When Harry Became Sally

https://www.youtube.com/watch?v=BoeBLvIe5mk

The individual mandate

It's my understanding that the GOP tax bill repeals the individual mandate. In one respect that's a good thing, but if it leaves other Obamacare provisions intact, including the requirement to insure everyone with preexisting conditions, isn't that an unfunded mandate leading to a death spiral, which in turn leads to a single-payer system? That's what liberals wanted all along. 

Cryfest

https://www.youtube.com/watch?v=O3v30jVtXMI

There are other fallacies in Kimmel's sob story, besides what Shapiro exposed:

i) For many or most folks, Obamacare made healthcare far less affordable. And some physicians are leaving the medical profession because they aren't adequately remunerated under Obamacare. 

ii) There's no one-to-one correspondence between affordability and availability. Kimmel praises the world-renown pediatric heart surgeon who operated on his newborn. But there's only so many world-renown pediatric heart surgeons in the world. Even if every patient could afford it, that doesn't mean everyone will magically have access to world-class physicians. Patients outnumber cream-of-the-crop medical specialists by a wide margin. 

iii) Kimmel acts as if conservatives were happy with the situation prior to Obamacare. But many conservatives think we needed to overhaul the system long before Obama or Hillary. For instance, tort reform to lower malpractice premiums. Likewise, competition between states for health insurance. 

iv) Kimmel is a rich talkshow host. It's not as if he can't afford to pay out of pocket. 

v) Finally, if we lowered tax rates, more people could afford healthcare. Likewise, more people could afford to donate to hospital charity funds. 

Supreme Court to hear WTS case

http://www.wts.edu/stayinformed/view.html?id=2038

No, Donald, Single-Payer Health Care Doesn't 'Work Incredibly Well' In Canada & Scotland

http://www.forbes.com/sites/theapothecary/2015/08/07/no-donald-trump-single-payer-health-care-doesnt-work-incredibly-well-in-canada-scotland/print/

Doctor/patient confidentiality

Obamacare is just a means to an end, not an end in itself. The real goal is a gov't-run healthcare system. Barney Frank, an architect of Obamacare, admitted that in a 2009 interview:

Because we don’t have the votes for it. I wish we did. I think if we get a good public option that could lead to single-payer and that’s the best way to reach single-payer.  

http://www.breitbart.com/blog/2014/08/04/flashback-barney-frank-told-the-truth-about-single-payer-but-didn-t-volunteer-it/

He didn't quite explain how Obamacare is transitional to a single-payer system. One possibility is that it's a softening-up exercise. It prepares the public for a single-payer system.

There is, however, a more cynical theory. That Obamacare was designed to destroy private healthcare by producing a death spiral in the private insurance market. Here's a description:

Obamacare’s community rating results in insurance prices that are higher for younger people than they would be in a free market, and its guaranteed issue allows people to sign up for insurance even if they get sick, so young and healthy people have ample incentive to forgo insurance. This leaves the insurance “risk pool” older and sicker and, hence, more costly to insure. Premiums will have to rise to cover those costs, leading some of the younger and healthier people who did initially sign up to then drop out. The risk pool then becomes even older and sicker, premiums rise again, and the process repeats. 

http://thefederalist.com/2015/06/02/the-obamacare-death-spiral-is-still-coming/

Now, why do I bring this up? There's a tradition of doctor/patient confidentiality, as well as doctor/patient privilege. But a single-payer system will erase the doctor/patient confidentiality/privilege? To begin with, if physicians are actually gov't employees, then your medical records are gov't records. Even if technically, only a subset of gov't employees has access to the records, there is no real doctor/patient confidentiality. Also, it's trivially easy for "confidential" records to be accessed by unauthorized personnel. 

And even if the physicians don't work directly for the gov't, if many of the treatments require authorization by some gov't bureaucrat, then once again, there will be a gov't record of the patient's condition and treatment. 

Perhaps a parallel objection might be raised with respect to physicians who must request authorization from a private health insurance company. That's a problem, but that's still different from the gov't knowing all about your sensitive medical conditions.

Also, Americans didn't always have health insurance. That's not a given. 

Subverting democracy

http://www.nationalreview.com/node/420315/print

A system of rubber checks and thumbs on the balance

The Anti-Constitutional Consequences of King v. Burwell

By George Will — June 25, 2015

The most durable damage from Thursday’s decision is not the perpetuation of the ACA, which can be undone by what created it — legislative action. The paramount injury is the court’s embrace of a duty to ratify and even facilitate lawless discretion exercised by administrative agencies and the executive branch generally.

While purporting to not apply Chevron, Roberts expands it to empower all of the executive branch to ignore or rewrite congressional language that is not at all ambiguous but is inconvenient for the smooth operation of something Congress created. Exercising judicial discretion in the name of deference, Roberts enlarges executive discretion. He does so by validating what the IRS did when it ignored the ACA’s text in order to disburse billions of dollars of subsidies through federal exchanges not established by the states.

Thursday’s decision demonstrates how easily, indeed inevitably, judicial deference becomes judicial dereliction, with anticonstitutional consequences. We are, says William R. Maurer of the Institute for Justice, becoming “a country in which all the branches of government work in tandem to achieve policy outcomes, instead of checking one another to protect individual rights. Besides violating the separation of powers, this approach raises serious issues about whether litigants before the courts are receiving the process that is due to them under the Constitution.”

The Roberts Doctrine facilitates what has been for a century progressivism’s central objective, the overthrow of the Constitution’s architecture. The separation of powers impedes progressivism by preventing government from wielding uninhibited power. Such power would result if its branches behaved as partners in harness rather than as wary, balancing rivals maintaining constitutional equipoise.

Roberts says “we must respect the role of the legislature” but “a fair reading of legislation demands a fair understanding of the legislative plan.” However, he goes beyond “understanding” the plan; he adopts a legislator’s role in order to rescue the legislature’s plan from the consequences of the legislature’s dubious decisions. By blurring, to the point of erasure, constitutional boundaries, he damages all institutions, not least his court.

http://www.nationalreview.com/node/420320/print

Abetting deception

I ran across I comment on the Obamacare ruling with I will use as a foil:

A lot of the criticism I'm seeing of this decision would cut against many apologetical arguments for the consistency of scripture, undermining the principle of "scripture interprets scripture" and such. It's as if it's impossible for something to look like it means something on the surface but really mean something else, where you can tell it by looking elsewhere in the document to see what the overall intent was. That point can be observed even in original public meaning, as long as the principle of charity is in operation to guide how we interpret the public meaning. We don't have to turn to intent derived from looking at external documents to get such a thing.
It's a separate question, of course, whether their arguments for interpreting things this way are correct, but much of the rancor I'm seeing from conservatives against the Roberts opinion would seem to me to undercut some of the better apologetical arguments defending scripture from the charge of contradiction (ones that are eminently reasonable when you take a whole book into account but seem unlikely if you only look at one verse, say).

For several reasons I disagree with his comparison:

i) Inerrantist Bible scholars pursue harmonistic strategies under the presupposition that the Bible can't contain substantive contradictions. But that's disanalogous to an uninspired piece of legislation.

ii) Some Bible scholars who aren't committed to inerrancy, or who bracket inerrancy for methodological reasons, still pursue harmonistic strategies because they think a good historian doesn't automatically assume that apparent contradictions in his source material are actual contradictions. He should first explore whether there are reasonable harmonizations. 

However, even on that weaker principle, the alleged parallel breaks down. Obamacare is a huge, complex bill (2700 pages). A consensus document. Lots of compromises. Lots of horsetrading to get the necessary votes for passage. Probably no Democrat who voted for the bill even read it in toto. Under those circumstances, it is to be expected that the bill will contain actual contradictions. 

iii) In addition, bills like this contain many loose ends because they don't detail policies; rather, they authorize an agency of the executive branch to use these laws as general guidelines to formulate specific regulations. It's up to the secretary of HHS and her team to tie up all the loose ends. Under those circumstances, there's no reason to think the bill will be free of inconsistencies. 

iv) Even more to the point, on at least four occasions, Jonathan Gruber, who basically ghostwrote the disputed provisions, publicly admitted that the wording of the provisions was intentionally deceptive. The wording deliberately concealed the true intentions of the lawmakers. Had the lawmakers can been candid about their real aims, they would have been unable to secure enough votes for passage. The proposed bill would be too unpopular with the electorate. 

But a deliberately devious formulation scarcely merits charitable reading. It's not an epistemic virtue to play the fool for a deceiver. It's not an epistemic virtue to let someone pull the wool over your eyes. It would be gullible to give a known deceiver the benefit of the doubt.

Roberts calls it "inartful drafting." To the contrary, it was very artful drafting. It was willful dissimulation. 

v) In addition, the court has no duty to do the dirty work for Congress. The court has no obligation to honor the mendacity of the lawmakers who were acting in bad faith by rewriting the law to make it say what it doesn't say because lawmakers duplicitously wrote something different than what they really meant the provisions to achieve. 

All things being equal, I think the court ought to take legislative intent into consideration. But not if the text of the law is an exercise in studied prevarication. It is not the duty of the court to collude with lawmakers in committing legislative fraud.  

Several hours later, the same person I quoted made some observations similar to mine–although I take a harder line. He went on to say:

The ambiguity argument was a different one. The claim there was that the text could be read either way but that they can choose to interpret it in the way that leads to the best consequences if it's genuinely ambiguous. They chose not to go that way.
What they instead said is that, in context in terms of what the rest of the law says, the best interpretation of this one particular line is that it doesn't mean what the surface meaning would lead you to expect if taken by itself.
That's an error in interpreting the rest of the act, i.e. the particular reasoning in the opinion, not an argument against the type of reasoning being done here, which is what many conservatives are unwisely giving without thinking of how terrible it would be to apply that kind of criticism across the board.
The other problem I have is that it's not clear the act is even consistent. Roberts did take them to task for how badly it's written, how the closed-door sessions, multiple authors, and limited ability for members to read it before voting makes it a bad law even apart from what it requires. I'm not sure he appreciates how bad, thought, because there's a plausible argument that it's not ambiguous between the two readings but is just plain inconsistent because it outright asserts both conflicting readings.
In such conditions, judges have been known to make a call to remove a contradiction, usually relying on some kind of revealed intent, but I don't think that works here, because you have Gruber and the other architects saying one thing and the others who were totally unaware of what he act did who added other stuff that conflicted with it, and there just isn't one original intent. That's much more plausible to me than the one-meaning Roberts view, the ambiguity view that they rejected, or the one-meaning but other-interpretation view of the dissent. 

Supreme Court strikes down Obamacare!

Some readers might find the title of my post confusing. Didn't the Supreme Court uphold Obamacare rather than strike it down?

Only if you operate with a wooden, binary view of lexical semantics according to which words have objective meanings. But twice now, Chump Justice John Roberts has taught us that legal language has no objective meaning. 

Roberts and his allies on the bench have taught us that "tax" and "penalty" are synonyms. Who knew? "Established by the state" really means "not established by the state," or "established by the Federal government."

Therefore, I apply to the majority opinion the same semantic relativism which the majority opinion applies to statutory law. 

Since, according to the hermeneutical principles of Chump Justice John Roberts, antonyms are synonyms, since the meaning of one word can be arbitrarily reassigned to another word, if I were a chief executive (i.e. president, governor, mayor), I'd commend the Supreme Court for striking down Obamacare, and proceed to dismantle it.

It was a lie all along

http://dailycaller.com/2014/11/09/obamacare-architect-lack-of-transparency-was-key-because-stupidity-of-the-american-voter-would-have-killed-obamacare/?print=1

Inverted priorities

In Washington on Friday, while military officials announced that the Army would more than double the number of soldiers it is sending to West Africa to help contain the Ebola virus there, senior White House officials tried to play down the series of missteps in the handling of the Ebola case in Dallas. They insisted that the public health system in the United States was working effectively and would prevent an epidemic of the deadly virus from taking root in this country. 

http://www.nytimes.com/2014/10/04/us/containing-ebola-cdc-troops-west-africa.html?_r=0

i) Um…doesn't that risk exposing US soldiers to the deadly disease? And if they're infected, where will they be treated? Walter Reed? 

ii) This suffers from a fundamental inversion about what our armed forces are for. The US military exists to protect Americans and American assets. 

That's especially the case when the assignment puts our troops at risk of harm or death. National defense is an extension of self-defense. For instance, if a burglar breaks into your home, it's the duty of a teenage son to protect his mother or younger brothers. He hazards his life to protect theirs. Family members have that duty to one another. 

Every soldier is someone's husband, father, son, or brother. A US president doesn't have the right to risk their life on behalf of someone who's not part of the social contract. An American soldier shouldn't have to die for a non-American–unless it's a military alliance. 

The principle of national defense involves reciprocity. I'm prepared to die for you if you're prepared to die for me. Pooling our collective resources for the common defense. It's for the benefit of people who have a stake in the system. Shared risk, shared reward. 

iii) On a related question: why are we even treating Duncan? Why should US hospitals supply free medical services for someone from another part of the world who decides to hop on a plane and come here? 

Yes, I know that sounds cruel, but there are 7 billion people on the planet. The US is not and cannot be a free health clinic for all the desperately ill people outside our borders (not to mention illegals inside our borders). We don't have the resources, and it's not our duty. 

Duncan is a looter. He's siphoning medical resources away from American families who've paid into the system. 

Consider the drain on hospital resources just to treat one Ebola patient. We can't have an open-door policy for anyone to hop on a plane and demand free medical services. 

I mean, who's footing the bill for Ducan's treatment? I assume the hospital will have to pass the cost along to paying customers. Keep in mind that Obamacare is already stressing a struggling healthcare system beyond the breaking point. 

It's different for the medical missionaries. They're Americans. And they're risking their lives to save lives. Duncan, by contrast, is risking lives to save his life. 

(Mind you, I think it would be more prudent to treat the medical missionaries on site.)

Hobby Lobby

A detailed legal analysis:

http://christianthought.hbu.edu/2014/06/30/on-hhs-vs-hobby-lobby/

Kathleen Sebelius v. Lemonade Stand

Reuters

In a 5-4 vote, the Supreme Court sided with plaintiffs Tina and Tabitha Brown (ages 6 and 8). The DOJ, acting on behalf of HHS, had filed suit against Tina And Tabitha Brown, proprietors of a lemonade stand, for noncompliance with the Affordable Care Act. 

In a blistering dissent, Justice Ruth Bader said "The exemption sought by Tina and Tabitha's lemonade stand operation would deny legions of little girls who don't hold their employers' beliefs access to Viagra and vasectomies."

Ilyse Hogue, President of NARAL Pro-Choice America said: "Allowing lemonade stand bosses this much control over the health-care decisions of their employees is a slippery slope with no end. Every American could potentially be affected by this far-reaching and shocking decision that allows big sisters to reach beyond the lemonade stand and into their kid sister's bedrooms. The majority claims that its ruling is limited, but that logic doesn't hold up. Today it's birth control; tomorrow it could be executives denying asthmatic employees the right to carry inhalers."

Presumptive presidential hopeful Hillary Clinton said: “It’s the first time that our court has said that a lemonade stand has the rights of a person when it comes to religious freedom, which means little girls selling lemonade can impose their religious beliefs on their employees, and, of course, denying lemonade stand checkout operators the right to contraceptives as part of a health care plan is exactly that."

"Free" contraceptives

I'm no expert on health insurance, but I find the mindset of liberals on this issue peculiar.

i) First of all, liberals operate with the shortsighted notion that if their employer "gives" them something, like "free" contraceptives, they don't have to pay for it. Really?

If it costs a business something to provide contraceptives to employees, then that is coming out of someone's pocket, is it not? On the face of it, there are only two candidates: either the business is charging customers more to defray the cost, or else the company is paying the employee less. Or both. 

So what's the advantage of making less, of having a smaller paycheck, so that someone else can use your money to buy you contraceptives? 

Also, if all businesses above a certain size are legally required to provide contraceptives, and if the company must raise prices on goods or services to do that, then consumers in general are subsidizing contraceptives. And employees are consumers. So aren't you paying for it one way or the other? Either it comes out of your paycheck or it comes out of the hidden surcharge for whatever you buy. 

Put another way, if businesses weren't require by law to provide contraceptives, they could afford to pay their employees more. Likewise, if they weren't required by law to provide contraceptives, they could afford to charge their customers less.

So isn't it a tradeoff? Yes, you have to buy your own contraceptives, but your take-home pay is higher. 

ii) Another problem is that, to my knowledge, companies are often required to provide a preset package of healthcare benefits, whether or not you need all or most of the benefits. In effect, you're paying for a lot of benefits that don't benefit you. Paying for lots of stuff you don't need and don't use. In effect, the company is garnishing your wages.

I suppose the theory behind this is to spread the cost around. Make healthcare more expensive for more people so that it's less expensive for a few. Fewer people using more benefits over against more people using fewer benefits. 

Again, though, that's a tradeoff. You're making healthcare more expensive for many or most people to make it less expensive for fewer people. What if a company is required to offer 20 different kinds of contraception, even though you only use one kind. Or what about postmenopausal female employees who don't need contraception?

We can debate the pros and cons of this arrangement, but I'm struck by how nearsighted many liberals seem to be. Let's consider some alternative arrangements:

a) There's a distinction between a business offering insurance and a business providing insurance. 

Suppose a company was able to give employees an opt-out option. The company would provide insurance coverage if you want it, but you are given a choice. If you receive coverage, you will receive less pay–if you decline coverage, you will receive more pay. If you opt out of company-sponsored insurance, less money will be withheld from your paycheck. What you do with your extra income is up to you. You could get private insurance. Or, if you're young and healthy, you might prefer to be uninsured–and pay out of pocket on a fee-for-service basis if you need to see a doctor.

Is there some obvious reason why that would be an outrageous arrangement?

b) Likewise, what about customized insurance packages where you pay for as much or little coverage as you want or need? Why not give policyholders a checklist of items to choose from? They are free to select what they want or need, rather than paying for the entire menu. Is there some reason why that would be an outrageous arrangement? Is having the freedom to spend your own earnings on what you want such an evil notion?

Obamacare death spiral

http://acadeathspiral.org/

Hobby Lobby

http://www.forbes.com/sites/ryanellis/2014/04/02/hobby-lobby-owners-can-have-a-401k-and-first-amendment-rights/print/

Public accommodations

This issue crops up in the current debate over religious liberty:

http://www.volokh.com/2010/05/25/some-strange-consequences-of-public-accommodations-laws/

The Affordable Hair Act

The Washington Post

March 13, 2017

Last year, as readers may recall, President-for-Life Barak Obama introduced the Affordable Hair Act to improve the availability of wigs and toupees for aging rock stars and transgender individuals. All Americans 18 years old and above were required to purchase gov't approved hairpieces. 

Youth groups initially objected on the grounds that teens and twenty-somethings with full heads of hair shouldn't be required to buy wigs and toupees, but as Kathleen Sebelius patiently explained, it was necessary for those who didn't need them to invest in the follicular risk pool to make hairpieces universally available for those who might need them. She also shamed youthful dissidents as freeloaders. What if, 40 years from now, they needed a wig or toupee? 

Under the Affordable Hair Act, the Consumer Products Safety Commission recalled wigs and toupees manufactured before 2016 which failed meet the stringent new standards. Americans were required to turn in substandard hairpieces at collection stations around the country or face stiff fines and jail time. 

Today, acting on a tip from the NSA, an M1 Abrahms convoy of ATF agents descended on Polly Parton's estate to confiscate contraband wigs. Escaping through the back door, Miss Parton was kneecapped by a domestic drone. After handcuffing the country music star, she was airlifted to GITMO. 

There are lies and then there are lies

Even when presidents are caught in lies, they often get away with it. Likewise, many presidential scandals lack traction at the voting booth. 

Obama lied about Benghazi, but that didn't cost him reelection because it happened half a world away. The very name sounds foreign. So, for many voters, that's just an abstraction. They don't see the relevance to them.

Likewise, NSA snooping isn't overly intrusive. Not something you're normally aware of. So for many voters, out of sight–out of mind. 

Likewise, the very fact that the IRS selectively targeted conservative groups means most voters don't pay attention. 

By contrast, Obamacare is lie that sticks. It affects too many voters. It affects them drastically. And it affects Democrat voters as well as Republicans. So that's not something that Obama can talk his way out of by giving another speech or interview. Words won't make it go away. Tens of millions of cancelation notices go out. 

It's more like a freeway pile-up that keeps getting worse. A chain-reaction.

You have the dysfunctional exchanges. That makes a very bad first impression.

In addition, if, due to the technical difficulties, only the most desperate individuals are prepared to log in the necessary hours to get through, that means the sickest, most expensive individuals are signing up first, which (so I've read) will spike premiums and deductibles for those who wait later to sign up.

Lack of security protocols will further alienate the electorate. 

But in a way, the dysfunctional exchanges mask the deeper problems. When you successfully enroll, that's when the trouble begins in earnest. The system is lowballing enrollees on the actual cost. So they are in for a rule surprise when they find out what the premium and deductibles really amount to. 

If that wasn't bad enough, not only are enrollees generally paying much more (they are frequently ineligible for the subsidies), but many doctors and hospitals are opting out of Obamacare. So you're paying more while losing access to the best doctors and hospitals.