Why 'Health Care' Reform Cannot Work

I have for several months now been referring to the current national debate as a 'health care' reform debate --using quotation marks around the words health care. Though I have made oblique references as to why I am doing this, it is time now to explain why.

But first you have to take a little trip with me.

That trip is one in both time and space. The time is June 2009. The place is Nashville, Tennessee.

One of the hospitals in my community is in the multi-year process of installing a fully-electronic health information system, with the ultimate goal of becoming as paperless of a hospital as a hospital can be. And they embarked on this path even before the HITECH Act was even thought of, much less passed. The time had come in this process to start gearing up for the conversion to computerized physician order entry, or CPOE. As part of that endeavor, the computer vendor sent a delegation from the hospital to a seminar at Vanderbilt University. This seminar involved more than just how to set up CPOE; it involved the why of CPOE and how to start thinking in a CPOE way. As a member of the information technology advisory council, I was a member of this delegation. In fact, I had to finagle my way onto the trip, as I was not one of the physicians originally chosen to go.

(As an aside, let me say that this seminar was one of the most innovative, exciting, thought-provoking conferences that I have ever had the good fortune to attend. I don't want to mention the name of the software vendor involved, but if you, dear reader, ever get a chance to go to this seminar [if you get involved with this company, you will hear of this seminar as it's an important part of booting up their CPOE], fight, scrape, and claw your way onto the trip. It's worth it.)

At this conference, one of the 'why' lectures was being given by one of the first people to start seriously thinking about the need for computers in medicine. The basic gist of the talk was that, due to the increasing depth of medical knowledge and medical technology, the number of pieces of information necessary to make a rational medical decision is increasing. And it is increasing at a rapid pace; so rapid, in fact, that within 5 to 10 years, the number will exceed the ability of the human brain to hold all that information and do anything with it. And it will still keep on increasing with no end in sight. So we will need computers to keep track of all that information and organize it in a way that our brains can make sense of it.

While the professor was lecturing, one of his associates was writing on a huge mark-sense board behind him. Ostensibly he was charting the important points, but about half of what he wrote on the board was only peripherally related to the talk at hand. The following is a near-direct quote of one of these peripherally related comments:

The U.S. spends $3k-$4K more per capita on our health care than France does. We have the best rescue care system in the world, but we are no better at treating chronic disease than is France.

I read this, and then I read it again and again. It wasn't just a light bulb that went off in my head -- it was a full-blown supernova. I even lost track of the lecture for a few moments. In that moment, with that statement, the true nature of the national debate became apparent. And it also became apparent that 'health care' reform was doomed to fail, could not work, cannot work, will never work, no matter whose plan is implemented or who implements it or how much money we do or do not spend doing it.

That's because we do not have a health care system. We never have had one. Since you cannot 'reform' something that doesn't exist, it follows that any such 'reform plan cannot work.

The statement above crystallized my thoughts on this matter in a blinding flash, but obviously my subconscious had been processing its way toward this conclusion for a long time. Otherwise I wouldn't have had such a sudden epiphany. For those whose subconscious is not as postally twisted as mine, let me explain.

The obvious point of the statement written on that wall was that we are spending more money on our 'health care' and not getting anything for it -- "we are no better at treating chronic disease than is France". But I chose to look not at the money but at the outcomes -- not "The US spends $3K to $4K more per capita than France does", but "We have the best rescue care system in the world..."

I'm sure that when most people hear the phrase 'rescue care system', the first thing that comes to mind is paramedics, fireman, ambulances, the Jaws of Life, and the like. But that's not what's being referenced here by 'rescue care'. What rescue care means here is 'emergency care' or 'acute care' -- what happens after you get to the hospital or emergency room.

Despite what you hear in the news (from the liberal press doing everything in their power to promote the programs of Dear Leader), if you have an illness in the United States, you have the best chances in the world of surviving. If you show up in the ER having a heart attack, in the throes of acute heart failure, or with a severe pneumonia, you have a better chance of surviving than anywhere else in the world. If your physician diagnoses you with cancer, your survival (in terms of percentages and duration) is better here than anywhere else. I could go on and on with examples. But none of this has anything to do with health care. It's medical care.

What's the difference? Medical care is what gets you over that acute MI, CHF, pneumonia, or cancer. It's the care provided by physicians and surgeons based on a tradition of treating acute medical problems that dates back more than two thousand years, to well before the time of Hippocrates. It's treatment based on anecdotal and then scientific observations of medical illnesses and treatments performed during those two thousand-plus years. It's the application of chemicals and fluids and electromagnetic radiation and invasive interventions to find the cause of a deranged physiological process and correct it.

Health care is none of these things. Health care does not involve fixing a deranged physiology. It involves maintaining a normal or optimal physiology for as long a time as possible. This rarely involves chemicals (other than vitamins), radiation, or invasive interventions. It does involve diet, exercise, avoidance of unsafe activities and toxic agents such as illicit drugs and excessive alcohol, the use of proper safety equipment, and the like. These are not the things that physicians and surgeons do. They are the things that each and every one of us should be individually doing but most of us do not, or do not do well.

Physicians and hospitals and home health nurses and physical therapists provide 'rescue' care -- medical care, not 'health' care. We have a medical care system, not a 'health care' system. This country doesn't have a health care system and has never had one! So there's no way we can reform it.

Trying to 'reform' the medical care system to try to be simultaneously a health care system will not improve health, as the medical care system and the people who work in it have no real training in it (such is not part of the system's two millenia-long tradition), and it will degrade the quality of the medical care system we have now, as these people cannot do that job and a second even more difficult one and not have the first job suffer.

It might be to the benefit of our nation to create a new system to encourage, support, cajole and reward health care. Exactly how to do this is beyond me; recall I am a physician and a member of the medical care system. Shoehorning it into the medical care system is a bad idea and is unlikely to work. And it's going to have to be a system that works at an individual level, as that problem starts at the level of the individual.

Let's reword the statement that was written on that wall in Nashville:

France spends $3K-$4K less per capita on health care than the U.S. does. France is no better at treating chronic disease than is the U.S., and its rescue care system is not as good.

When you look at it that way, France doesn't look that good any more, does it? You could replace France in that statement with any other country in the world and it would be just as true.

But look at both statements. France spends less and the U.S. spends more, and neither country is better at treating chronic disease (most of which is caused by poor health care choices) than the other. This tells you that spending more or less money is not the root of the problem. And it tells you one other thing.

France doesn't have a health care system either.

A Legacy We Can Live Without

The forces of the left are now trying to argue that Senator Edward Kennedy's death is another, new, powerful reason that we must pass H.R. 3200 (or something like it) as a tribute to the "great Senator", or as his last great legacy, or something else equally foolish. They even want to rename the bill in his honor (something that I expected to actually happen before his death and am surprised that it didn't happen).

If H.R. 3200 (or any other similar Democratic version of 'health care' reform) is to be Senator Kennedy's legacy, then it needs to be a legacy that goes to the grave with him.

John Donne said, "No man is an island, entire of itself...any man's death diminishes me, because I am involved in mankind..." I will not debate this philosophy, but if Senator Kennedy's death diminishes me, I am having a hard time seeing exactly how. I will lament the death of a fellow human being, but at the same time I will rejoice in his personal and permanent absence from the U.S. Senate, which should have happened long ago. America can sleep sounder since Thursday night, for she is safer now. "The Lion of the Senate" -- give me a break.

I also have a hard time understanding, much less accepting, why Kennedy's death makes a hill of beans difference in the fundamental arguments and problems that the majority of Americans have with this reform plan. Mr. Kennedy was in the Senate for nearly 46 years. If he didn't manage to make his 'legacy' in that length of time, then I propose that he wasn't effective enough to deserve having this travesty being passed as a tribute to him.

The last time the US passed legislation as a tribute to the legacy of a deceased Kennedy, we got the Civil Rights Act (good) and the Medicare Act (bad, as it has led us to where we are today). That's 50-50 odds on the outcome of passing H.R. 3200, and since this is a health care bill, the past presents an ominous omen for the future.

Let us ridicule the notion of passing this 'tribute' or 'legacy' at each and every opportunity. And let's certainly not pass another piece of crappy legislation to honor a political dynasty that rightfully should have been a relic of history by now.

If we want to pay tribute to the man, let's rename a bridge for him. I hear there's one near Chappaquiddick that's quite appropriate. Though it probably ought to be named after someone else.

The True Face of Liberalism

If you did not see On the Record with Greta van Susteren on Fox News on the evening of August 20, 2009, you missed something very special. On that program, the true face of liberalism showed itself.

Fortunately, in this age of the Internet and YouTube, you have a chance to see it. Here it is, preserved for all posterity, or at least until either YouTube goes away or the Fox News lawyers have their say.

The setting is a debate about the recent comments by Whole Foods Market, Inc. CEO John Mackey's recent editorial in the Wall Street Journal regarding his opposition to President Obama's medical care reform bill.

While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead we should be trying to achieve reforms by moving in the opposite direction -- toward less government control and more individual empowerment....

Many promoters of health-care reform believe that people have an intrinsic ethical right to health care -- to equal access to doctors, medicines, and hospitals..... A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food, or shelter. That's because there isn't any. This "right" has never existed in America.

Mr. Mackey also explains how such a right does not exist in any other country either, especially in those countries with government-controlled medical care systems, where governmental restrictions actually block individuals from exercising their actual right to seek the treatments that they desire. He continues with a short (and correct) assessment regarding the current state of affairs in the United States where the vast majority of our medical problems are the result of self-inflicted unhealthy lifestyle choices; in other words, our illnesses are in large part because each of us is not owning up to the responsibility to live in a more healthy manner.

Sounds like my kind of guy. Goes right along with what I have been saying for years. If there was a Whole Foods Market near me (there isn't), I might have to start shopping there just to support his views. (Though I doubt I'd ever get past the fact that I could get essentially the same merchandise much cheaper at Walmart.)

Mr. Mackey does not just criticize the President's plan. He lays out succinctly
eight reforms that would dramatically improve the ability of everyone to have better access to medical care. I not only do not disagree with any of these eight reforms -- I would wholeheartedly endorse all of them. The problem, as it were, with these ideas is that they fly in the face of the whole socialist concept of taking over the 'healthcare' industry. And Greta van Susteren was able to find someone who could not prevent the true face of liberalism from showing.

Fox News has a transcript of this encounter on Greta's show if you'd like to read it. But the video is so much more revealing, as it is the attitude and emotions of the liberal opposition to Mr. Mackey that is impressive. This gentleman's (and I use that term loosely) name is Russell Mokhiber, and I want you to pay attention to his voice and his facial expressions. Listen to the venom in his voice; look at the sneer and the scowl on his face; note that he does not smile nor even come close to smiling during this entire segment. He gets into a shouting match with Greta over this issue. And why? Simply because Mr. Mackey's editorial dares to oppose his and the liberals' ideal solution of the government controlled single payer system.

Mr. Mokhiber is the epitome, the classic example of the face of liberalism, driven by anger, seeing no joy in anything, being opposed vehemently to anything that deviates even slightly from what liberalism demands, loudly and angrily shouting down any voice of dissenting opinion.

Amazingly, Greta even calls him on this, chiding him that his only issue is that Mr. Mackey disagrees with him, and criticizing him for not seeing the good Mr. Mackey has done for his employees and the fact that he made concrete proposals for reform and was not calling for the maintenance of the status quo. (This is amazing because Greta van Susteren is a registered Democrat, but is apparently one of the few Democrats willing to give consideration to the other side of an argument.) Mr. Mokhiber gives Mr. Mackey no credit for Greta's points, as Mr. Mackey's 'heresy' cannot be tolerated.

I will take issue with Mr. Mokhiber on a couple of other issues.

He states that "the majority of doctors" now see single payer as the "only way" to fix the system. His debate opponent, Crystal Jones, says, "That's false. I want to see a source for that." I'm with her. Don't make that kind of assertion without hard evidence. I haven't yet run into any other doctor who is anything less than scared spitless about what ObamaCare is going to do to us.

Mr. Mokhiber also states:

...and 60 Americans are dying every day because of lack of health insurance -- when you cross over into Canada and that number is zero....

Is this the same Canada that Mr. Mackey reports has 830,000 people on a waiting list to be admitted to a hospital or receive treatment for their illnesses? (Though that's better than England where there are 1,800,000 people on the list.)

Now let's take on that "60 Americans are dying every day for lack of health insurance" bit. If one compares the 5-year survival rate for cancer patients in the US vs Europe, one will find some sobering statistics. In the US, 66.3% of men and 62.9% of women survive for five years, while in Europe (collectively) the rates are 47.3% for men and 55.8% for women. (Intriguingly, the rates for the UK, whose system so enthralls Obama adviser Tom Daschle, is amongst the lowest in Western Europe.)

Now, the number of people in the US who develop cancer each year is 766,130 men and 713,220 women (taken from an American Cancer Society PowerPoint presentation linked above). I won't bore you with the math, but if you apply government-controlled-healthcare-system European survival rates to the American numbers and figure out the excess mortality, that would result in 145,568 more men and 50,639 more women dying of cancer each year -- or 196,207 more American deaths, for an average of 537 deaths per day. This is 895% higher than what Mr. Mokhiber has his panties all in a wad about. And this is just taking cancer mortality into account; it doesn't consider cardiovascular disease or diabetes or any other cause of death, most of which would also increase under a European-style single-payer system.

So is it really that "60 Americans are dying every day because of lack of health insurance" that is what bothers Mr. Mokhiber? If it is, then he needs to educate himself about the reality of the situation so he'll know what to really worry about. However, I think that pointing this out to him would not alter his position, as he is using his statistic merely as a emotional debating tactic.

And that showing him data that his position would lead to more Americans dying would not change his position reveals even more clearly just how ugly the true face of liberalism really is.

Where Did Anybody Get The Idea That There Were Going To Be Death Panels?

Proponents of the misguided "health care" reform bill H.R. 3200, and particularly the members of the Obama Administration, from the Big O on down, continue to play damage control in trying to get their plan back on track. However, they are not doing to well so far, as noted by the Financial Times of London. [This site's policies won't allow excerpting, so I'll just have to link and direct you to paragraphs 9-11.]

The gist of these paragraphs is that by having to utilize time and resources beating back what they see as "myths and facts" that they had planned to use to extol the 'virtues' of their plan, the Administration has lost control of the debate and losing support for their program.

The hardest blow they've taken so far is Sarah Palin's devastating designation of the coming rationing in their plan as "death panels". AJStrata at The Strata-Sphere points out just why this little two word label is so devastating -- because it is extremely accurate. I cannot excerpt enough from AJStrata's post to do it justice without being accused of plagiarism, so go to the link above right now and read it.

Okay, so for those of you to lazy to jump to the link, I'll try to summarize.

The liberals are now all up in arms because someone (i.e., Governor Sarah Palin) was finally able to label the core problem with any and all government run health care options. That label is “death panels”, and it is very appropriate and accurate, and is only marginally attached to end-of-life consultations....

Interestingly, right now the opponents of the liberals’ government run dreams of conquest don’t need to theorize or extrapolate about the possible outcomes, because the UK clearly shows us all where a government run health care ‘option’ will lead us. What they are going through now, in terms of ‘cost savings’, is what ANY government controlled health spending program for individuals will end up. And realize, this is not about consultations – it is about cost savings (aka ‘cheap healthcare’, ‘affordable health care’, ‘universal access’, etc) and how the liberal inquisitors will chose the worthy.....

It is no secret the prime intent of the government run system is to ’save money’, which everyone with two brain cells to rub together knows actually means to NOT SPEND money. They take our money and determine how not to spend it for us. Voilà! Health care cost savings.

So, how do they not spend money? AJ quotes one of President Obama's "health care" advisers, Dr. Ezekiel Emanuel, brother of White House chief of staff Rahm Emanuel, who bluntly states that all the vaunted savings from eliminating fraud and waste, using electronic medical records, improving 'quality', and increasing preventive care is all for show, since it will actually save very little money. The real cost savings comes from using the idea of “communitarianism” (not specifically defined but clearly meaning spending resources on only those whose value to the community at large is worth the expenditure) "to achieve a just allocation of scarce medical interventions". And what is just? Look at this graph:

As AJStrata concludes, "This is not rationing, this is worse. Under rationing everyone gets an equal share, but to allocate is to distribute unequally."

Under advanced triage, which is the essence of the liberal government run plans as outlined above, a panel of bureaucrats and appointed ‘experts’ decide what is a ‘just allocation’....

Yes, there is even a formal definition of what these panels do when cutting costs. They decide who lives or dies by deciding who to spend money on (see graph above). This ‘advanced triage ‘ or ‘communitarianism’ process or ’complete lives system’ is rightfully summed up as a government ‘death panel’. The liberals will try and hide its true nature under pleasant sounding words strung together to lull the poor victims to sleep, but the label ‘death panel’ makes sense. And that is why it is sticking.

Most importantly, this has NOTHING to do with end of life consultations.

As stated above, the National Health Service in England is the prime example of what happens when government decides to begin justly allocating medical resources. Hospitals delay and deny orthopedic procedures to those just a bit obese or who smoke; those over 55 cannot get coronary angioplasty stents; back pain patients can no longer get epidural steroid injections because the government has decided that it can afford only 3000 per year (in a population of over 60 million!) instead of the 60,000 per year currently being performed. Americans are bright people; they intuitively understand this, and as I said before, they are worried about who's going to be making the decisions and how can they make sure they're not going to get shafted?

The Wall Street Journal has an editorial in their August 14th edition which is subtitled, "Why the elderly are right to worry when the government rations medical care". From the outset they state:

While claims about euthanasia and "death panels" are over the top, senior fears have exposed a fundamental truth about what Mr. Obama is proposing: Namely, once health care is nationalized, or mostly nationalized, rationing care is inevitable, and those who have lived the longest will find their care the most restricted.

Far from being a scare tactic, this is a logical conclusion based on experience and common-sense.

I also like the way the WSJ addresses the idea that our current system rations by the ability to pay (an idea that Peter Singer found unacceptable, as you will recall).

Yes, the U.S. "rations" by ability to pay (though in the end no one is denied actual care). This is true of every good or service in a free economy and a world of finite resources but infinite wants. Yet no one would say we "ration" houses or gasoline because those goods are allocated by prices. The problem is that governments ration through brute force—either explicitly restricting the use of medicine or lowering payments below market rates. Both methods lead to waiting lines, lower quality, or less innovation—and usually all three.

Of course, one might argue that to use the position of Dr. Emanuel as a criticism of the Obama reform plan is misleading, as Dr. Emanuel is merely a presidential adviser and not a decision maker. What if someone else higher up actually said something like this:

"Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now." (emphasis added)

An independent group like the National Institute for Health and Clinical Excellence? Oh, wait, that's what they call the agency in England that makes all the coverage decisions like the ones I listed above. Here we're going to call it the Center for Comparative Effectiveness Research.

By the way, the quote above came from one of the decision makers. It's from an interview in the New York Times with President Barack Obama on May 3, 2009.

I agree with Tom Maguire at the blog JustOneMinute when he says in regarding the idea that these panels will just be offering 'guidance':

And how voluntary will these imagined guidelines be? Doctors that are currently free to prescribe painkillers volunteer not to, to avoid hassles from the DEA. Mightn't doctors prefer to follow the "voluntary" end-of-life guidelines rather than risk Federal examination of their taxes, expenses, hiring decisions, and payroll? That would depend in large part on how aggressively the government chose to push the "voluntary" guidelines.

Government guidelines don't stay that way very long. They have a way of quickly becoming requirements and then mandates. Sometimes, like with seatbelts, that's a good thing. But usually it's not that good, either because the idea was bad to begin with, or just due to the law of unintended consequences.

Now you can see why the Administration is battling the 'death panel' rumor so vigorously. Because it is fundamentally true. In this case, the truth will set us, the American people, free. And that's not acceptable to our dear leaders.

A Warning from the Past from the Gipper

Almost 50 years ago, a B-grade movie star and TV actor made a 10 minute recording warning the American people about the coming of socialism to our great nation and how it would establish its beachhead in the guise of 'universal' medical care.

That actor would later go on to become quite possibly the greatest President of the 20th Century. His name was Ronald Reagan.

It is worth the time to listen to the whole 10 minutes of this audio recording. It is worth listening to again and again. It is worth sending the link on to everyone we know, to make it go viral 48 years after it was first recorded, to once again spread the warning of the coming of socialized medicine. Because now we are no longer trying to prevent the establishment of the beachhead. That was done long ago. Now we are trying to stop the evil of that beachhead from breaking out and destroying the country that oh so many patriots in the past have given their blood and their treasure to create and defend.

What Reagan was warning against in this message from 1961 was a bill that would ultimately be passed, in expanded form, as the Social Security Act of 1965, the legislation that created Medicare and Medicaid. And Reagan was correct. Medicare is for all intents and purposes a socialized medical care system. It isn't voluntary for senior citizens unless they are immensely wealthy. It dictates how much a doctor will earn for caring for those the system covers without regard to whether that fee covers the true cost of the care provided. The only system more socialized in this country today is the VA system -- and it is also run by the government.

Reagan's message rings even more true today than it did then -- that the beachhead of socialism would allow it to grow by gradual expansion until all of our liberties have been quietly taken from us. It rings more true today because we can see in the actions of the Obama Administration the final reach for the establishment of complete socialism.

Reagan speaks of a world in which the government, as the controller of medical care, dictates where a doctor will work, how many patients he will see, and even how much he can earn. Fortunately, this situation does not yet exist today -- in the medical care system. But look around at other parts of our economy. Hasn't this Administration dictated who the CEO of General Motors will be? Isn't the (Democratic) Congress openly discussing placing limits on how much corporate leaders of banks and other companies can earn? Is Congress not debating the creation of a medical 'reform' plan that is nothing more than a veiled way of sliding us down the slippery slope into a socialized, government-run system, exactly like Reagan was warning us about 48 years ago?

Where in our Constitution was either Congress or the President given these powers? Read the document and you will see the answer -- nowhere!

And when the leaders of government exceed the powers granted to them by the people through the Constitution, that very act starts the process of taking away our liberties.

But Reagan also tells us what we can do to stop this. At the 8:30 mark in the video, Reagan quotes 1950's Indiana Congressman Charles Halleck as saying

"When the American people want something from Congress, regardless of its political complexity, if they make their wants known, Congress does what the people want."

In other words, all it takes is for us to say "No!! Not now, not ever!!"

Reagan goes on to encourage us to contact our Congressmen "even if we believe he is on our side to begin with. Write to strengthen his hand, to give him the ability to stand before his colleagues in Congress and say 'I have heard from my constituents and this is what they want'."

This is what we must do.

It is already starting. Hundreds of people are being turned away from townhall meetings because the facilities cannot handle them. Daily on the news we see videos of ordinary people venting their frustrations at legislators who do not seem to understand that their job is to represent the views of their constituents and not to try to change the minds of those constituents. And even though the Administration and its communication department (aka "the main stream media") is doing their best to convince everyone these protests are being manufactured by various and rotating corporate and political bogeymen, the American people -- and the foreign press -- know the truth about how real this protest is.

What encourages me the most, however, is this article indicating that even now, at least one month before this plan goes to a vote, the Congressional email system is already starting to sag under the strain of the emails being sent through it, despite the use of "load balancing" technology to try to keep the system running.

Now is not the time to let up. Now is the time to pour it on. The protests and letters and videos and emails need to increase in number progressively and inexorably until after H.R. 3200 has gone down to defeat.

Let's see just how good that new load balancing system is. I'll bet we can break it.

Health Care via the Post Office Redux

This is too good to pass up.

Follow the link and get ready to sing along.

A Must-Read from Sarah Palin

Former Alaskan Governor Sarah Palin came out a few days ago decrying what she called "death panels" which will be authorized by H.R. 3200. Many on the hard right have been complaining about this provision, incorrectly portraying these end-of-life counseling sessions as mandatory, when the legislation does not specifically create such a mandate. (BTW, we physicians have been doing this for a long time, particularly when there has been a "change in status" of a patient's health; we just don't get specifically paid for it.)

President Obama quickly responded to her statement, addressing the non-mandatory status of these consultations. (Funny how he doesn't respond so quickly to other criticisms, just when it's from Sarah Palin.... The left must really fear her.)

Sarah Palin has countered Obama's reply, and where the President's response was a dismissive slap, Palin's reply is a hard right cross to the jaw. Go and read her new statement --THIS is how we fight this socialist takeover of the medical care industry.

There is no time to waste! Call/write/fax/email your Congressman and Senators and let them know in no uncertain terms that you want H.R. 3200 to suffer a first-term abortion. Contact them daily.

Health Care via the United States Post Office, per President Obama

It's obvious that President Obama never had to make a living in sales (though that's an interesting observation about someone who makes his living selling himself in the world of politics). Otherwise he wouldn't have made the blunder he made today.

Now, we know that Mr. Obama is really pushing for a single-payer, government-controlled "health care" system. He's said so much in the past. And lest you think that his plan, being given birth in the form of H.R. 3200, is not a back door to a single payer government system, take a look at what Congressman Barney Frank had to say about this.

So why did Obama make this comparison, like he did today?:

"UPS and FedEx are doin' just fine.... It's the Post Office that's always havin' problems..."

So he compares his public option insurance plan (and thus the single-payer he's really after) to the Post Office -- that shining example of government 'efficiency' that is chronically slow, always loses money, stresses its employees such that everyone recognizes the phrase "going postal", and is now talking about having to cut back on services (i.e., rationing).

Meanwhile, everyone also recognizes that private, free-enterprise firms such as UPS and FedEx are faster, more efficient, and in the long run cheaper than the 'public option'.

Do the American people want a public, government-run "health care" system guaranteed to make us wait, fail to deliver on time, constantly becoming more and more expensive, and having to ration services just to function?

The opinions being expressed at townhall meetings across the country are a clear answer to that question. And that answer is not just no, but hell no!

There is no time to waste! Call/write/fax/email your Congressman and Senators and let them know in no uncertain terms that you want H.R. 3200 to suffer a first-term abortion. Contact them daily. Shut down Washington the way we did when we successfully killed that bastard of an immigration bill two years ago.