Blame Yourself, Barack

Barack Obama has only himself to blame if Obamacare and other pieces of his legacy are so vulnerable to successful legal challenge.

He was an unscrupulous corner-cutter who bragged about how his "pen and phone" presidency minimized the need to work with Congress or forge political consensus. And the half-baked scheme called Obamacare was imposed on America via party-line vote, sowing the seeds of dissent that are bearing fruit today. 

Live by the pen, die by the pen, Big Guy. Expediency, executive overreach, corner-cutting and deceptive advertising (ala "you can keep your health plan") made this great reversal all but inevitable.

Trump is only following the arrogant, imperious, go-it-alone precedent set by his predecessor.

Nanny State Begets Nanny City

Cutting a city's payroll isn't an easy task, politically or practically, as we're learning in Colorado Springs. But one Florida mayor has found an ingenious new way to trim city staff using Nanny State justifications. It can seen so cold-hearted eliminating positions based on fiscal necessity alone. But what if you condition a city job on the employee making responsible lifestyle choices? That turns the heartless budget-cutter into the compassionate nanny. It's brilliant, really, and it just might fly, given the strange times in which we live.

Brooksville Florida Mayor Lara Bradburn really hates smoking, and smokers -- so much so that she wants the power to terminate city employees who don't kick the habit within a year. “For employees, they would have one year to quit smoking or using chewing tobacco or face disciplinary action that includes termination,”she has said. But these rules won't just apply in the workplace. They'll apply in the privacy of an employee's home.

How can Bradburn justify such an invasion of an employee's personal life? Easy. She uses the same reasoning that all nanny-staters use when they invade our personal lives.

Because the city helps pay for an employee's healthcare, it has an interest in that person making healthy lifestyle choices. An employee's failure to choose correctly can increase coverage costs, increase absenteeism, impact city operations. The city's control over a worker's healthcare plan gives it the leverage it needs to control a worker's personal life.

There's a reason that argument sounds familiar -- it echoes one we hear whenever nannies use the shared burden of healthcare costs as a reason to regulate personal choices. Motorcyclists should be required to wear helmets, say nannies, because "we all pay the price" when they fall and crack their skulls. If the motorcyclist isn't covered, other people pay directly for his care. And even if he is covered, the costs of his care may have to be subsidized by others with coverage who don't end up with an expensive cracked skull. Medicine in America already is "socialized," to some extend. And that gives nannies all the leverage they need.

But why stop at smoking, since city workers make other un-healthy choices? Maybe they gorge on snack foods and junk foods, leading to weight problems. Maybe they ride motorcycles or sky dive or scuba dive or engage in other high-risk activities. Once the state or the collective has a stake in your health -- once healthcare costs are socialized -- it also has an invitation to start dictating lifestyle choices. We see this on the small scale in towns like Brooksville, but on a much larger scale in the country at large.

The nanny state begets the nanny city, just as night follows day. ObamaCare will only accelerate the spread of such tyranny.

A "Baton" or a Bludgeon?

"Healthcare reform "baton" passes to states" is how The Washington Post headlined today's article about the ObamaCare mandates Washington is expecting states to implement -- which makes it sound as if we're all one big happy team, sprinting toward an agreed-upon finish line. But that "baton" looks more like a bludgeon to many states, judging from the resistance they're showing.

This isn't a foot race; it's a forced march, in a direction most Americans just don't want to go. Uncle Sam isn't the pace-setter; he's the cruel mule-driver, with a lash at the ready for any who dig in their hooves. But leave it to The Washington Post to spin the situation as a relay race in which a few of the runners are reluctantly falling behind.

That's the view today from WashingtonWorld. We now return you to more reality-based content.

Lights, Cameras, Logrolling

Brian Lamb, the founder and CEO of the C-SPAN networks, is one of the great (though unheralded) Americans of our time, in my opinion.

That most Americans don't know or care who he is doesn't mean he hasn't done them an invaluable service, by creating a set of cable channels that give average people unprecedented (and unbiased) access to the inner workings of Washington, D.C. It comes to them direct, without any "mainstream media" filter. It comes to them straight: Lamb carefully picks his on-air personalities not just for their high degree of intelligence and civic literacy, but for their notable lack of personality and political agendas. People speak in full sentences on C-SPAN, not sound-bites. And it comes to Americans free, courtesy of responsible cable providers.

Now the normally low-key Lamb is courting potential controversy by trying to do Americans another huge favor: He's asking Congress to open House-Senate CongressCare negotiations to C-SPAN cameras, which would give the people an unprecedented look into the inner-inner-workings of Congress -- taking us right into the backrooms where the deals are cut. That's why it's highly unlikely Congress will comply with Lamb's request.

"As your respective chambers work to reconcile the differences between the House and Senate health care bills, C-SPAN requests that you open all important negotiations, including any conference committee meetings, to electronic media coverage," Lamb wrote in a letter to President Obama and congressional leaders. "President Obama, Senate and House leaders, many of your rank-and-file members, and the nation’s editorial pages have all talked about the value of transparent discussions on reforming the nation’s health care system. Now that the process moves to the critical stage of reconciliation between the Chambers, we respectfully request that you allow the public full access, through television, to legislation that will affect the lives of every single American. We hope you will give serious consideration to this request. We are most willing to employ the latest digital technology to make the cameras, lights and microphones as unobtrusive as possible."

The more unobtrusive C-SPAN can be, the better, in my opinion. Maybe some of the conferees will forget they're being recorded, drop the phony veneers and become what they really are behind closed doors, in unscripted action (the pros and cons of televising such meetings is explored on this Fox News blog, penned by a former C-SPAN employee). The network's presence might confer an even greater benefit, however -- a blessing, really -- if the presence of cameras serves to reduce or eliminate the sort of back room deal-cutting, logrolling and earmark-chasing that normally marks such sessions.

One public interest will be served by pushing back the frontiers of government transparency. Another will be served if that transparency fosters more restraint, caution and circumspection on the part of conference participants, resulting in a better piece of legislation than we would see if the cameras are excluded.

The bill still will stink. It just may stink a little less.

The Congressional switchboard is at 202-224-3121 if you want to weigh-in on the issue. It's not just Congress that needs to support this proposal, though. President Obama said during a 2008 presidential debate that he would be "broadcasting those negotiations on C-SPAN so that the American people can see what the choices are," if this piece of legislation ever came to pass. Now is the time for Obama to make good on that promise.

To Hell with Tarot Cards . . .

. . . .I turn to the all-seeing, all-knowing Zoltar for the truth about ObamaCare.

Political Malpractice

Accidental death and murder-through-malpractice occur at every American hospital, much to the delight of the ambulance-chasers. It's just a sad fact of life -- or fact of death -- that every reasonable person understands, because to err is human and because hospitals, on balance, do far more good than harm.

But the sorts of accidents that go unnoticed or barely-noticed at most hospitals can threaten to shut down a doctor-owned hospital, as this story in today's Denver Post explains. This double standard isn't because such "specialty hospitals" deliver substandard care, as compared to non-doctor-owned counterparts; it's because they are upstarts, which bring competition into a system in which true competition is absent. It's because they threaten the profit margins of other hospitals. It's because they make easy scapegoats for politicians looking for someone "greedy" to blame for a system that politicians and regulators screwed-up. And it's because some interest groups hope to use the health care overhaul being contemplated by Congress to get rid of these rival institutions.

The Post, to its credit, delves into the interest group politics lurking behind the attack on doctor-owned hospitals:

"The debate over doctor-owned hospitals, ongoing since they began to flourish a decade ago, has pitted politician against politician — and doctors and their trade groups, including the American Medical Association, against hospitals and their trade groups — in a battle of wills and dueling studies on the hospitals' impact.

A proposed provision in the health care reform package Congress is debating could effectively end the debate — and kill future doctor-owned hospitals.

The provision would prevent doctor-owned hospitals from collecting Medicare reimbursements, which can be a hospital's lifeblood" . . .

". . . .No sooner did these hospitals start popping up than traditional hospitals started crying foul. Those cries struck consistent themes: The specialized hospitals cherry-pick healthy, insured patients, leaving the really sick, the poor, the uninsured to pile up in generalized hospitals. The advent of doctor-owned hospitals, generalized hospitals say, threatens their very survival."

And their profits, of course. "The American Hospital Association reported that hospitals made a record $43 billion profit in 2007, the largest single-year profit jump in 15 years," reports The Post. And non-specialty hospitals aren't interested in cutting specialty hospitals in on that action.


Conflicts of interest and self-referrals can be a potential problem in doctor-owned hospitals. But this exists with conventional hospitals, too. I've only had a few major surgeries, fortunately, but I've never enjoyed my choice of hospital for having the procedures done. Once I picked my surgeon, my choice of hospital was also decided for me. I didn't ask "why?" I didn't investigate potential conflicts of interest. I didn't wring my hands over whether the surgeon's fee was reasonable or obscene (assuming a layperson has the knowledge to make such a determination).

The system isn't set up for comparison-shopping -- which is part of what's wrong with it. I just showed up at the appointed date and went under the knife, turning my fate over to a system I don't understand and can't control.

With doctor-owned hospitals, "we have individuals who will personally gain from having the control of what happens, of who goes in, who's admitted, what tests are done," a spokesman for the Colorado Hospital Association told the Post. But isn't that an apt description of how most non-doctor-owned hospitals operate?

The problem isn't specialty hospitals; the problem is an impossibly convoluted and covert system in which market forces don't work, and which conspires against a patient's ability to act as a true consumer. The problem isn't malpractice at certain doctor-owned hospitals; but malpractice in the broader, systemic sense, driven not so much by the "greed" of doctors but my the incessant meddling of politicians and government regulators. And now, based on a misdiagnosis of the ailment, Congress wants to do major surgery on a system that Congress made ill.

Talk About a "Crash Course"

The Washington Post reports that House Democrats went back to school Monday afternoon, sitting still, without talking or interrupting, while congressional staff led a tutorial on what's in the 1,000-page overhaul of the American health care system that's been floating around the chamber for weeks.

This way, when they're home for August recess, members can speak coherently about the bill -- almost as if they understand it.

Explains the Post:

"The rough draft of the bill ("America's Health Choices Act") runs more than 1,000 pages, with amendments yet to come. Last week the Democrats decided that they needed to know more about the legislation before they go back to their constituents for the August recess. Hence the teach-in, an unusual basement seminar that lasted five hours with one break for procedural votes on the House floor."

But shouldn't members of the majority party have undergone this tutorial before, rather than after, the bill was written and introduced? And what does this say about the cluelessness (and sheer recklessness) of the people ostensibly in charge; and about the power wielded by unelected staff (and the lobbyists they're chummy with), who draw-up legislation first and educate their bosses about the details later, weeks after the bill is introduced?

More from the Post:

"Some members had a printout of the entire bill. Others used a 34-page cheat sheet . . . . To make matters somewhat easier for members, the packet of information handed out at the door included a glossary of health-care terms, including:
Actuarial
Equivalent
Adverse Selection
Capitation Comparative
Effectiveness
Cost Shifting
Duel Eligibles"

What a scary story. What an alarming situation. The county is being run by a gang of morons -- and their nameless assistants. Congress is about to attempt an overhaul of the American health care system -- based on a "cheat sheet."

Time to head for the lifeboats.