Category Archives: Healthcare

Connecticut Supreme Court: Tying a 17 Year Old To a Bed And Injecting “Poison” Into Her Body Against Her Will Is A-OK

Image credit: Hartford Courant

Image credit: Hartford Courant

In a stunning, tyrannical ruling, the Supreme Court of Connecticut has ruled that the Department of Children and Families has acted correctly in ruling that a 17 year old girl from Windsor Locks, identified in court documents as “Cassandra C”, was right in taking her from her home and forcing her to undergo chemotherapy for Hodgkin’s Lymphoma:

A 17-year-old Connecticut girl with a highly curable cancer is not mentally competent to make her own medical decisions and will continue to receive the chemotherapy treatments she’s battled to halt, the Connecticut Supreme Court ordered Thursday.

Chief Justice Chase T. Rogers ruled that the teen — listed only as Cassandra C. in legal records — is not mature by any standard.

That means Cassandra will remain at a Hartford hospital, in the temporary custody of child-welfare workers, and will receive her full course of chemotherapy to treat Hodgkin lymphoma. Doctors have said her odds at recovery are 80 to 85 percent with chemo, but that she will die without it.

(…)

In an interview Wednesday with NBC News, (Mother Jackie) Fortin denied pressuring her daughter into her decision to forgo chemo.

“I am not coercing her at all and that is what this is about, what they think I am doing,” Fortin said.

Cassandra simply does not want to be infused with “toxic” chemicals, Fortin added.

“My daughter does not want poison in her body. This is her constitutional right as a human being,” Fortin told NBC News. “She is almost 18. [Her birthday is nine months away]. If she was 18, I don’t think this would be an issue. She is not 10. She is over 17. She is very bright, very smart.”

In a Hartford Courant editorial, Cassandra told her own side of the story. Her description of what she went through when DCF got involved is surreal and gut-wrenching:

In December, a decision was made to hospitalize me. I didn’t know what was going to happen, but I did know I wasn’t going down without a fight.

I was admitted to the same room I’m in now, with someone sitting by my door 24/7. I could walk down the hallway as long as security was with me, but otherwise I couldn’t leave my room. I felt trapped.

After a week, they decided to force chemotherapy on me. I should have had the right to say no, but I didn’t. I was strapped to a bed by my wrists and ankles and sedated. I woke up in the recovery room with a port surgically placed in my chest. I was outraged and felt completely violated. My phone was taken away, the hospital phone was removed from my room and even the scissors I used for art were taken.

I have been locked in this hospital for a month, missing time from work, not being able to pay my bills. I couldn’t celebrate Christmas and New Year’s with my friends and family. I miss my cat and I miss fresh air. Having visitors is complicated, seeing my mom is limited, and I’ve not been able to see all of the people I’d like to. My friends are a major support; I need them. Finally, I was given an iPad. I can message my friends on Facebook, but it is nowhere near like calling a friend at night when I can’t sleep or hearing someone’s voice to cheer me up.

This experience has been a continuous nightmare. I want the right to make my medical decisions. It’s disgusting that I’m fighting for a right that I and anyone in my situation should already have. This is my life and my body, not DCF’s and not the state’s. I am a human — I should be able to decide if I do or don’t want chemotherapy. Whether I live 17 years or 100 years should not be anyone’s choice but mine.

Hodgkin’s Lymphoma is 80-85% curable with chemotherapy, but likely fatal without it.

I need to put forth some of my own perspective on Connecticut’s Department of Children and Families. Growing up poor in Connecticut, DCF was never, EVER the “good” guy. Even in cases where intervention to protect a child was warranted, DCF was viewed by everyone I knew as nothing short of terrorists. They were often called in by people who did not have a child’s best interests in mind – often by a former boyfriend/girlfriend of a single parent to “get back” at their ex – and were known to forcefully remove children from their houses and homes, putting them in a foster care environment that is comparable to prison, with all of the social issues (read: constant larceny, constant beatings, and constant sexual abuse by both peers and superiors) that entailed. The threat of DCF coming into my life was a constant for the child of a single mother that worked full time, and led to other consequences in my life that I will tell publicly at a later time. To put it bluntly: DCF was basically the Ministry of Love in our eyes, and rightly so.

Their actions in this case justify that mindset. They took a 17 year old girl out of her house – someone who can legally enlist to fight in a war – and blew away any idea of a mature minor1, judging her too immature – in a state where the sexual age of consent is sixteen – to reject medication that they are forcing her to take by strapping her wrists and ankles to a bed, drugging her, and sticking a pipe in her chest to inject, while removing any form of communication with her family and friends. You know, for her own good. Just One Child™, and all that.

So she can enlist to get shot at in our (illegal) wars, she can have sex with whoever she wants, and she can work. But she can’t say that she doesn’t want something she’s called “poison” to be forcefully injected into her body by a state that is keeping her prisoner and abusing her Constitutional rights.

The mindset of the state – assuming anyone has any good intentions beyond simply exerting their authority – is likely that she will thank them in twenty to thirty years. This assumes that her fears of not being able to give birth, or that her fears of other side effects, do not come true. The quality of Cassandra’s medical care has been atrocious. Now, she would be right to distrust the state for any reason. She was terrorized by people who ostensibly have her best interests in mind, and has been routinely degraded in demeaned in the one way no one should be: by losing total bodily autonomy. She has had her dignity permanently destroyed, and I would not blame her, or her mother, for leaving the state of Connecticut forever, if they haven’t been put on some No Fly List for daring to cross a few bureaucrats.

This is pure fascism. Hateful, evil fascism. There is no other way to put it. And I am ashamed to say I live here right now.

1 – From a legal perspective, Cassandra, her mother, and her lawyers did not assert the mature minor doctrine, which asserts that minors as young as 15 can make their own medical choices without authorization or knowledge of their parents, though the American Civil Liberties Union of Connecticut mentioned it in their amicus brief (PDF). Connecticut is not one of the states that has codified a mature minor doctrine into law. DISCLOSURE: I am a member of the Connecticut ACLU.

Christopher Bowen covered the video games industry for eight years before moving onto politics and general interest. He is the Editor in Chief of Gaming Bus, and has worked for Diehard GameFan, Daily Games News, TalkingAboutGames.com and has freelanced elsewhere. He is a “liberaltarian” – a liberal libertarian. A network engineer by trade, he lives in Derby CT.

Community Conservatism: Healthcare Under Fire

The "A"CA - Good for Elites, Bad for the Middle Class

The “A”CA – Good for Elites, Bad for the Middle Class

Contain the Cost of Healthcare and Preserve Options for the Middle Class

This is an issue that requires a bit of an introduction. We believe it is very important to recognize that our healthcare system is both incredible in its productivity and humanity…and very much broken. The middle and lower class see healthcare is a pressing concern because the cost to maintain insurance is getting high enough that it is forcing some serious and uncomfortable decisions onto struggling families who have to balance their budgets. The CBO estimates that, by the year 2045, the average American family will spend nearly 20% of its take-home pay on health insurance (about what they currently spend on their mortgage!). At the same time, unfunded liabilities to cover the cost of government-backed health programs like Medicare and Medicaid will soon account for 100% of all estimated tax revenue taken by the government. This is obviously an enormous problem. One that threatens to destroy our economy, cripple our access to quality care, and generally make us miserable in the not so distant future.

There are many theories for how we might go about solving this problem, but few of them have been fleshed out enough to back with the force of legislation. Prior to the bastardized half-breed of state-driven insurance mandates and taxes that is now commonly known as the Affordable Care Act, there were two competing visions for the future of healthcare in American. On the left, you had advocates for a single-payer state-run healthcare system as is common throughout the European Union and in Canada, among other places. On the right, you had advocates for transparency in healthcare service charges, tort reform, and interstate insurance commerce. The left’s concept would immediately be recognized by the American public as a massive tax hike. The right’s concept is a series of piecemeal, small-scale ideas that don’t sound like they can really fix the problem of out-of-control healthcare costs on their own.
The healthcare system has costs far beyond the basic ones associated with providing care directly. There are costs associated with:

• Medical Research and Development (and government regulation thereof)
o The research has basic costs
o The government heavily regulates how this research must proceed to get drugs and equipment to market
o The government research institutions try to assist in a wide variety of areas and this unfocused mandate yields inefficiencies
• Malpractice Insurance
o Private practice doctors report that something like half of their profits go straight to malpractice coverage because malpractice lawsuits now routinely go for huge payouts and the insurer must cover the cost
• Hospital Administration
o Here again, there are basic administration costs for running any healthcare business
o And then there are bloated government regulations that require record-keeping that rarely makes sense and is exceedingly expensive, while forcing administrators to retain fleets of expensive lawyers
• The Actual Medical Care
o Even here, there are basic costs…and then there are costs associated with doctors padding their bills to bilk the insurance companies (or at least to force them to pay out as much as they possibly can)
o And further, there is the cost of unpaid medical care given to people who are not insured and cannot pay
o And, ironically, there is the added cost of the government’s drive to get us to see our doctors more regularly (preventive care), which has yet to show any evidence of reducing expensive and undesirable health outcomes
• Insurance Company Administration
o And then we have the insurers – who are, themselves, heavily regulated by the government, and are also guilty of padding their bottom lines, and perhaps of paying out more than they should when doctors are overbilling
• American Status as Cost Sponge
o What I mean here – the US is doing most of the work to lead the way on new medical breakthroughs because countries running on single-payer systems or depending on US financial assistance to function cannot afford to do high end medical research – the result is that all of the world comes here to advance medical science (at great cost to our government research institutions), but we in the U.S. pay higher prices for all of the beneficial new drugs and technology they produce, because other places around the world can’t pay enough for big pharma and big med-tech to break even without us being charged far more

The ACA does, to its credit, recognize many of the places where profiteering, waste and excessive spending are occurring, but the liberal answer to each spending sore spot is the heavy hand of more regulation. Rather than just propose a series of bills the way we’ve done elsewhere in this series, we will explain what the ACA does about each sore spot and the risks that method poses vs. what the conservative counter should be. We’ll use the same bullets from above to organize our plan.

A) Medical R&D Costs

The ACA doesn’t specifically address medical research in a major way, other than to levy a medical device tax and make matters worse for research, but the common answer on the left is to move the cost out of the private sector and into increased government spending on the issue. This way, private sector companies can charge less for the drugs and technology they produce and the actual cost of the work can be spread among the taxpayers less obviously. The conservative approach would include carefully relaxing certain regulations on big pharma and big med-tech regarding the cumbersome and lengthy process to get from experimental drug to approved market-ready drug or experimental medical device to sales and reduce the scope and cost of the FDA. It would also include a restructuring of the NIH, CDC and other government health researchers to significantly narrow their focuses and cut the sugar out of their research diets. And finally, the GOP approach should include a repeal of the medical device tax in the ACA.

B) Medical Malpractice

The ACA doesn’t even tackle the cost of malpractice insurance for private practitioners or legal counsel for hospitals – one of its most disappointing failures, but one that is understandable, considering that the Federal Legislature can’t really regulate state civil courts). The left has, traditionally, completely ignored the increasing need for tort reform. Unfortunately, so has the right. Every once in a while, you’ll hear a Republican talk about the need for it, but they tend to be economists, rather than politicians with any clout. The GOP must act now to enact stiff limits on settlement amounts in medical malpractice cases in the states. We recognize that medical mistakes are always extremely damaging and life-altering (or ending) for their victims. We also recognize that the legal system shouldn’t be a lotto-draw for someone looking to get even with a doctor or make a quick killing after a mistake. The GOP should also enact “loser pays” laws for all civil matters, including medical malpractice. Unfortunately, these are generally matters reserved for the states, and the GOP must spearhead the effort at the state level to address them.

C) Hospital Administration and Record-Keeping

The ACA likely made these costs much worse, I’m afraid, by changing medical billing codes to a ludicrous, byzantine array of unrecognizable codes and further regulating how this information is to be collected. The GOP should move to vastly simplify medical insurance/incident/billing codes, and take a more holistic approach to auditing hospital financial and medical records.

D) Medical Fees and Insurance Models

As we know, the ACA attempts to decrease the number of people who are uninsured and thus to lower the liabilities for hospitals who must treat all patients, whether or not they are insured, by requiring that everyone get health insurance and taxing you if you do not. On top of this, the ACA requires all businesses of a certain size (more than 50 full time employees) to offer health insurance or pay massive fees. The ACA requires that children under the age of 26 be allowed to remain covered by their parents. And it requires that insurance companies never reject someone who has a pre-existing condition. And finally, the ACA requires that those plans cover a huge range of medical services in an attempt to capture all of the potential costs. The theory was that young, healthy people were going uninsured to avoid paying for it when they felt invincible at rates high enough to balance out all of the people who’d been rejected for preexisting conditions. The mandate-driven approach has proved to be a spectacular failure. Many are choosing to pay the tax – especially the healthy – many more are finding that their plans are far too expensive and have huge deductibles as insurance companies look for ways to shield themselves from the increased cost of covering high risk people. And, of course, if the government is forcing the insurers to cover everyone, many insurers will drop out of the marketplace, and that is exactly what is happening.

Having said all of that, we do not think that every idea in the ACA is bad and we do not think it is necessarily the best approach to wholesale repeal it at this point. We believe that there should be a national program to provide everyone with catastrophic insurance (to protect hospitals for huge unpaid bills, and patients from bills that ruin them financially). We also believe “guaranteed issue” and the clause extending coverage to children under the age of 26 are popular because they are necessary. We even believe the idea of a national health insurance marketplace is a very good one (we wouldn’t have the government running it, we’d set up a cooperation between the various health insurance providers and let a private company maintain the marketplace). Here is what a conservative plan would look like:

• Repeal the individual and employer mandates
• Require all Americans to buy catastrophic coverage plans the same way we require them to buy at least minimal collision insurance if they drive
• Nationalize the healthcare market (no more state insurance networks; this is not simply “selling across state lines”, this is true nationalization) and allow insurers to offer a la carte supplemental coverage – if you need coverage for prenatal care, you buy it; if you need coverage for prescription drugs, you buy it, etc.
• Require healthcare providers (private doctors and hospitals and clinics) to publicly announce their price points on a government-managed website for all of their procedures to allow consumers to price compare instead of being blind to the cost – market awareness frequently leads to market efficiency
• Require insurers to similarly announce what they’ll pay out for given procedures (in an attempt to prevent the sort of “doctor charges way too much to max out what the insurer will pay out” games we previously mentioned)
• Give tax credits to people who buy preventive care packages and repeal the Cadillac tax
• Enact the Ryan/Wyden plan for Medicare

E) Insurance Company Administration

The ACA includes a bunch of downright frightening top-down controls in an attempt to reign in insurance payouts for Medicare (because retired people are expensive, health wise, and paid for on the government dime), including but not limited to yet another in a long line of ill-advised price-fixing schemes promulgated by the left. They keep trying to fix the market to their liking and it keeps going spectacularly wrong and cause misery every time. This time, I’m referring to the Independent Payment Advisory Board. While I would stop short of calling it a ‘death panel’, there is excellent reason to fear this entity and its impact on the end of life process. IPAB will basically regulate insurance company payouts to Medicare by fiat, which will cause doctors and hospitals to begin to refuse to perform certain procedures, leading to a downward spiral in the quality of care for the elderly. We saw a glimpse of this with the VA – where aging WWII and Korean War veterans were being denied access to treatments and redirected to hospice care in some cases. The left sees the IPAB as a way to end insurance company inefficiency and doesn’t understand why this process should lead inexorably to premature death in some cases, but we have many examples – starting with the British National Health Service. The conservative answer to insurance company bloat and overpayment is, as noted above, to improve price transparency and let the customers straighten out the market. We would also add that government could play a role here with some far less heavy-handed regulations on payouts based on the going market rate for the service, once the service itself is priced publicly. Data is power – market data leads to a powerful market. Either way, the IPAB must be dismantled as soon as possible.

We’ve laid out many proposals here that attempt to make healthcare decisions less costly and stressful for the middle class, but rest assured, we’ve barely scratched the surface. We are hoping that this will start a dialogue among conservatives as to what sort of healthcare platform GOP Congressmen should build heading into 2016.

Watching the Watchers: Resistance to Transparency a Problem at Every Level of Government

We do not have leaders in the United States of America. We have representatives. They are chosen by us to do a job for us. They are our employees. We do not owe them any respect or subservience beyond the same basic respect we choose to show fellow human beings, and in particular those who are our employees.

And we have a right to watch them.

Yet at all levels of government, we face rebellion against our right to watch.

STATE LEGISLATURE IN THE NEWS FOR VIOLATING OPEN MEETING LAWS

Open MeetingsOne of the Republican candidates for my state’s legislature actually came to my door twice this election cycle in an effort to earn my vote. Even had I been otherwise inclined to vote for him, his refusal to answer voter guide questionnaires would have been a deal-breaker.

He explained at my door that politicians who answer voter guide questions are sometimes “discriminated against for their religion.” Only by questioning him on my porch was I able to elicit his position on issues from gay marriage to the War on Drugs—which he supports because “we need to be moral.”

He won handily without my vote and is now a state senator. His counterparts in the state House have just made news by, once again, being accused of violating Montana’s open meeting laws. Earlier this month, the House Republican Caucus met in the basement of a hotel without providing the requisite notice. During the 2013 session, the Caucus similarly met in the basement of the state Capitol without posting notice.

The state media have been quick to point out that both parties and both houses of the state legislature routinely violate the state’s open meeting laws. The interviews with the politicians engaged in such violations are candid and telling. One Democrat senator, for example, detailed how rather than simply post the notice and allow reporters to cover the event, his party would instead make just enough people leave to be under the limit of the notice requirements:

“We were always mindful of the numbers,” added Sen. Mike Phillips, D-Bozeman. “And when we realized we were over the limit, someone would leave.”

One of his Republican counterparts lamented that the open meeting requirements make it “impossible” for elected politicians to talk to each other:

Where do you draw the line?” he asked. “How does a group function if they can’t get together and talk to each other? This is supposed to be a country of freedom of association and freedom of speech. If you’re going to take that away at a caucus, how is the caucus going to function?”

He does not seem to understand that the caucuses can still talk, even if the people they work for are listening. If they do not want the voters to know about it, perhaps they ought not be doing it.

POLICE DEPARTMENTS RESIST BEING RECORDED

olson_scottOn Saturday night, Ferguson police arrested a member of the press, apparently for standing on a sidewalk. This comes in the wake of federal court orders directing that Ferguson police not engage in any practice of interfering with citizens’ right to record police. These orders were obtained based on events following the death of Michael Brown, in which police detained journalists, wrongfully interfered with people recording the protests and police response, and instituted a no-fly zone to prevent the media from flying over.

Both cops and citizens behave better when they know they are being recorded. Recordings exonerate innocent people who have been wrongfully accused and help ensure that the right people are punished. As Reason’s Ronald Bailey has reported:

Earlier this year, a 12-month study by Cambridge University researchers revealed that when the city of Rialto, California, required its cops to wear cameras, the number of complaints filed against officers fell by 88 percent and the use of force by officers dropped by almost 60 percent. Watched cops are polite cops.

Yet all over the country, police continue to harass citizens who lawfully record the police, a fairly well recognized right in these United States.

Police officers are not our overlords. They are public employees hired by the people to enforce the laws passed by the people. Like any other employer, We, The People, get to watch the work done by our employee police officers.

MOST TRANSPARENT ADMINISTRATION IN HISTORY

Obama secretOpen enrollment for Affordable Care Act health plans began in mid November. States have been releasing their enrollment numbers. But trying to get enrollment numbers from the federal government continues to be like pulling teeth.

In the wake of an embarrassing revelation about an “unacceptable” mistake inflating the total enrollment numbers, Health and Human Services Secretary Sylvia Mathews Burwell has ordered her agency to come up with ways to increase transparency. I hope she follows through.

But the “most transparent administration in history” has a mixed record on living up to its own hype. Lingering questions remain about the transparency of the drone program. Just this week, the administration continued its established practice of dumping thousands of new regulations on the eve of a major holiday.

Let us not forget that last month, USA Today Washington Bureau Chief Susan Page called this administration “the most restrictive” and “most dangerous” to the press than any other in history. She echoes sentiments expressed earlier this year by New York Times editor Jill Abramson, who said the Obama administration is setting new standards for secrecy:

“The Obama years are a benchmark for a new level of secrecy and control,” says Abramson. “It’s created quite a challenging atmosphere for The New York Times, and for some of the best reporters in my newsroom who cover national security issues in Washington.”

*     *     *

Those that are covering national security, according to Abramson, say that is has never been more difficult to get information.

*     *     *

Abramson says that the Obama Administration uses legal loopholes to make things difficult for journalists and media organizations. She says, for example, that the Obama Justice Department pursues cases against reporters under an obscure provision of the 1917 Espionage Act.

“I think, in a back door way using an obscure provision of an old law, they are tip-toeing close to things that, here in the United States, we’ve never had,” says Abramson.

*     *     *

While Abramson says that the White House hasn’t completely shut out the U.S. press corps, even routine media coverage has become difficult to obtain.

“The amount of friction and confrontation involved in just going about what I see as perfectly normal coverage, that in the past wouldn’t have even provoked a discussion, becomes a protracted and somewhat exhausting process,” she says.

As technology and government overreach continue to threaten the walls of privacy that traditionally protected Americans, we must be vigilant in making sure the watchers are themselves watched. They are not leaders, but employees. We should demand that they conduct themselves as such. That entails consistently subjecting their official conduct to scrutiny.

_____________________________________________________

Open Meetings image via In El Dorado County News. Ferguson image via The Center for Media and Democracy’s PR Watch. Obama image via Poor Richard’s News.

Sarah Baker is a libertarian, attorney and writer. She lives in Montana with her daughter and a house full of pets.

Long Slow Burn – GruberGate as a Microcosm

GRRRRRR

We, here, at The Liberty Papers do not generally share our correspondence, but the big issues of the day are, in fact, talked about at length in our site’s Google Group as we coordinate what we’ll be talking about at this lovely blog. Without being specific or quoting anyone directly, I would like to put forward what the group reaction was to the so-called ‘GruberGate’ scandal. In a word:

‘Meh’

If you’ve been living under a rock or watching nothing but MSNBC (same difference, really), I’ll give you a quick summary of what GruberGate entails. For six years, conservatives have blasted away at the Affordable Care Act (hereafter, the ACA). For six years, we’ve been talking about how the promises made by people trying to get it passed were impossible to keep, how the bill would raise the deficit, make healthcare more expensive and less stable, drive away doctors, narrow your networks of providers – basically the exact opposite of every claim put forward by Democrats between 2008 and 2012. The media uncritically reported White House talking points for most of that time, doing absolutely zero digging and finding no evidence of problems with the law as a result.

Then some guy who’d lost his insurance after being promised that that wouldn’t happen and decided to do some actually investigating. Within a day of beginning his search, he found video footage of one of the ACA’s chief architects, Jonathan Gruber, candidly discussing the ACA with his peers in Academia in which he said THIS (follow the links to see the videos), THIS, and THIS.

Many things have been said about GruberGate, and I won’t rehash them here. The response to this story by many libertarians (not just those of us writing here) has been a collective “well duh!” We have, after all, been talking about everything that Gruber willingly admits in his various talks on the ACA – that it’s a pack of lies intended to fool the American taxpayer by fooling the Congressional Budget Office, that it amounts to a giant national experiment and the architects have no clue what it’ll do, that expanded coverage can’t happen without raising revenue to pay for it, and that the archetype (RomneyCare) was already a failure, being propped up by federal dollars all along. We knew all of that. The insults he lobs at the American voters aren’t entirely unfounded either. Many Americans, like it or not, vote without any idea of what they’re supporting. So why should we get up in arms over it.

After arguing rather cantankerously with my fellow bloggers here, trying to explain why this story enraged me so, it dawned on me what was really going on in my head. I may come to self-awareness later than I should on occasion, but I generally get there if I think on it long enough. This whole story – the story of the Affordable Care Act from conception, to birth, to signing, to repeal efforts to angry Americans who feel lied to and voting R to prove something to the left to the GruberGate controversy…it is a microcosm of everything I’ve been battling for years.

When the ACA was first being discussed, the conservative reaction was a combination of people like those in my family, who were horrified by the likely outcome of such a bill and who relied heavily on health insurance to make their various medical problems affordable to treat, but who reacted by studying the proposal and attempting to logically argue as to why it was a very bad bill indeed…and people screaming at town hall meetings because they just instinctively feared such a big, sweeping change. It’s human to fear change, and in this case their fears were justified, but instead of focusing on doing the work of exposing the lies in the ACA, most of conservatism was consumed with death panels and doomsday imagery of Uncle Sam examining a woman’s lady parts (yes, that was a real conservative ad).

Now I’m not saying I think the IPAB is good for “end of life” care…it’s not. But ‘death panel’ rhetoric sounds literally insane to your typical low-information swing voter who might be swayed by bringing a convincing argument to the debate. And, of all of the conservative reactions to the ACA, which ones do you suppose were primarily covered by the media, by ACA advocates and in the political discussion on Capital Hill – the reasoned arguments as to why the ACA would fail and make things worse, or the fear-mongering?

But guess what – that made someone like me who worked hard to understand the problems with the ACA into a looney tune screaming about death panels when I voiced my opposition to the law before any leftist. They accused me of being a liar. They accused me fearing change. They accused me of not caring about the poor and the uninsured. And they had the support of, once again, an uncritical, unserious mainstream media telling them any concerns about the ACA raising costs, impairing the system, causing doctor shortages or narrow networks, etc. were just crazy conservative fear mongering. Our detached, empirical expert, Jon Gruber, says so – read the study.

When the truth came out – when it turned out that Jon Gruber believed everything I did about the ACA except the part about those results being bad for healthcare…when he gleefully admitted that RomneyCare was a failure economically, that the ACA had nothing to do with making healthcare affordable, and that he and his colleagues had no clue how to bend the cost curve down – and then had the audacity to call us stupid for believing him, I would have been satisfied. I wouldn’t have been angry for long – it would have brought some semblance of peace to be vindicated in the fight. Except that the reaction of the left was to lie even more, minimize Gruber’s roll in crafting the bill, and then…call conservatives fear mongers again for reacting to this story with anger and for losing trust in government to solve problems like these.

This is inherently the entire problem I have with the left – every time their bad ideas don’t work and people realize it, they find the loonies in the conservative ranks and make those guys their opposition, and when you try to bring reason to the party, they accuse you of just being one of the loonies. And when you turn out to be RIGHT…oh well whatever nevermind. That fight never mattered anyway – on to the next fight.

Until conservatives are willing to call liberals (and other conservatives) out for not fighting fairly, for distorting the history of the argument, for scanning through the crowd for the easiest person to attack, for straw men and lies, for parliamentary tricks and poor research, and for their ugly assumptions about the American people, we will always lose the argument. Always. And that…is what is truly terrifying me into anger. We were right. All along, conservatives were right about the ACA and the insincere, cynical motives of its creators. We were right, they were wrong, and somehow, we still lost the argument. And it’ll happen again and again until we get angry enough to turn the tables on them – to call them out on their unfair tactics and their bad science and their twisted, utilitarian assumptions.

We’re about to have the same fight on immigration. Learn to recognize their tactics and fight back, or there will come a day when you remember how right you were about the negative consequences of an open border, and how little it mattered that you were right.

SCOTUS Has Accepted Appeal of Case That Could Topple Obamacare

SCOTUS

On Friday, United States Supreme Court agreed to hear the appeal in King v. Burwell. The plaintiffs in that case assert that the Patient Protection and Affordable Care Act only allows tax credits to people who buy insurance “from an exchange established by a state.” The Fourth Circuit Court of Appeal disagreed and ruled that the federal government may interpret that language as allowing tax credits to purchasers who bought insurance on one of the federal exchanges, operating in the more than 30 states that declined to create their own.

On the same day the Fourth Circuit delivered its decision in King, a panel in the D.C. Circuit found for the plaintiffs in a companion case captioned Halbig v. Burwell. This conflict would ordinarily invite SCOTUS to weigh in. However, the D.C. Circuit then accepted a rehearing en banc in Halbig. Thus, even though the King plaintiffs appealed, many observers speculated SCOTUS would wait to see if a conflict really developed, or if after rehearing in Halbig, the courts ended up aligned.

As a result, it is somewhat surprising that SCOTUS accepted the King appeal, and it may signal bad news for the Affordable Care Act. As Nicholas Bagley writing a SCOTUSblog explains:

[F]our justices apparently think—or at least are inclined to think—that King was wrongly decided. … [T]here’s no other reason to take King. The challengers urged the Court to intervene now in order to resolve “uncertainty” about the availability of federal tax credits. In the absence of a split, however, the only source of uncertainty is how the Supreme Court might eventually rule. After all, if it was clear that the Court would affirm in King, there would have been no need to intervene now. The Court could have stood pat, confident that it could correct any errant decisions that might someday arise.

There’s uncertainty only if you think the Supreme Court might invalidate the IRS rule. That’s why the justices’ votes on whether to grant the case are decent proxies for how they’ll decide the case. The justices who agree with King wouldn’t vote to grant. They would instead want to signal to their colleagues that, in their view, the IRS rule ought to be upheld. The justices who disagree with King would want to signal the opposite.

And there are at least four such justices. If those four adhere to their views—and their views are tentative at this stage, but by no means ill-informed—the challengers just need one more vote to win. In all likelihood, that means that either Chief Justice Roberts or Justice Kennedy will again hold the key vote.

If I read this correctly, the speculation is that four (or more) SCOTUS justices agreed to accept the case in order to send a signal to the lower courts still considering challenges to this provision of the ACA. The signal they wanted to send is that those other courts should not necessarily follow King, because SCOTUS might think it was wrongly decided.

A reversal of King (i.e., a finding in the plaintiff challengers’ favor) would seriously undermine—perhaps fatally—the structure of the Affordable Care Act. Fully 87% of the people who purchased policies through the federal exchanges during the first open enrollment period are receiving subsidies. If the government cannot give subsidies to low-income purchasers, it cannot tax them for failing to have the insurance, and the entire system collapses under its own weight. Fewer people can afford the insurance, the risk pool shrinks, costs rise, and more people are forced to opt out.

If on the other hand, SCOTUS upholds tax credits not authorized by Congress, it would be one more in a long line of revisions, waivers, exemptions, delays and modifications made to the law made by the very administration that purports to uphold it.

Sarah Baker is a libertarian, attorney and writer. She lives in Montana with her daughter and a house full of pets.
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