastrophic, health care are high. Nevertheless, most doctors look at history and know that changes in government health policies will likely mean that we will be burdened with regulations and that any talk about “savings,” means a cut in pay for what we do, on top of increased regulations.

At least as often as I hear complaints about payment for our services, docs express urgent concern that aren’t able to care for our patients due to limitations on services, requirements for prior authorizations with limited, sometime under qualified, personnel approving necessary treatments, limitations on numbers of prescriptions per month, and the inability to find sub-specialists when patients need them. And that it is only going to get harder. In my opinion, the “hassle factors” introduced by bean-counters and government bureaucrats are responsible at least as much for the increase in costs as increased definitions of health and improved technology.

A well-known cliché’ about of the cost of regulations is the ridiculous bill for an aspirin in the hospital. My own experience with regulations is another example. In 2003, when HIPAA came into force, requiring compliance, the vendor for my billing software wouldn’t support my old Linux software. They demanded that I buy the new Windows program, requiring all new computers, with the resulting cost of installation, training and the inevitable lag (and error) in billing. At least for some of us, there comes a point when the hassles aren’t worth borrowing the money to keep the office open.

Extrapolate these cascades of costs across the entire system and add in the regulations we know about, much less the ones we don’t know about – yet. Who can calculate the true cost of the Federalization of medical care?

New England Journal of Medicine: “The Health Care Jobs Fallacy”

Attempts to justify increasing intrusion of the Federal government into health insurance and health cost distract from the purpose of the practice of medicine, which is to treat patients.

Remember when doctors talked about “medical care” of individuals, not “health care” for populations?Remember when medicine was an “art,” not an “industry?” People aren’t machines with interchangeable parts and neither medicine nor “health care” are amenable to assembly line production, except in very rare instances.

The bottom line is that employment in the health care sector should be neither a policy goal nor a metric of success. The key policy goals should be to achieve better health outcomes and increase overall economic productivity, so that we can all live healthier and wealthier lives. Our ability to ensure access to expensive but beneficial treatment is hampered whenever health care policy is evaluated on the basis of jobs. Treating the health care system like a (wildly inefficient) jobs program conflicts directly with the goal of ensuring that all Americans have access to care at an affordable price.

via The Health Care Jobs Fallacy — NEJM.

Penumbra of a tax

It’s not tax enough to invoke the Anti-injunction Act of 1987, but it will be collected by the IRS so it’s a legal, Constitutional, tax?

Maybe it’s just a shadow of a tax?

The Roberts decision on the mandate to purchase health insurance, is more confusing to me than most legal decisions. I keep looking for a way to untangle what appears to be circular contradiction, rather than logic. Here’s the best summary I’ve found that seems to say that the money the IRS collects is a tax, not a penalty for breaking the law:

Such an analysis suggests that the shared responsibility payment may for constitutional purposes be considered a tax. The payment is not so high that there is really no choice but to buy health insurance; the payment is not limited to willful violations, as penalties for unlawful acts often are; and the payment is collected solely by the IRS through the normal means of taxation. Cf. Bailey v. Drexel Furniture Co., 259 U. S. 20, 36–37. None of this is to say that payment is not intended to induce the purchase of health insurance. But the mandate need not be read to declare that failing to do so is unlawful. Neither the Affordable Care Act nor any other law attaches negative legal consequences to not buying health insurance, beyond requiring a payment to the IRS. And Congress’s choice of language—stating that individuals “shall” obtain insurance or pay a “penalty”—does not require reading §5000A as punishing unlawful conduct. It may also be read as imposing a tax on those who go without insurance. See New York v. United States, 505 U. S. 144, 169–174. Pp. 35–40.

Many of us have complained that laws and regulations have become too complicated, that no one can keep up or even avoid inadvertently breaking laws here and there. But this law is even worse because it forces action and taxes or penalizes the failure to act according to the Government’s determination of what is for our own good, rather than punishing an action or inaction that infringes on the rights of another.

To repeat hundreds of others, including the Justices who wrote the dissenting report, what are the limits of the Government once it can charge me for not doing some act?

All I can say is, vote to overturn the ObamaTax.

Health Care spending continues to fall

National Review’s James C. Capretta comments on the attempts by some in the Obama Administration would like to take the credit for the decrease in health care spending in 2009-2010.

The decrease in spending follows the previous curve,according to the data.

In addition, we docs haven’t had a real increase in Medicare pay in years. We waited for Medicare to – and find out how much they would – pay us 3 or 4 times in 2010, thanks to the planned, threatened and repeatedly deferred “Sustainable Growth Rate” doc pay cuts.. Then, there was the planned moratorium at the end of the Federal Fiscal year.

As the Dems ramped up their plans for “reform,” the cuts and deferred payment were reinforced by threats of more if organized medicine didn’t play ball. I reported on the threats at LifeEthics.org in October, 2009.

First Amendment on Life Support

“More sparingly should this praise be allowed to a government, where a man’s religious rights are violated by penalties, or fettered by tests, or taxed by a hierarchy. Conscience is the most sacred of all property.” John Madison, “Property,” National Gazette, March 29, 1792.

“In purity and holiness I will guard my life and my art.” Hippocratic Oath, approximately 400 BC.

“Refusals based on moral disapprobation, however, are not typical of medical ethics” R. Alta Charo, ”Health Care Provider Refusals to Treat, Prescribe, Refer or Inform: Professionalism and Conscience.” February, 2007.

Fully enjoying the protections of the First Amendment themselves, the New England Journal of Medicine has published yet another editorial, “Warning: Contraceptive Drugs May Cause Political Headaches,”  by Robin Alta Charo, J.D., denouncing conscience and those of us who abide by ours. I suppose that she thought it was the right thing to do.

The Journal does not offer background on Ms. Charo’s previous editorials on the subject, including the notorious 2005 “The Celestial Fire of Conscience.” The editors don’t include any  note – any “warning’ – that she was part of the political Obama transition team. Ms. Charo did not mention any of these possible conflicts of interest in her “disclosure form,” available online.

Charo’s entire argument relies on readers’ agreement that the argument is about “public policy and contraception.” It is vital to her argument since, as she quotes Georgetown University theologian Tom Reese, “If the argument is over religious liberty, the bishops win.” Because, if we understand that the issue relates to “an establishment of religion,” Congress cannot legitimately pass, and the Executive Branch may not enforce, any law that infringes on the free exercise of religion.

Charo would instead have us focus on “public institutions, public places, and public duties.” Although hospitals and universities serve the public by providing healthcare and education, they are still owned by private, religious entities. In addition, the Obama Administration’s “accommodation” – the suggestion that the institution’s insurance company provide contraception free of charge to the ensured who want it – becomes much more complicated in light of the fact that most large religious hospitals and universities privately self-insure rather than enter into the market to buy first dollar coverage from a third party insurance company.

Charo’s essay is political appeal to emotion and half-truths, full of the “partisan sound bites and slogans” she denounces. However, not even the lie about mandatory transvaginal ultrasounds compares with her earlier error of logic in warning that the institutions could withhold “ordinary salary.” I don’t know of any religious organization that considers agreed-upon salary for agreed-upon service as inherently sinful. Keeping a promise, like that in the First Amendment or a contract with an employee is sacred to those of us with a conscience.

The Constitution demands that Congress “shall make no law” limiting religious freedom. The attempt by the Obama Administration to write regulations that require religious institutions to engage in acts that are contrary to long-standing, organized tenets of that religion goes directly against the First Amendment and cannot be justified.

Conservatives, Republicans: Fire, Aim, Ready!

Conservatives are at it again: shooting our own.

When Conservatives decide not to vote for Republican candidates, Republicans lose. Conservatives lose. The Democrats, socialists, and atheists win. Obama wins.

Where Republicans voted in 2008, we won new offices. Where they voted in 2010, we won majorities. Conservatives made the difference in the winning races and in the lost races. Not only did we have fewer Republican victories in those races where Conservatives didn’t vote, the races were decided by the least knowledgeable among us or by the Dems.

More than before, in conservative blogs and forums, I’m reading good men and women declare that they will never vote for Romney if he’s nominated. They remind me that they were the ones who refused to vote for John McCain in 2008, or who (like me) voted for Sarah Palin and McCain just benefited as a side effect.

I certainly wish that Conservatives had found themselves working hard to force McCain to keep his promises for that last three years instead of watching Obama keep his.

And here come the third party rallies!

The problem is certainly the “GOP elite,” and their support for Romney — that’s why Michelle Bachmann, Rick Perry, and Rick Santorum couldn’t get a foothold, right? And why Newt Gingrich is still so far behind?

How many votes do you suppose the “elite” have, anyway?

Talk about doing the same thing over and over and expecting different results, yesterday, Rush Limbaugh warned Conservatives what may happen if the Republican nominee doesn’t win. Yes, he  titled the post of the segment “A Warning to the Republican Establishment,” ending with a prediction that the Republican Party might never recover if “they screw this up.”

The warning to the rest of us is ignored:

If this doesn’t pan out to big-time electoral victory the way the establishment has it figured, then what will their excuse be? And I think I know. I think that if this campaign goes on and if it results in Obama winning, I think what the establishment is going to do is blame us. They’re gonna blame us conservatives for once again being too rigid and too demanding and too narrow and unrealistic and all this, and telling us that we’re the reason that Obama won.

Why not? That’s exactly what happened in ’06 and ’08. (And don’t forget Rush’s own Chaos.) The media and the Left ate it up! The lesson learned was that no one can count on Conservatives. That’s why we repeatedly watch people who should be our champions “pander” (Rush’s word) to the “middle,” the “undecideds,” the independents.

Why not learn instead from successes, like the 2000 election, a victory that the Dems never saw coming? A good friend recommended that I re-read David Horowitz’ “How to Beat the Democrats.” One of the lessons is,

Lesson 3: There Is No Natural Conservative Majority (But You Can Create One through Political Action). The critical role Republican unity played in the election leads to a third lesson: There is no “natural” conservative majority.

. . . Such facts are no cause for conservatives to despair. What they are is a reality-check. If the conservative mission is to restore basic American values, the way conservatives fight the political battle will determine its outcome. There may be no current conservative majority in America, but there is a potential majority, if Republicans have the will and intelligence to create one.

David Horowitz (2002-10-06). How to Beat the Democrats and Other Subversive Ideas (Kindle Locations 842-843, 861-863). Spence. Kindle Edition.

Do we have the will? The intelligence? Can we forget the animosity we have had for each other the last year? Are we willing to say, “Let him who never had a change of heart cast the first stone?”

An estimated 56% – give or take – of the Republican National delegates have been decided, but 44% have not. The numbers aren’t set in stone, yet, depending on what happens to the delegates who went to candidates that dropped out or in States like Iowa, where the actual choice will be made at caucus in June. “It ain’t over till it’s over.”

I’m sure that I won’t see Conservative blogs pulling their anti-Romney posts, but I hope to see a few willing to be positive and work together to ensure Primary victories for the remaining Conservative in the Republican Primary, in order to deny Romney an easy nomination. Is their motto, “Anybody but Romney,” or is it, “Anybody but Obama?”

ObamaCare Morbity and Mortality Conference

Reading the transcripts of the three days of Supreme Court hearings (Day 3 is here) on Obamacare is enough to make me scream in frustration and pain at the convoluted arguments.  Sometimes it seems to me as though the Court is playing games with our lives and laughing about it as though it’s an inside joke.

Why don’t they just stick to the plain reading of the Constitution and the law? Who cares about Lochner or Brock or Printz, Raich, Wickard?  Why are Ginsburg and Sotomayor leading the Solicitor General?

Part of the problem is that this really is an elite group, immersed in the minutia of Court rulings that most of us have never heard of, much less read. What probably should have been a clear and easy reference by Justice Scalia, made me look up the Eighth Amendment and “cruel and unusual punishment.”

In an attempt to give the Justices and lawyers the benefit of the doubt, I’m trying to think of the hearings as a sort of “Morbidity and Mortality” (“M and M”) conference. (The other analogy had to do with zombies. Decided not to go there.)

I imagine that a layman would feel equally lost and frustrated at a M and M, watching doctors review outcomes from tough cases where something went wrong or someone died. No detail is too small or unimportant for debate and (excuse the pun) dissection, unless the attending or Chief (Justice) declares it so.  Where there are rivalries or competition, the docs try to “one up” each other by the use of jargon and eponyms, correct pronunciation, obscure research and cute little “you had to be there but you weren’t so I’m brilliant/safe/top dog and you’re not” digs.

(Even here, I indulge in jargon: “eponyms” are names given to something based on the person who is given credit for the technique or discovery or some aspect of the disease or technique discussed, a sort of nickname that saves time and breath for the speaker. My theory about jargon – at least since I’ve finished residency and can’t be made to repeat a couple of months of training – is that whoever says the word loudest, is right about the pronunciation. As a Family Physician among sub- and super-sub-specialists, I want the anatomical or pathological name, not some esoteric reference to a paper in a journal or a dead guy’s name. I advise my patients to demand the same.)

Going back to the M and M: families and patients watching the conference, with our obscure references, jargon and eponyms probably would feel that the doctors and doctors-in-training don’t care as much about the patient as we do about shaming our rivals and proving and improving our own superiority and power in the group. While that may be true in some cases, the purpose – and more often than not, the result – of the process of review and debate is to make each of us more knowledgeable and to try to make sure we never make the same mistakes twice.

So when we call patients (or the hearings) “trainwrecks” we don’t really mean disrespect. The analogy is good: just as the cars on the train hit the one in front of them, go off the track, pile up each other, turn upside down and cause damage on top of damage, treatment.of very sick patients involve correcting one problem without creating another, organ failure on top of organ failure and digging through the most urgent crises before we can get to the point where we can fix what went wrong in the first place. It just looks like we don’t know what we’re doing.

Hopefully, we’re watching the Supremes review the autopsy of Obamacare rather than a debate over how much and how long to give life support. The “patient” in this case was a “trainwreck” from the beginning, but maybe Congress will learn something.

HatTip to Sonja Harris’ Conservatives in Action for the “trainwreck” link.

Best questions from Supremes on ObamaCare debate

The only thing sure in life is death and taxes. The difference is that “We the People” can avoid taxes by making sure our Republic is sound and avoid the errors that the founding fathers  and de Tocqueville (and I) warned us about.

Unfortunately, our Nation has decided – whether by default or not – that a group of nine appointed Justices are not only the “highest court in the land,” they are the highest LAW in the land. And so, we find ourselves at the mercy of the whims – and sometimes the least consistent – of these justices

I’ve been scanning the transcript from the Tuesday, March 27, 2012 debate before the Supreme Court, which is available at the SCOTUS website.

A question by Justice Alito :

“All right, suppose that you and I walked around downtown Washington at lunch hour and we found a couple of healthy young people and we stopped them and we said, “You know what you’re doing? You are financing your burial services right now because eventually you’re going to die, and somebody is going to have to pay for it, and if you don’t have burial insurance and you haven’t saved money for it, you’re going to shift the cost to somebody else.”

“Isn’t that a very artificial way of talking about what somebody is doing?”

RedState.com’s Erick Erickson wrote about “Sinners in the hands of Anthony Kennedy,” and noted “the quote heard round the world,” from Justice Kennedy:

“But the reason this is concerning, is because it requires the individual to do an affirmative act. In the law of torts our tradition, our law, has been that you don’t have the duty to rescue someone if that person is in danger. The blind man is walking in front of a car and you do not have a duty to stop him absent some relation between you. And there is some severe moral criticisms of that rule, but that’s generally the rule.

“And here the government is saying that the Federal Government has a duty to tell the individual citizen that it must act, and that is different from what we have in previous cases and that changes the relationship of the Federal Government to the individual in the very fundamental way.”

Hear and read the passage, at Real Clear Politics.

Erickson points out that the media are changing the meme of the debate from whether the law is Constitutional to a rant that the Conservatives on the Court are bullying the rest. The Houston Chronicle joins the chorus and proves Erick’s point.

To think that I almost posted this without adding the Category “Media Abuse.”

Abortion of the Teaching Moment

Public policy in education and ethics discourse are approaching a climate in which there are no standards of morality and no expectation of – much less recognition of – any ultimate Truth and no acknowledgement of right or wrong other than arbitrary enforcement of faddish laws.

“The Journal does not specifically support substantive moral views, ideologies, theories, dogmas or moral outlooks, over others. It supports sound rational argument. Moreover, it supports freedom of ethical expression.”

Earlier this month, I reported on the Journal of Medical Ethics’ “After Birth Abortion; Why should the baby live?” The quote above is from one of the editors of the Journal, Julian Savulescu, who apparently does not understand that his support of “rational argument” and “freedom of ethical expression” is a substantive moral view, dogma or moral outlook. Savulescu is a perfect example that my opening statement is true.

Among the many unintended consequences of this lack of standards is that there is now seems to be no place for teaching and learning. How do our teachers, much less our students, develop judgment about ethics in a world with only subjective standards? How do our teachers correct a horrible overstepping of what were once considered boundaries if there are no boundaries?

Where and when do we find the teaching moment, an opportunity to review basic ethics and learn once again why these ethics fit the event or question?

ObamaCare facts from American Doctors for Truth!!!

Watch this video!!!! American Doctors 4 Truth looks very interesting, and they certainly know how to tell the truth!

http://www.youtube.com/watch?feature=player_embedded&v=PJ-p29xEM0s

The doctors on this video tell the truth about the Independent Payment Advisory Board, ObamaCare and what we need to do!

Planned Parenthood “affiliates” and the Texas Women’s Health Program

Today, the Austin Chronicle, the local “alternative” news source, has yet another article “Perry continues assault on women’s healthcare,” claiming that Governor Perry and the Commissioner of Health and Human Services Suehs have acted – seemingly on their own – to shut down the Texas Women’s Health Program (more info here) in order to spite the poor underdog, Planned Parenthood.

Today’s statement is that “The new regulation signed by Suehs – redefining “affiliate” to mean that Planned Parenthood clinics not providing abortions are deemed affiliated with those clinics that do – conflicts with federal law, as confirmed last week by U.S. Health and Human Ser­vices Secretary Kathleen Sebelius.”

Actually, the Attorney General ruled on the definition of “Affiliate.” The Secretary must follow the law passed last Spring by the 82nd Texas Legislature.

It’s not surprising – in fact it’s common sense – that subsidiary corporations are considered “affiliates” by the State, since they are members of the Planned Parenthood Federation of America.  The annual report of PPFA calls these facilities their “medical affiliates.” The President of PPFA, Cecile Richards, shown above with Texas Senator Jeff Wentworth at a Planned Parenthood of San Antonio and South Texas event, visits these subsidiaries in her official duties.

(Photo from the 2009 Annual Report of Planned Parenthood of San Antonio and South Texas)

Paralysis, Gridlock?

Are the Republicans causing “gridlock,” “paralysis,” etc. in Congress? Is it the Republican-controlled House or the Democrat-controlled Senate that can’t pass bills, can’t even pass a budget? Why is the theme of the day that nothing is happening in DC because of (wink, Republican) extreme partisanship? (See “Senate Gridlock explained in one chart,” “‘Deliberative’ Senate gripped by paralysis,” “Chipping away at Senate gridlock,” and the many articles about how “moderate” Olympia Snowe is.) (Whatever you do, do not mention “Jumpin’ Jim” Jeffords, much less Arlen Specter.)

My husband and I visited Washington, DC last week with the National Pawnbrokers Association. Members of the NBA heard lobbyists and Legislators in their meetings and visited Capitol Hill to meet with Congressmen and Senators from our States. Time after time, we heard that staffers and the occasional Rep told the pawnbrokers that the two sides are too far apart, too polarized to get any legislation done — or even to have a conversation.

First of all, the partisanship is not new. Take a look at the history of “cloture votes” in the Senate. Does anyone else remember all the talk about – the never invoked –  “nuclear option” or the “constitutional option” when Trent Lott or Bill Frist were Majority Leaders in the Senate? The problem then was that the Senate Dems were using the filibuster to block ALL judicial appointees. That the Dems didn’t want President Bush to appoint judges doesn’t seem equivalent to the fact that Republicans do wish the right to debate and amend legislation that changes or creates law.

Of course, we’re supposed to forget that the Dems had a majority in both the House and the Senate from January, 2007 until the Republicans won the House in the 2010 election and were sworn in in January, 2011. Don’t look at the number of Dems in the Senate, today, or read the news reports that Harry Reid will not even allow a vote on the budget.

Good Dems don’t remember that the Nancy Pelosi House had such a huge majority that they didn’t need a single Republican vote to pass legislation — and yet they still shut down the tradition of “open rule” on Republican amendments. One day, Pelosi even shut off the lights and CSPAN cameras in an attempt to silence Republicans!

And really good Dems deny that Harry Reid used the “nuclear option” to force ObamaCare through the Senate — while changing the rules for the Senate for all future Congresses. (Reid used “reconciliation” to pass Obamacare. Furthermore, the Act mandates that any recommendation from the Independent Payment Advisory Board on Medicare cuts must go straight to the Senate Finance Committee and all future Congresses may only debate Obamacare with a 2/3 majority vote, and then only for a time set in the original “Accountable Care Act.“)

Why are we called “Conservatives” in the first place? Isn’t it because we prefer transparent government, lower taxes, a strong defense, less spending and defend the right to life and traditional marriage? These are matters of principle that have been in the Republican platform since the ’60’s, at least.  And yet, we’re portrayed by the media as “do nothing,” the “party of no,” and as though it is WE who are trying to make radical changes in the law.

Oppose theObama Standoff!

Bravo, to all the Letters to the Editors and comments in favor of religious free expression, conscience and State’s rights that I’m seeing. (My hometown paper has one from a man I don’t know – but only subscribers can read it.)

It’s been said before: if the Federal government can make you buy anything, it can make you buy *anything.* Will the mandated insurance packages in Washington include Physician Assisted Suicide?

This administration has already imposed regulations that infringe on the right of conscience of physicians and other health care providers. (“Anti-abortion” docs should never serve under-served areas and should have cooperative referral agreements with abortionists according to previous opinions by Sebelius.)

Who wants a doctor or church leader without a conscience giving you medical or spiritual care?  Or even picking out what you hope is a reliable insurance company who will be there when you really need them?

In a particularly unconscionable moment, one Obama Administration representative told representatives of religious organizations that they had a year to reconcile – with Obama, not with God.

“Obama Standoff,” or To Coin a Phrase – Revised

We used to call it a “Mexican standoff,” but that could be considered bigoted these days. Or at least non-PC.

“Obama Standoff”  is a better description for a specific condition – one that’s becoming more common and hitting us more frequently. In the “Obama Standoff,” the Obama administration demands that Texas, some other State, or any individual or organization of individuals with a conscience,  violate their own laws, Constitution, or conscience – threatening to withhold Federal tax money, fine, or break that law himself if others don’t comply.

Unbelievably, Obama’s Secretary of Health and Human Services, Kathleen Sebelius visited Houston today and announced – on the Friday before the funding for Texas’ Women’s Health Program expires on Wednesday, March 14 – that she is going to deny renewal of the Medicaid waiver. She did this *before* notifying the State or the Commissioner! See the Governor’s announcement in response, here. http://governor.state.tx.us/news/press-release/17025/ )

The Obama Administration doesn’t even care that there will be no meeting of the Texas Legislature until January 2013. Of course, this is the Constitutional scholar in the White House who ignored the meaning of “recess appointment” in January. Why should he honor concepts like the Legislature makes laws and the Executive Branch must follow them?

It doesn’t matter that Texas has had the same law for 10 years  any more than it matters that the Catholic Church has opposed contraception for thousands of years. It doesn’t matter that physicians have defended the right to follow their consciences for 2500 years, since Hippocrates’ oath was adopted by the Profession.

Why should they? They don’t care that the First Amendment guarantees the free expression of religion — to “establishments of religion,” by the way!

In a particularly unconscionable moment, one Obama Administration official told representatives of religious organizations that they had a year to reconcile – with Obama, not with God.

And they certainly don’t understand, much less care, what a “conscience” is other than some roadblock in their goal to control and force every doctor to be complicit with ending human life – or at least make sure to move next door to someone who will.

To paraphrase C. S. Lewis: We laugh at honor and are surprised to find treachery among us.

“Women Speak for Themselves” up to 4 pages

The list of women who have asked to co-sign the open letter to President Obama and Secretary Sebelius is still growing. Have you signed up?
There’s a button on the top of the page, just fill in your name and State, more information is optional. You, too, can say,

Here We Are!

Texas Governor Perry Pushes Back (Family Planning, Women’s Health and PP)

Governor Rick Perry is pushing back against the Obama Administration’s threat to kill our Texas Women’s Health Program due to law passed by the Legislature last June. The Governor’s office has produced 4 new videos (one of which includes me) explaining that the State is prepared to ensure that women are able to access continuing comprehensive care under these programs.

If you only have time for one, watch Carol Everett’s video in which she relates that the Commissioner of Health and Human Services has identified 2500 doctors willing to participate with the Well Woman Program and Texas’ Family Planning, even in rural areas where there has never been a Planned Parenthood clinic. There are also videos from former Waco PP Executive Director Abby Johnson, Texas Alliance for Life’s Executive Director Joe Pojman, Ph.D., and me.

The videos can be viewed at the Governor’s YouTube page and via the Office of the Governor website. They are the beginning of a series of announcements and news releases in hopes of convincing the Obama Administration and Secretary Sebelius to preserve these programs. Time is short as the current Medicaid waiver is due to expire at the end of March.

Stop and think about it: What the media is reporting as a single crisis is really the effect of two separate events. One is the cut in funding to Family Planning that went into effect in October,  along with many other cuts that were made in order to balance the State budget according to the Texas Constitution while paying for Medicaid for children and education.  The second is what is happening in a few clinics that are partners with other clinics that do abortions and are panicking because they are about to lose State funds.

Where are the reports about the thousands of providers who have agreed to see patients under both these programs?

The media is also acting as though the law prohibiting anyone who performs or refers to abortions, or who is a business partner with an abortion provider is brand new or that the Governor got up one morning and changed the law. No, the House and Senate of the 82nd Texas Legislature deliberated for months on Medicaid funding, including the best way to provide care under the Family Planning Title X funds and the Medicaid funded Women’s Health Program. They continued the old prohibition on funding affiliates.

The only change is that the Attorney General has clarified that “affiliates” include organizations that are part of the same national corporation.

The media and President Obama also ignore that the legislature won’t meet until January, 2013, so there is no way to change the law that appropriates State Tax funds.

Don’t say I didn’t warn you: I was nervous as I could be and I spent too much time giving a list of my credentials. But if you’re brave, here’s my video.

Update on Texas, Contraception, and Women Who Vote (and blog)

Over the weekend, there were more op-eds published in online magazines and newspapers all over the Internet championing women’s “right” to contraceptives and nearly everyone of them tied that “right” to the “right” to obtain an abortion. Search the news on “Texas contraception politics” and you’ll find a few dozens of articles published repeatedly in newspapers across the Nation. They often begin discussing cuts in State funding for contraception and move straight to the theme that mean old Republicans in Texas just don’t want to pay for abortions.

Yes, we don’t want to pay for abortions or support corporations that do them. That is our “choice.”

However, the reality is that Texas Legislators had no choice other than to cut spending. Where is the money going to come from?

Texas also cut money to train resident doctors – the future family doctors, OB/Gyns and pediatricians because there was not enough money. But I don’t see any articles on “The war against physician workforce.”

The only way to raise money would be to raise taxes. In order to raise taxes, we would have to have a vote to change our Constitution. I, for one, would vote “no.”

Everyone – including the Obama Administration – ignores the fact that Texas’ part-time Legislature will not meet again until January 2013, so there won’t be a chance to change the funding until after the November election.

Please notice the hateful tone of many of the blogs, op-eds and especially the readers’ comments and letters to the editors. And note that they always focus in on abortion – and that even the National articles narrow in on Texas. The truly mean comments claim that Republicans hate women. Some articles are even titled, “. . . War on Women,” and “When States Abuse Women.” One of the “War on Women” articles was published in the UK’s Guardian.

Women vote in Texas. We believe that life begins at fertilization and that every human being is endowed by our Creator with the right to life.

And we sure don’t have extra money to pay higher taxes. How hard is that concept to understand?

Here are the women – thousands of us

Earlier, I linked to an “Open Letter to President Obama, Secretary Sebelius and Members of Congress.” There are now about 2000 names of women from all over the country who volunteered to add their “signature” to the letter. I believe that more will be added, since I received a response from the organizers on March 3, but can’t find my name on the list.

Here is the “Open Letter” in full:

OPEN LETTER TO PRESIDENT OBAMA, SECRETARY SEBELIUS AND MEMBERS OF CONGRESS

DON’T CLAIM TO SPEAK FOR ALL WOMEN

We are women who support the competing voice offered by Catholic institutions on matters of sex, marriage and family life. Most of us are Catholic, but some are not. We are Democrats, Republicans and Independents. Many, at some point in our careers, have worked for a Catholic institution. We are proud to have been part of the religious mission of that school, or hospital, or social service organization. We are proud to have been associated not only with the work Catholic institutions perform in the community – particularly for the most vulnerable — but also with the shared sense of purpose found among colleagues who chose their job because, in a religious institution, a job is always also a vocation.

Those currently invoking “women’s health” in an attempt to shout down anyone who disagrees with forcing religious institutions or individuals to violate deeply held beliefs are more than a little mistaken, and more than a little dishonest. Even setting aside their simplistic equation of “costless” birth control with “equality,” note that they have never responded to the large body of scholarly research indicating that many forms of contraception have serious side effects, or that some forms act at some times to destroy embryos, or that government contraceptive programs inevitably change the sex, dating and marriage markets in ways that lead to more empty sex, more non-marital births and more abortions. It is women who suffer disproportionately when these things happen.

No one speaks for all women on these issues. Those who purport to do so are simply attempting to deflect attention from the serious religious liberty issues currently at stake. Each of us, Catholic or not, is proud to stand with the Catholic Church and its rich, life-affirming teachings on sex, marriage and family life. We call on President Obama and our Representatives in Congress to allow religious institutions and individuals to continue to witness to their faiths in all their fullness.

 

(Found my name! Add yours!)

Pro-Planned Parenthood against @GovernorPerry

Governor Rick Perry wrote an Editorial about the refusal of the Medicaid waiver for our Women’s Health Program by the Obama Administration. While it appears that very few news organizations actually print the op-ed, many have published their own, and a few reference the Governor’s essay. (A search at Google News on “Women’s Health Program” yields about 100 media posts, more blogs.)

Once again, the comments from the media and readers are derogatory, don’t contain the facts, and very critical of all of us “anti-abortion idiots” (per one commenter at Texas Tribune).

Texas has had law limiting the distribution of Medicaid and the Woman’s Health Program funds to those who perform, refer to, or affiliate with abortion providers for years, and received waivers in the past – even from this Administration – under this law.

The real difference is that this year, the Legislature prioritized funds to providers who provide comprehensive, continuing care at Federal, State, local, and County health clinics.

Yes, there was a renewal of the ban on abortion providers, although PP itself was never mentioned. And, yes, the Attorney General has clarified the meaning of “affiliate.”

However, while a nice side benefit, PP wasn’t excluded because they are PP. They were excluded because the State had to prioritize our funds and PP doesn’t offer comprehensive continuing care. They don’t treat high blood pressure, but Federally Qualified Health Centers do. They don’t treat diabetes, but the health clinic run by the county does. They don’t even write orders for mammograms, they just have a list of clinics that do.

In the last few months, the State has already made contracts and arrangements with other providers for a more efficient use of the limited funds we have. If access is cut, it won’t be for a lack of doctors and clinics – it will be because the Obama Administration doesn’t like the way our Legislature decided to prioritize the funds.

There is no federal law that says that Texas has to make contracts with anyone and everyone. As pointed out by the Governor and in this fantastic letter from the Executive Commissioner of the State Department of Human Services, Tom Suehs, the Social Security Act specifically gives the right to the State Legislatures set preconditions for contracting with the State to provide Medicaid.

Since PP only provides a narrow range of care, they don’t qualify – even though they aren’t mentioned in the law. They don’t treat high blood pressure or diabetes, or even do mammograms.

However, the Obama admin – and all those hateful commenters and editorializers – choose to focus on only one “provider.” The same organization that had 4 illegal abortion clinics shut down in San Antonio. The one that gives directions to facilities that do mammograms, but doesn’t even write prescriptions or give orders for the mammogram lab. The one that Texas is finding surprisingly easy to replace.

Now, our limited State tax dollars will go to Women’s Health Program doctors and clinics where they can receive treatment after being screened.

Exec. Office of President visits WingRight.org

There are several programs that give me information about visits to the website. Sometimes I know the location and even their actual site of the visitor.

Today, around 9:30 AM, someone at the Executive Office of the President (USA) spent 36 seconds viewing WingRight. The entry page was yesterday’s post about the AMA’s endorsement of the repeal of the Independent Payment Advisory Board.

They also visited my posts that mentioned Layoff Lloyd Doggett. This means that they had to do an actual search. There have been other White House and DC visits to individual WingRight.org posts that mention Layoff in the past.

I understand why the WH may have been searching for news on the IPAB. It’s an integral part of the pretense of balancing the budget – or at least decreasing the deficit – through Obamacare. Why is the White House – the Executive Office of the President, no less – so interested in the man responsible for so many teachers being laid off in Texas?

The AMA supports repeal of the Independent Payment Advisory Board (IPAB)

The American Medical Association has published a letter in support of the Congressmen who are attempting to overturn the Independent Payment Advisory Board (IPAB). I’m no longer a member of the AMA, but salute them for this move.

On behalf of the physician and medical student members of the American Medical Association (AMA), I am writing to express our strong support for H.R. 452, which was introduced by Representative Phil Roe, and would repeal the Independent Payment Advisory Board (IPAB). Accordingly, we strongly support the advancement of this important legislation through the Energy and Commerce Committee.
The AMA has consistently expressed its opposition to the IPAB on several grounds. The IPAB puts important health care payment and policy decisions in the hands of an independent body that has far too little accountability. Major changes in the Medicare program should be decided by elected officials. We have already seen first-hand the ill effects of the flawed sustainable growth rate (SGR) physician target and the steep Medicare cuts that Congress has had to scramble each year to avoid, along with the significantly increasing price tag of a long-term SGR solution. Adding additional formulaic cuts through IPAB is just not rational and would be detrimental to patient care, especially as millions of baby boomers enter Medicare.
The experience with the SGR also raises concerns about policy decisions based on projections that require subsequent adjustments to reflect more accurate data. In 2003, Congress had to take action to allow the Centers for Medicare & Medicaid Services to correct $54 billion in projection errors under the SGR target. The IPAB also imposes a rigid budget target that is prone to “projection errors” that would force Congress to produce billions of dollars in offsets due to inaccurate calculations.
We appreciate the need to reduce the federal budget deficit and control the growth of spending in Medicare. However, we believe that this can best be achieved by Congress working in a bipartisan manner to reform the delivery system and improve quality, access, and efficiency. At a time in which Congress is struggling to eliminate the SGR, it does not make sense to allow another rigid formula to be implemented that risks a bigger set of problems for a broader cross-section of Medicare services.
We thank you for your leadership on this issue, and look forward to working with you to repeal the IPAB and preserve access for seniors to their physicians.

Satisfied with higher cost, mortality?

Everyone who questioned the endless emphasis on patient satisfaction surveys in modern healthcare might be vindicated by a new study.  The Cost of Satisfaction: A National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality concluded,

Conclusion: In a nationally representative sample, higher
patient satisfaction was associated with less emergency
department use but with greater inpatient use, higher overall
health care and prescription drug expenditures, and
increased mortality.

The results may be skewed by a phenomenon noted in the article: among seniors, there is no correlation at all between satisfaction and the “technical quality of care.”

I also question research that indicates that less and/or cheaper care is better, or that doctors over-treat their patients. I sometimes suspect the motive is to advocate for knee-jerk protocols and eventual rationing along with the removal of individual physician judgement in the treatment of individual patients.   (Dont’ think “death panels.” Okay, go ahead.)

However, this particular research looks at whether doctors order tests and treatments their patients ask for, whether or not the evidence supports that route. The researchers correlated these “discretionary” treatments and tests with satisfaction and with mortality, and came up with a 25% higher risk of mortality or death with in the time studied. (In the world of medical statistics, this is not a very high risk, but it is significant to those who die, right?)

The caveat is to watch and wait as the medical community evaluates the study and how the data was “cooked” by the statisticians. One area where the conclusion may be weak is that the health status of the patient was self reported (although mortality was not). I’d like to see correlation with lab values such as measurements of kidney function.

One of my fears has always been that I might become like some of the older docs I saw when I was training:  a very nice doctor who is well-liked but incompetent because I’ve failed to keep up my skills and knowledge. I should have worried about being the doctor who goes along to get along – or to make more money because my pay is directly related to how happy – not how healthy – I keep my patients.

CPAC: My first and probably my last

I have a new expletive or two for really, really, really bad “screw ups”: one is CPAC and the other is the name of one particular rude CPAC staffer I encountered.

I’ve had a miserable time at CPAC, the only shining moments were Governor Rick Perry’s speech, Andrew Brietbart’s rant about Obama and the “silver pony-tail gang”, and the Presidential Banquet with Paul Ryan’s talk and the privilege of meeting some wonderful Conservatives. I was especially struck by one panelist’s comment that the proof that faith and family are priorities and that the proof is that the TEA Party hasn’t literally formed a third party.

I’ll complain about the Convention itself later, but, first, the Politics!

Here at CPAC, virtually everyone who finds out I’m from Texas told me they were rooting for Perry and/or that he was their first choice. The exceptions were one who switched over from Sarah Palin, two that were interested in Cain, and one Ron Pauler; all but the Pauler had supported Perry while he was in the race.

Governor Perry’s speech was extraordinary and had more passion and truth than all the current candidates’ speeches. He gave the boldest speech so far.

For the Powers That Be, all the candidates should have acted like they were at CPAC. Early in the speeches, we needed to hear their conservative ideas, social issues, and self-criticism of their past mistakes, preferably with a passionate conversion story, preferably one that made us all know how strong and permanent the change has been. At CPAC convince us that you could smell the brimstone and feel the singe of the heat.

Instead: We got Santorum’s very sad-faced family and 20 minutes of foot-stomping and whining without any substantial plan, Romney’s wide-eyed gaze at us, and his assumption that he’s already won and we’d better study his 50 page plan. Newt not only had his friend introduce Saint Calista, but Newt himself gave us big government plans to *replace* the EPA with a new Federal bureaucracy and *reform* the FDA, both of which should be abolished and their regulations returned to the States.

And now, to my own rant about the Conference: I have a new expletive or two for really, really bad times: one is CPAC and the other is the name of the incredibly rude staffer I encountered on Thursday

My husband and I have attended several very large conventions (The Texas Straw poll in ’07, the Value Voters Summit in DC in ’08, American Academy of Family Physicians with up to 10,000 in attendance, the National Pawnbroker’s Convention, and the Texas Republican State Convention, etc.) The system and facilities for CPAC2012 are the worst I’ve ever experienced.

The Marriott’s too small, the ballroom was set up wrong, and no one could have designed a more dangerous traffic pattern, even without the Mormon missionaries standing shoulder to shoulder, blocking traffic in the halls and lobbies.

I could never recommend that anyone pay for “Platinum Package.” Several people have said that they should have saved the money and gone “Diamond.” And it turns out that there’s another level of Very, Very Important People, but none of the rest of us get to even glimpse them.

I’m told that all previous CPACs offered less security rules and presence and more access to the Candidates and celebrities. That access was exactly why I asked my husband to buy me the “Platinum Package” tickets for my birthday this year. I also signed up for Blogger credentials (free), as well.

Well, there was no access.

The bloggers were divided weeks ago into the in-crowd and the rest of us.

And money can’t buy happiness, either. I’ve been in more lines this week than I thought possible, and there has been very little of the promised “special lines.” Even the “VIP entrance” is a joke: I’ve been stopped more than half the time and then still fight the fire-hazard crowds in the single in/out aisle. On the first day, I couldn’t find and empty chair in the “Platinum/Diamond” area until after noon. The Platinum Balconies offer little or no view and the food is available for very limited times.

The opportunity to hear the 3 main candidates in one day and to meet some great Conservatives is the only benefit I’ve seen this week at CPAC. (You can follow my tweets @bnuckols )