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BrundleFly or Hillarycare: The sad choice for Graham-Cassidy

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The other day, I wrote a long-winded defense of Graham-Cassidy. In response, JD Rucker, the EIC of this site, wrote a short rebuttal. These two pieces illustrate the upside-down nature of this bill.

In short: people who believe Graham-Cassidy should not be passed argue on the basis of it actually being implemented. People who argue that we should pass Graham-Cassidy do so on the basis that it cannot possibly be implemented.

They’re both right

If Graham-Cassidy is implemented as the bill is written, no politician could ever claim that it will solve Obamacare’s problems. All it does is intensify them and allow healthy individuals to go without insurance or join health cost sharing organizations. (Disclosure: I am a member of Medi-Share, a Christian medical expense sharing ministry that’s exempt from Obamacare.)

Moving the money to the state level as Medicaid block grants without gutting the Medicaid expansion, the coverage requirements or the heinous recordkeeping and administrative load of Obamacare is worse than living with the current, mostly-implemented and known system. States will not have enough time to enact enabling legislation, therefore by the 2020 deadline, many states will simply fall in a huge crack or the federal government will have to grant en-masse extensions. Remember, we went through this with Obamacare, which took until 2014 to fully swing into action, and by 2016, 19 states still hadn’t really done anything to get people off the federal exchanges.

Supporters say this is a feature, not a bug.

Burn the ships!

We’re passing Graham-Cassidy so we can be like Cortés in 1519. I love this story.

In 1519, Captain Hernán Cortés landed in Veracruz to begin his great conquest. Upon arriving, he gave the order to his men to burn the ships. As I imagine it, someone then laughed and Cortés promptly thrust his sword into the man’s chest. After which, the rest proceeded to get hammered on rum by the glow of the blaze. Almost like a bloodier version of The Pirates of the Caribbean with Cortés played by Johnny Depp.

The lesson, presented by business leadership coach Travis Robertson is: Retreat is easy when you have the option.

There is no political body in America more in need of a swift sword smack in the behind than the United States Congress. It is in a permanent state of retreat, unless it comes to spending your money and mine on endless projects in this district and that district to make a few people wealthy and the rest of us feel good about getting something for nothing. Most of us just pay and get nothing anyway, then go about electing the same people over and over again.

There is only one argument for Graham-Cassidy. Passing it destroys Obamacare with no way to go back. Passing Graham-Cassidy burns the ships and cuts off retreat.

Brundlefly

Passing Graham-Cassidy will force Republicans to either embrace Bernie-style single-payer or proceed to a fuller repeal of the destroyed, mutated Obamacare-monster. Like the 1986 horror classic “The Fly,” the Graham-Cassidy fusion teleporter only works one way. There’s no going back. And like the BrundleFly-Telepod monster, the result cannot survive.

There will be no choice but to destroy it or it will self-destruct before it ever sees the light of day.

Or do nothing and have Hillarycare

The other option is to not pass Graham-Cassidy and do nothing. Just embrace Obamacare and let all states adopt it. We could tweak coverages or eliminate some waste and inefficiency from the program. President Trump could re-enable the IRS (still led by Obama appointee John Koskinen) to enforce the fines for not purchasing coverage. Congress could make some allowances for conscience in health sharing ministries. But that’s it.

We could make Obamacare work, such as it is, and try to keep health care costs from ballooning further within that framework. But it means more government control, more cronyism, less small government, state-controlled commerce. It also means higher taxes for everyone.

In a nutshell, it would be what Hillary Clinton would do. We’d have Hillarycare.

Congress won’t advance when it can retreat

The one truth here is that Congress will never advance when it can retreat. It will never take on anything for which it has to later be responsible without someone standing up behind them holding a sword. It will never act on its own unless leadership does what Cortés did and make an example of someone. Until we can get some leadership, or Trump actually begins to lead on health care, our only options are between BrundleFly and Hillarycare, either of which could lead to single-payer.

The solution is not one we can achieve with this iteration of Congress. It will take something else from outside.

I say burn the ships and force the issue, but others say it’s too risky to deal with Brundlefly. Sadly, both answers are probably right.

Healthcare

GOP will really, really, really repeal Obamacare if victorious in November

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Good news, America! If we give Republicans control of the House and the Senate in November, they will repeal Obamacare! No, this isn’t an old headline found in the election-year archives from 2012, 2014, or 2016. This promise is now! Today! 2018!

In an interview on Hill TV yesterday, Republican Nation Committee (RNC) spokeswoman Kayleigh McEnany informed voters that if the GOP maintains control of the House and picks up a few seats in the Senate, bada bing, bada boom, the Republicans will pass the Graham-Cassidy Repeal-In-Name-Only healthcare bill—a piece of legislation that does nothing to fix the Obamacare disaster.

“We were a big proponent of Graham-Cassidy. That, of course, was a Senate bill that gave states the power and allowed each state to select what the best way forward was for them on healthcare.

“That was one vote short, and if we maintain the House as we expect we will, pick up a few Senate seats, Graham-Cassidy can become a reality.”

Besides McEnany’s sad and pathetic use of the GOP election-year playbook—make promises, break promises, repeat—Graham-Cassidy failed to pass in the first go around because it fails to do as promised concerning Obamacare repeal.

In an opinion piece on FOX News by Sen. Rand Paul at the time—he was one of the “no” votes—he pointed out how Graham-Cassidy failed to return healthcare decisions to the American people and how it instead created an even greater reliance on the federal government for our healthcare needs. And even though Graham-Cassidy eliminated Obamacare mandates—something that was accomplished in the Tax Cuts and Jobs Act—it “doesn’t repeal a single Obamacare insurance regulation.”

One more thing. Even though Graham-Cassidy was touted at the time within some conservative circles as a step toward Federalism and states rights, the block grants paid to the states by Washington bureaucrats as stipulated in the bill made states more dependent on the federal government, not less.

And for those partial to defending Trump by blaming Congress for the GOP’s failure to keep its promise to repeal Obamacare, the New York liberal supported Graham-Cassidy.

Clearly, the GOP has repeatedly failed to deliver on its promises. This is why Republicans engage in the politics of distraction by holding show votes on vital conservative issues like: abortion, term limits, and balancing the budget. It’s also why the RNC is recycling—for the fourth election year in a row—the promise to repeal Obamacare.

Maybe it’s just me, but I’ve got a feeling that repealing Obamacare will still be an issue in 2020 and will most likely be part of the GOP platform.

Originally posted on The Strident Conservative.

 


David Leach is the owner of The Strident Conservative. His daily radio commentary is distributed by the Salem Radio Network and is heard on stations across America.

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Healthcare

Minneapolis Police: Uses dangerous drug to sedate criminals

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Minneapolis has some creative people. Too creative for their own good. Somebody probably saw that the guys who take down large animals with tranquilizer darts use darts filled with ketamine. “Hey, if it will take down those animals, why don’t we use it on the animals our police are fighting?” And an immensely stupid program began. It was also illegal, but if we’re controlling bad guys, who cares?

Time for disclosure. I am a doctor. I do not play one on TV. Not only that, I’m an anesthesiologist and used ketamine in my practice. For certain things, it has no equal. But its proper uses are quite limited.

Ketamine comes from a class of drugs called phencyclidines. The street version is known as Angel Dust, and abusers are Dusters. Because ketamine causes profound analgesia (pain relief), Dusters are known for feats of superhuman strength. Broken handcuffs are just one relatively well-known example. At the same time, Dusters may break their own bones. The analgesic effect of ketamine keeps them from realizing the damage they are doing to themselves.

By now, it should be pretty clear that ketamine is no panacea for the problem of sedating troublesome persons being arrested. At the wrong dose in the wrong person, police can put themselves in worse difficulties than when they started. How do you control someone who feels no pain and wants to cause you harm? Flashback to the villain Renard in The World is Not Enough. He is almost impossible to defeat in a fight because he feels no pain. But I guess the Minneapolis wise guys don’t watch James Bond films.

I have to wonder if the police bothered to look at any references. Even Wikipedia would have been helpful. If they had, they’d discover that there are a lot of other problems with ketamine. The first one should have given them a real headache. The primary reason we don’t use ketamine a lot in anesthesia is that it has a high incidence of emergence delirium. In language even an inattentive civil servant can understand, that means that if you give someone ketamine, they can hallucinate. This happens often enough that we try to avoid ketamine except in those odd cases where its other effects make it the best drug available. Just to make a bad problem worse, there are a lot of times when there isn’t anything you can do to stop the delirium. Welcome to hell.

We’ve only scratched the surface. Since Minneapolis police officers obviously consulted Dr. Conrad Murray, we should expect that they got the same level of advice Michael Jackson got. That means that they missed the fact that ketamine can lead to airway obstruction and death. It releases adrenaline, so it can cause hypertension and tachycardia leading to death. Did I mention that it can kill you? And, unlike opioids, you can give all the naloxone you want and it won’t do a bit of good.

But the Minneapolis police officers are really interested in saving lives, so we can let them use this drug they simply don’t understand on patients who aren’t consenting and may suffer badly from its administration. No problem.

The track record is as bad as I suggested up front. Ketamine administration has led to multiple episodes of cardiac and breathing problems, with many patients requiring emergency intubation. Now for a skilled health care provider, intubation is generally no big deal. But you never deliberately put yourself in a position where you create an uncontrolled need for intubation. The moment you do that, you’ll find yourself looking at the impossible situation. With somewhere around fifty thousand intubations under my belt, the next one can still be the one where I have to call a partner in to give it a try. My practice had over eighty anesthesiologists and two hundred nurse anesthetists, so there was usually another set of hands available. But who is the paramedic in the field going to call? Ghostbusters has an unlisted number.

Let’s get one thing clear. Minneapolis police officers did not have a hand on the syringe. They asked the Hennepin County paramedics to administer ketamine. And if a cop asks, how is a paramedic supposed to refuse? But the paramedics are supposed to operate according to a strict protocol, and only give ketamine when a patient is “profoundly agitated, unable to be restrained, or a danger to themselves or others.” It’s clear that this guideline was violated on multiple occasions.

And this brings us to the nub of the matter. Ketamine is properly used only in the sort of situation described in the protocol. In anesthesia, we will also use it in autistic or severely mentally retarded patients who cannot be managed by breathing them to sleep with gases. In short, we mostly use it in the controlled medical equivalent of the field situation.

It’s likely that Dr. Jeffrey Ho (the director of Hennepin County EMS who happened to graduate from the same medical school I did!) is actually well aware of the proper use of ketamine. He’s a recognized expert in pre-hospital emergency care. And if ketamine is used in the very restricted fashion the policy describes, it’s probably better than most alternatives. But when police decide that they want a set of chemical handcuffs rather than doing their job, we have a problem.

Police work can be difficult and dangerous. But police are not allowed to place people in danger just to make their own life easier. Doing so exceeds the bounds of our social contract with police, and also violates a host of laws. For a paramedic to go along with such an improper request places that paramedic in violation of state laws on the practice of medicine. Their drivers’ license isn’t enough. You follow the protocol or get permission from the supervising ER doc by calling it in.

Hennepin County and the city of Minneapolis have a problem on their hands. Their best bet will be to quietly approach persons who were harmed by this cavalier misuse of ketamine and buy out their legal liability. Then the EMS and police persons involved should be invited to leave. Promptly. Do not pass Go. Do not collect $200.

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Culture and Religion

The Context of Life

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Man #1 shoots Man #2. As a result, Man #2 dies. Is Man #1 a murderer?

Obviously, it depends. Context matters. Did Man #1 fire in self-defense? Did he shoot Man #2 by accident? Was Man #1 part of a legally appointed firing squad or under a hypnotic trance? Was the weapon a prop gun that mistakenly contained live ammunition? There are many points to consider before we can definitively say that an instance of killing constitutes murder.

Let’s try another thought exercise: protesters are gunned down by a neighboring country’s military forces. Is this murder? Is it a breach of international law? Is it a gross violation of human rights?

Again, it depends. Context matters. Are these protesters peaceful, or are they, say, planting landmines, tossing grenades, hurling molotov cocktails, and threatening to invade the country that is firing back at them? Have these protesters sworn to murder and pillage their neighbors until they are eradicated from the earth, all in the name of radical religious zeal? Are upwards of 50 out of the 62 protesters killed members of a terrorist organization?

Here’s another one: are illegal immigrants animals?

That depends; are the immigrants in question members of a ruthless gang that rips the beating hearts out of its victims? Do these immigrants peddle drugs, commit brutal assaults, and routinely rape women? Given the context and Oxford’s alternative definition of “animal” — “a person whose behavior is regarded as devoid of human attributes or civilizing influences, especially someone who is very cruel, violent, or repulsive. Synonyms: brute, beast, monster, devil, demon, fiend” — I think we can deem that perhaps too kind a descriptor.

Some people, however, seem to reject the value of context when it goes against their narrative. For instance, on the issue of calling MS-13 members “animals,” singer John Legend tweeted on Thursday, “Even human beings who commit heinous acts are the same species as us, not ‘animals’. I’m in the hospital with our new son. Any of these babies here could end up committing terrible crimes in the future. It’s easy, once they’ve done so, to distance ourselves from their humanity. … Dehumanizing large groups of people is the demagogue’s precursor to visiting violence and pain upon them.”

While MS-13 undoubtedly deserves any visitation of violence and pain upon them, the most glaring hole in Legend’s argument is that mere hours ago, he wouldn’t have considered “any of these babies” to be the same species as him (except when it’s his own baby). And as an outspoken donor and supporter of Planned Parenthood, he wouldn’t hesitate to defend the visitation of violence and pain upon them. But because of arbitrary abortion arguments, Legend and countless other Leftists ascribe more humanity to murderous villains than preborn babies.

Ironically, the one issue where Leftists insist on considering context is the one topic for which nuance is largely counterproductive — the sanctity of life.

As mentioned earlier, not all killing is murder, nor is it always unjustified. The right to life is unalienable, meaning it is intrinsic and therefore cannot be given nor taken away by man. It can, however, be surrendered through certain violations of another person’s unalienable rights. This is why many conservatives support capital punishment for perpetrators of homicide and rape. But it’s critical to recognize that this position is taken in order to emphasize the dignity of life and the severity of seriously harming and/or violating it. Similar reasoning is what justifies depriving someone of their unalienable right to liberty after they’ve committed a crime — they’ve automatically surrendered that right based on their actions.

That single caveat aside, any attempt to contextualize the debate for life pushes the dialogue further down a nonsensical rabbit hole designed to cheapen the worth of the weakest among us, or, to borrow Legend’s term, “dehumanize” them. At every turn, the argument gets slipperier and slipperier.

The Left will say that all human life is precious, even murderers, but they don’t extend this philosophy to unborn babies.

“Context!” they scream. “Fetuses aren’t fully human, and they aren’t really alive.”

Even if we gave the Left that argument, we have to ask whether fetal life, though not fully developed, is still worth protecting.

But the Left can’t give a straight answer here either, because while they celebrate a woman’s choice to terminate her unborn child, they cry for the conservation of fetuses that aren’t even human, proclaiming their inherent dignity well before birth. Eagle and sea turtle eggs come to mind, among other examples.

Next, the Left tries to establish what differentiates a human before birth and a human after birth, or rather what about birth makes someone human, but their attempts at context again fall short:

On one hand, they say it’s about viability outside of the womb, but standards of what constitutes viability are fully arbitrary. A baby born at 37 weeks is no more viable than one at 41 weeks that refuses to pop out — but because it’s still in the womb, it’s still not a living human, apparently. A baby born at 25 weeks in a big city is more viable than a baby born at 35 weeks in the boonies. My one-year-old daughter couldn’t survive without constant care from someone else, and neither could many elderly folks.

Other pro-aborts claim that if there’s no heartbeat, there’s no life, yet I don’t see many of them rushing to pull the plug on grandpa because he’s hooked up to a pacemaker.

I’ve heard some say that a baby’s first breath is what makes it human — so what about those who require artificial sources of oxygen? And if air confers humanity, then why aren’t all air-breathing animals human? If it determines life, then what happens when I hold my breath? I have the potential to breathe again, just as a fetus, left alone, has the potential to be born through natural processes.

The same goes for the sentience test. People in comas still enjoy an unalienable right to life.

Under the law, a woman can abort her baby, but if a pregnant woman is murdered, the assailant is charged with double homicide. No context can sensibly explain this double standard.

Some on the Right are guilty of it too. When asked whether abortion is murder, many engage in a similar exercise to the example I presented earlier about whether a shooting death necessarily constitutes murder: “it depends, what are the circumstances?”

There is no nuance to this question. Either the intentional taking of innocent life is murder or it is not. What difference does it make whether the baby was the result of rape or incest? I’ve stated in this very article that rape sometimes requires taking a life — but the baby is not the guilty party. Either life is sacred or it is not, regardless of how it got there.

Others cite the safety of the mother as context, but this argument is likewise flawed. Pursuing a vital cure for a woman’s ailment that indirectly harms the baby isn’t the intentional taking of innocent life but an unfortunate externality, so it’s not murder. And the case for actively terminating a pregnancy to save a mother is virtually identical to a self-defense argument, but again, there’s a problem: a baby is not an aggressor. It does not violate a woman’s rights, and a woman cannot violate the rights of her baby.

And a baby either has rights or it doesn’t. “Unalienable” means a baby doesn’t magically receive rights the moment it exits the birth canal, nor are a human’s rights any less inherent because he or she is dependent on someone or something else to sustain them. From the moment of existence, all human life has worth.

Life is the only consistent position, and it is so straightforward that it requires no nuance. Life either has intrinsic value or it does not. Context matters in almost every discussion of politics. But on the question of life, what people think is context is just an excuse to kill.


Richie Angel is the Editor at Large of thenewguards.net. Follow him and The New Guards on Twitter, and check out The New Guards on Facebook.

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