Just in Time for Bernie

Social Conservatives Call Out Trump

From Wisconsin Family Action (and multiple other organizations) a challenge to Donald Trump on his socially liberal record:

Mr. Trump:

We, the undersigned, represent millions of pro-family Americans who are dedicated to a nation where God is honored, religious freedom flourishes, families thrive and life is cherished. As a national alliance with nearly 40 state-based organizations, we have invited you to participate in our Presidential Teleconference Series to share your views on the issues important to values voters. We have interviewed most of the leading candidates, but after several attempts, we have not yet been able to schedule such a call with you. Therefore, we direct the following questions to you on policy issues important to our constituents:

1. After years of describing yourself as “pro-choice in every respect”—even supporting partial-birth abortion—you now say that you are pro-life. Your explanation for this change of position – that a baby who was nearly aborted ended up being a “superstar” – is confusing, particularly since you acknowledged that if the child had been “a loser,” your pro-abortion position probably wouldn’thave changed. Please explain this utilitarian view of the sanctity of human life. Do you consider life only worth protecting if it meets certain criteria, and, if so, what are those criteria?
2. How do you square your new position on life with your statements in 2015 supporting continued taxpayer funding for Planned Parenthood, the nation’s largest abortion seller?
3. The next president is expected to nominate two to four U.S. Supreme Court justices, beginning immediately with the vacancy caused by the passing of Justice Scalia. These nominations will likely decide critical issues such as abortion. You’ve recommended your sister, Maryanne Trump Barry, for the High Court. Yet, as a federal judge, she overturned the New Jersey Partial-Birth Abortion Ban, writing that it “burdened a woman's constitutional right to obtain an abortion.” How can we trust you to nominate judges who will respect the constitutional limits on judicial power and uphold the sanctity of human life?
4. You claim to support religious freedom, yet a leading gay-activist organization calls you “one of the best, if not the best, pro-gay Republican candidates to ever run for the presidency” – particularly because of your “standout position” when it comes to legislation that forces Christian business owners – and others of faith – to either betray their conscience or lose their business. How do you reconcile these contradictory positions?
5. You have built your campaign on lifting the economic outlook of lower-income Americans, yet you built your fortune in part on gambling, which preys on those very people. How will you make America great when you’ve run businesses associated with increased crime, bankruptcies, brokenmarriages and suicides?
6. The first casino in the nation to add a strip club was Trump Taj Mahal Casino in Atlantic City, which boasts of “36,000 square feet of adult entertainment.” What would you say to young girls and women who are concerned about a president who is directly connected with the exploitation of women?
7. As someone who claims to be a fiscal conservative, how do you justify your statements in support of a huge tax increase and government bailouts. Regarding the bank bailouts, you even stated: “I do agree with what they're doing with the banks. Whether they fund them or nationalize them, it doesn't matter, but you have to keep the banks going.” Perhaps most concerning of all is your continued admiration for single-payer, government-run healthcare systems. Please explain how this is consistent with the party of limited government?
8. One of your favorite campaign themes is that you are going to “run America” if elected. Considering our system of checks and balances, and especially in light of the last seven years of government by fiat, how will you demonstrate your respect for the U.S. Constitution and the limited power the Founding Fathers intended for the federal government in general, and the executive branch in particular?

Mr. Trump, we look forward to your response to these, and many other questions, affecting the lives of American families nationwide.

Liberals may look at this list and say “good for Trump.” But, of course, his record does not suggest that he is so much a liberal as an opportunist with no abiding convictions — except for the promotion of Donald Trump.

Canadian Warns About Socialized Medicine

Canadian Health Care: Yet More Failure

Given that socialized medicine in Canada was the model that proponents of ObamaCare looked to -- although happily they had to make some large compromises -- news from north of the border is relevant.

From The Star:

It’s no surprise to Thelma Lee that emergency room wait times are not meeting provincial targets.

Lee said her 41-year-old daughter, Marlene Stephens, died Saturday after waiting nearly 90 minutes at the William Osler Health Centre’s Etobicoke campus emergency room with breathing problems.

Lee feels her daughter was not seen fast enough by medical staff.

“They didn’t touch her,” said the grieving Lee. “She was crying out, ‘I can’t breathe, I can’t breathe’. . . Nobody attended to my daughter.”

On Monday, Auditor General Jim McCarter released his annual report which found that despite putting an extra $200 million into shortening emergency room wait times over the last two years, “significant province-wide progress has not yet been made.”

“Complaints about overcrowding and delays in hospital emergency rooms have persisted for years,” McCarter told a news conference on Monday.

Emergency room waits for people with serious conditions sometimes reached 12 hours or more, the report said. That is far greater than the province’s 8-hour wait time target, the report found.

And for emergency patients who need a hospital bed, they waited on average for about 10 hours but some waited 26 hours or more, according to the 2010 Annual Report.

“Our audit found that wait times for patients with less serious ailments have been reduced somewhat,” McCarter said. “However, there has been only minimal progress in reducing wait times for patients with more serious conditions.”

Health Minister Deb Matthews defended the province’s ER wait times strategy, saying Ontario is the first province to set targets and measure waits.

“When we started, about 81 per cent of people who went to emergency departments were seen within the target,” she said. “Now we are at 85 per cent . . . a lot of hard work goes into getting those wait times down.”

McCarter’s report shows the real problem with ER waits doesn’t necessarily start in the emergency department.

A big part of the problem is the lack of in-patient beds, which forces admitted patients to be housed in the emergency departments, the report said.

The lack of in-patient beds is influenced by two things, McCarter found. Beds are being blocked by patients who no longer require hospital care but who are waiting for a long-term care bed and by “less-than optimal practices” by hospitals in managing patient flow to free up space.

“There is no question; the ER is the canary in the coal mine. When something isn’t being properly being managed anywhere in the health system, the problems then show up in the emergency department,” Matthews said, adding that is why the Liberals are expanding homecare initiatives.

Progressive Conservative Leader Tim Hudak said the auditor has been saying for some time that an investment in long-term care beds can help the backlog.

“It makes me sad when I hear about families who have to wait 23 hours with their sons or daughters in an ER room,” Hudak said.

“It is absolutely outrageous when you see the money is there but it has been abused and wasted in scandals . . ..”

Hudak said getting rid of Local Health Integration Networks — 14 bodies across Ontario that direct community-based health care planning — would save the system $250 million. That money could go back into hospital care, he said.

New Democratic Leader Andrea Horwath said Ontario families are forced to play a waiting game for services and even life-saving programs.

“Families are waiting longer in emergency rooms . . . and to get their loved ones into long-term care or see them provided with home-care support,” she told reporters.

Lee called 911 early Saturday morning after her daughter collapsed with breathing problems when she came down the stairs.

Paramedics arrived quickly, but Lee said her daughter waited for about 90 minutes in the emergency room before being treated.

“This should not be happening in Canada,” Lee told the Star on Monday.

Stephens, an early childhood educator and mother of two sons, did not have any pre-existing breathing problems, said Lee.

Susan deRyk, chief communications officer for William Osler Health System, said the hospital cannot comment on any individual patient case due to patient privacy. “Our sympathies go out to the family,” she said.

Of course, horror stories about emergency rooms in the U.S. are not unknown. But this case is consistent with systematic data collected by the Auditor General.

It is in the nature of systems of socialized medicine to starve the providers. Given the choice of raising taxes, or imposing explicit draconian rationing, the politicians simply demand that the system produce better outcomes with the same resources -- or equal outcomes with fewer resources. But quickly that catches up with patients.

ObamaCare does not make it certain that this will happen in the U.S. But the vast increase in the power of the Federal government over health care now makes that a very real danger.

Obama Flip-Flop on “Cadillac” Tax Plans

The Real Cost of ObamaCare: Your Freedoms

One of the fundamental problems with the health care “reform” proposals of liberal Democrats is that they have a hidden agenda. Fundamentally, the seek government control of the entire health care system -- even if it’s left under nominal priivate ownership.

From CNN, an analysis of what would really happen if Obama gets his way.

NEW YORK (Fortune) -- In promoting his health-care agenda, President Obama has repeatedly reassured Americans that they can keep their existing health plans -- and that the benefits and access they prize will be enhanced through reform.

A close reading of the two main bills, one backed by Democrats in the House and the other issued by Sen. Edward Kennedy’s Health committee, contradict the President’s assurances. To be sure, it isn’t easy to comb through their 2,000 pages of tortured legal language. But page by page, the bills reveal a web of restrictions, fines, and mandates that would radically change your health-care coverage.

If you prize choosing your own cardiologist or urologist under your company’s Preferred Provider Organization plan (PPO), if your employer rewards your non-smoking, healthy lifestyle with reduced premiums, if you love the bargain Health Savings Account (HSA) that insures you just for the essentials, or if you simply take comfort in the freedom to spend your own money for a policy that covers the newest drugs and diagnostic tests -- you may be shocked to learn that you could lose all of those good things under the rules proposed in the two bills that herald a health-care revolution.

In short, the Obama platform would mandate extremely full, expensive, and highly subsidized coverage -- including a lot of benefits people would never pay for with their own money -- but deliver it through a highly restrictive, HMO-style plan that will determine what care and tests you can and can’t have. It’s a revolution, all right, but in the wrong direction.

Let’s explore the five freedoms that Americans would lose under Obamacare:

1. Freedom to choose what’s in your plan

The bills in both houses require that Americans purchase insurance through “qualified” plans offered by health-care “exchanges” that would be set up in each state. The rub is that the plans can’t really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer.

Today, many states require these “standard benefits packages” -- and they’re a major cause for the rise in health-care costs. Every group, from chiropractors to alcohol-abuse counselors, do lobbying to get included. Connecticut, for example, requires reimbursement for hair transplants, hearing aids, and in vitro fertilization.

The Senate bill would require coverage for prescription drugs, mental-health benefits, and substance-abuse services. It also requires policies to insure “children” until the age of 26. That’s just the starting list. The bills would allow the Department of Health and Human Services to add to the list of required benefits, based on recommendations from a committee of experts. Americans, therefore, wouldn’t even know what’s in their plans and what they’re required to pay for, directly or indirectly, until after the bills become law.

2. Freedom to be rewarded for healthy living, or pay your real costs

As with the previous example, the Obama plan enshrines into federal law one of the worst features of state legislation: community rating. Eleven states, ranging from New York to Oregon, have some form of community rating. In its purest form, community rating requires that all patients pay the same rates for their level of coverage regardless of their age or medical condition.

Americans with pre-existing conditions need subsidies under any plan, but community rating is a dubious way to bring fairness to health care. The reason is twofold: First, it forces young people, who typically have lower incomes than older workers, to pay far more than their actual cost, and gives older workers, who can afford to pay more, a big discount. The state laws gouging the young are a major reason so many of them have joined the ranks of uninsured.

Under the Senate plan, insurers would be barred from charging any more than twice as much for one patient vs. any other patient with the same coverage. So if a 20-year-old who costs just $800 a year to insure is forced to pay $2,500, a 62-year-old who costs $7,500 would pay no more than $5,000.

Second, the bills would ban insurers from charging differing premiums based on the health of their customers. Again, that’s understandable for folks with diabetes or cancer. But the bills would bar rewarding people who pursue a healthy lifestyle of exercise or a cholesterol-conscious diet. That’s hardly a formula for lower costs. It’s as if car insurers had to charge the same rates to safe drivers as to chronic speeders with a history of accidents.

3. Freedom to choose high-deductible coverage

The bills threaten to eliminate the one part of the market truly driven by consumers spending their own money. That’s what makes a market, and health care needs more of it, not less.

Hundreds of companies now offer Health Savings Accounts to about 5 million employees. Those workers deposit tax-free money in the accounts and get a matching contribution from their employer. They can use the funds to buy a high-deductible plan -- say for major medical costs over $12,000. Preventive care is reimbursed, but patients pay all other routine doctor visits and tests with their own money from the HSA account. As a result, HSA users are far more cost-conscious than customers who are reimbursed for the majority of their care.

The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses. “The government could set extremely low deductibles that would eliminate HSAs,” says John Goodman of the National Center for Policy Analysis, a free-market research group. “And they could do it after the bills are passed.”

4. Freedom to keep your existing plan

This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It’s worth diving into the weeds -- the territory where most pundits and politicians don’t seem to have ventured.

The legislation divides the insured into two main groups, and those two groups are treated differently with respect to their current plans. The first are employees covered by the Employee Retirement Security Act of 1974. ERISA regulates companies that are self-insured, meaning they pay claims out of their cash flow, and don’t have real insurance. Those are the GEs (GE, Fortune 500) and Time Warners (TWX, Fortune 500) and most other big companies.

The House bill states that employees covered by ERISA plans are “grandfathered.” Under ERISA, the plans can do pretty much what they want -- they’re exempt from standard packages and community rating and can reward employees for healthy lifestyles even in restrictive states.

But read on.

The bill gives ERISA employers a five-year grace period when they can keep offering plans free from the restrictions of the “qualified” policies offered on the exchanges. But after five years, they would have to offer only approved plans, with the myriad rules we’ve already discussed. So for Americans in large corporations, “keeping your own plan” has a strict deadline. In five years, like it or not, you’ll get dumped into the exchange. As we’ll see, it could happen a lot earlier.

The outlook is worse for the second group. It encompasses employees who aren’t under ERISA but get actual insurance either on their own or through small businesses. After the legislation passes, all insurers that offer a wide range of plans to these employees will be forced to offer only “qualified” plans to new customers, via the exchanges.

The employees who got their coverage before the law goes into effect can keep their plans, but once again, there’s a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it’s likely that millions of employees will lose their plans in 12 months.

5. Freedom to choose your doctors

The Senate bill requires that Americans buying through the exchanges -- and as we’ve seen, that will soon be most Americans -- must get their care through something called “medical home.” Medical home is similar to an HMO. You’re assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.

Under the proposals, the gatekeepers would theoretically guide patients to tests and treatments that have proved most cost-effective. The danger is that doctors will be financially rewarded for denying care, as were HMO physicians more than a decade ago. It was consumer outrage over despotic gatekeepers that made the HMOs so unpopular, and killed what was billed as the solution to America’s health-care cost explosion.

The bills do not specifically rule out fee-for-service plans as options to be offered through the exchanges. But remember, those plans -- if they exist -- would be barred from charging sick or elderly patients more than young and healthy ones. So patients would be inclined to game the system, staying in the HMO while they’re healthy and switching to fee-for-service when they become seriously ill. “That would kill fee-for-service in a hurry,” says Goodman.

In reality, the flexible, employer-based plans that now dominate the landscape, and that Americans so cherish, could disappear far faster than the 5 year “grace period” that’s barely being discussed.

Companies would have the option of paying an 8% payroll tax into a fund that pays for coverage for Americans who aren’t covered by their employers. It won’t happen right away -- large companies must wait a couple of years before they opt out. But it will happen, since it’s likely that the tax will rise a lot more slowly than corporate health-care costs, especially since they’ll be lobbying Washington to keep the tax under control in the righteous name of job creation.

The best solution is to move to a let-freedom-ring regime of high deductibles, no community rating, no standard benefits, and cross-state shopping for bargains (another market-based reform that’s strictly taboo in the bills). I’ll propose my own solution in another piece soon on Fortune.com. For now, we suffer with a flawed health-care system, but we still have our Five Freedoms. Call them the Five Endangered Freedoms.

The U.S. Has Better Health Care Than Canada

From the National Bureau of Economic Research, a scholarly and detailed comparison of the U.S. and the Canadian health care systems.

It has lots of data. But read it, if you want the best scholarly read on the two systems.

It might seem that events in Washington are now leaning against a government takeover of U.S. health care. But the people who want government control have not given up.

More on Poor Health Care in Canada

Health Care Debate Tonight

Unaffordable or Unavoidable:
A Forum on Health Care Reform

A town hall forum featuring:
Dr. Susan Giaimo
Panelist: Visiting Assistant Professor of Political Science
Dr. John McAdams
Panelist: Associate Professor of Political Science
Dr. Robert Kraig
Panelist: Executive Director, Citizen Action of Wisconsin
State Rep. Leah Vukmir
Panelist: Representative for Wisconsin’s 14th Assembly District

Wednesday, November 11, 6 p.m. in
Marquette Hall, Room 200
Here is the flyer for the event.

This ought to be pretty good, especially since we are talking about legislation that could radically change a sixth of the U.S. economy, and affect the quality of health care that Americans get for the rest of their lives.

ObamaCare: Demagoguing the Insurance Companies

From Jeff Jacoby in the Boston Globe:

TWO THINGS supporters of a government-run “public option” for health insurance know for sure. One is that private health insurers are raking in obscenely high profits. The other is that only a government rival can force them to compete on price.

In a clever new commercial featuring Heather Graham as an agile sprinter named “Public Option,” the left-wing pressure group MoveOn combines both themes, describing insurance companies as “lazy” and “bloated from the profits of raising our health care costs sky-high.” Why, it asks, should anyone resist the competition a public option would generate? After all, “competition is as American as apple pie.” In a less amusing print ad a few weeks ago, MoveOn charged that “insurance companies are willing to let the bodies pile up, as long as their profits are safe.”

President Obama also attacks health insurers as avaricious profiteers.

“The insurance industry is making this last-ditch effort to stop reform,” he declared on Oct. 16, “even as costs continue to rise and our health-care dollars continue to be poured into their profits (and) bonuses.” When he addressed Congress in September, Obama insisted that only a public option will “keep insurance companies honest.” On the White House Blog, ObamaCare opponents are accused of “fighting to protect insurance industry profits.”

Indeed, there is no shortage of voices characterizing health insurers as greedy villains. Earlier this year, House Speaker Nancy Pelosi praised her party for highlighting “the immoral profits being made by the insurance industry.” On CNN last week, Ohio Senator Sherrod Brown demanded a public option “so the insurance industry can’t continue to game the system and discriminate” against women and the disabled — tactics insurers have used to “quadruple their profits in the last five years.” If quadrupled profits don’t seem rapacious enough, the union-backed Health Care for American Now! ups the ante, claiming, according to the AFL-CIO’s news blog, that “during the past five years, health insurance company profits have soared by 1,000 percent.”

Outbidding them all is Senate Majority Leader Harry Reid. Health insurance companies “are so anti-competitive,” he said last month, “because they make more money than any other business in America today.”

To such overheated agitprop, the only useful response is a cold shower of facts, and the Associated Press supplied a timely one last week. For all the impassioned talk about obscene profits and bodies piling up, AP’s Calvin Woodward reported, “health insurance profit margins typically run about 6 percent” of revenues, a return “that’s anemic compared with other forms of insurance and a broad array of industries.”

87 cents out of every premium dollar pays for medical services, according to a PriceWaterhouseCoopers study for America’s Health Insurance Plans. Insurance company profits account for just 3 cents.

On the Fortune 500 list of top industries, health insurance companies ranked 35th in profitability in 2008; their overall profit margin was a mere 2.2 percent. They lagged far behind such industries as pharmaceuticals (which showed a profit margin of 19.3 percent), railroads (12.6 percent), and mining (11.5 percent). Among health insurers, the best performer last year was HealthSpring, which had a profit of 5.4 percent. “That’s a less profitable margin,” AP noted, “that was achieved by the makers of Tupperware, Clorox bleach, and Molson and Coors beers.”

For the most recent quarter of 2009, health-insurance plans earned profits of only 3.3 percent, ranking them 86th on the expanded Yahoo! Finance list of US industries. The application-software industry, by contrast, is pulling in profits of nearly 22 percent. Why aren’t MoveOn and the Democrats demanding a “public option” to compete with Microsoft and Adobe and drive down their “immoral” profits?

There are certainly industries doing worse than health insurance — airlines and newspapers, for example — but the notion that health insurers “make more money than any other business in America today” is preposterous. Advocates of a public option may find it tactically expedient to paint insurers as insatiable predators, swollen with ill-gotten profits. The reality is otherwise.

Still, the critics do have one thing right: More competition would bring down health-care premiums. But the way to increase competition is not by adding a government-run health plan to the 1,300 private firms already providing Americans with health insurance. After all, there’s no public option for auto insurance and life insurance, yet they’re sold in a highly competitive national market. There is no reason health insurance can’t be sold the same way.

Let’s be clear on this: the pro-Obama Care liberals, when they attack the insurance companies, are no different from the late and unlamented Senator Joe McCarthy in their willingness to demonize any group that stands in the way of their agenda.

And their tactic dates back to the demagogues of Ancient Greece, who would demonize the groups they wanted to oppress — typically the wealthy whose property they wanted to seize. They are, in other words, not merely misguided. They are sleazy.

The Future of U.S. Health Care (If the Liberals Get Their Way)

Further news on an issue we have blogged on before.

From The Times:

AN 80-year-old grandmother who doctors identified as terminally ill and left to starve to death has recovered after her outraged daughter intervened.

Hazel Fenton, from East Sussex, is alive nine months after medics ruled she had only days to live, withdrew her antibiotics and denied her artificial feeding. The former school matron had been placed on a controversial care plan intended to ease the last days of dying patients.

Doctors say Fenton is an example of patients who have been condemned to death on the Liverpool care pathway plan. They argue that while it is suitable for patients who do have only days to live, it is being used more widely in the NHS, denying treatment to elderly patients who are not dying.

Fenton’s daughter, Christine Ball, who had been looking after her mother before she was admitted to the Conquest hospital in Hastings, East Sussex, on January 11, says she had to fight hospital staff for weeks before her mother was taken off the plan and given artificial feeding.

Ball, 42, from Robertsbridge, East Sussex, said: “My mother was going to be left to starve and dehydrate to death. It really is a subterfuge for legalised euthanasia of the elderly on the NHS. ”

Fenton was admitted to hospital suffering from pneumonia. Although Ball acknowledged that her mother was very ill she was astonished when a junior doctor told her she was going to be placed on the plan to “make her more comfortable” in her last days.

Ball insisted that her mother was not dying but her objections were ignored. A nurse even approached her to say: “What do you want done with your mother’s body?”

On January 19, Fenton’s 80th birthday, Ball says her mother was feeling better and chatting to her family, but it took another four days to persuade doctors to give her artificial feeding.

Fenton is now being looked after in a nursing home five minutes from where her daughter lives.

Peter Hargreaves, a consultant in palliative medicine, is concerned that other patients who could recover are left to die. He said: “As they are spreading out across the country, the training is getting probably more and more diluted.”

A spokesman for East Sussex Hospitals NHS Trust, said: “Patients’ needs are assessed before they are placed on the [plan]. Daily reviews are undertaken by clinicians whenever possible.”

Well that’s reassuring. Just how often is it “possible” in a system starved for resources.

In a separate case, the family of an 87-year-old woman say the plan is being used as a way of giving minimum care to dying patients.

Susan Budden, whose mother, Iris Griffin, from Norwich, died in a nursing home in July 2008 from a brain tumour, said: “When she was started on the [plan] her medication was withdrawn. As a result she became agitated and distressed.

“It would appear that the [plan] is . . . used purely as a protocol which can be ticked off to justify the management of a patient.”

Deborah Murphy, the national lead nurse for the care pathway, said: “If the education and training is not in place, the [plan] should not be used.” She said 3% of patients placed on the plan recovered.

Of course, even 3% is a large number of people who are literally being starved and dehydrated to death.

But nobody knows how many would have recovered had they never been placed on the plan to begin with.

Even if “the education and training” is in place, no assessments from even well-trained people can be perfect, and the inevitable effect will be to kill patients who could recover and live a year or two or five years of meaningful life.

And, under any system of socialized medicine, budgetary constraints will bias the assessments toward the option that releases scarce resources for other uses, that is, which lets people die.

The phrase “death panels” just can’t be avoided here.

Big Labor and Whole Foods’ Health Care Sanity

Government Run Health Care and Killing Patients

From National Review Online:

Compare America’s system with Canada’s and Great Britain’s. The latter are single-payer, universal health-care programs in which medical treatment is free at the point of service (Yay!), although citizens eventually pay for it through higher taxes (Boo!).

According to Organization for Economic Cooperation and Development data, there were 26.6 MRI machines in the U.S. per million people in 2004. In Canada, there were 4.9 such devices, while Britain enjoyed 5. For every 100,000 Americans, 2006 saw 436.8 receive angioplasties. Among Canadians, that figure was 135.9, while only 93.2 Britons per 100,000 got that cardiac procedure.

Maybe that’s why, among American men, heart-attack deaths in 2004 stood at 53.8 per 100,000. In Canada, 58.3 men per 100,000 died of cardiac arrest, while coronaries buried 69.5 of every 100,000 British males.

The fatality rate for breast cancer, according to the National Center for Policy Analysis and Lancet Oncology, is 25 percent in the U.S., 28 percent in Canada, and 46 percent in Great Britain.

Among those diagnosed with prostate cancer, 19 percent die of the disease in America. In Canada, 25 percent of such patients succumb to this disease. And in Great Britain — an Anglophone NATO member and America’s closest ally — prostate cancer kills 57 percent of those who contract it. That is triple the American fatality rate.

The Senate Finance Committee should sink Obama-Baucuscare and instead craft a patient-friendly, pro-market, limited-government approach to health-care reform. Perhaps some senators cannot fathom the Hippocratic Oath’s key insight: First, do no harm. If that’s Greek to them, here it is in language they understand: First, don’t kill your voters.

Unfortunately, a fair number of politicians are in thrall of an ideology that favors government, and a fair number of others don’t much mind hurting people if they can’t be blamed for it.

Health Insurance as Though Economics Matters

Two more examples of how market competition drives down prices are stand-alone imaging centers and dialysis centers. It’s clear that sane health-care reform would involve high coinsurance, deductables and out of pocket maximums, combined with medical savings accounts.

But that doesn’t serve the political interests of certain people.

Obama’s Arrogant, Partisan Health Care Speech

From Reason, a fairly long post, in which we found the following particularly cogent:

As the reform supporter and professional skeptic Mickey Kaus noted before the speech, “Obama doesn’t need to get ‘Republicans on board.’ He doesn’t need to get Blue Dog Democrats on board. He needs to get voters on board.” And if there’s any tactic less effective at wooing skeptics than number-fudging insincerity, it’s number-fudging insincerity coupled with attacks on the veracity, motivation, and worldview of the skeptics themselves.

Again last night, Obama invoked the boogeyman of “special interests” who “lie” in order “to keep things exactly the way they are,” despite the fact that the special interests in this case are lining up to support the president, and that the critics of his plan tend to bemoan, not defend, the status quo. Opponents of his plan, he said, were “ideological”; Ted Kennedy’s support for health care reform, meanwhile, “was born not of some rigid ideology, but of his own experience.” Obama said his door was “always open” to those bringing “a serious set of proposals,” and he slammed that door shut on any attempts to break the almost universally unloved link between employment and insurance. He yearned to “replace acrimony with civility,” then got Democrats stomping on their feet with attacks against the Iraq War and “tax breaks for the wealthy.” The center of the debate, as always, was wherever he chose to stand.

And above all else, Obama chose to shadowbox against the more extreme claims of the Sarah Palins of the world, rather than engage the most serious of the skeptics’ arguments. No, the administration doesn’t “plan to set up panels of bureaucrats with the power to kill off senior citizens,” but what about the possibility of government cost-cutters frowning upon expensive hip replacement surgeries for the chronically old? No, the proposal doesn’t amount to a complete “government takeover” of health care, but it does continue to expand the government’s role (and, promises aside, expenses) in ways that make a deficit-whiplashed nation nervous. No, “no one would be forced to choose” a public option, but what about the argument that incentives would eventually push Americans from private insurance to the public plan?

Obama’s problem is simple: he has a hidden agenda. He wants a complete government takeover of health care. He wants health care rationed, as it is under systems of socialized medicine. He wants taxpayer money to pay for abortions. He wants illegal immigrants covered. He doesn’t mind if the deficit is drive up even higher.

But the public wants none of those things. Thus Obama simply has to lie.

What Was Wrong With the Obama Health Care Speech

ObamaCare and Forced Unionization

From the Wall Street Journal:

In the heated debates on health-care reform, not enough attention is being paid to the huge financial windfalls ObamaCare will dole out to unions—or to the provisions in the various bills in Congress that will help bring about the forced unionization of the health-care industry.

Tucked away in thousands of pages of complex new rules, regulations and mandates are special privileges and giveaways that could have devastating consequences for the health-care sector and the American economy at large.

The Senate version opens the door to implement forced unionization schemes pursued by former Govs. Rod Blagojevich of Illinois in 2005 and Gray Davis of California in 1999. Both men repaid tremendous political debts to Andy Stern and his Service Employees International Union (SEIU) by reclassifying state-reimbursed in-home health-care (and child-care) contractors as state employees—and forcing them to pay union dues.

Following this playbook, the Senate bill creates a “personal care attendants workforce advisory panel” that will likely impose union affiliation to qualify for a newly created “community living assistance services and support (class)” reimbursement plan.

The current House version of ObamaCare (H.R. 3200) goes much further. Section 225(A) grants Secretary of Health and Human Services Kathleen Sebelius tremendous discretionary authority to regulate health-care workers “under the public health insurance option.” Monopoly bargaining and compulsory union dues may quickly become a required standard resulting in potentially hundreds of thousands of doctors and nurses across the country being forced into unions.

Ms. Sebelius will be taking her marching orders from the numerous union officials who are guaranteed seats on the various federal panels (such as the personal care panel mentioned above) charged with recommending health-care policies. Big Labor will play a central role in directing federal health-care policy affecting hundreds of thousands of doctors, surgeons and nurses.

Consider Kaiser Permanente, the giant, managed-care organization that has since 1997 proudly touted its labor-management “partnership” in scores of workplaces. Union officials play an essentially co-equal role in running many Kaiser facilities. AFL-CIO President John Sweeney called the Kaiser plan “a framework for what every health care delivery system should do” at a July 24 health-care forum outside of Washington, D.C.

The House bill has a $10 billion provision to bail out insolvent union health-care plans. It also creates a lucrative professional-development grant program for health-care workers that effectively blackballs nonunion medical facilities from participation. The training funds in this program must be administered jointly with a labor organization—a scenario not unlike the U.S. Department of Labor’s grants for construction apprenticeship programs, which have turned into a cash cow for construction industry union officials on the order of hundreds of millions of dollars each year.

There’s more. Senate Finance Committee Chairman Max Baucus has suggested that the federal government could pay for health-care reform by taxing American workers’ existing health-care benefits—but he would exempt union-negotiated health-care plans. Under Mr. Baucus’s scheme, the government could impose costs of up to $20,000 per employee on nonunion businesses already struggling to afford health care plans.

Mr. Baucus’s proposal would give union officials another tool to pressure employers into turning over their employees to Big Labor. Rather than provide the lavish benefits required by Obamacare, employers could allow a union to come in and negotiate less costly benefits than would otherwise be required. Such plans could be continuously exempted.

Americans are unlikely to support granting unions more power than they already have in the health-care field. History shows union bosses could abuse their power to shut down medical facilities with sick-outs and strikes; force doctors, nurses and in-home care providers to abandon their patients; dictate terms and conditions of employment; and impose a failed, Detroit-style management model on the entire health-care field.

ObamaCare is a Trojan Horse for more forced unionization.

Liberal supporters of ObamaCare will doubtless say that nothing like this will necessarily follow from the president’s program. And yes, it doesn’t necessarily follow.

But the same people will be scheming and conniving to make it happen.

Yet More on Socialized Medicine in the U.K.

From the Daily Mail:

Patients in Health Service hospitals are far more likely to go hungry than criminals in jail, scientists warned yesterday.

They say frail and elderly patients do not get the help they need with meals, and nobody checks whether they get enough to eat.

Despite years of Government promises to tackle poor hospital nutrition, food still arrives cold, and patients often miss out because meal times clash with tests and operations.

Meanwhile, prisoners are enjoying carbohydrate-rich, low-fat foods which in many cases are better than they would have been eating on the outside.

The Daily Mail has been highlighting the scandal of old people not being fed properly in hospital as part of its Dignity for the Elderly campaign.

Hospital meals are often taken away untouched, because they are either unappetising or are placed out of patients’ reach.

The latest figures show 242 patients died of malnutrition in NHS hospitals in 2007 - the highest toll in a decade. More than 8,000 left hospital under-nourished - double the figure when Labour came to power.

The NHS throws away 11million meals every year, and many nurses say they are too busy to help the frail eat.

Earlier this year the Mail revealed that some hospitals spend less on meals than the average prison.

Ten hospitals spent less on breakfast, lunch and an evening meal than the £2.12 a day allocated for food by the prison service. One spent just £1.

Although most hospitals do spend more than £2.12, prisoners end up better nourished than patients, say experts from Bournemouth University. After studying the food offered to inmates and across the NHS, they found patients face more barriers in getting good nutrition.

Professor John Edwards said around 40 per cent of patients were already malnourished when they were admitted to hospital, but their condition did not tend to improve while they were there.

“If you are in prison then the diet you get is extremely good in terms of nutritional content,” he said.

“The food that is provided is actually better than most civilians have.

“There’s a focus on carbohydrates, then there’s the way they prepare the food, it’s very healthy. They don’t add salt and there’s relatively little frying of food - if you have a burger then it goes in the oven. Hospital patients don’t consume enough.

“And from the work we’ve done we know that people who sit round a table eat a lot more, but this doesn’t happen in hospitals.”

His colleague, Dr Heather Hartwell, said fruit and vegetables were given out in hospitals “but this doesn’t mean it’s eaten.”

While patients suffer due to a loss of appetite as a result of their illness, they often go hungry because there is no one to help them eat.

Dr Hartwell said once food was prepared, it generally hangs around waiting for porters to transport it to patients. Then it may be left on wards until it goes cold.

“Ward staff also don’t actually know how much patients are eating because it is domestics who clear the trays away,” she said. “This is an example of fragmentation in hospitals that does not necessarily happen in prisons.”

The research found temperature and texture are among the most important factors in patients’ satisfaction with food.

It concluded lack of appetite due to a medical problem is probably the main reason for under-nutrition, but said hospitals can make improvements.

Liberal Democrat health spokesman Norman Lamb said: “It’s incredible that so many hospitals are failing to serve healthy meals. If prisons can serve good food then so can hospitals.”

Then we have this, from The Telegraph.

Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors warn today.

In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.

But this approach can also mask the signs that their condition is improving, the experts warn.

As a result the scheme is causing a “national crisis” in patient care, the letter states. It has been signed palliative care experts including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, and four others.

“Forecasting death is an inexact science,” they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.

“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients.”

The warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS.

The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours.

Developed by Marie Curie, the cancer charity, in a Liverpool hospice it was initially developed for cancer patients but now includes other life threatening conditions.

It was recommended as a model by the National Institute for Health and Clinical Excellence (Nice), the Government’s health scrutiny body, in 2004.

It has been gradually adopted nationwide and more than 300 hospitals, 130 hospices and 560 care homes in England currently use the system.

Under the guidelines the decision to diagnose that a patient is close to death is made by the entire medical team treating them, including a senior doctor.

They look for signs that a patient is approaching their final hours, which can include if patients have lost consciousness or whether they are having difficulty swallowing medication.

However, doctors warn that these signs can point to other medical problems.

Patients can become semi-conscious and confused as a side effect of pain-killing drugs such as morphine if they are also dehydrated, for instance.

When a decision has been made to place a patient on the pathway doctors are then recommended to consider removing medication or invasive procedures, such as intravenous drips, which are no longer of benefit.

If a patient is judged to still be able to eat or drink food and water will still be offered to them, as this is considered nursing care rather than medical intervention.

Dr Hargreaves said that this depended, however, on constant assessment of a patient’s condition.

He added that some patients were being “wrongly” put on the pathway, which created a “self-fulfilling prophecy” that they would die.

He said: “I have been practising palliative medicine for more than 20 years and I am getting more concerned about this “death pathway” that is coming in.

“It is supposed to let people die with dignity but it can become a self-fulfilling prophecy.

“Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway.”

He added: “What they are trying to do is stop people being overtreated as they are dying.

“It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking.”

He said that he had personally taken patients off the pathway who went on to live for “significant” amounts of time and warned that many doctors were not checking the progress of patients enough to notice improvement in their condition.

Prof Millard said that it was “worrying” that patients were being “terminally” sedated, using syringe drivers, which continually empty their contents into a patient over the course of 24 hours.

In 2007-08 16.5 per cent of deaths in Britain came about after continuous deep sedation, according to researchers at the Barts and the London School of Medicine and Dentistry, twice as many as in Belgium and the Netherlands.

“If they are sedated it is much harder to see that a patient is getting better,” Prof Millard said.

The letter has also been signed by Dr Anthony Cole, the chairman of the Medical Ethics Alliance, Dr David Hill, an anaesthetist, Dowager Lady Salisbury, chairman of the Choose Life campaign and Dr Elizabeth Negus a lecturer in English at Barking University.

Of course, supporters of ObamaCare insist that nothing like this can ever happen in the U.S. And all the while Obama promises to cut a half trillion dollars from Medicare.

And all the while Obama and liberals work to vest in unelected bureaucrats the power to deny certain treatments to people deemed somehow unworthy.

And they keep insisting that the U.S. spends “too much” on health care, and should be spending an amount more like that of Canada and the U.K.

And of course, liberals reject policies that might actually make the system more efficient, like malpractice reform and allowing interstate competition among insurers.

Are the ignorant of the foreseeable consequences of what they promote, or are they simply dishonest?

Obama On Health Care: Shut Up and Take What I Give You

The “Lies” About Socialized Medicine

From Patrick McIlheran, who is responding to the claim of liberal Paul Krugman that horror stories about socialized medicine are “lies”:

You mean like this story, just to grab one from the headlines this week? “A young mother gave birth on a pavement outside a hospital after she was told to make her own way there,” the Daily Mail reported. Carmen Blake went into labor unexpectedly, the paper reports, and called for an ambulance. Walk, she was told, since it was only 100 meters. “Her daughter Mariah was delivered on a pavement outside the hospital by a passer-by, just before ambulance crews arrived.”

Or this story, surely a wholesale fiction, in the Telegraph, about the Alzheimer patient who couldn’t get a home health aide because “because her condition was a ‘social’ rather than ‘health’ problem,” authorities said. The family won reimbursement only after their mother was bedridden and her house lost.

And surely the Telegraph was making it up when it reported that thousands of emergency patients were left waiting for hours in ambulances outside emergency rooms. This wasn’t new: For years, hospitals are fiddling with their performance stats in this way, the Daily Mail surely lied.

Paul Krugman said it’s all false, so I’m sure it was.

He also said that Canadians are happier with their health care than Americans are. Well, no: In fact, they like the price but don’t like the waits. And if you try asking parallel questions in the two countries, you find that Canadians’ satisfactions about the quality of their care and their ability actually to see a doctor is much closer to that of uninsured Americans than to insured ones. Insured Canadians are only slightly happier about health care than uninsured wretches here.

And all that for a system that’s financially “imploding,” as the incoming head of the Canadian Medical Association put it the other day. “(Canadians) have to understand that the system that we have right now -- if it keeps on going without change -- is not sustainable,” said Anne Doig, a family doctor from Saskatchewan. “Our system is crumbling around us,” she told a newspaper the other day -- and she’s a fan of government-run care.

Krugman, of course, is just throwing up blather, utterly refusing to engage with facts. This is one reason Obamacare just isn’t flying with the public: So many of its advocates, first, can’t conceal that they’d really prefer a single-payer, straight-up government-run system. And then those advocates tell you that the news stories you’re reading about Canada having to fly mothers in labor to small-town Montana to find hospital space are just fiction.

It’s not loud dissent that’s sinking the president’s dreams; it’s the overwhelming sound of cognitive dissonance, instead.