Wednesday, March 31, 2010

Days of Rage: The Health Care Debate. (0135, Wednesday, March 31, 2010, Bangkok time and date)

If the debate over what has been billed as "health care reform" before the House vote Sunday, March 21 was often bitter and divisive, it has, if anything, become worse in the days since.

Some of the worst excesses can be condemned and dismissed quickly. A member of Congress was sit on and called a "nigger," another was called a faggot, yet others received threatening phone calls and faxes, one Representative's address was posted on the Internet along with a message for those objecting to the legislation to drop by and "thank" him -- except the address belonged to his *brother,* whose gas line to his outdoor grill was cut, and bricks were hurled through windows. Among the worst of the worst was a threat posted on YouTube by a guy, now under arrest, threatening Republican House Minority Whip Cantor and his family with harm or death.

All of this is despicable. Reprehensible. Hateful. In many of the cases, laws were clearly violated -- reasonable laws to most of us. And we need to utterly reject such actions, from every quarter and from whichever side of The Great Divide they come. I assume you noticed that the actions above involved targets in both parties.

Now what? Well, though the House and Senate have both signed off on the legislation and the President has done likewise, the fight really has just begun. To wit: there are two lawsuits challenging it, suits filed by various state attorneys general. Constitutionality is an issue in these suits.

One argues that the law violates the commerce clause, which enables Congress to regulate commerce between and among states, though (according to this argument) not within a single state; medical insurance is not sold across state lines. That seems straightforward on the face of it, appearing to trump -- and invalidate -- the legislation. However, there's apparently nothing preventing a single company setting up headquarters in, say, Chicago, then establishing branches or subsidiaries not only in Illinois (in the case of Chicago), but in any other state(s) as well. Does that make that company's business subject to the interstate commerce clause? I don't know, and apparently there is no precise Supreme Court precedent. Proponent argue that it is subject to the commerce clause, pointing out that claims are often paid across state lines. Another component of this suit is that individuals will be required to buy medical coverage. Opponents argue that it's unconstitutional to require us, by law, to buy a product or service offered by the private sector, and further argue this has never been attempted before.

I gather both suits also argue that the legislation violates the principle of state sovereignty, a controversial issue in just about any state, though more so in some than in others. I should point out that I have to rely on news reports for my information, and I'm not clear that both suits actually involve this principle, though I'm virtually certain that at least one does.

There are some points to keep in mind as we sit here trying to peer into the crystal ball to divine how all this might come out. First, this legislation isn't about health care reform -- it's about health care insurance reform. One's an apple and the other's an orange, though just as apples and oranges are both fruits, health care reform and health care insurance reform are indeed related, as both center on, well, health care (obviously). Second is this business about rationing and death panels. These require some detail.

Medical care is already rationed, and long has been.

This is most obvious in times of widespread natural disaster, when there's not enough of anything to go around for all the sick and injured, and doctors (and other medical personnel) have to make triage decisions -- "who needs it the most and the fastest?" It is also effectively the case within the medical insurance sector; adjusters decide what to pay for and what not to pay for. If an adjuster decides not to pay for something and the insured person can't afford it, then he's out of luck -- not treatment/medine/surgery/etc.

The government panels? They are to try to discover the most efficacious treatment. The law specifically prohibits them from making medical decision, further specifically leaving that up to your doctor. Further, nowhere is there a single syllable empowering a government panel to summon Granny to learn whether she's getting a death sentence. There was even a case of a protester berating a guy who is apparently -- please note the word "Apparently" (I'll explain in a moment) -- a victim of Parkinson's disease. The protester has since apologized and expressed remorse, to his credit. It's still worth watching the video:

Whatever happened to the "civil" in "civil discourse"?

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