Historic Health Care Reform Bill Signed into Law

After months of wrangling and heated debates, President Barack Obama delivered on his campaign promise to make health care affordable to Americans by signing Tuesday a historic health care reform bill into law.  While the newly-signed law does not provide for a single payer system being pushed by progressives, it is lauded by many liberals and democrats as a step toward sweeping health care reform.

The most important features of the law include health insurance coverage for people with pre-existing conditions, protection of the insured against abuses from insurance companies (such as uncontrolled increase in insurance premiums), providing affordable insurance to the more than 30 million uninsured Americans through insurance exchanges and government subsidies, removal of lifetime limits on health insurance benefits, a cap on out-of-pocket expenses, tax credit for middle class families to afford health insurance, expansion of the medicaid program, substantial reduction in prescription drug prices to cover the gap under the Medicare prescription drug plan (called donut hole), among others.   

Even as now, however, a number of States, through their respective attorney generals, have filed lawsuits to challenge the constitutionality of the law, arguing that the federal government does not have the power to mandate individuals to purchase health insurance.  Constitutionalists, however, believe these suits will fail because the US Constitution empowers Congress under its commerce power to regulate health care.

Universal Access Health Care

Despite intense opposition from Republicans in Congress, President Barack Obama hopes to sign a government-run health care system by the end of the year.  A universal health care program or what is popularly known as universal access – or deridedly called socialized health care by conservatives – is simply a health care system run by the government, much like the Medicare (health insurance program for Americans 65 years old and up) and Medicaid (health insurance for low-income Americans).  It is also called a single-payer system. 

Those who object to universal access argue that it is costly, rations health care, will force people and businesses to give up their private insurance, and yet another effort at big government.  Let us examine these arguments individually.

Costly.  Opponents of the program may have just buttressed their arguments with a release by the Congressional Budget Office of a report estimating the cost of universal access plan to the whopping tune of $1.7 trillion!  In a country that is yet to rise from the mire of  economic crisis, not to mention a ballooning deficit, spending such a gigantic amount does not appear to make sense.  And the Obama administration as well as his allies in Congress are yet to give specifics on how to overcome this problem.  At best, Obama is only saying that the money can be raised from savings to be made in the operations of Medicare and Medicaid by addressing, among others, the fraudulent reimbursement practices of some health care providers that cost the government billions of dollars.  There is also suggestion to the effect that employee health care benefits be taxed – although this appears unlikely given Obama’s position during the campaign that health care should be treated as a right, rather than a privilege. 

Rationing.  A government-run health care could end up with people waiting in line to get treatments.  Proponents of universal access counter this by saying that there is already some form of rationing under our current health care system.  For most people with health insurance, unless it is an emergency, they still would have to wait before getting a doctor’s appoinment, which could take weeks or even months.  They argue further that in countries with a national health care system rationing only takes place on elective procedures (non-life threatening).

Destruction of Private Insurance. This is probably not the most convincing argument against universal access.  As Nobel Prize-winning economist Paul Krugman observes in his op-ed column in New York Times  Congress should not concern itself so much with the profit margins of private insurance companies.  Republicans in Congress, like Senate Minority Leader Mitch McConnell of Kentucky, claim that if a public option is created, individuals and businesses will lose their private health insurance coverage.  But this has been amply countered by Democrats in saying that the current plan being pushed only provides a public option, meaning those who want to be covered by it are free to do so and are not forced to give up their current insurance coverage.  As Obama has repeatedly said, those who want to stay with their current health care providers may do so.  Conservatives and Republicans, however, counter that since a public option would provide cheaper coverage most would certainly switch to it, thereby wiping out private insurance.  But isn’t this counter-intuitive?  It is precisely the high cost of private health insurance that there are 47 million uninsured and another 20 million underinsured.  A public option would make these insurance companies become competitive by lowering their costs while at the same time improving their services to stay afloat. 

Big Government.  House Minority Leader John Boehner of Ohio recently said that a government-run health care will incur the risk of government inefficiency in delivering services.  He posed the question of whether we would want the same type of service in going to the DMV for our medical treatments.  Instead of doctors, it would be government bureaucrats who would make our health care decisions.  But Jessamyn Conrad debunked the idea of inefficiency in a government-run health care in her book What You Should Know About Politics But Don’t by saying that Medicare actually spends almost 95% of its money directly for health services, and spends only 5% for administering the program as opposed to private insurance companies which spend 15% for administrative costs – one of the major factors for our costly  medical insurance. 

There is of course the argument that universal access is a step toward socialism.  But the question should not really be one of ideology, but rather what works better.  Whether it is called socialism or not if it works for the benefit of the vast majority of people it shouldn’t be a problem.  Besides, we have already been embracing a socialized program in the nature of the Social Security where we contribute to a pool of money which is utilized whenever a member of the program gets ill.  Also, we have long been paying for the medical treatments of people who have been convicted of crimes, not to mention the suspected terrorists in Guantanamo Bay!

Domestic Terrorism and Hate Crimes

With the stereo-typical portrayal of a terrorist as one with an Arabic ancestry, wearing an explosive vest and blowing himself up in a crowded place, you’d think all terrorists are like this.  But recent and current events have once again brought us back to the reality that even among us, there are those who are ready to spread havoc and kill innocent people who did nothing but be at the wrong place at the wrong time.  Who would expect that an 88-year old man would suddenly appear on the steps of the Holocaust Memorial Museum in Washington, D.C. today, shoot an unsuspecting security guard and attempt to enter the museum, where there are about 80 people – mostly kids on an educational field trip, to spread terror and possibly take several lives.

Fortunately, alert security guards inside the museum were able to stop this deranged man and shot him down before he could do any further damage.  As we write this, the shooter and the fallen guard are both in critical condition. 

James Von Brunn is the name of this domestic terrorist.  This man is a World War II veteran and is said to be highly decorated.  But there is another side to him.  He has been known by civil rights organizations as affiliated with white supremacist neo-nazi groups, and has written several incendiary articles attacking Jews, African-Americans and other minority groups.   From his sordid background, it is clear that this attack, coming only a few weeks after Dr. George Tiller of Kansas has been fatally shot point blank by a man believed to be against the doctor’s abortion activities, is a hate crime.

To this day that we already have a black president, it is unfortunate that racial hatred and violence still persist.  I’m not suggesting that by electing a black president America’s problems about race have already disappeared or will disappear.  It is just shocking to our moral sense that there are still some people who live with that non-sense and abominable idea that one race could be superior to another, and could go down to that pit of darkness so low that they would have no qualms about resorting to violence just to get their twisted message across.

Talk About Empathy

When President Obama mentioned empathy as one of the qualities he seeks in a Supreme Court nominee, Republicans and conservatives spared no time lambasting him, saying “empathy” is a code word for an activist judge or one who would interpret the law not in accordance with the intent of those wrote it but according to his or her own views and feelings.  But empathy might just be what Sen. Jeff Sessions has when he told Obama’s Supreme Court nominee Judge Sonia Sotomayor that she would get a fair confirmation hearing when the Senate Judiciary Committee considers her nomination.

 

Senators Sessions and Leahy – strange bedfellows?

 

In an interesting item on CNN this morning, CNN senior congressional correspondent Dana Bash reported that 23 years ago, when  39 year-old Jeff Sessions was Alabama’s Attorney General, Senator Sessions was nominated by then President Ronald Reagan to become a federal judge.  But due to charges of racial insensitivity – stemning from Session’s calling of a black man a boy and tagging the NAACP as engaging in “un-amercian activities,” among others – Session’s nomination was rejected by the Senate Judiciary Committee.  Just like Judge Sotomayor, Sessions has been branded as racist by Democratic senators who opposed his nomination.    

Now Senator Sessions will be among those in the Senate Judiciary Committee – the same committee that rejected his bid for judgeship 23 years ago – who will consider the nomination of Judge Sotomayor.  If anything, it’s probably empathy that is now restraining Sessions from joining the vitriolic attacks of his Republican partymates against Judge Sotomayor.  Interestingly, Senator Sessions now shares the committee with colleagues who were once his detractors, such as its chairman Sen. Patrick Leahy of Vermont, who made sure Sessions’s nomination would not be confirmed.

The Abortion Debate

Despite all the hubbub about General Motors entering into bankruptcy and the looming confirmation hearing of Federal Appeals Court Judge, now Supreme Court nominee Sonia Sotomayor, the abortion debate managed to share the headlines after the recent murder of so-called “abortion doctor” George Tiller of Kansas.   Dr. George Tiller became popular and, I should say, notorious for taking the lead in performing late-term abortions when most doctors have scruples about it. 

In a country where abortion is a highly divisive legal and moral issue, the murder of Dr. Tiller has once again resuscitated the debate on this controversial subject, with pro-choice (pro-abortion) groups labelling the killing as yet another effort by pro-life (anti-abortion) groups in resorting to “terroristic” means of pursuing their agenda.  The pro-lifers, on the other hand – at least those who choose only peaceful means – categorically deny this accusation and even expressed outrage for the killing, while at the same time renewing calls on their followers to continue the struggle against abortion.  Incidentally, as Judge Sotomayor faces the Senate Judiciary Committee for her confirmation to the Supreme Court, most expect the issue of abortion coming to the fore, where senators may grill her about her views on the famous 1973 abortion case of Roe v. Wade.  Since 1973, this case has been a favorite topic in confirmation hearings for nominees of the Supreme Court of the United States (SCOTUS); in fact, it defines to a large extent the ideological divide between liberals and conservatives on the court.

As a way of contributing to the debate, I would like to devote this posting on the prevailing rule on abortion.  Abortion was legalized in the United States when the SCOTUS in Roe v. Wade ruled that a woman’s right to privacy is broad enough to include her right to terminate her pregnancy.  But the SCOTUS, speaking through Justice Blackmun, was cautious enough to say that the right of abortion is not absolute; it gave the states the power to restrict the right when they can show compelling interest, such as protection of the woman’s health.  The SCOTUS went further to relate the states’ interest in regulating abortion to the woman’s period of pregnancy by referring to medical literature in dividing it into trimesters (dividing the normal nine months of pregnancy into three: first, second and third trimester).  It found that the first trimester is the riskiest for the woman and held for this reason that states could not restrict the woman’s right to have an abortion.  But it also ruled that states may assert legitimate interests in protecting the life of the fetus as the pregnancy nears birth. 

After Roe states have enacted abortion legislations.  Those that restricted the right have found their way to the SCOTUS and the most remembered, next only to Roe, is the 1992 case of Planned Parenthood of Southeastern Pennsylvania v. Casey.  This case established the rule on pre-viability and post-viability of the fetus.  Viability refers to the ability of the fetus to survive outside the womb on its own.  The rule enunciated is that at pre-viability (before viability), the states cannot impose undue burdens on the woman’s right to secure an abortion.  Thus, in Planned Parenthood the SCOTUS struck down the requirement that a woman must secure her husband’s consent to an abortion as being an undue burden.  At post-viability, on the other hand, states can prohibit abortion subject to the rule that if the woman’s health or life is threatened by pregnancy, abortion can be resorted to.   This post-viability period appears to be the time when late-term abortions, which were being performed by Dr. Tiller, take place. 

As it now stands, the prevailing rule is that a woman has the right to get an abortion during the pre-viability period of her pregnancy, and at post-viability the states can legitimately ban abortion except when the health or life of the woman is at stake.  Likewise, even during pre-viability states can enact legislations in the manner of obtaining abortions as long as these laws will not constitute undue burdens on the exercise of a woman’s abortion right.  In several cases, the SCOTUS found the following as not constituting undue burdens:  limiting the conduct of abortion to physicians only, imposing a waiting period of 24 hours to get an abortion, getting parental consent as long as an alternative to get consent from the courts is allowed, and getting the woman’s informed consent for an abortion, etc. 

With the SCOTUS serving as the forefront, the abortion debate has become more of a legal battle, rather than moral and political.  Since  the promulgation of  Roe,  unsuccessful attempts to overturn it have been made by the conservative bloc of the SCOTUS, and pro-lifers and pro-choice groups have played active roles in supporting or opposing candidates to the SCOTUS, depending on whether they are pro or anti-abortion.  It seems, however, that the conservatives will have to wait for the next SCOTUS vacancy to press their agenda as the replacement of Justice David Souter, a liberal, possibly by liberal Judge Sotomayor, will not affect the ideological balance of the court.   In a nine-member court with four identifiable liberals and four unqestionable conservatives, and a swing vote justice in the person of Anthony Kennedy – who has taken a position against overturning Roe in the Planned Parenthood case -  the fate of the abortion debate remains uncertain for anti-abortion groups.

Gratuitous Claims

Republicans who have mounted vicious attacks against Obama’s Supreme Court nominee Judge Sonia Sotomayor have unwittingly formed themselves in a circular firing squad.  By stooping low in their attacks, such as engaging in inane name-calling and by employing specious arguments, even their fellow and respected partymates disagree with them and are now the ones taking the heat.

Former House Speaker Newt Gingrich fired the first volley by calling Sotomayor a racist.  This accusation is based on Sotomayor’s 2001 speech at the University of California Berkeley where she mentioned that she “would hope that a wise Latino woman, with the richness of her experiences would, more often than not, reach a better conclusion than a white male who hasn’t lived that life.”  Thereafter, conservative radio commentator Rush Limbaugh called Sotomayor a bigot and other Republicans jumped in like a pack of hungry hyenas feasting on a carcass. 

But top Republicans, such as RNC Chairman Michael Steele, Senate minority leader Mitch McConnell, Sen. Lindsey Graham and Senate Judiciary Committee member Sen. Jeff Sessions, disagree with Gingrich and company.  They refuse to engage in this baseless characterization and urge their partymates to take the high road in scrutinizing the nominee’s records. 

While concededly Sotomayor’s statement is less than judicious, labelling her racist and judging her qualification to the highest judicial post in the land on the basis of this statement is certainly naive, if not ridiculous.  A person may at times use wrong choice of words, as White House Press Secretary Robert Gibbs said, but to really judge his or her character requires more than this choice of words.  These words may be indicators of a person’s thoughts and beliefs, but are not always conclusive.  In the case of Sotomayor, her record in the bench speaks for itself that she is not racist, and her being a Latina coming from a poor family is not the only record that she will bring to the Supreme Court, as ridiculously suggested by some.

In a survey of decisions handed down by the three-judge panel federal court where Sotomayor sat as a member, prominent D.C. lawyer and Supreme Court litigation specialist Tom Goldstein concluded in his popular SCOTUSblog that “given [Sotomayor's] record, it seems absurd to say that Judge Sotomayor allows race to infect her decisionmaking.”  Goldstein based this conclusion after finding that out of the 96 race-related cases decided by Sotomayor’s panel, she rejected discrimination as a factor by a ratio of 8 to 1.  Her panel upheld the claim of discrimination in only 10 cases,  but Goldstein was cautious to point out that these cases were successful only on procedural grounds, meaning the issue of race was not even tackled in substance and the claimants won based on certain technicalities only.

Another issue Sotomayor’s attackers are harping on is the possibility that her ethnic background will influence her decisions in the Supreme Court if confirmed.  This has, however, been sufficiently rebutted by Sotomayor’s backers by saying that a judge is also a human being who is shaped, like everyone else, by his or her background and upbringing and human nature is such that these factors would somehow factor in.   In fact, as has already been pointed out, even Justice Samule Alito, a conservative and a Republican appointee,  admitted during his confirmation hearing that his background as a child of immigrant parents influenced his decision-making on the bench, especially on discrimination and immigration-related cases.    What is important here is that this background should not be the only parameter in the decision-making process, but only as one of the perspectives on how the law is to be applied.

Finally, on the claim that Sotomayor does not possess the necessary credentials, suffice it to say that she graduated summa cum laude at Princeton, earned her J.D. from Yale Law School where she was editor of the law review journal, and brings with her a long and outstanding record of legal and judicial career.

What’s interesting in all of these is that despite the vitriols being heaped on Sotomayor, she is likely to sail through the confirmation process without much of an objection, making the attacks pointless.   The only conceivable reason Gingrich and company are doing this is to fire up their base and keep their following interested in them.  But what they really miss is that these kinds of attacks don’t really help the Republicans at all.

Rebuffing Bush and Cheney

Former Vice President Dick Cheney has been busy doing the rounds lately defending Bush-sanctioned interrogation techniques.  He claims that torture . . . I mean ”enchanced interrogation”  has enabled the US to extract valuable information from suspected terrorists that saved hundreds, possibly thousands, of American lives.  Cheney says there are CIA memos that would back his claim and hopes the Obama administration will declassify them.

Finally somebody – someone with authority and credibility – has decided to rebuff Cheney.  In a recent speech, Senator Carl Levin, a Democrat from Michigan and a ranking member of the Senate Armed Services Committee, categorically stated that there are no such CIA memos; there are no memos showing facts and figures that would back Cheney’s claims and establishing a correlation between torture and averting of a terrorist attack against Americans.  As a member of the Senate Armed Services Committee, Senator Levin has access to highly classified government documents and information.  Republicans on the committee would, of course, refute Senator Levin’s assertion if it were not the case.

Then came General David Petraeus, Bush’s former point man in Iraq who was behind the success in the surge of troops there during the waning days of the Bush administration.  In an interview, the baby-faced general did not mince words by saying that the US violated the Geneva Convention Against Torture, in a clear rebuff of former President George W. Bush’s declaration that no violation of international law was committed in dealing with suspected terrorists.  Now General Petraeus is not a politician; he is a professional soldier.  If ever torture was committed by our troops and intelligence operatives he would certainly be aware or would have known it.

As we can see, witnesses after witnesses are surfacing to rebut the Bush-Cheney position on torture.  This is not even mentioning the FBI interrogator who recently testified in Congress and FBI Director Robert Mueller - who also made statements contrary to the Bush-Cheney position.  All these damning evidence should already silence Cheney, so as not to unnecessarily incriminate himself. Invoking the right to remain silent wouldn’t be a bad idea.