markomalley

Reminds me of how glad I am I got out before then...

Oh, and here are some tidbits from the "approved" UK news source (The Times): Fatal or serious NHS medication errors double in two years (Sep 7, 2009) Hundreds report poor care suffered by NHS patients (Aug 28, 2009) Shortage of NHS midwives is barrier to safety of mothers and babies (Aug 25, 2009) Nurses 'left elderly patients lying in urine' (Aug 27, 2009) <h1 class="heading"></h1>Elderly left at risk by NHS bidding wars to find cheapest care with reverse auctions (June 1, 2009) The NHS is enormous, expensive and still growing (Sep 3, 2009) NHS scandal: dying cancer victim was forced to pay (Jun 1, 2008) Life-saving cancer drugs 'kept from NHS patients by red tape' (Sep 20, 2005)<h1 class="heading"></h1> And my favourite (British spelling in honor of The Times): USA versus the NHS (Aug 16, 2009) When Bobbie Whiteman moved to the United States from Britain, she did not give medical insurance a thought. She had no cover for six months and it was only when she was offered a job at Variety, the Hollywood newspaper, that it became an issue. It was part of her salary package and she had to decide between several schemes the company had on offer. Seven years later, in 2007, the value of the scheme she chose became all too evident. Suffering from persistent backache – which doctors initially attributed to being “unfit” - she was given an MRI scan which showed she had a string of cancerous tumours down her back. Instead of heading for home and the National Health Service, she had treatment in America - and is glad she did. “Every time you go for any treatment here, they want to see your insurance card and check every detail they have about you and that is wearisome,” said Whiteman, 49. “But I’ve had some terrific treatment.” Little expense was spared in having the necessary scans, tests, radiation treatment and drugs. So far her cancer is stabilised: “There are all sorts of things you have to be aware of: some treatments you part-pay for and you have to choose a doctor who is approved by your insurer. But it’s not all about money here. The doctors are doctors - they really want to help you.” (snip) “Most doctors in Britain, if they’ve worked overseas, will admit that somewhere like America has the best of the best. What it doesn’t have is the breadth of coverage,” he said. “Ours is an equitable, morally cogent way of doing things. But looking at the amount and quality of research into my cancer, there was a clear difference between Britain and the United States.” Thanks to the vast sums poured into the US system, those Americans with insurance undergo more x-rays and other diagnostic tests than British patients, which appears to have some impressive spin-offs. America’s superior survival rate from prostate cancer – 92% after five years compared with 51% here – is probably down to diagnoses being made earlier. Indeed, in the United States the complaint is sometimes too much healthcare, not too little. “Overconsumption or overprovision of healthcare is a huge problem in the States,” said James Gubb, director of the health unit at Civitas, the British think tank. “You get paid in some cases for each x-ray you carry out or each operation and clearly, if that’s happening, then there’s a big incentive to overtreat. “There is unquestionably more of a sense of customer service in the States – that it is important to look after the patient as a customer and provide the services they want – than there is in the NHS.” (remainder snipped) Yup, I think we ought to switch to Obamacare...100% /s

So I guess now the standard is only a partisan paper published by Labour is an adequate British source. Got it. The quote said that no baby under 22 weeks should be resuscitated. With or without parents' request. Likewise, the only murder of a live baby is the murder in your own mind. Neither the Mail article nor the Telegraph article asserted that, nor did I in my initial comment. Some around here are probably capable of comprehending the difference between not resuscitating a patient and murdering a patient, regardless of age. In fact, the only quote that I made in this entire thread that came close to that was this one (from post #29) The rules that they will have to set up may or may not be like this one, where they just refuse to treat a 21-week gestation baby. Or the rules may be that they don't provide chemotherapy to a 90 year old with cancer. Or the rules may be that they won't treat a smoker for lung cancer or a drinker for cirrhosis of the liver. Regardless, they will have to put some kind of rule in place. Perhaps you can point out to me where I gave any indication of murdering patients, whether they be 21 week babies or 90 year old cancer patients. Actually, you are making my point (though I realize that this is the last thing you would ever want to do). Yes, patients get kicked out here. Through insurance company guidelines for a standard of care. I have personal, first-hand experience with this in fact. It will be worse once we go over to nationalized medicine. Why? Because they are doing nothing to fix the problem, they are just shifting who will be accountable to pay for the problem. "Oh, but Mark, the government will not allow insurance companies to force patients to be kicked out." OK, then that means that premiums will go up. "Oh, but Mark, no they won't. The government won't allow it." In which case the insurance companies will no longer do medical insurance. If you force somebody to lose money, they will not stay in a business. "Oh, but Mark, we need to be on single-payer anyway, so who cares if some money-hungry insurance company goes out of business?" In which case subsidies will have to go up. Meaning that either Geithner has to print more money (since China won't buy up all of our debt anymore), or taxes will go up, or your premiums to the single payer will go up. Allow me to let you in on a secret: I actually hope the health care plan goes through. The most radical possible version of it." Signed, The evil one.

True, and that is what separates it from the "boss" card in a work environment, but I think the teacher can play the same exact card as the preacher (at least to a child / adolescent)

I don't think there's much difference between that and the naughty-teacher-syndrome. And, for that matter, I don't think there is that much difference between that and standard boss-subordinate sexual harassment. I think it is more a matter of degree rather than type.

You may be right about it not going anywhere, but I question it. The bill was introduced by the chairman of the committee that will have to do the bill's markup. I think that the staff is currently doing background research on it. See here. Also see the following releases from the chairman on this bill: here here. While the bill doesn't have the visibility of Health Care Reform, it does address an administration priority. Hopefully in the markup process, they make it significantly more concrete.

Just have a couple of minutes, but want to add one comment for now. Pre-existing conditions are a factor that everybody is concerned with. We need to take a look at the issue of pre-existing conditions on a more level-headed basis: boogeymen are not conducive for real discussion. First, why do most insurance plans have some sort of exclusion against pre-existing conditions? The short answer is to keep premium costs down to an affordable level. One thing you have to remember is that corporations, whether for-profit or not-for-profit, are going to turn a profit (or, at least to not lose money). If any one of these enterprises loses money over a long term, they will go out of business. So what? Insurance, if you think about it is nothing more than a shared risk pool. In other words, you have a set group of people who band together and agree to equally absorb everybody's costs. The purpose of an insurance company is to provide the administrative support to allow that group of people to actually participate in this endeavor. To put some concrete numbers behind this, let us use the following examples (that are more-or-less realistic, if not "real." Size of the insurance pool: 1,000,000 families Amount of the premium per family: $10,000 per year Administrative costs: 11% Desired profit: 6% What this means is that the size of the pool is: $10,000,000,000. After administrative costs, there will be $8,900,000,000 in the pool If they want to hit a 6% profit, that means that they will need to make sure that no more than $8,366,000,000 is spent on medical expenses over the year. How do they do that? They set up coverage rules, determine how much network providers will be reimbursed, and make a decision on what kind of exclusions there will be on people who sign up to be part of the pool. If they guess right on setting up the above business rules, they will make a six percent profit. Let us say that the actual amount they pay out is not $8,366,000,000 this year but is $9,366,000,000. Well, that means that they will have to increase their premiums to $11,020 per family per year. They will make their profit. Or they will find another business to be in. What does this have to do with pre-existing conditions? Namely this: pre-existing conditions add to the money that is paid out to providers. Therefore, it will add to premium costs charged to subscribers. Period. How much? Well, honestly, I don't know. Nobody has ever really asked that question, at least in the press. Are we willing to accept those extra costs?

OK. The paradigm right now is a "semi-Socialist" system. That is a bad thing, in my book. For the most part, people don't care about the cost of the services they receive. They care about things like the size of their copay and the amount of their insurance premiums. That is not conducive toward establishing any kind of market-based controls on the system. I am not talking about the uninsured (either by choice or by mandate), but about the majority of Americans who are covered. Secondly, through the result of the restrictions on payments to providers by both insurance companies and government systems (medicare and medicaid), physicians need to eke every cent they can out of the system to cover their expenses. We need to do something to encourage them to do more on a charitable basis. The system I'd like to see is one that is more distributed and where all decisions are pushed out to the doctor and patient level, not at the private / government insurance level. I think that this would make a major shift in how the system operates and would make it more human and less bureaucratic. Cases like the ones that mstar posted on his "rescission" thread (on 'tacks) are heartbreaking. But they happen as the result of fear on the part of the individuals for not being able to pay for their medical care if they are denied insurance; abuses happen as a result of an insurance system that has to consider things on a dollar-and-cents basis in order to stay in business. As it stands, you can't go from point-"A" to point-"B" instantly, though. Here are a few things that would help greatly on that matter: 1) One of the biggest problems we have in this country is a lack of primary care physicians. This country does pretty good with specialists, but family doctors are becoming harder and harder to find. I would not have a problem with a loan forgiveness program for primary care physicians (GP, family practice, internal medicine, pediatrics, and the like), provided that there is a mandate that those physicians agree to work in underserved areas and agree to take medicare/medicaid patients while doing so. The forgiveness program would be that the phyisician is required to serve for 2 years for every year of loans that are to be forgiven and that the loans would be forgiven at the end of that service period (and would continue to accrue interest until they are forgiven). Over a period of several years, that would make a large dent in the shortage. 1a) A useful exercise for the government would be to conduct a study on the constituent costs to a university with the goal being empirically finding out why tuitition is going up at the rate it is. Once the constituent causes are known, there might be something that can be done to control those costs the the universities and, thus, the rationale for tuitition increases. The benefit of the above is if there are more providers, there will be more competition in a market-based system, thus allowing the system to control itself. 2) Currently, IRS Publication 526 prohibits a person (a human or a corporation) from deducting charitible services delivered. What that means to me is that if I want to work at the food distribution function this weekend, I cannot deduct my hours. And that's OK. But if I am a small businessman, like a family practice physician, I cannot deduct the cost of my services if I want to charitibly see a patient. Nor can I deduct the cost of wages I pay my staff that are expended in seeing that patient. The other part of IRS Publication 526 is that I cannot deduct a chartible donation to an individual; I can only deduct charitable donations to approved charities. As a result, if a doctor did want to see a charity patient, it would not be something he could claim as part of his cost basis (and thus be factored into the amount he charges), he would have to recognize the costs as off his profit as a write-off (thus reducing the viability of his small business). Making a change to IRS Publication 526 to allow charitable services to be deductible for professionals would make a big difference... The benefit of the above is that it would be in a physician's interest to fill his schedule with uninsured charity cases when he wasn't busy seeing pay patients. 3a) Fully authorize the use of tax-advantaged Medical Savings Accounts. Allow those MSAs to be used to cover deductibles and cost-shares for all medical expenses. Allow those MSAs to accrue value over multiple tax years and allow them to be probated (provided the heir adds the value to his / her own MSA). Put a cap on the amount every year that could be contributed (say, like $10K or $20K per year), in order to prevent them from being some kind of a tax shelter for the super-rich, but, within reason, allow a person to contribute as much as he or she likes to them within that cap. Allow money that has been in the MSA for more than 12 months to be used for services, if desired by the MSA owner, that would not traditionally be covered by insurance (e.g., cosmetic medical and dental procedures, LASIK, alternative medicine, or whatever) 3b) Create an MSA-like account for people who receive some sort of public-subsidized insurance, like Medicare or Medicaid. The difference being that the value would not be probateable and, upon the death of the "owner," would go back to the government. 3c) In conjunction with MSAs, strongly, strongly encourage the use of high-deductible insurance plans. The idea is that an employer buys (with cost share) the high deductible plan, contributes an amount to the MSA to make up for the difference between the "high" deductible and the typical deductible negotiated for employee insurance, and then allows the employee to make up the remainder through before-tax payroll deduction (like what happens with flex spending accounts). For self-employed people, they would buy the insurance and build the MSA themselves (sorry, but that's the way it is). What this would do is give insured people an awareness of the costs of the routine, non catastrophic medical care they receive. When you are aware of a cost, you are more likely to try to control it yourself, particularly if you have an incentive to be thrifty (save money this year and be able to have a facelift paid for next year). This could be particularly significant if the number of primary care physicians can be increased so that there In addition, over a number of years, the MSA, with its accrued value, could be used to pay for long term care (assisted living, nursing home, or whatever). There is more (including changing the way that physicians are reimbursed from the flat drg system used today, tort reform, and a couple of others), but the idea is to encourage an actual marketplace for services and incentivising charitable acts on the parts of providers would make a big difference and move us toward a different paradigm -- one of decentralization rather than increasing central control. I have an early morning meeting and so can't write more about it now (I'll try to add some later on today), but hopefully you get the idea. Thanks for actually asking.

By the way, P-Mosh, you should look up HR 1 section 804 (FEDERAL COORDINATING COUNCIL FOR COMPARATIVE EFFECTIVENESS RESEARCH) on http://thomas.loc.gov And in the appropriation part of the bill for HHS (Title VIII), you will see the following text: In addition, $400,000,000 shall be available for comparative effectiveness research to be allocated at the discretion of the Secretary of Health and Human Services ('Secretary'): Provided, That the funding appropriated in this paragraph shall be used to accelerate the development and dissemination of research assessing the comparative effectiveness of health care treatments and strategies, through efforts that: (1) conduct, support, or synthesize research that compares the clinical outcomes, effectiveness, and appropriateness of items, services, and procedures that are used to prevent, diagnose, or treat diseases, disorders, and other health conditions; and (2) encourage the development and use of clinical registries, clinical data networks, and other forms of electronic health data that can be used to generate or obtain outcomes data In most cases, you will note that this will be a matter of saying: "Treatment 'A' works better than Treatment 'B'"...but they also can make a determination that "Treatment A" is just not cost effective in certain clinical situations (i.e., an old fart or a smoker) and shouldn't be done. Just like the Nuffeld Protocol described in the Telegraph article earlier. Or a slightly over-active government use of the Liverpool Care Pathway.

How about the Telegraph? That is a broadsheet, so it ought to satisfy even a news snob such as yourself. The Nuffield Council on Bioethics had stepped gingerly into an area which was already the topic of fierce debate. During a two-year inquiry, its working party took evidence not just from doctors and nurses in neonatal medicine, but from professors of philosophy, and religious leaders. But however carefully the debate was handled, the categorical nature of its final recommendations had an incendendiary effect. The guidelines were clear: no baby below 22 weeks gestation should be resuscitated. If a child was born between 22 and 23 weeks into pregnancy it should not be standard practice to offer medical intervention, which should only be given if parents requested it, and following a through discussion about the likely outcomes, the document said. Or how about this, from the Times, another broadsheet (different topic, same NHS) Almost 2,000 critically ill patients were discharged early from NHS intensive care units last year because of a shortage of beds, the Conservatives have claimed. Data from eight out of ten hospital trusts in England suggests that a further 20,000 patients had their discharge from intensive care delayed because there were no suitable beds in other wards to which they could be transferred. You can get mad all you want. Facts are facts. I hope the Telegraph is a good enough source to meet your high standards of journalism.

Unfortunately, what you excerpted was not a quote from the author, it was a quote from Jena Longo, deputy communications director for the Senate Commerce committee. Her boss is Senator Jay Rockefeller, the chairman of that committee. Sort of puts the expert in context a bit, doesn't it? Had you read the text of the bill, which I took the time to link, you would find the following in it: SEC. 18. CYBERSECURITY RESPONSIBILITIES AND AUTHORITY. (2) may declare a cybersecurity emergency and order the limitation or shutdown of Internet traffic to and from any compromised Federal Government or United States critical infrastructure information system or network; (5) shall direct the periodic mapping of Federal Government and United States critical infrastructure information systems or networks, and shall develop metrics to measure the effectiveness of the mapping process; (6) may order the disconnection of any Federal Government or United States critical infrastructure information systems or networks in the interest of national security; By the way, you may have noticed a term "cybersecurity emergency" and the term "United States critical infrastructure information systems." The term "cybersecurity emergency" is not defined in this bill, so if the bill becomes law as is, that means that the President, through the National Institute of Standards and Technology (part of the Department of Commerce) will have to define it for you. However, the term "United States critical infrastructure information systems" is defined as follows (Section 23): (3) FEDERAL GOVERNMENT AND UNITED STATES CRITICAL INFRASTRUCTURE INFORMATION SYSTEMS AND NETWORKS- The term `Federal Government and United States critical infrastructure information systems and networks' includes-- (A) Federal Government information systems and networks; and (B) State, local, and nongovernmental information systems and networks in the United States designated by the President as critical infrastructure information systems and networks. So what does all of this mean: 1) The President can declare any information system and network in the United States to be a critical infrastructure system and network. (Section 23(3)(B) ). This could include Citibank's information systems, Boeing's information systems, Qwest's network, Verizon's network, thePlanet.com hosting service, or even AOL. It's not defined in law; therefore, it may be defined through regulation or through executive order. 2) The President may declare a "cybersecurity emergency" at his discretion (there are no limitations as to when he may do this or not in the bill) and may order the limitation or disconnection of any Internet traffic to or from any network he defines as "critical" in 1) above. 3) The President is directed to map the topology of any network or information system defined as "critical" above. 4) The President does not even require a "cybersecurity emergency" to disconnect a network or information system declared as such in 1) above. He can do so at his sole discretion for national security purposes. What is a "national security purpose?" The President determines that. Chances are that major Internet backbone providers, major financial houses, major chemical / petroleum processors, and major defense contractors' networks will be those that are identified as "critical." But here's a key concept to wrap your arms around: the term "critical infrastructure" is not defined in law. It is defined by a Presidential Decision Directive (the current definition is in PDD-63, signed in 1998, by B.J. Clinton). The term can thus be redefined by the President at his convenience. Chances are it wouldn't be, but it could be. I am one who opposed the creation of DHS. I also opposed the creation of the position of Director of National Intelligence (with budgetary authority over all intelligence agencies in the government). These were both created during the Bush administration. I also opposed the passage of the Patriot Act, when it was passed as a permanent measure. The reason why is that it concentrated too much power in one spot -- power that could be gravely abused. I take it, since the ONE quote you decided to pull from that article was a quote from the deputy communications director for the person who introduced the bill, I will assume that you have no problem with giving Mr. Obama that amount of power. But let me ask you: would you have wanted Richard Nixon to have that amount of power? Or if Tricky Dicky is before your time, would you feel totally comfortable giving Dick Cheney that much power? If your answer is anything but an enthusiastic "yes," then I'd submit that this is a bad piece of law. Because your guy will not always be in office. That might make me a conspiracy buff. Or it might make me somebody who actually reads the law. FWIW/YMMV

Roy, I'm terribly sorry that I didn't make myself adequately clear above. This did not happen in the USA. This happened in England. The point I was getting at was that in order to cut costs, some rules will have to be set up on what they will pay for and what they won't. Sometimes those rules might have to be rules that most of us don't understand or like. The rules that they will have to set up may or may not be like this one, where they just refuse to treat a 21-week gestation baby. Or the rules may be that they don't provide chemotherapy to a 90 year old with cancer. Or the rules may be that they won't treat a smoker for lung cancer or a drinker for cirrhosis of the liver. Regardless, they will have to put some kind of rule in place. Why do they have to put those kinds of rules in place? Well, take the example from the article I posted above. They say that only 16% of infants survive that are born after only 21 weeks of pregnancy. So they figure that it's just not cost effective to treat those babies when 84% of them will die anyway. They could make the same argument for providing some kind of treatments for old people or for people with bad habits like smoking, drinking, or being fat. They have to make some kind of rules on what they will pay for, otherwise, the costs will be totally out of control. Insurance companies do it right now. And the government will have to do it as well. I don't know what those rules will be nor does anybody else, but there will have to be rules, I can 100% guarantee that. But once again, this article shows an example of a rule that they have in place for the nationalized health care in England. Neither Obama nor any doctor in the US had anything to do with that baby dying.

Kit, What do you think about this: From today's (9/8) UK Mail: A young mother's premature baby died in her arms after doctors refused to help because it was born just before 22-week cut-off point for treatment. Sarah Capewell, 23, gave birth to her son Jayden when she was 21 weeks and five days into her pregnancy. Although doctors refused to place the baby in intensive care, Jayden lived for two hours before he passed away at James Paget Hospital in Gorleston, Norfolk, last October. (snip) Miss Capewell, of Great Yarmouth, said: 'When I asked about my baby's human rights, the attitude of the doctors seemed to be that he did not have any. 'They said before 22 weeks he was just a foetus.' (snip) The medical guidance for NHS hospitals, limiting care of the most premature babies, was drawn up by the Nuffield Council on Bioethics in 2006. The guidelines are clear: no baby below 22 weeks gestation should be resuscitated. And, before anybody says anything, I realize that we are not in the UK and what is being proposed is not the NHS. However, when business rules are set up to control costs, they will make arbitrary decisions...if not an arbitrary decision like this one, some arbitrary decision that will upset somebody. Right now, there is a bogey man: the insurance companies. When the government-run "Health Benefits Advisory Committee" (HR 3200 Title 1 sec 123) makes its recommendation on coverages (sec 121), there may be some wailing and gnashing of teeth when the tough decisions have to be made.

You might want to check out this article from Declan McCullagh / CNET, before assuming anything. The text of S.773 (referenced in the article) is here.

Well, if you were here before, you'd know that the real name of the place is not Greasespot Cafe, but Hotel California.

There is a HUGE cultural difference between other countries and the US. I lived in Europe for 9 years (while stationed over there) -- I saw those differences first hand. There is no amount of law that can turn us into Europe, no matter how much a politician wants to do so. If, for no other reason, geography. This is changing somewhat, but traditionally, Europeans live in clusters (to include farmers). Whether those clusters are cities, towns, or farming villages. They might own land, upon which they could farm, but it is highly unusual to see a home placed on 5-6 acres of land (the exception being a baron or the like). Urban sprawl, like what we have in this country and have had since WWII, is a very recent phenomenon in most parts of the world. The clustered nature of living as they do allowed for the development of really effective mass transit systems...thus encouraging walking. The idea of park-and-ride is a fairly unique American attempt and, at least when I lived over in Europe, was unheard of (if you're going to drive to work, you just drive to work. If you're going to take transit, you take transit). So to adopt the walking culture like you accurately point out exists over there, we would really-and-truly have to change our culture to live in far denser housing in relatively self-contained clusters. One other thing is that Europeans are, even today, a lot more classist than they are over in this country. For example, at least up through the 80s in Germany, a person's class for life would basically be determined for them by the time they were in 5th grade. It would be at that time that they would be tracked into a college-preparatory curriculum, or schooling that would prepare them to enter a skilled trade or the arts, or a "practical" education that would prepare them to be a laborer. I don't know if that is the situation any more or not. When I lived in Italy, the situation was pretty much the same. I also understand that there is education tracking in the UK, as well (but I'm not sure exactly how it works over there). So it would be pre-determined whether or not you could go to college or not at an early age. For the most part, at that time, people lived within their class. As a result, the concept of "climbing" as we have over here and have had for ages, particularly since the 60s, did not exist (though I recognize that this has been changing in recent decades, as well). Food choices that we have as part of the American culture didn't really exist over in Europe because there wasn't the time pressure brought on by the idea of social climbing (with the extra hours and dual income families), along with transit times to take people out to the suburbs. In other words, to change our food and exercise habits, we would really need to make organic, integral changes in our entire culture. I don't see that happening any time soon. And I don't see it as something that will be forced by politicians, bureaucrats, or anthropologists.

Hap, none of us know whether or not any measure is going to be in the bill signed by the President. And we won't until the last second. What will happen is that the House will pass their version and the Senate will pass theirs. Then they will form a bicameral reconciliation committee who will meet behind closed doors and craft one bill that must be passed by both houses without alteration...just an up and down vote. If that reconciled bill passes, it will go to the Presdient for signature. We won't know the content of the reconciliation committee bill until probably hours before votes are called on both the House and Senate floors. Frankly, it could be dramatically different than either the House or Senate versions. We agree on conscience clauses. I wish more on your side would accept that common-sense provision. Well, consider this: In 2006, the Massachusetts Legislature passed a law mandating that adoption services must attempt to place children with homosexual adoptive parents (i.e., the adoption service could not consider a couples' sexual orientation in making a placement recommendation). There was no explicit exemption for religiously-oriented adoption services, like Catholic Charities. Naturally, placing a child with a homosexual couple goes against the teaching of the Catholic Church. Whether you agree with it or not, it does (not up for debate). When regulators finished implementing that law, Catholic Charities of Boston was faced with a choice: go against Church teaching or shut down. According to this Boston Globe article, they decided the latter. Am I saying that this guarantees that Catholic hospitals will close down? No. But they might have to stop calling themselves "Catholic" if they did start allowing it. The decision would likely belong to the board of trustees who exercise control over the individual hospital or hospital system. A hospital that was directly a function of the local diocese would, undoubtedly, shut down before being forced to perform abortions, but I don't know how many of those there are any more.

I'm not anti-choice, I'm pro-life, but I'll take a stab at your question. First of all, there is nothing particularly good or evil about the D&C procedure, in of itself. My wife and my first child died while in her womb; she had a D&C done after it was determined that the baby was no longer alive. The baby would have eventually been expelled anyway. As to the second example (a severely malformed or diseased baby), let me reframe the question: Would it be morally licit to kill a patient who was ravaged with cancer and only had a few days left? Please note: I am not asking if it would be OK to allow the patient to kill himself, nor am I asking if it would be OK for a doctor to do the deed if the patient asked for it. I am asking if it would be OK for the doctor to do so of his own volition Alternatively, in the absence of a clear directive or proxy by the patient, would it be morally licit for a doctor to let a trauma victim go because the trauma victim might wake up a paraplegic? There are a couple of us on GSC who might posit that these two situations would be morally licit, but I don't think that the majority would. Since I consider the baby to be alive from the moment of fertilization, I don't see that there is morally much difference between killing a baby for therapeutic reasons and killing an adult for therapeutic reasons. As far as the "plan b" drug, I, for one, would not allow it to be used, nor would I allow hormonal contraceptives or IUDs to be used for the reasons that you state. I am morally opposed to the use of birth control, but I would not be in favor of banning "barrier type" or "spermicidal" contraceptives, though, because I would think that banning those types of contraceptives would be imposing my specific religion upon others. If you ask why banning barrier or spermicidal contraceptives would impose my religion upon somebody else, while banning hormonal contraceptives or IUDs would not be doing the same thing, my answer would be that once a life is created, the natural moral law applies ... and that is something that should be discernable regardless of one's religion or not (the same as banning murder and theft is not imposing Judaism, Islam, or Christianity on somebody) Should Catholic hospitals be allowed to provide "plan b" to rape victims? If the chemicals are legal, then they should be allowed to do so by the state. But the state should not impose itself on Catholic hospitals, Baptist hospitals, or Muslim hospitals to mandate its use. By the way, we've run into situations where a Catholic hospital has decided to disassociate itself with the Church because of a disagreement on these matters. And, as long as its board of trustees does not try to play both sides of the fence (let folks think it is a Catholic hospital while at the same time performing abortions), I don't really have much of a problem with such a decision. (Well, any more of a problem than I have with any hospital performing abortions in the first place, that is) The same holds true with abortion or any other procedure.

Hap, I think you are referring to the Hyde Amendment(s), which are provisions in appropriations bills that provide Federal funding for Medicaid. These provisions are not codified and so have to be passed with each year's appropriations bills. For example, in the Consolidated Appropriations Act, 2008, the language said: SEC. 507. (a) None of the funds appropriated in this Act, and none of the funds in any trust fund to which funds are appropriated in this Act, shall be expended for any abortion. (b) None of the funds appropriated in this Act, and none of the funds in any trust fund to which funds are appropriated in this Act, shall be expended for health benefits coverage that includes coverage of abortion. © The term ''health benefits coverage'' means the package of services covered by a managed care provider or organization pursuant to a contract or other arrangement. SEC. 508. (a) The limitations established in the preceding section shall not apply to an abortion— (1) if the pregnancy is the result of an act of rape or incest; or (2) in the case where a woman suffers from a physical disorder, physical injury, or physical illness, including a life endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death unless an abortion is performed. (b) Nothing in the preceding section shall be construed as prohibiting the expenditure by a State, locality, entity, or private person of State, local, or private funds (other than a State's or locality's contribution of Medicaid matching funds). © Nothing in the preceding section shall be construed as restricting the ability of any managed care provider from offering abortion coverage or the ability of a State or locality to contract separately with such a provider for such coverage with State funds (other than a State's or locality's contribution of Medicaid matching funds). (d)(1) None of the funds made available in this Act may be made available to a Federal agency or program, or to a State or local government, if such agency, program, or government subjects any institutional or individual health care entity to discrimination on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions. (2) In this subsection, the term ''health care entity'' includes an individual physician or other health care professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization, or plan. The key point to remember is that this is within an annual appropriations act and it must be passed each and every year. For the pro-choice among us, that should be considered good news. For the pro-life among us, that should be very worrisome. In regards to the Hyde Amendment's implementation, it primarily referred to Medicaid funding. It specifically did not cover military medicine, VA medicine, or Medicare, nor did it include Federal Employee Health Insurance. As to HR 3200, there is no specific mention of abortion. There is neither a mandate for it nor is there a prohibition for coverage. For the pro-life among us, here are the concerns in that bill (I haven't seen a Senate Bill introduced yet and so can't comment on it. I won't waste my time looking through an informal committee markup): For a person to be considered to have health insurance (for the purposes of this law), the insurance plan held by the individual must be a "Qualified Health Benefit Plan" The decision on what procedures are and are not covered is not a matter of statute. The decision will be made by the Secretary of Health and Human Services (Kathleen Sebelius) (See sec 124 of the bill). Her decision on coverage is the minimum coverage required. In other words, it will be up to Kathleen Sebelius (I'm quoting that name to make Kit cringe ) whether abortion is considered a service that must be covered by a Qualified Health Benefit Plan or not. So what? Companies or non-profit organizations (for example the Catholic Diocese of Las Vegas or the Catholic Diocese of Reno) will have to provide their employees with health coverage or pay a 8% "contribution" to the government if they don't do so. (See Section 313). The plans offered by an employer must be Qualified Health Benefits Plans (See section 311 and review the above to show what must be covered), otherwise, for the purposes of this law, the employer isn't offering health coverage. If a person is not covered by an employer-provided Qualified Health Benefits Plan, the employee must participate in the Health Insurance Exchange (See Title II, in whole). If the person doesn't wish to participate in the Health Insurance Exchange, then that person will pay a "contribution" to the government (Section 401). That fine is 2.5% of the difference between the person's Adjusted Gross Income and the minimum amount where a person would have to file an income tax return (I know, the formula is a pain in the butt). Here's the rub: a person who participates in the Health Insurance Exchange does not automatically have a cost-share, like what happens with employer-based health coverage. Typically, the employer will pay 75% and the employee will pay 25% (or some other proportion). So, rather than paying $3,000 - $4,000 per year for family health coverage, as it is now, a person in the Health Insurance Exchange will be liable to pay the full $12,000 to $14,000 per year. In order to "help," Congress has a provision in the bill to provide "Affordable Premium Credits" (Section 243). What this does is provide a federal subsidy to help low to moderate income families pay their premiums. It is done on a sliding scale based upon family adjusted gross income. For a family making 200% of the poverty rate, that means that the government will provide a credit to make sure that coverage does not exceed 7% of that family's Adjusted Gross Income. On the other hand, if a family makes 400% of the poverty rate, that means that the government will provide a credit to make sure that coverage does not exceed 11% of that family's income. (See sec 243(d)(1) ). There is no provision in this bill to have these federal subsidies segregated to make sure federal monies are not used by plans in the Health Insurance Exchange to provide abortions. So, from a pro-life perspective, there are three issues: IF abortion coverage is mandated as a requirement, through regulation, for a "Qualfied Health Benefits Plan," employers will be required to provide that coverage for their employees, even in situations where abortion coverage is anathema to those employers (for example, the Catholic Church) unless the employer opts out of providing coverage for his employees. In which case, the 8% "contribution" will be used to provide abortion coverage via the "Health Insurance Exchange." IF abortion coverage is mandated as a requirement, through regulation, for a "Qualfied Health Benefits Plan," participants in Health Insurance Exchange plans will have no choice but to participate in a plan that has abortion coverage (whether they, themselves, use it or not is besides the point, their money will go toward providing abortions) IF abortion coverage is mandated as a requirement, through regulation, for a "Qualfied Health Benefits Plan," tax money will be used, through the "Affordable Premium Credit," to pay for abortions From a pro-life perspective, respect for life includes not only a prohibition of women receiving abortions and men pressuring women into having abortions, but also includes providing material support for abortions to occur. As to hospitals being required to perform abortions, that, too will be a part of the regulatory process. There are quality control provisions in this bill that impact how well providers implement the provisions of the bill. DEPENDING UPON HOW THE REGULATIONS ARE WRITTEN, that could provide a tremendous amount of pressure on hospitals to provide required services, including abortion services and on physicians to provide those services as well (in order to keep qualification to receive insurance payments). But the important thing to remember is that this bill calls on reams and reams of regulations to be written, none of which will be overridable by the Congress, even if they were so inclined. What would make pro-lifers far more sanguine (even those who would otherwise not object to this bill...unlike me) is if abortion funding was explicitly prohibited and if conscience clauses were explicitly included protecting doctors and hospitals. But neither will happen and you know it.

Right. This was the interesting part of it. I understand your interest in sunspots due to their impact on E and F layer propagation. Back when I had room to set up HF antennas, I used to live and die by the sunspot cycle. My interest are other impacts on the atmosphere that could impact climate for several years.

The latest from NASA: The sun is in the pits of the deepest solar minimum in nearly a century. Weeks and sometimes whole months go by without even a single tiny sunspot. The quiet has dragged out for more than two years, prompting some observers to wonder, are sunspots disappearing?"Personally, I'm betting that sunspots are coming back," says researcher Matt Penn of the National Solar Observatory (NSO) in Tucson, Arizona. But, he allows, "there is some evidence that they won't." Penn's colleague Bill Livingston of the NSO has been measuring the magnetic fields of sunspots for the past 17 years, and he has found a remarkable trend. Sunspot magnetism is on the decline: Above: Sunspot magnetic fields measured by Livingston and Penn from 1992 - Feb. 2009 using an infrared Zeeman splitting technique. [more] "Sunspot magnetic fields are dropping by about 50 gauss per year," says Penn. "If we extrapolate this trend into the future, sunspots could completely vanish around the year 2015." (remainder of article snipped) Later on in the article, the NSO researchers Livingston and Penn (cited above) wonder if the Sun is entering a long-term period without sunspots known as the "Maunder Minimum" where, magnetic activity on the Sun is minimal. This minimum, along with the Spoerer Minimum, which preceded it, and the Dalton Minimum, which occurred afterwards, were coincident with the Little Ice Age that gripped the world from the 1500s through the first part of the 1800s. So if this lack of sunspots is, in fact, a trend that is approaching zero, we could be in for some serious weather changes in the next few upcoming years.

Just a little early morning snarkiness, Tom.

You're really such a bunch of A-holes. Dang, Tom, when are you going to tell us how you really feel? C'mon now, no need to be sensitive about it; candor is good sometimes...

Erika sure is depressing, isn't she?

Then there's the truth in advertising issue. The Way International is not "The" Way, it is merely "A" No Way (to go). There. Fixed it for you. No charge, either. ;)