As you know, earlier this week, the President had a few choice words for the Supreme Court, warning them that judicial activism in the form of striking down the health reform law would undermine the Court's integrity. Well, it seems a judge on the Court of Appeals for the Fifth Circuit was offended. He demanded to know of a Justice Department lawyer whether the Justice Department recognizes that courts have the power to strike down Acts of Congress in appropriate cases -- and when she said yes, he ordered her to submit a letter brief, no shorter than 3 pages, analyzing the President's comments in light of the powers of the judicial branch. I feel horrible for this poor lawyer, but it seems pretty clear to me that the key is "in appropriate cases." Courts should strike down laws that are unconstitutional, not laws with which they do not agree. The President toned down his remarks yesterday.
Meanwhile, here's a list of 15 consumer protections that we would lose if the health reform law was struck down. Republicans are starting to think about what to do if the health reform law is struck down -- they always said repeal and replace, so what if they get to the "replace" part of things? Predictable answer: toss the goal of universal coverage and substitute cost cutting instead. I can feel my blood pressure rising as I write this. Obstacles to people getting care cost us money because people without insurance wait until they are very ill, end up in an ER, and when they can't pay the bill, it's your tax dollars that cover it. So failing to provide universal coverage increases costs -- period. They'll let people by insurance across state lines (which means eliminating state coverage mandates), offer tax deductions for people who buy individual insurance, pass malpractice reform. As if any of that makes a dent in this huge problem we have.
Meanwhile, panels of doctors -- professional societies, not government "death panels" -- are recommending that certain tests not be performed in certain circumstances -- things they consider to be wasteful. This is good if the result is really to eliminate waste; it's bad if it's used by insurance companies to limit treatment options. What works for one person may not work for others, and doctors should be free to tailor their practices to the individual patient's needs. The problem will not be these consensus protocols; it will be how they are applied. But note that this is NOT something that is mandated under health reform; this is something the medical profession realizes it needs to address. The hope is that this will empower patients to ask their doctors why they are ordering certain tests -- do I really need this, doc? From that standpoint, this can be a great thing. This is all part of a project called Choosing Wisely. Check out their website -- it's pretty interesting.
Nearly 90,000 poor children in Pennsylvania were kicked off of Medicaid in an effort to control the state's budget. The Governor says he's cleaning house, eliminating people whose paperwork is not in order. It's just just Pennsylvania; lots of states are trying to cut back. Colorado is using a lottery to see which 10,000 of 50,000 eligibles will get benefits. Hawaii tried to limit adults to 10 days in the hospital per year, but the feds wouldn't agree. This is horrendous. If we do not find a way to get a handle on health care costs without leaving people with no care -- who, again, get sicker and end up in ERs and cost us even more money -- our country's economy will not be sustainable. People have to get this. Something has to change. The question, from my standpoint, is how we can control costs without depriving people of care they need. For example, there are many proposals for revamping Medicare. We don't have to go with a GOP plan that converts Medicare to a voucher system designed to make private insurance companies rich. But we do have to do something.
On that note, I'm off to try to do my little part in this massive struggle for the civil rights of people with chronic illnesses. Have a great day. Jennifer