Devi Shetty keeps photographs of Mother Teresa and Mahatma Gandhi on his desk, and he’s obsessed with making cardiac surgery affordable for millions of Indians. But these two facts are not connected. Shetty’s a heart surgeon-turned-businessman who founded a chain of 21 medical centers around India. Every bit the capitalist, he has trimmed costs by buying cheaper scrubs and spurning air-conditioning and other efficiencies. That’s helped cut the price of artery-clearing coronary bypass surgery to 95,000 rupees ($1,555)—half of what it was 20 years ago. He wants to get it down to $800 within a decade. The same procedure costs $106,385 at Ohio’s Cleveland Clinic, according to data from the Centers for Medicare & Medicaid Services.
“It shows that costs can be substantially contained,” says Srinath Reddy, president of the Geneva-based World Heart Federation. “It’s possible to deliver very high-quality cardiac care at a relatively low cost.”
Medical experts like Reddy are watching closely to see if Shetty’s severe cost-cutting can serve as a model for making life-saving heart operations more profitable and more accessible to patients in India and other emerging nations. “The current price of everything that you see in health care is predominantly opportunistic pricing and the outcome of inefficiency,” says Shetty, who opened his flagship hospital, Narayana Hrudayalaya Health City, in Bangalore in 2001.
While some states will see medical claims costs per person decline, the report concluded the overwhelming majority will see double-digit increases in their individual health insurance markets, where people purchase coverage directly from insurers.
The disparities are striking. By 2017, the estimated increase would be 62 percent for California, about 80 percent for Ohio, more than 20 percent for Florida and 67 percent for Maryland. Much of the reason for the higher claims costs is that sicker people are expected to join the pool, the report said.
The report did not make similar estimates for employer plans, the mainstay for workers and their families. That’s because the primary impact of Obama’s law is on people who don’t have coverage through their jobs. [Link]
Spiked has two interesting articles on eating. One is about the “war against obesity” (newly declared) because fat people, it is alleged, are a drag on the environment and on society. Body-mass challenged people ought to be compelled to consume less and register at the local gym to work off all their ripples and redundant pounds. Frank Furedi makes short shrift of this policy, which the health Nazis in the U.S. arduously campaign to have implemented, as well, starting with Big Gulps and banana-split milkshakes, among other enjoyables.
The overbearing omniscience of obesity objectors.
Barbara Hewson, in the meantime, asks the question: If a person wants to die, why would the state be so interested in keeping her alive, and be willing to spend a small fortune of taxpayer money to attempt it? Suppose she signed the necessary paperwork in the way of medical directives that would allow her to die on her own terms? Suppose the state overrode her intentions and prescribed a regimen that would kill her in the end? What purpose would be served? Whose life is it anyway? Has the state first dibs on your existence? Hewson doesn’t answer these questions, but comes close to it.
Very interesting reads.
From The Atlanta Journal-Constitution:
Provisions of the federal Affordable Care Act, also known as ObamaCare, “may violate the constitution of Ayn Rand, but they do not violate the Constitution of the United States,” acting solicitor general Neal Kumar Katyal told a three-judge panel of the 11th Circuit Court of Appeals Wednesday. Conversely, attorney Paul Clement, representing Georgia and 25 other states, framed the issue of mandated purchase of health insurance as an issue of liberty. “Can the federal government compel an individual to take part in commercial activity in order to better regulate that individual?” he asked the judges. [ObamaCare gets put through judicial wringer | Jay Bookman]
And what does Ayn Rand have to say about the constitution?
The American system of checks and balances was just such an achievement. And although certain contradictions in the Constitution did leave a loophole for the growth of statism, the incomparable achievement was the concept of a constitution as a means of limiting and restricting the power of the government. [...]
Today, when a concerted effort is made to obliterate this point, it cannot be repeated too often that the Constitution is a limitation on the government, not on private individuals—that it does not prescribe the conduct of private individuals, only the conduct of the government—that it is not a charter for government power, but a charter of the citizens’ protection against the government. [“The Nature of Government”, The Virtue of Selfishness]
The clause giving Congress the power to regulate interstate commerce is one of the major errors in the Constitution. That clause, more than any other, was the crack in the Constitution’s foundation, the entering wedge of statism, which permitted the gradual establishment of the welfare state. But I would venture to say that the framers of the Constitution could not have conceived of what that clause has now become. If, in writing it, one of their goals was to facilitate the flow of trade and prevent the establishment of trade barriers among the states, that clause has reached the opposite destination. [“Censorship: Local and Express”, Philosophy: Who Needs It 184]
This view is apparently what the Nihilist’s of the Obama administration disagree with.
Health Care Reform: Setting Doctors Free [Livestream]
Dr. John David Lewis: Obamacare is a moral assault on free people, and an attack on human life itself.
Government medicine treats doctors as cogs in a giant machine, run from Washington, as if treating patients required no independent thought or action. Twenty-eight states have filed suit against Obamacare, claiming it is unconstitutional. But it is much worse than that. It is a moral assault on free people, and an attack on human life itself. John Lewis has a unique perspective on this issue, both as an advocate for individual rights and as a cancer patient. Don’t miss this hard-hitting lecture on the deepest evil of government medicine.
John David Lewis is a Visiting Associate Professor in the Philosophy, Politics, and Economics Program at Duke University, and a senior research scholar in history and classics at the Social Philosophy and Policy Center, Bowling Green State University. He has taught at the University of London and Ashland University, and is a fellow of the Anthem Foundation for Objectivist Scholarship. He has a PhD in classics from the University of Cambridge. He is an outspoken proponent of free market medicine.
[...] If Obamacare is so great, why do so many people want to get out from under it? More specifically, why are more than half of those 3,095,593 in plans run by labor unions, which were among Obamacare’s biggest political supporters? Union members are only 12 percent of all employees but have gotten 50.3 percent of Obamacare waivers.
Chapman University law professor Dr. John Eastman discusses the implications of limiting the government’s control in health care.
[...] When I first read the opinion, I was not pleased. I was not pleased that Vinson began by using an Originalist approach; I was not pleased that he seemed to concede the propriety of treating the Constitution as, in effect, a “living” document; I was not pleased that he implied that the Supreme Court could — in fact that he seemed to invite them to — eliminate the activity/inactivity distinction. I feared that the Supreme Court might just decide that, in our modern commercial age, yada, yada, yada, an economic decision can constitute “activity” for purposes of the Commerce Clause, and that Vinson hadn’t done enough to prevent this. I found his basic argument — that, given the current state of Commerce Clause jurisprudence, if this law were to be upheld, no real distinction could be made between the “individual mandate” and anything else Congress wanted to make people do, and therefore, if this law were to be upheld, our government would no longer be a limited one whose powers are enumerated — terribly unsatisfying. But today, after sleeping on it (even if only for a few hours), and having a brief interchange with an actual Constitutional Lawyer, I realize that my expectations are unrealistic. This is about as good as one could expect.
First, even if Vinson were an Objectivist, his job would be to apply the law, as it exists, to the facts of the case before him. Thus, even if he rejected the Originalist approach, he would still be stuck with the language of the Commerce Clause itself, plus all of the horrible precedent expanding Congress’s powers under that clause. Especially given that Vinson is a district court judge, it seems the best he can do is to explain why, in the context of this binding precedent, Obamacare goes too far, and is therefore unconstitutional. So, given that I’ve concluded this was Vinson’s assignment, is there something significant he could have done that would have been more satisfying to me? I did find his expressing “reluctance” in striking down the legislation to be annoying. I mean, at least he needn’t be reluctant! He is, after all, assuming he is right, saving us from a government whose powers are no longer enumerated and limited, right? He should be glad about this! I also was annoyed that he seemed to be inviting the Supreme Court, twice during the course of his opinion, to reformulate its Commerce Clause jurisprudence in a way that allows them to uphold this legislation. However, what I realized today is the only significant thing I found missing was some sort of argument as to why it must be an activity that Congress regulates under the Clause. I wanted some sort of positive justification for the activity/inactivity distinction. It was no good to just hang one’s hat on the idea that, if you get rid of this distinction, Congress could do whatever it wants. I needed more!
What sort of argument could one provide?
Find out in her enlightening post, Notes on Judge Vinson’s Opinion.
A U.S. district judge on Monday threw out the nation’s health care law, declaring it unconstitutional because it violates the Commerce Clause and surely reviving a feud among competing philosophies about the role of government.
Judge Roger Vinson, in Pensacola, Fla., ruled that as a result of the unconstitutionality of the “individual mandate” that requires people to buy insurance, the entire law must be declared void.
“While the individual mandate was clearly ‘necessary and essential’ to the act as drafted, it is not ‘necessary and essential’ to health care reform in general,” he continued. “Because the individual mandate is unconstitutional and not severable, the entire act must be declared void.”