http://communities.washingtontimes.com/neighborhood/medicine-and-politics-america/2012/mar/25/supreme-musings-obamacare/

SAN DIEGO, Sunday, March 25, 2012—Beginning this Monday 3/26 and continuing through Wednesday 3/28, the Supreme Court will hear oral arguments both for and against the PPACA law; their decision on the challenges posed against Obamacare is expected to come down sometime this June, 2012, about four months prior to the presidential election.

Here are the main elements that will be presented over the next few days at the Supreme Court:

  • The      Tax      Anti-Injunction Act states “no suit for the purpose of      restraining the assessment or collection of any tax shall be maintained in      any court by any person, whether or not such person is the person against      whom such tax was assessed.”

Question:  Is, indeed, the ‘penalty’ in PPACA a “tax” such that the Tax Anti-Injunction Act would prevent review of the law until after the ‘taxes’ are collected in 2014? Hence, must the Supreme Court case be deferred another two years down the road?

  • Is      the Individual Mandate (i.e.,      that we must all purchase health      insurance or pay a penalty for not purchasing such insurance)      constitutional?
  • Is      the mandate to purchase health insurance, or pay a      penalty for abstaining, ‘severable’ from the rest of      the two thousand-plus page law, in the event the mandate is found to be,      in fact, unconstitutional?
  • Is      it constitutional that States must either expand Medicaid (or lose      federal funding altogether) under Obamacare?

The Media

The ‘Affordable Care Act’ is dangerous for America, and yet the pro-Obamacare Zeke Emmanuel’s and Michael Moore’s of the world should relish in the fact that media outlets rarely report on the meaty deficiencies which make this law egregiously detrimental to the doctor-patient relationship.

Shocking as it may be, politics is an insider’s game where pundits on both sides of the Obamacare debate are rarely jockeying for positions of principle as much as for platforms of power.

The ‘right’ despises MSNBC for its consistently pro-Obama stance, and the ‘left’ despises FOX News for its steadfast tilt in favor of Libertarian and Republican viewpoints. Both FOX and MSNBC, however, largely do a disservice to their viewers by missing the forest for the trees when it comes to the new healthcare reform law.

A well-known reporter for FOX told one of my colleagues that he “would lose his job” if he gave air time to the weighty and substantive rather than ‘talking points’ arguments against the Patient Protection and Affordable Care Act legislation.  How sad!

The Pivotal Role of the American Medical Association

Lying low now, the AMA sought a high-profile role in the run-up to the Affordable Care Act’s passage in March, 2010.  Such eagerness to be considered a dutiful ‘player’ (and to gain a ‘seat around the table’) even resulted in high-level meetings of AMA officials at the White House during the early months of the Obama presidency.

In and of itself, this is not news; it is merely democracy in action, right? Well, perhaps, if you consider democracy to be pay-offs and favors behind closed doors. Even the AMA’s own henchmen will now openly concede what the majority of doctors have been saying for over two years: their membership of “practicing physicians” is only at 15% of the total number of practicing physicians in the United   States. This means that 85% of American doctors are not, and have not been, members of this organization for some time, and the number is dropping as 12,000 private practice members alone quit the AMA in the year 2010.

Many believe that the AMA could have set the tone that other major state medical societies would have likely followed (e.g., California), and stopped the healthcare bill from passing if they had not lent their support for Obamacare.  Instead, the AMA supported the bill because it won them ‘security’ for their coveted contract with the government for exclusive copyright medical billing coding rights, which nets upwards of $70-100 million dollars annually for the organization.

Despite this, doctors who still enjoy their “seat” around the political table courtesy of the diminished, yet wealthy, AMA had this to say about the critics of the AMA’s exclusive billing revenue stream in the February, 2012 edition of the San Diego County Medical Society PHYSICIAN magazine, page 29:

“We will declare first what it was not: It was not some evil deal to protect CPT revenue or any other AMA business line. That one is right up there with the Sept. 11 “truthers” on the far left or the Obama “birthers” on the far right — great conspiracy theory and great physician lounge chatter, but an idea based only on the fantasies of people who have never been to an AMA meeting or who in some cases are trying to derive personal financial benefit by trying to tear down AMA.”

This is an odd statement, considering that the AMA’s once secretive deal with the government was only revealed to the public by the diligent work of Andy Schlafly, counsel for the Association of American Physicians and Surgeons (and one of the few attorneys privileged to have petitioned the Supreme Court on PPACA), and AAPS Executive Director, Jane Orient, M.D. Interestingly, Doctor Orient, and many others in the non-AMA physician (majority) category, have been or are members of the AMA’s inner working circle.

More information on the work of AAPS before the Supreme Court can be gleaned at their dedicated anti-Obamacare legal website.

Basic Premise to be Argued in Favor of State-based, rather than Federally-mandated, Health Reform

Section 36 of the 11-398 February 13, 2012 Counsel for Amici Curiae Supreme Court Brief:

“Although many States have made this case in challenging the individual mandate, several have filed an amicus brief supporting the Government. In support of the Government’s position, State Amici argue that the ACA is a blueprint for model cooperation between the federal government and the States. See, e.g., State Amici Br. at 29-36. This portrayal ignores the unconstitutionally coercive Medicaid expansion the Act foists on States, as well as the fact that the ACA imposes a particular purported solution—the individual mandate and associated insurance reforms—to attempt to solve a complex problem that States have attempted to address in diverse ways. The fact remains that the States within our constitutional system have both the traditional power and the practical ability to enact meaningful healthcare reform. Accordingly, a decision by this Court to reaffirm the traditional constitutional boundaries on Congress’s power to regulate commerce will encourage and promote State-sponsored and -administrated solutions that reflect the appropriate workings among the laboratories of democracy in our federal system.”

The Supreme Court ruling this Spring/Summer 2012 will have profound implications not only for the upcoming presidential election cycle, but for the United States in general for the foreseeable future. Many see this argument about federal vs. state power, and the rights of individuals to live and work in a free-market-driven economy, to be paramount.

It is regrettable that money and positions of perceived importance have pitted physician against physician in the run-up and aftermath of the new healthcare reform law. It is even more profoundly tragic that, to this date, no explanation of reason can be offered by the American Medical Association for their egregious behavior in posturing on the East Lawn of the White House in ‘white coats’ that were offered to them by political staffers for their disingenuous display of doctor ‘unity’ in support of Obamacare.

We can only hope that the National Doctors’ Coalition Meeting in San    Diego this May 5th/6th, where non-AMA medical groups will assemble to write their blueprint for true patient/doctor-centric healthcare reform, will help reassert medical-political influence back in the hands of the 85% majority of American physicians on this matter. (Registration and portal for doctors coalition meeting)

… another recent article by Doctor Dorin in The Washington Times:

http://communities.washingtontimes.com/neighborhood/medicine-and-politics-america/2012/mar/19/diagnosing-healthcare-reform-crisis/

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