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Health Care: Category Archive

Discussions of health care and its impact in society

Two Ways to Cross a Stream

Today, the Supreme Court struck down nearly 50 years of precedent, finding (correctly) that there is no right to abortion in the Constitution. Finding it there was incorrect in 1973 and proved to be even more incorrect as medical science advanced. To say I am ecstatic would be underselling it; I have advocated against it for decades, and even wrote publicly about it as far back as 19 years ago. This is a wonderful day!

To be sure, this court case does nothing for the generation lost to this barbaric practice, nor does it eliminate it on a nationwide basis; the rescinding of the Roe v. Wade decision returns the issue to the states. I am a big believer in an incremental approach because, in large part, any absolutist effort is doomed to failure. Every prenatal murder we can avoid is a cause for celebration. The states that have laws that go into effect will have the effect of outlawing 12.8% of abortions (subscription-only link) - just over a literal decimation of this abhorrent practice.

I won't rehash my posts from the past nearly-two decades; if you want to read those, just peruse the “Prenatal Murder” category linked at the bottom of this post. Rather, I want to reflect on various aspects of this decision, what led up to it, and what is next for those of us who value the sanctity of human life from conception through natural death.

Roe Was Bad Law

The Roe decision only made sense by stretching the logic of a 1965 decision that had also stretched to reach its conclusion - Griswold v. Connecticut. Griswold centered around a law that prohibited the dispensing of birth control advice or devices. The majority opinion in this case found a previously-undiscovered “right to privacy” in the Constitution (as amended) that “emanated” from prior case law's “penumbras” (shadows). Calling this innovative thinking is probably too kind; it set precedents in all sorts of bad ways.

Just eight years later, Roe took a hop from Griswold's stretch, equating the act of abortion with any other form of birth control. This was also innovative, but not in the way you may expect. You likely grew up hearing about “trimesters,” those three 3-month periods of fetal development prior to birth. That did not come from current medical thinking; it came from renowned biologist Justice Harry Blackmun, via his majority opinion in this case. (Maybe justices do need to have a good working knowledge of biology, eh Justice-in-Waiting Jackson?) Justice Blackmun used this “trimester” framework to literally "split the baby", finding that the state had no interest in the first, some interest in the second, and the near-prevailing interest in the third. It also provided prohibitions on laws that did not allow abortions to preserve the “life and health” of the mother.

At the time, its companion case (Doe v. Bolton) defined “health” to include “mental health,” which was the key for the abortion free-for-all that followed. Parenting has profound effects on your mental health, whether you set out to be parents or are surprised, and doctors were all too willing to use this as cover to grant abortion for any reason (or no reason at all).

In 1973, the decision was not great; however, in the intervening years, medical science and our understanding of fetal development increased greatly. In 1992's Planned Parenthood v. Casey decision, the Supreme Court replaced the trimester framework with a “viability” standard. Sadly, they left the “mental health” definition from Doe intact, so the effect was the same. Medical science continued advancing, and as those who were pro-abortion rights continued to ignore it, their “rights” platitudes rang more hollow. In 2009, they thought they had finally won, but in reality…

The ACA's Overreach Accelerated This Decision

The Affordable Care Act (ACA, also known as “Obamacare”) mandated, among other things, what type of health care coverage employers must provide their employees (whether they want/need it or not). Reproductive health care was part of that package, and within that were some “birth control” measures that prevent implantation of a fertilized egg or induce spontaneous abortions (“abortofacients”). There were also very limited exceptions to this policy; in short, if you were not a church, you had to provide this.

This took the debate from the public square and into the courts. In 2014, the Supreme Court's decision in Burwell v. Hobby Lobby found that this lack of exception for religious beliefs for for-profit businesses violated 1993's Religious Freedom Restoration Act (RFRA). That was a good ruling, but it only applied to abortofacients and for-profit businesses. Catholic Charities' Little Sisters of the Poor were not as fortunate. The Roman Catholic religion views any birth control as sin, and even if the Hobby Lobby exception applied, they were still mandated to provide something against which they have long-standing, well-documented, sincerely held beliefs. It took until 2020 – 11 years after the ACA became law – to win their exemption via Little Sisters of the Poor v. Pennsylvania.

While businesses were fighting in court, state legislatures were passing laws. Some states passed laws ensuring that this travesty could occur right up until the moment of delivery, but many states passed further restrictions on abortion. These restrictions varied from those thought to comply with Casey, to near or complete bans that were deferred until Roe and Casey were struck down, to some innovative thinking the other way (which isn't a compliment; Texas gets their own section under “What's Next” below). These laws codified, within each state, where they wished to draw the line on their compelling state interest. Among the ones that took effect, some held, some were struck down (like 2020's moderately surprising decision in June Medical v. Russo), and the Mississippi law challenged in Dobbs v. Jackson is what led to today's majority opinion.

A draft of that opinion was leaked in early May. Not only did this allow me to write large portions of this post ahead of time (hooray), it also led to some really revealing arguments from the side who felt that they were about to lose. Despite their claims to the contrary…

Abortion Is Not Health Care

The most egregious and disingenuous of these claims is that the reversal of Roe will lead to doctors being prohibited from taking care of troublesome pregnancies, such as ectopic pregnancies (where the egg implants in the fallopian tube) and miscarriages where the fetus has already died (but the woman's body is not eliminating it properly). It is true that, particularly with the miscarriage, the medical procedure itself is similar. However, no one is saying ectopic pregnancies should remain (except some knuckleheads in Missouri - again, addressed below), and removing an already-perished pre-born baby is also not abortion. These are health care procedures, and will remain legal in all 50 states, even if it takes a court challenge. (Again - maybe we do want our judges up on their biology, no? Maybe the legislature, too?)

Strawmen out of the way, this leaves us with four general scenarios to consider.

  • The first scenario goes something like “I just missed my period; uh oh - ain't nobody got time for that!” While I would love for this to be outlawed, the reality is that these will likely be legal - or at least accessible - forever. The Mississippi law challenged in Dobbs mandated no abortions after 15 weeks, which would have no effect on this abortion scenario. All that said, though, this is no more health care than elective breast augmentation.
  • The second scenario is selective termination after genetic testing. In these cases, there is absolutely no difference in the health of the mother who is carrying a baby with genetic deformities. All her systems still work the same; failing to give these children the opportunity for the life they have been given is something which should be prohibited by law. Again - not health care, just early murder.
  • The third scenario is a woman who changes her mind well into her pregnancy, and her baby is fully viable outside the womb. In this case, there is no prevailing health care concern that requires the baby to die; a delivery eliminates the pregnancy and gives the baby the opportunity it deserves. “Not health care” is an easy call here; all three cases thus far show that something being a “medical procedure” does not mean that the procedure is “health care.”
  • The final scenario is pregnancies resulting from rape (which includes incestuous statutory rape; I am not considering consenting related adults' children here). Here, I will probably part ways with some of the more ardent pro-lifers; while I do not believe abortion is the right decision in these cases, girls and women in this situation are already in a non-ideal situation. I believe it should be legal to counsel them to keep these pregnancies, but you will not find me pushing an absolutist position here. That being said, this is the only case where mental health should play any sort of consideration at all; outside of that, this is not health care either.

I mentioned the revealing arguments in the wake of the leak. The health care argument was one, but again, contrary to their claims, this is…

No Slippery Slope

(At this point, I would love to divert and discuss the difference between a “slippery slope” argument and an “argument of progression.” However, this is already essay-length; maybe that will be a post for another day.)

The claim goes something like “If they take this right away, what's to stop them from taking away birth control totally? Or gay marriage?” Well - in two words, “the Constitution.” Eliminating a stretch from the emanating penumbras doesn't eliminate the penumbras themselves, so birth control's legality remains covered under Griswold – just not the murder-your-baby kind. A better parallel for gay marriage would be 1967's Loving v. Virginia case, decided on equal protection grounds rather than right-to-privacy; these same equal protection claims were central to 2015's Obergfell v. Hodges case. There is also no nationwide movement against either of these decisions. There may be local overreach on these laws, and there may be lawsuits where the plaintiff's rights under RFRA were found to be violated – but these (contrary, again, to the hyperbolic claims of the losers) do not remove the laws from the books; they recognize religious freedom in our pluralistic society.

So, all that being said…

What's Next? (AKA “Fix Your Law, Texas”)

The fight for the legal rights of the unborn now has 50 fronts. This is not necessarily a new development; as I mentioned above, there has been legislative action in several states. There will likely be vociferous screeds about abolishing filibusters, expanding courts, and other harebrained schemes, all in hopes of getting a quick nationwide reversal of Dobbs. The conversation around the 2024 election will be hysterical and insufferable – not that the outlook there was all that reasoned and sufferable to begin with…

Some ways I would like to see the issue progress (and things I would support) include:

Continued Vigilance

There will be, no doubt, efforts to reverse today's decision, both in the courts and in Congress. While many of us see today's decision as the natural consequence of the way culture, science, and jurisprudence have been moving for the past generation, we should assume absolutely zero momentum. There will be a reaction, and it will be covered favorably by the legacy media; stand on principle, and do not concede the phrasing or the terms of debate. Culture has changed because pro-life advocates have publicized both the amazing miracle of life in the womb and the horrors of abortion; keep doing that.

No Overreach

We no longer need “bold” laws to “challenge” the unconstitutional Roe; it's done, and the states have the power. “With great power comes great responsibility,” though, so any future laws restricting abortion must be free of some of the sloppiness contained in prior abortion laws (and some current “anti-woke” laws). (No, you may not criminalize treatment of ectopic pregnancies.) These laws must be specific, measurable, enforceable, and medically sound. I like heartbeat bills, I'm OK with 15-week bans; I'm not OK with jailing abortive mothers.

Texas, I promised you some special attention. If your law had been passed contingent upon today's ruling, or passed in the future, it would not have the same baggage that it currently does. I'm quite surprised that the Supreme Court did not issue an injunction; my only guess is that they had an inkling that today was coming and wanted to give you a head start. Working around the Constitution is not the way to accomplish this. Revisit this law; if you want to be the only state in the Union to have a civil penalty for abortion, so be it, but surely you can do better by the children of Texas than outsourcing their protection to (possibly out-of-state) profiteers.

Don't Be “Pro-Life in Name Only”

You know what's tough? Being a mom through pregnancy, birth, and early childhood. (It doesn't get a lot easier, but at least you start getting sleep – until the teenage years, anyway.) Not engaging in an activity that will create life until one is ready to take responsibility for the life created is quite pro-life; this is the “hearts and minds” aspect, which wasn't ever part of Roe. Until that happens, though, we need to be prepared to support those who have created life and don't know what to do. Crisis pregnancy centers will be even more vital in the years to come, and they will need both counselors/volunteers and funding to help their clients.


While Roe v. Wade will exist as reversed Supreme Court precedent, I look forward to the day when “row” and “wade” are just two ways to cross a stream.

It’s Not about the Breasts

A pink ribbon in a tight upward loop October is Breast Cancer Awareness Month. Lots of places turn pink for awareness, but I don't know exactly what this “awareness” is supposed to accomplish. We're now “aware” that grown men tackling other grown men while wearing pink uniforms is - uh - different, and that cars zooming around a racetrack with pink paint schemes bring back memories of Pepto-Bismol. In our sex-obsessed society, it almost seems as though it's Breast Awareness Month. “Save the Ta-Tas!” “Save Second Base!” (Although I do have to admit that the one with two bees dressed like ghosts, with the caption “Save the Boo Bees,” is quite creative.) Certainly many Halloween costumes accentuate the fact that their wearers still possess them; but, again, I don't think that's the awareness this month is really meant to bring about.

The issue at stake with breast cancer, as anyone who has ever had it, or had a loved one or friend who had it, is the same issue at stake in nearly every other thing that has “cancer” in the name. It's your life. According to the NIH's National Cancer Institute, there have been around 232,000 cases of breast cancer found in 2013, with 40,000 of those resulting in death; but that's just for females. Males are responsible for another 2,200 cases of cancer and 400 deaths. That puts the death rate at 17% of women and 18% for men; for women, this is the #1 or #2 cause of death from cancer, depending on your ethnic heritage. The breast cancer survivors I know would give their breasts up in a heartbeat (and I believe that all of the ones I know have) to be rid of the cancer, and live to see their children grow.

The death rates are decreasing, which is good. Awareness is leading to action. That's really the key - a change of behavior based on the knowledge acquired. Both men and women can benefit from regular self-examinations; if something feels different, get it checked out. It's not just a lump of flesh at stake.

Post-Independence Day Thoughts

I've got a good bit on my mind this morning. I held back from posting anything negative about our nation yesterday (apart from a call to repentance - but that was me as a Christian, not as American; I would feel that way about whatever nation I called home). “Happy Birthday America - you suck!” just seemed inappropriate.

However, our nation does have many, many flaws. I'm not ready to discard her, by any means; but I see, at nearly every turn, her people and her government making the wrong decisions, and continuing her slide towards mediocrity and insecurity, under the guise of improving both. In nearly every issue, the underlying cause appears to me to be the same - an inability to dispassionately, rationally evaluate a situation, policy, etc. on its merits alone. This is displayed on both sides of the political divide, where talking points and comebacks are slung back and forth, and seems to be what passes for civil discourse. It isn't!

This originated as a Facebook post, but I thought it was more appropriate for the blog; heaven knows it's had some cobwebs for a while, and hits its tenth anniversary next month. Were I to blog each of these issues individually, though, I'd end up with thousands of words that no one would read, save to search it for keywords so they could post their comebacks in the comments (see above). Does it matter that I can't succinctly express what's on my mind? The problems I see aren't succinct problems with succinct solutions. An exclusively inward focus seems wrong; I should be trying to leave a better nation and world for my children, right?

But, as I look back at those nearly 10-year-old posts, the issues are the same. “Gay Bishops - A Big Deal?” Well, I (regrettably) have been vindicated in my view that this gave license for people to just ignore parts of the Bible with which they disagree; at this point, were a hair's breadth away from forcing people to behave in ways they feel are contrary to the Bible, because others disagree with parts of It. “The Ten Commandments - A Monumental Controversy” was about a man's personal decorations in his office, yet the intervening ten years have seen a continuing push to eliminate every vestige of our Christian heritage from the public square. “Abortion - A Bad Idea Whose Time Has Passed” has seen some progress as of late, but the Todd Akin/Wendy Davis dichotomy prove my point about civil discourse; neither side is immune. However, since that post, there is one political party that has decided they should be for it at any time, for any reason, at no cost. I'm no legal expert, but I don't think that was quite the point of Roe v. Wade, or even Griswold v. Connecticut. How does one rationally argue against such an irrational, yet quite passionately-held, position?

America is not beyond hope. We must change course, though, or we will find ourselves swimming in self-induced mediocrity, while we are crowing over how advanced we are. To get God's blessing, we must turn to Him; to elevate civil discourse, we must teach reasoning. (Morgan Freeberg had a great (and succinct!) summary of this where he dissects Dennis Prager's statement that he'd prefer clarity over agreement.)

p.s. The ambiguity in the title of this post is intentional; whichever meaning is appropriate will be up to us going forward.

Well Said, Congress

Congress, addressing the Pentagon's request to increase TRICare fees. I don't know think that I can improve on this, so it's presented without further comment.

...career members of the uniformed services and their families endure unique and extraordinary demands and make extraordinary sacrifices over the course of a 20- to 30-year career in protecting freedom for all Americans. ... Those decades of sacrifice constitute a significant pre-paid premium for health care during a career member's retirement that is over and above what the member pays with money.

(Full story here.)

An Illustrative Salvo in the War on Women

When George Stephanapoulos brought up a birth control question in one of the Republican debates, Mitt Romney was taken quite by surprise, as were most of the other analysts and pundits. This wasn't an issue; why was the question posed? As it turned out, this was the first rumbling of the “Re-Elect Barack Obama 2012” narrative - “The Republicans hate women!” From Sandra Fluke's testimony, Rush Limbaugh's criticism, and the resulting fallout (which I thoroughly dissected in the post immediately preceding this one); to the framing of the debate on Obamacare; to the sneering condescension shown by more than one person towards Ann Romney, stay-at-home wife to her husband Mitt; the narrative has been plodding forward.

Part of this is based on the quite-successful efforts against Planned Parenthood, in the wake of revelations that many of their offices were caught covering up for underage sexual abuse, failing to report what they were legally required to report. However, cutting back on Planned Parenthood might cut back on abortions, the 2nd Sacrament of Liberalism, and we simply cannot have that. With the stakes so high, the Great Uniter Himself can't just leave the battle to his surrogates:

If a Republican candidate made such a claim against a person or party, he or she would rightly be taken to task by media watchdogs for making false claims. Just THINK about this claim. Now, let me ask you this. WHO IN THEIR RIGHT MIND WOULD WANT TO “DENY” HEALTH CARE TO ANYONE, REGARDLESS OF GENDER? I am a Republican, I have many friends who are Republicans, and I have never heard any of them talk about denying anyone health care.

This is the lunacy behind this question. But, their lunacy is enabled by the alternate dictionary through which they view the world. This is a different lexicon that we were taught in school. Here, if the government isn't paying for something, it's being withheld or denied; if the individual in need can't get something because they can't afford it, and you don't believe the government should pay for it - well, why do you hate them? There is also no distinction between necessary and elective procedures; “health care” must cover them all. Your objections to this can't possibly be motivated by your morals, or your belief that there is a better way; they must be motivated by hate. Therefore, Republicans are hate-filled bigots who want you to die.

I can assure you that any health care plan that covers breast cancer will also cover mammograms; if it doesn't, I would stay away from that company! The cost of a mammogram far outweighs the cost of oncological care, and since the insurance company's job is to save as much money as possible, they would rather pay for mammograms than pay for cancer treatments. If they did not cover mammograms, they would also be at a competitive disadvantage to companies that do.

Will the media call out this lunacy? Probably not; they'll just leave us to bask in the warmth of this toasty, smoldering straw man.

Contraception, Conviction, and Personal Responsibility

Contraception has been in the news quite a bit recently, culminating this week in testimony before Congress and calls for Rush Limbaugh's microphone over his response. Let's look at the timeline and how we got here, then I'll share my thoughts on the whole thing. (If you're in a hurry, skip to the last 2 paragraphs; but, if you have the time, read the whole thing, as it goes deeper than I have seen most analysis go.)

This issue came to the forefront of popular discussion when the Roman Catholic church expressed their opposition to the provision of the health care reform bill (AKA “ObamaCare”) that required employers to provide health insurance that covers contraceptive care. Official church doctrine regards this as sin, and requiring their hospitals and other organizations to provide this, they claim, is a violation of their religious beliefs. The fact that Rick Santorum, a leading candidate for the Republican presidential nomination, is a practicing Roman Catholic (and has lived these beliefs for years), has brought this issue even into the primary process.

Some legislators, seeing this as a legitimate complaint from the church, presented legislation that would amend this requirement, allowing an exemption for employers who have religious objections to these requirements. To help combat this, a Georgetown University student named Sandra Fluke testified to Congress about how important she held contraception, and how she felt that free contraceptive coverage was an integral part of health insurance coverage. Rush Limbaugh, long known for “illustrating absurdity by being absurd” (his term), seized this testimony and ran with over-the-top commentary, using terms to describe Ms. Fluke that have people calling for his job.

Those are the facts as they now stand. Let's dig in, shall we?

The first thing we need to discuss is the term “contraception;” the literal definition is “against the fertilization of the egg” (contra = against, con-ception = fertilization of the egg). A popular synonym for contraception is “pregnancy prevention,” but that is a much broader term. Some feminists define contraception as “that which prevents birth,” an even broader definition than pregnancy prevention. There cannot be an agreement on contraception until we can all agree on what that means. We'll leave abortion out of it, as the view of abortion being contraception is a minority one, and it's not part of this mandate.

What is part of this mandate, however, are drugs that are collectively termed abortofacients; these are techniques or medicines that do not prevent the fertilization of the egg, but they prevent the implantation of the fertilized egg onto the uterine wall. RU-486, the “morning-after pill,” and certain intrauterine devices (IUDs) fall into this category. These methods of “contraception” violate not only the Roman Catholic views against contraception, but the evangelical churches' beliefs that life begins at conception - it is equivalent to an abortion. This greatly expands the pool of those organizations which would be required to provide coverage which violates their moral beliefs.

Some would say that the argument of “it's against my religion” has been made spuriously in the past, and they would be right. However, the prior misuse of this argument cannot be used to strip away the principle, long recognized in this country, that we generally do not create laws that force mainstream religious organizations to violate their consciences. I personally do not hold to the belief that contraception is wrong; however, I do hold to the belief that life begins with conception. This is described in Scripture, and has been validated with medical advances over the past few decades. So, I believe that this law is a bad law because, among its other many problems, it forces religious organizations to either violate their conscience or face criminal prosecution. In a nation founded on the principle of religious liberty, this is not something we should do.

Now, let's turn our attention to Sandra Fluke and her testimony before Congress. Her testimony brought a valuable insight into the mindset of many of her generation. She said “Without insurance coverage, contraception can cost a woman over $3,000 during law school.” Let's ignore the math of that statement ($1,000/year?) for now and look at what she didn't say. Implicit in this statement is the fact that she feels entitled to not only practice sexual activity as much as she wants, but to be free from the consequences of that activity. That is one of the lies that now permeated a second generation. They have been told that their sexuality is best expressed by using it repeatedly, and however they choose to do it, that defines who they are. The sexually “repressed” have been ridiculed or even shunned, while the sexually “liberated” are celebrated. Thanks to contraceptive methods, they can express themselves free from the traditional consequences of sexual activity.

This is a lie. “Liberated” sexuality does not empower women; rather, it strips them of their power, instinctively inherent in the human race. It is no secret that the male of the human species is inordinately preoccupied with this aspect of his life from adolescence forward; traditionally, while the female may have wanted the same thing, she would hold back, which encouraged men to make a commitment they might not otherwise make. The old adage “Why would you buy a cow when you can get the milk for free?” illustrates this principle quite vividly. 40 years out from the sexual revolution, commitment has taken a nose-dive into near non-existence. Cohabitation, hooking up, friends with benefits, and no-fault divorce now provide avenues for sexual activity that were not available to men in the past. So, rather than commit to one person, and do the hard work of changing themselves to become better mates in order to earn this gift from their brides, men can just float from one partner to another. If a partner sees something in him that, were he to change, would make him a better man, he has very little motivation to endure that change. This has led to weaker men and weaker women, and in two generations has brought us to the place where over 50% of babies born to women under 30 are now born out of wedlock.

Yes, we're getting deep into this, but it is crucial that we do so, because this begins to get to the biggest problem with the Fluke generation (heh - I should copyright that). We can expect nothing different, because they simply haven't been taught, and they did not see it modeled in anything but generations so old they'd never dream of mimicking them. They see no reason for people to have a problem with this. This is also why there is such a visceral reaction when these beliefs are challenged. That doesn't absolve them of their responsibility to seek out and evaluate whether what they believe is right, but it helps to understand their thought process.

Notice also that I am not judging the character or intentions of the generation as I described it above. Even with parents teaching their children these things, and living them out in front of their children, people will make choices that are less than optimal. The above should be read as a commentary on society, not as a condemnation of its participants. Besides, assigning blame to people is counterproductive; we need to look at the decisions that were made, where they have led us, and determine what decisions we should make to get us to where we need to be. My goal is to encourage behavior that is beneficial to society.

(Wow, what a rabbit trail. OK, back to my point from 4 paragraphs ago…) Although I doubt she sees it this way, what she expressed in her testimony was a desire to choose to act however she wants, but be free from the negative consequences of her actions. This is what has provoked such a reaction from her detractors - why should I (through government-funded insurance programs) pay for your decisions, or for shielding you from the consequences of your decisions? Engaging in sexual activity is a choice; you don't just “catch” sex. (We're ignoring rape with this statement - but what kind of attitude do you have to have to always have contraception for fear of rape? That doesn't apply in this argument.)

This brings us to Rush Limbaugh, who used absurdity to greatly ridicule Ms. Fluke. He said some things that he knew were over the top; that's what he does, both to illustrate points and to garner ratings. Predictably, there have been calls for his job, and some advertisers have pulled their spots from his show. Since I started this post earlier this morning, he has apologized to her for the incendiary words that he used. (Interestingly, one of those words has been used triumphantly by feminists to describe themselves, as a celebration of their sexual freedom; if she truly is a feminist activist, one might think she would take that as a compliment. Sadly, the double-standard discussion will have to wait for another time, or this post will never wrap up.)

Just as we looked at the Fluke generation, think about the Limbaugh generation. Rush is part of the first generation that began, in large numbers, to shed the morals and values that had been with us for hundreds of years. He is now seeing the results of this, and is flabbergasted that things have gone so far so quickly. He also enjoys getting people riled up, particularly the “femi-nazis,” a group that is pretty easy to tick off. So, when we look at his statements, considering his history and background can help put his comments into their intended context. As has been proved by both the right and the left, an out-of-context sound bite can be made to say whatever one wants; however, the truth, whether exculpatory or damning, can only be determined by evaluating the statement as whole.

Are there any of you who feel that Limbaugh should have been censured, who also feel that, now that he's apologized, all his sponsors should return to his program on Monday? Now you're starting to see it. He may very well have to live with the negative consequences of his actions, even though he has apologized for them. Should his insurance company produce the lost revenue from these advertisers? Of course not - he would be crazy to suggest that they should. This is the exact same principle we evaluated above! Maybe seeing it turned on someone less sympathetic will help you understand the issue more clearly.

Personally, I believe that shielding people from the negative consequences of their isolated bad actions can be beneficial, particularly if they are allowed to experience part of those, and have to expend some effort in ameliorating the remainder. (I'm not talking about Limbaugh here; this is a general statement.) As the adage goes, “Good decisions come from experience; experience comes from bad decisions.” People are not perfect, and they are going to make choices which bring negative consequences. Notice, though, that I started this by saying “personally.” Forgiveness is a personal virtue, not a government policy. However, even with forgiveness, it is often neither possible nor desirable to shield the person from the consequences of their actions. What people like Sandra Fluke want is for the government to spare no expense in its attempt to shield her from whatever consequences she deems undesirable. A government policy of forgiveness, paired with the equal application of the law, amounts to a tacit approval of the activity. It is not fair to forgive or shield one person and not another; some would argue that limiting it to one instance would not be fair either. It just simply does not work.

Sexual activity is certainly not the only area where we see this mindset at work. One of the major sparks behind the Occupy movement was frustration from people who got a college education, but could not parlay that education into employment. They wanted their school loans forgiven - and, with the value they were seeing from that piece of paper, who could blame them? But, again, actions have consequences. They chose to get the education in certain degrees, and at a pace that incurred debt. Their demand that others pay to shield them from the negative consequences of those decisions was met with some sympathy, but mostly derision from people who saw them as a bunch of freeloaders, protesting their poor state from their iPhones and iPads.

Let's distill all of the above down to five main points. First, the contraception provision in ObamaCare is wrong, and inconsistent with our legal traditions; it becomes more so as the definition of the term contraception is widened. Second, the nuclear family is the most beneficial for society, and provides the greatest motivation for both man and woman to improve themselves as they grow closer to one another. Third, while people like Ms. Fluke may not see it, they are expecting others to pay to shield them from the negative consequences of their actions, and this is what many people, myself included, find distasteful. Fourth, consider the context from which both sides originate when analyzing arguments, particularly those which generate a strong reaction; it may not make their argument any more believable, but it will help reveal not just what they are saying, but what they want. Fifth, while forgiveness is a positive personal character trait, it is incompatible with government policy.

I hope my analysis has helped you evaluate this issue; it goes way deeper than sound bites can convey. At its core, this is about respecting religious convictions and accepting personal responsibility. I hope and pray that my nation chooses to do both.

2010 Year in Review: The Bad

This is the middle post of my three-post “Year in Review: The Good, the Bad, and the Ridiculous.” The linked words in that title will take you to the other two posts. Here are the things that I considered bad in 2010.

Wikileaks

Wikileaks began as a whistleblower website, where people could release information about injustices. In 2010, they made a leap into classified government documents. Purportedly stolen by PFC Bradley Manning, these documents were not only embarrassing for some government agencies, the information contained in those documents identified informants and other non-public allies in the War or Terror. While the creator of Wikileaks, Julian Assange, is currently in custody (due to some somewhat-questionable sex crime charges), there is little legal enforceability on a citizen of another country disclosing secrets of another. Several US companies have severed ties with the site, and kudos to them for that; however, I believe that the net result of this will be bad.

ObamaCare

What I've identified as the most ridiculous quote of 2010 (“We have to pass the bill to find out what's in it”) was spoken in reference to this bill. Going by the formal name of the Patient Protection and Affordable Care Act of 2010 (colloquially known as “Obamacare”), this bill enacted many reforms to our health care system, most notably in the area of insurance coverage. The bill mandates that all people purchase and retain health care insurance (a provision already rule unconstitutional), stipulates that insurers must cover preexisting conditions and may not drop insured people for certain conditions, and provides for the creation of a public co-op. There may be more, but at 1,300+ pages, who knows?

We are already seeing the unintended consequences of this legislation. Insurance rates are going up, with many companies raising rates 25% or more. This shouldn't catch anyone by surprise; what is called “insurance” in the bill is more like a membership. Insurance is a bet against bad things happening, which is the entire reason preexisting conditions aren't covered. Where's the bet when you know the outcome? Insurance rates are not designed for this type of use. (Conspiracy theorists could speculate that those who passed the law knew this. They really wanted public control, but the people didn't want it - instead, they passed a bill that will bankrupt the insurance companies. Then, who rides in to save the day? Liberal government!)

Insurance is but one of the problems with this bill; there are many others where the unintended consequences outweigh the intended benefits. Hopefully, the 112th Congress can undo this monstrosity before most of its provisions become effective. Until then, though, this remains on the bad list.

The FCC Implements Net Neutrality

“Net neutrality” is the concept that network service providers (ISPs, cell carriers, etc.) must treat all network traffic equally. This means that they cannot favor certain types of packets (ex. their own video streaming) while slowing down other packets (ex. competitors' video streaming, voice over IP). While, on the surface, this sound good, it fails to take into account bandwidth considerations, and the consequences of that bandwidth being used up. A TV signal can be broadcast through the air, and whether one TV or a million TVs receive the signal, the signal is the same; however, the same signal received over the Internet must be duplicated once for each end point receiving it - it is a request-response network. It's not as cut-and-dried of an issue as some of its more ardent supporters would like to paint it.

Congress has failed to implement net neutrality legislation, and courts have ruled that the Federal Communications Commission (FCC) has no jurisdiction to implement it on its own. That didn't stop the intrepid FCC, which issued net neutrality guidelines near the end of the year. Hopefully 2011 will find these regulations to be unenforceable; as it stands now, though, these regulations are bad, and have the potential to slow innovation around the network.

My Prescription for Health Care Reform

I've been asked by some, regarding my last post, what my solution is for the problems that plague our current health care system. I was also accused of being too verbose - so, here is my solution, minus the qualifications that tend to make my explanations longer. So, no griping about sweeping generalizations - just ask for clarification. :) Without further ado, I present Dr. Daniel's Prescription for Health Care Reform.

Illegals Gone

With the number of people who are in this country legally, we cannot support those who are not. This extends to emergency care as well, because if we leave that open, we'll just have illegals using the ER for their everyday health care. Raises the stakes a little, but we can't afford to fix everyone “for free.” Additionally, insurers must verify citizenship for their standard policyholders. They are still free to obtain health care at their own expense.

End HMO/PPO Discounts

This is the #1 thing that drives the cost of health care for the uninsured. To get what they need, providers have artificially inflated their charges; so, when they apply the HMO/PPO discounts, they get what they wanted to begin with. Make these post-markup, post-discount prices the standard prices, and health care becomes much more affordable, even for the self-insured (AKA uninsured).

Choose Your Own Coverage

There is no reason that a single male should buy a policy that, by law, must cover OB/GYN services. People should have the ability to select only the coverage they need, and companies should have the right to sell it to them. Don't want prescriptions covered? Don't buy the coverage - buy the $10 90-day supply from Wal-Mart instead. This will let premiums be lower for people who only desire catastrophic coverage, and would bring health insurance more in line with homeowner and auto insurance.

Just the Total, Please

There is absolutely no reason that someone should receive 4 bills for one visit. However, go to the ER, and you'll likely end up with a hospital bill, a doctor's group bill, a radiology bill, and maybe even a laboratory bill. Funnel all billing through one of these; the hospital or doctor's office is the one I would pick. This will make it easy to get estimates and totals for the consumer, and I'm sure that, given this requirement, these organizations could come up with an efficient way to make it happen pretty quickly. I see this as a parallel to the standard “Nutrition Facts” labels on food - one bill from one place, with no hidden charges.


There you have it. Take four of these and call me in the morning if pain persists.

Health Care - From the Folks Who Brought You “Cash for Clunkers”

I made a Facebook status update earlier today where I said I hoped that the mismanaged “Cash for Clunkers” program (C4C hereafter) had caused some people to think about whether they wanted the same people in charge of their health care. Of course, with the limited space for status updates, and my double-dose of verbosity (which is genetic, I thnk), I really didn't have room to flesh out my thoughts on the matter.

A review would be in order here. C4C is a government program that gives incentives for people to trade in cars deemed older and less fuel-efficient on a new car that is more fuel-efficient. A consumer group has a FAQ. A controversial provision of this bill is that these trade-ins must be completely destroyed - no parts can be salvaged at all, no tires, no body parts, nothing. One of my Facebook friends described the process they used - drain the oil, replace it with water, and run the engine until it seizes up. Anyway, this program was funded at $1 billion to go from July 24th to November 1st of this year. Yet, a short week later, the news begins to break that the program is almost out of money. There is talk of adding another $2 billion - that's $3 billion of our tax dollars to buy and destroy perfectly functional cars, because they don't fit someone's idea of a “good car.”

Regarding the way these cars are being destroyed - this is the classic broken window fallacy, the economic theory that says that vandalism is good for the economy. A boy breaks a window; the shopkeeper must get it replaced. This benefits the window maker, which can benefit others in turn. However, the fallacy is that it does not look at what the money that the shopkeeper had to use to fix the window might have otherwise been used to do. For example, while the window maker advances, the shoe maker and baker, who might have received the money the shopkeeper would have spent, are hurt. (As an aside - wouldn't it be better to keep the window maker in business by providing windows for new business? Oops - that was the greedy capitalist in me.)

Now, let's look at the health care issue. Nearly every proposal I've heard coming from Washington decries the number of uninsured people in this country, how much we pay for health care, and how bad the insurance companies are. There are many ways to go about this; I'll look at each of these in turn. As we do, keep in mind what happened to the “bad” cars in C4C.

We hear bad, bad things about the number of uninsured Americans - the latest numbers have it about 47 million. That's a lot, right? Maybe, but maybe not. One thing that these stats do not take into account is the number of people who choose to be uninsured. Many college students are uninsured by choice (or by lack of giving it a thought - that would have been me right after high school!). The census bureau said that the number of college students was 15.9 million in 2004. How about single people? I certainly didn't worry about health insurance when I was single. The census bureau said in 2007 that of the 92 million single people, 60% had never been married at all, and 15 million were over 65. Certainly not all of these are without insurance, but a good many may very well choose not to have it. That leaves the ones that can't afford it - we'll look at ways to make it more affordable in our third point.

Next up is how much we pay for health care. Yes, just like our military prowess, America is #1 in the world at spending per-capita on health care. We are also #1 in the world at medical advances and technology. These things do not come for free - what is the incentive for a company to develop the newest bang-up drug if they aren't going to be able to make enough money on it to fund the research it took to develop it? Altruism may be nice, but it doesn't put food on the table. While the exchange of money for services seems to be distasteful to some people, you'll look long and hard to find a better motivator. Why do doctors put themselves through years and years of education after most people are already out working? For a few, they may just love their fellow man that much, but for the most part, it's that American dream of making it, and having the things they want. How does one acquire things? Money.

All this talk about money brings us to those evil, horrible insurance companies. I've dealt with them just as many of you have, and it's frustrating to have things denied because a t wasn't crossed or an i dotted. However, let's look at what we expect from insurance. Does homeowner's insurance cover carpet cleaning, painting inside and out, and re-weatherstripping the windows? Does auto insurance cover oil changes, new tires, detailing, and radio upgrades? Then why must any health insurance cover check-ups? The litany of required services on some insurance providers is astounding - and, the consumer has no choice. I don't think I could go to a state in the Union and get an insurance plan that didn't cover maternity; as a male, I really don't think that's coverage I need. People view health insurance completely different from any other insurance. Why is it that, if something exists, people think that their health insurance should cover it? Some of these treatments or experimental procedures weren't even in existence when the policy was written, but people think that they're entitled to them.

This is where affordability comes in. Let insurance companies customize plans, so that people can buy just what they want (catastrophic coverage, for example) and exclude what they don't (TMJ). End the ridiculous “discounted rate” on the billing - doctors have artificially raised their rates because they know that, for the most part, their patients' insurance will only pay a portion of it. The price should be the same for someone paying out-of-pocket as it is for the insurance companies. (Back to auto insurance, does Ford offer Allstate a discount? Yeah right.)

What happens with this is the regular free-market benefits. First, the availability of health care goes up, because the people who opted out of “hypochondriac” coverage will not take up a doctor's time for every sneeze and sniffle. Second, there is an incentive for providers to get into the business, as the playing field is more level and less laden with red tape. Third, people will be so happy that we'll never have to hear about this ridiculous socialized health care mess ever again! (Well, okay, maybe that last one is a stretch.)

Now, let's look at C4C health care. You'll have politicians and government paper-pushers determining what's covered and what isn't, with their decisions holding the force of law. The thresholds will be hard - the qualifying line is drawn in the cement as it hardens. It will cost 10 times what “they” estimate - at least. Wait times will be through the roof, as anyone who qualifies for something will get in line for it, whether they need it or not. Over five or ten years, there will be a shortage of providers, because doctors will decide that law is a much more lucrative field. And, one of the founding principles of our nation will have been sacrificed on the altar of good intentions.

I know which one I'd prefer.