Posts Tagged ‘ObamaCare’

“HEALTHCARE REFORM”: SOME HARD TRUTHS

Monday, January 23rd, 2017

Note (06FEB2017): More Republicans now plan not to repeal ObamaCare but to repair it. What would Mr. Peifer say (See below.)? Why? They have no credible replacement even though one has existed since 1994.

“But if thought corrupts language, language can also corrupt thought.” -George Orwell (1903-1950)

Elected and in-office, Republicans now face some hard truths associated with issues challenging this declining nation on fire. One is ObamaCare and the Republicans’ pledge to “repeal and replace” it. Words have power.

“Not on fire,” you say.

Witness the new President’s address at his inauguration; never mind the protests nationwide, some violent. Would you characterize it as conciliatory? Aggressive? Words have power.

“Healthcare”
In any debate, it is reasonable and appropriate to ask the opposition — the entrenched political establishment, Democrat and Republican — to define the terms that it uses; in this case, “healthcare”. Webster’s New Collegiate Dictionary (1977) does not list the term even. Whence cameth it?

What exactly is “healthcare”? As the term denotes, it is a governmentally concocted, pleasant-sounding euphemism that refers to caring for one’s health. (In contrast, “medicine” is not so pleasant-sounding because it denotes suffering.) “Healthcare”, however, is amorphous and includes everything from washing your hair to brushing your teeth to cutting your toenails. Simply put, “healthcare” is not synonymous with medicine. Words have power.

Another governmentally concocted euphemism, “healthcare-provider”, includes anyone and everyone who promotes himself as rendering advice, assistance, or instruction in the care of one’s health. It is intended to diminish the stature of the lynchpin in medical delivery, the physician. Words have power.

What is medicine? It the healing art based upon science the mission of which is the relief of suffering caused by disease and trauma. Its practitioners are known as physicians; those whom they diagnose and treat, patients. Words have power.

Repair Not Replace
Definitions notwithstanding, of “repeal and replace”, “repeal” is the easier; whereas, “replace”, the more difficult — the much more difficult. Accordingly, some Republican legislators now are talking about “repair” instead of “replace”. Surprised?

“An error lurking in the roots of a system of thought does not become truth simply by being evolved.” -John Frederick Peifer

The basis of this “repair” seems to be a new, politically concocted term — “Health Savings Accounts”, which are merely “Medical Savings Accounts” in new verbal clothing. Country-club Republicanism as its worst! The average American cannot afford a car, let alone a “Medical Savings Account” by whatever name.

“Catastrophic Coverage”?
Some opponents of ObamaCare, such as Tucker Carlson at Fox News, are promoting “Catastrophic Coverage” rather than basic medical coverage. “Catastrophic Coverage” may play well on television, but basic medical coverage offers the biggest bang for the medical buck.

Who most needs “Catastrophic Coverage”? The unproductive old.

It has been known for years, for example, that, during the last year of life, Medicare recipients spend 30-cents of every dollar expended on medical care during their entire lifetime. Of the 1% of Medicare beneficiaries with the highest costs in any given year, approximately 50% die. Of the 5% with the highest costs, approximately 40% die. Of the elderly who survive, 50% are demented by the age of eight-five. Therein lie the reasons that Medicare alone is bankrupting these United States of America. Hard truths!

PART TWO

Today, a major question facing physicians and the rest of American society is whether the consequence of past declines in mortality is an increase in active life-expectancy or merely an expanded and grotesque period of frailty, enfeeblement, and dependency. Apparently, the answer is the latter.

“Diaper, madam? Catheter, sir? Don’t worry. The young and productive will be paying tomorrow for the old and unproductive today.”

Not a pretty picture! Even physicians do not like looking at it. Chronic, debilitating illness — not dying — is becoming our worst medical enemy, individually and socially.

Meanwhile, who least need “Catastrophic Coverage”? The productive young who generally require only acute medical care for acute medical problems with occasional exceptions. Therein lies the reason that premiums would be so cheap to insure, really insure, all American young for serious medical events.

Fooling The Public
To paraphrase Abraham Lincoln, “You can fool all of the people some of the time and some of the people all the time, and them’s pretty darn good odds.”

Be not fooled by self-styled gurus on television or in the newspaper spinning misinformation. Be not fooled by power-hungry professional politicians seeking to retain control of medicine.

Remember Obama’s promises about the benefits of ObamaCare, such as keeping your doctor and your plan? Once again, those who direct public opinion are acting against the Public Good by promoting inefficient systems politically based and politically directed.

Science And Medial Delivery
A patient’s seeking medical care is a behavior. A physician’s providing medical care is a behavior.

There is a science that describes behavior as well as thoughts, feelings, and physiological responses. That science is Biobehavioral Science.

“What?” you say. “Biobehavioral Science? Never heard of it!”

Therein lies the problem not just for you but for nearly all humanity. Guess what? Ignorant about Biobehavioral Science themselves, were they not, the politicians would not want you to hear of it; especially its derivative, the Science of Human Behavior. To them, it would represent an anathema.

Were they willing to listen, they would screech in terror, “Specificity, Objectivity, and Accountability? Never! Never, I tell you!”

Any system not scientifically based and scientifically directed to deliver medical care to a population must be, by its very nature, fatally flawed and fated to failure — doomed to delivering care that is of decreasing availability and decreasing quality. Less availability. Lower quality.

“An ounce of prevention is worth a pound of cure.” ―Benjamin Franklin

Do you care? Actually, few do until they fall ill or become injured. Too late!

We already are suffering from the Sovietization of American medicine; whereby, for example, you see “Doctor Nurse” not “Doctor Doctor”. When you do see “Doctor Doctor”, he — or increasingly she — is looking mainly at the computer-screen not at you. Why? In order to fulfill the increasing regulatory demands of governmental bureaucrats for increasing documentation of decreasing care.

Meanwhile, a scientifically-based, scientifically-directed, detailed plan for delivery of universal medical care by a competitive private sector characterized by the following attributes is available and has been available for more than 20 years. It is characterized by the following:
1) Simple;
2) Straightforward;
3) Free of special taxes;
4) Minimal regulations;
5) Minimal bureaucracy;
6) Free of fraud at taxpayers’ expense; and
7) Acceptable to insurance companies.

No, it is not the failed ClintonCare. In fact, the opposite.

Will the politicians ever acknowledge it, let alone adopt it? Fat chance! Unless, of course, you make them. It’s your health. It’s your life.

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A Paradox?

Monday, February 15th, 2016

NOTE (22FEB2016): Today, we mark the anniversary of the birth of George Washington (1731-1799). Actually, he was born on the 11th of February, but the colonies switched calendars from Julian to Gregorian; thereby, advancing the date of his birth.

“As a very important source of strength and security, cherish public credit. One method of preserving it is to use it as sparingly as possible;” -George Washington’ Farewell Address (1796)

How does ObamaCare correspond to that directive of the Father of these United States of America? How can we employ a system of medical delivery that does? How can we protect the future of our youth, who represent the future of this nation now on fire?

“Life outside society would be solitary, poor, nasty, brutish, and short.” -from Thomas Hobbes (1588-1679)

What can be more important to an individual than life and health? In that regard, what single advance most has improved the human lot — for the individual and for society? Sewage.

Ah, but what about medicine? Has it, too, not improved the human lot? Yes, for the individual. For society? Yes — and no.

It may seem paradoxical that a physician would give such an answer. It is not.

The well being of society depends upon the overall health of its truly creative and truly productive members. The goal of Public Health is to have maintained the health not of the individual but of the society, as a whole. Sewage has done more to fulfill that goal than any other, single measure. Moreover, the cost:benefit ratio had been enormously favorable.

In contrast, the goal of Medicine is to have relieved the suffering of the individual as a consequence of disease and trauma. All well and good until one looks at the cost:benefit ratio. It has become dreadfully unfavorable.

The average American now expends half the cost of his medical care during his entire lifetime during the last year of his life — a year in which kindness often becomes cruelty — a year that, from the perspective of society, typically is pathetically uncreative and unproductive; from the perspective of the patient, typically is progressively enfeebling and painful; from the perspective of family and friends, typically is unrelentingly burdensome and depressing.

You might comment, “Wait! In these United States of America, the individual has no obligation to be either creative nor productive. We are not Nazi Germany where the individual exists for the State. Here, the State exists for the individual — doesn’t it?”

Even so, does the individual have the right to rob his productive neighbor to pay for his own medical care, the end result of which will be of no use to that neighbor or to society and likely of little use, if any, to family, friends, and himself? If so, what are the limits of such theft?

Should the individual be paying with his own money, he very well may be entitled to the most expansive and expensive care that he can afford. Is he so entitled when it is his productive neighbor who is paying — and paying involuntarily via taxes collected by the government at the point of a gun if need be?

When medical care is limited to basic care at a primary level — especially of acute medical problems such as fractures and infections — the cost:benefit ratio becomes tolerably favorable. When medical care is expanded to advanced care at a secondary level — especially of chronic medical problems among the elderly, problems  such as non-healing wounds; failing hearts; and, worst of all, dementias — the cost:benefit ratio becomes intolerably prohibitive as witnessed by Medicare/Medicaid well on the way to bankrupting this declining nation now of fire. Once having bankrupted the nation, Medicare/Medicaid will leave precious little medical care for any but the richest.

You might ask, “There must be some humane alternative between callous disregard and misguided ‘humanitarianism’, mustn’t there?”

Fortunately, yes. The alternative is a medial system that delivers care universal but affordable, partially governmentally funded, provided by the private sector under medical supervision, acceptable to insurance companies, and scientifically based and scientifically driven.

For a description of such a system of medical delivery, see Chapter 17 in the semi-fictional novel, Inescapable Consequences. It is drawn from a detailed plan initially presented in the non-fictional book, Healthcare Reform D.O.A., nominated for two, national awards by The American Risk & Insurance Association — an academic arm of the American insurance-industry.

Americans need not be saddled with the ill-conceived ObamaCare favored by the socialistic, irresponsible Democrats nor the hodgepodge of misguided proposals by the feckless, inconsistent Republicans. The choice really is theirs. It is yours.

Choose selflessly and wisely, and your grandchildren will bless you. Choose selfishly and foolishly, and your grandchildren will curse you.

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MEDICAL DELIVERY: A TALE OF WOE

Monday, August 6th, 2012

“An error lurking in the roots of a system of thought does not become truth simply by being evolved.”
– John Frederick Peifer

Forward: Will Mr. Obama’s “Patient Protection and Affordable Care Act (PPACA)” improve the American system of medical delivery, or will the nation slide from American-style medical care into Soviet-style “healthcare”?  Given the data from its model, RomneyCare in Massachusetts, the answer is the latter.(1) The following is a highly abridged excerpt from the semi-fictional novel, Inescapable Consequences; “The Doctor” and “Uncle” are two of the characters therein.‘Tis the kind of tale likely to be told and retold millions of times:(2)

The patient, a thirty-eight-year-old, married, obese, mother of three had a past psychiatric history of a single brief psychotic episode ten years previously, treated successfully with complete remission and without recurrence. Her recent health had been good until the current presenting complaint of several days duration characterized by abdominal pain with nausea and vomiting.

The morning prior to admission to the hospital, she had complained to her husband of a slight sore throat and a persistent mild but increasing nausea. She had declined to accompany the rest of the family to services at church. Upon his return, the husband found the patient still feeling ill. Her nausea had intensified somewhat, and she continued complaining of diffuse, dull abdominal pain.

Through his employer, the husband subscribed to a “healthcare-plan” issued by a “health-maintenance organization” or so-called HMO, the premium representing a significant portion of his wage. He telephoned the number provided by the HMO for such occasions, receiving only a recorded message with the usual disclaimer instructing him to telephone “911” if he, a layman, determined that the situation was a life-threatening emergency. Then, pursuant to the subsequent instruction by the recorded voice, he left his own brief message with his telephone number.

Approximately one hour later, a woman identifying herself as a nurse returned his call. She had no records of the patient available. As best he could, the husband described his wife’s current complaints and past history including her psychiatric history.

Addressing him by his first name, the nurse quizzed him primarily about his wife’s past psychiatric history, neglecting her present illness.  She then suggested that he telephone the following morning, Monday, to schedule a regular appointment.

He informed the nurse that, since his wife had been feeling increasingly ill for several days, she herself already had called for that regular appointment. The soonest that the receptionist would agree to schedule one was three weeks hence.

The nurse replied by advising him, nevertheless, to try again the next morning and to inquire whether there had been a cancellation. She also prescribed bed-rest and a diet of clear liquids.

Concerned about the typically long wait at the Emergency Room of the HMO, he asked if he could take his wife to a nearby ER. The nurse answered, “You’re free to do whatever you think best, but we can’t authorize an Emergency Room visit ‘out -of-network’.”  Her parting words reverberated in his brain like car-brakes without a lining. “Have a nice day.”

Late that afternoon, his wife was feeling no better. He decided that he would drive his wife to the Emergency Room of the HMO and hope for the best. Upon arriving, he registered his wife with the clerk, who told him that there would be “a considerable wait”.

One hour later, a nurse approached them in the waiting room for a “screening evaluation”. After a brief conversation, she said that she did not believe that his wife’s symptoms warranted a visit to the ER but that his wife would be seen “in due course”. Three hours passed. Feeling as sick as she looked, his wife was pleading for him to take her home. Instead, he took her to the Emergency Room at their local hospital, the financial risk be damned.

There, the clerk advised him that, if his HMO should decide, in its sole opinion, that the patient’s case was not a true emergency, he himself would be responsible personally for all charges. He agreed. He allowed the clerk to take an imprint of his credit card.

Another hour later, a nursing aide escorted them into an examining room. She recorded the patient’s vital signs, noting a slightly rapid pulse and a slightly elevated temperature.

Another thirty minutes of waiting. Then, a man in a white coat with a stethoscope entered. He introduced himself as “Dr. Faki”. Neither patient nor husband understood that Dr. Mohandas Faki was not a physician with an M.D. from an American medical school but a nurse with a Ph.D. from a foreign nursing school, nor did either understand the right to be attended by a physician not a nurse.

The husband again reviewed the course of events and again made the mistake of mentioning that his wife tended toward anxiety and did have a past psychiatric history. Upon hearing about the patient’s psychiatric history, as had the telephonic nurse before him, the “doctor-nurse” focused his questioning in that area.

He then performed a brief physical examination, noting only a slightly injected pharynx and mild, diffuse, abdominal tenderness. He ordered some routine studies by the laboratory “stat”. The couple returned to the waiting room.

Two more hours passed. The nursing aide reported that the results from the laboratory returned as “non-specific” and that the doctor-nurse had said that they should return home then see the patient’s “healthcare-professional” the next day. At no time did a doctor-doctor examine the patient.

Having returned to their home, by late that evening the patient’s husband could see that his wife’s condition was deteriorating further. Her nausea had intensified. She had vomited. Her abdominal pain had intensified. Emotionally, she was becoming distraught.

Her husband tried calming her while he himself was feeling increasingly anxious. Risking the punitive cost, he decided to try a different Emergency Room. He happened to choose a hospital where Uncle’s nephew, The Doctor, held surgical privileges.

Viewing her presenting appearance, the hospital-staff quickly registered the patient then wheeled her into an examining room, where a nurse performed an initial screening. By then, the patient was complaining of increasingly severe abdominal pain in the right upper quadrant. Her skin was cold and clammy to the touch.

The surgeon-on-call that evening already was working on another case in the Operating Room, so a nurse telephoned The Doctor. He ordered her to prepare the patient for immediate surgery, including typing and cross-matching three units of blood, and hastened to the hospital.

By the time that he arrived, the patient was in the Operating Room but going into shock, which the staff, none of whom was a physician, feverishly was attempting to reverse. The Doctor hastily changed from “civvies” into “scrubs”, washed, gowned, and gloved. He took a moment to evaluate the situation before beginning an exploratory laparotomy while the nurse-anesthetist was doing her best to maintain the patient’s vital signs; no physician-anesthesiologist was available. Everyone but the patient was breathing the air of desperate urgency. On her own, she was breathing hardly at all.

Entering her abdominal cavity, The Doctor quickly discovered the cause of the patient’s trouble; a gangrenous gallbladder, now-ruptured. He began to correct the condition by cleansing the cavity of the spilt bile and pus. In the midst of his doing so, the woman suffered a cardiac arrest. Instantaneously, the cardiac monitor screamed its piercing alarm, an unnerving “bleeeeeee . . . .”.

Following a series of frantic efforts, the nurse-anesthetist admitted failure. “We’ve lost the patient,” she reported meekly, gazing fixedly at the floor.

“We?”  The Doctor angrily shot his question at her; his expression, grim; his emotion, impotent rage.

Masking his feelings, he reluctantly entered the hallway, where he found the patient’s husband pacing like the proverbial caged animal. He approached the man slowly and introduced himself. With a quiet compassion in his voice, he informed the husband that his wife had died.

He then attempted to provide what little consolation he could offer. It was difficult for The Doctor to find the right words; actually, to find any words. What could he say?  The wife’s dying had been avoidable. It never should have happened. The medical system had failed her directly and her husband indirectly.

The Doctor’s efforts at sympathizing were in vain; the husband remained disconsolate. The Doctor stood silently while the suddenly-widowed man sobbed.

Then, the tears stopped. Shaking his head, the man looked at The Doctor with a compassion of his own. Paradoxically, he began offering consolation to The Doctor, apologizing for the system foisted upon the country by politicians for whom he himself had voted. Looking into The Doctor’s eyes, he noted tearing.

Whereas the husband felt apologetic, The Doctor felt ashamed, not for himself as much as for his profession or what was left of it. “The medical profession . . . my profession . . . no longer controlled by physicians but by politicians, bureaucrats, lawyers, and profiteers. The consequences? Casualties. This man, his wife, and I are three of them,” he whispered silently to himself.

The husband gently took The Doctor’s hand and held it.“Go home, Doctor . . . get some sleep. You did your best. It wasn’t your fault.” He predicted that, with his wife’s death, the HMO would agree that his wife’s illness had represented a real emergency, after all.

 The Doctor put his other hand on the husband’s shoulder and gave it a slight squeeze. He turned and walked away, leaving the bereaved man behind with his grief-stricken widowerhood bestowed by a system of managed costs euphemistically characterized as “managed care”.

On his way to the locker-room, The Doctor stopped at the desk to request that an aide stay with the husband while the secretary summoned the husband’s brother from home. The secretary said that she would try but that the hospital was understaffed, as usual.

At the moment of the husband’s shock and grief, The Doctor had not wished to disabuse him of his financial fantasy. The Doctor predicted that the HMO would deny the charges, claiming that, in spite of its staff erroneously having told the husband by telephone and at their ER that his wife’s condition represented no real emergency, she should have stayed to be seen “in-network”. He assumed that the charges would force the husband into bankruptcy. Oh, the man would rant and rage and threaten legal action, but, given current law protecting the profiteers, he would find no lawyer to take the case “on-contingency”, and he ill could afford hourly fees.

As for The Doctor’s fees? He would never receive a penny. “The people’s right to ‘healthcare’ . . . their right to my labors . . .” would be his only response, silent and ineffectual.

That night, The Doctor managed to get an hour or so of sleep. Then, he was off to make rounds at the hospital; then, to see patients at the office.

Given the schedule of fees dictated by the government and by the various governmentally-promoted “healthcare-plans”, caring for many of those patients also would generate little financial gain, if any; caring for a few of them would generate financial losses; caring for all would risk unfounded lawsuits filed by unscrupulous, avaricious lawyers.

Months later, The Doctor’s prediction would prove valid. The premiums that the husband had paid to his HMO were for naught when an actual need arrived. His HMO had denied care by delaying care then had forced him, the subscriber, to take the financial fall. Ironically, the same day that the man filed for bankruptcy, the HMO filed a fifteen percent rise year-to-year in its profits.

© Gene Richard Moss (2009)

References
1) “RomneyCare 2.0″. The Wall Street Journal, 06 August 2012, p. A12.

2) Already, under “Expansion of Physician Assistants Training”, the PPACA is directing tens of millions of dollars to training paramedical personnel. Meanwhile, under Medicare, funding for physicians-in-training and payments to physicians-in-practice are being slashed.

WHAT’S AMERICA TO DO?

Monday, July 2nd, 2012

Well, well . . . one unelected governmental officeholder with lifelong tenure, Chief Justice John Roberts, Jr., ironically a known epileptic, became the single, deciding factor in determining the future of all medical services for the entire USA.(1) What power! What would James Madison say?

It might be noted that the context in which Mr. Roberts made his decision not only is his own chronic illness but a Court in which not one of the “Supremes” is a WASP-male or a WASP-female. As Mr. Roberts reasoning represented a gross distortion of the language of the legislation, the composition of the Court represents a gross distortion of American demographics. Mightn’t even Abraham Lincoln be aghast?

To what extent did Mr. Roberts having served as counsel to the insurance-industry influence his decision, especially his loss in 2002 before what is now his Supreme Court (Rush Prudential HMO, Inc. v Moran)? The answer is unclear, given the disparate consequences for different companies.(2)

Twisting definitions the way only a lawyer can do, Mr. Roberts pronounced legislation that he himself, otherwise, would have considered unconstitutional . . . constitutional. Talk about miracles! Such a feat of legalistic resurrection might amaze even Moses, Jesus, and Mohammed.

The four dissenting Justices noted that Mr. Roberts re-categorized, as a tax, the “penalty” attached to the “individual mandate”. The penalty was categorized numerous times in the legislation as such and not as a tax even though it will be administered via the Internal Revenue Service. Moreover, Mr. Obama and his Democratic supporters repeatedly denied that it is a tax,(3) and, although some of his supporters now might deny his denial, others within the White House continue to affirm it.(4) In the words of the radio-character, Chester A. Riley, “What a revoltin’ development this is!”

So, what’s America to do? Given her history, probably nothing more than passive acceptance. Isn’t it all over but the shouting?

Will Mr. Romney continue to campaign loudly for repeal of ObamaCare despite its model having been RomneyCare in Massachusetts? Such linguistic gymnastic is well within the abilities of Mr. Romney . . . after all, he is a lawyer himself.

Two lawyers campaigning for the presidency. What a sight to behold!

Admittedly, at this point in the campaigning, the consequence of Mr. Romney’s emphasizing his opposition to Obamacare might be less voters’ support not more. Whatever he chooses, in November, should the House remain Republican and, by some chance, Mr. Romney win the White House,(5) he still will be unable to repeal ObamaCare in its entirety unless the Republicans also capture a minimum of sixty seats in the Senate, unlikely, then band together into a united whole, even more unlikely given their past record of fecklessness . . . think Olympia Snowe from Maine or Arlen Specter from Pennsylvania.

Okay, other than the Republicans’ capturing the White House and both chambers of Congress, is there anything else that America can do? Yes, but she won’t . . . or might she?

As Alexis de Tocqueville noted in 1831, the real power in America, albeit currently remaining buried under the big foot of the federal government, lies with the individual States.(6) State-based governments simply could refuse to establish the “exchanges” demanded by ObamaCare. Will any? Governors Perry of Texas and Scott of Florida say, “Yes.” Talk is cheap, however . . . money, expensive. Time and politics will tell.

Wait! Even if a State so refuses, pursuant to the Act, won’t the federal government do so in its stead? Not necessarily . . . not if the U.S. House of Representatives, likely to be Republican-controlled, refuses to appropriate the necessary funds.

The U.S. Constitution is clear. Federal appropriations originate in the House not the Senate. “All Bills for raising Revenue shall originate in the House of Representatives; but the Senate may propose or concur with Amendments as on other Bills.”(7) No money . . . no ObamaCare.

James Madison wrote in The Federalist No. 58, “The House of Representatives cannot only refuse, but they alone can propose the supplies requisite for the support of the government. They, in a word, hold the purse – – . . . . This power over the purse may, in fact, be regarded as the most complete and effectual weapon with which any constitution can arm the immediate representatives of the people, for obtaining a redress of every grievance, and for carrying into effect every just and salutary measure.”

After all, if Mr. Obama can refuse to enforce the law in the form of the Defense of Marriage Act because it offends his personal or political sensibilities, why can’t the House of Representatives refuse to fund a law that a majority of its members deem unconstitutional, Mr. Roberts’s opinion notwithstanding?

What would be the consequence of such behavior? A constitutional crisis? Maybe. If so, perhaps a constitutional crisis is what America needs to save the Constitution and herself (www.inescapableconsequences.com).

References
1. Epilepsy: a recurrent, paroxysmal disorder of cerebral function marked by sudden, brief attacks of altered consciousness or abnormal motor signs or sensory symptoms. Of note, patients with epilepsy are at risk of developing psychiatric problems including anxiety, depression, and psychosis. Whether patients develop an “inter-ictal” personality remains a source of medical controversy.

Whatever the case, Mr. Roberts’s condition has raised criticism about his fitness to serve on the U.S. Supreme Court or, perhaps, any court. Some might claim that his medical condition never having become a source of national or congressional debate prior to his confirmation would seem to reflect the power of political correctness or what, alternatively, would be called Radical Maternalism.

2. Schoenholtz, JC: The Managed Healthcare Industry: A Market Failure (2nd Ed.). North Charleston, SC: CreateSpace (2011).

3. “ObamaCare and the Power to Tax”. The Wall Street Journal, 29 June 2012, page A13.

4. “A Vast New Taxing Power”. The Wall Street Journal, 02 July 2012, page A10.

5. In this election, some might characterize Mr. Romney as a lightweight in a heavyweights’ bout. One example has been his refusal to address candidly and completely two issues of substantive importance . . . namely, 1) his promoting of RomneyCare, about which Rick Santorum beat him to a pulp during the primaries and 2) his wife’s medical condition (multiple sclerosis) and her ability to meet the challenges of becoming First Lady,(A) about which, unlike his wife, he himself essentially has refused to comment.(B) His reluctance to meet these issues head-on projects a personal image lacking strength, lacking courage, and lacking conviction.

A. Multiple Sclerosis: a chronic, progressive, auto-immune, inflammatory condition of the central nervous system, marked by intermittent damage to the myelin sheath that covers all axons of nerve-cells. One of the hallmarks of the disease is chronic fatigue (90% of patients) in addition to often severe motor and sensory dysfunctions, including loss of control of bladder (90% of patients) and bowel (15% pf patients). Fifty percent of patients suffer from depression while 20% exhibit “la belle indifference”, an unrealistic degree of complacency about gross symptoms.

B. Burton, TM: “Ann Romney Talks of Her Struggle With MS”. The Wall Street Journal, 02 July 2012, page A4.

6. de Tocqueville, A: Democracy in America. Chicago, The University of Chicago Press (2000).

7. U.S. Constitution, Article 1, Section 7.