“It’s like Purelling the Gum Wall and then taking a piece to chew.”
Side-effect disclaimers are generally a laff-riot (unless you're the target demographic), but this commercial for Axiron (embedding not allowed; I wonder why), which is testosterone therapy that men can paste onto their armpits, just screams "wrong." To wit: "Women, especially those who may become pregnant, and children should avoid contact where Axiron is applied, as unexpected signs of puberty in children or changes in body hair or acne in women may occur."
Look, I'm all for dudes getting their junk fixed if it doesn't work, but YOWZA—that's messed up, Jack! What if little Johnny gets into the medicine cabinet and thinks this stuff is shaving cream? Or little Janie decides to play makeup? I'll tell you what happens: PUBIC HAIR BEARD. Just swallow a pill or take the injection, pls. How much harder is that? In other news, I got cable last weekend (which is how I saw this most disturbing commercial), and I basically haven't left the house since.
If you're anything like me, you awoke this morning with an entire three-pound turkey leg resting uncomfortably and snoring loudly inside your upper intestine, refusing to awake. It took a while, but I finally rousted him from his slumber and made him move along—though it took a grand total of four separate trips to the can. Here's my recipe:
One ginormous cup of black coffee.
One large bowl of Kashi's GoLean cereal (with 10 grams of fiber).
Followed by an exerting series of sidebends, backbends, and sit ups.
The result? It was like the Ghostbusters stepped into my colon armed with power washers.
However! I'm always looking for faster, more efficient methods of bowel expurgation—and I trust you to supply those in the comments below. BOMBS AWAY!
Last week, I wrote about my (probably unhealthy) fascination with the state's DoH disciplinary announcements. Here's an item from this week's newsletter.
In October 2012 the Unlicensed Practice Program notified [redacted] of its intention to issue a cease-and-desist order for performing veterinary dentistry without a credential as a veterinarian or veterinary assistant. Charges allege that [redacted] was paid $150 for aligning, balancing, and correcting teeth on two horses in February 2012. He later admitted to a Department of Health investigator that he had performed equine dentistry on the two horses. He represented himself as an equine dentist and advertised his services on bulletin boards in the Port Angeles area and on his website.
Ever wondered if there was an equine dentistry/gnathology museum? Wonder no more! (And be sure to click on the play button to hear the groovy tunes of the Equine Gnathological Training Institute, Inc.)
Courtesy of the Wall Street Journal (courtesy of someone I overheard talking about the article the other day): more than you ever wanted to know about ear wax removal, including the TRUTH ABOUT EAR CANDLING.
In my experience, ear candling is scary—it DOES seem like you might very easily catch your hair on fire—and it doesn't actually do anything (thanks a lot, Satan!). If your ear gets weird, like it's popping from time to time and you feel a little "WHAT?" on that side, I second the put-a-few-drops-of-hydrogen-peroxide-in-it recommendation in the WSJ (it's doctor-approved and Beelzebub-free!). Lie on your side and have a friend pour the hydrogen peroxide in, and be ready: It bubbles insanely, as if your entire head has been filled, suddenly, with hysterically delightful champagne. Then, voila: ear all better! Unless something's really wrong in there.
I just received my semi-weekly email from the state Department of Health about all the doctors, nurses, dental hygienists, and other health-care professionals in trouble.
The updates are tragically voyeuristic reading, and have that special can't-not-look-at-a-car-crash magnetism. Besides the usual rounds of people stealing drugs, forging prescriptions, and having "inappropriate relationships" with patients (those are the big ones), some items are especially depressing and/or bizarre. Such as:
The Nursing Assistant Program charged registered nursing assistant [redacted] with unprofessional conduct. [Redacted] allegedly falsified timesheets claiming she had provided 52 hours of care to a patient and was then paid by the Department of Social and Health Services for time she didn’t work. Charges say [redacted] took a heavily medicated patient shopping and coerced the patient into buying things for her.
In September 2012 the Nursing Assistant Program charged registered nursing assistant [redacted] with unprofessional conduct. Charges say [redacted] allegedly didn’t properly supervise a patient with special care needs. The unsupervised patient ate laundry detergent. Charges say the detergent may have contributed to the patient’s death.
In September 2012 the Nursing Assistant Program granted the credential of certified nursing assistant [redacted] and placed it on probation for at least one year. [Redacted] entered into an agreed continuance for a charge of drive-by shooting in 2012.
I called up Sharon Moysiuk, the very nice DOH communications officer who sends these updates, to ask if they were an especially depressing part of her job. "Well, yeah," she said. "Sometimes you see the stuff people do and it's just, like, 'oh my gosh.'"
She said she'd been working at that job for four years. In that time, what was the strangest disciplinary item she remembers seeing? "You kinda set that aside and just edit them," she said. "Having opinions about them isn't really part of it."
But items like that nurse who took the medicated patient out shopping—those that have to stick out, right?
"Oh, that's not the first time I've seen that, someone going shopping with someone who's medded up," Moysiuk said. So she's just about seen it all? "Yeah, I guess so."
The New York Times Mark Bittman writes about a fascinating (though not particularly surprising) ten-year Department of Agriculture study on 22 acres of Iowa State University farmland:
[R]esearchers set up three plots: one replicated the typical Midwestern cycle of planting corn one year and then soybeans the next, along with its routine mix of chemicals. On another, they planted a three-year cycle that included oats; the third plot added a four-year cycle and alfalfa. The longer rotations also integrated the raising of livestock, whose manure was used as fertilizer.
The results were stunning: The longer rotations produced better yields of both corn and soy, reduced the need for nitrogen fertilizer and herbicides by up to 88 percent, reduced the amounts of toxins in groundwater 200-fold and didn’t reduce profits by a single cent.
This type of integrated, long-rotation land management is what farmers practiced for generations before the widespread adoption of chemical fertilizers and pesticides starting in the mid-20th century, so I personally don't find its efficiency all that surprising. These longer rotations required more labor, the study found, but fewer expensive chemical inputs, so the costs balanced out in the end.
And note, we're not talking organic here. Chemical fertilizers, pesticides, and herbicides were still used when needed, but only when needed, as opposed to on some Monsanto-dictated regime. As Bittman observes:
PopSci says that if you have a pacemaker, hackers could now kill you.
Pacemakers could be infiltrated to deliver deadly shocks, according to a security expert. It wouldn’t be simple, but it offers the very James Bond-like possibility of anonymous digital assassination.
Hackers could also acquire personal information from pacemakers. Or they could just become mass-murderers with a few keystrokes:
“The worst case scenario that I can think of, which is 100 percent possible with these devices, would be to load a compromised firmware update onto a programmer and … the compromised programmer would then infect the next pacemaker or [defibrillator] and then each would subsequently infect all others in range,” he reportedly said.
I don't really know that anyone would have the motivation to murder a bunch of people via their pacemakers, but it's certainly a design flaw. Also: This scenario will be featured in a CSI-style TV show in a matter of months.
As I've written before, the biggest issue in the gubernatorial campaign—the one that will have the most impact most immediately on the most people—is Medicaid expansion. At stake is health insurance coverage for nearly 350,000 low-income Washingtonians.
Democrat Jay Inslee favors participating in the Medicaid expansion provisions of Obamacare, saying it will save the state hundreds of millions of dollars. Republican Rob McKenna appears to oppose Medicaid expansion, claiming it would be too costly and would drive people out of the private insurance market. Well, they can't both be right, so let's look at the numbers.
Under the Medicaid expansion provision about 261,000 Washingtonians would become newly eligible for Medicaid. Rather than the usual 50-50 federal-state split, the federal government would pick up 100 percent of the cost through the first three years, gradually decreasing to 90 percent by 2020.
That's a pretty good deal; 261,000 more Washingtonians would receive health insurance, but Washington taxpayers would pick up only 1.5 percent of the cost over the first seven years, and only ten percent thereafter. That's hundreds of millions of dollars we won't have to pay through taxes or cost-shifting, while expanding access to hundreds of thousands of our neighbors. Who could be opposed to that?
But wait, McKenna warns. What about the 82,000 Washingtonians who are already eligible for Medicaid, but currently not enrolled? The state would have to pick up 50 percent of the cost of their coverage, an expense, he says, that we simply cannot afford. Judging from his answers during debates, that appears to be McKenna's main objection to Medicaid expansion. (I'd love to discuss it with him in wonky detail, but we're not on speaking terms.)
But once again, McKenna's math is flawed, because the bulk of these 82,000 Medicaid eligible Washingtonians are going to enroll in Medicaid anyway once the personal mandate and other provisions of Obamacare go into effect in 2014. This "Welcome Mat Effect" will be seen with or without Medicaid expansion, and state coffers will be forced to absorb the cost regardless.
A new study of 1,400 girls finds that the HPV vaccine does not alter sexual behavior. That is, those girls who receive the HPV vaccine do not engage in sexual activity earlier, more frequently, or riskier than those who do not. But what really fascinates about this this study is that it was even necessary:
Since public health officials began recommending in 2006 that young women be routinely vaccinated against HPV, many parents have hesitated over fears that doing so might give their children license to have sex.
HPV is the most common sexually transmitted disease in the United States (nearly a third of teens age 14 to 19 are infected), and it is known to lead to cancer of the cervix, throat, and anus. And yet apparently, some parents would rather let their children die of cancer than have sex. Which they're gonna eventually have anyway.
The BIG issue in this year's gubernatorial race is Medicaid expansion. This is the issue that will have the most impact on the most people, most immediately.
If Jay Inslee wins, we get it, expanding health coverage to 350,000 uninsured Washingtonians. If Rob McKenna wins, we don't. The right for states to opt out of the Medicaid expansion is the only thing McKenna won in his anti-Obamacare lawsuit, and he's made clear that he has every intent of exercising this option. And barring the two-thirds vote necessary to override a veto, there's nothing the Legislature could do to stop him.
The Washington State Budget & Policy Center has put together a handy infographic illustrating the "Four Reasons Why Medicaid Expansion is a Good Idea." I've posted the first above, and the other three after the jump:
The Mohave Valley Daily News in Arizona reports that Wexford Health Sources Inc., which took over heath care for prisons in Arizona in July, has already been fined for doing a crappy job—not distributing medication properly (in some cases, not distributing it at all), a nurse who contaminated a vial of insulin and potentially exposed around 100 inmates to hepatitis C, and more:
In the state cure letter, a series of problems were noted. They included a Wexford nurse administering medication to an inmate by having the inmate “lick the powdered medication from her own hand,” instead of putting the medication in a small cup of water.
Other problems included a significant number of inmates not receiving medication. One of those was a Florence inmate who was found hanging in his cell Aug. 23 after not getting his psychotropic medication for the entire month. The letter does not state if the inmate died.
The state said Wexford showed a “lack of urgency” to correct the medication problems, and the state had to deploy staff “to identify inmates in need of medication renewals.”
According to Wexford's website, they've worked with 270 "correctional or other institutions" in 13 states. That includes Washington, where Wexford got in trouble a few years ago for some similar problems:
The issues raised by Evelyn [a former commander in the Clark County Sheriff's Department], as well as the county’s report, are echoed in recent lawsuits against Wexler filed this past summer in New Mexico.
Evelyn’s laundry list of Wexford’s contract violations included the lack of any operating manual or written procedures; inadequate staffing and medical supplies; inadequate training and oversight for medical employees; delays in providing medicine and services to chronically-ill inmates; promotion of workers into positions where they were not properly licensed, and even a refusal by some mental health counselors to provide services to inmates they “didn’t like.”
A Clark County audit later found similar problems with Wexford Health Sources. And here's a kicker: Recent cost studies have shown that Arizona's private prisons are costing the state $3.5 million more per year than the equivalent state-run units in Arizona.
At around 10:30pm we noticed a couple of cop cars and and ambulance on our block. Didn't seem like anything too serious, we could hear the cops talking to an agitated and possibly mentally ill man, the usual talking-him-down stuff. No lights or sirens or weapons or anything.
After a few minutes, they came from around a parked car and we saw that they had him on a stretcher, and for what seemed to be the first time he realized they were going to put him in the ambulance and take him to the hospital. They kept telling him it was for his own safety.
And that's when he really became terrified and kind of lost it. He had been sounding pretty deranged before, but when he saw the ambulance, he completely freaked out. And why? Not because he might be committed, or lose his freedom, or get pumped full of some drugs, or anything like that. No, he lost it because he "[did] not have the money to pay for this." He screamed this over and over and over again, practically sobbing as they loaded him into the ambulance. Begging and pleading to not be given medical help because of the financial disaster he knew it would cause. Heartbreaking.
Obama 2012, and fuck the rest.
Just as tomato season is drawing to close, flu season is almost upon us. But fortunately, a Washington State Department of Health reminds us, this year's vaccine is already widely available.
Everyone six months of age and older should get a flu shot. It’s especially important for young kids, people 65 and older, pregnant women, parents of newborns, and people with medical conditions like asthma and other lung diseases, heart disease, diabetes, and neurologic conditions.
Different types of flu vaccine are available. Besides the regular flu shot, there’s a high-dose vaccine for people 65 and older, and a nasal spray vaccine for healthy people ages 2-49. There’s also a vaccine that has a much smaller needle than regular flu shots. Ask your health care provider which is best for you and your family.
Um, can't imagine why I'd opt for the old-style vaccine with the much bigger needle, but I guess I'll ask my health care provider.
Also of note:
This season’s flu vaccine protects against three different strains of flu virus. It doesn’t protect against the newer H3N2 variant virus that is showing up in other parts of the country. Most cases of this new virus have been from direct contact with pigs at county fairs.
Which is why health officials always recommend that you thoroughly wash your hands after coming into contact with former state senator Luke Esser.
The most cynical aspect of Paul Ryan's budget plan is the way it preserves full Medicare benefits for those in or near retirement, while ending Medicare as we know it for those of us currently under the age of 55. The political gamble was that current retirees would support it because, "Fuck our children and grandchildren, we got ours!"
Um... apparently not.
Fearing that it could open the door for a conservative US Supreme Court to reverse the rights of the disabled, advocates nationwide are pleading with Washington Governor Chris Gregoire not to appeal a 9th Circuit decision instructing the state to fully restore in-home care to 12 senior and disabled plaintiffs.
Ruling in M.R. v. Dreyfus, a 9th Circuit panel determined that across the board state budget cuts that reduced in-home care hours by 10 percent violated the Americans with Disabilities Act (ADA) by threatening to force the 12 plaintiffs into institutionalized care. Under the landmark 1999 Olmstead v. L.C. decision, a 6-3 majority of the US Supreme Court ruled that the ADA requires states to administer services in the "most integrated setting" that meets the individual's needs. Considered by some to be the Brown v. Board of Education for people with disabilities, it was Olmstead that made it possible for millions of disabled Americans to stay in their own homes and communities rather than being institutionalized.
The state has a September 17 deadline to file an appeal (it has asked for an extension to October 1), and Gregoire has clearly signaled her intention to do so, prompting great concern within the disability community that an activist court might seize the case as an opportunity to role back protections.
In an August 29 letter (pdf), two dozen organizations warn Gregoire that filing an appeal "could place at risk one of the most fundamental civil rights of individuals with disabilities, the right to avoid needless institutionalization":
So, yeah, there I was, innocently flipping through yesterday's NYT, just catching up on the Dead Tree News, when I encountered this photo. No disrespect to anyone's religious beliefs... but... um... ugh.
Immunization rates for Washington toddlers improved last year, from 71 percent in 2010 to 75 percent in 2011, putting our state above the national average (74 percent) for the first time ever.
"There are so many tragic diseases that can be prevented by making sure children get recommended vaccines," State Health Officer Dr. Maxine Hayes said in a news release. "It's one of the most important things a parent can do to protect their children, families, and communities from serious preventable diseases."
The state Department of Health survey measures six vaccines—DTaP, polio, MMR, hepatitis B, chickenpox, and pneumococcal—and comes in the midst of a statewide whooping cough (pertussis) epidemic.
Donald Trump is scheduled to play a "surprise" role at next week's Republican National Convention, which, judging from his latest tweet, I'm guessing may involve murdering a baby. Because that's what comes from stupid fucking anti-vaccine celebrities like Trump repeating the anti-scientic bullshit of the stupid fucking anti-vaccine baby killers: Dead babies.
Of course what Trump is responding to is a new S C I E N T I F I C study linking an increased risk of autism and schizophrenia with the increased age of the father. But rather than accepting that at the age of 66, he might want to stop impregnating supermodels with his own aging, mutated sperm, Trump has decided to blame autism on vaccines, citing... absolutely nothing. (Because there is no credible anti-vaccine science to cite.)
Stupid fucking anti-vaccine baby killer.
To repeat: The goal of our immunization programs is to vaccinate enough people to build a "herd immunity" sufficient to protect those with weak or immature immune systems from disease and death. So don't be a stupid fucking anti-vaccine baby killer like Republican Donald Trump. Be a responsible neighbor and vaccinate yourself and your children.
Washington's voters have overwhelmingly approved expanded training and certification requirements for long-term home healthcare workers, twice—by a 73-27 margin for I-1029 in 2008, and by a 65-35 margin for I-1163 in 2011—prompting the union-hating Seattle Times to obsessively call for the union-backed measure's repeal. In some of the dozen or so anti-1163/1029 editorials over the past few years, the editors hypocritically argued that legislators have the "moral authority" to repeal the popular SEIU-funded initiative, decrying it as "increased training that most of their members don't need ."
Well apparently, the US Department of Labor disagrees, recently recognizing SEIU 775NW's training program as a Trailblazer and Innovator of Apprenticeship. "We're supporting a new generation of workers who earn while they learn," Labor Secretary Hilda Solis said at an August 1 event commemorating the 75th anniversary of the National Apprenticeship Act.
"Establishing career pathways for home care aides is transformative not just for the home care aide but also for the long-term care system in general," explained DOL's training partnership executive eirector Charissa Raynor in a press release. "Apprenticeships create an incentive for workers to stay in the field long term, which in turn creates greater stability in the fast-growing long-term care system."
But, you know, it's backed by a labor union. So fuck it.
First of all, if my penis looked like this, I would call 911 immediately. But "penis snake" is what the internet has named this ugly old thing after it was unearthed by engineers who were busy defiling the Madeira River, a major tributary of the Amazon, for some hydroelectric riches. Other notable things about the thing people are calling the penis snake:
It's not even a snake! It's thought to be a caecilian, a "limbless amphibian that resembles an earthworm" and has "poor eyesight and navigate[s] primarily though smell"! Maybe that's why it doesn't appear to have any eyes but gigantic, drug-ready nostrils. It is thought to breathe through its skin! It's totally hung—specimens can reach up to 30 inches! Also, it's not a newly discovered critter! There's been a shellacked one in the Vienna Museum forever, and it's already been named a couple of different things. Lastly, if you didn't click on the first link in this story, look at the less-good picture after the cut. And DON'T CALL IT A SNAKE.
After the US Supreme Court ruled that the federal government could not penalize states for choosing to opt out of the Medicaid expansion provisions of the Affordable Care Act, several Republican governors announced that they would do exactly that. It's an act of defiance that, according to a new study published in the New England Journal of Medicine, will end up killing thousands of their citizens:
State Medicaid expansions to cover low-income adults were significantly associated with reduced mortality as well as improved coverage, access to care, and self-reported health. ... Mortality reductions were greatest among older adults, nonwhites, and residents of poorer counties.
Oh. Well. As long as they're just killing poorer nonwhites, I guess that's okay.
The researchers compared mortality rates for 20 to 64 year olds in three states that substantially expanded Medicaid since 2000 to rates from neighboring states that did not. Researchers found that Medicaid expansion reduced the death rate by 19.1 per 100,000, or 6.1 percent. Rates of access to care, delayed care, uninsurance, and self-reported health status all significantly improved with Medicaid expansion.
While not announcing plans to opt out of Medicaid expansion if elected governor, attorney general Rob McKenna expressed pride in his role in the health care law suit, while stating concerns about the cost of Medicaid expansion in Washington state. He even claimed a victory of sorts following the court's ruling, kvelling "we achieved our goal of defeating the mandate on commerce clause grounds," as if what was truly at stake was some vague constitutional tangent rather than the lives of millions of un- and underinsured Americans.
Compassionate conservatism, and all that.
...but if you think about it for a even second it's a feel-bad story too:
Some of the victims fighting for their lives after being wounded in the movie-theater shooting rampage may face another challenge when they get out of the hospital: enormous medical bills without the benefit of health insurance.... Three of the five hospitals treating victims said Wednesday they will limit or completely wipe out medical bills. Some of the victims, however, still face a long recovery ahead and the associated medical costs—without health insurance.
Three hospitals aren't going to go after uninsured shooting victims—they're not going to take them for everything they're worth, they're not going to send them to collections, they're not going to bankrupt them—and that's good news for the uninsured victims of the Aurora movie theater shooting. But uninsured shooting victims in Colorado who weren't fortunate enough to get shot in a particular movie theater on a particular night? Those people are still screwed. The same three hospitals being praised for wiping out the medical bills for the uninsured Aurora shooting victims will continue to bankrupt other victims of other shootings. Because that's how our system works.
And some of the people who might wind up bankrupted? The insured victims of the Aurora theater shooting. Sixty percent of bankruptcies in the US are caused by medical bills and more than 50% of those bankrupted by medical bills actually had health insurance. Take it away, Justin Beiber:
Asked if he wanted to become an American citizen, Bieber made clear his love for Canada—and its health care system. "You guys are evil," he told the magazine. "Canada's the best country in the world. We go to the doctor and we don't need to worry about paying him, but here, your whole life, you're broke because of medical bills. My bodyguard's baby was premature, and now he has to pay for it. In Canada, if your baby's premature, he stays in the hospital as long as he needs to, and then you go home."
Our system is sick. Still.
From this week's I, Anonymous:
There was a time when the various organizations and programs in Seattle were geared toward finding homes for the homeless, particularly the aged and disabled like myself. Nowadays, if you're elderly, you get sympathy. If you're disabled, you get pity. If you're all of the above and living on borrowed time and the minimum SSI, you get NADA. If you're comparatively healthy and 10 years younger than me and get $200 a month more than me, you get the nice one-bedroom apartment in a nice neighborhood. I, on the other hand, have to languish in a shelter with 60 drunks, psychopaths, crackheads, and baby rapers for another year or more before I can have the dubious privilege of squeezing myself into a 9-by-12-foot box in a roach-infested old hotel in a neighborhood where someone gets shot every fucking Saturday night. Yeah... I'm livin' the dream.
Read the whole thing and get in on the argument here.
In the last few weeks I've had three separate conversations about what to call the Affordable Care Act.
"Obamacare" is currently in heavy rotation as a slur by the right.
In response, I've heard the argument that it should instead be called simply the Affordable Care Act. This, I feel, is correct and noble.
But posterity does not begin quite yet. Today is a day for electing.
Therefore, the best reclamation/rhetorical strategy for those of us who support the Affordable Care Act right now might be to refer to it as Romneycare, so that in exposing his hypocrisy we also reveal the Republicans for the craven powermongers they are. Let's not pretend we're talking about health care when we're talking about politics.
Over at my old blog HA, Darryl responded to last week's SCOTUS decision upholding the Affordable Care Act by pointing to an old post of mine I had completely forgotten. Way back on March 29, 2010, in a post titled "A layman’s refutation of Rob McKenna’s bullshit lawsuit," I attempted to explain in non-legalese terms why I thought the health care law would be upheld.
"[W]hile I don’t put anything past the machinations of the highly partisan and activist Roberts Court," I wrote at the time, "I’m pretty damn confident that this layman is going to prove to have a better grasp of the law than our state’s attorney general." In fact, at the risk of sounding immodest, it turns out I fucking nailed it:
See, the recently passed health care reform legislation does not require that all U.S. citizens purchase insurance, it merely provides a tax incentive to those of us who do. If you are not covered by an employer, and if you have not purchased your own individual policy, and if your income is above certain levels, and if you don’t hail from a state that has opted out of this mandate by implementing its own qualified health insurance system, you will be required to pay an additional federal tax, starting at the greater of $95 or 1% of income in 2014, and rising to $695 or 2.5% of income in 2016, up to a cap of the national average premium on a bronze plan. Both the minimum tax and the cap will increase by the annual cost of living adjustment.
Now, some might argue that this is still a mandate to engage in some sort of economic activity because it targets a tax at those who refuse, but one could easily flip this perception around. What it really is, is a flat, 2.5% federal income tax — much along the lines of what is already imposed to fund Social Security and Medicare — but for which the law provides a substantial exemption to those who choose to purchase private health insurance.
And don’t attempt to bog down this discussion in jibberish over whether this is a “tax” or a “fee” or a “penalty” or a “mandate” or whatever. The courts have long been consistent that lawmakers need not jump through such semantic hoops; if a law is constitutional worded one way, it is constitutional worded another, as long as the practical application is the same. And clearly, our tax laws are filled with provisions intended to encourage some economic activities and discourage others.
... [T]he federal government clearly has the constitutional authority to impose a tax to pay for health care (it does so now with Medicare), and it clearly has the constitutional authority to grant deductions, exemptions and other tax incentives in order to encourage or discourage certain forms of economic activity. And from a practical standpoint, that’s all the health care reform bill really does.
Yup, while everybody else (McKenna included) focused on the commerce clause, I correctly predicted that the law would be upheld based on Congress' taxing power. Two-plus years ago. Read the whole damn thing. It's like I practically wrote the majority opinion. McKenna on the other hand, not so much.
What with all that happened at last week's McKenna press conference I haven't had time to write much about the US Supreme Court decision itself, upholding the constitutionality of the Affordable Care Act. So I thought I'd take a moment to express my personal relief.
In the months leading up to last week's landmark opinion I had grown increasingly pessimistic about my own health care future. Although a supermajority of constitutional scholars had opined that the provisions were constitutional, the conventional wisdom was that the court's conservative majority would toss it out nonetheless. At the same time Republican House budget writer Paul Ryan was continuing to push his own plan that would eliminate Medicare for people like me who were stupid and irresponsible enough to be born past a certain arbitrary date.
Without health care reform and without Medicare, I literally did not see a way I could afford health care for myself in my old age. There's simply no profit to be made providing affordable health insurance to old people, so after a healthy lifetime of paying into the system I figured the day would soon arrive where I would have no choice but to join the ranks of the uninsured.
At least in this country. See, I had a backup plan: Move to Israel.
I'm not a particularly observant Jew, but I am Jewish nonetheless, and as such Israel's "Law of Return" guarantees me both residency and citizenship. And Israel offers its citizens a comprehensive, and by all accounts high quality, universal health care system.
Nothing against Israel—it's kinda like South Florida only with less humidity and fewer Jews—but I don't particularly want to move there. I've never even visited. Still, I suppose it's better than dying.
But now, thanks to the US Supreme Court, I don't have to learn Hebrew. The ACA is almost certain to survive (only a Romney victory and filibuster-proof senate Republican majority could kill it), and Ryan's faze-out of Medicare makes even less sense in that context.
My own personal health care exodus has been averted.