The KHIT Blog: The Jennings Moot Court tees up the PPACA

Sunday, March 25, 2012

The Jennings Moot Court tees up the PPACA

From the Constitutional Accountability Center:

IDEOLOGICALLY DIVERSE MOOT COURT PANEL VOTES 8-1 THAT ACA INDIVIDUAL MANDATE IS CONSTITUTIONAL

Brooke C. Obie
March 22, 2012

As the Supreme Court gears up to hear oral arguments in the Affordable Care Act cases next week, the Peter Jennings Project for Journalists and the Constitution tested the central issue of the Act at its Sixth Annual Moot Court Program on March 20. During the simulated court proceedings, a panel of distinguished law professors, noted legal thinkers, and current and former federal judges -- including four Bush (41 and 43) appointees and CAC Board member and former DC Circuit Judge Patricia Wald -- heard oral arguments on the constitutionality of the minimum coverage provision in the ACA and voted 8-1 that the ACA’s mandate that Americans obtain insurance coverage or face a tax penalty is within Congress’s constitutional power to regulate interstate commerce.

You can watch the webcast of this terrific moot court program below:

A Moot Court: Health Care on Trial from National Constitution Center on FORA.tv

I watched all 2 hours and 2 minutes. Riveting. Cheryl and I know an attorney who once argued at Orals before SCOTUS twenty-some years ago (a disability case). The constant interruptions and vigorous pushback from the Justices in this video square precisely with her recounting of her experience.

I wish FORA.tv would publish a verbatim transcript of this event. There are for me some striking seminal moments a bit over an hour in that I'd love to cite. This stuff is the antidote to people like this:

Yeah, my friend, real "governance" and evidentiary due process are a pain.

I will be listening closely to each day's Orals audio release. A significant part of our work going forward is joined at the hip with a number of PPACA subtitles, so it's worth keeping tabs on this.
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From

"...Those Americans who die or go broke because they happened to get sick represent a fundamental moral decision our country has made. Despite all the rights and privileges and entitlements that Americans enjoy today, we have never decided to provide medical care for everybody who needs it.The far-reaching health care reform that Congress passed in 2010 is designed to increase coverage substantially—but it will still leave about 23 million Americans uninsured. Even when “Obamacare” takes full effect, the American health care system will still lead to large numbers of avoidable deaths and bankruptcies among our fellow citizens. As we saw in the national debate over that bill, efforts to increase coverage tend to be derailed by arguments about “big government” or “free enterprise” or “socialism”—and the essential moral question gets lost in the shouting. All the other developed countries on earth have made a different moral decision.

All the other countries like us—that is, wealthy, technologically advanced, industrialized democracies—guarantee medical care to anyone who gets sick. Countries that are just as committed as we are to equal opportunity, individual liberty, and the free market have concluded that everybody has a right to health care—and they provide it. One result is that most rich countries have better national health statistics—longer life expectancy, lower infant mortality, better recovery rates from major diseases—than the United States does.Yet all the other rich countries spend far less on health care than the United States does..."

Reid, T. R. (2010-08-31). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care (Kindle Locations 62-73). Penguin Group. Kindle Edition.

New in my Kindle. Saw this referenced on Fareed Zakaria's new CNN "GPS Global" on the subject of health care reform (still trying to find a direct video embed link).

I know; this is "exceeding your scope." -- Just get EPs to MU.

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More to come...

1 comment:

UnknownMarch 28, 2012 at 2:15 AM
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Brave New Health

Commonwell Health Alliance

Another important read (pdf)

I love this kind of stuff. It sustains and humbles me. "As politicians, advertisers, salesmen, and propagandists for various political, economic, moral, religious, psychic, environmental, dietary, and artistic doctrinaire positions know only too well, fallible human minds are easily tricked, by clever verbiage... Common language—or at least, the English language—has an almost universal tendency to disguise epistemological statements by putting them into a grammatical form which suggests to the unwary an ontological statement. A major source of error in current probability theory arises from an unthinking failure to perceive this."

Quotes

"An economist is a person who sees something that works in practice and tries to figure out whether it will work in theory."

- J.D. Kleinke, medical economist
___

"The only person who enjoys change is a baby with a wet diaper."

"Every misspent dollar in our health care system is part of somebody's paycheck.

- Brent James, M.D., M.Stat

“We could do healthcare, at markedly higher quality, for everyone in this country, without rationing or denying anybody the care that they need, without having the government dictate how doctors practice or whether hospitals could expand, at half the cost we do it now.”

- Health Care Futurist Joe Flower

Most of the sciences, unlike parts of medical science, are not concerned with the impossible. There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering. These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned."

- Mark A. Crislip, MD

"Q: How much alcohol is too much?
A: More than your doctor drinks."

- a physician I once heard speak during a CME presentation

“Just because science doesn’t know everything, doesn’t mean you get to fill in the gaps with whatever fairy tale most appeals to you.”

- Dara O’Briain

'[I]t is one small step from using the computer for "helping" doctors to monitoring them, judging them, dictating to them what to do, and withdrawing payment for computer non-compliance. The use of computer data is a multi-edged sword. It can be used for the "good," facilitating diagnosis and treatment and making it more accurate and up-to-date, and for “evil,” invading privacy, inviting security breechs, and making decisions based on the opinions of remote authorities rather than those present at the patient-doctor encounter.'

- Richard Reece, MD

“[T]here ARE statistics which are non-political. Just because The Washington Post/Fox News reports the temperature is 75 degrees doesn’t mean it’s really snowing and sunscreen is a liberal/conservative plot. Even if you earn a living being ideological.”

- Michael L. Millenson

"It is a generally a fairly convincing argument that people shouldn’t have to be subsidized to undertake a change which is in their best interest.

The reconciliation seems to be that EHR is not supposed to make a doctor’s practice more efficient and higher quality. It is supposed to make the system of care more efficient and higher quality, which is not the same thing. Those of you who took calc recall that maximizing the total of variables is not achieved by maximizing any one variable and this is a perfect example of that.

Those of you have served in combat certainly noticed that too — if everyone works as a team the unit takes fewer casualties. If you try to save your own hide, you might, but at the expense of more casualties overall."

- Al Lewis

"There are two ideas to keep in mind about Bayesian reasoning and how we tend to mess it up. The first is that base rates matter, even in the presence of evidence about the case at hand. This is often not intuitively obvious. The second is that intuitive impressions of the diagnosticity of evidence are often exaggerated."

- Daniel Kahneman, "Thinking, Fast and Slow"

"Physicians apply advanced scientific knowledge, but they must do so without the favorable conditions that experimental scientists create for themselves. Multitasking is forced on physicians, often in chaotic environments and under severe time and resource constraints."

- Lawrence and Lincoln Weed, "Medicine in Denial"

"It’s time to stop the whining about Obama care and acknowledge we already have universal health care. We just pay for it in the stupidest way possible that ensures problems are that much more disastrous and complicated when they’re finally treated."

- Mark Hoofnagle, MD, PhD

"Every act of conscious learning requires the willingness to suffer an injury to one's self-esteem. That is why young children, before they are aware of their own self-importance, learn so easily."

- Thomas Szasz, MD
___

"Of course, one reason that process metrics* are so popular is that processes are much easier to define and measure than outcomes."

- The Skeptical Scalpel
___

"There is an “illusion of validity” for any random data point, a seductive sense that is colored by what we hope will be true. Mountains of pharmaceutical claims are often made from mere molehills of data."

- Danielle Ofri, MD
___

"Joy empowers people. It is a source of energy that enables people to hope and plan and change their lives for the better. Spend some time around someone who is relentlessly negative and how do you feel–drained, right? More and more research shows that joy is not something that just happens to you, like a bolt of lightening out of the blue. Joy is, instead, a habit to cultivate. Negative thinking and despair are the crabgrass of our souls–weeds that take root and spread, sometimes to all areas of life. Joy, in contrast, is a soul’s rose–hardy when cared for, able to put down roots over time and withstand disease and extremes. Like a rose, however, your joy can become blighted from neglect or harsh conditions. We all need to tend to our joy–to prune away the badness, and to know that, even though it may look like a prickly bare root, if you invest time in a joyous outlook, gorgeous things will bloom, even in the harshest conditions."

- Dr. Jan Gurley
___

"'Solutions' exist only in mathematics."

- Karen Martin
___

"The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license."

- Adrian Gropper, MD
___

"Economist, rope, tree: some assembly required."

- Source unknown

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I write this blog wholly on my own time and my own dime. The views proffered are expressly my own as a concerned and active citizen/taxpayer (in addition to being the result of my substantive experience in the various IT fields), and in no way reflect any policy views of my former employer, notwithstanding that some of the thinking has indeed obviously been spurred by the implications of the work with which I have been doing for them.

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Sunday, March 25, 2012

The Jennings Moot Court tees up the PPACA

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