Thursday, December 31, 2009

British parents have 90 days to raise £250,000 for cancer treatment to save son

That's socialized medicine at work for you. Big talk, very limited action. No funds even to save a kid's life. And how odd that the best treatment is in America!

The parents of Jamie Inglis, 4, have been told his only hope is expensive treatment in the US which is only available privately and has to be administered within three months of the end of his chemotherapy. Jamie has been diagnosed with an aggressive form of the childhood cancer neuroblastoma, which began with a tumour on his kidney and spread to the rest of his body.

He has had eight sessions of chemotherapy and went through a seven-hour operation to remove the infected kidney, but his cancer is so virulent he is still expected to relapse, which could kill him. However, a new treatment developed in America could help save him. Doctors say it must be administered within 90 days to reduce his chances of relapsing.

Jamie's father John, 37, an environmental health officer for the Royal Medical Corps, was due to be posted to Afghanistan until he and wife Vicky, 34, a teacher, received the news about their young son in April. He said: "After his final treatment yesterday he has a 90 day window to receive the antibody. Children who have received it so far have shown a rapid improvement and it greatly reduces the chance of a relapse. "His body is so fragile after all the chemotherapy and surgery that a relapse would probably be fatal for him."

Recalling Jamie's diagnosis, he said: "One of the many problems with this form of cancer is the symptoms are so subtle. We noticed Jamie would sweat in the night and seemed tired but he didn't seem too serious until he was taken ill at nursery. "He was taken to his GP who referred him to hospital and we were told he had this rare and aggressive form of cancer. You feel like you have been stabbed in the chest. Just a few days earlier he had been happy and playing at his friend's birthday party. "You just want to curl up in a ball and hope it all goes away. He started chemotherapy within a week and has had regular monthly bouts of chemotherapy since he was diagnosed, as well as having one of his kidneys removed."

The antibody treatment is only available at a cancer hospital in New York and, because it is so new, it is expensive only available privately.

Mr Inglis said: "Hopefully in a few years time this treatment will be far more readily available and much cheaper to children like Jamie suffering from neuroblastoma. But that's obviously too late for him." The family, who also have a five-month-old daughter called Poppy, live near Düsseldorf in Germany, where John has been working.

John added: "Jamie is in good spirits and always has been. The one thing that has kept us going is the fact that he is always smiling. He earned the nickname Prince Charming from the nurses at the hospital, he's so cheery and belligerent. "The military community have been fantastic but we need to raise this £250,000. It's a lot of money but we have to do it, anything to give Jamie a better chance of life."


Decline in British diabetic care

Increase in diabetes patients having limbs amputated

The increase in amputations has almost doubled over a 10 year period with up to 100 patients a week losing a leg to complications of the disease. The number of people diagnosed with type-two diabetes the type caused by obesity - has increased greatly in the past decade, which could partly explain the findings, according to researchers. But doctors believe that with better care up to 80 per cent of amputations could be avoided.

Major amputations, above the ankle joint, have risen by 43 per cent and the average age of those having above-ankle amputations fell from 71 to 69 years, which followed the pattern of more people being diagnosed younger.

Dr Eszter Vamos, from Londons Imperial College, who led the study, said they had expected to see long-term complications of diabetes rising because the number of people diagnosed with the condition had increased. "But at the same time there is very strong evidence that you can prevent up to 80 per cent of the amputations.

Along with complications such as heart attacks and strokes, people with diabetes are far more likely to develop foot problems, including ulcers, which can become infected and lead to gangrene. Researchers believe that better checks by doctors and awareness of symptoms by patients could reduce the need for amputation.

The findings in the journal Diabetes Research and Clinical Practice - highlight the importance of frequent foot checks and getting control of blood sugar levels, blood pressure and cholesterol."

Diabetes UK said more early diagnosis was needed, as diabetes could go undetected for more than 10 years and most people already had complications when they were diagnosed. The charity also said too many people with diabetes are walking barefoot around their houses. It warned that diabetes sufferers are at risk of damage to their feet caused by them being numb, a complication of the disease. Damage can lead to foot ulcers and slow- healing wounds which, if they become infected, can result in amputation. Podiatrists recommend that people with diabetes should always wear slippers around the home to reduce the risk of foot injuries.

Caroline Butler, care adviser at Diabetes UK, said: "It's appalling that thousands of people with diabetes in the UK undergo lower limb amputations every year. We want to help reduce that number by getting people with diabetes to wear suitable slippers at home.


Rasmussen: Obamacare Disapproval at New High

Rasmussen's health-care polling results since Senate Majority Leader Harry Reid orchestrated the Christmas Eve vote are full of undeniably bad news for Democrats. In roughly ascending order of bad news (if one is a Democrat)...

Likely voters oppose Obamacare by more than the (18-point) margin by which Ronald Reagan beat Walter Mondale: 58 percent to 39 percent.

There are far more likely voters who "strongly" oppose Obamacare (46 percent) than there are likely voters who support it even "somewhat" (39 percent).

Only 24 percent of likely voters think that the quality of health care would get better under Obamacare, while 54 percent think it would get worse -- a gap of 30 percent.

Only 13 percent of likely voters think that the cost of health would go down under Obamacare, while 63 percent think it would rise -- a gap of 50 percent.

Seniors oppose Obamacare by more than 2 to 1: 63 percent to 31 percent.

And the worst news of all for Democrats...

Independents oppose Obamacare by the head-turning tally of 66 percent to 28 percent.

Lest Democrats try to console themselves with the thought that perhaps Rasmussen has got it wrong, CNN's latest poll, from just a few days before the Christmas Eve vote, showed Americans opposing Obamacare by a similar tally: 56 percent to 42 percent.

In light of these numbers -- and in light of the extreme difficulty that the Democrats had in squeezing a bill tailor-made for the House through the House, and one tailor-made for the Senate through the Senate -- anyone who thinks that either the passage or the subsequent implementation of Obamacare is anything remotely resembling inevitable, is forgetting that Tocqueville's book wasn't called Monarchy in America.


Ten New Reasons Why Obamacare Can Still Be Killed

New reasons emerge almost daily as to why Obamacare can and must be defeated.

1. The American people oppose Obamacare by almost 2 to 1 in the latest CNN poll. Other polls show lopsided opposition to passing either the Senate or House health-care bill.

Public opinion is against the bill because of its obscene costs in higher taxes, burdensome debt, anti-freedom mandates, rationing, and reduced care for seniors. The American people have awakened to the fact that Obamacare is transformational legislation that will drag us against popular will into European-style Socialism.

2. The Democrats' double-counting of Obamacare's financial benefits has been exposed as a colossal lie. Harry Reid told the Senate that his bill strengthens our future by both "cutting our towering national deficit by as much as $1.3 trillion over the next 20 years" AND "strengthening Medicare and extending its life by nearly a decade."

The Congressional Budget Office (CBO) refuted that assertion. CBO said the claim that Obamacare would provide these benefits simultaneously "would essentially double-count a large share of those savings and thus overstate the improvement in the government's fiscal position."

3. Obamacare is unconstitutional because of its mandate that all individuals must carry "approved" health insurance, and all businesses must give health insurance to their employees whether or not the company can afford it. "Universal" coverage will be enforced by the Internal Revenue Service with power to punish those who don't have such a plan.

Constitutional lawyers point out that the Commerce Clause does not give Congress the authority to force Americans to buy health insurance as a condition of living in our country because personal health insurance is not "commerce." The CBO wrote that "a mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action"; the Supreme Court has never upheld any requirement that an individual must participate in economic activity.

4. Since the Senate bill imposes sharp limits on health-insurance companies' ability to raise fees or exclude coverage, it likely will force many of them out of business. Obamacare is unconstitutional because it violates the Bill of Rights protections against takings without just compensation and deprivation of property without due process of law.

5. Other Obamacare provisions blatantly legislate racial and other forms of discrimination. The U.S. Commission on Civil Rights sent two letters to the President and congressional leaders warning about the obnoxious requirements for racist and sexist quotas.

The Senate bill requires that "priority" for federal grants be given to institutions offering "preferential" admissions to minorities (race, national origin, sex, sexual orientation, and religion). Institutions training social workers, psychologists, psychiatrists, behavioral pediatricians, psychiatric nurses, and counselors will be ineligible for federal grants unless they enroll "individuals and groups from different racial, ethnic, cultural, geographic, religious, linguistic, and class backgrounds, and different genders and sexual orientations."

6. Obama's claim that "everybody" will now be covered creates few winners but lots of losers. Universal health insurance will be achieved by forcing young people to pay the additional costs (insurance for the youngest third of the population would rise by 35 percent), and by restricting and rationing care for the elderly.

7. According to Robert Samuelson in the Washington Post, the "wild card is immigration." From 1999 to 2008, 60 percent of the increase in the uninsured occurred among Hispanics, and Obama's refusal to close our borders will make this problem more costly every year.

8. Obamacare gives Medicare bureaucrats the power to ration health care by forcing doctors to prescribe cheaper medical devices and drugs. In the recent case of Hays v. Sebelius, the court ruled that Medicare doesn't have the right to make this rule, but Obamacare takes jurisdiction away from the courts to hear any appeal from decisions of the new Medicare Commission.

The "stick" applied to primary-care doctors is imposing financial penalties if they refer too many patients to specialists. The "carrot" is financial rewards to doctors who give up small practices and consolidate into larger medical groups or become salaried employees of hospitals or other large institutions.

9. The Senate bill contains at least a dozen of what can be described as bribes. Senator Mary Landrieu received a $300 million increase in Medicaid funding for her state (known as the Second Louisiana Purchase), and a $100 million bribe to Senator Ben Nelson gives Nebraska a permanent exemption from the costs of Medicaid expansion.

10. The Senate bill even has a four-page section artfully written to enable ACORN to get federal health-care grants. This section describes grant recipients as "community and consumer-focused nonprofit groups" having "existing relationships ... with uninsured and underinsured consumers."


About Those “Death Panels”

It seems inevitable that the government will grab the remains of “private” medical care, so I will look at our medical futures. One development will be the implementation of the infamous “death panels” that socialists swear are a figment of the imaginations of paranoid persons like Sarah Palin.

For example, I received emails from the religious left-wing organization “Sojourners,” which declared that Palin was lying when she made the comment last August 7 in her Facebook page that declared:
The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

In the ensuing firestorm, the New York Times called it a “false rumor,” and the “fact checkers” at the Politifact website named her statement the “Lie of the Year.” Kate Snow of ABC News said the claim was “shocking” and “inflammatory.”

Neither the House nor the Senate bills use the phrase “death panels,” but that is not surprising. None of the other countries that have socialist care actually have committees with that name. However, the “death panel” mentality certainly exists, and it exists precisely because socialist medical care exists not for care of individuals, but rather to enforce larger egalitarian political goals.

Ironically, the New York Times provides the “smoking gun” to the egalitarian mentality that leads to the “death panels” route. The paper last year carried a story about a British woman, Debbie Hirst, who suffered from cancer, but could not receive the medications she needed because the National Health Service declared them too costly.

Hirst decided to raise the money herself by selling her house, but the government said that if she did that, then it would not pay for any of her care:
Officials said that allowing Mrs. Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones.

Patients “cannot, in one episode of treatment, be treated on the N.H.S. and then allowed, as part of the same episode and the same treatment, to pay money for more drugs,” the health secretary, Alan Johnson, told Parliament.

“That way lies the end of the founding principles of the N.H.S.,” Mr. Johnson said.

In other words, unless one can justify one’s treatment under larger socialist purposes, then the government will be happy to let someone die, for enforced egalitarianism trumps actual care. This is not something new. Writing in the November 1993 Freeman, Dr. Jane Orient noted that government medical “cost containment” is another term for denying care:
The global budgeters “contain costs”—ration health care by denying those things that you do need insurance to pay for: heart surgery, radiation treatments for cancer, hip replacements, things like that. Out of “compassion,” reformers may open another exit: the one that leads to the cemetery. Do you think it’s accidental that euthanasia and “universal access” are on the agenda at the same time?

Thomas Sowell is correct. Entrepreneurs lower real costs by finding ways to create more goods and using fewer resources. Governments “lower” costs via raw force or denying medical care, and if a person offers to pay for the care, well, that defeats the real purpose of socialism. Yet, we are told that private entrepreneurship in medical care is evil and medical socialism is good. People who accept such things as being true also will endorse the presence of “death panels,” even while denying that the panels exist.


Government health care is a children's fable

In the spirit of the Christmas season, let me offer up the following analogy for why health care reform, as envisioned by congressional Democrats, won't work.

Imagine that you're a child and you wake up on Christmas morning. Instead of that bike you wanted, there's a note under the tree saying that a lot of kids want bikes and the elves' workshop is backlogged for years. Don't worry -- you're guaranteed to get a bike, but Santa says that unfortunately he can't tell you where or when you might finally get that bike you're owed. Here's the part where my festive analogy breaks down: If you don't get that bike soon, you might die.

That's the problem with Democrats' health care legislation in a nutshell. It promises coverage for millions of Americans, but a government IOU is a far cry from seeing a doctor when you need one. And yet, the Senate health care legislation promises to expand Medicaid coverage to those making up to 133 percent of the federal poverty level. Do that would make 11 million more Americans dependent on a program that's already broken. The government can't compel doctors to treat Medicaid patients at fixed rates they dictate, at least not yet.

The policy outcome is Econ 101: Price controls always result in scarcity. Over half of all specialists in many major metropolitan areas are refusing to take on new Medicaid patients, according to a 2009 survey by Merritt Hawkins and Associates on physician wait times. "Medicaid is not widely accepted in most markets surveyed, in at least some of the medical specialties reviewed, and, in some cases, all of them," according to the survey.

The practical consequences of the government printing more health care IOUs than doctors can handle are horrifying. The Baltimore Sun recently reported that state auditors found 250 people out of the 17,000 people listed on the state's Medicaid waiting list are deceased. Other states have similarly outsized Medicaid backlogs of people desperate for medical care.

The worst part is that Democrats lean heavily on Medicaid as cost control mechanism in their health care legislation, even though they know it doesn't provide adequate care.

While hashing out the Senate's health care legislation, Democrats rejected a Republican amendment to increase Medicaid reimbursement rates to the same level as Medicare. It didn't pass. Democrats fought with a Republican president over expanding the State Children's Health Insurance Program (SCHIP) just a few years ago.

But Sen. Jay Rockefeller, D-W.V., a multi-millionaire oil scion, axed expanding SCHIP in favor of putting kids in Medicaid, cutting the price tag on the current legislation. The SCHIP program utilizes private insurance and costs more, but that also means there are many more doctors willing to treat kids with SCHIP coverage.

This is the same reason why the Democrats are gutting $122 billion out of the popular Medicare Advantage program. Medicare Advantage allows for private insurance through Medicare, and consequently it's more expensive. In 2003, there were 5.3 million Americans enrolled in Medicare Advantage. As of 2009, there were 10.2 million Americans enrolled in Medicare advantage -- including more than one-in-three Medicare recipients in New York and California. Why the explosion of people enrolled in Medicare advantage? More doctors take private insurance with better reimbursement rates. A 2008 report by the Medicare Payment Advisory Commission found 29 percent of Medicare patients have trouble finding a primary physician.

Health care for all Americans is a noble goal, but adding 11 million more Americans to an overtaxed Medicaid system is not the way to do it. For far too many Americans, the prospect of getting good health care through the government insurance is a lot like Santa Claus. It doesn't exist.


Wednesday, December 30, 2009

British hospital food campaigns 'have failed'

Lots of patients come out of British hospitals with malnutrition but more than £50 million spent on bids to improve hospital food has been wasted, according to a recent report

Researchers said 17 separate government initiatives since 2000 had resulted in no discernable improvement in the quality of meals served to patients and a change in the law was needed. Alex Jackson, from the Good Food for our Money campaign which published the report, said the initiatives had been a missed opportunity. He said: "The Government has led us into an expensive ground hog day to improve hospital food and seems incapable of learning from past mistakes.

"One billion meals are served by public sector institutions every year, paid for by taxpayers' money. This huge amount of food provides a unique opportunity to improve health and encourage more sustainable farming. Yet the Government has failed to seize this opportunity, and continues to spend our money on issuing weak voluntary schemes and yet more 'guidance' to public sector caterers, who are given no incentive to take action."

The authors of the report, called A Decade of Hospital Food Failure, want to see the introduction of legal standards guaranteeing the quality of the food and its environmental benefits.

Among the schemes criticised was the £40 million Better Hospital Food Initiative which was launched in 2001, headed by former Masterchef host Loyd Grossman, before being scrapped five years later. It set a target for all hospitals to introduce at least three new meals from its menu, but figures from the Hospital Caterers Association found after five years a quarter of NHS trusts had failed to introduce a single dish.

The report also quoted researchers from Bournemouth University who tested the quality of food in hospitals earlier this year and found patients were often left "undernourished and hungry" and would be better fed in prison.

The Good Food for our Money campaign is organised by Sustain, a charity that campaigns for better food, whose members include Christian Aid, Friends of the Earth and the Wholesome Food Association.


Bungling NHS fraud busters

NHS fraud investigations cost three times more than they recover

A fraud squad dedicated to detecting those cheating the National Health Service has cost three times as much money as it recovered, new figures have revealed. Over the last three years, the budget of the NHS Counter Fraud unit was £32.4 million, while the squad recovered £10.1 million. The figures, contained in a Parliamentary written answer obtained by the Liberal Democrats, also show that fewer than 200 convictions were secured.

Norman Lamb, the party’s health spokesman, said that the unit was failing to deliver value for money. He added: “Tackling fraud and ensuring that every penny spent by the NHS can be accounted for is a vital task. There must be serious question marks over whether this unit is working effectively. “It is clear from these figures that the current approach isn’t working.

The NHS needs to work more closely with the police to tackle fraud at a local level and ensure that every penny possible goes to frontline services. “These figures raise serious questions about whether a dedicated NHS Counter Fraud Unit is the best way to tackle this complex issue. We need an urgent review of how fraud is investigated.”

Fraud is estimated to cost the NHS £115 million a year.


Surprise: NYT Discovers Spending Money on Frail Elderly Not Always Useless

After a year of front-page stories pushing not so subtly for reductions in “costly” end of life care for the old and “frail” (as a precursor for the kind of universal health care the editors favor) reporter Reed Abelson looked at the other side of the debate in a December 23 front-page piece from Los Angeles, an entry in the paper’s new “Months to Live“ series: “U.C.L.A. Medical Center at Heart of End-of-Life Debate.”
The Ronald Reagan U.C.L.A. Medical Center, one of the nation’s most highly regarded academic hospitals, has earned a reputation as a place where doctors will go to virtually any length and expense to try to save a patient’s life.

“If you come into this hospital, we’re not going to let you die,” said Dr. David T. Feinberg, the hospital system’s chief executive.

Yet that ethos has made the medical center a prime target for critics in the Obama administration and elsewhere who talk about how much money the nation wastes on needless tests and futile procedures. They like to note that U.C.L.A. is perennially near the top of widely cited data, compiled by researchers at Dartmouth, ranking medical centers that spend the most on end-of-life care but seem to have no better results than hospitals spending much less.

Listening to the critics, Dr. J. Thomas Rosenthal, the chief medical officer of the U.C.L.A. Health System, says his hospital has started re-examining its high-intensity approach to medicine. But the more U.C.L.A.’s doctors study the issue, the more they recognize a difficult truth: It can be hard, sometimes impossible, to know which critically ill patients will benefit and which will not.

That distinction tends to get lost in the Dartmouth end-of-life analysis, which considers only the costs of treating patients who have died. Remarkably, it pays no attention to the ones who survive.

Take the case of Salah Putrus, who at age 71 had a long history of heart failure. After repeated visits to his local hospital near Burbank, Calif., Mr. Putrus was referred to U.C.L.A. this year to be evaluated for a heart transplant. Some other medical centers might have considered Mr. Putrus too old for the surgery. But U.C.L.A.’s attitude was “let’s see what we can do for him,” said his physician there, Dr. Tamara Horwich.

Indeed, Mr. Putrus recalled, Dr. Horwich and her colleagues “did every test.” They changed his medicines to reduce the amount of water he was retaining. They even removed some teeth that could be a potential source of infection. His condition improved so much that more than six months later, Mr. Putrus has remained out of the hospital and is no longer considered in active need of a transplant.

One certainly doesn't see admissions like this in the Times very often:
Indeed, U.C.L.A. and five other big California medical centers recently published their own research results with a striking conclusion: for heart failure patients, the hospitals that spend the most seem to save the most lives


Obamacare: Less Healthcare For More People

Over the Christmas holiday lull, I saw one commenter support Obamacare on the purely utilitarian grounds that the government should do that which benefits the most people. I almost spit out my eggnog. Obamacare will actually harm most people to benefit the minority by reducing the level of medical care we now receive so that the minority can get greater access. I am not saying that is wrong–protecting minorities is usually a very worthy endeavor. But that statement just wasn’t true. For better or worse, the point of Obamacare is to provide less health care for more people, not better health care or more affordable health care.

None other than the liberal columnist Bob Herbert sees it and complains that union members will be hurt by that agenda in today’s New York Times. He writes against taxing so-called “Cadillac” insurance policies–most of which are enjoyed by union members, and reveals an important truth. From his column:
The bill that passed the Senate with such fanfare on Christmas Eve would impose a confiscatory 40 percent excise tax on so-called Cadillac health plans, which are popularly viewed as over-the-top plans held only by the very wealthy. In fact, it’s a tax that in a few years will hammer millions of middle-class policyholders, forcing them to scale back their access to medical care. Which is exactly what the tax is designed to do.

Precisely. And that “cost cutting” agenda is the law’s primarily thrust–which is why the expensive for whom to care will find themselves rationed out.

Moreover, since another primary purpose of the bill is to grant the government greater power over all our lives to promote the cultural agendas of the Left, Obamacare exacerbates the cuts to come by expanding the meaning of health care to encompass non medical things, like paying counselors visit the homes of families with small children. When the health care financing system pays for non health care services, it will mean, by definition, there will be less money to pay for the delivery of true medicine.


Why the Personal Mandate to Buy Health Insurance Is Unprecedented and Unconstitutional

Some excerpts from an extensive legal analysis of the interstate commerce clause and the Supreme Court's most expansive precedents

Executive Summary

A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States. An individual mandate would have two features that, in combination, would make it unique. First, it would impose a duty on individuals as members of society. Second, it would require people to purchase a specific service that would be heavily regulated by the federal government.[1]

This statement from a 1994 Congressional Budget Office Memorandum remains true today. Yet, all of the leading House and Senate health-care reform bills being debated in Congress require Americans to either secure or purchase health insurance with a particular threshold of coverage, estimated by CBO to cost up to $15,000 per year for a typical family.[2] This personal mandate to enter into a contract with a private health insurance company is enforced through civil and criminal tax penalties in section 501 of the House bill[3] and with a freestanding mandate and equally questionable civil tax penalties in sections 501 and 513 of the pending Senate bill.[4]

The purpose of this compulsory contract, coupled with the arbitrary price ratios and controls, is to require many people to buy artificially high-priced policies to subsidize coverage for others as well as an industry saddled with other government costs and regulations. Congress lawfully could enact a general tax to pay for these subsidies or it could create a tax credit for those who buy health insurance, but that would require Congress to "pay for" or budget for the subsidies in a conventional manner. The sponsors of the current bills are attempting, through the personal mandate, to keep the transfers entirely off budget or--through the gimmick of unconstitutional taxes or penalties they dub "shared responsibility payments"--make these transfers appear to be revenue-enhancing.

This "personal responsibility" provision of the legislation, more accurately known as the "individual mandate" because it commands all individuals to enter into a contractual relationship with a private insurance company, takes congressional power and control to a striking new level. Its defenders have struggled to justify the mandate by analogizing it to existing federal laws and court decisions, but their efforts do not withstand serious scrutiny. An individual mandate to enter into a contract with or buy a particular product from a private party, with tax penalties to enforce it, is unprecedented-- not just in scope but in kind--and unconstitutional as a matter of first principles and under any reasonable reading of judicial precedents.

Congress has a responsibility, pursuant to the oath of all Senators and Representatives, to determine the constitutionality of its own actions independently of how the Supreme Court has previously ruled or may rule in the future. But it is very unlikely that the Court would extend current constitutional doctrines, or devise new ones, to uphold this new and unprecedented claim of federal power.

Constitutional Overview

In reaction to states that were enacting trade barriers and violating the rights of their citizens, those who drafted and ratified the U.S. Constitution were determined both to constrain the powers of states and, at the same time, limit the power of Congress. They designed an ingenious system of checks and balances that divides state and federal authority in the hope of preventing any one government from exerting too much control over a free people.[5] To that end, the Constitution creates a national government with a legislature of limited and enumerated powers. Article I allocates to Congress "[a]ll legislative powers herein granted,"[6] which means that some legislative powers remain beyond Congress's reach. The Constitution's Necessary and Proper Clause similarly grants Congress the power "[t]o make all laws which shall be necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this Constitution in the government of the United States, or in any department or officer thereof."[7]

The Supreme Court recognized and affirmed this fundamental principle from the earliest days of the republic, as Chief Justice Marshall famously observed: "The powers of the legislature are defined and limited; and that those limits may not be mistaken, or forgotten, the constitution is written."[8] And in his canonical opinion interpreting the Necessary and Proper Clause, Chief Justice Marshall insisted that "should Congress, under the pretext of executing its powers, pass laws for the accomplishment of objects not entrusted to the [national] government; it would become the painful duty of this tribunal, should a case requiring such a decision come before it, to say that such an act was not the law of the land."[9]

Nowhere in the Constitution is Congress given the power to mandate that an individual enter into a contract with a private party or purchase a good or service and, as this paper will explain, no decision or present doctrine of the Supreme Court justifies such a claim of power. Therefore, because this claim of power by Congress would literally be without precedent, it could only be upheld if the Supreme Court is willing to create a new constitutional doctrine. This memorandum explains why the two powers cited by supporters of this bill--the power of Congress to regulate interstate commerce and the power of Congress to tax--do not justify an individual mandate, even under the most expansive readings given these powers by the Supreme Court. In particular, this paper addresses four topics that have not yet been given adequate consideration by Congress and most, if not all, of the commentators:

First, most arguments, either favoring or opposing the individual mandate, do not discuss the Supreme Court's "class of activities" test, which it has applied in every relevant Commerce Clause case. This paper addresses this oversight and argues that, despite the broad congressional power to regulate interstate commerce, the individual mandate provision fails this test and is unlikely to survive the Court's review.

Second, this paper addresses the common, but mistaken, suggestion that a universal federal mandate to obtain health insurance is no different than a state requiring its licensed automobile drivers to have liability insurance for their injuries to others.

Third, this paper analyzes claims arising under the Taxing Clause. A preliminary review raises serious questions about the constitutionality of using the taxing power in this manner.

And finally, this paper explains why it is highly unlikely that the Supreme Court would break new constitutional ground to save this unpopular personal mandate.....


In theory, the proposed mandate for individuals to purchase health insurance could be severed from the rest of the 2,000-plus-page "reform" bill. The legislation's key sponsors, however, have made it clear that the mandate is an integral, indeed "essential," part of the bill.[54] After all, the revenues paid by conscripted citizens to the insurance companies are needed to compensate for the increased costs imposed upon these companies and the health care industry by the myriad regulations of this bill.

The very reason why an unpopular health insurance mandate has been included in these bills shows why, if it is held unconstitutional, the remainder of the scheme will prove politically and economically disastrous. Members need only recall how the Supreme Court's decision in Buckley v. Valeo--which invalidated caps on campaign spending as unconstitutional, while leaving the rest of the scheme intact--has created 30 plus years of incoherent and pernicious regulations of campaign financing and the need for repeated "reforms." Only this time, the public is aligned against a scheme that will require repeated unpopular votes, especially to raise taxes to compensate for the absence of the health insurance mandate.

These political considerations are beyond the scope of this paper, and the expertise of its authors. But Senators and Representatives need to know that, despite what they have been told, the health insurance mandate is highly vulnerable to challenge because it is, in truth, unconstitutional. And political considerations aside, each legislator owes a duty to uphold the Constitution.

Much more here

Tuesday, December 29, 2009

British government seizes hospital charity money

It seems to be aiming to treat donations as part of what the government pays to hospitals -- so that it can reduce what it actually pays. So donations to a particular hospital will no longer benefit it and might as well not be made. Very socialist but incredibly stupid

Hundreds of millions of pounds of charity donations to hospitals are to be “nationalised” under an NHS accounting change, which critics say will make it easier to slash health budgets. Ministers are imposing new rules on NHS charities requiring all donations — including those to specialist children and cancer units, local fundraising campaigns, teaching hospitals and local community trusts — to be listed on a hospital’s balance sheet.

The Charities Commission says that this is “wholly inappropriate” because combining the trust and charity accounts will jeopardise the charity’s autonomy and discourage donations. About £330 million was given to 300 NHS charities in the year to June 2008, and they control an estimated £2 billion of assets. A spokeswoman for the Commission said: “The Charity Commission does not agree with the interpretation of the accounting rules in the Department of Health letter to NHS bodies. We are currently engaging with the Department on this matter.”

Charities also fear that the change, due to come into effect in April, will be used as a smokescreen to hide cuts in health spending, with ministers reducing funds for organisations such as children’s hospitals that have successful charitable arms. Jenny Willott, a Cabinet Office spokeswoman for the Liberal Democrats, said: “This could lead to hundreds of millions of pounds of charitable donations being effectively nationalised under the NHS. “The Government has no right to get its hands on any charitable NHS funds. People make donations on the understanding that it is up to charities to decide how to spend it, not ministers.”

A source at a leading hospital said that the rule change appeared entirely unreasonable and risked creating unnecessary budgetary pressures and distorted disparities between hospitals with different levels of fundraising ability.

Ministers were banned from counting charitable donations towards the central NHS budget under the original legislation that created the NHS in 1948. But this looks set to be reversed after the Treasury agreed to implement International Accounting Standard (IAS) 27. Now all NHS Trusts whose trustees have the “power to control” their charitable arm look likely to be forced to consolidate both sets of accounts in one. Estimates of the number of NHS charities affected vary between 30 and 300 organisations.

A Department of Health spokesman said: “The accounting rule does not change the fact that the deployment of all the monies donated remain the responsibility of the trustees.” The spokeswoman denied that the change would stop NHS charities from claiming Gift Aid.


The massive accounting blunder that should sink U.S. healthcare reform

Yesterday, David discussed the CBO's miscalculation regarding the Senate health care bill. Democrats had been insisting that bill somehow cut the deficit and strengthened Medicare, but as it turns out the CBO had to clarify that the savings of the bill were being double counted. The "savings" the bill produces either have to be applied toward the Medicare trust fund or they have to be put toward the cost of the legislation to make it reduce the deficit by $132 billion over the next ten years. (That's assuming you buy into the shady accounting tricks used to score the bill.) Megan McArdle has a typically astute blog post up discussing the implications all of this. Megan even observes that as recently as Saturday, President Obama was trumpeting the bill's twin achievements of deficit reduction and strengthening Medicare. However, Megan didn't quote Obama in full -- fortunately The American Spectator's Phil Klein did. The entirety of Obama's remarks in the immediate aftermath of Senate Democrats securing finally securing 60 votes to pass their health care bill are worth pondering:
"This bill with strengthen Medicare and extend the life of the program. Because it’s paid for and gets rid of waste and inefficiency in our health care system this will be the largest deficit reduction plan in over a decade. In fact, we just learned from the Congressional Budget Office that this bill will reduce our deficit by $132 billion over the first decade of the program, and more than one trillion dollars in the decade after that."

Well, we now know that whether it was an innocent mistake or fiscal prestidigtation, one of these claims is simply not true. Which is all the more reason you don't railroad an unpopular bill through in the middle of the night, as this episode proves conclusively that the Senate can't be trusted not to make mistakes involving literally hundreds of billions of dollars.

But the bottom line is that this is a massive, massive blunder and the President and the Senate Democrats need to come clean about it. They sold the American people, or tried to anyway, on specific promises regarding deficit reduction and preserving Medicare. Now they can't be sure of either of those promises. And Joe Taxpayer should probably be scared has heck about what else they've overlooked regarding the consequences of health care legislation.

If the President and Senate Democrats are serious about their repeated promises to produce health care reform that saves money in the long-term, then they're going to have to scrap what they've got and go back to the drawing board. But nothing in the way that health care legislation has been handled so far suggests that Democrats are hoping for anything other than a short-term, ego-driven legislative victory.


Like Mushrooms, Health Care 'Reform' Flourishes in the Dark

In a key scene in Frank Capra's 1939 film "Mr. Smith Goes to Washington," appointed senator (and unwitting pawn in a corruption scheme) Jefferson Smith, played by Jimmy Stewart, suggests to a colleague that perhaps it would be a good idea to read bills before voting on them. "The bills?" responds an incredulous Senator Paine, played by Claude Rains. "These bills are put together by legal minds after long study. I can't understand half of them myself, and I used to be a lawyer." Forget it, he tells Smith. "When the time comes, I'll advise you how to vote."

Never has art so closely mirrored life as with the mammoth 2,100-page health care bill passed by the Senate. "The result makes no sense whatsoever -- not to conservatives, not to liberals, not to anyone," accurately concludes the Weekly Standard. "Rather than reform a system that everyone agrees is a failure, it will subsidize that system and compel participation in it."

Many who have long touted health care reform are turning up their noses at the final product. Michael Bloomberg, New York's independent mayor, told "Meet the Press" over the weekend: "I have asked congressperson after congressperson. Not one can explain to me what's in the bill, even in the House version. Certainly not in the other version. And so for them to vote on a bill that they don't understand whatsoever, really, you've got to question how -- what kind of government we have."

Mr. Bloomberg added that his own reading of the Senate bill led him to conclude that it would blow a hole in the New York State budget and force closure of perhaps 100 health clinics.

It's no wonder Congress and the White House are so determined to hide their handiwork from the public while the House and Senate versions are "reconciled." President Obama has said the negotiations will take place in the West Wing and he will be actively involved. But when ABC's Jake Tapper asked White House Press Secretary Robert Gibbs about the president's campaign pledge to "have the [health care] negotiations televised on C-SPAN," Mr. Gibbs dodged the question and took refuge in his talking points, insisting that voters already "have a pretty good sense of who is battling on behalf of thousands of lobbyists that are trying to protect drugs profits and insurance profits, and who's fighting on behalf of middle-class Americans."

In other words, no one in the White House wants the public to be looking on as this Frankenstein monster is finally stitched together.


Democrats on the Health-Care Precipice

Enacting health-care legislation in the face of overwhelming public disapproval may cost the party its chance of forging a sustainable majority

Barack Obama emerged from his meeting with Senate Democrats this week to claim Congress was on the "precipice" of something historic. Believe him. The president is demanding his party unilaterally enact one of the most unpopular and complex pieces of social legislation in history. In the process, he may be sacrificing Democrats' chances at creating a sustainable majority.

Slowly, slowly, the Democratic health agenda is turning into a political suicide pact. Congressional members have been dragged along by momentum, by threat, by bribe, but mostly by the White House's siren song that it would be worse to not pass a bill than it would be to pass one. If that ever were true, it is not today.

Public opinion on ObamaCare is at a low ebb. This week's NBC-WSJ poll: A mere 32% of Americans think it a "good" idea. The Washington Post: Only 35% of independents support it—down 10 points in a month. Resurgent Republic recently queried Americans over the age of 55, aka Those Most Likely to Vote In a Midterm Election. Sixty-one percent believe ObamaCare will increase their health costs; 68% believe it will increase the deficit; 76% believe it will raise their taxes.

Democrats also have managed to alienate the liberal base to which they were catering. The death of the public option and Medicare buy-in this week sent Howard Dean to thundering "kill the bill." A week from now, the current polls might look good.

Yet it is in individual states where the disconnect between the White House's soothing words and the ugly political reality is most stark. While Democrats are under fire for the economy and spending, it is health care that has voters thinking it's time for political change.

Consider North Dakota. A recent Zogby poll showed 28% (you read that right) of state voters support "reform." A full 40% said they'd be less likely to vote for Democratic Sen. Byron Dorgan next year if he supports a bill. In a theoretical matchup with Republican Gov. John Hoeven (who has yet to announce), Mr. Hoeven wins 55% to 36%. Mr. Dorgan has been in the Senate 17 years; he won his last election with 68% of the vote. This should not be happening.

In Arkansas, 32% support this health-care legislation. Sen. Blanche Lincoln, also running next year, trails challengers by more than 50 points among the 56% of voters who strongly disapprove of the health plan. Senate Majority Leader Harry Reid, the public face of health reform, can barely break 38% approval in Nevada. In Colorado, where 55% of voters oppose a health bill, appointed Democratic Sen. Michael Bennet told CNN he'd vote for a bill even if it "cost him his job." Give the freshman credit for honesty.

Nor is this a red state/swing state phenomenon. In deep-blue Delaware, 46% oppose the health plan. Democrats pounded Delaware GOP Rep. Mike Castle, running for Senate, for voting against the House bill. That vote has in fact kept Mr. Castle leading his expected opponent, Beau Biden, the vice president's son. Chris Dodd helped author the Senate health bill and is up for re-election next year. He is arguably the Senate's most politically vulnerable Democrat.

Don't trust the polls? In the past weeks, four well known House Democrats announced they will not run for re-election. All are longtime incumbents; one, Tennessee's respected John Tanner, co-founded the Blue Dog coalition. These folks have seen the political handwriting on the wall.

Democrats have also been pulled by another White House promise: That once Americans witness reform, they will turn around. Yet even supporters know this ugly bill will not "fix" health care. The problems will remain—with more in addition—and Democrats will own them. Meanwhile, the backlash against the pending health-care legislation is seeping out to hamper Democrats' broader agenda. Pew this week published a poll in which it marveled (fretted?) over the "extent to which the public has moved in a conservative direction on a range of issues" since President Obama took office.

So why the stubborn insistence on passing health reform? Think big. The liberal wing of the party—the Barney Franks, the David Obeys—are focused beyond November 2010, to the long-term political prize. They want a health-care program that inevitably leads to a value-added tax and a permanent welfare state. Big government then becomes fact, and another Ronald Reagan becomes impossible. See Continental Europe.

The entitlement crazes of the 1930s and 1960s also caused a backlash, but liberal Democrats know the programs of those periods survived. They are more than happy to sacrifice a few Blue Dogs, a Blanche Lincoln, a Michael Bennet, if they can expand government so that in the long run it benefits the party of government.

What's extraordinary is that more Democrats have not wised up to the fact that they are being used as pawns in this larger liberal game. Maybe Mr. Obama will see a bump in the polls if health care passes; maybe not. What is certain is that this vote is becoming one that many in his party will not survive.


House backers of public insurance option may yield

Two House Democrats who favor a government insurance plan, a central element of health care legislation passed in their chamber, acknowledged Sunday it might have to be sacrificed as negotiators work out a final agreement with the Senate. Rep. James Clyburn of South Carolina, the No. 3 Democrat in the House and one who had appealed to President Barack Obama not to yield on the public plan, set out conditions for yielding himself. Asked during rounds on the Sunday news shows whether he could vote for a final bill that does not embrace a public plan, Clyburn said: "Yes, sir, I can."

Clyburn added: "We want a public option to do basically three things: Create more choice for insurers, create more competition for insurance companies, and to contain costs. So if we can come up with a process by which these three things can be done, then I'm all for it. Whether or not we label it a public option or not is of no consequence."

While insisting "it's not dead," Rep. Chris Van Hollen of Maryland said he recognizes realities in the Senate, where Democrats had to scrape up every vote from their side even to pass a bill without a government plan to compete in the private insurance marketplace. "Before the House was to give up the public option, we would want to be persuaded that there are other mechanisms in whatever bill comes out that will keep down premiums," said Van Hollen, appearing to sketch out a bottom line without a government plan necessarily included. "We've got to make sure that the final product is affordable."

Sen. Robert Menendez, D-N.J., underscored the divisions Democrats will need to bridge when negotiators from the House and Senate meet next month to reconcile the two bills. He said there will need to be more give on the House side than the Senate, which took weeks to find the 60 votes needed for passage. "If we are going to have a final law, it will look a lot more like the Senate version than the House version," Menendez asserted.

The Senate's Christmas Eve achievement brought the nation closer than it's been for generations to a new order in health insurance, one that would eventually require nearly all Americans to get coverage, help many pay for it and restrict onerous insurance company practices such as denying coverage to people with pre-existing sickness. But nothing will change for anyone until the House and Senate can settle on common legislation, pass it and send it to Obama to sign.

The high stakes have both parties hoping they can find a few converts from the other side. Nearly every Republican in Congress has opposed the measures. "If some of the Republicans would come forward with suggestions - offer a vote or two, or three or four - to take away the need to have every last one of the 60 Democrats, you'd have a much better bill in accordance with the tradition of the Congress, especially the Senate, on bipartisanship," said Democratic Sen. Arlen Specter of Pennsylvania, himself a party switcher.

Republican Sen. Jim DeMint of South Carolina voiced similar hope, to opposite ends - "a few Democrats to stand up in the House that maybe didn't before and help us stop this thing." DeMint, Van Hollen, Menendez and Specter spoke on "Fox News Sunday." Clyburn was on CBS'"Face the Nation" and CNN's "State of the Union."


Monday, December 28, 2009

British Conservative leader meets NHS privatisation campaigners

David Cameron has met a health care pressure group that advocates full privatisation of the National Health Service - a meeting that could infuriate doctors and nurses. The Conservative leader held an hour of talks with the leader of the group Nurses For Reform (NFR) in his private office in the Commons two weeks ago.

His decision to meet the radical group, which calls the NHS a "dystopian, Soviet-style calamity", will be seen as foolhardy after the painstaking efforts he has made to reassure voters that the NHS is safe in Tory hands. The meeting risks reigniting the row which exploded four months ago when Mr Cameron was forced to distance himself from a leading Tory MEP who suggested that the NHS was a "mistake". The Tory leader's meeting with the leader of the group, Helen Evans, is revealed on her internet blog where she claims she was invited by him to present the group's ideas.

Among others, she says, these included "the view that the state should not own or have any of its agents manage hospitals." In comments which could embarrass Mr Cameron she says: "If he becomes Prime Minister I have no doubt NFR will meet with him and his policy team again. But whatever happens, he can rest assured that NFR will remain very much on the outside of his – and any other party political – tent. We will remain dangerous and continue to think the unthinkable."

A spokeswoman for Mr Cameron said: “David Cameron meets with lots of people of different views but his commitment to the NHS is clear and it should be an NHS that is free at the point of delivery.” However the meeting is bound to be exploited by Labour ministers in the run-up to the election. Nurses For Reform, by its own admission, is the most extreme pressure group calling for NHS privatisation in Britain.

On its website it denounces the NHS as a "Soviet" organisation which must be dismantled. "The idea that state can do it all, on its own – for everyone – is dead," it says. "Sixty years on from the inception of the NHS, British patients, voters and politicians are rightly moving away from the calamity of fully nationalised health care." Britain is a society "that is fast turning against the dystopian realities of unsustainable Soviet-style medicine."

It says a hugely slimmed down NHS should remain only as a "last resort" provider for those who cannot afford private health care. The vast majority of people would get care through insurance schemes or simply pay themselves. It also calls for controversial "top-up" care to be brought in now, so that people currently using the NHS can pay extra to get better treatment, drugs and services if they have the money.

The group, which describes itself as a "pan-European network of nurses" dedicated to health care reform across the world, says the government should "recast" the NHS as "simply a funder of last resort alongside an insurance and self-funder based market."

Dr Evans, a senior nurse with more than 20 years experience in the NHS, is now a health policy consultant with Farsight Strategic Political Intelligence Ltd, which describes itself as Britain's leading predictive public affairs consultancy in health policy. She also works with right wing, free market organisations such as the Centre for the New Europe, the Institute of Economic Affairs and the Libertarian Alliance.

In August Mr Cameron was forced to distance himself from the Conservative MEP Dan Hannan after he said the NHS "hasn't worked, it's made people iller". Although he did not discipline the MEP, Mr Cameron said: "I don't agree with Daniel Hannan. The Conservative party stands full square behind the NHS ... We back it, we are going to expand it, we have ring-fenced it and said that it will get more money under a Conservative government, and it is our No 1 mission to improve it."


Australia: Elective surgery wait shows that government hospitals are still not coping with many medical needs

And that's despite the fact that 40% of Australians have private insurance and go to private hospitals

ALMOST 200 Queenslanders have been waiting more than five years to have elective surgery. The 183 patients have conditions classified as "non-urgent" but under Queensland Health guidelines should still have had their operations within 12 months. Another 310 people have been languishing on the waiting list for up to two years, despite having more serious illnesses or injuries that should have put them in an operating theatre within 90 days.

However, the figures – revealed in an answer to an Opposition question on notice to the Government – have improved significantly in the past year. Twelve months ago, almost 400 Queenslanders had been waiting more than five years for surgery. The release of the figures comes as Health Minister Paul Lucas prepares to unveil a new initiative to tackle the so-called long-waits for elective surgery.

Opposition health spokesman Mark McArdle said yesterday the State Government needed to go back to the drawing board to address the problem. "No Queenslander should be waiting any longer than the recommended time for elective surgery, particularly these 310 category two patients who have waited more than 90 days even though some of them have quite serious conditions," Mr McArdle said.

Mr Lucas said hospitals performed 115,000 elective surgery operations each year, so it was a small percentage that waited longer than the recommended times, but agreed it was "not acceptable". "Frankly it should be 0 per cent. It is simply not acceptable to have people waiting more than five years for surgery, even if it is the non-urgent type," he said. "By this time next year, I want that figure reduced to zero." Mr Lucas remains tight-lipped on his plan to tackle long waits but earlier this month took time out to meet surgeons.

One of the options believed to be under consideration is turning the Royal Children's Hospital at Herston into an elective surgery centre once the new children's hospital opens in 2014. The move would help ensure elective surgeries went ahead.

According to the figures, 310 category two patients who should have their surgery within 90 days have been waiting between one and two years for surgery, 83 have waited up to three years and 21 for four years.


Cross the River, Burn the Bridge

Obamacare is the fast-track to a permanent left-of-center political culture

By Mark Steyn

Last week, during a bit of banter on Fox News, my colleague Jonah Goldberg reminded me of something I’d all but forgotten. Last September, during his address to Congress on health care, Barack Obama declared: “I am not the first President to take up this cause, but I am determined to be the last.” Dream on. The monstrous mountain of toxic pustules sprouting from greasy boils metastasizing from malign carbuncles that passed the Senate on Christmas Eve is not the last word in “health” “care,” but the first. It ensures that this is all we’ll be talking about, now and forever.

Government can’t just annex “one-sixth of the U.S. economy” (i.e., the equivalent of annexing the entire British or French economy, or annexing the entire Indian economy twice over) and then just say: “Okay, what’s next? On to cap-and-trade . . . ” Nations that governmentalize health care soon find themselves talking about little else.

In Canada, once the wait times for MRIs and hip surgery start creeping up over two years, the government distracts the citizenry with a Royal Commission appointed to study possible “reforms” which reports back a couple of years later usually with recommendations to “strengthen” the government’s “commitment” to every Canadian’s “right” to health care by renaming the Department of Health the Department of Health Services and abolishing the Agency of Health Administration and replacing it with a new Agency of Administrative Health Operations which would report to a reformed Council of Health Policy Administrative Coordination to be supervised by a streamlined Public Health Operations & Administration Assessment Bureau. This package of “reforms” would cost a mere 12.3 gazillion dollars and usually keeps the lid on the pot until the wait times for MRIs start creeping up over three years.

The other alternative is what the British did earlier this year: They created an exciting new “Patient’s Bill of Rights,” promising every Briton the “right” to hospital treatment within 18 weeks. Believe it or not, that distant deadline shimmering woozily in the languid desert haze can be oddly reassuring if you’ve ever visited a Scottish emergency room on a holiday weekend. And, if the four-and-a-half months go by and you still haven’t been treated, you get your (tax) money back? Ah, no. But there is a free helpline you can call which will give you continuously updated estimates on which month your operation has been rescheduled for. I mention these not as a preview of the horrors to come, but because I’ve come to the bleak conclusion that U.S.-style “health” “reform” is going to be far worse.

We were told we had to do it because of the however many millions of uninsured, yet this bill will leave some 25 million Americans uninsured. On the other hand, millions of young fit healthy Americans in their first jobs who currently take the entirely reasonable view that they do not require health insurance at this stage in their lives will be forced to pay for coverage they neither want nor need. On the other other hand, those Americans who’ve done the boring responsible grown-up thing and have health plans Harry Reid determines to be excessively “generous” will be subject to punitive taxes up to 40 percent. On the other other other hand, if you’re the member of a union which enjoys privileged relations with Commissar Reid you’ll be exempt from that 40 percent shakedown. On the other other other other hand, if you’re already enjoying government health care, well, you’re 83 years old and, let’s face it, it’s hardly worth us giving you that surgery for the minimal contribution you make to society, so in the cause of extending government health care to millions of people who don’t currently get it we’re going to ration it for those currently entitled to it.

Looking at the millions of Americans it leaves uninsured, and the millions it leaves with worse treatment and reduced access, and the millions it makes pay significantly more for their current health care, one can only marvel at Harry Reid’s genius: government health care turns out to be all government and no health care. Adding up the zillions of new taxes and bureaucracies and regulations it imposes on the citizenry, one might almost think that was the only point of the exercise.

That’s why I believe America’s belated embrace of government health care is going to be far more expensive and disastrous than the Euro-Canadian models. Whatever one’s philosophical objection to the Canadian health system, it is, broadly, fair: Unless you’re a cabinet minister or a bigtime hockey player, you’ll enjoy the same equality of crappiness and universal lack of access that everybody else does. But, even before it’s up-and-running, Pelosi-Reid-Obamacare is an impenetrable thicket of contradictory boondoggles, shameless payoffs, and arbitrary shakedowns.

That’s why Nebraska’s grotesque zombie senator Ben Nelson is the perfect poster boy for the new arrangements, and not just another so-called Blue Dog Democrat spayed into compliance by a massive cash injection. There is no reason on earth why Nebraska should be the only state in this Union to have every dime of its increased Medicare tab picked up by the 49 others. So either that privilege will be extended to all, or to favored others, or its asymmetry will be balanced by other precisely targeted lollipops hither and yon. Whatever happens, it’s a dagger at the heart of American federalism, just as the bill’s magisterial proclamation that the Independent Medicare Advisory Board can only be abolished by a two-thirds vote of the Senate strikes at one of the most basic principles of a free society — that no parliament can bind its successors.

These details are obnoxious not merely in and of themselves but because they tell us the truth about where we’re headed: Think of the way almost every Big Government project bursts its bodice and winds up bigger and more bloated than its creators allegedly foresaw. In this instance, the stays come pre-loosened, and studded with loopholes. Because the Democrat operators — the Nancy Pelosis and Barney Franks — know that what matters is to get something, anything across the river, and then burn the bridge behind you.

My Republican friends often seem to miss the point in this debate: The so-called “public option” is not Page 3,079, Section (f), Clause VII. The entire bill is a public option — because that’s where it leads, remorselessly. The so-called “death panel” is not Page 2,721, Paragraph 19, Sub-section (d), but again the entire bill — because it inserts the power of the state between you and your doctor, and in effect assumes jurisdiction over your body. As the savvier Dems have always known, once you’ve crossed the Rubicon, you can endlessly re-reform your health reform until the end of time, and all the stuff you didn’t get this go-round will fall into place, and very quickly.

As I’ve been saying for over a year now, “health care” is the fast-track to a permanent left-of-center political culture. The unlovely Democrats on public display in the week before Christmas may seem like just a bunch of jelly-spined opportunists, grubby wardheelers and rapacious kleptocrats, but the smarter ones are showing great strategic clarity. Alas for the rest of us, Euro-style government on a Harry Reid/Chris Dodd/Ben Nelson scale will lead to ruin.


Health Care, Barack Obama, and the U.S. Constitution

In the aftermath of the Senate’s passage of an Obamacare bill, Attorney’s General from multiple states have begun to announce that they are launching investigations into the legality, and constitutionality of the Senate legislation. Chief among their concerns is the possibility that that the bill places Americans outside the state of Nebraska at a significant disadvantage, financially and otherwise, to residents of the state of Nebraska.

South Carolina Attorney General Henry McMaster, along with the Attorneys General in the states of Washington, Michigan, Texas, Colorado, Alabama and North Dakota – have joined forces to consider, among other things, if the Obamacare bill in the U.S. Senate violates the 10th Amendment of the U.S. Constitution. The 10th Amendment stipulates that powers not granted to the national government nor prohibited to the states by the constitution of the United States , are reserved to the states or the people.

As such, the 10th Amendment may pose constitutional challenges to the Obamacare bill itself. Does the constitution grant to the federal government the “power” to provide healthcare? More curiously, does the constitution grant to the federal government the “power” to mandate that people buy anything - including health insurance (the Senate version of the healthcare reform legislation stipulates both)?

Additionally, state Attorneys General should also be concerned about Obamacare for another reason: it could be in violation of the “equal protection” clause of the Fourteenth Amendment.

Concerns over the Fourteenth Amendment appear to be present (this is based on what we know of the legislation, which, because of Pelosi and Reid’s secretiveness, is not a lot) in the portion of the Obamacare bill that grants special (and expensive) privileges to residents of the state of Nebraska. In the Senate’s Obamacare bill, the state of Nebraska is afforded special financial advantages from the federal government - to the tune of hundreds of millions of dollars every year – for the funding of Medicaid. The reason this provision appears in a Senate healthcare bill, as many readers of this column are aware, is because the bill could not be passed without the vote of Democratic Senator Ben Nelson of Nebraska .

Obamacare is strongly opposed by roughly two-thirds of American voters. And according to a survey published less than two weeks ago by the Tarrance Group polling firm, sixty-seven percent of Nebraskans oppose Obamacare, while ninety percent of Nebraskans are happy with the heatlhcare they currently receive and don’t want it to change.

Additionally, the Senate Obamacare bill is vague, at best, as to when and where it funds abortion procedures – and Nebraskans overwhelmingly find the aborting of unborn children to be abhorrent. And for all these reasons, Senator Ben Nelson had every reason to vote against the Obamacare bill.

So, given Senator Nelson’s incentives to oppose the Obamacare bill, Senate Majority Leader Harry Reid crafted a special deal to incentivize Nelson to vote in favor of the bill. The “incentives” included special economic incentives for the state of Nebraska , incentivizes that people in the other 49 states don’t receive.

Using the law to single-out certain individuals, or certain groups of individuals, and impart to them either special privileges or penalties that don’t apply to other Americans, is, well – Un-American. And it may very well prove to be un-constitutional in court.

Residents in the other forty-nine states pay taxes according to the same federal taxation structure as do Americans in Nebraska. Furthermore, in as much as we are U.S. citizens, we are all deserving of the same “protections” under the law to which Nebraskans are subject.

But the Senate Obamacare bill sets aside Nebraskans, and makes a special privileged class of them. If this bill becomes law, Nebraskans will be entitled to subsidies from the federal government that those of us who belong in the category called “non-Nebraskans” are not.

This disregard for the U.S. Constitution and matters of “equal protection” do not begin and end with Senator Ben Nelson. Earlier this winter, Senator Mary Landrieu (D-Louisiana) was asked a simple question by reporter Nicholas Ballasy of CNSNews.Com: “What part of the Constitution do you think gives Congress the authority to mandate that individuals have to purchase health insurance?”

In response, Senator Landrieu (who, much like Senator Nelson of Nebraska did, essentially “sold” her vote in the Senate despite opposition to Obamacare in her home state of Louisiana) replied “we’re very lucky as members of the Senate to have constitutional lawyers on our staff, so I’ll let them answer that.”

Yes, of course – “the lawyers clean up all details” as American poet (and “classic rock” star) Don Henley once lamented about his country. The fact is, however, that Senator Landrieu couldn’t answer the question if she tried.

But just like the legal profession itself, our current President and Congress have little regard for the U.S. Constitution, and for the rights of the human individual. Just as it is with the practice of law, the process of “law making” revolves around “leverage” – what can one individual or group force another individual or group to do? What does it take to accomplish what we, the politicians, want to accomplish?

Will any more among the 535 elite Americans in Congress dare to raise any constitutional concerns about this? And how about the Attorneys General of the other 43 states? Does the Constitution matter any more?


Pro-Life Democrat Predicts Senate Health Care Bill Will ‘Go Down in Flames’ in House, Unless Changes Made

The Senate health care bill is dead on arrival in the House of Representatives unless major changes are made, including removal of special “carve outs” for Medicaid funding for certain states and inclusion of language barring taxpayer-funded health plans that cover abortions, Rep. Bart Stupak (D-Mich.) told on Tuesday.

Faced with the possibility that House Democratic leaders and the White House will try to force the U.S. House to accept “as is” the health care bill that the Senate is poised to pass on Christmas Eve, the pro-life Democrat said the Senate bill differs too much from the version passed by the House to be accepted. “If they expect the House to accept the Senate bill, it’s going to go down in flames,” Stupak told in an interview. asked Stupak: “Are you prepared to vote for a bill that looks more like the Senate bill – and Senator Nelson’s language on abortion – than the House bill, with your language?” “No, absolutely not,” said the Democratic congressman, whose district encompasses all of Michigan’s Upper Peninsula and roughly one-quarter of the territory in the remainder of Michigan.

“The Senate bill will not receive support in the House,” Stupak said. “If they tell us we have to take that bill without changes, it will not survive the House. Regardless of the abortion language, there are just too many objectionable items in there that at least I see, and in talking with maybe a half-dozen other members, they sort of see the same thing.”

Stupak, like many in Congress, takes strong exception to the fact that, under the Senate plan, certain states would receive special “carve outs” for increased funding for Medicare/Medicaid. “That’s not what it’s all about,” he said. “This is about health care, this is providing health care for all Americans – it’s not to see who can strike the best deal for their state. This is the wrong piece of legislation to try to do carve outs, or get an exception for your state and the rest of the country is supposed to pick up the tab. That’s not what health care is all about. That’s not the policy, that’s not the principle behind the bill.

In exchange for their votes for the Senate bill, Sen. Ben Nelson (D-Neb.) reportedly obtained $100 million in additional Medicaid benefits for Nebraska and Sen. Mary Landrieu (D-La.) obtained $300 million in additional aid for Louisiana. In addition, Sen. Bill Nelson (D-Fla.) managed to obtain a carve-out for 800,000 Floridians, who will keep their Medicare Advantage plans, while those in other parts of the country are slated to lose their Medicare Advantage plans under the bill’s targeted cuts.

Stupak was incensed at the special deals. “All the rest of us that live in states that did not receive that exception, why would we [be] inclined to give Nebraska or Florida or Louisiana a special break underneath the bill and expect the rest of us to pay for it?”

Beyond the carve-outs, Stupak pointed out that seniors “take some cuts in the Senate bill that are not found in the House bill [that] members are not going to accept” -- and that the bill would tax people who have “decent” health insurance programs. “Aren’t you really going to force more people off health insurance?” Stupak said.

He added: “If you just take a look at my three main constituencies – Right to Life, labor unions, and senior citizens – the Senate bill is contrary to all their interests,” Stupak said. “I’d have no real desire to vote for this bill the way its being outlined in the media," he said. "I know the bill’s not finalized yet, but if that holds true, if they expect the House to accept the Senate bill, it’s going to go down in flames.”

Stupak, who succeeded last month in getting 64 House Democrats to join him in attaching his pro-life amendment to the House version of the health care bill, also firmly rejected language in the Senate bill regarding abortion. The “Stupak amendment,” as his provision is known, would prohibit the federal government from allocating taxpayer money to pay for any part of any health insurance plan that covers abortion except in cases of rape, incest, or when the life of the mother is in danger.

But the abortion language in the Senate bill secured by Sen. Ben Nelson (D-Neb.), which attempts to segregate taxpayer money from paying for health plans that provide abortion, does not contain an outright ban on taxpayer money going to fund abortion. Stupak, however, added: “Even if they fixed the abortion language, if it’s the Senate language, I have to vote for – I’m not voting for it.”


Sunday, December 27, 2009

Spending on NHS bureaucracy up 50 per cent

Spending on NHS bureaucracy has risen by 50 per cent in just four years, according to "heartbreaking" government figures. The increases include a 43 per cent rise in the costs of managers, while spending on clerical staff rose by 78 per cent at Primary Care Trusts (PCTs), which decide how NHS funds should be used. Meanwhile, their expenditure on management consultants and temporary staff more than doubled. Patients' groups accused the Government of wasting "ludicrous and heartbreaking" sums expanding an army of administrators while starving the frontline of resources.

In 2006, ministers promised to cut NHS administration costs by halving the total number of PCTs - the organisations which decide which treatments and medications are funded - from 303 to 150. In fact, Department of Health figures show that in the four years ending last year, the total amount spent on administration went from £1.43 billion to £2.14 billion - a rise of 49.5 per cent. The statistics, which cover the period from 2004 to 2008, show that the total spent on managers went from £566 million to £808 million, a rise of 43 per cent. Spending on other administrative staff increased by 78 per cent, from £606 million to £1.07 billion.

As the total number of organisations shrunk, the new larger bodies spent more hiring temporary staff and consultants, according to an analysis of the DoH figures by the Conservatives. In total, PCT spending on outside agencies rose from £53 million to £139 million - an increase of 162 per cent.

Katherine Murphy, from the Patients Association, said too often the millions spent on NHS bureaucracy did little to help patients, while the systems they set up left too many worse off. "These sorts of sums are ludicrous - and especially so given the heartbreaking stories we hear all too often about patients who have been denied their most basic needs," Mrs Murphy said. "This Labour Government has said an awful lot about putting the patient at the centre of services, but what we find is that the current system puts more and more layers between the patient and their doctor and nurse, and leaves vulnerable people fighting against a system of targets."

Andrew Lansley, the shadow health secretary, accused Labour of "pouring" huge amounts of taxpayers' money into the NHS while failing to ensure value for money. Highlighting figures published earlier this year, showing that the number of NHS managers is increasing at three times the rate of nurses, Mr Lansley said: "This Government has created a bloated NHS bureaucracy which is overloaded with Government targets. I am determined that under a Conservative government all of this would change."

In October, the Conservatives promised to cut total spending on administration by PCTs, strategic health authorities and dozens of NHS quangos by one third, from £4.5 billion to £3 billion, within four years.

Earlier this month, Labour said it would cut NHS "management costs" - a more narrow category than administration - by 30 per cent. A spokesman for the Department of Health said significant investment in the NHS had brought the shortest waiting times for patients since records began, but that it was for local organisations to decide how money was spent. He added: “To drive services forward, the NHS needs strong management - but efficiency is crucial, so we have set a clear goal of reducing management costs in strategic health authorities and PCTs by 30 per cent over the next 4 years.”

The Sunday Telegraph's campaign, Heal our Hospitals, has received 5,200 signatures backing its calls for a review of hospital targets to make sure they work to improve quality of care. The campaign has uncovered major pay rises for NHS chief executives who presided over hospitals exposed as having some of the worst death rates in Britain.


What Obamacare and the NHS Have in Common

As US legislators continue to advance the largest expansion of government control over health care in the US, many Americans may need some comic relief. Although such massive consolidation of federal control over health care is by no means a laughing matter, the following 2-minute clip from a popular BBC Documentary Series “Yes, Minister” illustrates the ridiculousness of the efforts.

This not an entirely trivial story contrived for political satire; in fact, even early this year, the 2009 opening to an NHS hospital was canceled until “early 2010” for among other items not being able to “[control] the heat of the floor in some parts of the hospital.” In 2008, a survey by the (British) Health Care Commission found that roughly 11 million hospital meals were simply wasted. Moreover, the Taxpayers’ Alliance in England, find that “misguided directive[s]” lead to a “total waste of NHS resources”, and most importantly, divert global health care resources “at a time when people are struggling to get life-saving operations and medication”.

While the US healthcare system is not (yet) the socialized health care system of the British NHS, Obamacare does continue a massive transfer of regulatory power in the health care and health insurance markets to the federal government. In the attempt to bring more equity into the US health care system by granting the federal government even greater power, even an advanced socialized health care system faces great concerns of inequality. This is highlighted best by Steve Webb, MP and Liberal Democrat Shadow Health Secretary, stating of the NHS that “health inequalities still run deeply through our society. People still face an unfair postcode lottery in accessing health services across the country, which bears little relation to need. Health needs around the country would be best met by democratic community bodies giving local people a direct say in the services they need.”

This underscores the gravity of the current health reform debate in the US where the federal government has progressively consolidated regulatory and financing power in health care for the last 30 years. Rather than moving more towards a decentralized system that many in Britain now want (and polls have shown US voters want) US legislators want to centralize more of the power in Washington.


10 Really Nasty Surprises For The American People In The Health Care Reform Bill

Most Americans who support the health care reform bills currently being rammed through Congress believe that this process will result in Americans receiving universal health care that is cheaper, more efficient and that gives all of us more choices. But that is not the case at all. Rather, Americans will soon have much fewer health choices which are much less efficient and for which they will end up paying much more for. In fact, there are a ton of really nasty surprises for the American people in the health care reform bill. The following are 10 of the nastiest of the surprises....

#1) All Americans will be forced to buy health insurance. If you don't like the new system, that is too bad for you. If you don't pay up, you will be heavily fined and you could ultimately end up in prison. There will simply be no escape from participating in this health care system until you die.

#2) Americans will have basically two places from which to get health coverage - either their workplaces or from "insurance exchanges" set up by the government. If you are not employed, you will have one choice.

#3) Americans will have much fewer health plan choices under the new system. The new "insurance exchanges" that the government is setting up will offer four health plan templates that have been mandated by the government. Each plan will contain health benefits that have been specifically dictated by government agencies. You will be forced to pay for the benefits contained in these plans whether you need them or not. So if you will never need substance abuse treatment or prescription drug coverage that is too bad - you will be forced to pay for them.

#4) Americans will be eligible for a federal subsidy to help them buy health insurance, but only if they earn less than 400 percent of the poverty level ($88,200 for a family of four). However, an individual will only be eligible for a subsidy if their employer does not offer health coverage and if that individual purchases a "government-approved" plan from a "government-approved" insurance exchange.

#5) The Congressional Budget Office estimates that a family insurance plan for a typical family of four will cost approximately $15,000 per year when the health care bill comes into full effect in 2016. How do you think most American families will react to that?

#6) The Congressional Budget Office also says that the coverage provisions in the Senate bill will cost the U.S. government $200 billion annually by 2019 and that these costs will grow by 8 percent per year. Considering the fact that the U.S. government is already drowning in red ink, where in the world will all of that money come from?

#7) American workers will be hit with nasty new taxes under the new system, including a .9 percent Medicare payroll tax increase that the Senate bill would implement.

#8) There is also a 40 percent tax on "Cadillac" health plans in the Senate version of the bill. That tax is not indexed to inflation, which means that eventually every health plan will be subject to the tax.

#9) Even if your current health plan is "grandfathered" in, your current health insurance company will be required to meet new federal mandates that will dramatically increase the cost for any health plan it offers you right now. Guess who the health insurance companies will pass those costs on to?

#10) Senator Harry Reid has inserted some really wicked provisions in the Senate version of the health care bill that will make it virtually impossible to repeal the Obamacare bill once it is adopted. So the reality is that once it is voted in, the American people will be stuck with it forever.


2009’s Present Under the Tree - Death

By Dick McDonald

It is almost incomprehensible that the Congress of the United States has just passed bills in both houses that will annually cut $500,000,000,000 (one-half a Trillion dollars) from the cost to extend the lives (longevity) of America’s senior citizens. The Republicans stood firm in their opposition to these bills but the Democrats claimed that their majorities were created by the public’s mandate in November 2008 to “change” health care to include the small minority of the uninsured.

The Democrats took a financial crisis – a deep recession – as an opportunity they couldn’t pass up to grow their political power and increase the size of government at the expense of the free market and the private sector. The medical profession had expanded the life span of the Average America from 62 to over 80 in just 75 short years. The eventual cuts the Democrats have proposed will stop that progress and the life span of the average American will start dropping.

All this is being done to seniors because keeping seniors alive has become too costly. In order for Democrats to pay for the enormous takeover of 1/6th of the private sector economy they have to cut expenses. They decided seniors in the last years of life were their best bet to finance their plan of “social justice” for a small number of Americans now relying on free emergency care to save their life.

Democrats reasoned why not kill seniors when they become too costly – they are living too long now anyway. They said let’s expand health care to the point where we Democrats can dictate who and when old people are deemed worthy of life saving procedures - in that way, we can ration and withhold expensive procedures from those who don’t have long to live thus financing our enormous medical bureaucracy.

It is true that half of the cost of Medicare is spent in the last years of life. That became a reality when Americans adopted Medicare. The cost of surgeries, medicines and hospitalization that have increased longevity have been costly. Under new healthcare these costs will be trimmed and earlier deaths assured.

This change to politician-controlled healthcare is just another dagger in the heart of the liberty and freedom of choice that built the greatest economy the world and the best medical care on the planet. From now on Americans will have to ask their government for permission to live. What a sad state of affairs. Our Founders must be turning over in their graves.

This is what a society gets when they stop making money, increasing overall wealth using the principles and freedom under capitalism and start concentrating on redistributing the wealth using the principles of socialism and collectivism. Under socialism wealth is consumed and eventually disappears. Under capitalism wealth is created and freedom and liberty deliver prosperity.

Comment received by email

Nanny State Gone Wild: Defining Dependency Up

by Michelle Malkin

The greatest gifts you can give your children can't be boxed and bowed. Consider the timeless gift of self-sufficiency -- a stubborn thirst to leave the nest, make it on your own and live as a free-willed adult. It's a concept that Big Nanny Democrats are sabotaging at every legislative turn.

Several times during the sneaky debate on the government health care takeover bill this past Sunday, Democrats hailed a provision requiring insurance plans that cover dependents to provide benefits to children up to age 26. Democratic Sens. Ben Cardin and Tom Harkin both specifically championed the unfunded mandate in their floor statements.

This manifestation of the Nanny State is especially galling given the massive levels of generational theft the Democratic majority has presided over this past year. If they truly cared about the physical and financial well-being of young Americans, they'd stop piling on expensive regulations that simply put affordable health insurance out of their reach.

I propose a new symbol for the Democrats. Out: donkey. In: a giant adult pacifier.

I can tell you what most fiscally responsible parents are thinking when they hear the feds "taking care" of everyone else's adult "children" by confiscating their tax dollars and forcing private companies to comply: You've got to be kidding me. Yes, Virginia, there are still some of us left who believe our children shouldn't depend on a government-manufactured umbilical cord as they approach their third decade on earth.

Nonetheless, there are now an estimated 20 states that have already passed legislation requiring insurers to cover adult children. The slacker mandates cover "kids" ranging in age from 24 to 31. And it's these government health care mandates that are driving up the cost of insurance.

Health policy researcher Nathan Benefield of the Commonwealth Foundation reported that in New Jersey, Nanny State peddlers claimed the adult kiddie protection law would help 100,000 uninsured young adults. "Yet in two years, only 6 percent of that estimate has been realized. The primary reason -- health insurance is still too expensive."

Wisconsin has experienced similar results. "Whenever you insure somebody whom you didn't insure before there's some additional risk," insurance expert James Mueller told the Milwaukee Sentinel Journal. Mueller points to the premium increases that have followed coverage mandates on employer-sponsored plans. "The problem with all these good ideas is there's funding necessary," Mueller said. In Wisconsin, not only are adult children covered, but also the children of those "children" if they live in single-parent homes.

As he rammed through this mandate and the mountain of other government regulations buried in Demcare, Senate Majority Leader Harry Reid promised on Sunday: "We are reshaping the nation. That's what we want to do."

Indeed, this defining dependency up phenomenon is part of the larger push for single-payer-by-proxy. The other universal health care Trojan horse signed into law this year -- the expansion of SCHIP (the State Children's Health Insurance Program) -- welcomed more non-"children" into the government insurance fold.

Both political parties have advocated federal waivers to use SCHIP funds for adults, including parents of Medicaid/SCHIP children, caretaker relatives, legal guardians and childless adults. According to the General Accounting Office, SCHIP-funded expenditures on adults nationwide "totaled about $674 million in 2006." J.P. Wieske of the Council for Affordable Health Insurance notes that the bennies provide an incentive for parents to drop their private coverage in order to take advantage of free or discounted health insurance for their children. "It has become a program for the middle class at the expense of the poor."

This is the engine that will power the Demcare architects' most naked, radical ambitions: "Health care as an inalienable right," as Sen. Harkin put it. How? By breeding a massive permanent culture of dependency and bottomless debt in the name of the "children" from birth through quarter-life -- and beyond.


A nasty Christmas Present

Scrooge came early on Christmas Eve this year -- and he looks strangely like Senate Majority Leader Harry Reid. Instead of "bah humbug," he delivered the U.S. Senate's version of "health care reform" -- the most expensive legislation ever passed by the Congress of the United States and the greatest expansion of government power in our nation's history. Now that's some Christmas present -- and a different way of celebrating the birth of Jesus Christ.

If the Democratic majorities in the House and Senate succeed in cobbling together a final bill after the new year begins, every American taxpayer will take a hit in the pocketbook, and every Tiny Tim in the next generation can look forward to government-rationed medical care. According to those who purport to speak for him, President Barack Obama is celebrating this "historic event," and they aren't talking about the Nativity two millenniums ago.

For reasons apparently obscure to Obama and Reid and House Speaker Nancy Pelosi, most Americans don't seem to be as pleased at their Christmas gift as those who gave it. Perhaps that's because "We the People" see the Senate's $848 billion stocking stuffer has a price tag that would choke a reindeer.

Actually, that's just the down payment. According to the Congressional Budget Office, the first decade of the Senate's bill would cost $2.5 trillion. Even the Magi couldn't imagine a gift this precious.

Those who voted for "Change!" last year may find that's all they have left in their pockets. Administration actuaries estimate that both the House and Senate bills would accelerate growing costs for medical care. The CBO calculates that annual health care premiums for middle-income Americans would go up by $300 for individuals and more than $2,000 for families. And just in case you didn't notice, not getting health insurance is no longer an option. Higher costs may not have been on your Christmas list, but the O-Team in Washington wants you to have them anyway.

Overwhelmingly, Americans have been telling pollsters for more than a year that what they really wanted this Christmas (and the rest of the year, as well) were "jobs" and "job security." Apparently, the elves at the White House and on Capitol Hill weren't listening. Instead, they want to give us a $400 billion tax increase, new mandates on employers and higher fees for prescription drugs and medical devices. None of this would stimulate private-sector job growth.

But not to worry. "Hark! The Herald Angels Sing"; there may be new jobs -- at the Office of Personnel Management. In the Senate version of this Christmas Carol, up to 10 million Americans would lose their employer-sponsored health coverage. The individual health insurance plans for millions more would be nonexistent soon. To "ensure these Americans will never be denied coverage," OPM would set up a whole new bureaucracy to administer a government-run "insurance exchange." Though OPM is the federal agency responsible for granting security clearances -- and hopeless backlogs are commonplace -- we should be encouraged that it would do better at "managing" our health insurance. Take an aspirin, and call OPM in the morning.

The O-Team is confident that shortly after we ring in the new year, the House and Senate health care bills will be melded into one giant gift that keeps on giving -- to the federal government. There are some "fine points" to work out, such as how many of our tax dollars can really be spent on abortions and how deep the cuts in Medicare coverage for seniors will be and how much more "the wealthiest Americans" will pay. But those are just "minor details" that we are assured can be "worked out in the spirit of the season." We all should remember that "it's the thought that counts."

According to Reid, the "hard work" is done. The "exhausted" members of Congress are now home on "winter recess." Mr. Obama and his family are on their "Hawaiian holiday." Notably, the word "Christmas" is rarely, if ever, used in our government.

But that proscription isn't as pervasive as some would like. Though the majority of our elected officials call their health care bills a "gift" -- yet dare not speak the word "Christmas" -- there are others who know the true spirit of this holiday. Right now, more than 250,000 soldiers, sailors, airmen, guardsmen and Marines are deployed far from home -- a good number in harm's way. Those who wear our nation's uniform and their loved ones embody what giving, self-sacrifice and Christmas are really all about.