Thursday, September 24, 2009

REREAD THE BOOK OF CHANGE







The iconic business book "Who Moved My Cheese?" is all about adapting to change. We might need to reread it as preparation for what is to come in Health Care in America. The electorate gave Obama a mandate for change, at least as he and the mainstream media in our country see it. The change that is coming was change, NOS--change, not otherwise specified. We the people bought a pig in a poke.

We will need to adapt to many changes that are coming. Most of these changes will not be on account of our new president and his congress. But he fact that America is fast becoming a socialist society, where government is the biggest employer in the land, is his doing. If this socialism is being constructed along the lines of National Socialism meets Mandarin Meritocracy (read Ivy League elite politicians and bureaucrats will attempt to run America and everything in it), our nation is about to break the sound barrier of social change. This is going to produce a shock wave. It's not going to feel good or look pretty.



Toll the bell for the death of Christian America. Unless you hate Christian America, in which case break out the champagne. And mourn the loss of our Judeo-Christian culture with its peculiar and unique melange of values, mores, ethics, hopes and aspirations. And say good bye to the Protestant work ethic, too, along with love thy neighbor as thyself, and the sacredness of life, and so much more. Secular humanism might be secular but it is hardly humane. Differential valuation of individual human lives according to productivity for the society at large, those who consume more care than they give will be valued low, and those who give nothing will have no value. Their lives will be forfeit to the state. Read the writings and opinions of Ezechiel J. Emanuel, MD, PhD, who is the chief advisor to Obama for Health Care Details, and Bioethics. See what you make of his ethics. Imagine what he is recommending to his Chief.



Nations have travelled this road before. When life in general and human life in particular is not sacred, every American is in jeopardy. Most especially those who have special needs. Asian Indian sages have observed that cultures can be judged by how they treat the cow. She is the most gentle, forgiving, pleasant, patient, and productive of animals. She is not so much sacred in India as revered and appreciated. Contrast that with our slaughter houses and feed lots. In particular, look at kosher butchery. Look at how the cow is treated in kosher slaughter--if you can stand to look at that.


Life is sacred. It is not a question of whether the challenged, weak, infirm, and elderly among us are worthy of our love and care, but of whether we are good enough to know it. Abortion is rightly viewed as a private matter between a woman and her doctor. But it is hardly something to celebrate. Secular humanism celebrates abortion and will defend the right to extinguish human life even when the fetus is term and viable--what do you think late term abortion means? Who was the most recent martyr for the cause of terminating human life in late term pregnancy? He was a major supporter of HHS Secretary Kathleen Sebelius, our present head of Health and Human Services. Those who are overhauling our medical system do not represent diversity of beliefs or values in this matter. They are a group for whom life is not particularly or intrinsically sacred. Read the ethicist-in-chief for his views. See my post on Ezechiel J. Emanuel, MD, PhD.



It is camp to denigrate Roman Catholicism
. The Church is one of very few things that one can lampoon these, politically correct days. But the Church stood up against murderous thugs who were in power in Germany. (Under the pope that some who call themselves historians (but who lack the fairness and objectivity of the historian), labelled Hitler's pope no less.) Check this out, please:

http://www.shoaheducation.com/t4.html: Bishop Galen and the Outcry Against T-4.

"During WWII, the Catholic Church had far more latitude than other denominations partly because many of the higher echelon of the Nazis had been raised Catholic or still were, and because at least half or more of the Catholic Clergy supported the new regime, which had initial but then wavering favor with the Vatican. The Wehrmacht saw many Catholic young men joining the ranks, in a 'God and Country' spirit during the early years as well. A few persons though, noted throughout that time, that the new Regime was not in accord with basic Christian and Catholic principles, and Catholic leaders such as Preysing, the Bishop of Berlin and Galen, stood against Nazi Racial Policies from the beginning, while others such as Faulhaber from Munich, supported and even hosted gala birthday parties for Hitler.
Catholic Clergy who opposed Hitler's policies often risked their lives as did those from other Christian denominations and some were imprisoned and killed. Notably, Galen, early wrote in vehement opposition to the policies of the T-4 Program in the massive State Killing of Innocents. It was one of his homilies which Sophie and Hans Scholl and the White Rose printed into pamphlets, distributing them at the University of Munich. The pamphlet called for the immediate end to the killings, leaning on traditional and contemporary Catholic doctrine. It was among the literature for which the Scholls and other members of the White Rose were tried, convicted and guillotined."


Whether neoatheists like it or not
, the Catholic Church stood up to bullies and still does. Something tells me that popular as they are, Dawkins, Harris, and Hitchens are not about to risk the guillotine for any cause or any persons. I think they are all talk. Please see my post on this subject if you have time. As far as our elected leadership goes, I don't so much worry that they will not stand up to bullies as that they are the bullies
.




This is from The Irish Independent, October 30, 1999), and shows a fetal hand grasping the finger of his in-utero surgeon who is going to repair the defects of spina bifida and then put him back in the uterus for a few more months of gestation.

"Take a good look at this picture. It's one of the most remarkable photographs ever taken. The tiny hand of a foetus reaches out from a mother's womb to clasp a surgeon's healing finger. It is, by the way, 21 weeks old, an age at which it could still be legally aborted. The tiny hand in the picture above belongs to a baby which is due to be born on December 28. It was taken during an operation in America recently."


A human fetus is a human
. And any society that applauds the termination of human life in not humane. Whether it's Muslim ululation in response to an American or Israeli tragedy or NOW rejoicing in yet another victory over their right-to-life opponents. Yes, I grant that our laws protect the killing of the not yet born, and that it is better to have this be a private matter between a woman and her doctor than put government and law and order in between the two. But it does not sanctify abortion or make it less reprehensible. Kosher butchery is legal, too. But it is reprehensible. Doubt me on this one? Check it out yourself. The point of this is not to change established law of the land or make legal illegal. The point is to know that our society must tread carefully in the Great Health Care debate. Others before us have gone down an ill chosen path.


"EUTHANASIA" KILLINGS

"Forced sterilization in Germany was the forerunner of the systematic killing of the mentally ill and the handicapped. In October 1939, Hitler himself initiated a decree which empowered physicians to grant a "mercy death" to "patients considered incurable according to the best available human judgment of their state of health." The intent of the so called "euthanasia" program, however, was not to relieve the suffering of the chronically ill. The Nazi regime used the term as a euphemism: its aim was to exterminate the mentally ill and the handicapped, thus "cleansing" the "Aryan" race of persons considered genetically defective and a financial burden to society.

The idea of killing the incurably ill was posed well before 1939. In the 1920s, debate on this issue centered on a book coauthored by Alfred Hoche, a noted psychiatrist, and Karl Binding, a prominent scholar of criminal law. They argued that economic savings justified the killing of "useless lives" ("idiots" and "congenitally crippled"). Economic deprivation during World War I provided the context for this idea. During the war, patients in asylums had ranked low on the list for rationing of food and medical supplies, and as a result, many died from starvation or disease. More generally, the war undermined the value attached to individual life and, combined with Germany's humiliating defeat, led many nationalists to consider ways to regenerate the nation as a whole at the expense of individual rights.

In 1935 Hitler stated privately that "in the event of war, [he] would take up the question of euthanasia and enforce it" because "such a problem would be more easily solved" during wartime. War would provide both a cover for killing and a pretext--hospital beds and medical personnel would be freed up for the war effort. The upheaval of war and the diminished value of human life during wartime would also, Hitler believed, mute expected opposition. To make the connection to the war explicit, Hitler's decree was backdated to September 1, 1939, the day Germany invaded Poland.

Fearful of public reaction, the Nazi regime never proposed a formal "euthanasia" law. Unlike the forced sterilizations, the killing of patients in mental asylums and other institutions was carried out in secrecy. The code name was "Operation T4," a reference to Tiergartenstrasse 4, the address of the Berlin Chancellery offices where the program was headquartered.

Physicians, the most highly Nazified professional group in Germany, were key to the success of "T-4," since they organized and carried out nearly, all aspects of the operation. One of Hitler's personal physicians, Dr. Karl Brandt, headed the program, along with Hitler's Chancellery chief, Philip Bouhler. T-4 targeted adult patients in all government or church-run sanatoria and nursing homes. These institutions were instructed by the Interior Ministry to collect questionnaires about the state of health and capacity for work of all their patients, ostensibly as part of a statistical survey.

The completed forms were, in turn, sent to expert assessors physicians, usually psychiatrists, who made up "review commissions." They marked each name with a "+," in red pencil, meaning death, or a "" in blue pencil, meaning life, or "?" for cases needing additional assessment. These medical experts rarely examined any of the patients and made their decisions from the questionnaires alone. At every step, the medical authorities involved were usually expected to quickly process large numbers of forms.

The doomed were bused to killing centers in Germany and Austria walled-in fortresses, mostly former psychiatric hospitals, castles, and a former prison — at Hartheim, Sonnenstein, Grafeneck, Bernburg, Hadamar, and Brandenburg. In the beginning, patients were killed by lethal injection. But by 1940, Hitler, on the advice of Dr. Werner Heyde, suggested that carbon monoxide gas be used as the preferred method of killing. Experimental gassings had first been carried out at Brandenburg Prison in 1939. There, gas chambers were disguised as showers complete with fake nozzles in order to deceive victims — prototypes of the killing centers' facilities built in occupied Poland later in the war.

Again, following procedures that would later be instituted in the extermination camps, workers removed the corpses from the chambers, extracted gold teeth, then burned large numbers of bodies together in crematoria. Urns filled with ashes were prepared in the event the family of the deceased requested the remains. Physicians using fake names prepared death certificates falsifying the cause of death, and sent letters of condolences to relatives.

Meticulous records discovered after the war documented 70,273 deaths by gassing at the six "euthanasia" centers between January 1940 and August 1941. (This total included up to 5,000 Jews; all Jewish mental patients were killed regardless of their ability to work or the seriousness of their illness.) A detailed report also recorded the estimated savings from the killing of institutionalized patients."


http://www.jewishvirtuallibrary.org/jsource/Holocaust/disabled.html

Given this much, how did Obama get the American Medical Association on board with his plan? Old fashioned carrot and stick. Medicare was set up to slash physician reimbursement--the stick. And the carrot was money, of course. Not that money is the only factor motivating this worthy organization of which I am a member. But money made the sale. Check this out: statement attributable to J. James Rohack, MD, President, American Medical Association.

“The AMA applauds Chairman Baucus and his colleagues for their hard work and important contribution toward our mutual objective of comprehensive health system reform. Expanding coverage through tax credits, insurance market reforms that protect patients if they get sick or lose their job, and offering more affordable choices through new health insurance exchanges will significantly improve our health care system.

“The AMA will continue to work with Chairman Baucus and his colleagues to strengthen this proposal. The AMA continues to call for permanent repeal of the current Medicare physician payment formula that threatens seniors’ access to care. The House has already recognized the importance of this action by including it in pending legislation.

Without permanent repeal of the current formula, physicians face cuts of 40 percent over the next few years that will erode access and choice for America's seniors. A recent AARP poll found that 90 percent of people 50 and over are concerned that the current Medicare physician payment formula threatens their access to care.

“After further review of the proposal, the AMA will continue ongoing discussions with Chairman Baucus and other Finance Committee members regarding policies of concern to physicians.”

###

Contact:
Katherine Hatwell
AMA Media Relations

202-789-7419
Follow AMA on Twitter and Facebook.


Bold face and highlighting are mine, not the speech writer's. .


Doctors are going to face uncomfortable change
in the coming years. I was in medical school when Medicare was enacted into law. It frightened a lot of practicing doctors. It turned out to be a great boon for seniors, for doctors taking care of them, and for our country. Sometimes change is for the better. Doctors should reread the book: "Who Moved My Cheese?"


Who Moved My Cheese? is the story of four characters living in a "Maze" who face unexpected change when they discover their "Cheese" has disappeared. Sniff and Scurry, who are mice, and Hem and Haw, little people the size of mice, each adapt to change in their "Maze" differently. In fact, one doesn't adapt at all...

This timeless allegory reveals profound truths to individuals and organizations dealing with change. We each live in a "Maze", a metaphor for the companies or organizations we work with, the communities we live in, the families we love places where we look for the things we want in life, "Cheese". It may be an enjoyable career, loving relationships, wealth, or spiritual peace of mind. With time and experience, one character eventually succeeds and even prospers from the change in his "Maze".In an effort to share what he has learned along the way, he records his personal discoveries on the maze walls, the "Handwriting on the Wall". Likewise, when we begin to see the "writing on the wall", we discover the simplicity and necessity of adapting to change.

Full of modern day insight, the story of Who Moved My Cheese? invites individuals and organizations to enjoy less stress and more success by learning to deal with the inevitable change.

Our doctors' organization is on board with some kind of change coming at us:


http://www.ama-assn.org/ama1/pub/upload/mm/399/hsr-testimony-15sept2009.pdf


Statement of the American Medical Association to the Democratic Steering and Policy Committee United States House of Representatives
Re: Urgent Need for Enacting Health System Reform
September 15, 2009

"The American Medical Association (AMA) appreciates the opportunity to testify on behalf of
our physician and medical student members before the House Democratic Steering and Policy
Committee regarding health system reform. We commend Speaker Pelosi and the chairmen of
the Committees on Energy and Commerce, Ways and Means, and Education and Labor for their
leadership in developing a framework to transform our nation’s health care system and in
successfully moving H.R. 3200 through committee mark-ups prior to the August recess.
With millions of Americans uninsured and millions more afraid of losing their health insurance,
the status quo is unacceptable. The AMA is committed to working with Congress, the
Administration, and other stakeholders to achieve enactment of health system reforms this year
that include the following seven critical elements:
• Provide affordable health insurance coverage for all Americans
• Enact insurance market reforms that expand choice of affordable coverage and eliminate
pre-existing conditions
• Assure that health care decisions are made by patients and their physicians, not by
insurance companies or government officials
• Provide investments and create incentives for quality improvement and prevention and
wellness initiatives
Repeal the Medicare physician payment formula that will trigger steep cuts and threaten
seniors’ access to care

• Implement medical liability reforms to reduce the cost of defensive medicine
• Streamline and standardize insurance claims processing requirements to eliminate
unnecessary costs and administrative burdens.

Repeal the Medicare Physician Payment Formula
The AMA greatly appreciates the House of Representatives’ recognition that the Medicare
physician payment formula, called the “sustainable growth rate” (SGR), is fatally flawed and
must be fixed to avoid steep cuts that threaten Medicare access to care and undermine broadbased
health reform efforts. Repealing the SGR is a critical element that must be included in any
health system reform legislation passed by Congress. We are pleased that the new target growth
rates proposed in the House legislation are not limited to GDP growth; however, we are
concerned that the new system could still lead to significant pay cuts in future years, and we urge
inclusion of design features that will preclude negative payment updates.
The physician and allied health community face over a 21 percent Medicare payment cut on
January 1, 2010, and further substantial cuts over the next several years. Physicians and allied
health professionals cannot absorb cuts of this magnitude nor continue to face the threat of cuts
each year. In addition, the Centers for Medicare and Medicaid Services has released data
showing that, even before the cuts, physicians are only being reimbursed for half of the labor,
supply, and equipment costs that go into each physician service, which further exacerbates the
7
effect of these payment cuts. Without Congressional action to repeal the SGR, Medicare seniors
and disabled patients stand to lose significant access to their physicians.
A stable, predictable payment system is needed to allow physicians to plan ahead for practice
innovations, investments, and personnel decisions that are fundamental to improved care
coordination, chronic disease management, and quality of care initiatives. It will also help
sustain the physician workforce, which policy makers acknowledge will experience severe
shortages in the near future, just as the baby boomer generation begins entering the Medicare
program."


Bold face and differential highlighting mine.


Well, we can trust our doctors
. They would not breach their oath of Hippocrates or of Maimonides, right? There is the doctor patient relationship, after all. Certainly there are the oaths and there is the doctor patient relationship. But a universal, government run system of Health Care does not pay attention to these things. I know doctors in Sweden, UK, Canada. I know doctors in the VA, in the US Navy, in the Bureau of Indian Affairs. You can and should trust your doctor to practice ethical and scientifically sound medicine. Formulating health care legislation is not in the skill set of most doctors. I would not trust the oaths and the doctor patient relationship to protect against unwanted policies. Our leadership is being advised by a prominent and respected academic doctor who took the oath and is a renowned bioethicist as well. But he does not accept the intrinsic sanctity and inviolability of human life. He values human life differentially. It's his viewpoint.


In its day, German medicine was what American medicine is today
: at the cutting edge of science, technology, and art. Our American medical schools were reformed by Dr. Abraham Flexner after his survey of all schools revealed widespread deficiencies. The German academic medical school model was adapted following that review and report (Carnegie Foundation Bulletin number four of 1910).

The Carnegie Foundation Bulletin 4, "Medical Education in the United States and Canada" (1910), commonly known as the Flexner Report, is widely credited with the reform and reconstruction of the entire medical school curriculum. The report was the result of a mandate by the American Medical Association to conduct a study of North American medical schools. The study was completed by Abraham Flexner, a former schoolmaster who had received his undergraduate degree from Johns Hopkins University. He chose the Johns Hopkins Medical School as the model program to which all others were compared. Flexner visited all 155 North American medical schools, spending only one-half hour at each collecting data. His report recommended a drastic decrease in the number of medical schools, affiliation with universities, and establishment of the scientific model in medical education. The original Flexner Report was part of a broad move of professional education from the private sector to the university. When this happened, professional education incorporated the values of the academy (scientific thinking, rigor, and analysis).

http://www.eric.ed.gov/ERICWebPortal/custom/portlets/recordDetails/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=ED480298&ERICExtSearch_SearchType_0=no&accno=ED480298

And after whose "scientific thinking, rigor, and analysis" were the newly reformed American medical colleges modeled?
So we assume our doctors will protect us from abuses of any national medical system that does not value human life. Just as the doctors of Germany protected their patients during the Weimar years and during the National Socialist years. Right.


"I have no words. I thought we were human beings. We were living creatures. How could they do things like that?" - Auschwitz survivor.

It was in my own lifetime that many German doctors went From Healer to Killer:


There was a problem in the Fatherland
--"not just Doctor Joseph Mengele and the 23 other physicians tried at Nuremberg, either. Over 45% of German doctors joined the Nazi party. Physicians joined the Nazi party not only earlier, but in greater numbers than any other professional group - the same with the SS and the storm trooper units.[510] As a 1933 editorial from the National Socialist (Nazi) Physicians' League boasted, the Nazi movement was, "the most masculine movement to appear in centuries."

http://upalumni.org/medschool/appendices/appendix-47a.html. This is a Cornell University alumni organization. Above and below courtesy of them. Sources referenced in their web site.

The Noble Profession


"According to an article in JAMA, physicians were essential in running the death camps
. Indeed the first commandant of Treblinka was a physician. The euthanasia program, for example, was planned and administered by leading figures in the German medical community. Unlike in the Milgram study, physicians were never ordered to harm anybody. No euthanasia law was ever formally enacted by the Third Reich. No direct orders were given and refusal to cooperate didn't result in any legal or professional sanction. Rather, physicians were empowered to carry out "mercy killings," but never obligated to do so. They went about killing psychiatric patients, disabled children, etc., without protest, often on their own initiative. In some cases the inducement for physicians to name candidates for euthanasia was a financial reward. Quoting from an article published in JAMA, "In short, the medical profession served not only as an instrument of Nazi mass murder, but was involved in the ideological theorizing and in the planning, initiation, administration, and the operation of the killing programs."


If so civilized and cultured and scientifically advanced a society as Germany
prior to WWII could set about such heinous activities, we in America should be watchful. Pride goeth before the fall. We are proud of our liberal and enlightened society and its scientific basis. Well and good. Humility is the least prized of personal virtues, understood. But will prove to be the most valuable social virtue. We would do well to acquire some and watch what our leadership is doing.
Does the leadership consider human life sacred? Does our Bioethicist-in-chief, Ezechiel J. Emanuel, MD, PhD, consider all human lives sacred? Or does he believe, as did so many prominent academic doctors in the Weimar Republic and the Third Reich that followed it, that human life is valuable only in proportion to potential or actual productivity.
The difference between Emanuel and his boss Obama is that the former is not a politician, and so he speaks and writes his mind. The latter is too subtle to do that. As the sign says: Obama lies, Grandma dies. Don't believe me, its too important for you to know the truth. Read what Ezechiel J. Emanuel has written. Then try to discern what Obama is thinking.


But how is what happened an ocean away and generations ago relevant to Americans today
? Read the following, it's closer to home:


"In the first three decades of the 20th Century, American corporate philanthropy combined with prestigious academic fraud to create the pseudoscience eugenics that institutionalized race politics as national policy. The goal: create a superior, white, Nordic race and obliterate the viability of everyone else. How? By identifying so-called "defective" family trees and subjecting them to legislated segregation and sterilization programs. The victims: poor people, brown-haired white people, African Americans, immigrants, Indians, Eastern European Jews, the infirm and really anyone classified outside the superior genetic lines drawn up by American raceologists. The main culprits were the Carnegie Institution, the Rockefeller Foundation and the Harriman railroad fortune, in league with America's most respected scientists hailing from such prestigious universities as Harvard, Yale and Princeton, operating out of a complex at Cold Spring Harbor on Long Island. The eugenic network worked in tandem with the U.S. Department of Agriculture, the State Department and numerous state governmental bodies and legislatures throughout the country, and even the U.S. Supreme Court. They were all bent on breeding a eugenically superior race, just as agronomists would breed better strains of corn. The plan was to wipe away the reproductive capability of the weak and inferior.

Ultimately, 60,000 Americans were coercively sterilized — legally and extra-legally. Many never discovered the truth until decades later. Those who actively supported eugenics include America's most progressive figures: Woodrow Wilson, Margaret Sanger and Oliver Wendell Holmes.

American eugenic crusades proliferated into a worldwide campaign, and in the 1920s came to the attention of Adolf Hitler. Under the Nazis, American eugenic principles were applied without restraint, careening out of control into the Reich's infamous genocide. During the pre-War years, American eugenicists openly supported Germany's program. The Rockefeller Foundation financed the Kaiser Wilhelm Institute and the work of its central racial scientists. Once WWII began, Nazi eugenics turned from mass sterilization and euthanasia to genocidal murder. One of the Kaiser Wilhelm Institute doctors in the program financed by the Rockefeller Foundation was Josef Mengele who continued his research in Auschwitz, making daily eugenic reports on twins. After the world recoiled from Nazi atrocities, the American eugenics movement — its institutions and leading scientists — renamed and regrouped under the banner of an enlightened science called human genetics."

http://www.waragainsttheweak.com/


This is hard to believe and seems way over the top
. But even if this one is ten percent factual, it's scary. I for one am going to look into this some more.



How American corporate philanthropies launched a national campaign of ethnic cleansing in the United States, helped found and fund the Nazi eugenics of Hitler and Mengele — and then created the modern movement of "human genetics."

Here is mainstream media on the need to change.
We can always count on the fourth estate to keep our leadership under surveillance and thereby protect us. Right, especially these days. (When one has loved someone or some idea or some thing for a lifetime, change will be hard and slow in coming. The press is people, too. And they are almost to a person very liberal.) They are strongly against oppression of the weak, dishonesty in high places, phony morality, false piety, and unscientific, primitive, violent, barbaric behavior by individuals or nations.
Still, the press is people and these people are in love with Obama. Meanwhile, Kejserens nye Klæder. (Danish, read my post by this name, please. It's short.)


You Have No Idea What Health Costs.
If You Did, You Might Just Want Real Reform


By Ezra Klein
Washington Post Staff Writer
Sunday, September 20, 2009

"The most important health-care document released this week was not Sen. Max Baucus's Healthy Future Act. It was the Kaiser Family Foundation's 2009 Employer Benefits Survey.

While the proposal by Baucus, chairman of the Senate Finance Committee, outlines a direction for policy, the survey, which polls employers about health benefits to assemble a detailed look at the actual cost of health care, fits it squarely in our pocketbooks.

The truth is we all pay, and much more than we recognize, for health care.

For many, it's among the largest investments we'll make, on par, even, with the money we spend on a house or tuck away for retirement. But while it's easy to track our stock portfolios as they tank along with the market, our outlay for health care is less obvious. Employers pay some, and so do individuals, and taxpayers. And some even hides behind the deficit. As such, few of us see the full picture. But to make sense of the proposals for reform, getting a grasp of the cost is critical.

The average health-care coverage for the average family now costs $13,375, according to Kaiser. Over the past decade, premiums have increased by 138 percent. And if the trend continues, by 2019 the average family plan will cost $30,083.

Three years of slightly above-average health insurance will cost a solid six figures.

Those are numbers to marvel at. Those are numbers to fear. But they are not the numbers that loom in the minds of most Americans. And therein lies the problem for health-care reform.

About 160 million Americans receive health coverage through their employers. In general, the employer picks up 73 percent of the tab. This seems like a good deal. In reality, that money comes out of wages.

As Ezekiel Emanuel, who advises Office of Management and Budget Director Peter Orszag on health-care policy, has pointed out, health-care premiums have risen by 300 percent over the past 30 years (and that's after adjusting for inflation). Corporate profit per employee has soared by 200 percent. Hourly earnings for workers, adjusted for inflation, have fallen. The wage increases have been consumed by health-care costs.

Another 80 million Americans are on public plans, mainly Medicare and Medicaid. Those costs are paid by taxpayers. And about 46 million Americans are uninsured. The costs for their care are shifted to the insured: This raises premiums for the average family by $1,100 each year, according to an analysis by Ben Furnas and Peter Harbage of the Center for American Progress."

I for one do not count on the Fourth Estate to protect us from evil. Or at least, not this time. As pointed out above, the First Estate waffled when the going got hard. The Second Estate is never to be trusted: politicians are about power over people. They begin in high school. You remember them when they were embryonic pols. In America politicians wield power. The president wields immense power. If he does not hold human life sacred, many Americans' lives will be in jeopardy--for the fact that they were not worthy of our love and support, for the fact that they became economic burdens for society, for the fact that they were inconvenient truths.


So who will protect the weak and vulnerable
? Well, the first thing to realize is that we will all be in that number sooner or later. At which point we will be the ones looking for help. Help is ideally based upon an abiding belief in the dignity and sanctity of human life, indeed of all life. If I am correct that such a belief is under siege, and that the weak and vulnerable are in jeopardy, it will not be the Fourth Estate who stands between us and the active or passive mercy killers of our new world order. That's too bad as they have always been a bulwark for freedom, truth, and justice in our democracy.

The First Estate waffled in the mid 20C and will again, I am afraid.

The Second estate is looking more like the problem in this case than the solution.

So who is left--the Third Estate, you guessed it. Who holds the ultimate power in America? The Third Estate, that's who. (And what in the world is the basis of all this "estate" talk, you ask. The 1789 Estates General called by the king of France is where this terminology originates. In that great convocation Louis XVI convened the bishops, the nobles, and representatives of the people of France. These were the first, second, and third estates of France.)


We the people must exercise our legitimate rights. The Constitution of These United States spells out who holds ultimate power in America, and it is we the people. Obama and the rest of the Chicago thugs might wield the power, but when push comes to shove, we own it. Until our Constitution gets a rewrite, of course. Hold on tight; we are in for quite a ride. Sapienti sat . . .

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