Certain values and principles are inherent in every constitutional provision and every piece of legislation that as ever been signed into law in the United States. Without question, Judeo-Christian principles and values have been the main driving force behind the U.S. Constitution, America’s other founding documents and most of the legislation that has traversed the halls of Congress and the corridors of the White House. But are those same Judeo-Christian values, principles and ethics the philosophical underpinning of Obama Care and, if not, can those principles, values and ethics survive Obama Care?
Overview of Executive Talent
The first point of consideration is to review the values of the government agents empowered to implement Obama Care as they impress their values on the government-run health care system. This is especially true because by passing the 2,800-page Patient Protection and Affordable Care Act, our Congressman and Senators have conveyedmore of their legislative power to the unelected, appointed regulators of the Executive Branch than in any other legislation in our history.
…Kathleen Sebelius, the health and human services secretary, is the general in charge of another sweeping change in the health care system . . . .
The massive health care law says ‘the secretary shall’ make roughly 1,300 decisions on provisions in the law, everything from the smallest detail to defining what constitutes ‘essential’ health care.
She’s charged with leading teams of government regulators who will add an expected 30,000 to 50,000 pages of regulations to the 2,800-page law.[i]
As of 2008, there were about 145,000 pages of rules produced by all 50 regulatory agencies. New health care regulations alone will therefore increase the volume of regulations by 34% (50,000/145,000). We have no idea what these 50,000 pages will contain, or what they will do to our lives. But, we do know that there will be no easy recourse to what the regulators write in them. Obama Care gives them a blank check on health care. Just recently, a major and critical change in the current law was effected by Obama Care:
Section 32098 of the Obama Health Care Law [codified at 42 USCS § 1395w-24(a)(5)(C)(i)] indirectly amended the section in existing law allowing private fee-for-service plans to set their premiums without CMS approval by adding, ?Nothing in this section shall be construed as requiring the Secretary to accept any or every bid submitted by an MA organization . . . . Indeed, the provision literally authorizes CMS [Medicare], if it decides to do so, to refuse to allow private-fee-for-service plans altogether.
With this dangerous provision the Obama Health Care Law could lead to elimination of the only way that seniors have to escape rationing – by taking away their right to spend their own money to save their own lives.[ii] (emphasis added)
Had the provision been debated openly in Congress, would it have ever passed? Or, would it have just increased America’s wrath towards Obama Care?
Kathleen Sebelius’ values will influence our lives as she begins oversight and drafting of the regulations that implement Obama Care. What we observe about her values?
Gov. Kathleen Sebelius’ recent eleventh-hour veto of commonsense abortion regulations should erase any lingering doubts for pro-life Senators. Those looking to evaluate the allegiances of Obama’s nominee for Secretary of Health and Human Services should now have their answers. For Gov. Sebelius, women’s health and well-being will always come second to her support for the abortion industry . . . .
…The latest piece of common-sense legislation vetoed by Sebelius, the 2009 Late-Term and Partial-Birth Abortion Regulation Act, provided a clear definition of a qualified medical professional and defined the standards for late-term abortion data reporting. It strengthened the requirement that late-term abortion providers submit a written medical diagnosis to pinpoint exactly which physical ailment places the mother’s life in jeopardy, therefore allowing a legal late-term abortion. It also granted abortion victims legal recourse if they later discovered that the procedure performed on them violated state law . . . .
If her words were to be believed, Kathleen Sebelius the Health and Human Services nominee would have supported this bill. Yet in practice, Kathleen Sebelius the Kansas governor vetoed it . . . .
…With the stroke of a pen, Sebelius denied legal recourse to women who are lied to by clinics and whose lives are endangered by dubious medical practices. She cut short the ability of prosecutors to “enforce the law.” Again, which position does Sebelius actually believe? Does she believe the law must be upheld by everyone? Or does she believe abortion providers are exempt from such a duty?
…This was not the first time she vetoed a bill that offered greater protections for women. She has opposed or vetoed several abortion-accountability bills, including medically-supported clinic regulation legislation, which she vetoed in both 2003 and 2005.[iii]
Other authorities have also evaluated her values. In a March 10, 2009 interview with Thomas J. McKenna of the Catholic Action for Faith and Family, Archbishop Joseph Naumann discussed the pastoral aspects of his discipline of then Governor Sebelius for her pro-abortion stance:
Your Excellency: As you know the Governor of Kansas, Kathleen Sebelius, is a Catholic with a long record of supporting abortion and has been nominated by President Obama to be the director of Health and Human Services.
Last year you wrote the governor a letter asking that she refrain from presenting herself to receive Holy Communion because she was not in communion with the Catholic Church and its teachings. Can you explain what prompted you to do this?
I had entered into a rather long dialogue with the governor over many months, trying as best as I could, to make her aware of the seriousness of her past actions as well as her present positions. Following our long conversations and additional actions on her part, such as vetoing a bill that was aimed at trying to regulate abortion clinics, I first asked her, privately in a letter, not to present herself for Communion for her own integrity and for her own spiritual welfare. My intention was not to make that public. It was only subsequent to that when in March of the following year she presented herself for communion at one of our parishes and the pastor informed me that I wrote her again renewing my request. I informed her that I would make the request public because, in addition to my concern for her spiritual wellbeing, I was also very concerned about others being misled by her presenting herself as a faithful Catholic while holding positions that were completely contrary to our teaching on the sanctity of human life.[iv]
If you really had a choice about this person being the head of the government agency that is going to write at least 50,000 pages of regulations about what the government can do or not do to you with your health care, would you choose Kathleen Sebelius?
It makes you wonder about the values and mindset of the person who appointed her. What was he thinking?
Here are some observations by Robert P. George, McCormick Professor of Jurisprudence at Princeton University:
Barack Obama is the most extreme pro-abortion candidate ever to seek the office of President of the United States. He is the most extreme pro-abortion member of the United States Senate. Indeed, he is the most extreme pro-abortion legislator ever to serve in either house of the United States Congress . . . .
…For starters, he supports legislation that would repeal the Hyde Amendment, which protects pro-life citizens from having to pay for abortions that are not necessary to save the life of the mother and are not the result of rape or incest. The abortion industry laments that this longstanding federal law, according to the pro-abortion group NARAL, ‘forces about half the women who would otherwise have abortions to carry unintended pregnancies to term and bear children against their wishes instead . . . .’
But this barely scratches the surface of Obama’s extremism. He has promised that ‘the first thing I’d do as President is sign the Freedom of Choice Act’ (known as FOCA). This proposed legislation would create a federally guaranteed ‘fundamental right’ to abortion through all nine months of pregnancy, including, as Cardinal Justin Rigali of Philadelphia has noted in a statement condemning the proposed Act, ‘a right to abort a fully developed child in the final weeks for undefined ‘health’ reasons.’ In essence, FOCA would abolish virtually every existing state and federal limitation on abortion, including parental consent and notification laws for minors, state and federal funding restrictions on abortion, and conscience protections for pro-life citizens working in the health-care industry-protections against being forced to participate in the practice of abortion or else lose their jobs. The pro-abortion National Organization for Women has proclaimed with approval that FOCA would ‘sweep away hundreds of anti-abortion laws [and] policies . . . .’
…Obama, unlike even many ”pro-choice” legislators, opposed the ban on partial-birth abortions when he served in the Illinois legislature and condemned the Supreme Court decision that upheld legislation banning this heinous practice. He has referred to a baby conceived inadvertently by a young woman as a ”punishment” that she should not endure. He has stated that women’s equality requires access to abortion on demand. Appallingly, he wishes to strip federal funding from pro-life crisis pregnancy centers that provide alternatives to abortion for pregnant women in need. There is certainly nothing ”pro-choice” about that.
…Senator Obama, despite the urging of pro-life members of his own party, has not endorsed or offered support for the Pregnant Women Support Act, the signature bill of Democrats for Life, meant to reduce abortions by providing assistance for women facing crisis pregnancies. In fact, Obama has opposed key provisions of the Act, including providing coverage of unborn children in the State Children’s Health Insurance Program (S-CHIP), and informed consent for women about the effects of abortion and the gestational age of their child . . . .
… In an act of breathtaking injustice which the Obama campaign lied about until critics produced documentary proof of what he had done, as an Illinois state senator Obama opposed legislation to protect children who are born alive, either as a result of an abortionist’s unsuccessful effort to kill them in the womb, or by the deliberate delivery of the baby prior to viability . . . . But Barack Obama opposed it and worked to defeat it. For him, a child marked for abortion gets no protection-even ordinary medical or comfort care-even if she is born alive and entirely separated from her mother. So Obama has favored protecting what is literally a form of infanticide . . . .
…Obama . . . has co-sponsored a bill . . . that would authorize the large-scale production of human embryos for use in biomedical research in which they would be killed. In fact, the bill Obama co-sponsored would effectively require the killing of human beings in the embryonic stage that were produced by cloning. It would make it a federal crime for a woman to save an embryo by agreeing to have the tiny developing human being implanted in her womb so that he or she could be brought to term . . . . In an audacious act of deceit, Obama and his co-sponsors misleadingly call this an anti-cloning bill. But it is nothing of the kind. What it bans is not cloning, but allowing the embryonic children produced by cloning to survive . . . .
Decent people of every persuasion hold out the increasingly realistic hope of resolving the moral issue surrounding embryonic stem-cell research by developing methods to produce the exact equivalent of embryonic stem cells without using (or producing) embryos. But when a bill was introduced in the United States Senate to put a modest amount of federal money into research to develop these methods, Barack Obama was one of the few senators who opposed it. From any rational vantage point, this is unconscionable. Why would someone not wish to find a method of producing the pluripotent cells scientists want that all Americans could enthusiastically endorse? Why create and kill human embryos when there are alternatives that do not require the taking of nascent human lives? It is as if Obama is opposed to stem-cell research unless it involves killing human embryos . . . .
…In Obama’s America, public policy would make a mockery of the great constitutional principle of the equal protection of the law. In perhaps the most telling comment made by any candidate in either party in this election year, Senator Obama, when asked by Rick Warren when a baby gets human rights, replied: ‘that question is above my pay grade.’ It was a profoundly disingenuous answer: For even at a state senator’s pay grade, Obama presumed to answer that question with blind certainty. His unspoken answer then, as now, is chilling: human beings have no rights until infancy – and if they are unwanted survivors of attempted abortions, not even then.[v] (emphasis added)
If life is precious from conception to natural death, does this reflect the mindset of someone you would want to give control over your health care for the same period of time? And his choice for the head of the Centers for Medicare and Medicaid Services is a fellow named Donald Berwick.
Berwick’s appointment was during a Congressional recess in order to prevent Berwick’s extreme views from exposure during a U.S. Senate confirmation hearing. What does the President of the United States not want us to know about him? It just has to be part of a contrived deception to obscure what is really going to happen to our health care under Obama Care.
Donald Berwick finally appeared before the Senate Finance Committee, not a confirmation hearing, in November 2010:
The prepared transcript of Berwick’s remarks at first glance, conveys a sense that he is a strong patient advocate and champion of patient rights . . . . However, the spoken word in Washington is not to be trusted, and nowhere more so than in this case. We need simply go to You Tube or the internet and find the Berwick speeches and articles that portray a very different man.
The Donald Berwick that we have come to know, has stated his positions clearly and they are very different from what he is now trying to convince Senators and the American people that he supposedly stands for. There is no ambiguity about how Berwick feels about the sanctity of the doctor patient relationship. In his book ‘New Rules’ he writes: ‘Today, this isolated relationship (between doctor and patient) is no longer tenable or possible . . . . Traditional medical ethics, based on the doctor- patient dyad must be reformulated to fit the new mold of the delivery of health care . . . Regulation must evolve. Regulating for improved medical care involves designing appropriate rules with authority . . . . Health care is being rationalized through critical pathways and guidelines. The primary function of regulation in health care, especially as it affects the quality of medical care, is to constrain decentralized decision making.’[vi] (emphasis added)
For those of you who have had successful long-term patient relationship with your doctor, say goodbye to it. And, if traditional medical ethics, based on the doctor-patient relationship, must be reformulated to fit the new mold of the delivery of health care by Donald Berwick himself, we have the first direct answer to our question about the survivability of Judeo-Christian ethics under Obama Care. They won’t survive. And, if “the primary function of regulation in health, especially as it affects the quality of medical care, is to constrain decentralized decision making,” there will be a chilling restriction on the doctors acting in emergency and critical situations. Under Obama Care, doctors will became increasingly responsive to regulatory requirements and regulatory penalties, not the patient.
Recently, the life of my daughter and one of her twins may have been saved by the immediate, bold and extremely well executed procedure which her doctor undertook in exigency during the delivery. Without this bold action, had the doctor been restrained because of the threat of recrimination by Washington, both my daughter and one of her twins might have died. How can the top executive of Medicare and Medicaid Services, not have any respect for the long history of the doctor-patient relationship? What world has he been living in? Oh, yes, he was incubated in the world of academic tenure in which you can avoid many realities.
Here are more ruminations about Berwick:
Berwick is in a position to fulfill his agenda, of transforming our healthcare system into one that resembles the British system, with its rationed care and inferior outcomes, unchecked and accountable to no one. This is a system to which he has professed his love and admiration. He has a dislike of our system of healthcare and disapproves of it. Here are some other ‘pearls’ that have come directly from Dr. Berwick. ‘I cannot believe that the individual healthcare consumer can enforce through choice the proper configurations of a system as massive and complex as healthcare. That is for leaders to do.’ ‘Please don’t put your faith in market forces. It’s a popular idea: that Adam Smith’s invisible hand would do a better job of designing care than leaders with plans can.’ ‘The U.K. has people in charge of its health care- people with the clear duty and much of the authority to take on the challenge of changing the system as a whole. The U.S. does not . . . .’
…Dr. Berwick has always viewed himself as a “leader” who needs to radically change American health care; he cannot now suddenly alter these years of radical opinions about how terrible American healthcare is by giving a hopeful speech about his plans for Medicare . . . .
Dr. Berwick’s appointment was a final episode in the story of tawdry, backroom dealing and the-people- be- damned politics that rammed Obamacare through Congress and on Election Day cost so many members of Congress their jobs. Dr Berwick’s role in this episode and the disdain he has shown for the prerogatives of the US Senate speak to the same problem his views on health care show – an avarice for personal power that is deeply at odds with a system of government that places that power in the hands of elected representatives and ultimately in the people themselves.[vii] (emphasis added)
As to Berwick’s claim “please don’t put your faith in market forces,” I make no apologies for pointing out to Donald Berwick that centralized planning of economies and sectors of them has been a failure wherever it has happened throughout history. There are no “leaders with plans” who are smart enough to successfully allocate resources the way market forces do. Centrally planned economies always produce lower per capita incomes and worse health care, if any. Berwick’s assertion is a pure dogma of socialism. And, he is a classic elite who ignores relevant history to assert his ideology. You can find no mass emigration of sick people to the health care facilities of centrally planned economics.
He is a nominee with little management experience poised to head the second largest insurer on the planet, an agency with more funding to disperse than all but the top 15 economies in the world . . . .
As we saw in the process of Obamacare’s passage, there is nothing – not precedent, not tradition, not even the most basic expectations of fairness or responsible governance – that will stop President Obama and his allies in their quest to remake American social policy in their image.[viii]
The appointment of Donald Berwick without Senate confirmation is a final step in the completely corrupt legislative process that was led by Congresswoman Nancy Pelosi and Senator Harry Reid. They used unprecedented bribes to force legislators to do what they should never do—vote against the will of their constituents. The scale of this corruption was unprecedented in our history.
Critique of British National Health Service
After you review some of the following qualitative analysis on the British model of government health care, you may re-look at Donald Berwick’s fawning and self-promoting address to the members of the British health care system, and wonder what delusions Berwick was under when he prepared the address:
-•Wherever national health insurance has been tried, rationing by waiting is pervasive—with waits that force patients to endure pain and sometimes put their lives at risk.
•Not only is access to health care not equal, if anything it tends to correlate with income—with the middle class getting more access than the poor and rich getting more access than the middle class, especially when income classes are weighted by incidence of illness.
•Not only are health care resources not allocated on the basis of need, these systems tend to overspend on the relatively healthy while denying the truly sick access to specialist care and lifesaving medical technology.
•And far from establishing national priorities that get care first to those who need it most, these systems leave rationing choices up to local bureaucracies that, for example, fill hospital beds with chronic patients while acute patients wait for care.[ix]
-Why do single-payer health insurance schemes skimp on expensive services to the seriously ill while providing so many inexpensive services to the marginally ill? Because the latter services benefit millions of people (read: millions of voters), while acute and intensive care services concentrate large amounts of money on a handful of patients (read: small numbers of voters). Democratic political pressures dictate the redistribution of resources from the few to the many.
Why are sensitive rationing decisions and other issues of hospital management left to a hospital bureaucracies? As a practical matter, no government can make it a national polity to let 25,000 of its citizens die from lack of the best cancer treatment every year, as apparently happens in Britain.[x] Nor can any government announce that some people must wait for surgery so that the elderly can use hospitals as nursing homes or that elderly patients must be moved so that surgery can proceed. These decisions are so emotionally loaded that no elected official could afford to claim responsibility for them. Important decisions on who will receive care and how that care will be delivered are left to the hospital bureaucracy because no other course is politically possible.
Why do low-income patients fare so poorly under national health insurance? Because such insurance is almost always a middle-class phenomenon. Prior to its introduction, every country had some government-funded program to meet the health care needs of the poor. The middle-class working population not only paid for its own health care, but also paid taxes to fund health care for the poor. Single-payer health insurance extends the “free ride” to those who pay taxes to support it. Such systems respond to the political demands of the middle-class population and serve the interests of this population.
Why do the rich and the powerful manage to jump the queues and obtain care that is denied to others? Because it could not be otherwise. These are the people with the power to change the system. If members of Parliament had to wait in line for their care like ordinary people, the system would not last for a minute.[xi]
-As noted in the introduction, countries with single-payer health insurance limit health care spending by limiting supply. They do so primarily by imposing global budgets on hospitals and are health authorities. Often there is a separate budget for high-tech equipment, to make doubly sure that high-cost procedures are curtailed.[xii] The consequences of making health care free, thus creating unconstrained demand, while limiting supply is that demand exceeds supply for virtually every service. That, in turn, leads to rationing, usually by forcing patients to wait for treatment.
By U.S. standards, rationing by waiting is one of the cruelest aspects of government-run health care systems[xiii] . . . .
•In England, with a population of almost sixty million, government statistics show more than one million are waiting to be admitted to hospitals at any one time.[xiv]
•In Canada, with a population of more than thirty-one million, the independent Fraser Institute found that more than 876,584 are waiting for treatment of all types.[xv]
•In Norway, with a population of almost 4.5 million, 270,000 are waiting in queues on any given day for various types of medical treatments, including hospital admission.[xvi]
•In New Zealand, with a population of about 3.6 million, the government reports the number of people on waiting lists for surgery and other treatments is more than 90,000.[xvii]
-…However, considering that only 16 percent of the population enters a hospital each year in developed countries and that only a small percent requires serious (and expensive) procedures, these numbers are quite high.[xviii] In New Zealand, if 11 percent (496,000) are admitted to a hospital each year, a waiting list of 90,000 would represent a ratio of almost one person waiting for every five who receive treatment.[xix]
-In most countries with waiting lists for care, the poor wait longer than the wealthy and powerful. For example, a survey of Ontario physicians found more than 80 percent of physicians, including 90 percent of cardiac surgeons, 81 percent of internists and 60 percent of family physicians had been personally involved in managing a patient who had received preferential access on the basis of factors other than medical need. When asked about those patients most likely to receive preferential treatment, physicians reported that 93 percent had personal ties to the treating physician, 85 percent were high-profile public figures and 83 percent were politicians.[xx]
Other studies have reached similar conclusions. One study found that the wealthy and powerful have significantly greater access to medical specialists than the less-well-connected poor.[xxi] A University of Toronto study finds that high-profile patients enjoy more frequent services, shorter waiting times and greater choice in specialists[xxii] . . . .
. . .The president of the Canadian Medical Association, Dr. Victor Dirnfeld, suggested in 1998 that the Canadian system is in fact a two-tiered system, and said that he knew of seven prominent political figures in British Columbia and Ontario who received special treatment. “Instead of waiting three months for an MRI,” he said, “they will have it done in three or four days.”[xxiii]
-In an extensive study of Britain’s NHS in the mid-1980’s, Brookings Institution economists estimated the number of British patients denied treatment each year, based on U.S. levels of treatment. Most of the patients suffered from life-threatening diseases and the denial of treatment meant certain death. According to the study,[xxiv]
•About 9,000 British kidney patients failed to receive renal dialysis or a kidney transplant—and presumably died as a result.
•As many as 15,000 cancer patients and 17,000 heart patients failed to receive the best treatment.
•As many as 1,000 British children failed to receive lifesaving total parenteral nutrition (TPN) therapy and about 7,000 elderly patients were denied pain-relieving hip replacements . . . .
. . .The number of dialysis patients per 100,000 Britons is only about one-third the rate in the United States, although the prevalence of kidney disease is not much different.[xxv] One in eight British nephrologists say that due to limited resources they have refused treatment to patients they thought were suitable for such care.[xxvi] The comparable figure among United States nephrologists is 2 percent.[xxvii]
-If the experience of other countries is any guide, the elderly have the most to lose under a national health insurance system. In general, when health care is rationed, the young get preferential treatment, while older patients get pushed to the rear of the waiting lines . . . .
Access to both emergency and nonemergency surgery is limited, as younger, healthier patients are given priority and allowed to pass seniors in the queue. In Britain, what is termed ageism has been discussed extensively in medical circles and in the popular media.[xxviii]
•Extrapolating from a Gallup survey, the charity Age Concern estimated that one in ten people, or nearly two million, notice a difference in the way they are treated by the NHS after their fiftieth birthday.[xxix]
•One in twenty people over age sixty-five said they had been refused treatment; and many said their doctors told them the money would be better spent treating younger patients.[xxx]
•A British newspaper, The Observer, says, “[T]he NHS suffers from ‘entrenched ageism,’ with elderly patients lower standards of care and less respectful treatment than the rest of the population.[xxxi]
•Although more than one-third of all diagnosed cancers occur in patients seventy-five years of age or older, most cancer-screening programs in the NHS do not include people over age sixty-five.[xxxii]
•The British Thoracic Society and Society of Cardiothoracic Surgeons of Great Britain and Ireland reported that only one in fifty lung cancer patients over age seventy-five receives surgery.[xxxiii]
•In one particularly disturbing case, BBC News alleged that sixty seniors died after being deprived of food and water by hospital staff in an effort to free up hospital beds[xxxiv]. . . .
. . . For example, guidelines issued by the British Medical Association allows NHS doctors to withdraw food and water given by tube to elderly patients suffering from severe stroke and dementia even if they are not facing imminent death.[xxxv] In an effort to curb costs, the NHS has cut the number of geriatric beds in British hospitals by 50 percent over the past twenty years.[xxxvi]
Some NHS critics claim that its policies toward the elderly deliberately aim to eliminate the burden they place on the system and amount to a strategy of involuntary euthanasia.[xxxvii] This may help explain the number of senior citizens deaths per capita from pneumonia is much higher in Britain than in the United States. For instance[xxxviii]:
•Deaths from pneumonia for patients between the ages of sixty-five and seventy-four are more than double in Britain compared to the United States.
•Almost three times as many British males aged seventy-five and above die of pneumonia than comparable American males—1,304 per 100,000 versus 492.
•More than three times as many British females aged seventy-five and above die of pneumonia than comparable American females—1,233 per 100,000 versus 385.[xxxix]
Failure of Integrity
It is a cruel crime against the Judeo-Christian origins of our government and the Judeo-Christian communities and citizens practicing their values that Obama Care could have been stopped by so-called pro-life Democrats. If these people had held to their professed convictions, our health care system would not have been handed over to Obama, Sebelius and Berwick, whose resumes at best would make them radical secularists. None of these are good for Western Culture. Here is a recap of the pathetic collapse of the so-called pro-life Democrats:
As late as March 19, 2010, Stupak, Driehaus, and nine others introduced a formal resolution (H.Con.Res. 254) to amend the bill to strike pro-abortion language added in the Senate, and to insert a bill-wide, permanent prohibition on any provision being used to subsidize abortion. But Pelosi refused to allow a vote on this amendment. Tragically, the Stupak group then splintered. Stupak, Oberstar, Driehaus, and a handful of others voted for exactly the same bill they had previously refused to embrace. Their flimsy justification was an Obama executive order that did not (and could not) change a single word in the bill—an executive order that the president of Planned Parenthood accurately dismissed as a ‘symbolic gesture . . . .’
…In a recent sworn affidavit [http://nrlc.org/AHC/DvSBA/GenericAffidavitOfDouglasJohnsonNRLC.pdf], backed by numerous primary documents [http://www.nrlc.org/AHC/DvSBA/Index.html], I detailed four distinct program components of the law that authorize federal subsidies for abortion, which is not an exhaustive list. Moreover, this affidavit did not touch on additional provisions of the bill that may be employed as foundations for abortion-expanding administrative decrees, nor the ways in which the legislation fails to protect the conscience rights of pro-life health care providers. Other provisions of the law will result, unless corrected, in government-dictated denial of lifesaving medical treatments on quality-of-life grounds, as detailed in other materials published by NRLC–http://www.nrlc.org/HealthCareRationing/Index.html).
Now we have received the judgment of the electorate: the bloc of Democrats who abandoned the pro-life movement to satisfy President Obama and Speaker Pelosi suffered severe losses. In all, at least a dozen House incumbents who had taken high-profile stands against federal funding of abortion, but who ended up voting for the health care law, were defeated by pro-life challengers (or, in Stupak’s case, suddenly retired).[xl] (emphasis added)
Obama Care is a direct assault on Judeo-Christian culture and values. Obama Care’s executives and the public records of their philosophies give Judeo-Christian communities little or no hope that their cultural values will be protected. Thousands of pages of regulations yet to be written will be a blank check forever into the future. This gaggle of secularists pose an unprecedented and unending threat to Judeo-Christian values being subordinated to those holding political power. This is an unacceptable injustice and a threat to anyone’s sense of the common good. There is no amendment process that can contain the reach of 50,000 pages of more of regulations forever into the future.
Other European Experiences with Secularist Governments
During the last century a large part of Europe had an intimate experience with atheistic governments. Here is the personal commentary of someone who experienced such a government for 40 years:
In our ancient Europe, which was formerly the fatherland of Christianity, Jesus Christ is almost unable to appear in public . . . . In Russia and in other nations of Eastern Europe, faith in Christ was practically forbidden. The peoples of East Europe . . . were unable to give her even a little space because atheism had occupied all spheres of their lives . . . . The atheism proposed by the German Democratic Republic until 1989 was a dark cloud under which we had to live. In a sense, we were intimately connected and related to the Christians of other atheistic countries of Eastern Europe . . . .
The media generally report only the external activity of politicians and of people who have led demonstrations in the streets and in the squares of Eastern European capitals, protesting against atheistic and inhuman systems . . . .
From the outside, nobody could see where the people found the secret reserves of strength to live through those forty years—in Russia, even more than seventy years—in that atheistic and inhuman desert.
The speaker was Cardinal Meisner, formerly Archbishop of Berlin in East Germany, and on the date of the speech, May 12, 1990 as Archbishop of Cologne.[xli]
History has proven that giving an atheistic government’s executive branch the power to rule by executive order or so-called regulations, is not healthy for peoples who are its subjects. The vast regulatory powers of Obama Care regulators, are, therefore, essentially unjust because there is a strong probability they will erase the personal and moral content of all health care delivery, and substitute political or ideological goals.
Unlimited regulatory power will degrade the excellence of America’s entire health care industry. As has happened in all single-payer government controlled health care systems, everybody’s health care will get worse.
Quality of American Health Care
The day before Obama Care passed, the American health care system was the best in the world. A closer look at Americans’ view of the U.S. health care system pre-Obama Care shows:
According to a new University of Texas/Zogby poll 84% of Americans are satisfied with their health care.[xlii]
Here is an analysis of our health care system using 2008 data:
2008 US Economic and Health Care Data
Using this data, we can see some very important things. Taxpayers, through the government, are paying for $814 billion of a health care system costing approximately $2.456 trillion. Private payers therefore provide the remaining $1.642 trillion of health care. And, every worker who pays for private health care also pays payroll taxes and income taxes to provide the government with the funds necessary to fund the government’s portion of health care. Therefore, if Obama Care is going to provide us with the same health care we have, they are going to have to increase our health care taxes by at least $1.642 trillion or about 200% of their $814 billion share. Why would we ever consider doing this? It would be totally insane! Why destroy the world’s best health care system by putting it under the political control of the Executive Branch? It is not perfect, but a takeover of this magnitude is completely unjust. And, this sledge hammer approach of Obama Care would result in the total tax burden increasing by 65% ($1.642 trillion + $2.524 trillion=$4.166 trillion). There can be no justification for increasing our total tax burden by +65% so the ghouls of Obama Care, Kathleen Sebelius and Donald Berwick and their unelected regulators can take over and degrade the existing private sector of our health care system.
But, what proof do we have that American’s were happy with their health care prior to Obama Care’s passage? Here is a compilation of observations that you will enjoy reading as a background of why 84% of Americans are satisfied with their health care:
-•The percent of American seniors reporting they are in good health (72.6 percent) is the highest of any country in the Organization for Economic Cooperation and Development (OECD); among the also-rans, the range is from 70.8 percent in Australia to less than half (47.4 percent) in Germany.
•Among those age forty-five to sixty-four who report they are in good health, Americans top out at 85.4 percent; the others range from 84.9 percent in Canada to 58.2 percent in Germany.[xliii]
-According to a recent study by Health Services Research,[xliv]
•Low-income persons in the United States without job-related health insurance spend only about fifty dollars per year more out of pocket for health services than those with employer-provided health benefits.
•On the average, they make 2.4 visits to physicians each year, compared to 3.4 visits for persons with employer-provided insurance coverage.
•However, when seriously ill, uninsured low-and moderate-income Americans receive about the same level of treatment and services as those with employment-based coverage, and their out-of-pocket costs are about the same.
This suggests that the health care safety net in the United States is actually more reliable than many people think.[xlv]
-A study by the Texas Comptroller of Public Accounts found that public and private organizations in Texas spend, on the average, approximately $1,000 per year on care for each uninsured Texan.[xlvi] This is equivalent to $4,000 for a family of four, enough to buy private health insurance in many Texas cities. Another study from the Urban Institute in Washington, D.C., found that the United States spends $34.5 billion on free health care for the uninsured, or about $820 per person each year.[xlvii]
-At Children’s Medical Center, next door to Parkland, a similar exercise takes place. Children on Medicaid, children on S-CHIP (for low-income families who do not qualify for Medicaid), and uninsured children all come through the same emergency room door. Again, they all see the same doctors and receive the same treatments. Again, it is only the hospital that seems to care whether anybody is insured and by whom.[xlviii]
-Europeans who have grown up on a steady diet of anti-American-healthcare propaganda would probably be surprised to learn how much Americans actually spend on health care for low-income families. Each year, Medicaid costs U.S. taxpayers almost $1,000 for every man, woman and child in the country, or $4,000 for a family of four.[xlix] Free care for the uninsured costs another $4,000. And if taxpayer support for the low- and moderate-income elderly are included, the average family of four is probably spending $10,000 or more on other people’s health care. Indeed, most taxpayers with private insurance are paying far more in taxes to fund health insurance for other people than they pay for private health insurance for themselves and their own families.
Low-income beneficiaries on Medicaid probably have more access to better health care than low-income citizens in any other country.[l] (emphasis added)
So, how can Donald Berwick, the new czar of Medicare and Medicaid Services make the following statement in a speech to the British National Health Services?
. . . You could have kept your system in fragments and encouraged supply-driven demand, instead of making tough choices and planning supply. You could have made hospitals and specialists, not general practice, your mainstay.
You could have obscured – you could have obliterated – accountability, or left it to the invisible hand of the market, instead of holding your politicians ultimately accountable for getting the NHS sorted. You could have let an unaccountable system play out in the darkness of private enterprise instead of accepting that a politically accountable system must act in the harsh and, admittedly, sometimes very unfair, daylight of the press, public debate, and political campaigning. You could have a monstrous insurance industry of claims, and rules, and paper-pushing, instead of using your tax base to provide a single route of finance.
You could have protected the wealthy and the well, instead of recognizing that sick people tend to be poorer and that poor people tend to be sicker, and that any health care funding plan that is just, equitable, civilized, and humane must – must – redistribute wealth from the richer among us to the poorer and less fortunate. Excellent healthcare is by definition redistribution. Britain, you chose well . . . .[li]
But the facts presented in Lives at Risk: How the Obama Health Care Plan Will Ration Your Family’s Medical Treatment-A Factsheet categorically refute Berwick’s assertions about our health care system.
Patients Spending More than 20 Minutes with Doctor
Patients Seen Annually
Patient Wait Time in 5 Nations
Prostate Incidence and Mortality
Breast Cancer Incidence and Mortality
Use of High Tech Medical Procedures
How Sicker Patients Evaluate Their Health Care
Breast Cancer Mortality Ratio
Prostate Cancer Mortality Ratio
Administrative Costs as a Percentage of Medical Expenditures in the US
These charts speak for themselves and tend to explain America’s 84% satisfaction with their health care.
The False Assertion-Many Have No Access to Health Care
Here is excellent supporting data about the distributions of resources through our health care system. It was prepared to challenge a claim by the Kaiser Foundation that 50 million Americans were without medical insurance.
… The Kaiser Foundation report, in turn, bases its findings of 50 million uninsured Americans (under the age of 65) on the Current Population Survey’s Annual Social and Economic Supplement (CPS ASEC), published by the Census Bureau. Kaiser describes the CPS ASEC as ‘the primary source of annual health insurance coverage information in the United States’ and as ‘the most frequently cited national survey on health insurance coverage.’
The problem is that, as the Census admits within the pages of the CPS ASEC (on page 22), ‘Research shows health insurance coverage is underreported in the CPS ASEC for a variety of reasons.’ This concern is serious enough that the report notes, ‘There are several ongoing projects aimed at improving the quality of health coverage data from the CPS ASEC.’ On page 69, the Census elaborates on this over-counting of the number of uninsured, admitting that while almost all surveys” inflate the number of uninsured, its CPS ASEC report inflates that number by even more than most . . . .
The Census report also admits within its own pages that recognition of its inaccuracy led to ‘a research project to evaluate why CPS ASEC estimates of the number of people with Medicaid are lower than counts of the number of people enrolled in the program from CMS’ — in other words, to evaluate why the CPS ASEC lists millions of Americans as being uninsured while the Centers for Medicare and Medicaid Services (CMS), which runs Medicaid and keeps the official tally of enrollees, says that these people are on Medicaid. During this project, ‘files from the Medicaid Statistical Information System (MSIS) were linked with the CPS ASEC files and the individual records were compared.’ The conclusion? ‘A key finding indicating survey response error in the CPS ASEC was that 16.9 percent of people with an MSIS record indicating Medicaid coverage reported in the CPS ASEC that they were uninsured.’
Any private citizen can do the math from there, which the Census has done as well: 16.9 percent of the 47.8 million people on Medicaid is 8.1 million. So more than 8 million of the 50 million ‘uninsured’ are people who aren’t actually uninsured at all, but instead are on Medicaid.
That leaves us with approximately 42 million uninsured, according to the Census’s correction of its own survey figures (a correction that Kaiser doesn’t make). Of these, according to the same report, 10 million aren’t citizens. That leaves us with 32 million uninsured Americans — a far cry from 50 million, but apparently close enough for government (or Kaiser) work.
Are these 32 million uninsured Americans languishing in Dickensian squalor, as the advocates of Obamacare would lead us to believe? Far from it. The Census states (in Table 9 of the CPS ASEC report) that approximately 11 million of those who are uninsured live in households that make over $75,000, while another 9 million (giving us 20 million total) live in households that make more than what the same report shows (in Figure 1, on p. 6) to be the median American household income of $49,777 annually.[lii] (emphasis added)
Here is a recap:
US Adjusted Numbers of People Who Are Not Insured
Supposing out of this, we could all end up agreeing there are 12 million people who absolutely need more help. Each of these people could be provided with a $5,000/year insurance coverage with the increase in costs to the health care system only being $60 billion, or an increase of just 2.4% in 2008 federal tax revenue of $2.524 trillion. Using this approach of providing the truly uninsured with insurance is infinitely simpler and would eliminate the invasion of the federal government into our health care with many more regulators and regulations—over which we will have no control.
Let’s now look more deeply at the question of whether or not the poor are being adequately served.
Poverty among Americans between ages 18-64 has fallen only marginally since 1966, from 10.5% then to 10.1% today. Poverty has significantly fallen among Americans under 18 years old from 23% in 1964 to 16.3% today. The most dramatic decrease in poverty was among Americans over 65, which fell from 28.5% in 1966 to 10.1% today.[liii]
Using this data as background, we will compute the actual number of individuals in each cohort of ages. Using the actual 2000 Census population distributions by sex at five year intervals, we compute the following composite for each age cohort based on the official 2010 Census total population of 308,745,538:
US Poverty Levels and Use of Health Care Based on 2000 Census
US Health Care Resources for the Poor
So, the total poverty population is an estimated 37,617,156. But, the first thing we know is that those over 65 are eligible for Medicare. So, their treatment is no different than anyone else under Medicare. This leaves an estimated 33,757,844 (37,617,156-3,859,312) legally defined poor. The average age of this group is 32 years. So, a lot of these people are statistically healthier. What other services are available to provide health care to these people? Well, as we have just learned, 47.8 million people are on Medicaid. And, there are $57 billion of unreimbursed expenses that are funded by a combination of government funds, charitable funds and hospitals and physicians who just write-off unpaid medical bills.
Finally, there is the federal law providing emergency care at any hospital that receives Medicare revenue. It is called the Emergency Medical Treatment and Active Labor Act and provides as follows:
Any patient who ‘comes to the emergency department’ requesting ‘examination or treatment for a medical condition’ must be provided with ‘an appropriate medical screening examination’ to determine if he is suffering from an ‘emergency medical condition.’ If he is, then the hospital is obligated to either provide him with treatment until he is stable or to transfer him to another hospital in conformance with the statute’s directives . . . .
If the patient does not have an ‘emergency medical condition,’ the statute imposes no further obligation on the hospital.[liv]
Perhaps the best lines of defense for the underserved poor are the countless faith based organizations that are functioning in the interests of all our urban and rural areas providing “human contact charity” 24/7. They are the most knowledgeable advocates for the underserved poor. Therefore, they would be the best source for defining the true amount of the underserved poor and offering an effective solution for this problem. That, at worst, would be to get them to an emergency room or clinic.
This emergency room statute certainly provides a pretty solid safety net for anyone who has a really serious medical condition no matter how poor they may be. And history shows that emergency rooms are tending to become the admitting office to health care. When taken with the above clarifying data, although there are certainly cases of failure to treat poor people adequately, it seems that the burden of proof of inadequate medical care for the poor is shifted to the need for much more precise data. And, when the true amount of underserved people if finally isolated, there is no doubt that a less expensive and more traditional health care system will provide a better solution than the Obama Care’s radical takeover of our whole health care system.
Income Tax Funding for Health Care is Very Progressive
There is a common liberal belief that we need more progressive taxation to help all these poor individuals. Here is some data that will help clarify who is paying for what based on using income taxes to further expand health care revenues. Using income tax cohorts from 2006 data, we observe effects of addition $100 billion of health care expenditures all financed by income taxes.
The top 1% of taxpayers (1,357,000 people) will contribute 40% of the new $100 billion or $40 billon, which will be used to give more health care to 40% of the 300 million in the US (120 million people). Therefore, each of the 1,357,000 workers/taxpayers will each be paying taxes for more benefits for 88 people.
People Supported Per Taxpayer By Cohort in US
This should be compared to the bottom 50% of all taxpayers, 67.8 million people. These taxpayers will pay for just $3 billion of the new $100 billion in new health care which would be allocated to 3% of the population of the US or 9 million people. In this case, each taxpayer would contribute less than enough for one person. Whatever is said to be just or unjust should be evaluated in this type of analysis. In fact, I believe you could say that our existing tax system is highly progressive in providing funds to our existing health care system. So much so that it already beats Berwick’s requirement that:
. . .any health care funding plan that is just, equitable, civilized and humane, MUST redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is, by definition, redistribution.[lv]
We are actively doing what Berwick wants. All the blatant assertions about how badly the poor are being mistreated are the sounds of ideological proponents of Obama Care trying to create support for their takeover of America’s health care system.
Separation of Religious and Government Power
Now, we are going to have some experts explain why Obama Care violates principles that keep excessive government power in check that will further define the relative excellence of our health care system as it existed before Obama Care.
If we haven’t catalogued enough objections to Obama Care, here is one of the clearest reasons to reject it:
. . . Pope Leo XIII in Rerum Novarum [taught] . . . that government should undertake only those initiatives which exceed the capacity of individuals or private groups acting independently. Functions of government, business, and other secular activities should be as local as possible. If a complex function is carried out at a local level just as effectively as on the national level, the local level should be the one to carry out the specified function. The principle is based upon the autonomy and dignity of the human individual, and holds that all other forms of society, from family to the state and the international order, should be in the service of the human person.[lvi]
This concept was further pushed by Pope John Paul II.
This is why Pope John Paul II took the ‘social assistance state’ to task in his 1991 encyclical Centesimus Annus. The Pontiff wrote that he Welfare State was contradicting the principle of subsidiarity by intervening directly and depriving society of its responsibility. This ‘leads to a loss of human energies and an inordinate increase of public agencies which are dominated more by bureaucratic ways of thinking than by concern for serving their clients and which are accompanied by an enormous increase in spending.[lvii] (emphasis added)
In his encyclical Rerum Novarum—which inaugurated the modern era of papal social teaching–, Pope Leo XIII pointedly rejected the confusion of Christian charity with mere humanitarianism:
They would substitute in its place a system of State-organized relief. But no human methods will ever supply for the devotion and self-sacrifice of Christian charity. Charity, as a virtue, belongs to the Church; for it is no virtue unless it is drawn from the Sacred Heart of Jesus Christ; and he who turns his back on the Church cannot be new to Christ (Rerum Novarum 24).
No doubt some will say that the Church has changed her social doctrine since the 1960s. But this too, is a serious error. Pope John Paul II in Centesimus Annus and Pope Benedict XVI in Deus Caritas Est have explicitly reaffirmed this teaching. Nothing has changed.[lviii]
Fifty thousand pages of the yet to be written regulations under the authority of President Obama, Kathleen Sebelius and Donald Berwick pose an unknown threat to the U.S. health care system. The potential abuses and violations of political power over moral principles are completely unacceptable to our rights under the Constitution and Judeo-Christian morality, values and ethics.
There is a very simple reason why government controlled single-payer health care will always produce poorer health care and a scarcity of it—rationing. Who cares how much of your money you spend on housing, cars, professional sports, and vacations? If you voluntarily want to spend more on housing there are almost infinite alternatives of vendors who will try to satisfy your wants. The same is true for automobiles. And, the same is true for professional athletics and vacations. What creates economic growth is that people spend more of their money on things that will draw more supplies into the economy. Who questions the billions of dollars that support professional athletics? Its sole value is entertainment. Why isn’t the government trying to takeover the professional athletics industry or Hollywood, both of which just cause people to spend money on worthless visual entertainment? Really, why can’t we, and especially older people, spend any amount of their money on health care?
The more people want to spend, the more suppliers will come into the market and new spending and new suppliers will increase the percentage of gross national product devoted to health care. If you need any urgent health care whether you just slashed your finger cutting carrots or you have colon cancer, you would be as willing to spend your money on health care as you spend on cars or watching Sunday football.
So, why is the government so upset about the amount of gross domestic product that we are spending on health? Back in 1965, single party government under Lyndon Johnson and the Democratic Party passed Medicare, the Social Security Act of 1965.
Medicare is a social insurance program administered by the United States Government providing health insurance coverage to people who are aged 65 and over, or who meet other special criteria. Medicare operates as a single-payer health care system. The Social Security Act of 1965 was passed by Congress in late-spring of 1965 and signed into law on July 30, 1965, by President Lyndon B. Johnson as amendments to Social Security legislations . . . .
Medicare is partially financed by payroll taxes imposed by the Federal Insurance Contributions Act (FICA) and the Self Employment Contributions Act of 1954. In the case of employees, the tax is equal to 2.9% (1.45% withheld from the worker and a matching 1.45% paid by the employer) of the wages, salaries and other compensation in connection with employment . . . .
In general, individuals are eligible for Medicare if:
They are 65 years or older and U.S. citizens or have been permanent legal residents for continuous years, andthey or their spouse has paid Medicare taxes for at least 10 years.[lix]
It is quite clear that Medicare is for people “65 years or older” and is financed by employment taxes. Since most health care expenditures are made during this period of our lives, millions and millions of older people were made very happy by this Medicare entitlement and thus they became very happy and loyal Democratic voters.
Now, jump forward to Obama Care. The 2009 Medicare Annual Report stated:
The financial outlook for the Medicare program continues to raise serious concerns. Total Medicare expenditures were $468 billion in 2008 and are expected to increase in future years at a faster pace than either workers’ earnings or the economy overall . . . .
HI tax income and other dedicated revenues are expected to fall short of the expenditures in all future years. The HI trust fund does not meet our short-range test of financial adequacy, and fund assets are projected to be exhausted in 2017. In the long range, projected expenditures and scheduled tax income are substantially out of balance and the trust fund does not meet our test of long-range close actuarial balance.[lx]
So, having made such grand promises to America’s older generations in 1965 and thereafter, and having spent so much of our payroll taxes not on Medicare, Medicare itself is going broke. As we have pointed out, in 2008, approximately $814 billion was funded by taxpayers and $1.642 trillion on health care was funded by private sources.
The Democratic Party needs to get control of this $1.642 trillion private funding so they can try to avoid losing their political power because they have made false promises about Medicare for two generations. And in a great irony, the 65 and older crowd are going to be out in the cold through rationing by the transfer of benefits to younger people who need less health care and who will become loyal voters for the next two generations. To fulfill their promises they need to take control of the private sector’s $1.642 trillion of resources and manage all spending through rationing. This complete about face on who is going to get health care, first the older than 65 crowd and now the younger than 65 crowd, proves absolutely that the Democratic Party has passed Obama Care for the benefit of its own political power rather than for the benefit of everyone needing health care. Therefore, health care will be worse because all distribution of it will have a political bias. A large part of this violation will come from the rationing of health care to the elderly.
It is an intrinsic absurdity that Medicare was founded for health care needs for those over 65, but those same people are now going to have their health care redistributed under Obama Care to people with less need for health care. As we have previously observed, 49% of health care expenditures occur after 65. This is when people typically need more health care. It is an assault on common justice to take it away from them at the time when they most need it. And, it is especially unjust to do so when they have paid payroll taxes for as long as 45 years. Obama Care turns the Medicare Act of 1965 on its head and into a fraud against those 65 and older.
And the fraud committed against those 65 and older will continue with the implementation of rationing.
Earlier this month, the Food and Drug Administration banned doctors from prescribing Avastin, a potent but costly drug, to patients with advanced-stage breast cancer. According to the FDA, the drug doesn’t offer “a sufficient benefit in slowing disease progression to outweigh the significant risk to patients . . . .”[lxi]
Ponder the FDA’s justification—there wasn’t “sufficient” benefit in relation to Avastin’s risks. Sufficient according to whom? For your wife, mother or daughter with terminal breast cancer, how much is an additional month of good-quality life worth?
Let’s examine this FDA justification by posing the question, should we have stopped the advance of health care in 1945 when penicillin was discovered?
Over the last year or so, one of my wife’s best friends has been suffering from terminal breast cancer. Several months ago, she was given 30 days to live and had just been rejected by a research project working on its trial of a very hopeful medicine. Therefore, she was devastated when not selected. But, along came another doctor with another more regular treatment, and, so, she is still alive and full of hope.
Why shouldn’t she be able to spend her own money on her health care to try to go forward another day, month or year?
All new medicines are expensive. But as long as there are risk takers and people willing to pay higher prices, why shouldn’t we let these forces try to advance progress in drugs and medicine? Should we care that new drugs are so expensive? The story of the discovery of penicillin is instructive.
The discovery of penicillin is attributed to Scottish scientist and Nobel laureate Alexander Fleming in 1928. He showed that, if Penicillium notatum were grown in the appropriate substrate, it would exude a substance with antibiotic properties, which he dubbed penicillin. This serendipitous observation began the modern era of antibiotic discovery . . . .
However, several others reported the bacteriostatic effects of Penicillium . . . . The use of bread with a blue mould (presumably penicillium) as a means of treating suppurating wounds was a staple of folk medicine in Europe since the Middle Ages. The first published reference appears in the publication of the Royal Society in 1875, by John Tyndall. Ernest Duchesne documented it in an 1897 paper, which was not accepted by the Institut Pasteur because of his youth. In March 2000, doctors at the San Juan de Dios Hospital in San José, Costa Rica published the manuscripts of the Costa Rican scientist and medical doctor Clodomiro (Clorito) Picado Twight (1887-1944). They reported Picado’s observations on the inhibitory actions of fungi of the genus Penicillium between 1915 and 1927. Picado reported his discovery to the Paris Academy of Sciences, yet did not patent it, even though his investigations started years before Fleming’s. Joseph Lister was experimenting with penicillum in 1871 for his Aseptic surgery. He found that it weakened the microbes but then he dismissed the fungi . . . .
Fleming recounted that the date of his discovery of penicillin was on the morning of Friday, September 28, 1928. (Haven, Kendall F. (1994). Marvels of Science : 50 Fascinating 5-Minute Reads. Littleton, Colo: Libraries Unlimited. pp. 182). It was a fortuitous accident: in his laboratory in the basement of St. Mary’s Hospital in London (now part of Imperial College), Fleming noticed a petri dish containing Staphyloccus plate culture he had mistakenly left open, which was contaminated by blue-green mould, which had formed a visible growth. There was a halo of inhibited bacterial growth around the mould. Fleming concluded that the mould was releasing a substance that was repressing the growth and lysing the bacteria. He grew a pure culture and discovered that it was a Penicillium mould, now known to be Penicillium notatum . . . .
In 1930, Cecil George Paine, a pathologist at the Royal Infirmary in Sheffield, attempted to use penicillin to treat sycosis barbae-eruptions in beard follicles, but was unsuccessful, probably because the drug did not penetrate the skin deeply enough. Moving on to ophthalmia neonartorum; a gonococcal infection in infants, he achieved the first recorded cure with penicillin, on November 25, 1930. He then cured four additional patients (one adult and three infants) of eye infections, failing to cure a fifth . . . .
The chemical structure of penicillin was determined by Dorothy Crowfoot Hodgkin in 1945. Penicillin has since become the most widely used antibiotic to date, and is still used for many Gram-positive bacterial infections. A team of Oxford research scientists led by Australian Howard Florey and including Ernst Boris Chain and Norman Heatley devised a method of mass-producing the drug. Florey and Chain shared the 1945 Nobel prize in medicine with Fleming for their work. After World War II, Australia was the first country to make the drug available for civilian use. Chemist John C. Sheehan at MIT completed the first total synthesis of penicillin and some of its analogs in the early 1950s, but his methods were not efficient for mass production.
The challenge of mass-producing this drug was daunting. On March 14, 1942, the first patient was treatedfor streptococcal septicemia with U.S.-made penicillin produced by Merck & Co. Half of the total supply produced at the time was used on that one patient. By June 1942, there was just enough U.S. penicillin available to treat ten patients. A moldy cantaloupe in a Peoria, Illinois, market in 1943 was found to contain the best and highest-quality penicillin after a worldwide search. The discovery of the cantaloupe, and the results of fermentation research on corn steep liquor at the Northern Regional Research Laboratory at Peoria, Illinois, allowed the United States to produce 2.3 million doses in time for the invasion of Normandy in the spring of 1944. Large-scale production resulted from the development of deep-tank fermentation by chemical engineerMargaret Hutchinson Rousseau . . . .
G. Raymond Rettew made a significant contribution to the American war effort by his techniques to produce commercial quantities of penicillin. During World War II, penicillin made a major difference in the number of deaths and amputations caused by infected wounds among Allied forces, saving an estimated 12%-15% of lives. Availability was severely limited, however, by the difficulty of manufacturing large quantities of penicillin and by the rapid renal clearance of the drug, necessitating frequent dosing. Penicillin is actively excreted, and about 80% of a penicillin dose is cleared from the body within three to four hours of administration. Indeed, during the early penicillin era, the drug was so scarce and so highly valued that it became common to collect the urine from patients being treated, so that the penicillin in the urine could be isolated and reused (Silverthorn, DU. (2004). Human physiology: an integrated approach. (3rd ed.). Upper Saddle River (NJ): Pearson Education. ISBN 0-8053-5957-5) . . . .
Penicillin production emerged as an industry as a direct result of World War II. During the war, there was an abundance of jobs available in the U.S. on the home front. The War Production Board was founded to monitor job distribution and production. Penicillin was produced in huge quantities during the war and the industry prospered. In July 1943, the War Production Board drew up a plan for the mass distribution of penicillin stocks to Allied troops fighting in Europe. At the time of this plan, 425 million units per year were being produced. As a direct result of the war and the War Production Board, by June 1945 over 646 billion units per year were being produced (Parascandola, John (1980). The History of antibiotics: a symposium. American Institute of the History of Pharmacy No. 5. ISBN 0-931292-08-5).[lxii] (emphasis added)
When you look at Penicillin, you see that everything going on in medical research then is the same today. Huge and expensive efforts are needed to get the first cure:
On March 14, 1942 . . . . Half of the total supply produced at that time was used on one patient . . . . A moldy cantaloupe in a Peoria, Illinois, market in 1943 was found to contain the best and highest-quality penicillin after a worldwide search . . . .
Penicillin production emerged as an industry as a direct result of World War II . . . . As a direct result of the War and the War Production Board, by June 1945 over 646 billion units per year were being produced . . . .[lxiii]
Wow! Talk about a decline in unit costs! From 2 doses for all production in 1942 to 646 billion doses for production in 1945. This is a declining unit cost curve in the extreme. The discovery of Penicillin is a perfect example of how future beneficiaries benefit forever thereafter from the initial high cost and complications of perfecting drugs and medicines.
Unequal outcomes are what propel economic progress in every way. The steam engine for ships and trains produced huge reductions in the cost of moving people and goods around the world or across the territory—and unit costs are still dropping.
The internal combustion engine and automobile have done the same thing for motorized transportation. Henry Ford made a fortune by perfecting the mass production of the “Model T.” Should we have let political envy of his accomplishment shut down and restrict the subsequent explosion of motorized transport? There is no counting the vast subsequent benefits to human society by getting out of the horse and donkey drawn wagons and their support systems of dirty barns and corrals.
Unequal outcomes always result from huge increases in productivity. And, productivity always results in lower long-term costs of the produced items. Market economies create this rise in productivity and lower unit costs whereas Socialistic economies always “tax success” and destroy this process. Why stop the progress of Avastin? Compare and contrast drug discoveries in America versus Cuba.
Enforcing equal outcomes is a big ideology of Socialism. It disguises itself so deceptively as a matter of so-called social justice. The real injustice is that by denying early beneficiaries who can afford to buy early technology, you would destroy the opportunity for the inevitable drop in unit costs for the almost unlimited future beneficiaries at much lower costs as productivity continues. Just consider over the last 100 years, unequal outcomes propelled economies forward. Stopping the advances of technology arising from initial unequal outcomes, is a grave, if not, the gravest injustice of requiring equal outcomes. Equal outcomes is an ideology of socialism that stops economic progress and discourages future producers from taking risks to advance productivity. It creates untold future victims in exchange for government power now.
The FDA made a crude cost calculation; as everyone in Washington knows, it wouldn’t have banned Avastin if the drug cost only $1,000 a year, instead of $90,000.
The Avastin story is emblematic of the government’s broader agenda to ration care based on cost and politics. Once ObamaCare comes into full force, such rationing will be pervasive. When the government sees insufficient benefit, all but the wealthiest and most politically connected will have to go without.
Think it can’t happen here? Think again. The 2009 stimulus bill spent $1.1 billion to research ‘comparative effectiveness.’ That’s the same approach used by Britain’s National Health Service to ration care, weighing cost against factors such as the ever-elusive concept of quality of life. And in an interview that year, President Obama confessed that ‘the tougher issue . . . is what do you do around things like end-of-life care.’ Pushed to articulate a solution, he replied, ‘It is very difficult to imagine the country making those decisions just through the normal political channels.’ He asserted that we needed ‘some independent group’ to ‘give [us] some guidance.’
He got that wish. ObamaCare created a commission—the Independent Payment Advisory Board—tasked with limiting spending on Medicare. Its recommendations will be binding, unless Congress can come up with equivalent cost-savings of its own. For the first time, an unelected group will be empowered to limit health spending for the vulnerable elderly . . . .
. . . Yes, the ‘death panels’ charge is somewhat crude, but combine cost-based rationing with end-of-life counseling and, well, here we are.
There’s an enormous difference between government-imposed rationing and treatment decisions in the private sector. When insurance companies deny coverage—for example, on grounds that treatment is ‘experimental’ or not ‘medically necessary’—they do so based on contract language agreed to in advance by subscribers. If you don’t like what a particular insurer offers, you’re free to shop around. Moreover, you and your doctor have extensive rights to appeal the insurer’s denial . . . .
But when the government denies approval of a medication, there will often be no appeal and no escape . . . . The next time the FDA bans a drug because its benefits are not ‘sufficient,’ patients may not be so lucky. FDA disapproval will be the equivalent of the emperor’s thumbs-down.[lxiv]
This did not happen to penicillin, and this type of action opens up a door that will lead to rationing.
If government can limit Americans’ choice of effective medical treatments, there’s no limit to its control over our bodies, and the right to bodily autonomy is an illusion. In the context of the new health law, the FDA’s Avastin decision is the tip of a looming iceberg of government rationing. It must be challenged.[lxv]
And so, history shows the government run health care will propel the rationing of health care to people who need it the most–the elderly.
In his book, Mr. Daschle [Obama’s first choice for Secretary of Health and Human Services—Ed.] proposes a National Health Board to regulate the way health care is provided. This board would have vast powers in regulating the massive federal health care system—a system that includes Medicare, Medicaid, and other programs . . . .
Liberal experts, Mr. Daschle included, believe that America needs to ration new technology and drugs. In his book, Mr. Daschle complains about overuse of new technology and praises the United Kingdom’s National Institute for Health and Clinical Excellence (NICE), a rationing system that controls government costs. NICE’s denial of care is legendary – from the arthritis drug Abatacept to the lung cancer drug Tarceva . . .
He punts he hard decisions about rationing to an unelected board.[lxvi]
And President Obama’s own vision of our health care future shaped the health care debate.
‘Look, the first thing for all of us to understand that is we actually have some — some choices to make about how we want to deal with our own end-of-life care,’ Mr. Obama replied. After discussing ways ‘we as a culture and as a society [can start] to make better decisions within our own families and for ourselves,’ he continued that in general ‘at least we can let doctors know and your mom know that, you know what? Maybe this isn’t going to help. Maybe you’re better off not having the surgery, but taking the painkiller.’
What Mr. Obama is describing is his preferred health-care future. If or when the Administration’s speculative cost-cutting measures under universal health care fail to produce savings, government will start explicitly limiting patient access to treatments and services regarded as too expensive. Democrats deny this eventuality, but health planners will have no choice, given that the current entitlement system is already barreling toward insolvency without adding millions of new people to the federal balance sheet.[lxvii]
Additionally, to pay for Obama Care’s takeover over the private health care sector, President Obama plans to dramatically slash the amount of Medicare funding.
Since Medicare was established in 1965, access to care has enabled older Americans to avoid becoming disabled and to travel and live independently instead of languishing in nursing homes. But legislation now being rushed through Congress—H.R. 3200 and the Senate Health Committee Bill—will reduce access to care, pressure the elderly to end their lives prematurely, and doom baby boomers to painful later years.
The Congressional majority wants to pay for its $1 trillion to $1.6 trillion health bills with new taxes and a $500 billion cut to Medicare. This cut will come just as baby boomers turn 65 and increase Medicare enrollment by 30%. Less money and more patients will necessitate rationing. The Congressional Budget Office estimates that only 1% of Medicare cuts will come from eliminating fraud, waste and abuse.[lxviii]
With the need to cut expenses under Obama Care, the necessary outcome of these cuts is rationing.
Although administration officials are eager to deny it, rationing health care is central to President Barack Obama’s health plan. The Obama strategy is to reduce health costs by rationing the services that we and future generations of patients will receive.
The White House Council of Economic Advisers issued a report in June explaining the Obama administration’s goal of reducing projected health spending by 30% over the next two decades. That reduction would be achieved by eliminating ‘high cost, low-value treatments,’ by ‘implementing a set of performance measures that all providers would adopt,’ and by ‘directly targeting individual providers . . . (and other) high-end outliers.’
The president has emphasized the importance of limiting services to ‘health care that works.’ To identify such care, he provided more than $1 billion in the fiscal stimulus package to jump-start Comparative Effectiveness Research (CER) and to finance a federal CER advisory council to implement that idea. That could morph over time into a cost-control mechanism of the sort proposed by former Sen. Tom Daschle, Mr. Obama’s original choice for White House health czar. Comparative effectiveness could become the vehicle for deciding whether each method of treatment provides enough of an improvement in health care to justify its cost.
In the British national health service, a government agency approves only those expensive treatments that add at least one Quality Adjusted Life Year (QALY) per £30,000 (about $49,685) of additional health-care spending. If a treatment costs more per QALY, the health service will not pay for it. The existence of such a program in the United States would not only deny lifesaving care but would also cast a pall over medical researchers who would fear that government experts might reject their discoveries as ‘too expensive.’[lxix]
And actually, President Obama has one of the world’s most articulate and committed proponents of rationing as his advior. Who has ever heard of Zeke Emmanuel?
Dr. Ezekiel Emanuel, health adviser to President Barack Obama, is under scrutiny. As a bioethicist, he has written extensively about who should get medical care, who should decide, and whose life is worth saving. Dr. Emanuel is part of a school of thought that redefines a physician’s duty, insisting that it includes working for the greater good of society instead of focusing only on a patient’s needs. Many physicians find that view dangerous, and most Americans are likely to agree.
The health bills being pushed through Congress put important decisions in the hands of presidential appointees like Dr. Emanuel. They will decide what insurance plans cover, how much leeway your doctor will have, and what seniors get under Medicare. Dr. Emanuel, brother of White House Chief of Staff Rahm Emanuel, has already been appointed to two key positions: health-policy adviser at the Office of Management and Budget and a member of the Federal Council on Comparative Effectiveness Research. He clearly will play a role guiding the White House’s health initiative . . . .
True reform, he argues, must include redefining doctors’ ethical obligations. In the June 18, 2008, issue of JAMA, Dr. Emanuel blames the Hippocratic Oath for the ‘overuse’ of medical care: ‘Medical school education and post graduate education emphasize thoroughness,’ he writes. ‘This culture is further reinforced by a unique understanding of professional obligations, specifically the Hippocratic Oath’s admonition to ‘use my power to help the sick to the best of my ability and judgment’ as an imperative to do everything for the patient regardless of cost or effect on others.’
In numerous writings, Dr. Emanuel chastises physicians for thinking only about their own patient’s needs. He describes it as an intractable problem: ‘Patients were to receive whatever services they needed, regardless of its cost. Reasoning based on cost has been strenuously resisted; it violated the Hippocratic Oath, was associated with rationing, and derided as putting a price on life . . . .’
Of course, patients hope their doctors will have that single-minded devotion. But Dr. Emanuel believes doctors should serve two masters, the patient and society, and that medical students should be trained ‘to provide socially sustainable, cost-effective care.’ One sign of progress he sees: ‘the progression in end-of-life care mentality from ‘do everything’ to more palliative care shows that change in physician norms and practices is possible.’ (JAMA, June 18, 2008) . . . .[lxx] (emphasis added)
For those of you who have never had a chance to read the Hippocratic Oath, here is an excerpt. Bear in mind that it has survived over 2000 years of all sorts of attacks and erosions from a long history of cultures, governments, peoples and religions.
…No part of the Hippocratic Collection is more impressive than the famous passage know as the ‘Hippocratic Oath.’ There is perhaps more suggestion of it in Egyptian payri of the 2nd millennium B.C. and there is evidence that it was prepared under strong Pythagorean influence. Nevertheless, no passage better reflects the spirit of the Hippocratic physicians:
I will look upon him who shall have taught me this Art even as one of my parents. I will share my substance with him, and I will supply his necessities, if he be in need. I will regard his offspring even as my own brethren, and I will teach them this Art, if they would learn it, without fee or covenant. I will impart this Art by precept, by lecture and by every mode of teaching, not only to my own sons but to the sons of him who has taught me, and to disciples bound by covenant and oath, according to the Law of Medicine.
The regimen I adopt shall be for the benefit of my patients according to my ability and judgment, and not for their hurt or for any wrong. I will give no deadly drug to any, though it be asked of me, nor will I counsel such, and especially I will not aid a woman to procure abortion. Whatsoever house I enter, there will I go for the benefit of the sick, refraining from all wrongdoing or corruption, and especially from any act of seduction, of male or female, of bond or free. Whatsoever things I see or hear concerning the life of men, in my attendance on the sick or even apart therefrom, which ought not to be noised abroad, I will keep silence thereon, counting such things to be as sacred secrets.[lxxi]
This speaks for itself and suggests that the Natural Law of God is present in some way in all of us. But not Zeke Emanuel and his minions. Here is what their better way is:
‘However, other things are rarely equal—whether to save one 20-year-old, who might live another 60 years, if saved, or three 70-year-olds, who could only live for another 10 years each—is unclear.’ In fact, Dr. Emanuel makes a clear choice: ‘When implemented, the complete lives system produces a priority curve on which individuals aged roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get changes that are attenuated . . . .’
The youngest are . . .put at the back of the line: ‘Adolescents have received substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments . . .’ (thelancet.com, Jan. 31, 2009).
. . .Dr. Emanuel’s assessment of American medical care is summed up in a Nov. 23, 2008, Washington Post op-ed he co-authored: ‘The United States is No. 1 in only one sense: the amount we shell out for health care.’[lxxii] (emphasis added)
We could also say the same for housing, cars, entertainment, and probably every other major category of expenditure, because we have one of the highest per capita income of any nation, and thus can spend more for all these things. Here is Ezekiel Emanuel’s graph:
Zeke Emanuel Curve
The unfortunate graph should be retitled to say: Probability of receiving voter loyalty because you received an intervention. Especially notice that you reach the minimum probability of intervention at just about 65 years of age. This is when you would have finished paying payroll taxes for 45 years and would finally be eligible for Medicare.
Here is revealed a truth about liberalism as expressed in Obama Care. Government will be happy to receive your payroll taxes for 45 years, and your income taxes for even longer, and will promise you ill-defined future benefits to acquire your political loyalty. But once you discover that their promises are illusions and will not be fulfilled and thus they will lose your political loyalty, they don’t care who you are. You are just a commodity which burdens resources that they need to purchase the political loyalties of others.
If you cannot spend your own resources for your health which preserves the utility of your life to enjoy what constitutional freedoms you have, you actually have NO RIGHTS at all and are subject to being “rationed to death” by regulatory FIAT. For liberals, “health care” is not about health care; it is about their right to destroy your right to health care for their own political power.[lxxiii]
Let’s look at Zeke Emanuel’s death curve again . . . . The full horror of the implications of the graph are not obvious as it stands. To shine a light on what is there, we have imposed additional lines on the graph.
Moving up the vertical axis, the Y-axis, we will divide it into 4 equal spaces. The first space designates a 25 percent probability of intervention, the second line will mark a 50 percent probability of intervention, the third line will mark a 75 percent probability of intervention, and the fourth part will mark the point of a 100 percent probability of intervention. At each of these four points we will then extend a horizontal line parallel to the bottom line. When these lines are so extended they will intersect the Zeke Death Curve at the indicated probability. From these points of intersection, the following things will become obvious to the casual reader.
Zeke Emanuel Curve and Probability of Medicial Intervention
. . .Before you are born, you are subject to being killed by abortion that will be federally funded by the taxpayers for almost any reason at all under the health care bill. And all state restrictions on abortion are to be suspended by federal regulations.
If you are lucky enough to be born, you had better be very healthy, for it looks like you have to be alive for about 2 years before you have an even 25% chance of getting needed medical care. By the time you are 10 years old you just have a 50% chance for critical care. Too bad for you if you have an early or complicated birth. And you’d better live a pretty protected childhood.
Don’t get into too much trouble before you are about 18. This is coincidently when you can start to vote, and therefore you begin to arrive in the zone of maximum probability of an intervention (i.e. getting some health care). But maximum probability does not mean a certainty of intervention at any time.
The period of maximum probability continues until you are about 33 years old. By 50 you are down to only a 75% chance (sic) of receiving a needed intervention. By your late 50s you are down to only a 50% chance of getting what you need. And just about the time you turn 65, the very time you would have expected to begin to be eligible for Medicare after having paid payroll taxes for years, you will only have a 25% chance (or less) of getting a needed intervention.
This is worthy of being repeated. You have paid your payroll taxes for 40 years or so in the expectation that you will receive full Medicare benefits for your health care needs. Then you discover that under Zeke Emanuel’s Reaper Curve, you will only have a 25% chance or less of receiving medical intervention when you reach a health crisis.
We assert that it will never be known exactly what multitudes of factors “their computer, or invisible bureaucrats utilize” in deciding whether or not you get an “intervention”—and if you don’t get one, you will probably not live long enough to seek redress for your denial, if there even is any appeal process. All of this will be hidden in the regulatory process. This will be a form of hell. You need critical health care and you won’t even be able to go on emergency room. Just think about it . . . .
In other words, why should we trust the government which rammed Obama Care upon us in a corrupt political process to make decisions about who gets medical interventions, i.e. who lives and who dies?
In the last century, governments have historically been the very worst at making such decisions. Why should we trust governments, then, to decide who gets to live and who gets to die . . . ?
Rummel: Concentrated political power is the most dangerous thing on earth.
During this century’s wars, there were some 38 million battle deaths, but almost four times more people—at least 170 million—were killed by governments for ethnic, racial, tribal, religious, or political reasons. I will call this phenomenon democide, and it means that authoritarian and totalitarian governments are more deadly than war . . .
Another shocking thing, for me, as a political scientist, was to see how political scientists almost everywhere have promoted the expansion of government power. They have functioned as the clergy of oppression . . . .[lxxiv]
Rummel’s history of government killings shows that strong, centralized government power always goes to extremes with the passing of time.
Maybe we ought to take a look at Rummel’s discoveries about government killings as we consider the potential surrender of these life-and-death medical decisions to government authorities [through Obama Care’s 50,000 pages of to be written regulations]. Let’s assume [that] (sic) there are ~300 million people in the United States today:
In 1900, 75 percent of people in the United States died before they reached age 65; now 75% of people die after age 65.[lxxv]
Seventy[-five] percent of the current population is 300 million x 75% = 225 million people who will live to over age 65. During the next century, if 75% of these people are denied critical health care as envisioned by the Zeke/Reaper Curve, the casualties of this government-mandated health care rationing would be 225 million people x 75% denied care = 168.5 million people.[lxxvi]
What is Christian about this potential democide through rationing by Obama Care?
[i] Stafford, Diane. “Kathleen Sebelius has a full plate with implementing health-care reform.” The Kansas City Star. 7 August 2010. n. pag. Web. 2 September 2010.
[ii] “Lives at Risk: How the Obama Health Care Plan Will Ration Your Family’s Medical Treatment-A Factsheet.”Robert Powell Center for Medical Ethics at the National Right to Life Committee. November 2010: p. 5. Web. 8 February 2011.
[iii] Dannefelser, Marjorie. “The Real Kathleen Sebelius: Abortions Uber Alles.” Human Events. 28 April 2009: n. pag. Web. 8 February 2011.
[iv] Naumann, Archbishop Joseph. Interviewed by Thomas J. McKenna. “Archbishop Joseph Naumann Discusses the Pastoral Aspects of Disciplining the Governor of Kansas, Kathleen Sebelius, because of Her Insistent Pro-Abortion Stance.” Catholic Action. 10 March 2009. Web. 8 February 2011.
[v] George, Robert. “Opinion: Robert P. George on ‘Obama’s Abortion Extremism.’” Catholic Online. 16 October 2008. n. pag. Web. 9 February 2011.
[vi] Scherz, Hal. “Meet the ‘New’ Donald Berwick.” Real Clear Politics. 17 November 2010. n. pag. Web. 8 February 2011.
[viii] Domenech, Ben. “Donald Berwick Exemplifies the Obama Agenda.” RedState. 7 July 2010. n. pag. Web. 8 February 2011.
[ix] Goodman, John C., Gerald L. Musgrave, and Devon M. Herrick. Lives at Risk: Single-Payer National Health Insurance Around the World. 1st ed. New York: Rowman & Littlefield Publishers, Inc., 2004. Print: p. 9.
[x] Goodman, p. 10 (citing Karol Sikora. “Cancer Survival in Britain.” British Medical Journal (August 21, 1999): 461-62).
[xi] Goodman, p. 10.
[xii] Goodman, p. 18 (The draft EU constitution states, “Everyone has the right of access to preventive health care and the right to benefit from medical treatment under the conditions established by national laws and practices.” European Union draft constitution, Part II (The Charter of Fundamental Rights of the Union), Title IV, Article II-35 on Health Care. Available at http://europa.eu.int/eur-lex/en/treaties/dat/C2003169en.002201.htm.
[xiii] Long before the advances of modern medicine, Enoch Powell, former British minister of health, argued that waiting lines are inevitable under the NHS, regardless of the resources devoted to health care. See Enoch Powell,Medicine and Politics, 1975 and After. New York: Pitman, 1976. For a discussion of British hospital rationing, see John C. Goodman. National Health Care in Great Britain: Lesson for the U.S.A. Dallas: Fisher Institute, 1980, chapter 6).
[xiv] Goodman, p. 18 (citing “Waiting List Figures, November 2001,” UK Department of Health, Statistical Press Release, January 11, 2002).
[xv] Goodman, p. 18 (citing Esmail, Nadeem and Michael Walker. “Waiting Your Turn: Hospital Waiting Lists in Canada, 13th Edition.” Fraser Institute, Critical Issues Bulletin, October 2003).
[xvi]Goodman, p. 18 (citing Hoel, Michael and Erik Magnus Saether. “Private Health Care as a Supplement to a Public Health System with Waiting Time for Treatment.” Frisch Center for Economic Research, Oslo, Norway, 2000).
[xvii] Goodman, p. 18 (citing “Purchasing for Your Health 1996/97,” New Zealand Ministry of Health, March 1998).
[xviii] Goodman, p. 19 (Hospital admissions as a percent of the total population average 16.01 percent for all OECD countries. The figures are 16.0 percent for the United Kingdom, 13.8 percent for New Zealand and 11.0 percent for Canada. See Gerald F. Anderson and Jean-Pierre Poullier. “Health Spending, Access, and Outcomes: Trends in Industrialized Countries,” Health Affairs. 18, no. 3 (1999): 178-92).
[xix] Goodman, p. 19.
[xx] Goodman, p. 34 (citing Basinski, A. S. and C. D. Naylor. “A Survey of Provider Experiences and Perceptions of Preferential Access to Cardiovascular Care in Ontario, Canada,” Annals of Internal Medicine 129, no. 7, 1998).
[xxi] Goodman, p. 34 (citing Alter, David A., et al., “Effects of Socioeconomic Status on Access to Invasive Cardiac Procedures and on Mortality after Acute Myocardial Infarction,” New England Journal of Medicine 341, no. 18 (October 28, 1999): 1359-67).
[xxii] Goodman, p. 34 (citing Dunlop, Sheryl, Peter C. Coyte, and Warren McIssac. “Socio-Economic Status and the Utilisation of Physicians’ Services: Results from the Canadian National Population Health Survey,” Social Science and Medicine 51, No. 1 (July 2000): 1-11).
[xxiii] Goodman, p. 34 (citing Bohuslawsky, Maria, “Politicians Jump Medicare Queue.” Ottawa Citizen, June 6, 1998).
[xxiv] Goodman, p. 71 (Author’s calculations based on Henry J. Aaron and William B. Schwartz, The Painful Prescription: Rationing Hospital Care (Washington, D.C.: Brookings Institution, 1984). Reported in John C. Goodman and Gerald L. Musgrave, “Twenty Myths about National Health Insurance,” NCPA Policy Report No. 128, National Center for Policy Analysis, December 1991).
[xxv] Goodman, p. 71 (citing Anderson, Gerard F., Uwe E. Reinhardt, Peter S. Hussey, and Varduhi Perosyan, “it’s the Prices, Stupid: Why the United States Is So Different from the Other Countries,” Health Affairs 22, no. 3 (May/June 2003): Exhibit 6. See also E.C. Mulkerrin, “Rationing Renal Replacement Therapy to Older Patients: Agreed Guidelines Are Needed,” QJ Med 93, no. 4 (April 2000): 253-55).
[xxvi] Goodman, p. 71 (citing Mackenzie, J.K., et al., “Dialysis Decision Making in Canada, the United Kingdom, and the United States,” American Journal of Kidney Diseases 31, no. 1 (1998): 12-18. Britain, at 12 percent, was only slightly worse than Canada, where 10 percent of nephrologists report treatment due to limited resources).
[xxvii] Goodman, p. 71.
[xxviii] Goodman, p. 147-148 (See, for example, J. Grimley Evans, “The Rationing Debate: Rationing Health Care by Age: The Case Against,” British Medical Journal 314, no. 7083 (March 15, 1997): 822-825, Ann Bowling, “Ageism in Cardiology,” British Medical Journal 319, no. 7221 (November 20, 1999): 1353-55; Graham C. Sutton, “Will You Still Need Me, Will You Still Screen Me, When I’m Past 64?” British Medical Journal (October 25, 1997): 1032-33; and Michael Rivlin, “Should Age-Based Rationing of Health Care Be Illegal?” British Medical Journal 319, no. 7221 (November 20, 1999), 1379).
[xxix]Goodman, p. 147-148 (citing Beecham, Linda, “Patients Say the NHS Is Ageist,” British Medical Journal(April 24, 1999): 1095; Celia Hall, “Campaign to Halt Ageism in NHS,” Daily Telegraph (London), November 8, 1999).
[xxx] Goodman, p. 147-148 (citing Hall, “Campaign to Halt Ageism.”).
[xxxi]Goodman, p. 147-148 (citing Ahmed, Kamal, “Elderly Suffering ‘Ageism’ in NHS,” The Observer, January 27, 2002. For the results of a survey on ageism in the NHS, see Caroline Gilchrist, “Too Old to Care,” The Guardian, May 17, 2000).
[xxxii]Goodman, p. 147-148 (citing Turner, Nicola J., et al., “Cancer In Old Age: Is It Inadequately Investigated And Treated?,” British Medical Journal 319, no. 7205 (July 31,1999): 309-12. Also see Sutton, “Will You Still Need Me?”).
[xxxiii] Goodman, p. 147-148 (citing Patridge, Martyn R. “Thoracic Surgery in a Crisis,” British Medical Journal(February 16, 2001): 376-77).
[xxxiv]Goodman, p. 147-148, (citing “NHS Euthanasia Claims Ludicrous,” BBC News, December 6, 1999).
[xxxv] Goodman, p. 147-148 (citing “British Hospitals Deprive Elderly, Doctors Say,” BBC News, December 6, 1999. Also see Sandra Laville and Celia Hall, “Elderly Patients ‘Left Starving to Death in NHS,” Daily Telegraph(London), December 6, 1999).
[xxxvi] Goodman, p. 147-148 (See report by the Counsel and Care Charity as reported in “Pensioners a Burden to NHS,” BBC News, April 3, 1998).
[xxxvii] Goodman, p. 147-148 (citing “NHS Euthanasia Claims Ludicrous,” BBC News, December 6, 1999).
[xxxviii] Goodman, p. 147-148 (citing Redwood, Heinz, Why Ration Care? London: CIVITAS, Institute for the Study of Civil Society, 2000).
[xxxix] Goodman, p. 147-148.
[xl]Johnson, Douglas, “Phony ‘pro-life’ groups couldn’t save them: Lawmakers who defected from pro-life side on health care paid a big price at ballot box,” National Right to Life News. Nov-Dec. 2010: n. pag. Web. 7 February 2011.
[xli] Tindal-Robertson, Timothy. Fatima, Russia and Pope John Paul II. Stillriver, MA: The Ravengate Press, 1992. Print.
[xlii] University of Texas/Zogby. Survey. 15 July 2009. Web. 8 February 2011.
[xliii] Goodman, p. 49.
[xliv]Goodman, p. 36-37 (citing Johnson, Richard W. and Stephen Crystal, “Uninsured Status and Out-of-Pocket Costs at Midlife,” Health Services Research 35, no. 5, Part I (December 2000): 911-32).
[xlv] Goodman, p. 36-37.
[xlvi] Goodman, p. 35 (citing Bauman, Naomi Lopez and Devon M. Herrick, “Uninsured in the Lone Star State,”National Center for Policy Analysis, Brief Analysis No. 335, August 29, 2000).
[xlvii] Goodman, p. 35 (citing Hadley, Jack and John Holahan, “How Much Medical Care Do the Uninsured Use and Who Pays for It?” Health Affairs (February 12, 2003)(Web exclusive)).
[xlviii] Goodman, p. 36.
[xlix] Goodman, p. 36-37 (citing Bond, Michael, John C. Goodman, Ronald Lindsey, and Richard Teske, “Reforming Medicaid,” National Center for Policy Analysis, Policy Report No. 257, February 2003).
[l] Goodman, p. 36-37.
[li] “Transcript: Dr. Donald Berwick’s Speech To The British National Health Service.” Kaiser Health News 8 July 2010: n. pag. Web. 7 February 2011.
[lii] Anderson, Jeffrey H. “The Real Number of Uninsured Americans.” The Weekly Standard 29 December 2010: n. pag. Web. 7 February 2011.
[liii] War on Poverty. Wikpedia. 5 February 2011. Wikimedia Foundation, Inc., 7 February 2011 < http://en.wikipedia.org/wiki/War_on_Poverty>.
[liv] Fosmire, M. Sean. “FAQ on EMTLA.” Garan Lucow Miller, P.C. 10 October 2009. Web. n. pag. 8 February 2011.
[lv] Domenech, Ben. “CMS Nominee Donald Berwick’s Radical Agenda.” Heartland. 12 May 2010. Web. n. pag. 8 February 2011.
[lvi] “Subsidiarity (Catholocism).” Wikimedia. 2010. Wikipedia Foundation, Inc. 8 February 2011.
[lvii] Bosnich, David A. “The Principle of Subsidiarity.” Acton Institute. Web. n. pag. 8 February 2011.
[lviii] Homily by Father Ambrose. On Christian Hope.
[lix] Sauer, Fred N. A Simple Guide: How Liberalism, A Euphemism for Socialism, Destroys Peoples and Nations.St. Louis: Self-Published, 2010. Print, p. 134-135 (citing “Medicare.” Wikipedia, The Free Encyclopedia. Wikimedia Foundation, Inc. 31 January 2011. Web. 31 March 2010).
[lx] United States. The Boards of Trustsees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. 2009 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. Washington: 12 May 2009. Web. 8 February 2011.
[lxi] Rifkin Jr., David B. and Elizabeth Price Foley. “’Death Panels’ Come Back to Life.” Wall Street Journal. 30 December 2010. Web. n. pag. 8 February 2011.
[lxii] “Penicillin.” Wikimedia. 8 February 2011. Wikimedia Foundation, Inc. 8 February 2011.
[lxvi] Pipes, Sally C. “Obama Will Ration Your Health Care.” Wall Street Journal. 30 December 2008. Web. n. pag. 8 February 2011.
[lxvii] “Obama’s Health Future.” Wall Street Journal. 29 June 2009. Web. n. pag. 8 February 2011.
[lxviii] McCaughey, Betsy. “GovernmentCare’s Assault on Seniors.” Wall Street Journal. 23 July 2009. Web. n. pag. 8 February 2011.
[lxix] Feldstein, Martin. “ObamaCare Is All About Rationing.” Wall Street Journal. 18 August 2009. Web. n. pag. 8 February 2011.
[lxx] McCaughey, Betsy. “Obama’s Health Rationer-in-Chief.” Wall Street Journal. 27 August 2009. Web. n. pag. 8 February 2011.
[lxxi] “Hippocratic Oath.” Encyclopedia Britannica. 1956. Vol. 15. 197-198.
[lxxii] Sauer, Fred N. A Simple Guide: How Liberalism, A Euphemism for Socialism, Destroys Peoples and Nations. St. Louis: Self-Published, 2010. Print, p. 362 (citing McCaughey, Betsy. “Obama’s Health Rationer-In-Chief.” The Wall Street Journal. 27 August 2009. Web. 15 April 2010). <http://online.wsj.com/article/SB10001424052970203706604574374463280098676.html>).
[lxxiii] Sauer, Fred N. A Simple Guide: How Liberalism, A Euphemism for Socialism, Destroys Peoples and Nations. St. Louis: Self-Published, 2010. Print, p. 362-363.
[lxxiv] Sauer, Fred N. A Simple Guide: How Liberalism, A Euphemism for Socialism, Destroys Peoples and Nations. St. Louis: Self-Published, 2010. Print, p. 380-382 (citing Rummel, Rudolph. Personal Interview. Web. 28 March 2010. <http://www.hawaii.edu/powerkills/FREEMAN.INTERVIEW.HTM> (citing The Freeman: Ideas on Liberty 47 (July 1997): 396-403)).
[lxxv] Sauer, Fred N. A Simple Guide: How Liberalism, A Euphemism for Socialism, Destroys Peoples and Nations. St. Louis: Self-Published, 2010. Print, p. 382 (citing Saal, Walter Vom. “Selected Data on Aging.” Web. 17 April 2010. <http://employees.oneonta.edu/vomsaaw/w/psy345/handouts/demograf.pdf> (citing Hayflick, Leonard (1994). How and why we age. New York: Random House / Ballantine Books. P. 96)).
[lxxvi] Sauer, Fred N. A Simple Guide: How Liberalism, A Euphemism for Socialism, Destroys Peoples and Nations. St. Louis: Self-Published, 2010. Print, p. 382.