Rick Santorum, It Takes a Family 9

In my latest reading of It Takes a Family: Conservatism and the Common Good, Rick Santorum talked about abortion.  Sub-topics included: How he arrived at his pro-life stance; how he did not focus on abortion in his congressional and Senatorial races (in areas that had a lot of Democrats) but felt compelled to take a public stand in the partial-birth abortion debate; how his wife had a baby with severe defects (the sorts of babies who are often casualties of partial-birth abortion) and loved that baby during the baby’s brief life; and how Santorum gave a hundred minute speech against partial-birth abortion in a last-ditched attempt to gather votes to override President Bill Clinton’s veto, and, while he failed to get the votes, he did dissuade a lady watching him on C-Span from having an abortion.  There was more to my reading, but those were some of my favorite passages.

Santorum makes an excellent point on pages 262-263, but my question is whether his statement there is at odds with other things he has said.  Santorum states: “I know that for so many women this is the most painful decision in their lives: but the family, the churches, community organizations, and even the government have to be there to help.  Not just during the pregnancy and after the baby is born, but before.  I have introduced a bill to provide government grants for organizations that provide everything from prenatal care to diapers and baby clothes.  If abortion proponents are interested in ‘choice,’ they should join us in helping poor women afford the choice to have a baby.”

But how does this jive with Santorum’s criticism of the welfare system (which serves many low-income single mothers), and his statement during his Presidential campaign that health insurance should not be required to cover prenatal tests, which he thinks will encourage abortions because parents could abort their kid when they learn that he has defects?  Prenatal tests could do that, but they could also be an essential part of prenatal care.

Moreover, Santorum talks about how there are babies with birth defects who survive through medical care, against those who argue that partial-birth abortion may be necessary on account of such babies.  Santorum makes a valuable point, but that kind of medical care probably costs a lot, especially in America’s health care system.  Health care reform should be part of a pro-life policy.

One area in which I was disappointed in Santorum’s discussion about abortion is that he did not talk much about cases in which having a child can take a serious toll on the physical health of the mother.  He mentions that particular argument, so he is aware of it, but (at least in my latest reading) he does not engage it.  I think that this aspect of the debate is important, for one reason that Bill Clinton had issues with banning partial-birth abortion was that he did not feel that the bill in question contained a sufficient exception for the health of the mother.  I recall reading a reference Clinton made to mothers becoming crippled on account of childbirth.

Newt Gingrich’s Real Change 3

I read three chapters in Newt Gingrich’s Real Change: “Chapter Six: Replacing the Old Order: America Has Done It Before and We Can Do It Again”; “Chapter Seven: Becoming a Citizen Leader”; and “Chapter Eight: Replacing the Old Order: Lessons from Britain and France”.

1.  What stood out to me in my reading of Chapter 6 was Newt’s references to the Declaration of Independence.  The Declaration states: “whenever any form of government becomes destructive to these ends [of life, liberty, and the pursuit of happiness], it is the right of the people to alter or abolish it, and to institute a new government, laying its foundation on such principles and organizing its power in such form as to them shall seem most likely to affect their safety and happiness.”  Newt then spends this chapter discussing systemic transformations throughout American history: the American Revolution, the replacement of the Articles of Confederation with a strong central government, Jeffersonianism, Jacksonianism, Lincoln Republicanism, the progressive movement, the New Deal, and Reaganism.  Regarding Lincoln Republicanism, Newt says on page 71 that it “shifted the focus of American political philosophy from the Constitution back to the Declaration of Independence”.  He probably means that Lincoln Republicanism did so by highlighting the Declaration’s principle that all men are created equal, in its opposition to slavery.  The Constitution, however, did not treat slaves as full human beings, as well as mandated that runaway slaves be returned to their masters.

Newt is probably a strict constructionist, one who wants for judges to be faithful to the text and original intent of the Constitution, and so I’ll be taking the thoughts in the above paragraph in a direction that Newt most likely did not intend, and probably would find abhorrent.

During the health care debate, conservatives were telling me that the federal government has no authority to do anything about health care, for the Tenth Amendment to the U.S. Constitution says that the federal government can only do what the Constitution explicitly states, while all other powers are reserved to the states and the people.  I found such reasoning to be troubling.  There were people in the United States who were suffering and dying at the hands of America’s health care system, and my conservative friends were appealing to some archaic notion of federalism to argue that the federal government should do absolutely nothing about that problem!  That made me think: the government is meant to serve us and to promote the general welfare.  If it is set-up in such a way that it is doing the opposite or hindering this, then there is a problem.  I think of government the same way that Jesus in Mark 2:27 thought about the Sabbath: The government was made for humanity, not humanity for the government.  In my opinion, if the Constitution is designed to prevent the government from helping people, then there is a problem with the Constitution.  I’m NOT calling for the overthrow of the U.S. Government, mind you, but I’m just saying that I’m wary of conservatives who put an archaic notion of federalism above the lives and well-being of American citizens.

2.  I enjoyed some of the advice and the stories in Chapter 7.  Newt talked about a 174-page book that he has read and reread since 1969, Peter Drucker’s The Effective Executive.  Newt states that, according to this book, being an effective leader is not a matter of “intelligence or looks or charisma”.  Rather, it’s a matter of sharing your vision with others, and of listening to what they have to say with openness.

Newt also talked about Albert Einstein, who had a hard time getting an academic job and had to be a clerk in order to support himself.  But that ended up being a good thing, for Einstein was not held-back by the group-think that pervades academia, and he could approach issues in fresh ways. 

In a sense, what Newt says about Drucker and what he says about Einstein are contradictory: we should be a team-player working with others, and yet we should strike out on our own and see problems in fresh ways that the herd’s radar does not pick up.  Perhaps there’s a place for both.  After all, Einstein’s work had to interact with other scientists at some point, otherwise it would not have been accepted and put to use.

3.  Chapter 8 essentially lauds Margaret Thatcher of Great Britain and Nicolas Sarkozy of France, who took steps to liberate their respective countries’ economies from things that were holding those economies back (i.e., statism).  Newt talks about France and how its workers have had a short work week along with considerable vacation times, and he doubts that they’ll be as productive as countries where people work long hours (i.e., China and India).  The result, according to Newt, could be a decline in revenue in France, which is so necessary to pay for the French social programs.  But Newt states that Sarkozy has sought to encourage work.  For instance, Sarkozy proposed that overtime pay be tax-free.

I’m all for people working.  At the same time, it would be nice if they had time to spend with their families.  I know a lady who moved to Italy from the United States, and she says that she likes Italy because at least she can have lunch with her family.  In the U.S., she was always on the go, and so she couldn’t do that.  I hope that Europe’s way of doing things is not as perilous as Newt says.  But I’m far from being an expert on this topic.

Newt Gingrich on Health Care in Real Change

I read the material about health care in Newt Gingrich’s 2008 book, Real Change.  I have four items.

1.  One topic that Newt addresses in Real Change that I did not see in Saving Lives & Saving Money is doctors and dentists who defraud Medicare and Medicaid—-by overbilling the government or by requesting reimbursement for services that they did not perform.  Newt believes that this problem costs the health care system money, and he attributes it (at least in part) to bureaucratic incompetence.  After all, he says, while federal bureaucrats go home at 5, defrauders work long hours to figure out ways to cheat the system!

2. On page 227, Newt states that “Allowing individuals to pass their health costs onto others reinforces the attitude that their health is not their problem and adds to the irresponsible, unhealthy behaviors that bankrupt the current system.”

I don’t think this is entirely fair.  For one, a lot of individuals do not solely pass their health costs onto others in America’s health care system.  Even many who have health insurance have high premiums and copays, plus their insurance company may choose not to pay for certain treatments.  Second, it’s the current health care system that discourages preventative care, by making people reluctant and afraid to see a doctor on account of high medical costs.

To his credit, Newt is a strong advocate for preventative care.  He wants for the government to lead by example by incentivizing that, and he presumes that private health insurance companies would then follow its lead.  I hope so!  You’d think that private health insurance companies would support preventative care, since that costs them less than catastrophic care, leaving a larger profit for them.  At least that’s my opinion about how it would work, and I could be mistaken.

3. On page 235, Newt favorably quotes Franklin Roosevelt, who stated: “The success or failure of any government in the final analysis must be measured by the well-being of its citizens.  Nothing can be more important to a state than its public health; the state’s paramount concern should be the health of its people.”

I think that this sentiment is biblical (if that matters to you), for Ezekiel 34:2, 4 criticizes the rulers for not curing the ill or binding the broken.  Moreover, the U.S. Constitution talks about promoting the general welfare.  The government is supposed to be concerned about the health and well-being of the country’s citizens.

Unfortunately, when I hear many conservatives and libertarians talk, the vibe that I get is that they don’t think the government should be concerned about health care.  For them, the government should keep out of it, and people should be responsible for their own health—-for good or for ill.  I respect conservatives and libertarians who talk about ways to bring down the cost of health care, but I do not care for the callous approach that some of them appear to convey when discussing what the government’s role should be (or should not be).

4.  Did Newt Gingrich support a health insurance mandate, which now is a significant part of President Obama’s health care plan (though I am writing this post on April 7, before the Supreme Court has decided on whether or not the mandate will remain a part of the health care law)?  I did not see that in Saving Lives & Saving Money (which was published in 2003), for, while Newt highlighted the importance of universal coverage, he focused on how to make it cheaper for people to purchase health insurance, without mentioning a mandate.  In Real Change, however, he appears to support a mandate.  On page 276, Newt states: “…we should insist that everyone above a certain level buy coverage (or, if they are opposed to insurance, post a bond).”

Newt Gingrich’s Saving Lives & Saving Money 12

I finished Newt Gingrich’s Saving Lives & Saving Money: Transforming Health and Healthcare.  In this post, I’ll highlight something from my latest reading, then I’ll briefly state my impressions of the book as a whole.

At the end of his book, Newt talks about the prospect of a biochemical attack on the U.S.  Remember that this book was published in 2003.  I’m not sure if people are still fearing that nuclear or bio-chemical weapons could fall into the wrong hands, but that was a great fear in the early 2000′s.  It was one reason that we went to war against Iraq, and the Democrats accused the Republicans of not doing enough about nuclear proliferation.

Newt hopes that America’s health care system will be efficient in case a bio-chemical attack occurs.  Newt believes that the FDA “must fast-track and accelerate approval processes with priority reviews for emergency-use licensure” (page 291).  For Newt, risks should be managed and benefits should be analyzed, and “animal efficacy data” must be used instead of “human efficacy trials”.  But Newt thinks that there should be tort reform that acknowledges and understands “the need for risk and benefit” (page 291).  I am not sure what Newt means here.  If the FDA approves of something that harms someone (even if it did not harm an animal who was part of a test), does Newt believe the person’s right to sue for damages should be limited, since there is some risk when scientists try to come up with treatments that can help people?

In terms of my overall impressions of the book, it was all right.  Parts of it, I expected.  Newt is big on preventative care and computerization, so it did not surprise me that these issues were significant topics in his book.  I thought that he made sense on those issues.  Newt also touted some of the typical conservative proposals for health care reform, such as Health Savings Accounts and tort reform.  I think that Newt made a good case for the necessity for tort reform and the need to come up with a system that protects patients without lining the pockets of trial lawyers and driving up the cost of health care.  But I do not believe that Health Savings Accounts are much of a solution for the rising costs of health care, since health care can easily become so expensive as to wipe those accounts out.  I was expecting for Newt to write more about how special interests profit from the current system, since he mentioned that topic in debates, but he did not go into this in as much detail as I hoped.

Next, I’ll read the sections on health care in Newt Gingrich’s Real Change.

Newt Gingrich’s Saving Lives & Saving Money 11

In my latest reading of Saving Lives & Saving Money: Transforming Health and Healthcare, Newt Gingrich praises a Computerized Patient Record System that the Veterans Administration plans to use:

“The provider ‘view,’ Computerized Patient Record System, organizes and presents all relevant patient data in a way that directly supports clinical decision making.  The comprehensive cover sheet displays timely, patient-centric information, including active problems, allergies, current medications, recent laboratory results, vital signs, hospitalization, and outpatient clinic history.  This information is displayed immediately when a patient is selected and provides an accurate overview of the patient’s current status before any clinical interventions are ordered.”

This makes sense.  It’s better than what happens a lot of times now, when doctors ask patients the same questions over and over (i.e., Have you ever been hospitalized?  Do you use medications?, etc.), or the right hand may not know what the left hand is doing.

Newt Gingrich’s Saving Lives & Saving Money 10

I’m in the section of the book Saving Lives & Saving Money: Transforming Health and Healthcare in which Newt Gingrich praises companies and hospitals for taking steps to transform the United States’ health care system.  One company that Newt praises is Pfizer, a pharmaceutical company.  The reason that Newt likes Pfizer is that, in Florida, it is cooperating with the state to help Medicaid recipients with preventative care, which keeps them out of the emergency rooms and thus saves the health care system money.  This partnership also taps into the knowledge and experience of doctors across the state, which Newt likes.

I was wondering where I heard the name “Pfizer” in the news.  I knew it wasn’t in a positive context.  When I read the wikipedia article and did a google search on Pfizer, I saw some things that rang a bell, and more.  Pfizer was the company that tried to take advantage of eminent domain, resulting in the 2005 Supreme Court Kelo case, which allowed local governments to take private property for economic development.  In 2012, there was controversy about whether or not Newt acted as a lobbyist for Pfizer.  And, on wikipedia, I see discussion about Pfizer damaging the environment, lobbying against the prescription drug benefit and the entrance of generic drugs into U.S. markets, and supporting a ban on lawsuits against those who manufacture body implant parts.  The last item made its way into proposed tort reform legislation in the U.S. Congress.

These things concern me, and they tell me that Pfizer may be part of the problem, not just part of the solution.  Still, if Pfizer is working with the Florida government to promote preventative care, that’s a good thing.  And, while I think that tort reform can go too far, I agree with Newt that some form of tort reform is necessary, for the fear of being sued inhibits doctors from acknowledging and correcting mistakes, as well as imposes a monetary cost on them.

Newt Gingrich’s Saving Lives & Saving Money 9

In my latest reading of Saving Lives & Saving Money: Transforming Health and Healthcare, Newt Gingrich talks about the living arrangements of people with disabilities.  On page 198, he states:

“…most families want to do as much as humanly and financially possible to enable their family members with a disability to live in their own home and participate in the community.  And, from the perspective of public policy, it will be extremely difficult, if not impossible, for our country to continue providing costly institutional care for people with disabilities as the number of people needing these services grows.”

On pages 198-199, Newt quotes Carol Hughes-Novak, who was the chairperson of the Disabilities Task Force in Newt’s district and whose son has cerebral palsy.  Carol believes in promoting “implementation of President Bush’s Olmstead Executive Order that requires state Medicaid programs to provide long-term-care services in the community whenever appropriate for the individual.”  (See here for information about the Olmstead Executive Order.)  Carol supports reversing the bias in Medicaid towards institutional care, as disabled people under Medicaid are entitled to placement in an institution, while those who prefer “Medicaid Home and Community based long-term care services that are more humane and almost always less costly” must wait for years.

This discussion stood out to me because of posts that I read on the blog, Whose Planet Is It Anyway, during the 2008 Presidential election.  According to those posts, John McCain supported institutional care for the disabled rather than integrating the disabled into their communities because he thought that the latter was too expensive, when (as the blog, Newt, and Carol point out) it is actually institutional care that is more expensive.  Those posts made me question that Republicans were truly on the side of fiscal responsibility.  It turns out, though, that people in both parties think that we should move away from institutional care and towards helping the disabled to integrate into their communities.  See here and here.

Newt Gingrich’s Saving Lives & Saving Money 8

In my latest reading of Saving Lives & Saving Money: Transforming Health and Healthcare, Newt talks about the importance of increased government spending on scientific research.  In some cases, this would be to combat diseases, such as Diabetes and Alzheimer’s.  In some cases, it would be to promote national pride, as the space program does.  While Newt acknowledges that he wants for the country to spend more money on scientific research, he believes that doing so will save the country money in the long run, since Diabetes takes a toll on America’s health care system.  I’m cool with this argument, but I wonder how America could do this and cut taxes at the same time, which I say in light of Newt’s tax cut proposals.

I liked what Newt said on page 182 about education:

“…we teach these subjects as facts to be memorized rather than a great adventure of discovery to be pursued.  Teaching, memorizing, and testing are all familiar words.  But we must return the words wonder, adventure, and discovery to our schools.  We should not center on education, but on learning.  We should go beyond force-feeding numbers and theories to a level of true discovery where a child wonders what the answers are and goes in search of them for the pure excitement of it.”

I was one time working with a program that tutored at-risk youth, and I remarked that I could understand why the youths were so bored with what they were learning in school, for I was bored with that stuff and was happy to be in college where I could pursue my interests and take the courses that I wanted.  My supervisor responded that my opportunities to do so in college were my reward for doing well in the boring subjects in junior high and high school.  I think that it’s important for students to learn subjects that may not necessarily interest them.  At the same time, I believe that schools should encourage students to pursue their interests, and that opportunities to do so should not be limited to the gifted and talented or to those who go on to college.

Newt Gingrich’s Saving Lives & Saving Money 7

For my write-up today on Newt Gingrich’s Saving Lives & Saving Money: Transforming Health and Healthcare, I want to highlight what Newt says on pages 145-146:

“The current system dictates a focus on reactive acute care and does not incentivize prevention.  Coverage for prescription medications is a paramount example…Medicare will cover the visit to the doctor to discuss the numbness in the foot, but it will not pay for the insulin to relieve, and stop, the problem.  Medicare will pay for visits to the emergency room when a beneficiary has a heart attack, but it fails to pay for the cholesterol medication that may have prevented the incident all together.  Medicare’s end-stage renal-disease program (offers kidney dialysis when the kidneys no longer function) is one of the highest cost programs in Medicare, yet it will not pay for the insulin that could prevent many of those individuals from needing it in the first place.”

Newt wrote this before the Medicare prescription drug entitlement was passed into law.  And what Newt said makes sense, for you would expect for prevention to save money by reducing the number of people who end up in emergency rooms.  But did the prescription drug benefit save Medicare money?  As far I as know, Medicare spending has continued to increase since that benefit was passed.  Why?  Is it because the donut hole requires some people to still pay for their prescription drugs, thereby hindering them from a health-plan of prevention?  Is Medicare Advantage part of the problem, as I have read that it entails the government giving money to insurance companies, plus there are questions about the quality of Medicare Advantage plans?  Is the sheer cost of prescription drugs part of the problem?

Newt Gingrich’s Saving Lives & Saving Money 6

For my write-up today on Saving Lives & Saving Money: Transforming Health and Healthcare, I’ll highlight what Newt Gingrich says on pages 110-111:

“In a world where we have the ability to do our own trading on the stock market, it should be unacceptable that we are still at the mercy of an insurance company to understand care options, provider choices, and costs.  The role of a patient has evolved into a dependency relationship in the healthcare delivery system rather than the driver of the system.  Access to information and knowledge about healthcare will empower individuals, as consumers, to make the best healthcare choices in deciding which procedures, treatments, and preventive care will meet their mental, emotional, and physical needs.  We want to know that the physician performing our hip and knee replacement has done the procedure enough times to be proficient at it.  We want to know that if we have type 2 diabetes, our doctor has a high percentage of success in treating patients with that condition.”

But what if you do an online search and find a doctor you like, and the insurance company doesn’t cover a visit to that particular doctor?  Knowledge is not necessarily power, especially in a system where one is dependent on the insurance company.  I wonder how Canada would handle this: Can Canadians visit any doctor in the country, and the government pays for it?