Supreme Court Supremely Fails in Upholding the Individual Mandate

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English: The United States Supreme Court, the ...

English: The United States Supreme Court, the highest court in the United States, in 2010. Top row (left to right): Associate Justice Sonia Sotomayor, Associate Justice Stephen G. Breyer, Associate Justice Samuel A. Alito, and Associate Justice Elena Kagan. Bottom row (left to right): Associate Justice Clarence Thomas, Associate Justice Antonin Scalia, Chief Justice John G. Roberts, Associate Justice Anthony Kennedy, and Associate Justice Ruth Bader Ginsburg. (Photo credit: Wikipedia)

U. S. Courts have increased the power of the federal government vs. the power of the states. Those in favor of expanding federal power have often referred to the Commerce Clause to justify such actions, and that was the Obama Administration‘s tactic in its arguments before the Supreme Court supporting the individual mandate. This mandate requires that all Americans buy health insurance. States, fearful that they would be the ones paying for such insurance, sued, arguing that such a requirement is an unconstitutional expansion of federal power over the states. The individual mandate also marks the first time the federal government will require Americans to buy a particular produce.

Chief Justice John Roberts, in his majority opinion, argued that the power of the federal government to tax its citizens is sufficient to justify the individual mandate. This is a dangerous ruling–if the government has the authority under tax laws to force American citizens to buy health insurance, would it not have the power to require American citizens to buy other products? It would seem so. The states would have no veto power over the national government in this area.

Tax law is overly expansive already–anyone who deals with the Internal Revenue Service can witness to the maze of rules, the (often unintentional) violation of which can cost someone money, property, or freedom. Fines are the penalty for violating the individual mandate. How does the government presume to enforce such fines? Would prison become an option, an option that recalls the bad old days of imprisonment for debt. How else could the Supreme Court use the taxing powers of the federal government to increase government power over the states and over individuals? I fear the options are potentially unlimited. Hopefully a new administration will come into power with a willing Congress that will reverse this legislation. However, the harm the Supreme Court has done remains. Once again, the will of the majority of the American people has been thwarted by the Congress, by the President, and now by the Supreme Court. I wonder how long the dying embers of the Republic will glow before the light finally goes out on freedom in America.

The Health and Human Services Department’s Attack on Faith-Based Organizations

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Logo of the United States Department of Health...

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The United States Department of Health and Human Services mandated that employers offer health care insurance to employees that includes payments not only for standard birth control, but also for abortificants. Faith-based organizations are not exempt from this mandate. The Roman Catholic Church is resisting this mandate, as well they should, and since abortificants are also paid for, all faith-based groups who oppose abortion are being forced to violate their beliefs. I have no doubt that the social democrats and socialists who read this post will disagree, which is their right. What about the right of a faith-based organization to establish employment benefits in line with its beliefs? H. Tristram Engelhardt, Jr., a bioethicist and physician at the Baylor College of Medicine, has argued for ideological pluralism in health care choices. That is, if someone accepts abortion, she can buy insurance through a company that accepts abortion. Roman Catholic groups could have what Engelhardt calls “Vaticare” or something like that. Now Engelhardt is a Classical Liberal who is consistent that pluralism be respected. What the government is doing is the equivalent of telling “Vaticare” or similar organizations that their beliefs be damned. The government will now tell you what to do, and if you don’t like it, suck it up. The result, if this rule is not overturned, will be a mass closing of faith-based organizations that help a significant number of people.

Although Mr. Obama has tended to be a friend of Wall Street and warmongers, his ideological roots are strongly Marxist, and, I would claim, totalitarian. The fact that he is no more totalitarian than Dubya does not change the fact that Obama desires as much power as did Mr. Bush. Regulatory agencies have been one way that government can gain power without legislative approval. Congress should establish a conscience clause in the health care bill in order to allow for faith-based organizations to offer insurance to their employees consistent with their own beliefs. To do otherwise would be another step toward a “social democratic benevolent” dictatorship that the most radical on the left wing desire. Although this is by now a tired cliche, it remains true that freedom of religion was never construed by the founding fathers to mean freedom from religion. I am pleased that Eastern Orthodox Bishops (The Council of Canonical Orthodox Bishops) as well as conservative Protestants have joined the effort to reverse this rule change. I hope they succeed.

For Profit Medicine: An Oxymoron

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Universal health care

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As a traditional conservative I oppose for profit medicine. The classical liberal who calls himself a “conservative,” would probably label the previous sentence as an oxymoron. However, conservatives are not all of one stripe. The ethics of medicine must stem from the nature of medicine itself as an inherently moral enterprise. A patient, sick or injured, in need of help, comes to a health care practitioner. The practitioner, whether he be a physician, a D.O., a physician assistant, or a nurse practitioner, has the moral responsibility to use his skills and knowledge for the good of the patient. The profit motive should not enter into the patient-practitioner relationship–if it does, it becomes inherently corrupting.

For-profit hospitals are a monstrosity. When part of the responsibility of the physician is to the shareholders, business decisions often end up trumping medical decisions. This can lead to suboptimal patient care in order to bring more profit to the corporation, especially in a capitation system in which the practice keeps money left over that is not spent on patient care. . Even in “non profit hospitals,” business decisions affect medical care, and business people “run the show.” Hospital administrators are paid enormous salaries (500,000+ per annum in some cases) along with expensive benefits. I know of a case in which a CEO received a huge bonus even though the hospital had been in the red the previous year. Does this sound familiar? Remember the Wall Street bankers.

The American system of medicine, then, is run as a business rather than as a practice. It is no longer a true profession. Physicians are distrusted. Lawsuits are common and sometimes result in big judgments against a physician.

In reading UK newspaper articles about accidents or shootings, I have found (informally) that paramedics and physicians in the UK are more aggressive in starting trauma codes than their American counterparts. This is, of course, anecdotal–it would be interesting if a large-scale study could be done to compare the numbers in both systems. American physicians used to work up to two hours on a patient in a medical code (that did happen with my mother, who lived with no neurological sequelae). Now, three shocks interrupted by CPR, and often that’s it. Twenty minutes, perhaps thirty, and in rare cases, over an hour–but shorter periods are becoming more and more the norm. Doctors will say this is due to the low success rate–still, twenty minutes even in witnessed arrest in which the patient has no DNR is a short time to say, “He’s dead Jim,” given the utter finality of death. Money may play a bigger role in these decisions than medicine. The UK lacks the profit motive in medicine outside the private health facilities there, so the incentive is to keep trying in a code rather than stop in order to save money (I am indebted to my friend Megan for this insight).

Is it possible for a traditional conservative to endorse a non-for profit single payer system of health care for the United States? It has already happened: Paul Craig Roberts, whose conservative credentials are stronger than most self-styled “conservatives,” has endorsed that system. Affordability in the age of massive deficits is the problem, but if the system is run correctly more money might be saved in the long run due to decreasing health care costs–and if tort law is revised so as to protect physicians from frivolous suits, this could help even more. I am not quite ready to endorse such a system, but the more greed I encounter in the present privatized system the more I am tempted to endorse a nationalized system of health care.  It would at least take out the profit motive that is corrupting current medicine and taking it away from its proper ends.