ACA Aftermath: Three Little Pigs & the Big Bad Wolf

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Three Little Pigs. Silly Symphony Original Release Poster, 1933. Courtesy Walt Disney Company.

Remember the story of the Three Little Pigs?  You know, one pig built a house out of straw and a second built a house out of sticks, while the third built a house out of bricks.  The antagonist is the iconic “Big Bad Wolf” whose ravenous appetite for pork knew no bounds.  Endowed with an impressive lung capacity he goes to each of the little pig’s houses and, as the story goes, “He huffed and he puffed and he blew the house down!”  (It’s more fun if you say it out loud with all the enthusiasm and glee a four year old would put into it.) The house of straw immediately collapses under this pneumatic assault, and the one made of sticks fares no better.  Their plump porcine owners scramble to find shelter in the house made of brick, which as we all know, survived the wolf’s hurricane-force winds, unscathed.  It is, of course a morality tale about being wise to the ways of the world and “building” the various parts of one’s life out of material that can withstand its big bad wolves, or storms, be they actual or virtual.  Either that or a clever publicity story concocted by the bricklayers union, but I prefer the former.

Now that the Affordable Care Act (ACA) has been declared constitutional by the Supreme Court of the United States (SCOTUS) there has been non-stop huffing and puffing by the Republican opponents of the law, who thought they were going to be rewarded with a Health Care house that was made out of straw, or at the worst, of wood.  SCOTUS, they reasoned, would strike down all or part of it so that they could legislatively “huff and puff” and finish blowing the house down.

Big Bad Wolf: “I’ll huff and I’ll puff and I’ll blow your house down!” Three Little Pigs, 1933. Courtesy Walt Disney Company.

But it turns out that the Court took the position of the third little pig and, in declaring the law constitutional, revealed a house made of bricks.  It’s rather like that moment on the television show, Extreme Makeover (Huh, something familiar about that…), where at the moment of climax as the family stands in nervous anticipation, the crowd yells in unison, “Driver, move that bus!”  Only in this scenario, the Republicans and their conservative wolf pack are not overcome with emotion at the fabulous new home standing before them, but rather are stunned, being confronted with an edifice made out of material largely impervious to their huffing and puffing.

Here’s the thing.  The story ends with the wolf leaving in abject defeat, his hunger unsated.  Conservatives, however, apparently lack the capacity to see they have lost this fight and therefore continue to huff and puff, launching into tirades to any convenient warm body holding a mic and a TV camera, insisting that they have actually won and it’s only a matter of four months until the General Election to prove that point.  Already, they have coined a new term to try to recapture their bluster: Obamatax.

We will be subjected in coming months to their incessantly chanting this new mantra as the justification for their huffing and puffing, but they fail to realize the American people just aren’t that stupid and soon it will become distracting background noise.  In fact, it already is.  Yes, the Supreme Court changed the word “penalty” to “tax” but despite the conservative’s vitriolic demonstrations of outrage and consternation over the ACA being declared “constitutional” there is nothing new here.  Nothing.

It is completely dishonest to claim that on June 28, 2012, President Obama imposed a new tax on Americans.  Completely dishonest.  And it only piles a huge mound of disingenuous, uh, bovine excrement, on top of that dishonesty to claim that President Obama lied to the country by promising there would be no new tax.  There wasn’t and isn’t.  Chief Justice Roberts bears the responsibility for substituting the words in his ruling.  The wailing and gnashing of teeth on the part of the GOP and the hyper-cons is all for show, political theater at its most profane.  Over-played and badly acted, at that.

The inconvenient truth for the Republicans is that the statue of their graven idol, Antitaxus Ultimatum, has feet of clay.  The Supreme Court just took a sledge hammer to it.  It now teeters, susceptible to collapse from the tiniest puff of air from a butterfly’s wings.  Or a poorly aimed huff from one of their own, say, perhaps one Mitt Romney?

I see two important lessons that Democrats should learn (and avoid at all costs) from the Republicans: If you lie to the American public long enough on the theory that the one who shouts the loudest is telling the truth, it does not take long for you to start believing your own lies.  Second, once you begin believing your own lies, you lose all perspective regarding the reality that ultimately the Big Bad Wolf failed.  He could not blow down the house made of bricks. Ever.

Why?  The answer springs forth in the words of the man who neither succumbed to the lie nor lost his perspective of what it means to be an American:

“…that this nation under God shall have a new birth of freedom, and that government of the people, by the people, for the people shall not perish from the earth.”

Abraham Lincoln, November 19, 1863. The Gettysburg Address.

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Is Health Care a Constitutional Right?

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A Constitutional Right to Health Care?

The assertion that we have a right to medical care is one of the pillars supporting the Affordable Care Act.  Not the sole pillar, but one of them.

Photo Courtesy Blue Ridge Community College, NC

As with all of our rights, it has to be built up from some source that is part of the foundation of the national edifice.  Being a democratic republic, as I understand it, we in the United States have two sources.  One is the Constitution, and the other is the statutory authority given the various levels of government both federal and state by the Constitution.

Do we have the Constitutional right to medical care?  Read More…

The Supreme Court and the ACA: The Ultimate Death Panel?

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I started Extreme Thinkover in the fall of 2008.  The presidential race was in full swing.  Universal health care was one of the major topics that the candidates, media, and the public were debating.  One of my primary motivations for creating the blog was to have a forum in which to express my ideas about the health care debate.

I’ve worked in the health care industry for nearly 16 years and have daily contact with patients and families in the hospital.  I hear their stories, good and bad, about what these hospitalizations are doing to their lives.  Yes, what the hospitalization is doing to their lives.

Here in America, going to the hospital is not just about getting medical treatment; it’s also about entering a very broken and extremely expensive system. It nevertheless tries to limp along: In all fairness to the medical professionals who work very hard on behalf of their patients, in most cases, if you find yourself hospitalized, you get reasonably good medical care.

However, in the middle of this is an ongoing battle with the major health care players (hospital systems, health insurance, pharmaceuticals, medical equipment providers, etc.) all wanting to maximize their profits in an economic power race that too often is at the expense of the quality of care delivered to the patients who pay for their services, as well as forcing ever-increasing demands on their care givers to do more with less.  Admittedly, it doesn’t happen everywhere, but it is far too pervasive in Rube Goldberg “system” that passes for health care in America.

I wrote in fall 2008:

Here’s the question: What kind of treatment and medical care is needed so that all Americans can be healthy, or as healthy as possible?

That perhaps is not the question you expected to hear. The national conversation has focused on how much will it cost to provide all Americans with health insurance, how will the spiraling costs of health care be brought under control, will taxes have to be raised to pay for it, what will the roles of the health insurance industry, and the medical industries, and most of all the federal government be? Tough questions all around.

That question, “What kind of treatment and medical care is needed so that all Americans can be healthy, or as healthy as possible?” remains the key to a successful national health care program.  It also remains almost totally ignored by politicians, lobbyists, and, sadly the American public, none of whom have yet realized that without answering this question first, in my opinion, the debate about the cost cannot be resolved.  I contend this is why the health care law polls low for national support.

The current law, the Patient Protection and Affordable Care Act, passed in 2010, nibbles at the edges of what I think is essential, but it, also, is far too focused on trying to control medical costs.  And in case you are wondering, yes, I’ve read the law cover to cover.

Beginning Monday, March 26, the Supreme Court of the United States is going to hear arguments for and against the PPACA.  The primary question before the Court is whether Congress overstepped its authority regarding the interstate commerce clause of the U.S. Constitution by mandating all Americans (sort of) be required to purchase health insurance.  The debate is guaranteed to be rancorous, even in the sedate and forcibly polite setting of the Supreme Court.  The debate, though, once again is all about the money.  A healthy America will likely never even come up. The pundits will have a field day with this, without question, but I doubt any will see the fundamental flaw in all the arguments, based on my point of view.

Will the justices see past the smoke screen of political ideology, special interest group pressure, and inflammatory rhetoric that is fueling these proceedings?  If they do, and declare the law constitutional, there is hope that the ACA can continue to be refined, actually moving toward being a mechanism to support a healthier America.  If they don’t, by striking down all or parts of it, the Supreme Court will, for all intents and purposes, become the Ultimate Death Panel, condemning tens of millions of Americans to poor health, premature, and in some cases, an agonizing death because they will have been denied the right to even the most basic level of health care.  And that, tragically, just months before a law already on the books would have given them the care snatched away by the Supreme Court Death Panel.

Now we wait to see how this court rules on the fate of Americans’ health for generations to come.

The Thinkover:  When Patrick Henry uttered those iconic words, “Give me liberty or give me death!”  he wasn’t suggesting that death was preferred outcome of that stand for patriotism.  So far, the opponents of the ACA have been clueless to this obvious distinction in demanding “liberty” from the ACA mandate.