How's The Fishing?

I am reminded by Bill Cosby that dentists always like to talk to you when they have sharp instruments in your mouth.

"Do you do much fishing?"  he would start as he described the process of a conversation between patient and provider in the dentist's chair.  I believe him all the more now because my dentist seems to have the same habit.

As dentists go, he is a good guy.  He works to keep you comfortable.  He is personable.  He doesn't pontificate about why I need to floss nineteen times a day.  He just goes about his business and likes to ask questions that can't be answered thumbs up/thumbs down.  Oh well.

If this is the biggest problem I have, I guess I don't have problems.  Good Monday to you all.

I Scream, You Scream... (Reprise)

In the category of "Are You Serious?" a baseball player, namely Jesus Montero, should have been ejected for trying to brawl...with a cross checker, a senior level scout, from his own organization.

The media story goes Montero who showed up to Spring Training a hefty forty pounds overweight was coaching first base in Boise for the Everett Aquasox and was told to speed up on his way back to his dugout by the cross checker.

Deadspin reports that Montero who did not respond to the calls of Rapido! Rapido! then had an ice cream sandwich ordered for him by the cross checker and sent down to him in the dugout. At this point, Montero decided to throw the sandwich into the stands and may have held a bat in a menacing way.

Hmmm....so....was he mad it wasn't a banana split or was he mad he was being called out for not managing his weight as you might expect a professional athlete to do?  Despite being banned for 50 games last year due to a PED suspension, Montero did not seem to take the discipline to heart.

For me I do not mind a cross checker busting him for not busting it.  So far, Montero has hardly shown himself to be Major League material despite the initial projections which we now have to presume were PED driven.  Further, he seems to take his current standing as an opportunity to be lazy rather than to push himself every day?  What message does he send his team mates when he is not willing to work the weight off - especially after being shown to be a cheat?

I look at this really simply.  Montero showed up to Spring Training unable to play pro ball because he did not do the things he had to so that he could contribute.  He has ended up on a rehab assignment to the Northwest League where he can't seem to fight his urges at the dinner table, but is more than willing to fight the people who expect him to perform.  Further he isn't in Everett, Washington to play and get in some game time...just to rehab, i.e. he can't even play on a Short Season A Ball team!

I scream and apparently so should Mariners management who traded away an above average pitching prospect for this knucklehead.

Could We Or Should We?

An article in the The Independent this earlier this week reviewed the machinations occurring in Great Britain as their Parliament considers whether or not to make mitochondrial donation legal when it comes to In-Vitro Fertilization (IVF).

Though the process or "three parent" IVF was banned by the Food and Drug Administration there has been no public discussion about whether or not the procedure was safe.  Saint Barnabas Medical Center in New Jersey performed the procedures on many of the children currently alive and is studying whether or not there were any long term affects, but has refused comment to those interested in its survey results.  It would seem they are unwilling to share the bad news that their actions did not produce children without healthcare worries, but perhaps transferred new worries to the parents.  After all, if the results were good I suspect they would be ringing the newspapers instead of avoiding the questions like Cindy Lucus who would not answer questions for me or the Independent.


Science seems very comfortable treating children as a commodity.  If you want one, we can provide one.  You do not need to be in a marriage, you do not need to be in a marriage of man and woman.  We can develop a child for you - in the lab.  Perhaps, you would like a tall boy, blonde hair or brown, green eyes, or blue.  Science seems able to make all these decisions for us without questioning the cost.

The cost of course is not just is the procedure safe short and long term, but is it safe from how we view children.  Are they just a commodity that if I produce, but don't want I can dispose of easily?
  The American left loves to talk about caring for children, but again and again, children seem to simply be a commodity.

I can have a child on demand.  My friends who veer liberal also tend to be the first to complain about their child's selfish desires - I wonder if those are genetic too.  Moreover, while it is uncomfortable for anyone to think about, IVF is linked to higher birth defects.  Again, these are the same parents generally who think abortion on demand is okay or abortion to save a child from a birth defect.

Once again, it seems science is ready to take its hand into the world of God.  Once again, it appears that the slippery slope of science (and dollars of course) is more interested than a perfect child than any child.  It was only last week that scientist Richard Dawkins suggested it immoral to not abort a child who had been diagnosed with Down's Syndrome in utero.  Immoral to kill a child because of a disease?  Really?

This is the talk of Adolph Hitler.  Once again the reality is, Adolph Hitler spoke of systematically killing those children deemed "mentally defective."  Here, Mr. Dawkins speaks of the same idea yet he is not ostracized by the scientific community.  Hitler too believed in the mercy decree of allowing people the peace of death rather than suffering through life as "defective."

While the two items seem different, they are not.  In both cases, science wishes to enter the world of creation by adding their two cents.  They believe they can safely create a human being from three person's genetic material, but the issues is not can they, but should they.  Unfortunately, it does not appear that anyone is asking that question.

Are You Ready For Some Obamacare?

As the NFL season gets ready to descend upon us, I can almost hear the yelp of "Are you ready for some football?"  Unfortunately for the White House and Democrats on the campaign trail though, they should be worried about Obamacare and based on their silence on the issue I am guessing they are.  So are you ready for Obamacare...because it is about to get fun?

(1) You realize that premiums, which have already started going north, are headed for big bumps in 2015.  You get to see them come September 1 when open enrollments begin for folks.  Part of the original political plan to re-elect the President in 2012 was to have all the Obamacare goodies show up early and delay the pain, but the pain starts this year and keeps getting good through 2018 when Cadillac healthcare plans start getting taxed.  Hard.

According to Price-Waterhouse-Coopers, Arkansas, Iowa, North Carolina, Tennessee, and Virginia are all on pace for premium increases between ten and fifteen percent.  Louisiana may be on pace for twenty percent hikes.  I am guessing these will not be good tidings for US Senate candidates in Arkansas, Iowa, or North Carolina.

Premiums will likely go up even further given many of the participants who signed up for coverage, are not paying for it.  The system does not work when healthy young people do not sign up and pay for their coverage.  Maybe they are figuring out that Mr. Obama sold the proverbial pipe dream.

(2) From a practical perspective, not that Mr. Obama is Mr. Practical, he just doesn't get it.  Mr. Obama likes to blame President Bush for a number of issues, but does nothing to correct them.  The economy was bad when Obama was first inaugurated, but he has had the opportunity to correct that.  Instead he has gone out of his way with legislation like Obamacare to discourage employers from employing people.  If you want an improving economy, you do that by helping people get jobs that match their skill set, not by raising the cost of job creation which is exactly what Obamacare does.


(3)  Obamacare supporters keep crying every time a court strikes down requirements that do not allow conscience objections when people who do not want to pay for abortion are forced to...there seems to be no connection between the idea that if you want me out of your body, don't ask me to pay for your body.

In the meantime, Mr. Obama and Company have shown that they have zero understanding that we elected him President, not Emperor, and because of that have zero interest in paying for others' abortions, limiting the size of our sodas, or his wife's inability to allow school bake sales.  Obamacare is one more example of an administration run amok gleeful with its own happy juice of how great they are.

(4) The constitutional law professor we elected should be in for an interesting Supreme Court term, if not this year, then next, as the question of state exchanges gets worked out.  The fact is you had to pass the bill to see what was in it as then Speaker Nancy Pelosi famously quipped.  Unfortunately, the bill was passed and then created by a group of teenagers apparently who either did not understand combinations of equal protection laws, the implications to the tax code, or how healthcare really works.

(5) Finally, returning to Mr. Obama's practicality issue - he missed the boat on keeping your doctor.  You will remember his famous promise that if you like your doctor, you can keep your doctor.  Meanwhile, because of Obamacare regulations, networks have not gotten bigger, but smaller.  In New Hampshire, Anthem Blue Cross Blue Shield, the only participant in the marketplace gutted ten of the state's twenty-six hospitals from its coverage.  Two in five of you are probably out of luck when it comes to local care if you live in New Hampshire.

So as football season starts, so does the political football season.  This one should be pretty rough and tumble, but on this one, the Xs and Os were designed by the President so while we as a nation lose it is because of the game plan designed by the coach.

Anthem Blue Cross and Blue Shield

hat ever happened to Obamacare -- the unpopular healthcare bill that was to be the Republicans big weapon as they battled for control of the Senate this fall?   For sure, the Affordable Care Act has been pushed to the sidelines by the chaos in Iraq, Russia’s invasion of Ukraine, the surge in Central American minors across our border, the Veterans Administration scandal, the pestilential virus rampaging across the computers of the federal government, and so much more…
Now, the GOP should circle back. There are nine Senate seats described as “toss-ups” by Real Clear Politics, and Obamacare could move the needle in some of those races. The ACA is still a political stink bomb, with Kaiser Family Foundation polling showing only 37 percent of the country views the law favorably – one of its lowest ratings since it passed in 2010.  Some 53 percent of Americans have an unfavorable opinion of the ACA - up a shocking 8 points since June.
Related: Insurers Say Obama’s ‘Fix’ Is Driving Up Premiums
Democrats understandably have neglected to highlight Obamacare on their campaign sites. Instead, for example, North Carolina’s Kay Hagan implores visitors to “Take a Stand Against the Koch Brothers,” which must confuse the uninitiated. Bruce Braley, running in Iowa, focuses on veterans’ issues and the farm bill. Nary a word on Mr. Obama’s legacy issue.

IG: Obamacare’s Medical Device Tax Not Bringing In...

According to a federal report issued Tuesday, Obamacare’s controversial medical device tax isn’t bringing in nearly as much cash as expected. The Treasury inspector general for tax administration found that the...

Several GOP campaign sites go light on Obamacare too. Thom Tillis in North Carolina broadcasts Kay Hagan’s close ties to President Obama, while David Perdue in Georgia emphasizes his business background. Joni Ernst, running neck in neck for the Iowa seat, brags on her front page, “I grew up castrating hogs on an Iowa farm, so in Washington I’ll know how to cut pork.” Some local color.
Other Republicans are following the expected playbook. Scott Brown, campaigning for the New Hampshire seat held by Jeanne Shaheen, goes all in against Obamacare. Ditto Republican Cory Gardner, running an uphill battle against Mark Udall in Colorado, who notes that 335,000 Coloradans lost their policies because of the ACA.
Bill Cassidy, with a light lead against Mary Landrieu in Louisiana, charges that Obamacare is causing that state’s premiums to rise. But Cassidy lists it fifth of five issues, after amnesty, purportedly “illegal” travel expenditures and other missteps by the incumbent.
While local issues vary, Republicans should double down, and remind voters how much they dislike the ACA. Why?
Related: So Far, Obamacare’s Hospital Reform Isn’t Working
1. Big premium hikes are slated for 2015. Because the country erupted in outrage over the millions of policies cancelled under Obamacare, which made a lie of the president’s vow, “If you like your insurance you can keep it,” the White House reversed course and allowed people to maintain existing coverage. As a result, the Obamacare exchanges were starved of the healthier people needed to pay for the sick and poor previously without insurance. Insurers are now planning to raise premiums.
According to PwC Health Research Institute, the average premium increase request for 2105 in North Carolina is 10.8 percent; in Iowa the hike is 11.5 percent. Many in Louisiana are looking at almost a 20 percent increase, and in Arkansas nearly 12 percent. That’s big, unpleasant news for Democrats.
2. Critics claim the Obama administration is fudging the ACA enrollment numbers. The White House trumpeted that 8 million Americans had signed up for Obamacare, but that total has been shrinking. Aetna, one of the program’s biggest players, reports that of their 720,000 enrollees, only about 600,000 are paying for their coverage, a number they expect will drop to about 500,000 by year-end. Other insurers indicate fall-off as well.
3. People are angry about the narrower choices of doctors and hospitals available to them.  In New Hampshire, Anthem Blue Cross and Blue Shield was the sole insurer participating in the marketplace; it eliminated 10 of the state’s 26 hospitals from its network. According to Politico, such is the uproar about shrinking choices that “since the beginning of 2013, more than 70 bills have been introduced in 22 states to clarify the network rules, according to the National Conference of State Legislatures.” In California, more than one group has sued Anthem Blue Cross, charging that the insurer misrepresented the scope of its doctor network.
Related: Up to 300,000 Could Lose Obamacare on Federal Exchange
4. The ACA was constructed incompetently. The U.S. Court of Appeals for the D.C. Circuit recently ruled illegal the federal subsidies paid to Obamacare enrollees in states that have not set up their own exchanges -- a stark reminder of how badly the healthcare bill was implemented. This and other unintended consequences are excellent arguments for significantly overhauling the ACA – an undertaking that might be possible under a Republican Senate but that has little or no hope otherwise.
5. Obamacare highlights the president’s imperial tendencies. Mr. Obama has single-handedly changed the ACA some 24 times, delaying important provisions such as the employer and individual mandates. The president has rigged the rollout of the ACA to political advantage, putting off the most painful aspects of the bill and front-loading the goodies. Republicans should remind voters we have yet to encounter, for instance, the 40 percent Cadillac tax, which has been pushed back until 2018, but which is expected to raise as much as $214 billion by 2023.
6. Obamacare undermines job creation. The ACA has been the most important of a number of White House policies that have discouraged job creation at a time when the country is struggling to put people back to work. At last tally, there were 92 million adult Americans who are not working (like stay-at-home moms), are unemployed, retired or disabled. The workforce participation rate is at a decades-long low. This is unsustainable, and Obamacare is not helping. Companies have limited their hiring and also the number of hours their employers work because of the bill and have faced increased uncertainty. Meanwhile, because of the ACA, Americans no longer need to work to get health benefits – maybe a good thing for individuals, but not for a country whose safety net must be funded by an ever-greater workforce.
In short, there’s still meat on the bones of the Obamacare carcass; Republicans running for office should get out their knives and forks.
- See more at: http://www.thefiscaltimes.com/Columns/2014/08/20/6-Reasons-Obamacare-Can-Win-Senate-GOP#sthash.9It4kWMD.dpuf

at ever happened to Obamacare -- the unpopular healthcare bill that was to be the Republicans big weapon as they battled for control of the Senate this fall?   For sure, the Affordable Care Act has been pushed to the sidelines by the chaos in Iraq, Russia’s invasion of Ukraine, the surge in Central American minors across our border, the Veterans Administration scandal, the pestilential virus rampaging across the computers of the federal government, and so much more…
Now, the GOP should circle back. There are nine Senate seats described as “toss-ups” by Real Clear Politics, and Obamacare could move the needle in some of those races. The ACA is still a political stink bomb, with Kaiser Family Foundation polling showing only 37 percent of the country views the law favorably – one of its lowest ratings since it passed in 2010.  Some 53 percent of Americans have an unfavorable opinion of the ACA - up a shocking 8 points since June.
Related: Insurers Say Obama’s ‘Fix’ Is Driving Up Premiums
Democrats understandably have neglected to highlight Obamacare on their campaign sites. Instead, for example, North Carolina’s Kay Hagan implores visitors to “Take a Stand Against the Koch Brothers,” which must confuse the uninitiated. Bruce Braley, running in Iowa, focuses on veterans’ issues and the farm bill. Nary a word on Mr. Obama’s legacy issue.

IG: Obamacare’s Medical Device Tax Not Bringing In...

According to a federal report issued Tuesday, Obamacare’s controversial medical device tax isn’t bringing in nearly as much cash as expected. The Treasury inspector general for tax administration found that the...

Several GOP campaign sites go light on Obamacare too. Thom Tillis in North Carolina broadcasts Kay Hagan’s close ties to President Obama, while David Perdue in Georgia emphasizes his business background. Joni Ernst, running neck in neck for the Iowa seat, brags on her front page, “I grew up castrating hogs on an Iowa farm, so in Washington I’ll know how to cut pork.” Some local color.
Other Republicans are following the expected playbook. Scott Brown, campaigning for the New Hampshire seat held by Jeanne Shaheen, goes all in against Obamacare. Ditto Republican Cory Gardner, running an uphill battle against Mark Udall in Colorado, who notes that 335,000 Coloradans lost their policies because of the ACA.
Bill Cassidy, with a light lead against Mary Landrieu in Louisiana, charges that Obamacare is causing that state’s premiums to rise. But Cassidy lists it fifth of five issues, after amnesty, purportedly “illegal” travel expenditures and other missteps by the incumbent.
While local issues vary, Republicans should double down, and remind voters how much they dislike the ACA. Why?
Related: So Far, Obamacare’s Hospital Reform Isn’t Working
1. Big premium hikes are slated for 2015. Because the country erupted in outrage over the millions of policies cancelled under Obamacare, which made a lie of the president’s vow, “If you like your insurance you can keep it,” the White House reversed course and allowed people to maintain existing coverage. As a result, the Obamacare exchanges were starved of the healthier people needed to pay for the sick and poor previously without insurance. Insurers are now planning to raise premiums.
According to PwC Health Research Institute, the average premium increase request for 2105 in North Carolina is 10.8 percent; in Iowa the hike is 11.5 percent. Many in Louisiana are looking at almost a 20 percent increase, and in Arkansas nearly 12 percent. That’s big, unpleasant news for Democrats.
2. Critics claim the Obama administration is fudging the ACA enrollment numbers. The White House trumpeted that 8 million Americans had signed up for Obamacare, but that total has been shrinking. Aetna, one of the program’s biggest players, reports that of their 720,000 enrollees, only about 600,000 are paying for their coverage, a number they expect will drop to about 500,000 by year-end. Other insurers indicate fall-off as well.
3. People are angry about the narrower choices of doctors and hospitals available to them.  In New Hampshire, Anthem Blue Cross and Blue Shield was the sole insurer participating in the marketplace; it eliminated 10 of the state’s 26 hospitals from its network. According to Politico, such is the uproar about shrinking choices that “since the beginning of 2013, more than 70 bills have been introduced in 22 states to clarify the network rules, according to the National Conference of State Legislatures.” In California, more than one group has sued Anthem Blue Cross, charging that the insurer misrepresented the scope of its doctor network.
Related: Up to 300,000 Could Lose Obamacare on Federal Exchange
4. The ACA was constructed incompetently. The U.S. Court of Appeals for the D.C. Circuit recently ruled illegal the federal subsidies paid to Obamacare enrollees in states that have not set up their own exchanges -- a stark reminder of how badly the healthcare bill was implemented. This and other unintended consequences are excellent arguments for significantly overhauling the ACA – an undertaking that might be possible under a Republican Senate but that has little or no hope otherwise.
5. Obamacare highlights the president’s imperial tendencies. Mr. Obama has single-handedly changed the ACA some 24 times, delaying important provisions such as the employer and individual mandates. The president has rigged the rollout of the ACA to political advantage, putting off the most painful aspects of the bill and front-loading the goodies. Republicans should remind voters we have yet to encounter, for instance, the 40 percent Cadillac tax, which has been pushed back until 2018, but which is expected to raise as much as $214 billion by 2023.
6. Obamacare undermines job creation. The ACA has been the most important of a number of White House policies that have discouraged job creation at a time when the country is struggling to put people back to work. At last tally, there were 92 million adult Americans who are not working (like stay-at-home moms), are unemployed, retired or disabled. The workforce participation rate is at a decades-long low. This is unsustainable, and Obamacare is not helping. Companies have limited their hiring and also the number of hours their employers work because of the bill and have faced increased uncertainty. Meanwhile, because of the ACA, Americans no longer need to work to get health benefits – maybe a good thing for individuals, but not for a country whose safety net must be funded by an ever-greater workforce.
In short, there’s still meat on the bones of the Obamacare carcass; Republicans running for office should get out their knives and forks.
- See more at: http://www.thefiscaltimes.com/Columns/2014/08/20/6-Reasons-Obamacare-Can-Win-Senate-GOP#sthash.9It4kWMD.dpuf, N

at ever happened to Obamacare -- the unpopular healthcare bill that was to be the Republicans big weapon as they battled for control of the Senate this fall?   For sure, the Affordable Care Act has been pushed to the sidelines by the chaos in Iraq, Russia’s invasion of Ukraine, the surge in Central American minors across our border, the Veterans Administration scandal, the pestilential virus rampaging across the computers of the federal government, and so much more…
Now, the GOP should circle back. There are nine Senate seats described as “toss-ups” by Real Clear Politics, and Obamacare could move the needle in some of those races. The ACA is still a political stink bomb, with Kaiser Family Foundation polling showing only 37 percent of the country views the law favorably – one of its lowest ratings since it passed in 2010.  Some 53 percent of Americans have an unfavorable opinion of the ACA - up a shocking 8 points since June.
Related: Insurers Say Obama’s ‘Fix’ Is Driving Up Premiums
Democrats understandably have neglected to highlight Obamacare on their campaign sites. Instead, for example, North Carolina’s Kay Hagan implores visitors to “Take a Stand Against the Koch Brothers,” which must confuse the uninitiated. Bruce Braley, running in Iowa, focuses on veterans’ issues and the farm bill. Nary a word on Mr. Obama’s legacy issue.

IG: Obamacare’s Medical Device Tax Not Bringing In...

According to a federal report issued Tuesday, Obamacare’s controversial medical device tax isn’t bringing in nearly as much cash as expected. The Treasury inspector general for tax administration found that the...

Several GOP campaign sites go light on Obamacare too. Thom Tillis in North Carolina broadcasts Kay Hagan’s close ties to President Obama, while David Perdue in Georgia emphasizes his business background. Joni Ernst, running neck in neck for the Iowa seat, brags on her front page, “I grew up castrating hogs on an Iowa farm, so in Washington I’ll know how to cut pork.” Some local color.
Other Republicans are following the expected playbook. Scott Brown, campaigning for the New Hampshire seat held by Jeanne Shaheen, goes all in against Obamacare. Ditto Republican Cory Gardner, running an uphill battle against Mark Udall in Colorado, who notes that 335,000 Coloradans lost their policies because of the ACA.
Bill Cassidy, with a light lead against Mary Landrieu in Louisiana, charges that Obamacare is causing that state’s premiums to rise. But Cassidy lists it fifth of five issues, after amnesty, purportedly “illegal” travel expenditures and other missteps by the incumbent.
While local issues vary, Republicans should double down, and remind voters how much they dislike the ACA. Why?
Related: So Far, Obamacare’s Hospital Reform Isn’t Working
1. Big premium hikes are slated for 2015. Because the country erupted in outrage over the millions of policies cancelled under Obamacare, which made a lie of the president’s vow, “If you like your insurance you can keep it,” the White House reversed course and allowed people to maintain existing coverage. As a result, the Obamacare exchanges were starved of the healthier people needed to pay for the sick and poor previously without insurance. Insurers are now planning to raise premiums.
According to PwC Health Research Institute, the average premium increase request for 2105 in North Carolina is 10.8 percent; in Iowa the hike is 11.5 percent. Many in Louisiana are looking at almost a 20 percent increase, and in Arkansas nearly 12 percent. That’s big, unpleasant news for Democrats.
2. Critics claim the Obama administration is fudging the ACA enrollment numbers. The White House trumpeted that 8 million Americans had signed up for Obamacare, but that total has been shrinking. Aetna, one of the program’s biggest players, reports that of their 720,000 enrollees, only about 600,000 are paying for their coverage, a number they expect will drop to about 500,000 by year-end. Other insurers indicate fall-off as well.
3. People are angry about the narrower choices of doctors and hospitals available to them.  In New Hampshire, Anthem Blue Cross and Blue Shield was the sole insurer participating in the marketplace; it eliminated 10 of the state’s 26 hospitals from its network. According to Politico, such is the uproar about shrinking choices that “since the beginning of 2013, more than 70 bills have been introduced in 22 states to clarify the network rules, according to the National Conference of State Legislatures.” In California, more than one group has sued Anthem Blue Cross, charging that the insurer misrepresented the scope of its doctor network.
Related: Up to 300,000 Could Lose Obamacare on Federal Exchange
4. The ACA was constructed incompetently. The U.S. Court of Appeals for the D.C. Circuit recently ruled illegal the federal subsidies paid to Obamacare enrollees in states that have not set up their own exchanges -- a stark reminder of how badly the healthcare bill was implemented. This and other unintended consequences are excellent arguments for significantly overhauling the ACA – an undertaking that might be possible under a Republican Senate but that has little or no hope otherwise.
5. Obamacare highlights the president’s imperial tendencies. Mr. Obama has single-handedly changed the ACA some 24 times, delaying important provisions such as the employer and individual mandates. The president has rigged the rollout of the ACA to political advantage, putting off the most painful aspects of the bill and front-loading the goodies. Republicans should remind voters we have yet to encounter, for instance, the 40 percent Cadillac tax, which has been pushed back until 2018, but which is expected to raise as much as $214 billion by 2023.
6. Obamacare undermines job creation. The ACA has been the most important of a number of White House policies that have discouraged job creation at a time when the country is struggling to put people back to work. At last tally, there were 92 million adult Americans who are not working (like stay-at-home moms), are unemployed, retired or disabled. The workforce participation rate is at a decades-long low. This is unsustainable, and Obamacare is not helping. Companies have limited their hiring and also the number of hours their employers work because of the bill and have faced increased uncertainty. Meanwhile, because of the ACA, Americans no longer need to work to get health benefits – maybe a good thing for individuals, but not for a country whose safety net must be funded by an ever-greater workforce.
In short, there’s still meat on the bones of the Obamacare carcass; Republicans running for office should get out their knives and forks.
- See more at: http://www.thefiscaltimes.com/Columns/2014/08/20/6-Reasons-Obamacare-Can-Win-Senate-GOP#sthash.9It4kWMD.dp

Speechless

I am at a loss.  A loss for words.

As a Catholic I understand the church teaching on life, from conception to natural death.  Suicide is not part of the catechism and is not an option.  I am also an EMS responder and I know that it is an option though all too often.

Tonight after a happy go lucky family dinner I was stopped with the words that Robin Williams, one of my favorite actors, had apparently taken his own life.

I am here at a keyboard, unsure how to process this.  Williams was one of those people on my Ten People To Meet list.  Ugh.  Ouch.  Why?  Why would he prevent the world from his talents?  Why is it he did not find the same joy he brought to others with his characters from the Genie in Aladin to Adrian Cronauer in Good Morning Vietnam.

I have known for years he has battled both addiction and depression.  Surely he did not need Obamacare to find a physician who could treat him.  He placed himself back in rehab earlier this year to help keep himself sober.  Surely he had all the mechanisms in place to maintain his own safety.

His performance as Sean Maguire in Good Will Hunting made me believe he had it together and could overcome.  His performance made us believe...like most of us do when we want to think things are okay.

I look at him and he is a classic manic depressive and his audiences got to see those great moments when he was on.  When he loved us for loving him and he found ways to entertain us in new and inventive ways.

My question for this lost life is who is the next person who will take their own life because we missed the signs they were in deeper than we thought they were.  We have lost an amazing talent.  We have lost a man who could make us laugh with ease in any film, who brought us to tears over his student's self-inflicted death who fought too hard to find his voice (Dead Poets Society), and he reminded us of the importance of family in Hook and Mrs. Doubtfire.

I wrote about responder suicide back in February and whether it be an Oscar winning actor or a guy who I have ridden the ambulance with it breaks me.  Why would someone take the gift given to them and take it away from everyone else?

I am horrified.  Not by the act alone, but the utter desperation that must exist in those who can find no way out of the pain in their own mind, but to stop their mind and body.  I speak regularly across the country and parts of the world and I usually can get by in any conversation, but tonight, I am speechless.

The Real Illness

Unbelievable or Expected?

Jim Irsay recently had his driving license suspended for refusing a blood test after his arrest for driving and possibly intoxicated.  He was found with nearly $30,000 in cash and a number of prescription pain killers

Irsay checked himself into rehab, but I am not sure it is working.

Irsay's comments after the suspension of his license in an article in the Indianapolis Star included the comments, "these diseases, both alcoholism and addiction, much like bipolar or depression and different illnesses, are still not seen as real diseases..."  He goes on "I really think the disease aspect gets lost when you're talking about alcoholism and addiction -- it's not like you're battling leukemia or a heart problem."

The difference is Mr. Irsay, no one asks to have leukemia.  That one just gets plopped into your lap.  Whether or not you start on pain pills though is a whole other issue and I say that as an advocate for treating pain.

One thing, I do know about addiction though is the healing starts when you admit there is a problem.  Right now, it appears Mr. Irsay is still ready to blame someone or something else....his genetics, the initial injury or whatnot that caused is back pain, etc.

In an organization that has reportedly pushed pills down the throats of its players, I am a little surprised you want to get into the business of blaming others for creating addiction and then ask for sympathy as if your disease is beyond your control.  Maybe I am wrong here, but it seems like the real illness isn't addiction, it's denial.

Put The Fork Down...It Aint Genetics

A recent article in the British Medical Journal argues that the obesity epidemic is not secondary to a genetic condition that wasn't obvious for hundreds of years, but that obesity is caused by our eating habits and lifestyles.

A follow up from Art Caplan, from the Division of Medical Ethics at the NYU Langone Medical Center, notes that in a thirteen mile stretch of rural Pennsylvania he was driving he counted "19 kings, arches, colonels, and so on."

His point was that while genetics may have an influence on body size, more likely it is lack of discipline and the wide nature of choices we have...everywhere.

The study was clear that those most exposed to fast food were likely to have higher body mass indexes.  Again, I consider myself a foodie and love to eat.  Do I eat to excess?  Probably.  Do I blame it on genetics though?  No.  My family weight issues (to the extent they exist) have everything to do with excuse making and lack of willingness to get off the couch.  I feel lucky I have pretty active kids who want to play baseball with me or who want to run around the block.

For me though, Caplan's piece is equally important as the original study as it comes from the perspective of a medical ethicist.  We need to stop making "easy way out" excuses for our patients.  I know in EMS I have heard way too many partners who provide the excuse to the patient who wants a cigarette.  I have seen a 32 year old woman who I transported for open heart surgery two weeks earlier buying her cigarettes at the local pharmacy.  (She had a weight problem too.)

Weight is no different.  As a culture we need to step up and realize we have an obesity problem.  Part of that is putting the fork down, but the other part of that is putting the excuses down first.

Companies Are People...Or Not.

So, where are all my court watchers?  This Supreme Court of the United States (SCOTUS) term is about to get interesting.

This Tuesday, the justices will hear cases about whether or not the government can mandate a company to provide birth control to its employees via the Affordable Coverage Act, known as Obamacare.  Not being a lawyer, I am not sure which way this case goes.

It would seem that the court has two very distinct directions in could lean on.

One, it just said the ACA was legal and appropriate in one of the worst decisions I think I have ever witnessed.  Chief Justice Roberts basically wrote a defense of the ACA on grounds that weren't argued.  He provided the judicial activism conservatives love to hate.  That decision provides the groundwork that the government can tell you what you will buy and when and how whenever it wants to.  The loss of freedom in that basic decision is appealing.  It is almost as bad as the fact that four justices agreed that the government has the right to tell you to buy Coke or Pespi.  What?

The issue here is that there are companies who do not want to provide birth control to their employees saying it goes against their religious beliefs.  That is a serious fundamental question that will make other things interesting to like can I deny you the right to service at my restaurant if I find anything about you contradicts my religious beliefs.

Meanwhile, the Citizens United opinion was clear that companies could spend money on elections because to do otherwise would deprive them of their right to speech.  What company has a right to political speech?  Well, according to SCOTUS, they all do.  That being the case, it should not that big a jump to say companies like Hobby Lobby should also have the right to religious beliefs as well.

Since the First Amendment covers both the right to speech and religious choice one should not be inclined to believe this would be a big jump, but this will be another interesting one for sure.

Hold onto your seats folks...this one will be interesting.

Illness

The sickness continues.

I am not sure how else to describe what I saw earlier in the Washington Times, but depravity and illness.  Mostly mental.

A non-profit group in Washington, D.C. - The DC Abortion Fund (DCAF) - offered a small momento to those who contributed on an ongoing basis to their needs.  A necklace with a small hanger attached.

I guess I am silly enough to first wonder how much difficulty the IRS gave this group in establishing it as a non-profit.  Groups aimed at educating on the Constitution or balanced budgets can't seem to get non-profit status, but I bet it wasn't too hard for this group aimed at removing rights from those waiting to be born.

Part two though is why?  Why would you use a symbol of death as a sign to point to as something positive.  How did your world end up so upside down that you consider ending another life, usually for your own self advancement, a good thing?

At what point to people consider that they are celebrating the taking of an innocent?

With tens of millions killed since Roe v. Wade took over the landscape, why is it we celebrate the coat hanger?  Would we do this with the Nazi swastika?  Would we celebrate Joseph Stalin killing millions of his countrymen as a positive?  Of course not.

I say of course not because NPR would run sad documentaries outlining the carnage of Stalin today, but they remain deafeningly silent on the slaughter committed year after year in the United States.  They wring their hands over the death penalty of convicted criminals, but waste no breath on the death penalty against children.

Where is the ACLU?  They stand ready to defend those incarcerated from the evils of prison wardens who deny prisoners cable television, but do they defend those victims of Kermit Gosnell?

Truly, there is an illness in the land and it can be found in an organization that would solicit and accept donations from citizens to kill their neighbors.  I wonder when we will find a cure.





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Teaching Success

One of the problems with being involved with EMS education and training is does the student get it?  Sometimes despite the best intentions, tests, quizzes, and megacodes you don't know if someone "gets it."

Recently I got to hear about a patient who did not compensate post procedure.  Instead of the patient continuing to deteriorate though, a group of students I have been working with intermittently for years, sprang into action and executed a pretty good plan of action which resulted in the patient's condition improving dramatically.

Sometimes you don't realize whether or not you are successful, but is great when you get to see it and see the critical thinking post event in your students as they show not only did they get it, but that they want to then take the next step and go even further.  These are the days I love.

Miracles Do Happen

People ask all the time do miracles still happen and I would have to say they do.  In their Sunday, 12 January 2014 editorial, USA Today's editorial board criticizes the President for his attack on the Little Sisters Of The Poor.

While I missed the original editorial in my post on the subject, it is clear that we see things similarly. As their line notes "nuns and birth control just don't mix."

I did not realize the disparity, but as USA Today notes, the government is losing 95% of its cases.  In nineteen out of twenty cases, courts are issuing stays to non-profits from having to comply against their consciousness.  When President Obama says the American people want this, I think me might just be incorrect.  Worse for Obama and Co. is this statement:

In several cases, even if the government wins, the whole exercise will not result in a single woman getting a single free contraceptive, because under a different law, the insurers themselves are exempt. So what exactly does the administration hope to gain?

It shows the militant nature of those against the policy that they would rather pick a fight with nuns than simply allow them to care for the elderly poor as they have done for years.

The Biggest Threat

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As you walk down the street are you afraid?  If you live near a convent, you should be.  Nuns everywhere wearing their habit and holding their rosary are ready to pounce.  That’s right…if you believe the mainstream media, the Little Sisters Of The Poor are about to derail the brilliant piece of legislation which is the Affordable Care Act.

In a recent piece of glaring anti-Catholic fervor, Alex Wagner of MSNBC actually referred to a group of nuns as a threat.  And what atrocity had these poor women committed?  Well , they would not put pen to paper to sign off on a third party providing contraception services to its employees as it is against the doctrine of the Roman Catholic Church of which they are affiliated.  (You should not be surprised from MSNBC to see no one on the show defending nuns from the attacks of Howard Dean and Cecile Richards - two who support abortion on demand and have never been willing to discuss any of the protections and safety issues a large majority of Americans want when it comes to abortion.)

When I first started this blog with a single post, I made note of Henry VIII and his Succession Act.  That piece of legislation basically allowed him to pull England from Rome and form what would become the modern day Episcopal Church.  When one of his chief supporters found himself in disagreement with the legislation that would ultimately lead him to divorce and the marriage to Anne Boleyn, he didn’t write a book as former Defense Secretary Gates did, he didn’t run to Fox News to get his side heard, he simply retired back, but this was not good enough for King Henry VIII who required him to sign onto his marriage to the future headless queen.

Similarly, Obama says you can disagree with me, but you still have to provide the services, because contraception which is widely available should be subsidized by those who find it anathema, which brings us to the Roman Catholic Little Sisters of the Poor.

What is it the Little Sisters of the Poor do anyway?  Well, in both Baltimore and Denver they care for the elderly poor in nursing homes for those who can not afford a nursing home replete with its poor care and regular infections.  The Little Sisters prefer that the elderly not be warehoused with uncaring providers, but by persons such as themselves who have abandoned world pleasure to care for the elderly.  This would seem to be a goal of the Obama administration and the Affordable Care Act.  Instead it is the starting point to regular anti-Catholic bigotry which few in the media seem willing to call out.

In a recent, US News piece, Jamie Stiehm goes on a personal attack against Supreme Court Justice Sotomayor, for issuing a preliminary injunction on behalf of the Little Sisters of the Poor.  Again and again, her histrionics go on about the six Catholics who sit on the Supreme Court and the poor Jews who must contend with them.  The anti-Catholic and anti-Semitic rage she has should be grounds for termination in almost any other field, but US News stands by its “reporter.”

What is amazing is first, Justice Sotomayor’s move was only to stay the penalties to be issued by the IRS until the legal arguments could be made for and against the issue of whether or not nuns, who are caring for the poor elderly, should be made to provide contraception against their conscience.  Two and equally interesting, Justice Sotomayor is hardly the face of the conservative wing of the court so why would you blast her so publicly unless your argument just that desperate?  Could it be that the dream of big government liberals could come crashing down because of the efforts of a few nuns?  Not efforts to stop the law of course, just efforts of nuns to care for the sick and the old in their way, without interference from a US government who hasn’t been able to provide adequate healthcare to the elderly for decades or adequate care to our returning military veteran’s for generations?

If you argument is that weak, perhaps the Little Sisters of the Poor are a threat and your law is about to topple like the Tower of Babel.

Government Behaving Badly

Welcome to the new world where up is down and back is front and left is right.  What in the world is going on?  Today’s news features two stories which are appalling on their face as the government does its best impressions of incompetence. 

First, our venerable Customs and Border Protection who has multiple sites across Arizona, California, and New Mexico to detain Americans traveling wholly and entirely within the United States and ask them questions about their national heritage has recently confiscated and then destroyed thirteen wooden flutes of Boujemaa Razgui, a classical flutist, who has performed with these same instruments at the Lincoln Center and with both Shakira and Beyonce. 

Being the all powerful government they are, they refuse to apologize for destroying these rare instruments, just as they seem comfortable not apologizing for performing their primary mission of stopping foreign nationals from invading the country illegally.  Should I mention Boston bomber Dzhokhar Tsarnaev? 

Why is it again and again, when our government makes a mistake they refuse to try to fix it?  We get it that the US Government is not perfect.  It’s okay that you hit the baseball into the living room window, but now you have messed something up and you need to go mow lawns until you can pay to replace the glass. 

That being the case, how many of you who voted for President Obama are loving that decision now that they have forced through the Affordable Care Act and you get to not only pay higher premiums, get dropped from the insurance you did like, but now can’t get verified to receive treatment?  Let me get this right, I can’t keep my doc, have to pay more, and still can’t get service.  Thank you President Obama for creating a whole new black market called medicine.  You say you want more people insured and covered, well you have just done the opposite. 

Any apologies from 44?  How about Nancy Pelosi or Harry Reid?  Of course not.  You will remember, they are all exempt from the provisions of the ACA which they all loved so much they could not wait to force it on you and I. 

The ACA is now causing people with chest pain to leave hospitals without being seen because their brand new, shiny Obamacare insurance can not be verified. Woops. 

I am tempted to give these lawmakers the benefit of the doubt on these issues that this is not what they intended, but they realized there were problems and refused to delay the entire process, instead carving out for themselves exemptions that the ordinary American can not have for themselves. 

I realize that these issues would seem not to relate, but in both cases, you have bureaucrats acting in their own manner.  They are acting arbitrarily and capriciously without thinking through the consequences of their own actions and considering the effect on the populace.

While many Americans think about George Orwell and the spying in 1984, I am much more concerned about Animal Farm and the statement “all animals are equal, some are just more equal than others.”  Somewhere along the line President Obama became too comfortable with this idea to the chagrin of the rest of us.

Baseball and EMS

People ask me what I do in winter when there's no baseball. I'll tell you what I do. I stare out the window and wait for spring. – Rogers Hornsby

I am a few days away from sitting staring out the window.  Hornsby was right.  What else is there to do without baseball?

Okay, maybe this would be a poor use of my time, but it does make me think about EMS as baseball and vice versa.  We can sit around quite a bit too…granted not usually staring out the window, but are we focused on the current season?  In both EMS and baseball a few things are fundamentally similar.

One, the job is inherently physical.  In EMS, we move patients from point A to point B.  In baseball, you move runners from first to second thru third, hopefully home, more often than the other team does.

Two, the job requires a degree of sophistication that can not be just physical.  Sure, you may be a big bruiser who can smash homers or lift patients, but if you can’t determine the difference between a fastball (normal sinus) and a cutter (atrial fibrillation), you aren’t hitting home runs.  Realistically, you aren't even getting on base.

 

EMS is interesting in that like baseball, we have specific groups: infielders, outfielders, pitching staffs; much like managers, EMTs, and paramedics.  Like baseball we even specialize.  We know that in every 911 service there is one trauma junkie black cloud that can handle the proverbial mass casualty of hemophiliac children who drove into the glass factory with ease just like the greatest of closers.

Third, both jobs require practice.  I know, I know I’ve been droning on about skills and people practice, the last several posts.  Apologies, but I am disciple for the mindset that muscle memory drives actions in crisis.  I am also a disciple for the thought that as heart rate goes up, IQ drops exponentially faster.  Granted in EMS if you let the game come to you, your patient may become apneic, but this drives home my point of perfect practice in drills makes perfect execution when the time comes.  You practice intubation with your backup roll not because you aren’t going to be able to get the ET on Fred the Head, but because you have to get yourself into the mindset of having the backup for when you misjudge your current patient’s Mallampati score and get into trouble.

 

I get it...practice is boring and you already got it right, but I'm not in this game to get it right, I practice so I can't get it wrong.

Anyone remember the fall of 2001?  No, not September 11^th…in this case I am referring to the ALDS where Derek Jeter makes the flip to Posada to tag out Jeremy Giambi.  Why was he even in the vicinity of that play?  His answer: because I’m the third backup.  THE THIRD BACKUP!?!?!

Again, many days we aren’t even thinking about our first backup…maybe we should. 

There are a million more factors that go into success and could be added to this conversation about EMS and baseball.  I am still a fan of family and it applies equally to EMS as baseball.  Similar to EMS, baseball is an extended family – on the road together for months out of the year – and for many of us we are with our family, months out of the year. 

Success in the field of EMS or on the field of baseball usually still revolves around passion for what you are doing.  Do you want to take care of the sick and the injured?  Do you want to grind out game after game, practice after practice?  Do you have the self respect to prepare, the intelligence to make good decisions in your life?  Are you enthusiastic every morning when you walk in for shift change or do you have to be drug to the dugout?  Where are you with your team?  Are you the one superstar on your team or are you part of a high functioning group?

 

It's a topic for another day the issue of being the one person fighting the good fight and not having a team around you.  It's something I have to find a way to address, but teams mean 2 + 2 = 5 or 7 or 3.  It depends on the team and whether or not a single player or manager is trying to carry the load themselves or if they are allowing everyone to participate...the learners to learn, the doers to do, and the leaders to teach.

Anyway, I hope you figure it out, because it’s World Series time and I want to be a player on a World Series team…especially if the game is EMS.