Monthly Archives: March 2009

Medical civil liberties threatened by rollback of Provider Conscience Clause

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Just at the deadline for responding to the AAPS action to intervene in lawsuits challenging the Provider Conscience Clause, the Obama Administration started rulemaking to rescind the Clause completely.

This signals the intention of the Administration to refuse to enforce laws duly passed by Congress to protect medical professionals against discrimination for refusing to participate in procedures that violate their conscience, write Newt Gingrich and Rick Tyler (Newsmax.com 3/16/09).

These laws include the 1973 “Church Amendments,” the 1976 Public Health Services Act Amendment, and the 2004 “Hyde-Weldon Amendment.” The last prohibits certain federal funds from going to agencies or programs that discriminate against providers who decline to offer or refer for abortions.

Former Health and Human Services Secretary Mike Leavitt said the Conscience Clause was necessary to protect against growing intolerance for those acting on certain religious beliefs.

Sister Carol Keehan, president of the Catholic Health Association, said “We have seen a variety of efforts to force Catholic and other healthcare providers to perform or refer for abortions or sterilizations.”

The rule places no restrictions on any legal medical procedure. The Obama Administration, however, referred to comments asserting that “individuals could be denied access to services, with effects felt disproportionately by those in rural areas or otherwise underserved” (Steve Ertelt, LifeNews.com 3/6/09).

Apparently, the “right” of some to receive a service implies the obligation of others to provide it, regardless of their opinion about the morality or harmfulness of the procedure.

At a meeting of the UN Commission on the Status of Women (CSW), a representative of President Obama denied that abortion has any negative effects on women. In response to a question about the scientific evidence of detriment to the lives and health of women, Ellen Chesler dismissed the evidence as “unreliable because it has ideological elements” (Steven Ertelt, LifeNews.com 3/12/08). Chesler is former senior fellow at the Open Society Institute founded by George Soros, where she directed a $35 million “reproductive rights” program.

The evidence included three studies published in 2008 from the U.S., New Zealand, and Australia. These showed a 30 percent higher incidence of depression and other mental-health problems, a 120 percent increase in risk of alcohol abuse, and a 79 percent increase in risk of drug abuse in women who had had an abortion.

Obama also supported $50 million in funding for the United Nations Population Fund (UNFPA), which is complicit in using forced abortions and sterilizations to enforce China’s one-child policy, state Gingrich and Tyler.

The deadline for the 30-day comment period is April 9, 2009. You can submit comments to proposedrescission@hhs.gov. Put “Rescission Proposal” in the subject line of your email. You can also submit comments through www.freedom2care.org.

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White House Healthcare Summit, March 5, 2009

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SELECTED PARTICIPANT COMMENTS & AAPS NOTES

(Please leave your comments at bottom of this page.)

 

Stakeholders included advocates for psychologists and dentists, drug companies, large employers, AARP, AMA, labor unions, single-payer advocates, National Federation of Independent Businesses, school-based clinics, Indian tribes, AIDs patients, cardiologists, family practitioners, community health centers, chronic disease programs and long term care.

 

NOTE: The White House did NOT release an advance the list of participants, so we cannot yet attribute some of the comments. 

 

Nancy Nielsen, AMA president:

“We’re here to be partners.”

“Doctors resist being told what to do…what they resist is government control, and this is not government control.”

 

Q. What is organized med going to do this time to make things work?

R:Nielsen: “Docs not happy, pts not happy, what is different from before is that we’ve been included, and if we have constructive suggestions, we’ll be heard – we’re here to head off unexpected consequences.”

 

W. Douglas Weaver, American College of Cardiology:

We want imaging in an electronic form.  “College is willing to commit we could decrease inappropriate tests by 15% within one year – by using point of care decision-making tools.”

 

Sen. Robert Bennett (R-UT):

“Republicans need to get over their opposition to universal coverage. They are distrustful because they equate it with single payer.”

 

Rep. Henry Waxman (D-CA):

“We can’t control costs unless everybody’s covered.”

 

A Congressional Republican:

“I want to compliment the President on the process…if it’s real…if it’s a real process, then we’ll participate…

 

“…Medicare Part D, which I was skeptical, I was the last vote in house to pass, has worked to create transparency and competition for participants to choose best plans for them…

 

“…Don’t try to micromanage doctors practice, but I’m with Sen. Baucus on the need for accountability and performance review…

 

…Sen. Baucus and I have been working with AMA to get some quality measures.  This legislature ought to move us in that direction, or set a deadline for moving in that direction.

 

OTHER NOTES:

 

One claimed: 250,000 are dead because we didn’t act in 1993! It’s a violation of respect for human life to have access to care depend on ability to pay (as opposed, presumably, because of a political decision to ration care).

 

Transparency a big thing. Also data, lots of data needed. Zeke Emanuel: How do we get it collected? Should government pay for collection? Somebody noted that government makes lots of people collect data without getting paid for it.

 

Somebody who represents 10,000 companies commented on success record of HSAs. John Deere got rid of an HMO, allowed HSAs, significant numbers of employees chose it, 2/3 of those with moderate or high risk; avg $1900 in accounts at end of first year; 100% coverage for preventive services. He also said defending ERISA very important to protect against vulnerability to “add-ons” (insurance mandates?).

 

Disparity (racial and ethnic) a big problem, need more representation of minorities at all levels.


A number commented on how much money could be saved by eliminating medical errors.

 

In Massachusetts, 75% of businesses are happy; consensus is that it’s “not too bad.”

 

Drug companies “prepared to compromise.” Love comparative effectiveness research.

 

Medicare Part D is wonderful, costs 40% less than lowest estimate because it has a competitive market. Zeke said for first time government just organized something without running it.

 

Zeke Emanuel: we need to make health care services more efficient. How do we make doctors, hospitals, etc. deliver care more efficiently? Some suggested just getting information, as on quality, out would work magic.

 

It was noted that hospitals may bill uninsured 10 to 20 times as much as government or insured patients. It’s that uncompensated care that’s the problem! To stop indirect subsidization we need universal coverage.

 

Incentives to doctors—perhaps collective incentive to groups who get to share in dollar savings.

 

Malpractice costs: perhaps put doctors under Federal Tort Claims Act for Medicare patient, like federally qualified health centers? Some doctors might do Medicare exclusively!

 

End of life costs: allow doctors to charge for educating patients about advance directives during the Welcome to Medicare physical, and perhaps reduce premiums for patients who go to an educational seminar on advance directives.

 

“We need better coordinated, team-based care.”

American Academy of Family Physicians made it clear that they were ready to provide ‘Medical Homes.’ [Re-invent managed care?]

 

We need to “help the change,” and we all need to be “better than average.”

 

Patients need to be educated about the importance of change, the fact that more is not always better, and that we need to accept change. [Need to lower expectations.]

 

We must be bold, willing to overturn sacred cows.

House Doctor Diss’d by White House Healthcare Summit: Rep. Tom Price, MD speculates on why he wasn’t invited

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Another invitation apparently lost in the mail was that for
Rep. Tom Price, MD (R-GA) – not only one of the handful
of doctors in Congress, but also chair of the influential,
right-of-center Republican Study Group.
 

 
NOTE:   AAPS will hold a national citizen summit on healthcare
in June.  Details will be coming soon. 
 
Please email us know if your group is interested in participating: aaps@aapsonline.org

White House Healthcare “Prom” Invitations ‘Lost in the Mail’

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FEATURED IN VIDEO:
Andrew Moylan, Dir., Govt. Affairs, National Taxpayers Union
Ryan Ellis, Tax Policy Dir., Americans for Tax Reform
Amy Menefee, Communications Dir., Galen Institute

March 4, 2009

Contact: Kathryn Serkes, (202) 333-3855
serkes@att.net

For immediate release:

 WHITE HOUSE HEALTHCARE “PROM” INVITATIONS
‘LOST IN THE MAIL’

Who’ll Be Voted Prom King & Queen Tomorrow?

Washington — The Association of American Physicians and Surgeons (AAPS) issued the following statement by Kathryn Serkes, Director of Policy and Public Affairs, regarding the President’s Healthcare Summit on March 5, 2009:

 “We’ve received numerous media inquiries about our participation in the President’s Healthcare Summit on March 5

“But apparently, our invitation was lost in the mail.

“It’s interesting that reporters just assumed the nation’s only professional association of doctors in private practice would be asked to the dance. But apparently we didn’t make the cut. They could have asked Rep. Tom Price, M.D., one of the few physician Members of Congress. But no — better that more academics and politicians who have never examined a real patient are on the guest list.

“We’ve checked with dozens of leading healthcare and tax policy experts– big names that you would expect to be invited, that should be invited if you’re serious about throwing around some ideas. But their dance card is empty too. A party is always more fun when everyone there is your friend and won’t cause any unpleasantness.

“Since this Administration is rationing participation, it leads us to believe that it has no problem with rationing care as well.

“Yes, it’s fun to be asked to the prom. It’s a nice ego boost. But when all is said and done, the prom isn’t real life. Instead, you have to do the real work of making changes and getting things done, not just playing dress-up and going dancing.

“We’ll just keep working on changes that have already shown a tremendously positive impact on patients – like Health Savings Accounts and other ways to put patients in charge instead of government or insurance bureaucrats.

“We’ll let the ‘popular kids’ have their face time with the President and on TV while we actually take care of sick patients. That’s better than being crowned king or queen of the prom.”

 The Association of American Physicians and Surgeons is a non-partisan, professional association dedicated since 1943 to protecting the sanctity of the patient-physician relationship from third-party interference. It is entirely member-supported, and receives no grants or funds from government or corporate entities.

Obama presents “gutsy” budget; Clinton begs in China; Treasury writes obituary

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Obama presented Congress with an agenda described as “breathtaking in its scope and ambition,” “gutsy,” or “bold and courageous”—by his supporters. Passing it won’t be easy, Obama admits, because “it represents a threat to the status quo.” But his enormous popularity might make it possible to get a big share of what he wants (Charles Babington, Associated Press 3/1/09).

Some analysts called the budget “almost radical,” and the U.S. Chamber of Commerce noted that “You don’t rebuild a house by blowing up its foundations.”

Spending

The budget assumes a deficit of $1.75 trillion this year, quadrupling that from the year before: that is 12.7% of the GDP. Federal outlays will balloon in 2009 to $4 trillion, or 27.7% of GDP, up from $3 trillion or 21% of GDP in 2008, and 20% in 2007 (“The Obama Revolution,” Wall St J 2/27/09).

To “reform health care” by vastly expanding insurance coverage, Obama proposes a $630 billion fund for a national insurance program to cover all Americans. This amount will just be “a start.” Costs are soon expected to exceed $1 trillion. Savings will be achieved by cutting payments to providers, reducing hospital admissions, and “promoting efficiency.”

Revenue

The money will come from tax increases on “the rich”—for now defined as singles earning $200,000 or more, or couples earning $250,000 or more. High earners would also see limitations on personal exemptions and itemized deductions, including charitable contributions. The estate tax would be reinstated, and capital gains taxes increased. Revenue projections assume that taxpayer behavior will not change.

A key new source of revenue (“but don’t call it a ‘tax’!”) is an expected $78.7 billion from a cap-and-trade carbon emissions scheme, such as one recently rejected by the U.S. Senate, growing to more than $646 billion by 2019. In effect, this constitutes a very large tax increase on 100% of Americans.

Of the windfall, $15 billion/year is supposed to subsidize alternative energy—which can become relatively economical only if the cost of hydrocarbon fuels soars because of taxation, cap-and-trade, or EPA “Clean Air” regulations. The rest will help fund a promised $800 tax “rebate” or “credit” to people who pay little if any tax, creating a new constituency for keeping the current regime in power—and for “fighting global warming.” Recipients of this new entitlement may not notice that $800 is not nearly enough to offset a $4,000 loss in purchasing power owing to higher energy costs spread throughout the economy.

These revenue projections assume a robust market for carbon emissions permits. After peaking at nearly 30 euros ($38) in mid-2008, carbon dioxide traded at 9.95 euros ($12.60)/tonne on Feb 28 (AFP 3/1/09). Opposition to cap-and-trade schemes is building worldwide; it could bring down the Australian government (Business Spectator 3/2/09).

Until the Next Generation of Taxpayers Grows Up….

Secretary of State Hillary Clinton wrapped up her first overseas trip by urging China to continue buying U.S. debt, saying it would help jumpstart the flagging U.S. economy and stimulate the buying of Chinese imports. China is the top holder of U.S. Treasury bills, owning $696.2 billion worth in December, 2008. Its help is needed to finance the $787 billion stimulus package.

Clinton said that concern about the human rights situation in China should not be a distraction from the vital issues of the economy and climate change. A journalist reported seeing plainclothes police taking away some visitors attempting to enter a church where Clinton attended Sunday service (Britbart.com 2/22/09).

Is the U.S. Treasury Solvent?

Between January 2008 and January 2009, the M2 money supply increased from $7.3 trillion to $8.2 trillion, meaning that the Federal Reserve created $1 trillion out of thin air in one year. It has used this money to buy distressed assets. It claims that when the economy recovers it will sell the assets and retire the money before it causes runaway inflation. This assumes, of course, that somebody will want to buy these assets (Downsizer Dispatch 2/23/09).

The quality of the assets held by the Federal Reserve has deteriorated substantially, starting in August 2007, write Philip Baggus and Markus H. Schiml. The Fed’s leverage has increased from 22 to 50. This means that the Fed is insolvent if a mere 2% of its assets go into default.

In the “2008 Financial Report of the United States Government,” the Treasury wrote an obituary for the U.S. government, even before the “stimulus bill,” Secretary Geitner’s proposed TARP II, [and the proposed gutsy budget], states Craig Cantoni.

Some highlights:

  • The government debt held by the public will be 650% of GDP by 2080, compared to “only” 109% during World War II (Chart 2, p 2).
  • The balance sheet (p 10) lists government assets of $1.9 trillion and liabilities of $12.1 trillion. The bonds of a corporation with such an unhealthy balance sheet would be rated as “junk.”
  • The footnote to the balance sheet states that the unfunded liability of $49 trillion for Social Security and Medicare is not counted as a liability on the balance sheet.
  • In an addendum entitled “Management’s Discussion and Analysis,” retirement benefits for veterans and civil servants increased from $90 billion to $550 billion from 2007 to 2008 (Table 1, p 3).
  • The net operating cost of the federal government increased 266.3% from 2007 to 2008.
  • A letter from the Government Accountability Office states that: “The material weaknesses discussed in our [audit] report continued to …. hinder the federal government from having reliable financial information to operate in an efficient and effective manner.” [Cantoni’s translation: “The government cooks the books.”]

Additional information: