1. Expensive Death

We spend 1/3 or more of our overall health care resources in the last year of life, often exceeding hundreds of thousands of dollars, and only achieving a few months of weeks of poor quality life.

But how do we deal with this? Death panels? Will a population that doesn’t trust bureaucracy well enough to send cash in the mail trust one to manage The Plug?

What about the market? Currently, commercial insurance pays away while the family - does whatever can be done – nursing grandma along for months, or years, senile, hopeless, unaware, with a final price tag often exceeding a million dollars – an amount that if spend elsewhere might vaccinate 100 school districts and check another couple hundred for scoliosis.

Dying is scary. But we need to find a way to face death without fighting it tooth-and-nail. We need to stop using enormous amounts of resources on hopeless cases in exchange for prolonged agony. We need to let dead people die – but we won’t.

2. Heath Care is Expensive

When you buy a computer you either go shopping around, looking for a good deal on a system, or you buy a system that specifically meets your needs. Then you pay for it, either with cash right then or with a credit card and pay it off later. You don’t appear at Best Buy and expect everyone to wait on you and bring you the most advanced system available; a state-of-the-art $1500 processor, $450 for water cooling, 1200 watt $300 power supply, $200 case, $800 RAM, $800 RAID of HDs; and ignore the prices, because someone else is paying.

But that’s how we buy health care. We complain about the price of our insurance, but when we need treatment we expect space age miracles, and when we really get sick, we expect the insurance to show up at the hospital with dump-trucks loaded down with cash.

Anything treated this was is going to get expensive, as it should. We are talking about prolonging our lives and improving the quality of life. It shouldn’t cost less.

We need to accept the price of our long comfortable lives, but we won’t.

3. Chronic Illness

Why don’t we treat health insurance more like car insurance? Certain parts of health care, although sometimes expensive, aren’t unforeseen, like regular tests like cholesterol levels and simple treatments for mild illnesses like a sore throat. Why can’t we just pay for this kind of thing like we do everything else, and save insurance for the sudden horrible things no one can afford?

Regardless, chronic illness fits neither the medical insurance model nor the car insurance model. Some people, for whatever reason, are burdened with regular, constant, indefinite health care costs – disproportionate to the population, like diabetics.

We talk about poor people who don’t have access to health care resources. But that’s not the issue. The issue is sick people who don’t have access to health care resources, or don’t have access to enough. In other words, many poor people don’t worry about getting health insurance, even when it’s free, because they don’t need it, they aren’t chronically ill. While some people do have health insurance but they still struggle to get by, because they have numerous expenses due to their chronic illness.

If we want to address inequality, and fix the shortcomings of our health care system, we have to recognize the inequality of chronic illness, but we don’t.

Well done Esquire Dove (I still like Litigious Dove better). Logic and facts are a musical combination. That cleared up my thinking a bit.

I don’t like either path. As you point out, the power to tax path is just dishonest. A tax only applied to individuals who don’t do something – logically – is a penalty.

And as contrary as it is to initial constitutional Federal powers and State roles, according to precedence, a mandate most probably is, or will be deemed, constitutional by shoving it down the commerce clause pipe. Although, I’d keep a plunger handy, probably some old towels and news paper too. What irritates me most though is – what better exercise is there for a federation than to experiment with improving health care and access to it in 50 different ways?

And I agree: the Republicans shouldn’t get into this court business. But, at least they’re challenging a new law, which is healthy, instead of trying to make a new law through the courts after it fails in the legislature, or the other way around. It’s not a productive venture for them politically. They should be focusing on the stuff that will get them more seats in the legislature so President Palin can reform Obama’s reform. After all, she won’t be hindered by that silly old thing they used to do – filibuster I think they called it.

Also, forcing a decision in the Supreme court could turn a painful stretch in the commerce clause into an official big step – another powerful precedent on the slippery slope of precedence. And if it goes the other way, what then? For there to be coverage for all, all must invest. Which means, in this world logic demands a mandate, regardless if it’s Republican or Democrat reform.

If I were on the Republican’s side of the proverbial chess board, I’d minimize these court challenges and focus onshowing all the goofy flaws, confusion, contradictions, and other inherent problems any huge, hurried, and sloppily compromised bill like this has – and talk about REFORM or REPLACE and stop all the REPEAL talk. Then I’d be as reasonable as possible with this upcoming immigration reform and try to keep all the anti-amnesty enthusiasts calm, especially in the Teaparty. Protesting Liberal super-spending and taxing is perfectly rational. Some might argue anything but is irrational.

But I’ve got a bad feeling there are plenty of Tea Partiers who will protest anything containing anything that might be interpreted as amnesty. And sure, amnesty is wildly unpopular, but the alternatives are nothing and deportation. Those aren’t popular either. Regardless, Republicans need to treat immigration reform kindly so as not to keep frightening off the Latino vote. The Latino block and the recent-immigrant block are both such a good fit under the Conservative philosophy it would be tremendously unwise to piss them away irrationally fighting against amnesty – or whatever Obama decides to call it – and let the Dems scoop them up with their staple promises of entitlements.

Although Noisy Dove’s take on the constitutionality of the healthcare mandate made an interesting story, as Esquire Dove, I wanted to chime in on why I think the lawsuit filed by the Attorneys General of 14 states is likely to (and should) fail.  I do want to preface this post by admitting that I have neither read the entire healthcare bill nor the actual court papers filed in the suit at issue.  I also do not have access to the amount of legal precedent that I would like to make truly thorough arguments.  These are lay-opinions, not professional, make of them what you will.

As I understand it, the main thrust of the lawsuit (and an interesting question regardless) is that the new federal healthcare bill violates the 10th Amendment to the United States Constitution. The 10th Amendment provides that, “powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states.”  Basically, the argument against the bill’s constitutionality is that the healthcare bill exceeds Congress’ enumerated powers.

I agree with Noisy Dove that the best argument for the bill’s constitutionality is that Congress has the power to regulate healthcare under the Commerce Clause.  Some commentators have argued that the bill is constitutional under Congress’ taxing and spending power, but I disagree.  Even though it may be called a “tax”, the penalty for failing to purchase healthcare is not a tax but exactly that — a penalty.  The healthcare bill applies a charge only to those who do not purchase healthcare, in other words don’t purchase healthcare and you have to pay a fine.  The fine does not become a tax simply because the amount due may be delineated based on income brackets or paid at tax time.  Accounting for income levels is no different in this case from adjusting a fine based on the gravity of the offense.  If Congress had wanted to create a tax incentive for purchasing healthcare it would have been very simple – just tax everyone for healthcare and then provide a tax credit equal to the amount of tax charged for those who purchase their own care.  This is, however, not what they did.

Nonetheless, I do believe that Congress had authority to pass this healthcare legislation under the Commerce Clause.  Article I, Section 8 of the Constitution affords Congress the power, “[t]o regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes.”  No matter what the original intent of the Commerce Clause, which I agree was probably as Noisy Dove describes, it has a long history of litigation and interpretation by the Supreme Court (seems like about one-third of my Constitutional Law course was spent on this one topic).  This has created several layers to Congress’ power that are not obvious from the text.

First, Congress may regulate wholly intrastate activities of interstate commerce.  See Shreveport Rate Cases.  Even though a person may not cross state lines to purchase his or her individual healthcare, and it is, therefore, a wholly intrastate activity, it is extremely difficult to argue that healthcare costs do not affect interstate commerce.  The Supreme Court has “identified three broad categories of activity that Congress may regulate under its commerce power”: (1) “the use of the channels of interstate commerce;” (2) “the instrumentalities of interstate commerce, or persons or things in interstate commerce, even though the threat may come only from intrastate activities;” (3) “those activities having a substantial relation to interstate commerce, i.e., those activities that substantially affect interstate commerce.”  United States v. Lopez, 514 U.S. 549, 558-59, 115 S. Ct. 1624, 1629-30 (1995) (internal citations omitted).  Hospitals, insurance companies, prescription drugs and drug companies all have profound effects on interstate commerce.

In the past fifty years, the only laws passed by Congress that the Supreme Court has ruled were not sufficiently related to interstate commerce were: (1) a law involving the carrying of handguns in school zones; and (2) parts of the violence against women act.  The regulation of healthcare and the healthcare industry has a much more direct affect upon the nation’s economy than the tangential relationship in those cases.  Under the loose standards of Supreme Court precedent, I think that Obamacare passes the test.

As to whether Congress may mandate that people purchase something, i.e. healthcare, the scope of Congress’ power under the Commerce Clause is very broad.  Congress has discretion to choose its means so long as those means are “reasonably adapted” to the Constitution.  See Heart of Atlanta v. U.S..  Congress has a long history of unfunded mandates, which are often controversial, but perfectly legal.  I see this as no different.

Of course there is a powerful slippery-slope argument to be made.  For example, one could argue that if Congress can mandate that people purchase healthcare, they could also mandate that people buy GM cars (since the federal government now has a financial interest in the company).  Honestly, Congress may be able to legally mandate something along those lines, but at some point, we have to have trust that our republican form of government (not the Republican party, but our representative form of government) will prevail.  Personally, I do not think that the chances of re-election for anyone who would vote that a person must purchase a GM car would be very good, and the same may be true for those who voted for the healthcare bill.  That is the beauty of our government.  Laws are made, the people speak, and laws can be changed.  I think that there is a much greater danger in running to the courts for this type of dispute because the court is asked to interpret the United States Constitution, which is not easily changed.  Such decisions have much longer-enduring and devastating effects; just look at Roe v. Wade.  I find it extremely interesting how conservatives often complain, and in fact campaign on, “left-wing activist judges,” but yet go running to the courts to change long-established constitutional law when they lose a political battle.  Et tu?  Et tu?

I’m still amazed the Democrats are using Reconciliation. It’s just so inappropriate. But this is all on top of an amazingly brazen and belligerent bill – so my surprise is simply due to my optimism.

I think the main mistake they made was starting with the biggest most Liberal bill you can imagine, including fighting to keep language that many feel will allow for Federally funded abortion. And you know; I might have supported the original bill. Like I’ve said, if I couldn’t count and didn’t know any 20^th century history, I’d probably be on the Liberal side. The reason I generally hate Liberal thinking is because so many of their ideas are lofty and fundamentally flawed. They don’t work. Hey, yeah, let’s buy everyone a house and pay for healthcare.

“Nether do Conservative ideas,” – Not true – Conservatives generally want to maintain ideas that have been and are currently working – the ones that built our mighty nation. Liberals point to the few people for whom the system isn’t working, forwhatever reason, and use that as a reason for social upheaval. You know what I’m talking about. Those assholes can’t go a day without reading a letter supposedly from someone in some gravely unfortunate situation healthcare wise.

The original healthcare bill might have worked. At least the Dem’s own optimistic and rosy numbers worked out. But since then, to get Democrats to vote for the thing – yeah, it was that Liberal – they had to hack all the things to death that were supposed to pay for it, like the Cadillac plan tax.

So now this bill is just a big pile of unfunded partisan garbage, garbage that Obama wants to pass for little other reason than to score a perceived victory. If his reasons, or the reasons for the congressional Dems, were anything but, they would have pried this fist-size piece of crap out of their mouths and bitten off a rational piece we can thoughtfully chew and swallow without Historical abuse of something that was originally created to keep a solvent budget.

And the real danger here is the precedence. Reconciliation is for budget adjustments, not creating new bureaucracies. It has a lot of other rules too they’re working to get around. FFS… Don’t these hippies remember a few years ago when they were praising the Republicans who refused to use Reconciliation for some stuff Bush wanted?

Historical and proud. Historical and Proud. The bill’s gona pass, it’s historical and proud.

Scott Brown elected Massachusetts State Senator

Do you think a woman who had posed nude could ever achieve national political office?

Disaster in Haiti

The only hope long term for Haiti is a deadly disease that only affects jerks. That’s the only hope for a lot of developing nations criminally ruled by jerks. The CIA got close with AIDS, but they didn’t realize back then that butt-sex and being a jerk were not mutually inclusive. Ah well, dreams for the next conservative administration.

‘We are the world’ Haiti relief recording session begins

These people need to be stopped. Send your money to Red Cross.

State of the Union address

I don’t know why people take Obama’s speeches to seriously. I mean, they were never meant to be taken literally. His message is one of hope and change. We can all learn valuable lessons from his speeches but – lol – you can’t apply those ideas directly to policy – that was never the intended purpose of his message.

Toyota Recall

Yeah! Another fat-cat scapegoat! Yeah, let’s get’m! Whoohoo!

Obama getting tough on China for trade agreement infractions

I’m getting tough on my credit cards too. I’m taking a different approach though. I’m paying off the debt – or at least trying.

Underpants bomber now talking, encouraged by parents

Wow Obama administration! Way to go getting the kid to ignore his lawyer’s advice. If only all terrorists had responsible parents. And thanks for telling us about it too. Now all of America knows how great of a job you’re doing protecting us. Hey, so have you gone ahead and put Al Qaeda on the list to receive your FUCKING news letter yet?

Sarah Palin to receive $100k speaking fee for Tea Party Convention

Only a Liberal would find this controversial. She’s a Conservative from Alaska. What do you think she’s going to do with the cash? Buy something with it? You give those people a rifle and a pair of boots – a few years later they’ve got a city with a shipping port. Watch, she’ll invest in some unknown little jackass somewhere and turn another baby-blue state red. Astroturf my ass… U-S-A U-S-A U-S-A

Healthcare reform bill stalled

Ok guys, I get it. You got caught up in all the inaugural excitement. We elected Obama assuming “change” meant a thoughtful approach, but you thought we gave you a mandate to turn the country on its keel. So you went after you’re dreams: single payer, sky-rocketing business costs, and reduced carbon output. I can’t blame anyone for going after their dreams. And hey, at least you go that juicy stimulus!

But those darn Democrats, they got in your way. Single payer was compromised into single payer under a different name – then into a public option. Then even that was compromised – first into some fancy long winded name coined by Pelosi that essentially meant public option, and finally, a year later, into nothing more than a list new regulations – more similar to the Republican alternative to Hillary Care than the brilliant progressive stride we were all assuming would slide through. (Eh, regardless of the naïve math and unfunded state Medicaid mandates) And to add insult to injury, you have to buy some of those Dem votes too.

And darn-it – you could have passed it. Hell, you could have passed a bill covering sea lions FFS. I know you’d like to blame the Republicans, but shit man – you knew you had all the power and that’s how you wrote the bill. No Republican could have voted for that thing any more than you guys could all climb on board with invading Iraq! Or – wait. You got tricked on that one – hu? Well, you know what I mean. You can’t blame the dog you’re walking when you walk into a pole – even if he was enthusiastic about it.

So the question is: What now. Indeed, this bill is shot to shit. Stack that monstrosity on the back of the toilet in the staff bathroom. But what now? Should you pole-vault over the wall with Pelosi? Should you try to come to some reasonable consensus with a few reasonable Republicans? Should you keep this unorganized circus with your ring leader off in his own ring singing his poems?

I’m not sure what you should do. I’d like to see some actual reform though.

Congress to cut funding for KSM trial in NY

Every time anyone asks Obama or anyone in his admin a question about trying KSM in civilian court, they duck the question and assure us he’ll be convicted and executed. So if this is just going to be a $1 billion show trial – why not just “have the trial” (wink-wink)? You know – take a few days off, “have the trial,” print up some transcripts and stuff, execute the bastard, and use the $1 billion on some new Predator drones or something.

Don’t ask don’t tell – once again up for debate

What part of “don’t ask don’t tell” is so hard to understand?

I was just thinking about how the unions took the deal they just got with their ‘Cadillac’ healthcare plans?

Personally, and specifically Citibank – I don’t care if they ram it up their ass sideways with the trunk open. But rationally and fundamentally, it’s just another example of the philosophical approach the Left takes to problem solving:

– The élites decide we all are entitled to, or have a right to “this” – home’s, clean water, healthcare, high pay, and so on. Instead of promoting the growth and advancement of “this” – which can often require some pesky effort and understanding – they take the simply approach. They look at how much “this” costs, make up a number of people not currently enjoying “this”, multiply the two, then decide which group of wealthy people to tax for that amount and pass the legislation with a rushing screaming mob under the banners of for-the-little-guy compassion and demonizing their opposition as being “for the status-quo”. –

In this case they want all the banks to pay back all the money tax payers have lost bailing them out. All the banks can’t pay. So the one’s that have paid – the ones with money – Obama wants to force to pay the whole bill. And that might be fair. I don’t know or really care except for the fact that this approach to home ownership was the cause of the bank problems to begin with. And don’t bring up poorly regulated derivative funds. Yeah, they were brand new devices that needed regulation. But what else needed regulation was Fannie and Freddie – which the evil Bush brigade tried to pass legislation for but Franks – and even Obama himself – fought against it successfully. They called the Conservative’s warnings of an impending crash due to Fannie and Freddie fear mongers.

This is great. I watch the news online and listen through the radio. Since the Obamania hit my news sources degraded down mainly to Fox news (online) and Michigan Public Radio. Throughout the day I usually catch the Fox latest videos. This evening I did my normal dabble over on some other cable new websites. I do this mainly just to get a feel for the far left – so I usually go right to MSNBC.

I figured I’d get fed what they’ve been feeding all this year: how wonderful Obama is, how perfect the legislation the Dems are forcing through is, and how hateful, racist, and ignorant everyone is who won’t fall inline behind the President.

Well, I got a little shock today. I usually see two very different worlds on Fox and NPR than I see on MSNBC. But to day, I watched Fox’s videos, and now I’m watching MSNBC’s, and they’re all covering the same thing! Yeah, the op-ed goofballs have a very different tone on each channel, but they’re covering the same bad stuff.

Basically we have some democrats who have suddenly said: “This isn’t healthcare reform man – this isn’t even real healthcare reform!” (Boogie Nights reference)

You all know how I’ve been bitching about Obama’s promise for bipartisanship and CSPAN coverage, then allowing the bills to be written in a locked room full of Dems and insurance people making brazen vote-purchasing deals. So now we have this big obnoxiously ineffective wad of legislation only the most party-line jackass is supporting.

The ideologues are all pissed. Everyone wanting actual healthcare reform and can smell the difference are pissed. And MSNBC is actually covering bad news for Obama! They’re actually showing the same polls Fox was showing. Holy shit hughmiddle? I knew the vague play-the-middle would start catching up with old Barak. Shit, MSNBC is showing that 47% approval poll AGAIN. They’ve showed it like twice as much as Fox I think.

With hind sight it’s easy to see that handing healthcare reform and cap and trade over to Tweedle Dee and Tweedle Dum to ram through while real American are panicking about the economy was a big error. Pelosi and Reid spent the old man’s political capital almost as irresponsibly and they like to spend tax payer cash – and magically created cash for that matter.

Good crap! Maybe the pendulum has finally unstuck from the ceiling over on the left? If this momentum keeps up we’re going to have cheese-stuffed moose sausage at the Whitehouse. Shit – they’re even showing the pro 41% Tea party poll. Crazy.

one must meet aggression with aggression to stop its actions. Obama’s ideas about negotiation aren’t unprecedented. They just don’t work and many who try them fall out of history – because they either do no good or are simply destroyed. The Clinton era was to be an new age of engagement too.

And indeed, I believe in plenty of things that come out of the “Capitalist Manifesto”. It’s proven to work and create a prosperous society. Proven. Now your man Obama, his philosophy actually comes from a philosophy that studies and believes in Marxism. His policies are socialistic. He values ‘fairness’ over risk-reward. He’d rather artificially force a better standard of living for a few union workers, which takes from workers in general, than allow American industry to be more competitive. He’d rather take more income from people and have government decide how to spend it – more fairly. His solution to rising medical costs isn’t to stimulate more medicine – it’s to take over the payment system and short change. He calls tax increases “savings” and disagrees that a penalty is a “tax”.

Now – a discussion on the merits of replacing some efficiency in our society/economy in exchange for more fairness is valid. But that’s not what’s happening. Obama is being dishonest. He’s trying to sell the idea we can increase our efficiency by increasing our fairness, which is outrageous. He’s trying to sell the idea that we can all have better healthcare by allowing more government control, without paying higher taxes, without rationing care, and without hindering medical advancement – which is also ridicules. His philosophy is one that encourages people to feel owed something by society – rights like healthcare, a house, good education, and a high paying job. Any society following that philosophy will certainly be on its way down, like you said. No society who feels owed these things will long be exceptional.

But – a society who sees these things as goals to work hard for, things not everyone gets, that society will soon be exceptional.

Gosh, reminds me of someone else…

Yeah, definitely reminds of someone else, I just can’t quite place it though.