Health Care Policy

Docs 4 Patient Care @D4PC Annual Meeting

“By Doctors . . . For Patients.”  It’s about the patient, who is the only boss the doctor should have, other than his or her own conscience and integrity.

I’m attending my first annual meeting of Docs4PatientCare this weekend, in Crystal City, Virginia, just over the river from Washington, DC.  I stumbled upon D4PC following links from American Doctors for Truth last March.

Doctors 4 Patient Care stands in stark contrast to – and as a viable alternative to – the American Medical Association. The AMA has become a partner with the US government through the publication and sale of mandatory  “code books,” and increasingly with its advocacy for government funded healthcare coverage, especially by its endorsement of “ObamaCare,” even before the law (much less the ever-evolving regulations) was written.

So far this morning, we’ve heard from the founder of D4PC Dr. Hal Scherz, an advocate for reaching medical students through the Benjamin Rush Society, Beth Haynes, an expert on Media Strategy and Training, Ernest DelBuono, Sr., and two speakers on reforming medical liability (tort reform), Dr. Jeff Segal of “Medical Justice,” and Rick Jackson of “Patients for Fair Compensation.” 

I’ll post more through the weekend. In the meantime, read a some of the D4PC literature, “Like” Docs4PatientCare on Facebook and/or follow @D4PC on Twitter. Watch a few of the D4PC videos on YouTube.  Consider supporting the efforts of the group and/or to donating money. There’s even an alliance membership for non-physicians.

“Aid in Dying” promoted in the Journal “Chest”

It’s difficult to write about a respected medical journal which promotes “Aid in Dying” without resorting to emotional words such as “horrifying,” “shocking,” or “murder,” but I’ll try. However, I will not call the practice “physician aided death” or “aid in dying.”  It is, at best “physician assisted suicide,” and at worst, “euthanasia,” or the use of medical technology and procedures to actively end the life – to intentionally kill – a patient. This is not “medicine” as I understand it.

Chest is the journal of the American College of Chest Physicians. These are the Internal Medicine subspecialists who focus on lung disease, cardiac care, and sleep medicine. They are likely to be the doctors who care for the most vulnerable patients, especially in the Intensive Care Unit at your hospital.

Under the heading “Medical Ethics,” in the July, 2012 issue is an article titled, “Aid in Dying: Guidance for an Emerging End-of-Life Practice,” authored by Kathryn L. Tucker, J.D. The article is available online as a web page, here, and as in pdf., here.

Beginning with a principle that virtually all of us can agree with,the right to refuse intentional medical intervention, the article quickly moves to the very controversial opinion that the first principle ensures the “right” to request “treatment” that is intended to end the life of the patient – to kill:

•A patient with decision-making capacity has the legal right to refuse or request the withdrawal of any medical treatment or intervention, regardless of whether he or she is terminally ill and regardless of whether the treatment prolongs life and its withdrawal results in death.

•A patient with decision-making capacity has the legal right to request and receive as much pain medication as necessary for relief, even if it advances the time of death.

•Principles of autonomy that underlie respecting patient rights to refuse or direct withdrawal of life-prolonging interventions or to request pain medication even if it advances time of death support the choice for aid in dying. Aid in dying is increasingly accepted in law and medicine in the United States.

•Provision of aid in dying does not constitute assisting a suicide or euthanasia. Aid in dying is a practice with growing support in the public and medical and health policy communities and is likely to become more widely requested in the future.

•A clinician cannot be compelled to provide treatment that conflicts with his or her personal values. In these circumstances, the clinician cannot abandon the patient but should refer the patient to a colleague who is willing to provide the service.

Four prima facie principles have been used to characterize most ethical concerns in medicine: respect for patient autonomy, beneficence, nonmaleficence, and justice. Respect for patient autonomy refers to the duty to respect patients and their rights of self-determination; beneficence refers to the duty to promote patient interests; nonmaleficence refers to the duty to prevent harm to patients; and justice refers, in part, to the duty to treat patients and distribute health-care resources fairly.11 When applied to the care of an individual patient, however, these principles may conflict with one another. For example, a patient’s values, preferences, and goals may be at odds with a clinician’s perception of how best to help and not harm the patient. Clinical ethics identify, analyze, and provide guidance on how to resolve these conflicts.

While I believe that there may come a time when it is ethical to stop trying to keep a patient alive – when treatment is only making the dying process longer – I will never assist in an act that can only end in the death of my patient. The way I explain this is that I will assist in removing a ventilator under certain circumstances, but I won’t then put a pillow over the patient’s face to make sure she can’t breathe on her own afterwards. The intent of medicine is to diagnose and treat disease, not to end the life of patients suffering from disease.

5th Circuit Upholds Texas Law on Funding for Women’s Health Program

Guess what? States are allowed to decide what they want to spend tax money on!

From the ruling by the Fifth Circuit Court on Texas’ Law prohibiting our Family Planning tax funds from going to any “affiliate” of an abortion provider or anyone who “promotes” abortion: ”

Texas Medical Association wants you to pay for elective abortions @texmed @texasallianceforlife #pro-life #tcot

Not all of the members of Texas Medical Association agree with the TMA on this.

The San Antonio Express News published an editorial August 9th, by O. Ricardo Pimentel, entitled, “Texas tries to get between you, your doctor:”

For them, the issue isn’t abortion; it’s about the doctor-patient relationship, patient health and the ability to put everything on the table that needs to be discussed. Even if it’s abortion.

In a recent letter to the state, the Texas Medical Association, joined by other medical groups, said Texas is about to embark on a plan for providing medical care to low-income women that will impose a “gag order” on discussing abortion even on doctors working with patients not in the program.

Other groups, weighing in during the public comment period on proposed state rules, have similar concerns.

It’s a plan, they say, that will ensure not enough doctors for this program willing to provide care, including family planning services. And this, they say, will guarantee more unintended pregnancies, more abortions and more illness that might have been prevented for low-income women.

Among those also commenting on the rules were the Center for Public Policy Priorities, and leaders of Planned Parenthood entities in the state, South Texas groups among them.

Trust me, for everyone who is mentioned above, it’s about abortion. The law doesn’t stop anyone from discussing or even promoting true contraception that doesn’t end the life of our youngest children of tomorrow.

And it is about “elective abortions:” those that are performed on health babies in healthy mothers. We’re not talking about the more controversial abortions in cases of rape and incest, much less in the cases of congenital disorders that are “not compatible with life outside the womb and certainly not in cases where the mother’s life is in danger. Since when do elective abortions “need to be discussed?”

How difficult is it to understand that Texas taxpayers should not pay for “promotion” of abortion? Or that we most certainly do not want our State tax funds to go to doctors who perform elective abortions on healthy babies and healthy mothers?

While I don’t speak for the Society, I am an elected delegate for my County Medical Society to the TMA House of Delegates and I believe that most of our members would agree with me on this. I am very much in favor of restricting payment from our limited State funds to only those doctors and organizations that provide comprehensive and continuing medical care for the whole woman and her whole family. With Texas Family Doctors, Internal Medicine Docs, Pediatricians and OB/Gyns reeling from the lack of increasing fees from Medicare and decreases in Medicaid funding, why not help keep them in business by adding the availability of billing the State for screening tests like pap smears, exams for breast masses, diabetes and high blood pressure?

In fact, that’s what the Legislature decided: that money would be prioritized. First come the comprehensive care docs, hospitals, and county and city clinics. Planned Parenthood is never mentioned, although there is a section of the law that absolutely prohibits the State from contracting with anyone who “promotes” abortion *if there are other qualified providers available.*

Texas DHS has already identified more than enough doctors and clinics that qualify under the law. These doctors can actually treat the diseases for which the Texas Women’s Health Plan screens. Our Texas Legislature made a wise decision when they agreed that it doesn’t make sense to send our few dollars to a clinic that treats a very narrow medical spectrum in an intermittent manner.

And the law has already saved human lives: Austin city and Travis County taxes once paid for 400 elective abortions each year. A year ago, the law achieved what the taxpayers who protested this use of their money couldn’t do: Austin and Travis County health clinics were forced to stop funding those abortions.
If you have a family doctor, consider a polite call to his or her front desk asking them to let the TMA know their views on using Texas’ tax funds to support Planned Parenthood and other abortion providers.

You might also consider contacting Texas Alliance for Life and/or you local Crisis Pregnancy Center to let them know that you support their efforts to keep your State (and federal) tax funds from paying for the ending of lives of our Texans of tomorrow.

Action: Women Speak 4 OURSELVES @WomenSpeak2012 #tcot #pro-life

Based on the Declaration of Independence, the Constitution of our United States is designed to secure our rights to life, liberty and property for every human being, not just the ones who can speak out. Those of us who can speak, should join in the effort to protect the rights of all, including the unborn children of tomorrow, male and female, and everyone who objects to government-sponsored efforts to end their lives. The recent Obama mandate that infringes on the First Amendment protection of the right of free exercise of religion and their on-going efforts to force Texas to fund Planned Parenthood with State taxes is in direct violation of the Bill of Rights.

I received an email tonight from the group, “Women Speak for Themselves” asking for comments on next Saturday’s Washington, DC rally sponsored by pro-abortion, anti-family and anti-First Amendment rights groups:

This Saturday, on the National Capitol lawn, Think Progress (a George Soros funded group) is hosting a “We Are Women” rally. Soros’ group, along with some of their co-sponsors, the usual—the National Organization of Women, Planned Parenthood, and the National Women’s Political Caucus—along with some more peculiar groups—Rock The Slut Vote, The National Center for Transgender Equality, and the Reformed Whores entertainers, among others—have a specific goal in mind.

“Our mission,” their website reads, “is to bring national attention to the ongoing war on women’s rights…”

Not surprisingly, the language on their website gives the appearance that they’re claiming to speak for all women on matters of healthcare, family, and freedom…which makes this just the type of event at which we need to make our voices heard! And so, here’s where YOU come in.

Prior to the rally, we’ll be releasing a statement to the press, informing them that there are women with alternative views on these matters, should the press wish to include us in the discussion. We’d like to add YOUR voices to that statement.

Send us a brief statement (2-3 sentences), articulating why as a woman you stand for and believe freedom includes protection for life, family, and/or religion. Be sure to include your full name, city and state, and your occupation, if you’d like—along with permission for us to include your information and quote in our press release.

If you’re not sure where to start, feel free to use our two sets of talking points for ideas (though your statement need not be solely focused on the HHS mandate), and try to stay focused on why you’re FOR our view of women’s freedom, as opposed to AGAINST the view of women’s freedom being put forth by Soros and cohorts.

Thanks for your help with this….I look forward to your statements!

My best to you,
Helen

http://womenspeakforthemselves.com/
https://www.facebook.com/WomenSpeakForThemselves
https://twitter.com/womenspeak2012

P.S. I’m told some pro-lifers will be gathering at the North Capitol Lawn on Saturday, to hold a counter protest. The rally starts at 11am, I believe, so feel free to head on over, with signs and pro-life gear, if you’d like to be a joyful example of the alternative.

 

I wish I could attend the counter protest, but I’m committed to a meeting for the Christian Medical and Dental Association that day. If you can attend, please do. Either way, send a message to http://womenspeakforthemselves.com/ or @womenspeak2012!

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.

Ted Cruz Debates Dan Patrick (#TxSen)

“Every time I go on the radio, you ask the questions that the Dewhurst campaign want you to ask.”

This, from the guy who got caught red-handed trying to influence debate questions by a fellow candidate in order to team up against Lt. Governor Dewhurst!

Listen to the radio confrontation between Ted Cruz and Texas Senator Dan Patrick on Patrick’s “The Bell and Patrick” radio show, for yourself:

Mr. Cruz argued with Patrick for 30 minutes on the Baker and Patrick Radio Show that airs on KSEV  radio in the Houston area at 4 PM, week days. He unfortunately began with the flat statement that Senator Patrick had endorsed Dewhurst in the Senate race. You would think that a man would know that sort of thing, right? As Patrick said, if he’d done so, it would be public knowledge.

Cruz actually claimed that all Republicans and Democrats play a “game” with legislation they don’t want to pass, by entering into a conspiracy to pass a bill in one chamber in Session, and then in the other the next, but cheat to keep them from passing to law.

Senator Patrick spent quite a bit of time explaining the complicated workings of the Texas Senate, especially the work on the Sanctuary Cities Bills (SB 29 and HB 41) during last Summer’s Special Session of the 82nd Texas Legislature.

The two discussed the “Rose Bush Rule,” which requires 21 members of the Senate to vote in favor of bringing any issue up for a vote. Patrick reminded Cruz that the Senate members, not the Lieutenant Governor, vote on the rules of the Senate. Patrick also explained that the Lieutenant Governor has the authority to suspend that rule in a Special Session, but not in a Regular Session.

Cruz asked Patrick whether Patrick would have been able to pass Sanctuary Cities if he had been Lt. Governor. Patrick said, “No,” because “the only thing you can do is pass it out of the Senate.” Patrick said that Dewhurst had warned the Democrats in the Regular session that if they blocked the bill in the Regular Session, he would suspend the 21 vote rule in the Special Session. Patrick reported that Dewhurst did suspend the rule as he said, in order to pass the Sanctuary Cities Bill with over two weeks left in the SS and spoke of the frustration of having the Bill sit in Committee in the House.

He also told Cruz that all 19 Republican Senators had met on the issue and decided to pass SB29 as a separate Bill, rather than to try to tack HB41 as an amendment to the School Finance Bill. They were concerned that the school funding bill would be held up, preventing schools from knowing their budget until August.

Cruz ignored Patrick’s admonition to campaign on his own merits and plans, returning again and again to statements about what people “intend,” “know,” or ” believe.” Cruz accused Patrick and others of working against him, assigning underhanded motives to them, such as how much “better” for Patrick it will be to get Dewhurst out of Austin.

The creepiest bit of Cruz’ argument was this line, delivered with a strategic lowering of the voice at the last: “You have been acting as a surrogate for Lt. Gov. Dewhurst and I have seen you do it.”

I’ve described Cruz’ reactions to me when I was still a supporter asking him to cut back on the negative campaigning. At our County forum in February and then in New Braunfels. At the New Braunfels meet, he couldn’t walk away so he engaged me in debate. He kept coming at me for twenty minutes although others had questions.

Here’s a news report about another episode of over-reacting to questioning by another woman in Fort Worth at the RPT convention.

Cruz is not a “fighter” in any good sense of the word. Rather than a champion or defender, he’s a bully and a brawler. When faced with even mild opposition, he goes out of his way to prove the other person absolutely wrong. As Patrick said, he can “make numbers lie,” and has no problem with stretching the truth if it has what he calls “a basis in fact.” He sprinkles his speeches with dramatic descriptions of imagined conspiracies such as the ones above, and the notion that “Austin” Republicans had all agreed to make sure that “no one with a ‘z’ in his name is elected to State-wide office.”

For other summaries of the episode, each with their own twist, see the Houston Chronicle and Texas Tribune. But listen to the actual recording if you want the real story.

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.

Dr. Jack Wilke on “Romney’s Conversion”

Dr. Jack Willke is an unimpeachable pro-life activist. He has taught many of us both why and how to protect life over the years. I was reassured to read his account of the pro-life conversion of Mitt Romney on LifeSite News and that Dr. Willke (and Dr. Hurlbut) are secure in believing that it’s genuine

The first part of the article outlines the work Dr. Willke did with George H. W. Bush when Bush was named as Vice Presidential running mate with Ronald Reagan. The last part is about Governor Romney’s conversion:

As this is written, Barack Obama has proven to be the most pro-abortion president of modern times and he is now seeking a second term. Former Massachusetts Governor, Mitt Romney, is the presumptive nominee for the Republican Presidential slot in November. Naturally, some have questioned his pro-life credentials and convictions so let’s examine the details of Governor Romney’s conversion.

When he was first elected Governor of Massachusetts, it was generally presumed that his position was “prochoice.” However, about half way into his first term as governor in 2005, Romney announced that he was opposed to embryonic stem cell research and proceeded to veto a bill making the “Morning After,” plan B contraceptive pills available. In the same year, he declared that he was pro-life.

Governor Romney tells us that he changed his mind in November 2004. At that time, he was obviously searching and had questions. He met with Douglas A. Melton, PhD, a scientist from the Harvard Stem Cell Institute on November 9. In that interview the Governor said this researcher told him, “Look, you don’t have to think about this stem cell research as a moral issue because we kill the embryos after fourteen days.” This had a major impact on Romney and his chief of staff, as they saw it recognizing that such embryonic stem cell research in fact was killing what they were convinced were human lives already in existence. Later, through a spokesperson, Dr. Melton disputed that he used the word “kill.”

But Governor Romney, wanting to know more, consulted with one of the best people available in February 2005. This expert was William B. Hurlbut, a physician and professor at Stanford University Medical Center Neuroscience Institute. Dr. Hurlbut is a dedicated pro-lifer.

The two of them met for several hours, discussing the issue in great detail. They went through the dynamics of conception, embryonic development and repercussions of the various research and experimentation that has been going on aimed at exploring the first weeks after fertilization. At that point, Romney was under intense pressure to change a state law that, at the time, still protected human embryos from lethal stem cell research. Some of the pressure came from Harvard, his own alma mater. After this in-depth consultation, Romney stated that he was pro-life.

Asked about their meeting by columnist Kathleen Parker, Dr. Hurlbut said, “Several things about our conversation still stand out strongly in my mind. First, he clearly recognized the significance of the i s s u e, not just as a current controversy, but as a matter that would define the character of our culture way into the future. Second, it was obvious that he had put in a real effort to understand both the scientific prospects and the broader social implications. Finally, I was impressed by both his clarity of mind and sincerity of heart. He recognized that this was not a matter of purely abstract theory or merely pragmatic governance, but a crucial moment in how we are to regard nascent human life and the broader meaning of medicine in the service of life.”

Similar to my time with President H. W. Bush, Dr. Hurlbut presented Governor Romney with sound scientific and medical information. The Governor responded by changing his position to support the protection of innocent human life from the point of fertilization. He declared himself pro-life and has repeatedly done so since that time.

For over twenty years, Life Issues Institute has been solely dedicated to prolife education. It has been my primary contribution to the pro-life movement since the 1960s. Our strength comes from the central fact that we are daily changing the hearts and minds of Americans on abortion. And our efforts have greatly be en assisted by science. The tool of ultrasound has resulted in an entire generation having their first baby picture taken within the womb, and it’s greatly impacted people’s opinion on abortion. Every pro-life individual and organization should rejoice when anyone—political or otherwise—responds to the unmistakable fact that human life begins at fertilization and that it should be protected.

Life Issues Institute and I are confident that Governor Romney’s conversion is real, heartfelt and authentic. Since the Institute is a 501(c)(3) organization, we cannot endorse a political candidate. As such, this article should not be construed as an endorsement of Governor Romney’s candidacy but rather a testament to the fact that we believe Mitt Romney is truly pro-life.

Republican Party of Texas 2012 Final “Protecting Innocent Human Life”

Here is the final 2012 section containing the substituted 2010 language and the amendments made in the whole Platform Committee on Thursday night, June 7, 2012

STRENGTHENING FAMILIES, PROTECTING LIFE AND PROMOTING HEALTH

PROTECTING INNOCENT HUMAN LIFE
Party Candidates and the Platform on Protecting Innocent Human Life – We implore our Party to support, financially or with in-kind contributions, only those candidates who support protecting innocent human life. Further, we strongly encourage the State Republican Executive Committee to hear and recognize the longstanding and overwhelmingly consistent voice of the grass roots and revise its by-laws to make this action binding on our Party.
Partial Birth Abortion – We oppose partial birth abortion. We recommend that Congress eliminate from all federal court jurisdictions all cases involving challenges to banning Partial Birth Abortion.
Right To Life – All innocent human life must be respected and safeguarded from fertilization to natural death; therefore, the unborn child has a fundamental individual right to life which cannot be infringed. We affirm our support for a Human Life Amendment to the Constitution and to make clear that the Fourteenth Amendment’s protection applies to unborn children. We support the Life at Conception Act. We oppose the use of public revenues and/or facilities for abortion or abortion-related services. We support the elimination of public funding for organizations that advocate or support abortion. We are resolute regarding the reversal of Roe v. Wade. We affirm our support for the appointment and election of judges at all levels of the judiciary who respect traditional family values and the sanctity of innocent human life. We insist that the U.S. Department of Justice needs to prosecute hospitals or abortion clinics for committing induced labor (live birth) abortion. We are opposed to genocide, euthanasia, and assisted suicide. We oppose legislation allowing the withholding of nutrition and hydration to the terminally ill or handicapped. Until our final goal of total Constitutional rights for the unborn child is achieved, we beseech the Texas Legislature in consideration of our state’s rights, to enact laws that restrict and regulate abortion including:

1. parental and informed consent;
2. prohibition of abortion for gender selection;
3. prohibition of abortion due to the results of genetic diagnosis
4. licensing, liability, and malpractice insurance for abortionists and abortion facilities;
5. prohibition of financial kickbacks for abortion referrals;
6. prohibition of partial birth and late term abortions; and
7. enactment of any other laws which will advance the right to life for unborn children.

Harassing Pregnancy Centers – We urge legislation to protect pregnancy centers from harassing ordinances to require pregnancy centers to post signs in violation of their Constitutional rights. We further oppose any regulation of pregnancy centers in Texas which interfere with their private, charitable business.
Parental Consent – We call on the Legislature to require parental consent for any form of medical care and/or counseling to minors. We urge electoral defeat of judges who through judicial activism seek to nullify the Parental Consent Law by granting bypasses to minor girls seeking abortions. We support the addition of a legislative requirement for the reporting of judicial bypasses to parental consent on an annual basis to the Department of State Health Services and such reports shall be made available to the public. Further, we encourage the Congress to remove confidentiality mandates for minors from family planning service programs operating under Title X of the Public Health Services Act and Medicaid.
Protection of Women’s Health – Because of the personal and social pain caused by abortions, we call for the protection of both women and their unborn children from pressure for unwanted abortions. We commend the Texas Legislature for the passage of the Woman’s Right to Know Act, a law requiring abortion providers, prior to an abortion, to provide women full knowledge of the physical and psychological risks of abortion, the characteristics of the unborn child, and abortion alternatives. We urge the state government and the Department of State Health Services to ensure that all abortion providers are in compliance with this informed consent law and to ensure that all pregnancy centers and other entities assisting women in crisis pregnancies have equal access to the informational brochures created by the Department of State Health Services.
Alternatives to Abortion – We urge the Department of State Health Services to provide adequate quantities of The Woman’s Right to Know Resource Directory to anyone that works with pregnant women.
RU 486 – We urge the FDA to rescind approval of the physically dangerous RU-486 and oppose limiting the manufacturers’ and distributors’ liability.
Morning After Pill – We oppose sale and use of the dangerous “Morning After Pill.”
Gestational Contracts – We believe rental of a woman’s womb makes child bearing a mere commodity to the highest bidder and petition the Legislature to rescind House Bill 724 of the 78th Legislature. We support the adoption of human embryos and the banning of human embryo trafficking.
Fetal Pain – We support legislation that requires doctors, at first opportunity, to provide to a woman who is pregnant, information about the nervous system development of her unborn child and to provide pain relief for her unborn if she orders an abortion. We support legislation banning of abortion after 20 weeks gestation due to fetal pain. *
Unborn Victims of Violence Legislation – We urge the State to ensure that the Prenatal Protection Law is interpreted accurately and consider the unborn child as an equal victim in any crime, including domestic violence.
Abortion Clinics – We propose legislation that holds abortion clinics to the same health regulations as other medical facilities and that subjects clinics to the same malpractice liabilities. We oppose any public funding for Planned Parenthood or other organizations/facilities that provide, advocate or promote abortions.
Abortion Requirements for Hospitals – We propose legislation that entitles hospitals to refuse to perform abortions because government has no moral authority to require such an abortion.
Conscience Clause – We believe that doctors, nurses, pharmacists, any employees of hospitals and insurance companies, health care organizations, medical and scientific research students, and any employee should be protected by Texas law if they conscientiously object to participate in practices that conflict with their moral or religious beliefs, including but not limited to abortion, the prescription for and dispensing of drugs with abortifacient potential, human cloning, embryonic stem cell research, eugenic screenings, euthanasia, assisted suicide, and the withdrawal of nutrition and hydration. We call on the Texas Legislature to pass legislation to strengthen and clarify the current conscience clause in the Occupational Code to include the above-mentioned persons and practices. We further encourage legislation that requires hospitals and clinics to inform all health care personnel of their right to refuse to become involved in abortion or euthanasia, and their protection from prosecution and retaliation under Texas law.
Fetal Tissue Harvesting – We support legislation prohibiting experimentation with human fetal tissue and prohibiting the use of human fetal tissue or organs for experimentation or commercial sale. Until such time that fetal tissue harvesting is illegal, any product containing fetal tissue shall be so labeled.
Stem Cell Research – We oppose any legislation that would allow for the creation and/or killing of human embryos for medical research. We encourage stem cell research using cells from umbilical cords, from adults, and from any other means which does not kill human embryos. We oppose any state funding of research that destroys/kills human embryos. We encourage the adoption of existing embryos. We call for legislation to withhold state and/or federal funding from institutions that engage in scientific research involving the killing of human embryos or human cloning.
Human Cloning – Each human life, whether created naturally or through an artificial process, deserves protection. We confirm that somatic cell nuclear transfer (SCNT) is the process by which a human being is cloned, and that SCNT creates a unique human being with the same properties of a human embryo created through the union of sperm and egg. We seek a ban on human cloning for reproductive purposes (where a cloned human embryo, created through SCNT, is implanted in a womb and the human clone is birthed). We also seek a ban on research cloning (where a cloned human embryo, created through SCNT, is created, grown in the laboratory, and then destroyed when its stem cells are extracted for research purposes). Furthermore, criminal penalties should be created and experimenters prosecuted who participate in the cloning of human beings. No government or state funding should be provided for any human cloning.
Patient Protection – We support patients’ rights by calling on the state legislature to amend the Advance Directive Act to establish due process of law and ensure that a physician’s decision to deny lifesaving treatment against the patient’s will or advance directive is not due to economic or racial discrimination or discrimination based on disability. We also support the passage of legislation to amend the Advance Directive Act by requiring hospitals intending or threatening to withdraw life-sustaining treatment against the patient’s wishes or their advance directive to continue all treatment and care for such patients pending transfer to another facility.

Note that some of the 2010 language was removed and that the * the portion that I’ve printed in red was an amendment made after the substitution.

Lt. Governor David Dewhurst: A Record of Results

Why do I support David Dewhurst for Texas Senator?

From the Preamble to the 2010 Platform of the Republcan Party of Texas: The embodiment of the conservative dream in America is Texas.”

The result of conservative government in Texas is clear. Our State’s direction with the leadership of Lt. Governor David Dewhurst and Governor Rick Perry is a Conservative example for the Nation. Their policies and achievements demonstrate the results of action based on the belief that true liberty is Pro-life, Pro-Family, Pro-business, holds the line on taxes, spending, torts, and Washington, DC interference and regulation.

Texas leads the Nation in the creation of jobs. Our unemployment rate went down to 6.9% in May, in spite of legal US immigrants that average close to a thousand a day. Lt. Governor Dewhurst has balanced our budget in Texas, even when it meant cutting $10 million in 2003 and $15 million in 2011. In fact, the 82nd Legislature  cut Texas’ dollar amount spending below the previous biennial amount for the first time since WWII. Adjusted for inflation and population, Texas spends less than when Dewhurst took office.

And there is no contest when it comes to legislative victories on social issues. Texas’ Defense Of Marriage Act was passed not once but twice under Lt. Governor Dewhurst; the second time amended our State Constitution. Thanks to his leadership, Texas passed our own Prenatal Protection Act and the “Woman’s Right to Know” informed consent law in 2003. This year, we not only added sonograms to the informed consent law, we also managed to move all of our State health care funding away from abortion providers and any of their corporate affiliates. Yes, that’s right, Texas de-funded Planned Parenthood.

The 2011 Texas 82nd Legislature was also incredibly effective on protecting our State’s borders and Sovereignty;  banning drivers’ licenses for illegals, getting Voter ID, allocating $400Million for border security, and changing the law to allow Texas authorities to turn illegal aliens over for timely deportation after they’ve served their jail time. And yet, Lt. Governor Dewhurst’s opponents ignore these victories, claiming that the Lieutenant Governor “killed” two Bills in 2011: the Transportation Security Agency Anti-Groping Bill and the Sanctuary Cities Bill. However, both the TSA and Sanctuary Cities Bills were passed by the Senate at different times. The problem was coordination with the House, where the Speaker refused to allow timely consideration of the Bill and opposition by some strong conservatives, including Steve Hotze and Norm Adams.  In the Special Session, the TSA bill was passed by the Senate, along with the biennial budget and a landmark omnibus medical finance bill.

In fact, even the “failed” passage of the TSA Bill in the Senate during the 82nd Legislature’s Regular Session was an example of the power of Dewhurst. He is said to have “twisted arms,” along with Governor Perry, to get the vote to the floor, even going so far as to try to “suspend the rules” to bring it up out of order. The Democrat Senators block-voted to prevent the 2/3 vote necessary while every single Republican voted for it. It is likely that had the Lt. Governor not pushed for the suspension of the rules on the TSA Bill, the budget would have passed in the Regular Session if it hadn’t come down to the midnight filibuster by the Dems.

Finally, I support Lieutenant Governor Dewhurst because he’s proven that he believes that  “The government has no money, it’s the people’s money.”

Donna Campbell: pro-life. Jeff Wentworth: not

Not until the 3rd trimester, at 7 months or 24 weeks or so, anyway. And that’s exactly why I was one of the many who asked Dr. Donna Campbell to run for Senator for Senate District 25.

This is the man who fought the Choose Life license Plate for 6 years, who voted against the Sonogram Bill. Contrast this man with Dr. Donna Campbell the Conservative candidate for Senator from Senate District 25! Contrast

In fact, Wentworth brought up the subject of abortion up to the 3rd trimester at the Rotary Club meeting last Thursday, when I was either too busy giving Dr. Donna’s credentials  — and definitely too wimpy, compared to this woman. He made the same statement about abortion being illegal in the 3rd trimester.

If my video doesn’t work, you can watch it at the Wentworth on Abortion

Judge keeps Planned Parenthood out of Women’s Health Program

What happened: Texas passed a law last summer, SB 7, that specifically said that if the State is forced to give money to “entities that affiliate with abortion-promoting entities,” the State would shut down the Women;s Health Program. The Obama Administration tried to force the State to violate this law. Then, a Federal Judge  ruled that the law couldn’t go into effect,

U.S. District Judge Lee Yeakel on Monday granted a preliminary injunction to require the state to keep Planned Parenthood in the program until he makes a decision on the merits of the case.

But Texas Attorney General Greg Abbott’s office asked the 5th U.S. Circuit Court of Appeals for an emergency stay of the injunction, which was granted by Judge Jerry E. Smith.

via Judge keeps Planned Parenthood out of Women’s Health Program – San Antonio Express-News.

If the injunction had stood, there would be no Women’s Health Program in Texas. Planned Parenthood seems to think that if their corporation can’t have money, no one should. Luckily, Judge Smith understood the emergency.

Planned Parenthood wasn’t hard to replace. WingRight reported on the thousands of other doctors and clinics that participate in the WHP and how to find one in your area, here.

Update, 8 AM May 2:

The attacks are on against Judge Smith.

More at the usual suspects like the Texas Tribune.

Funny, the TT doesn’t take this opportunity to link to its own interactive map showing other providers or to link to Obama’s $61 million dollar grant  to Texas public health clinics.

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.

Feral Hogs and “Real Budget Solutions” for Texas

While reviewing budget issues with Dr. Donna Campbell, we discovered “Real Texas Budget Solutions” (a pdf) from the Texas Public Policy Foundation.

Besides recommending that Texas’ State agencies begin cutting budgets, now, rather than later, the paper suggests eliminating funding for the following:

Commission on the Arts; Texas Historical Commission; Texas Public Utility Commission: System Benefit Fund, Renewable Portfolio Standard, and Energy Efficiency Program; Fiscal Programs— Comptroller of Public Accounts: Major Events Trust Fund; Trusteed Programs within the Office of the Governor: Texas Music Office, Texas Film Commission, Economic Development and Tourism Division, Texas Enterprise Fund, Emerging Technology Fund, Economic Development Bank, and Texas Tourism program; Texas Workforce Commission: Skills Development Program; Texas Windstorm Insurance Association; Texas Education Agency: Regional Education Service Centers, Student Success Initiative, Steroid Testing, Campus Turnaround Team Support, Best Buddies; Higher Education Coordinating Board: Doctoral Incentive Program, Top Ten Percent Scholarship Program, and Research University Development Fund; Library and Archives Commission: Resource Sharing and Local Aid; Office of Public Insurance Counsel; Office of Public Utility Counsel; Texas Commission on Environmental Quality: Texas Emission Reduction Program; Pollution Prevention Advisory Council; Take Care of Texas Program; Texas Clean School Bus Program; and Recycling Market Development Implementation Program; Texas Department of Agriculture: Seed Quality, Seed Certification, Feral Hog Abatement, Egg Inspection Program, and Agricultural Commodity; Texas Parks and Wildlife Department: Promotion and Outreach Programs; Texas Railroad Commission: Energy Resource Development and Alternative Energy Promotion; Board of Plumbing Examiners; Texas Board of Professional Geoscientists; Funeral Service Commission.

I saw a couple in there that I wonder about (and had to wonder about my own Texas Institute of Health Care Quality and Efficiency) but where *do* we start? Everyone of these agencies and boards is taking money from Texas taxpayers’ own budgets.  Which can be better done privately?

(That photo is one that I took at a macadamia nut farm on  Hawaii, September, 2011).

Vanity: I’m Published in Fort Worth Star-Telegram (Texas Advanced Directive Act)

I submitted an editorial to the Fort Worth Star-Telegram which they have titled, “Nuckols: Navigating healthcare’s difficult decisions.” It was published March 28, 2013, but I can’t tell whether it’s in the dead-tree version.  (In case you ever wondered, no one notifies the author when a piece like this or a letter to the editor is published. I think it increases their readership, all of us checking back to see whether we made it to print.)

The paper had published a very biased and poorly written op-ed calling the Texas Advanced Directive Act, “the Texas Futile Care act.” Although the Star-Telegram corrected this one error, the piece has unfortunately been picked up by several other websites.

The editors edited: giving the piece its name and changing all my references to “TADA” and “the Act” to “the act.” They also did some research and posted a little biography that I was surprised to see. (I wouldn’t have been foolish or brave enough to give these credentials without checking in with the people they might have affected.)

I do wish that the paper had researched the original article more thoroughly. It’s so bad that I decided not to link to it.

I was privileged, back in 2006 and 2007, to sit in on a couple of year’s worth of the meetings that I mention in the article. We all worked diligently to come up with some compromise other than going to court on every disputed case. Because our compromise fell apart at the very last minute, families are still faced with only 48 hours between the notice that an ethics committee has been called and ten days’ notice if transfer is pending. I hope we can come to an agreement in 2013 to make these decisions a little easier, while keeping them out of court and in the realm of physicians’ medical judgment.

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?

Find a Women’s Health Program doctor in Texas

Planned Parenthood (“PP”) for years has used the media and fraud to bring in clients when those women could have gone to a family doctor or OB/Gyn. Below are three ways to find a local doctor who participates with the Women’s Health Program in Texas.

As a woman doctor, mother and grandmother from Texas, I support Governor Perry in his support of the law, passed once again by the Texas Legislature last summer, that prohibits any of our tax funds going to any “affiliate” of abortionists. Senate Bill 7, the huge law covering Texas medical financing, was passed in the Special Session of the 82nd Legislature and renewed a State prohibition on any Texas Medicaid funds going to “perform or promote elective abortions, or to contract with entities that perform or promote elective abortions or affiliate with entities that perform or promote elective abortions.” (See page 91.)

The Obama administration and countless media and op-ed articles would have us all believe that the law is new, but it’s not. The original Women’s Health Program (“WHP”) was created in 2005 and received a 5 year waiver from the Bush Administration in 2006, as finalized in these documents from the Center for Medicare and Medicaid Services. All of these facts are outlined in the Complaint filed by Attorney General Greg Abbott in his lawsuit against Kathleen Sebelius and Obama’s Health and Human Services:

11.From the outset of the Women’s Health Program, the Texas Legislature has explicitly prohibited taxpayer funds from going to entities that perform or promote elective abortions. The Legislature also prohibited taxpayer dollars from funding affiliates of entities that perform or promote elective abortions. See id. § 32.0248(h) (“The department shall ensure that the money spent under the demonstration project, regardless of the funding source, is not used to perform or promote elective abortions. The department, for the purpose of the demonstration project, may not contract with entities that perform or promote elective abortions or are affiliates of entities that perform or promote elective abortions.”).

Read the next few paragraphs of the Complaint for comments on dates and on approval of the waiver without restrictions on Texas’ prohibition on abortion providers.  Please note that the waiver was requested in December, 2005, and approved in December, 2006, for a period of 5 years, to end December 31, 2011. It is not true, as reported by a spokesperson for Secretary Sebelius, that the waiver was denied.

Texas law prohibited State funds from going to any provider who performed or referred to elective abortions beginning in 2003. Under a provision known as “Rider 8,” the State began requiring recipients of Medicaid and Family Planning money to sign an affidavit that they did not perform or refer for elective abortions. Texas won when PP challenged Rider 8 in Federal Court. The various PP sub-corporations in the State then set up separate corporations for the “medical affiliates” that were not licensed to perform abortions and the “surgical affiliates” that did perform elective abortions. These were shams, as all of the corporations came under the direction of Planned Parenthood Federation of America and some even shared buildings and staff. It turned out that 4 of the facilities run by the PP Trust of San Antonio and South Texas didn’t even bother with the sham. They were found to be illegally performing medical abortions, and were fined and shut down in 2009 as unlicensed abortion clinics and for fraudulently billing Medicaid.

Here are a few numbers from Governor Perry’s office that show that Planned Parenthood is not the most efficient way for Texas to spend our Medicaid dollars:

• There are more than 2,500 qualified providers in the WHP.
  Planned Parenthood represents less than two percent of providers in the WHP.
• Planned Parenthood’s cost per client is 43 percent higher than most other providers, according to the Texas Health and Human Services Commission.
• In FY 2010, nearly 80 percent of women served received WHP services from non Planned Parenthood providers.

What did happen is that last year, Attorney General defined “affiliates.” Logically, subsidiaries of a given corporation, such as all the “medical affiliates” of Planned Parenthood Federation of America, are “affiliates” of that corporation.

PP and their supporters would have us believe that hundreds of thousands of women will go without care because of the Texas law. On the contrary, those affiliates were easily replaced. Thousands of qualified doctors and clinics already participate with the Women’s Health Program in Texas.

And there are several ways to find one of the qualified providers for the Women’s Health Program in your town:

In Texas, we have “2-1-1,” a State services telephone information line. You can call 2-1-1 from any phone to find all sorts of assistance in your area, including doctors who participate with the WHP.  I’ve heard that this may not be the most up to date or complete list, however.

Texas Tribune published an interactive map that highlights the color coded stark reality of the differences in numbers and in the distribution of PP versus the many doctors who currently participate with the Women’s Health Program. Notice that Planned Parenthood only shows up where there are lots of other providers. Where there aren’t many doctors, there are definitely no PP facilities.

For the most accurate and largest number of WHP qualified doctors and clinics in your area, Texas’ Department of Health and Human Services has a search engine available here. Use the “Advanced Search,” then choose Plan type:”Traditional Medicaid,” Provider type: “Specialist” (although this will actually bring up family physicians and other primary care docs), and Waiver type: “Women’s Health Program.” You can search by County or by Zip Code.

Hopefully this information will help you answer the critics of Texas, our Legislature, Commissioner of Texas’ Health and Human Service Suehs, and our Governor Perry.

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!

Generation of blood vessel with patient’s own stem cells.

In the article, “To Fix a Heart, Doctors Train Girl’s Body to Grow New Part,” the Wall Street Journal reported yesterday on an adult stem cell treatment which may revolutionize care of as many as 3,000 children a year. The story focuses on Angela, now 4 years old, who was born with “hypoplastic left heart syndrome,” a condition in which a child never develops a normal 4 chamber heart.

Think of the heart as two tubes, each with an atrium or upper chamber and a lower chamber, the ventricle. The lungs are between the two, and the system is set up so that  low oxygen blood does not mix with the blood that is saturated with oxygen. 

If there is only one ventricle, the system can’t adapt to increased need for oxygen. Not only is the ability to pump the blood not enough to increase when exercising, excited, or scared – or even growing – but the oxygen-rich blood always mixes with the depleted blood, even on the way to the lungs.

Without surgery, 70% of children die before they turn one year old. Up until now, the corrective surgery has involved using grafts of artificial tubes, that don’t grow, and need to be replaced every so often.

The new technique uses a “bio-absorbable” scaffold on which the patient’s own stem cells are seeded and grown. This new blood vessel is surgically implanted so that the anatomy, and the blood flow, is more like the normal heart. It’s hoped that the new graft will grow with the child and prevent the need for repeat surgeries as the child grows.

In the end, the choice to become the first patient in Dr. Breuer’s study turned on three things, Ms. Irizarry says: the family’s faith in God, their trust in the doctor, and the potential for a natural blood vessel that could possibly help avoid more surgeries. “Before, they were using plastic, now they’re using this special graft that will grow with her,” Ms. Irizarry says.

Angela is the first, so we don’t really know whether the new vessel will grow with her. But there’s evidence from other, similar procedures to build new bladders and other organs.

Unfortunately, the process of getting the new procedures from early trials to use for those 3,000 babies a year is complicated and slow, even with an FDA “exemption:”

Development of the procedure has been painstaking. Dr. Breuer undertook four years of laboratory research after he joined Yale in 2003 before seeking approval from the U.S. Food and Drug Administration in 2007 to test the approach on patients. It took four more years and 3,000 pages of data before he got a greenlight. The study builds on the cases of 25 children and young adults successfully treated in Japan a decade ago with a similar approach.

Dr. Breuer, who holds several patents through Yale related to the technology, expects to implant a tissue-engineered blood vessel in a second patient soon as part of a six-patient study to test the safety of the procedure and determine whether the blood vessels actually grow in the body as a child gets bigger. The hope is that if these patients are treated without a hitch, the procedure may be available under a special FDA humanitarian device exemption, which would allow Yale to charge for it while conducting a larger study.

It’s a shame that it took so long to get the procedure to the first patient, and that many more will have to wait even longer. There must be a way to place judgement before bureaucracy in these cases.

Cross posted at LifeEthics.org

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)

Doomesbury defends abortion

Yeah, I know it’s “Doonesbury.”

Garry Trudeau has always been a leftist, pro-abort (he “satirized” the movie “Silent Scream” in 1985.) who has no problem flaunting the power of his cartoon, Doonesbury. This week, he’s taking on the Texas sonogram law. And he claims that “the GOP” has declared “war” and that for him to ignore it would be “comedy malpractice:”

“I chose the topic of compulsory sonograms because it was in the news and because of its relevance to the broader battle over women’s health currently being waged in several states. For some reason, the GOP has chosen 2012 to re-litigate reproductive freedom, an issue that was resolved decades ago. Why [Rick] Santorum, [Rush] Limbaugh et al. thought this would be a good time to declare war on half the electorate, I cannot say. But to ignore it would have been comedy malpractice.”

Two years ago, he mocked Sarah Palin. One week in July, 2010 he was laughing at the fact that her family was being stalked. The next week, he gave us a dream sequence depicting a Sarah Palin doll “refudiating the lame stream media” and trying to convince Mr. Potato Head and assorted toys to fight “to water the tree of liberty by spilling the tyrant blood” of the little girl who owns them. Then, we hear the girl’s mom tell her that everything Sarah says is “programmed in. Her brain is empty. Sarah’s a dummy. A shiny plaything. A cypher. A blank. A total nothing. Not a thought in her head. Just a piece of plastic crap.” and on and on . . .

Last year, Trudeau “partnered” with bogus biographer, Joe McGinnis to push the latter’s book in the cartoon.

Even though the comic strip is published in San Antonio and Austin papers, I didn’t know about these past incidents until I started doing research for this post.  Was there any outrage or demands for an apology from Trudeau or that advertisers or papers withdraw their support?

This week, some papers won’t run the abortion series, others will move the strip to the editorial section. A few plan to run an alternate series.

I subscribed to the SA Express News until 2010, when it became obvious that it was too politically biased in favor of Dems and the Obama “Health care reform.” It may be time to contact their advertisers to let them know what trash they support.

What will your paper do? And, how do you feel about it?