Americans are engaged in a healthy democratic donnybrook over “Obamacare,” the generic term for health care reform legislation that would remake the current American medical system. What a spectacle—citizens yelling at their elective representatives; the Speaker of the House of Representatives testily calling democratic organizing and agitation “un American,” the President of the United States forced by political pressures to take to the road to sell the plan.

In all the hue and cry, it is not easy to discern fact from fiction, truth from propaganda. This job is made particularly difficult by the length of the legislation—the House bill alone exceeds 1100 pages—and the difficulty of zeroing in on terms that have yet to be finalized. Still, the general outlines are becoming increasingly clear.  So, here is a quick primer on what Obamacare would—and would not—mean for the American people.

1. Would the law allow me to keep my current insurance policy?  Yes, but there is a reason proponents always emphasize the word “current.” If you change policies after the law becomes effective, your choices—whether public or private—would be limited to plans approved by the federal government.
   
   
2. What about health care rationing? That’s a reasonable fear. The plan calls for a centralized board or boards to establish uniform practice guidelines so as to control medical costs. Critics worry that these boards would impose a system of rationing (hence, Sarah Palin’s fear about “death panels”), as occurs under a similar system in the United Kingdom. Adding to the worry, some of Obama’s closest health care advisers have explicitly advocated the imposition of age and “quality of life”-based health care cost controls.
   
   
3. Would Medicare be affected? Definitely. The more than $1 trillion federal price tag would be partially paid for through a proposed $500 billion cut in Medicare payments to physicians and other health care providers.
   
   
4. What about waiting lines for tests and procedures? The president assures us that there won’t be any, but that seems an empty promise. When more than 40 million additional people obtain health insurance without materially increasing the number of physicians, nurses, and health care facilities, bottlenecks are sure to form—evidenced by the long waits for tests and some procedures in countries with universal coverage like Canada, the UK.
   
   
5. Will the elderly be forced to undergo end of life counseling? Not according to the president and the bill’s authors. They claim that the controversial section merely allows physicians and nurses to be paid for such counseling. However, since the point of the counseling would be to cut costs, critics worry that in actual practice, seniors would be pushed toward refusing care—as studies have shown pre natal genetic counseling after a diagnosis of Down syndrome is often directed toward abortion. Even though the controversy roiled the public square for weeks, supporters have not amended the legislation to explicitly ensure that counseling remains fully voluntary for both provider and patient.

There is one more important concern rarely mentioned in the debate about this complicated and mind-numbingly arcane bill. The legislation is only the general outline, the skeleton if you will—of what the remade American health care system would ultimately look like if the bill becomes law. The flesh and blood would be created beneath the public radar by unelected bureaucrats in the federal departments and agencies through the promulgation of thousands of additional pages of rules and regulations. Thus, whatever bill is ultimately passed, it will still be a pig in a poke.  The devil, as they say, will be in the regulatory details.

It may well turn out that the defining moment for the President’s campaign to reform American health insurance came on June 25th during a forum at the White House broadcast live on ABC news.

Jane Sturm told the President that she wanted her mother to receive a pacemaker six years ago at the age of 99. Her doctor initially balked at the cost to Medicare of $30,000. But Sturm was convinced the pacemaker would keep her mother out of hospitals for lengthy alternative therapy. Besides, her mother had a certain spirit, a certain joy of living. She wondered under the proposed health care reform plan would doctors and government boards consider these factors.

President Obama’s answer was chilling.
“We can let doctors know, and we can let your mom know,” he said, “that maybe this is not going to help. Maybe you’re better off not having the surgery, but taking the painkiller.”

Patients receive pacemakers to correct an abnormally slow heart rate. Most pain medications slow the heart and would be extremely dangerous for the patient to take. But even this misses the political moment. Jane Strum’s mother is still alive six years later. Jane was right to get her mom the pacemaker. The President should have acknowledged this. Furthermore, we should be discussing how to reform health care so such individual differences are taken into consideration.

YouTube Video Link
http://www.youtube.com/watch?v=U-dQfb8WQvo

President Obama’s recent appointment of John Holdren to Science Czar is troublesome, especially in light of the concern many Americans have that the House bill will lead to nationalized control of health care. Holdren seems comfortable with Washington making even our most personal decisions for us. In his 1977 Ecoscience, which he co-authored with Paul and Anne Ehrlich, Holdren wrote:

"Indeed, it has been concluded that compulsory population-control laws, even including laws requiring compulsory abortion, could be sustained under the existing Constitution if the population crisis became sufficiently severe to endanger the society.

It would even be possible to require pregnant single women to marry or have abortions, perhaps as an alternative to placement for adoption, depending on the society.

In today's world, however, the number of children in a family is a matter of profound public concern. The law regulates other highly personal matters. For example, no one may lawfully have more than one spouse at a time. Why should the law not be able to prevent a person from having more than two children?

Such laws constitutionally could be very broad. Indeed, it has been concluded that compulsory population-control laws, even including laws requiring compulsory abortion, could be sustained under the existing Constitution if the population crisis became sufficiently severe to endanger the society.

Adding a sterilant to drinking water or staple foods is a suggestion that seems to horrify people more than most proposals for involuntary fertility control. Indeed, this would pose some very difficult political, legal, and social questions, to say nothing of the technical problems. No such sterilant exists today, nor does one appear to be under development. To be acceptable, such a substance would have to meet some rather stiff requirements: it must be uniformly effective, despite widely varying doses received by individuals, and despite varying degrees of fertility and sensitivity among individuals; it must be free of dangerous or unpleasant side effects; and it must have no effect on members of the opposite sex, children, old people, pets, or livestock.

As United States taxpayers know, income tax laws have long implicitly encouraged marriage and childbearing...Such a pronatalist bias of course is no longer appropriate. In countries that are affluent enough for the majority of citizens to pay taxes, tax laws could be adjusted to favor (instead of penalize) single people, working wives, and small families. Other tax measures might also include high marriage fees, taxes on luxury baby goods and toys, and removal of family allowances where they exist. Other possibilities include the limitation of maternal or educational benefits to two children per family."

Ecoscience

http://www.washingtonexaminer.com/opinion/blogs/beltway-confidential/More-Holdren-Traditional-family-is-obsolete-50807107.html

Utilitarian activist and bioethics philosopher Peter Singer makes the case for rationed health care

In his recent New York Times opinion piece, Peter Singer argues that "rationing" is anything but a dirty word. He thinks “Medicare for All” should limit who gets health care, based on the number of quality life years saved. Senior citizens would lose their place in line even though they have paid Medicare taxes for decades.

"As a first take, we might say that the good achieved by health care is the number of lives saved. But that is too crude. The death of a teenager is a greater tragedy than the death of an 85-year-old, and this should be reflected in our priorities. We can accommodate that difference by calculating the number of life-years saved, rather than simply the number of lives saved. If a teenager can be expected to live another 70 years, saving her life counts as a gain of 70 life-years, whereas if a person of 85 can be expected to live another 5 years, then saving the 85-year-old will count as a gain of only 5 life-years. That suggests that saving one teenager is equivalent to saving 14 85-year-olds. These are, of course, generic teenagers and generic 85-year-olds. It’s easy to say, “What if the teenager is a violent criminal and the 85-year-old is still working productively?” But just as emergency rooms should leave criminal justice to the courts and treat assailants and victims alike, so decisions about the allocation of health care resources should be kept separate from judgments about the moral character or social value of individuals."

http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html

LISTENING TO YOUR CHILD

Introducing Sandy's Corner For Those Who Care About Young Children

tothesource is committed to strengthening the family as the primary source for the nurturing of children. Sandy's Corner offers expert insight for parents and all who affect the lives of children to help better care for them.

What would life be like for us if no one listened to our ideas or stories? Just like us, a child wants to be heard. In Kathryn Kvols book Redirecting Children’s Behavior, she suggests listening to your child for five minutes 5 different times a day: when she first wakes up, after school, etc.

Ways for your child to feel heard during those 5 minutes:

1) Get on your knees and listen at eye level. Practice the following with your spouse. Have one of you stand on a chair and the other kneel on the floor. Try to carry on a conversation this way. Next try talking at eye level with each other. Which way makes you feel more listened to and connected with the other?

2) Confirm her story by repeating it. Repeat/paraphrase her words even if it isn’t exactly the most exciting thing you have ever heard. For her, talking about the fact that the cloud looks like a rabbit is very important.

3) Stay engaged in the conversation. If the phone rings, don’t pick it up. You are communicating to her how important she is to you.

The best part about listening is that you will really hear your child and get to know her better.

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