"I'm not a doctor..."

Every time someone asks me for medical advice, I always start off with the phrase, "I'm not a doctor." The implication is that I'm not entirely trustworthy on the subject, and that what information I offer (or fail to offer) may be a serious error. The logical inverse, of course, is 'I'm a doctor, so you can trust that you'll be getting the full story,' barring highly unlikely scenarios.

Right wing legislators are assaulting faith in medical professionals this year. A number of bills have required that doctors provide inaccurate information to pregnant women regarding the developing fetus. Now the Arizona Senate has passed a bill that would immunize doctors against malpractice suits for failing to tell women about known pre-natal abnormalities. This would include obvious damage to the fetus, or even problems that can prove fatal to the woman.

It's about time that Republicans put down their toy stethoscope and religious props and utter four simple words: "I'm not a doctor." And even if they do hold the requisite training and certifications, "I'm not your doctor" would suffice.

Post-Semiotic Law

I worry for judges. Their jobs are getting increasingly difficult as legislatures are working to undo 50 years of administrative-made law making. Around the country, Tea Party candidates elected in 2010 are unwinding the administrative balance struck by regulatory agencies on state and local levels, substituting the will of one-term legislators for the judgment of career civil servants. That is the platform that they ran on: "smaller government," less technocracy, and a revolt against expertise.

The example in the news this week is the Virginia Republican Party's attempt to force women to undergo invasive ultrasounds before receiving an abortion. Though this bill likely won't become law, thanks to fantastic organizing among opponents in Virginia as well as the national spotlight from the Daily Show and Saturday Night Live, a costly modification to it is still on its way through the legislature. In this case, the law is taking a hatchet to the judicial-made rule that women must have access to reproductive health care without "undue burden." An unnecessary and costly ultrasound, is at best an undue burden. Of course the original version of the bill, requiring unnecessary vaginal penetration, was substantially larger of a burden and even more inappropriate.

The legislator who introduced the bill, and the governor who championed it, have both admitted that they did not know that the language would have required OB/GYNs to insert a plastic instrument into a woman's vagina. In fact, they had shut out testimony from doctors and experts in health who would have explained that detail to the lawmakers. The bill was fast-tracked to avoid such a discussion, and it was only derailed by effective protest and mockery.

This bill came close to becoming law. One chamber of the legislature had passed it, and other other was days away from sending it to the governor's desk for his signature.

Health Care Liberty: Republican Acts Against Women

Instead of improving the American health care system, Senate Republican leader Mitch McConnell joined the Republican House leadership in an attempt to take innumerable steps backwards. The repeal-the-Affordable-Care-Act bill would, had it passed, have allowed insurers to discriminate against patients with pre-existing conditions by refusing to offer them health insurance, taken away subsidies for businesses to pay for employee health care, and reduced competition.

Republicans have couched their attack on the Affordable Care Act in terms of 'liberty,' claiming a general link between government regulation and reduced individuals' freedoms. It's a pretty nonsensical position, considering things like sewer regulations increase citizens' quality of life enough to provide for additional opportunities for liberty. 'Liberty' is not a zero-sum game with Government taking up oxygen for individuals' liberty. The position that Republicans espouse in their HR3 bill belies their commitment to preserving health care consumer liberty.

HR3 is a plan to radically constrain the set of health care options that insurance companies can present to customers. The Affordable Care Act provides credits to small businesses and individuals who would otherwise have trouble purchasing health insurance. Health insurance corporations will design their plans to cater to attract the maximum amount of federal credits to capture the largest possible share of the market. Any restrictions on plans will form the floor for the options available to consumers.

The Affordable Care Act is structured such that the Department of Health and Human Services will design these minimums that the industry will likely adopt. The DHHS is, after all, staffed with career civil servants and experts. The staff of DHHS with guidance from political appointees has more expertise than Congress, can craft policies that are not purely motivated by partisan politics, and is invested in creating a sustainable health care system. The institution is more capable of making the rules of the road for the American health care system than Congress.

The regulations that DHHS puts in place will be designed to reduce stress on the federal bureaucracy and increase the value of insurance plans. The floor standard for insurance that an individual will have to purchase is one that provides comprehensive coverage.

HR3 attempts to limit the options available to consumers by removing taxpayer subsidies for insurance plans if they offer coverage for abortions. The result is that coverage for abortions will be nonstandard in health insurance, possibly being priced into the "Cadillac health insurance plans" that are subject to an additional excise tax. Republicans are replacing a subsidy for health insurance with a tax for comprehensive coverage that covers women's health.

If you're a woman in America, the Republican Congressional leadership wants to make your health care more expensive.

But the Symbolism!

House Speaker John Boehner just announced via twitter that the Republicans have introduced a bill to eliminate federal funding for abortions, calling the push one of their "highest priorities". So far, google news counts 141 related stories on this story. Speaker Boehner and fellow Republicans might want to brush up on their US Code however; the regulation they are attempting to pass is already enshrined in federal law. The Hyde Amendment prohibits the use of any federal money disbursed as part of the Health and Human services budget from paying for elective abortions.

Perhaps the forthcoming legislation will not be redundant, but will provide restrictions that go beyond the Hyde Amendment. One place where Republicans might attempt to prevent pregnancy terminations is in military hospital facilities. The current controlling US Code on the subject reads:

[1] U.S. Code Title 10 USC Sec 1093
(a) Restriction on Use of Funds – funds available to the Department of Defense may not be used to perform abortions except where the life of the mother would be endangered if the fetus were carried to term.

(b) Restriction on Use of Facilities – No medical treatment facility or other facility of the Department of Defense may be used to perform an abortion except where the life of the mother would be endangered if the fetus were carried to term or in a case in which the pregnancy is the result of an act of rape or incest

If the Republicans are serious about preventing any federally-funded abortions, they are putting the health women in the military at risk, who may not have access to civilian facilities. They will also endanger the lives of civilians that military doctors may treat in the field, prohibiting the US military from performing life-saving operations that build good will with the local population.