AMERICAN EXCEPTIONALISM

Posted on October 20, 2012 by Robert Sewell, MD

The terms Left wing and Right wing get thrown around constantly these days with little explanation as to what they mean. Therefore, its time for a brief lesson in government/history/civics. I don’t think most young people have ever even considered the theories behind the various forms of government, or what is referred to as American Exceptionalism. It appears they aren’t being taught such things in school.

The Left has many names; Communist, Socialist, Marxist, Leninist, Maoist, Nazi, STATIST, etc. Each of these describes a big central government controlled by a dictator or small group of Elites who make all the “rules” but live by none of them. Actually Monarchies and Oligarchies fall into the same basic category. At the opposite end of the spectrum is the Individual. The Right holds to the principle that the individual’s rights trump those of the State. However, when carried to the extreme, individualism leads to Anarchy, the total absence of a government.

The brilliance of our Founding Fathers vision for this country was the creation of a central government that was, by design, limited by a Constitution, the supreme law of the land. It is based on establishing a central government which has very specific limited powers while at the same time sustains the rights of the individual. This individual freedom and personal liberty to achieve one’s own dreams is what has drawn millions to this unique country from all around the world. But, since the day it was written and adopted our Constitution has been under attack, ALWAYS from the Left.

Those who oppose a limited form of Constitutional government are now described as “Progressives” because they have had to be satisfied with a gradual erosion of that document, through interpretation and Amendment, with their goal continuing to be a bigger and bigger central government. This is what Jefferson meant when he said, “The natural progress of things is for liberty to yield, and government to gain ground.” Thus the need for those on the Right, who support individual freedom and liberty, to continue the fight against those who would usurp those rights.

Leftist, Elitists, Marxists, whatever you want to call them, continue their efforts to control every individual based on the myth that a utopian state can be achieved once every individual becomes totally subordinate to the collective good. Obviously, this theory is contrary to basic human nature and is therefore pure folly. The intellectual elite know this as well, but they are not deterred. Their quest for power and control leads them to use the “suffering” of the masses to lure the working class toward what can only be described as a “counter revolution”, which is in reality waged against themselves.

Today we find ourselves fighting this ill-conceived and self-destructive counter revolution, orchestrated from the Left. I, for one, remain firmly to the Right of center because that is where American Exceptionalism resides.

Class dismissed, but please be aware there will be a final exam on Tuesday, November 6th. If you don’t show up that day you will fail. If you show up with the Wrong (Left) answer, we all fail.

Next – We Indict the Media

Posted on October 4, 2012 by Robert Sewell, MD

My friend and fellow advocate of Repealing Obamacare, Adrian Murray, posted the following on Facebook and with his permission I am re-posting it here. In the wake of last night’s Presidential debate in Denver it should be crystal clear to everyone that the Mainstream Media has an agenda that includes doing whatever it takes to keep the current President in office. Their blatant partisanship under the guise of reporting the news has become a modern day “Yellow Journalism” and borders on the criminal.

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NEXT – WE INDICT THE MEDIA

It was clear to anybody paying even the remotest attention four years ago that the media was selling the American public a fraudulent bill of goods called Barack Obama. The man clearly hadn’t the slightest qualification to be President of the United States and yet the mainstream media refused to properly vet him, refused to explore his past, ignored any relevant criticism and generally acted like preteen schoolgirls at a Justin Bieber concert. Talent schmalant. He’s just so dreamy.

That’s not meant to be a knock on the President. No one will deny his oratory skills and his unique ability to stir passions in his followers with thrilling platitudes about nothing. That a significant portion of the American public is so alarmingly naïve and simplistic is not Barack Obama’s fault. Ambitious men seize upon opportunities and if the media was intent upon creating a wedge formation to allow Obama to waltz into the end zone, we cannot fault him for taking the ball and running with it.

What we saw last night was the bare exposition of the media lie. For weeks we have been assured by both print and broadcast that the Romney campaign was all but over, that he had imploded and his campaign has fizzled. “It’s over,” we were told. “Disarray” was the buzzword most often heard. Ask yourself: who was in disarray last night, Mitt Romney or Barack Obama?

It’s often been said that the media elected Barack Obama in 2008, acting as little more than cheerleaders and adeptly playing defense for the man. But Obama was not so much elected by the media as he was inflicted by the media, a consortium of liberal and leftist feel-gooders so awash in white guilt they never even once considered that absolving themselves of their self-induced guilt by abetting the election to the presidency of the United States a man not remotely qualified for the position might, just might, not be a good thing for the citizens of this country.

Oh, how the American people have suffered these last four years. Twenty-four million unable to find a job. Think of that for a second. We bandy about numbers and percentages so much that we often forget those are real people, maybe your neighbor, maybe a relative. Imagine every man, woman and child in Texas out of work, living on food stamps and government handouts, without homes or hope. That’s what Obama’s presidency has inflicted on the American people. That is a direct result of the media’s malpractice and they should be made to pay the price.

Many viewers last night were presented with facts that the media has carefully hidden. Did you know that the big tax breaks oil companies (not much more than depreciation) is just $2.9 billion while Obama’s gifts to the wind and solar industries (i.e., Obama donors) amounts to $90 billion? Neither did I. The utter, complete and devastating failure of the Obama presidency was on full display last night and along with it the media conspiracy to cover it up.

It is often said that the cover up is worse than the crime. That is certainly the case with the media’s protective fawning of Barack Obama. They can almost be forgiven for 2008. At the time many Americans were suffering from Bush-fatigue and, let’s face it, McCain was an uninspiring candidate. Maybe the media’s wet dream would have a happy ending. Most of us woke up the day after the election and hoped that would be the case.

But the disaster that has ensued is blindingly clear to all but the blind. The American people have suffered enough. Too many homes have been lost. Too many suffer without work. Too many are made to shed their dignity for government handouts. Too many face an uncertain future and live in fear of what tomorrow may bring. The media must be called to account. The curtain was pulled back last night and the emperor had no clothes, his empty suit carelessly draped over an empty chair.

Democracy cannot exist in a vacuum and that is exactly what the mainstream media has dutifully created to cover up their 2008 crime.

Off with their heads.

Americans Deserve Better

Posted on September 12, 2012 by Robert Sewell, MD

I admit I haven’t read Saul Alinsky’s “Rules for Radicals” and I probably never will, but I know I speak for many of my fellow Americans when I say that after witnessing the actions of President Obama over the last few years it is easy to understand the basic tactics of the radical left. Some of them are pretty obvious, such as consistently dividing people into groups and then pitting the groups against each other. This has been most frequently accomplished by using charges of racism or homophobia or gender bias or whatever makes a great headline for a complicit media. The more outrageous the claims the more of an emotional reaction it generates, which is their real goal. Whether its a video showing grandma in a wheelchair being thrown off a cliff or simply an outrageous statement telling small business owners that they didn’t really build their businesses, the objective is to generate the maximum visceral response. Once the stage has been set with a backdrop of anger, class envy or fear, the opportunity exists to offer a magnanimous government solution. Clearly this is precisely the same technique used by mobsters back in the 1920’s to convince the people of Chicago they needed “protection”, and it is precisely the mechanism that was used to ram healthcare reform down the throats of the American people.

Sinister is the word that comes to mind when assessing these efforts of radical leftists. They “never let a crisis go to waste”, but more importantly their modus operandi is to actually create one crisis after another in the minds of an increasingly gullible public through reckless and divisive rhetoric. Perhaps the most subtle technique of all can best be described as reciprocal deception. Accuse anyone who opposes you of the very techniques you are using against them. I offer the following statement as a clear example of this process.

The Quote of the Decade: “The fact that we are here today to debate raising America’s debt limit is a sign of leadership failure. It is a sign that the US Government cannot pay its own bills. It is a sign that we now depend on ongoing financial assistance from foreign countries to finance our Government’s reckless fiscal policies. Increasing America’s debt weakens us domestically and internationally. Leadership means that, “the buck stops here.’ Instead, Washington is shifting the burden of bad choices today onto the backs of our children and grandchildren. America has a debt problem and a failure of leadership. Americans deserve better.” ~ Senator Barack H. Obama, March 2006.

I would simply say YES Mr. President, we do deserve better, and we are aware of your persistent attempts to deceive us with your predictable radical style. We are fully cognizant of your back room deals designed to usurp our basic, God-given human rights. We have been awakened by your all too transparent lies and your constant efforts to deflect blame for our failing economy. We have seen how intentionally weak and inept you appear to be in dealing with both our friends and our adversaries around the world. We understand that you believe you are above the Constitution, the Congress and the Supreme Court. We acknowledge that through your hollow rhetoric and shallow charm, you have been successful at convincing many trusting souls that you are indeed “the answer.” But, you should be advised that the rest of America is now fully aroused and we are on our collective feet.

So, on November 6, 2012, “We The People of the United States of America” hereby promise to soundly defeat you and your agenda in the most historic election of our time. There is nothing you can do or say at this point to stop us from turning out in record numbers, despite any Chicago-style efforts you or your minions may use to intimidate or suppress the vote, or fraudulently attempt to steal this election. As Clint Eastwood said, “We Own This Country” and it is well passed the time for you to vacate our White House.

Mr. President, for once you are absolutely correct; we not only deserve better, we will have better, so help us God!

The opinions expressed are my own and do not necessarily reflect those of any organization or group. please feel free to review other posts on www.spiritofhealthcare.com

Forestalling the Demise of Freedom

Posted on September 6, 2012 by Robert Sewell, MD

I am attaching an e-mail letter I received recently without specific permission, but, you will see at the end there is a request to forward it to everyone, thus the inclusion in this blog. I actually thought about trying to rewrite this in my own words, but I’m not sure there is any way I could deliver this message any more clearly than this author has.

Obama’s Second Term Transformation Plans

The 2012 election has often been described as the most pivotal since 1860. This statement is not hyperbole. If Barack Obama is re-elected the United States will never be the same, nor will it be able to re-capture its once lofty status as the most dominant nation in the history of mankind.

The overwhelming majority of Americans do not understand that Obama’s first term was dedicated to putting in place executive power to enable him and the administration to fulfill the campaign promise of “transforming America ” in his second term regardless of which political party controls Congress. That is why his re-election team is virtually ignoring the plight of incumbent or prospective Democratic Party office holders.

The most significant accomplishment of Obama’s first term is to make Congress irrelevant. Under the myopic and blindly loyal leadership of Harry Reid and Nancy Pelosi, the Democrats have succeeded in creating an imperial and, in a second term, a potential dictatorial presidency.

During the first two years of the Obama administration when the Democrats overwhelmingly controlled both Houses of Congress and the media was in an Obama worshipping stupor, a myriad of laws were passed and actions taken which transferred virtually unlimited power to the executive branch.

The birth of multi-thousand page laws was not an aberration. This tactic was adopted so the bureaucracy controlled by Obama appointees would have sole discretion in interpreting vaguely written laws and enforcing thousands of pages of regulations they, and not Congress, would subsequently write.

For example, in the 2,700 pages of ObamaCare there are more than 2,500 references to the Secretary of Health and Human Services. There are more than 700 instances when he or she is instructed that they “shall” do something, and more than 200 times when they “may” take at their sole discretion some form of regulatory action. On 139 occasions, the law mentions that the “Secretary determines.” In essence one person, appointed by and reporting to the president, will be in charge of the health care of 310 million Americans once ObamaCare is fully operational in 2014.

The same is true in the 2,319 pages of the Dodd-Frank Financial Reform Act. which confers nearly unlimited power on various agencies to control by fiat the nation’s financial, banking and investment sectors. The bill also creates new agencies, such as the Consumer Financial Protection Bureau, not subject to any oversight by Congress. This overall process was repeated numerous times with other legislation all with the intent of granting unfettered power to the executive branch controlled by Barack Obama and his radical associates.

Additionally, the Obama administration has, through its unilaterally determined rule making and regulatory powers, created laws out of whole cloth. The Environmental Protection Agency on a near daily basis issues new regulations clearly out of their purview in order to modify and change environmental laws previously passed, and to impose a radical green agenda never approved by Congress. The same is true of the Energy and Interior Departments among many others.

None of these extra-constitutional actions have been challenged by Congress. The left in America knows this usurpation of power is nearly impossible to reverse unless stopped in its early stages.

It is clearly the mindset of this administration and its appointees that Congress is merely a nuisance, and can be ignored after they were able to take full advantage of the useful idiots in the Democrat controlled House and Senate in 2009-2010, and the Democrat Senate in the current Congress.

Additionally, Barack Obama knows after his re-election a Republican controlled House and Senate will not be able to enact any legislation to roll back the power previously granted to the Executive Branch, or usurped by them. His veto will not be overridden as there will always be at least 145 Democratic members of the House or 34 in the Senate in agreement with or intimidated by an administration more than willing to use Chicago style political tactics.

The stalemate between the Executive and Legislative Branches will inure to the benefit of Barack Obama and his fellow leftists.

The most significant power Congress has is the control of the purse-strings as all spending must be approved by them. However, once re-elected, Barack Obama, as confirmed by his willingness to do or say anything and his unscrupulous re-election tactics, would not only threaten government shutdowns but would deliberately withhold payments to those dependent on government support as a means of intimidating and forcing a Republican controlled Congress to surrender to his demands, thus neutering their ability to control the administration through spending constraints.

Further, this administration has shown contempt for the courts by ignoring various court orders, e.g. the Gulf of Mexico oil drilling moratorium, as well as stonewalling subpoenas and requests issued by Congress. The Eric Holder Justice Department has become the epitome of corruption as part of the most dishonest and deceitful administration in American history. In a second term the arrogance of Barack Obama and his minions will become more blatant as he will not have to be concerned with re-election.

Who will be there to enforce the rule of law, a Supreme Court ruling or the Constitution? No one. Barack Obama and his fellow-travelers will be unchallenged as they run roughshod over the American people.

Many Republicans and conservatives dissatisfied with the prospect of Mitt Romney as the nominee for president are instead focused on re-taking the House and Senate. That goal, while worthy and necessary, is meaningless unless Barack Obama is defeated. The nation is not dealing with a person of character and integrity but someone of single-minded purpose and overwhelming narcissism. Judging by his actions, words and deeds during his first term, he does not intend to work with Congress either Republican or Democrat in his second term but rather to force his radical agenda on the American people through the power he has usurped or been granted.

The governmental structure of the United States was set up by the founders in the hope that over the years only those people of high moral character and integrity would assume the reins of power. However, knowing that was not always possible, they dispersed power over three distinct and independent branches as a check on each other.

What they could not imagine is the surrender and abdication of its constitutional duty by the preeminent governmental branch, the Congress, to a chief executive devoid of any character or integrity coupled with a judiciary essentially powerless to enforce the law when the chief executive ignores them . Americans must come to grips with this moment in time and their historical role in denying Barack Obama and his minions their ultimate goal. All resources must be directed at that end-game and not merely controlling Congress and the various committee chairmanships.

Steve McCann, May 12, 2012

Please forward this to all you can, maybe together we can save America for ourselves and those who will follow after us

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I would only add, if we (the American public) accidentally overheard this President telling Russian President Putin that he would have a lot more flexibility after the election, how many other “deals” has Obama made with those who would seek to destroy our freedoms and the American way of life? Now is a time for choosing. “We The People” of this great nation must stand against the tyranny that Abraham Lincoln warned us about 150 years ago. He said “America will never be destroyed from the outside. If we falter and lose our freedoms, it will be because we destroyed ourselves.”

Stop Calling It Obamacare

Posted on July 13, 2012 by Robert Sewell, MD

By Adrain Murray

When Mitt Romney went before the convention of the NAACP and said that as president he would repeal “Obamacare”, he was roundly and predictably booed. In doing so, he stepped into a carefully laid trap.

Why is the Patient Protection and Affordable Care Act routinely referred to as “Obamacare”? Surely no one seriously believes President Obama wrote the 2,700 page bill or, for that matter, even knows what is in it. Yet the act is commonly labeled President Obama’s signature piece of legislation, the crowning achievement of his first term.

Even Nancy Pelosi would not take credit for authoring the bill, famously declaring we had to pass it in order to find out what’s in it. So if the president didn’t write the Affordable Care Act and the Speaker of the House didn’t know what was in it, why is it called Obamacare?

One could make the argument that it’s just laziness on the part of the media, which revels in finding the lowest common denominator to explain complex issues. One could argue that it is political posturing by Republicans who want to saddle the president with responsibility for what is undeniably an unpopular law. One could argue it is the president himself, trying to take legislative credit for something he had nothing to do with, popular or not. In fact Obama, a supporter of a single payer system, actively campaigned against many of the provisions that have ended up as cornerstones of the ACA law.

One could make a lot of arguments, but calling the Affordable Care Act “Obamacare” is a huge tactical error. Why? Because naming the law after Obama personalizes it and, as Romney learned from the NAACP audience, opposing Obamacare equals opposing Obama and the only reason anyone opposes Obama is, of course, because he is black. To those inclined to think as such, opposing the complete government takeover of the healthcare system and changing the status of Americans from private citizens to property of the state is, quite simply, racist. It also distracts from the true question that should be asked:

Who, precisely, wrote the Patient Protection and Affordable Care Act and why?

Our first clue comes from testimony given by Peter Orszag, then-Director of the Office of Management and Budget, before Congress in August of 2009. “Ultimately,” he said, “without structure in place to help contain health care costs over the long term as the health market evolves, nothing else we do in fiscal policy will matter much, because eventually health care cost will overwhelm the federal budget.”

If Orszag had been addressing the board of directors of Wellpoint, the nation’s second largest managed health care company, such a statement might seem perfectly proper. But, even accepting the wildly suspicious claim that 30 million Americans were uninsured, that’s still just 10% of the population. If 90% of Americans in 2009 were covered by private insurance, why would health care costs overwhelm the federal budget? It is more likely that rising health care costs would soon overwhelm the nation’s health insurance providers.

According to Kaiser Permanente, total health insurance costs in 1980 were $286 billion. By 2010, they had increased nearly tenfold to $2.3 trillion. As the population ages, that number is expected to soar. According to federal estimates, health care costs will double in the next decade and are likely to double again by 2030, when 70 million Americans – fully 20% of the population – will be over the age of 65. Could such dire estimates have provided the health insurance industry with a powerful $10 trillion incentive to move this looming liability off their balance sheets and onto the backs of the American taxpayer?

In May 2010, after final passage of the current health care law, Senator Max Baucus, from whose Finance Committee the legislation emerged, stood before the Senate and members of the press to publicly thank the person he credited with making it all happen:

“I wish to single out one person, and that one person is sitting next to me. Her name is Liz Fowler. Liz Fowler is my chief health counsel. Liz Fowler has put my health care team together. Liz Fowler worked for me many years ago, left for the private sector, and then came back when she realized she could be there at the creation of health care reform because she wanted that to be, in a certain sense, her professional lifetime goal. She put together the White Paper last November–2008–the 87-page document which became the basis, the foundation, the blueprint from which almost all health care measures in all bills on both sides of the aisle came.”

So who is Liz Fowler? Prior to joining Baucus’ staff as the senior advisor on health care, she was Vice President of Public Policy and External Affairs for none other than the aforementioned number two insurance company, Wellpoint. Not to put too fine a point to it, but the chief lobbyist for AHIP (America’s Health Insurance Plans), a national trade organization of over 1,300 insurers, infiltrated the Senate Finance Committee and wrote a law to benefit not the American people, but the entire insurance industry. As it turns out, the Patient Protection and Affordable Care Act is not intended to make health insurance more affordable for the American people. It is designed to make the American people more affordable for the health insurance industry.

As it further turns out, Baucus’ staff was infested with Wellpoint hirelings. Prior to Fowler arriving on scene, the chief advisor on Senator Baucus’ team was Michelle Easton. Upon passing the baton to Ms. Fowler, Easton went to work as a lobbyist for Wellpoint at Tarplin, Downs and Young, a DC-based lobbying firm founded in 2006 “specializing in strategic consulting and policy development with a particular focus on health care”.

Keep turning the wheel, though, and we come to Stephen Northrup. Northrup was the chief health advisor to Wyoming Senator Mike Enzi when Enzi pushed similar health care legislation in 2006. Prior to joining Enzi’s staff, Northrup was the executive director of the Long Term Pharmacy Alliance, an organization that played a lead role in drafting the mother of all giveaways to Big Pharma, Medicare Part D. Not surprisingly, the revolving door and interchangeable roles of advisors/staff/lobbyists eventually lead Northrup in 2007 to Wellpoint, where he served as Vice President of Federal Affairs.

The insurance lobby, tired of decades of failed attempts to influence Congress to create a national health care plan which would immunize them from the looming trillions of dollars in liabilities they faced as the boomer generation aged, simply decided they would infiltrate Congress instead and write the legislation themselves. Time, after all, was running out.

But simply enacting the legislation was not enough. Big Insurance also demanded a seat at the table when it came time to actually drafting the regulations and implementing the law, since incompetent government bureaucrats could not be trusted to enact regulations and procedures that would fully indemnify the insurance lobby to its complete satisfaction. Which brings us to the return of Liz Fowler, the author of the Affordable Care Act who is now the Deputy Director of Consumer Information and Oversight at the U.S. Department of Human Services, sort of an industry cop on watch to be sure government employees do what they are told.

Despite Big Insurance’s success in pulling off one of the most intricate swindles in the history of mankind by transferring tens of trillions of dollars of liabilities from their balance sheets to that of the Treasury Department, all to be paid for by massive tax increases on the American people (or fees, if you’re still arguing about the Commerce Clause in the increasingly irrelevant Constitution), the whole transaction would certainly deserve a special place in the pantheon of lawlessness were it not for the decidedly unhappy outcome it will have for the true victims of this crime – the American citizens, who are now merely the property of an insurance industry that has a vested interest in keeping them healthy while they are still useful. Those 22 year-olds who are today gleeful that they can stay on Mommy and Daddy’s insurance for a few more years won’t be quite as cheerful in 2030 when they are called before a panel Liz Fowler will undoubtedly have had a role in creating to explain why their cholesterol level has increased or are informed that certain substances detected in their last blood test indicated they are surpassing the monthly limit on pepperoni pizzas. After being sent home with a hefty fine and orders to adhere to a strict diet of carrot sticks and mineral water, along with the latest behavioral modification drug developed by the recent merger of Pfizer and Merck, they may well wish they had been paying attention back in 2012, when there was still a chance to put a stop to it all.

In the meanwhile, it would be nice if certain political figures would put a stop to feigning political courage by mockingly referring to this legislation as Obamacare. Obama didn’t write it or read it and there is nothing caring about it. Call it what it is:

The Health Insurance Industry Protection Act.

You could also call it the end of freedom.

This post was authored by Adrian Murray is a business man in Fort Worth, Texas (President and CEO of Painless Performance Products) and an ardent Conservative thought leader in the North Texas community. It is with his expressed permission that this incredible piece is offered here. Thank You Adrian for your patriotism.

A Second Declaration Of Independence – “If Not Now, When?”

Posted on July 9, 2012 by Robert Sewell, MD

Two hundred and thirty-six years ago a small group of brave souls stood up to what was at the time the most powerful nation on earth, declaring their independence from the tyranny of the British Crown. The Sugar Act of 1764, the Stamp Act of 1765, and the Declaratory Act of 1766 (Collectively known as the Townsend Acts) along with the Quartering Act of 1765 and the Tea Act of 1773 all lead to the uprising of the colonies and the American Revolution. Today we are faced with a tyranny of a different sort, which is similarly unacceptable. The Patient Protection and Affordable Care Act of 2010 (Obamacare) has now been upheld by the Supreme Court on a rather thinly veiled technicality. Its not a tax, but its constitutional because it really is a tax. No matter what you call it, this law represents historically the most significant overreach by our own government, and all freedom loving Americans should vigorously oppose it.

As a physician I am privileged to represent the American Society of General Surgeons both as a Delegate to the American Medical Association and as a representative to the Coalition of State Medical and National Specialty Societies; a rather loose consortium of conservative organizations within the AMA, where we’re in the minority to be sure. Following the annual meeting of the AMA House of Delegates in Chicago in June, 2011, we were frustrated by the fact that the House reaffirmed existing AMA policy, supporting a government requirement that every American purchase health insurance, the so-called individual mandate. In the wake of that defeat our Coalition came away without a clear understanding of what our next move should be. Various e-mail threads since then have failed to define a coherent physician-lead strategy. One such series of communications was titled “What is the Battle Plan?” While some would prefer the term Game Plan, either way its clear that we’re talking about a critical contest.

It seems obvious that before any competition one must first determine what is the object of the battle, or game. The problems that exist within the healthcare system are myriad, but central to every argument is one question. Is healthcare a basic human right and therefore the responsibility of government to provide for its citizens, or is it a benefit that has been developed by a civilized society and should be available to those who exercise individual responsibility to obtain it? Not surprisingly this question is quite polarizing, both for healthcare professionals (notice I didn’t use the demeaning term “providers”) and for the public as a whole. This is obviously a complicated issue for which there is no simple answer.

It is ridiculous to imply that American healthcare is bad, as some have claimed. It is the best in the world, but its also the most expensive, and no matter what anyone says, this fact is the sole reason behind the impassioned pleas for reform. Part of the reason our system is so expensive is because there are so many hands in the cookie jar. For years special interest groups have invested heavily in obtaining power within the ranks of government and they were actually the authors of the more than 2,000 page healthcare reform act.

The AMA is often considered to be the doctors’ special interest group, but It is important to recognize that the AMA, and all doctors for that matter, were only peripherally involved in the process of producing Obamacare. AMA leaders were wooed by the White House, but not as potential authors of the new law. Instead they were relegated to the role of commentators. Then during the actual public debate, they inexplicably seemed content just to be at the table, failing to recognize that our profession was indeed the main course. AMA leadership openly supported some elements of the bill, but the public never heard about the parts they objected to. AMA leaders told their dwindling membership (now less than 17% of America’s physicians) that problem areas, like the Independent Payment Advisory Board (IPAB) and the flawed Medicare payment system known as the Sustainable Growth Rate formula (SGR), would be “fixed” when the House and Senate versions came to conference committee. But, as we all found out, aggressive back-room politicians who recognized their opportunity (“If not now, when?”), worked in concert with the giddy media to push the Senate bill through unaltered. In no small way, AMA statements that sounded like doctors supported the bill helped put it on the President’s desk. The total lack of transparency and last minute parliamentary maneuvering made this perhaps the most shameful act of legislative cowardice in American history.

Whether you agree with the concept of universal health insurance or not, (again note I didn’t say universal healthcare because they are clearly not one and the same) the question remains whether it is the role of the government to command it. Patronizing lawmakers have told America’s physicians and our patients that this Congress and this President know what is best for us, and that we’ll like this new system once we get used to the idea. That reminds me of a statement made during a campaign by a gubernatorial candidate in Texas a few years back. He offered this advice to any woman being raped. “As long as it’s inevitable, you might as well lay back and enjoy it.” Well, obviously he lost the election, and based on the results of the 2010 midterm elections, a clear majority of Americans have not yet learned to “enjoy it”, preferring instead to fight back. Many of my fellow physicians have joined in that fight through organizations like the Association of American Physicians and Surgeons and Docs4PatientCare. So to the rest of my colleagues, and to the patients we serve, I would offer the following as a guide for our collective efforts.

What is the objective of this fight? Repeal the ENTIRE law that we unaffectionately call Obamacare, and start over to create a patient centered system that encourages personal responsibility and rewards individuals for good health practices rather than punishing those who refuse to submit to some government mandate.
What is the Battle Plan? Practicing physicians must get to work, joining other similarly minded groups and individuals to save our beloved profession. This battle starts with winning the hearts and minds of our fellow physicians. Our message must be that the future of healthcare relies on the individual physician’s moral compass and professional ethics and responsibility, not arbitrary controls mandated by any third party, be they the Federal government or private insurance companies. If we provide clear leadership for those who have lost faith in their representative organizations we will be able to effectively call up the vast militia of practicing physicians to join the fight. They will in turn be able to marshal the support of their patients who intuitively trust their doctors and want us to lead the way.
What is our first engagement? Our main obstacle to achieving the basic objective of repealing Obamacare is the current uncompromising administration in Washington. Therefore, our primary mission must be to change the current regime. Unlike the Patriots in Philadelphia in the summer of 1776, we can accomplish this change at the polls, but it will not be easy. Between now and November 6, 2012 we must work tirelessly to turn the political tables on those who believe they know what is best for us and all our fellow citizens. There is a true urgency to get to work immediately as the elections are just four months away. Our battle cry in this effort should include that now famous phrase “if not now, when?”

Our God given freedoms and individual rights are like a handful of sand. We don’t lose them all at once; rather they slip through our fingers one grain at a time. The election this coming November has become our final opportunity for “We The People” to declare our independence from a government which openly seeks to control our personal health and individual wellbeing. If we fail in this effort to change the course of this nation now, how can we hope to retain any of our precious few remaining freedoms for ourselves or our posterity.

“The best way to predict your future is to create it.” Abraham Lincoln.

The opinions expressed are my own and do not necessarily reflect those of any organization or group. please feel free to review other posts on www.spiritofhealthcare.com and check out my clinical site at www.robertsewellmd.com

WINNING !!!

Posted on July 3, 2012 by Robert Sewell, MD

Oh! Say does that Star-Spangled Banner yet wave?

Over the last few days I’ve written a couple of impassioned healthcare related pieces and have received some very positive feedback, which I appreciate very much. But, sitting here at the computer today it suddenly hit me; I’m sick and tired of being on the losing side of all that is going on in America, and I don’t just mean healthcare. Like everyone else, I want to be on the winning side. After thinking about it for a bit, it’s clear that there are only two options available, assuming you want to be a winner. Either you join the side that appears to be winning already, or do whatever it takes to make your side the winner.

When it comes to politics I have been solidly right of center my entire life, but it seems the left has been winning most of the battles for the last several decades. And like I said, I’m tired of losing. The option of joining the left would mean I’d need to embrace the concept of big brother having oversight and control over virtually all aspects of people’s lives. I guess I could live with that idea for everybody else, but not for me, or my family. I’d also need to be willing to tell people who trust me whatever they want to hear, even if I know it isn’t true. Perhaps that would also be okay as long as no one was harmed in the process. Obviously I’d have to sacrifice my integrity. I’d also need to learn how to look the other way whenever a colleague or a friend fails to do their job then blames their failure on someone else. Even if one of my teammates committed a crime I would have to be willing to just stay silent. That might be okay as long as the victim wasn’t someone I know. Actually, I suppose I’d need to learn how to rationalize that kind of behavior by making every situation seem like someone else is at fault. All of this would be acceptable I guess, as long as no one found out, right? If I could do these things I’m sure I could fit right in with the winning team of enlightened liberals.

My other choice would be to do the things my dad taught me as a boy. I would have to accept responsibility for what I’ve done and what I haven’t done thus far, and how I may have contributed to our current state of affairs. I would have to recognize that like many others I haven’t always stood up for what I knew was right. I’ve sometimes been slow to speak out with conviction against things that I knew were wrong, like lying and cheating. I would need to recognize the hard-work of others and do whatever I could to ensure that everyone gets an opportunity to succeed or fail, based on their own work ethic and effort. I certainly could do more to offer charity to those individuals around me who are truly in need, given the abundant blessings I’ve received. I could also do more to teach my children the values that my dad taught me to help ensure they aren’t lost forever. Perhaps most importantly, I would need to be more active in fighting against the general ignorance of history among those who have been easily drawn into the clutches of the side that currently appears to be winning.

The easy choice is obvious, just join those who are celebrating victory after victory today. They will gladly embrace anyone who thinks and acts the way they do. But the question that lingers before deciding is, are they going to be the winning side in the end? After all, that’s what really matters once all is said and done.

So before declaring which side to choose it is critical to define what we mean when we say someone is a winner. It isn’t how much money you accumulate, what you do for a living, where you live or even how many people depend on you everyday. For me the answer is much simpler. Being a winner means being able to say without hesitation that you did the right thing, not just when it was easy, but especially when things seem to be going hard against you. This is a difficult measuring stick because it requires courage, stamina, conviction and most of all a passionate heart.

Today, our nation, the greatest, most honorable, most prosperous and most free in the history of mankind, stands on the brink of a disastrous fall. We all know that the direction we are headed is wrong, politically, economically and morally, and will lead to the certain collapse of the cherished way of life our ancestors fought and died to achieve. The challenge we face is obvious but the question remains, will “We the People of the United States of America” recommit ourselves to saving our nation from those who would destroy it? Are we willing to individually take up the task of securing for our children, our grand children and their posterity, the promises offered by our “Land of the Free”? I believe it is still possible to win, but only if we are each willing to once again prove to ourselves and each other that America is indeed the “Home of the Brave.”

If you agree to take up this challenge of winning back our nation, please join me in praying for God to renew his blessing on this country. We need it now more than ever.

TO ARMS! TO ARMS! British Healthcare Is Coming!

Posted on July 2, 2012 by Robert Sewell, MD

In the Spirit of the 4th of July holiday, the following is an updated version of an article published in “General Surgery News” – August 2009.

April 18, 1775 was a fateful date in American history. That night, Paul Revere, a Boston silversmith, rode his horse through the countryside and called his fellow colonists “To Arms!” British troops were arriving by sea to suppress any effort by the colonists to gain their freedom from the tyranny of the crown. Once alerted, the Minutemen responded at Lexington and Concord, and the rest is, as they say, history. The event was immortalized by Longfellow nearly a century later. But to be sure, not everyone in the colonies was in favor of revolution. There were those who were loyal to the crown called Tories or Loyalists, and those who vigorously opposed the repression of King George, commonly referred to as Whigs or Patriots. Thank God the Patriots’ efforts didn’t stop with the first “Tea Party.”

Today, we face another British invasion of sorts, and once again we must be called “To Arms!” This time the threat is to our personal healthcare freedoms, and is being imposed by our own government as it now has the power to regulate patients’ rights to choose what is best for them, as well as physicians’ rights to practice as independent advocates for our patients. Make no mistake, Obamacare has a distinctly British look and feel to it. In Great Britain everyone has access to “free” care through the National Health Service. While this sounds good, in reality diagnostic tests and treatments are frequently delayed for months or even years, and some treatments are denied as not cost effective.

Our Congress and the President have effectively seized the practice of medicine by controlling both reimbursement and access under the direction of a Healthcare Czar, otherwise known as Secretary of Health and Human Services, Kathleen Sebelius. Although government take-over of medicine has been occurring incrementally for decades, this current effort was designed to absorb the final segment, known as private practice.

Perhaps of even greater concern to all Americans is the precedent that has been set. This law was rammed through Congress based on the claim of an “economic crisis” requiring “emergency surgery.” This approach is now the model for achieving any additional “reforms” supposedly designed to “help us.” Thomas Jefferson once said “Be most on guard for your personal freedom when the government’s purposes are beneficent.” Interestingly, the members of Congress who proposed this new and improved healthcare plan voted down an amendment that would have forced them, their families and all government employees to participate in it.

Every American deserves a healthcare system that maintains our fundamental freedoms, including the right to choose and maintain their own physician. Obamacare severely curtails or eliminates these freedoms. Furthermore, it does nothing to improve the insolvent Medicare system. It actually makes it worse by cutting $500 Billion from the Medicare budget over the next ten years. It also failed to address the medical liability crisis that exists in most parts of this country, and does nothing to address the fatally flawed physician payment formula. The net effect of Obamacare promises to exacerbate the growing shortage of physicians in critically important specialties like General Surgery. New physicians won’t choose this or other equally demanding fields of medicine, and those who are in practice won’t remain because it simply isn’t worth it.

Many patients have asked, “Why don’t you doctors do something?” Well, many of us are trying but our influence is limited, partly because physicians are not well organized. On the issue of healthcare reform there are basically two camps, much like the colonist who were either Loyalists or Patriots. The AMA is often described as the voice of doctors, but it has fewer than 17 percent of America’s physicians as members. This is in no small part due to the fact the AMA leadership chose a “Loyalist” approach to government reforms, while the overwhelming majority of practicing physicians favor a “Patriot” strategy of active resistance. Organizations like the Association of American Physicians and Surgeons and Docs4PatientCare are among those attempting to carry this banner and are thus deserving of our support.

President Obama warned that writings such as this are the scare tactics of those who want to preserve the status quo. With all due respect, America’s physicians don’t need scare tactics. The public is already frightened and so are their doctors. A government take-over of our profession has everyone worried, as it should. Personally, as a physician who has been in practice for more than thirty years, I see this simply as an unacceptable intrusion by the federal government. However, it appears the only thing that can save American medicine is a general outcry from the public militia, our patients; thus the reason for this “Call to Arms.” All freedom loving Americans must make their voices heard at the polls in November.

Although this is a political process, it is actually very similar to the treatment of a patient with a life-threatening illness or injury. DIAGNOSIS: Obamacare threatens the very existence of what has been the best healthcare in the world. TREATMENT: Vote for candidates who will repeal this law. In addition we must also remove Mr. Obama from the Presidency to avoid his certain veto of the true will of the people. FOLLOW-UP: Watch closely what happens and call or write your representatives to ensure they don’t forget what you’ve sent them to Washington to do.

Liberty, like life, is a precious commodity and once lost cannot be replaced. We simply cannot give up the fight to retain the freedoms others have fought and died to secure. So, before you say “my voice and my vote don’t really matter,” consider what would have happened had the Minutemen remained safely in their beds, allowing the Red Coats to cross Concord Bridge unopposed.

Robert Sewell, M.D., F.A.C.S.

The opinions expressed herein are my own, and do not necessary reflect those of any group or organization. Visit my web site at http://www.robertsewellmd.com

A Healthcare Road Less Traveled

Posted on June 28, 2012 by Robert Sewell, MD

Robert W. Sewell, M.D., F.A.C.S.

Despite the fact that the Supreme Court has ruled the Patient Protection and Affordable Care Act of 2010 to be Constitutional, we continue to find ourselves at a fork in the road. The Republican members of Congress have pledged to repeal the law and start over with a patient centered healthcare reform act. While this sounds promising, the question remains, which way will we go this time? Will we continue to be lured down the path taken by most European countries and our neighbor Canada, where a central government-run system provides cradle to grave care, or will we choose to empower the individual with freedom of choice? It has been this road less traveled which has been and will continue to be the key to American exceptionalism.

Next week we celebrate the two hundred and thirty-sixth anniversary of our founding fathers telling the world that they refused to accept the tyranny of the British crown. They had witnessed the impact of higher taxation, restrictions on opportunity and forced subservience, and when they had endured enough they rebelled. They rightfully concluded that they were better off pursuing a course based on individual freedom and they set this country down the freedom road that has lead to unparalleled prosperity. It hasn’t been easy and there have been many bumps along the way, but there is no doubt it was the right choice then, and it is still the right choice today. The choice is between liberty and servitude, personal freedom and government mandates. So why is it that so many argue vehemently for a government run system? It all revolves around the concept of responsibility.

Since the beginning of civilization the “common man” has been typically subjected to the rule of kings, czars, emperors, dictators and various other demigods, sometimes willingly but often under threat of force. Frequently, aristocratic rulers declared themselves to be appointed by, or in some instances actually descendants of God, as a means of legitimizing their control over the sea of commoners. The masses accepted this form of centralized, top-down government in part because someone else assumed responsibility for many of the tough choices in life. Only when a ruler grossly exceeded the unwritten laws of human decency would the people rise up in protest. But, historically another ruler would invariably step forward to fill the void. It seems people must be reminded over and over again that “Power corrupts and absolute power corrupts absolutely.” (Lord Acton)

The alternative offered by the Great American Experiment has been individuals possessing the ability to exercise their own free will and accept responsibility for their own successes and failures. In a totally free society there isn’t a “higher power” waiting to bail-out the person who either makes poor choices or is simply unlucky. It is understood that there will always be winners and losers in a true “survival of the fittest” system. But man is no longer trying to simply survive on the planes of Africa. Our collective conscience compels us to adjust our social framework to one that provides a safety-net for those who are either born into poverty or have fallen on hard-times through no fault of their own. Herein lies the greatest challenge to any group of free individuals. On the one extreme, with total freedom you have “losers” who suffer while “winners” enjoy the opulence and privilege of the “elite”. On the other extreme you have a society where there are no winners or losers because the incentives that encourage personal achievement are destroyed by a collective philosophy. It is the state that ultimately decides how much individual success is allowed, “just to make it fair.” This is the basic premise behind socialism and communism.

Nowhere in modern civilization is this argument more prominent than in our evolving system of healthcare. Obviously, no one wants to see a child or an elderly person, or anyone for that matter, go without needed medical attention, but in our efforts to ensure against the socially unacceptable, we risk over-reaching, as we gradually come to accept the idea that no one should have to be responsible for themselves. Gradually, we have either turned over responsibility for our individual healthcare to a corporate insurance entity that offers some version of A-Z healthcare or accepted the idea that a government controlled system is the best model. In doing so we have lost control of the most important personal service any of us ever receives. We have in essence relinquished our personal responsibility in exchange for a sense of security, which rests in the hands of either corporate moguls or government bureaucrats. Benjamin Franklin summarized this dilemma when he wrote “They who can give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety.”

Certainly there are those for whom choices are limited and some form of government sponsored healthcare may provide the only option. Even for the majority who have the means and desire to choose for themselves, the options have become limited by those who benefit either financially or politically from maintaining control. The current mantra of both the insurance industry and the government is that healthcare is too expensive and therefore must be taken over by wiser and more responsible people, (i.e.) them, because they know what is best for us and have the resources to deal with the inequities of the system. It is to that assertion we must collectively say no thank you. After all, where do the resources come from, which they use to manipulate the system?

For the majority of Americans the best solution would be a free and open market where the cost and availability are determined not by an arbitrary government panel or an insurance contract, but by the basic laws of supply and demand. This can be accomplished by expanding on the idea of individual empowerment. Health Savings Accounts (HSAs) that are independent from employer based insurance is an idea whose time has come. People will become true consumers of healthcare only when they are making decisions about how to spend their own resources. Obviously, this only works if it is coupled with catastrophic insurance for major costs that are beyond the average individual’s capability, but isn’t that what insurance is for? There must also be competition in the marketplace. Anyone should be allowed to buy insurance from any entity, not just those who operate within the boundaries of the state where they currently reside. Both the catastrophic insurance and HSA should be totally portable and remain with the individual and his or her estate.

Our current system of healthcare financing does not empower the individual, in large part because of our current tax law. The vast majority of health insurance policies in this country are employer based. The employer provides health insurance as a benefit to employees and their dependents, and then writes off the premium as a business expense. Individuals who purchase their own health insurance are penalized twice. They are unable to benefit from “bulk rate” discounts that larger employers enjoy, and they cannot write off the cost of their insurance on their personal tax returns. This is blatantly unfair, and correcting this inequity should be a major part of any new healthcare reform act, and it should be part of the foundation of the promised Federal tax reform next year.

Currently, the American healthcare system is anything but a free market, and as a result prices are high, quality is in decline and availability is threatened for all. The solution will not be easy because it will require a return to the fundamental principle so eloquently stated by Eleanor Roosevelt when she said, “With Freedom Comes Responsibility.” Now is the time, in the wake of this historic decision by the highest court in the land, for all free men and women of this nation to renew our commitment to being worthy of our heritage. We must raise our collective voices and demand our individual freedoms be restored, lest we will all eventually become wards of the state; the very thing our forefathers rebelled against.

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The opinions expressed herein are my own and do not necessarily reflect or represent the policies or opinions of any medical organization or group.

Check out my web site at www.robertsewellmd.com

With Freedom Comes Responsibility

Posted on December 9, 2011 by Robert Sewell, MD

How in the world did we get ourselves into this gigantic healthcare mess? Well, it started following World War II when health insurance was offered by employers as a valuable benefit in lieu of higher wages. Americans quickly became accustomed to having their employer provide for their healthcare, and soon this benefit became a major bargaining chip that management used in every negotiation with labor.

But what about the elderly who were subject to losing their employer-based insurance coverage upon retirement? The answer was a Federal Government Program called Medicare. But, what about the poor and disabled? The answer was once again the Federal Government, only this time in conjunction with the States, developing a program called Medicaid. But, don’t we need a special program for children who might otherwise fall through the cracks? The answer again came from the government in the form of the State Children’s Health Insurance Program (SCHIP). Okay, this all sounds very noble and commendable, so what went wrong? The American people have quite simply been duped by those who would assume your responsibility and in so doing steal your freedom.

It isn’t just the general public who has been duped. Over the past three decades, physicians have also become dependent on insurance/government based payments. These contractual arrangements use a system whereby allowable charges for their services are established not by the physician, but by the payer. If independent physicians attempt to bargain collectively with an insurance company they risk violating the Federal Sherman Anti-Trust Act. So, as a result, your doctor is compelled to see more patients and spend less time with each one. Some physicians have resorted to offering services that are not covered by insurance, like laser hair removal and botox injections, on a cash basis, just to make a living. I have two friends who are highly skilled and highly trained surgical specialists who have essentially converted their practices into a cash based, cosmetic vein ablation clinic. The effective loss of their talents to the community of medicine is an incredible tragedy for everyone.

If the systematic takeover of American healthcare is allowed to continue unchecked, within just a few years the entire free market system will cease to exist, replaced by “Uncle Barack’s European style healthcare system.” What’s ironic is how most western European countries are actively trying to privatize their existing socialist healthcare programs, because they promote mediocrity and are financially unsustainable.

Everything our government attempts to micromanage becomes more expensive, less available and of poorer quality. Witness the US Postal Service. So, what’s the answer? First, we must repeal The Patient Protection and Affordable Care Act of 2010 (Obamacare). Then, we, the citizens of this country, must emphatically tell our government to stop trying to dictate to us how we can access our own personal healthcare.

While the Republicans have actively called for “Repeal,” they have been quick to add the word “Replace.” But replace with what, more regulations? We must emphatically tell them NO, unless their new laws specifically eliminate existing restrictive regulations and reestablish a free enterprise system. Any new legislation must include the following principles:

Promote individual, non-employer based Health Savings Accounts that will allow the individual to accumulate funds tax free, allow any unused funds to roll over every year and remain as part of the individuals estate (again free of federal income tax).
Couple HSAs with high deductible catastrophic insurance which could be provided either by employers or purchased individually.
Allow individuals to deduct the cost of any health insurance premiums on their personal taxes, the way businesses currently do.
Allow for any person to buy health insurance from any company, in any state, and carry their policy with them wherever they go.
Allow insurance companies to offer “good health” incentives similar to “good driver” incentives to encourage healthy behavior that will ultimately lower the overall cost of care.
Promote “real” health education in our public schools, including specific information about how communicable diseases are transmitted and how specific lifestyles and behaviors lead to costly chronic diseases.
Encourage insurance companies, through incentives not mandates, to offer high-risk pools, which would include coverage for pre-existing conditions.
Allow patients and physicians who participate in existing government programs the right to privately contract for services for fees that may differ from the government established payment without penalizing either party. This will ensure access will not be denied based on unreasonably low government payments.

Obviously, the liberal pundits will vehemently object, “Wait! We can’t do that! Who will be in charge of ensuring healthcare for everyone, especially those who can’t afford it?” With those words they actually betray their ultimate objective. “In charge of” can be translated “in control of”, and it is that control that must be vigorously resisted. Healthcare is a personal service and is therefore the responsibility of each individual, even if they are considered “underprivileged.” We have systems in place such as Medicaid and SCHIP that serve as a safety net for the truly impoverished and they should be actively promoted as public assistance for those in need. We also have tax supported county and state hospitals, which were originally built to offer care to those who otherwise couldn’t afford private care. But laws like the Emergency Medical Treatment and Active Labor Act (EMTALA) actually discourage their use by those most in need, and it too should be repealed. We should spend more time. effort and resources educating people who qualify, as to precisely how they can access these existing programs and facilities, instead of trying to convince the entire population of the virtues of a government run system.

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Beginning about 65 years ago, Americans started to progressively relinquish many of our rights and our personal liberties to a group of faceless insurance executives who promised us financial security. By allowing the government to complete the take over of the healthcare system we are simply exchanging one set of controls and restrictions for another.

The time has come to break our dependence on “the system” and regain control of this most personal of all human services. Eleanor Roosevelt once said, “With freedom comes responsibility.” That has never been more true than it is today with healthcare. Both patients and physicians must exercise personal responsibility by breaking our unhealthy dependence on the current third party payment system and regain our freedom, lest we will forever become wards and agents of the state.