DJP Update 6-12-2011 AMA Annual Meeting; George Will article re PPACA & IPAB; Oral arguments Appeals Ct Florida v. HHS June 8, 2011
OSMAP (state med society presidents past, present, and president-elect) meeting is on June 17 and AMA Annual Meeting June 18-22. Both at Hyatt on Wacker in Chicago.
For those not attending the meeting in Chicago, watch for tweets that give updates. I believe the tweet hash mark will be #AMAmtg
So if you put into the “Find” search of your Twitter program, you will get any tweet that contains #AMAmtg as soon as tweeted by someone. Twitter is an amazing way to stay current on news. And tweets are limited to 140 characters.
When I was a young boy, I was sent to St. Paul’s College boarding school in Covington, La. across Lake Pontchartrain because we lived a couple of blocks from a public housing project and gang activity was beginning. The gang was trying to recruit young kids. That began my transfer to a boarding school despite the school not having the grade I was scheduled to enter, the 3rd grade. Dad convinced the principal to put me in 4th grade!
My point in telling that story is to relate that there was a nearby park that bordered on the Bogue Falaya River. The first time I was allowed to visit the park, I was impressed with the sign at the entrance:
Let it not be said and to your shame, that all was beauty here before you came.
I have reflected on that statement many times since the 4th grade. I do believe it is appropriate for us in Medicine now as we reflect on medical care in America, the best medical care the world has ever seen. I am concerned that the wrong approach to fixing the problems in medical care financing will cause us to reflect later that the beauty of the great medical advances here was destroyed by central control of medicine by government. We will deserve the shame heaped upon our generation if we did not do our homework, if we do not have courage, and if we give up too soon. I am afraid PPACA, IPAB, and all of the other choking tentacles of PPACA will lead us to a medical system of rationing and destruction of the patients’ right to make their own decisions with the advice of the trusted personal physician.
So let’s have the final debate on this onerous law at this AMA meeting. On the items we all (almost all) can agree on, such as removing IPAB, let’s us send a strong message that it must be eliminated. Then let’s get to the individual mandate and the rest of PPACA. Let’s have a game plan to get the right to balance-bill in Medicare, strong AMA policy, into the law.
Failure to do this will be an admission that our meeting is only a debating society, interesting for some, but devoid of any practical significance. And yes, a strong stand on the principles that made Medicine great might well stop the bleeding of membership which is on a dangerous downhill slope.
Restore Liberty! I have been the spokesperson regarding Medicine in America over the years for many groups, but my message always has been the same: Get government out of Medicine; avoid coercion, and learn from the failures of socialized medicine world-wide. I just reviewed my testimony to the health subcommittee of U.S. Congress Ways and Means Committee in 1976. The hearing was on “National Health Insurance.” I said then, on behalf of the Orleans Parish Medical Society,
EXCERPT:
“We are opposed to any national health insurance scheme. So that my message may be clear, I repeat, we are opposed to any form of socialized medicine. National health insurance results in rationed care of a lower quality. National health insurance costs more. Remember you get nothing for nothing. The public always pays in the form of increased taxes. The trusted doctor-patient relationship can only exist in a system where patients and doctors can have freedom of choice through the selection of each other.”
Shortly after that portion of the testimony, I quoted Dr. Robert Sade, who in recent years became the Chair of the AMA Council on Ethical and Judicial Affairs (CEJA):
Under the leadership of such men as Thomas Paine and Thomas Jefferson, the concept of man as being sovereign unto himself, rather than a subdivision of the sovereignty of a king, emperor, or state, was incorporated into the formal structure of government for the first time. Protection of the lives and property of individual citizens was the salient characteristic of the Constitution of 1787.”
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As always, coercion has no place in America. We are a nation built on liberty and freedom.
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For those who skip the tweets or who are confused by format, don’t fail to go to these two links:
George Will article: http://tinyurl.com/3pldf89
I pasted article below.
Oral arguments in mp3 audio format re PPACA Florida et al suit on appeal: dld.bz/aaYvA
If link doesn’t work, go to these two links for
Arguments to dismiss:
Arguments on the merits:
Florida v. HHS: Oral Arguments on Appeal (June 8, 2011). Counsel from both sides present oral arguments to a three-judge panel in the U.S. Court of Appeals for the 11th Circuit, consisting of Judges Joel Dubina, Frank Hull, and Stanley Marcus. [Arguments for motion to dismiss: 91 mins, MP3 | Arguments on the merits: 55 mins, MP3]
Some selected tweets from www.twitter.com/DJPNEWS
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DJPNEWS Donald Palmisano
Docs & #PPACA ? RT @thequotemaster: ‘Many go out for wool, and come home shorn themselves.’ Miguel de Cervantes http://goo.gl/92i4G #quote
Retweeted by DJPNEWS – Great references re PPACA plus the ORAL ARGUMENTS. Listen to them yourself; don’t rely on talking heads on TV or radio; link: dld.bz/aaYvA
aapsonline AssocAmerPhys&Surg
by DJPNEWS
RT @Lucidicus: It took some work, but the audio from 6/8 11th circuit oral arguments in Florida v HHS is now up! dld.bz/aaYvA #hcr
DJPNEWS Donald Palmisano
Get ready! Spirited debates re #PPACA #hcr #IPAB AMA Annual mtg Chicago June 17-22 Hyatt on Wacker. Don’t miss #OSMAP -Follow #AMAmtg
DJPNEWS Donald Palmisano
Get rid of #IPAB of #PPACA disaster; great article by George Will: the Travesty of Lawmaking http://tinyurl.com/3pldf89 #tcot
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HERE IS THE GEORGE WILL ARTICLE OF 6-11-2011
http://m.cjonline.com/opinion/2011-06-11/george-will-travesty-lawmaking
Saturday, June 11, 2011
George Will: Travesty of lawmaking
“The legislative cannot transfer the power of making laws to any other hands. … The power of the legislative, being derived from the people … (is) only to make laws, and not to make legislators.”
— John Locke
“Second Treatise of Government”
WASHINGTON — Here, however, is a paradox of sovereignty: The sovereign people, possessing the right to be governed as they choose, might find the exercise of that right tiresome, and so might choose to be governed in perpetuity by a despot they cannot subsequently remove. Congress did something like that in passing the Patient Protection and Affordable Care Act, aka Obamacare.
The point of PPACA is cost containment. This supposedly depends on the Independent Payment Advisory Board. The IPAB, which is a perfect expression of the progressive mind, is to be composed of 15 presidential appointees empowered to reduce Medicare spending — which is 13 percent of federal spending — to certain stipulated targets. IPAB is to do this by making “proposals” or “recommendations” to limit costs by limiting reimbursements to doctors. This, inevitably, will limit available treatments — and access to care when physicians leave the Medicare system.
The PPACA repeatedly refers to any IPAB proposal as a “legislative proposal,” and speaks of “the legislation introduced” by the IPAB. Each proposal automatically becomes law unless Congress passes — with a three-fifths supermajority required in the Senate — a measure cutting medical spending as much as the IPAB proposal would.
This is a travesty of constitutional lawmaking: An executive branch agency makes laws unless Congress enacts legislation to achieve the executive agency’s aim.
And it gets worse. Any resolution to abolish the IPAB must pass both houses of Congress. And no such resolution can be introduced before 2017 or after Feb. 1, 2017, and must be enacted by Aug. 15 of that year. And if passed, it cannot take effect until 2020. Defenders of all this audaciously call it a “fast track” process for considering termination of IPAB. It is, however, transparently designed to permanently entrench IPAB — never mind the principle that one Congress cannot by statute bind another Congress from altering that statute.
That principle may cause courts to dismiss the challenge by the Phoenix-based Goldwater Institute to Congress’ delegation of its powers, because courts may say Congress can just change its mind. Hence the court may spurn the institute’s argument on behalf of two Arizona congressmen, Jeff Flake and Trent Franks, that the entrenchment of the IPAB seriously burdens the legislators’ First Amendment rights.
Diane Cohen, the institute’s senior attorney, demonstrates that the IPAB is doubly anti-constitutional. It derogates the powers of Congress. And it ignores the principle of separation of powers: It is an executive agency, its members appointed by the president, exercising legislative powers over which neither Congress nor the judiciary can exercise proper control.
Unfortunately, the IPAB may not be unconstitutional. This is because the Supreme Court, having slight interest in policing Congress’ incontinent desire to give to others the power to make difficult decisions, has become excessively permissive about delegation. Cohen notes this from Justice Antonin Scalia’s dissent in a 1989 case wherein the Supreme Court affirmed the power of the U.S. Sentencing Commission to set “guidelines” that, being binding, have the effect of statutes:
“I anticipate that Congress will find delegation of its lawmaking powers much more attractive in the future. … I foresee all manner of ‘expert’ bodies, insulated from the political process, to which Congress will delegate various portions of its lawmaking responsibility. How tempting to create an expert Medical Commission … to dispose of such thorny, ‘no-win’ political issues as the withholding of life-support systems in federally funded hospitals.”
The Supreme Court said the legislative power of Congress does not include the power to delegate legislative authority to an executive agency without “intelligible principles” to constrain such authority. The only principle — if such it can be called — constraining the IPAB is that its mission is to cut medical costs as it sees fit.
The Goldwater Institute’s challenge to the IPAB serves the high purpose of highlighting some of Obamacare’s most grotesque provisions, which radiate distrust of the public and its elected representatives. The essence of progressivism, and of the administrative state that is progressivism’s project, is this doctrine: Modern society is too complex for popular sovereignty, so government of, by and for supposedly disinterested experts must not perish from the earth.
George Will’s email address
is georgewill@washpost.com.
WASHINGTON POST WRITERS GROUP
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Stay well and travel with care.
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