Why the Swiss Health Care Model Will Never Work in America by Kevin D. Williamson

If you’re wondering what in Hell is actually going on with U.S. health-care policy, the short version is this: Policymakers in both parties are trying to replicate Swiss policies in a country that isn’t Swiss.

The Affordable Care Act was, as thinkers as different as Paul Krugman and Avik Roy both observed, an attempt to Swiss up the U.S. health-insurance and health-care markets. (Obligatory reiteration: Those are not the same thing.) The Swiss system, Santésuisse, achieves one big progressive goal — universal health-insurance coverage — while offering much to please conservatives: a private market for health insurance and health care, consumer choice, and relatively low government spending on health care.

Obamacare vs. Santésuisse

Santésuisse is, in its broadest strokes, a lot like the model established by the so-called Affordable Care Act — a model that is kept in large part by the Republicans’ “repeal-and-replace” proposal, which neither repeals nor replaces the Affordable Care Act, though it does make some substantial changes to it.

Like Obamacare, Santésuisse mandates that all citizens purchase insurance from private insurance companies; establishes by law a minimum package of acceptable benefits to satisfy that mandate; subsidizes health-insurance premiums for lower-income people, with a goal of keeping their insurance premiums to less than 10 percent of their incomes; mandates coverage of preexisting conditions and imposes “community rating,” which means that low-risk insurance buyers pay higher premiums to allow for high-risk buyers to pay lower premiums, though the Swiss do make some adjustments for age and sex (!); it imposes controls on procedure costs and reimbursement for providers.

The Swiss model also does a few things that ACA does not: It requires that insurance companies offer their minimal policies on a nonprofit basis; it is structured around relatively high out-of-pocket expenses (high copays and deductibles) in order to encourage consumers to spend soberly; and, perhaps most important, it does this in the context of a health-insurance market that is entirely individual: There are no employer-based health-insurance plans in Switzerland. Everybody buys his own health insurance, the same way people buy everything from tacos to mobile-phone service. Swiss regulations also mandate that prices be made public, which helps consumer markets to function.

The Cost of Health Care

In terms of government spending on health care, Switzerland isn’t terribly different from the United States. Indeed, with the exception of high-spending Norway, per-capita government spending on health care is pretty consistent across a selection of advanced countries with very different health-care systems: Switzerland, the United States, the Netherlands, Sweden, Germany, and Denmark all have similar per-capita outlays. Interestingly, none of those countries has a national single-payer system: Sweden and Denmark have largely public systems, but they are run mostly by local governments rather than by the national government.

Among countries with single-payer systems, there is a fair amount of variability in per-capita spending: Australia, for example, has lower government spending than does the United Kingdom.

In terms of total spending — government and private spending together — countries with quite different systems lead the pack: The United States spends the most, followed by Switzerland, Norway, the Netherlands, Germany, Sweden, Ireland, Austria, Denmark, Belgium, and Canada. (These are OCED statistics from 2014.) The lack of a robust relationship between health-care systems, health-care expenses, and health-care outcomes suggests that the most powerful determinants of these are exogenous to policy, things like national demographic characteristics and economic conditions: Older people with lots of disposable income will tend to spend more on medical services, the Swedes and Okinawans have been healthy and long-lived under a number of different health-care systems, etc.

Which is to say, one of the reasons the Swiss and the Americans spend relatively large sums on health care may be the structure of the insurance markets; it might simply be that they are rich countries in which consumers choose to consume more health care, which would explain why Sweden and Canada are in the club of relatively big spenders. And low medical spending is not necessarily a sign of health: They don’t spend very much on health care in Cameroon.

Cultural Differences Matter

As Avik Roy and others have pointed out, trying to build Swiss health-care architecture on American foundations is a project by no means guaranteed to succeed. Switzerland, for example, has enjoyed very strong compliance with its national health-insurance mandate. Part of that is cultural (the Swiss are rule-following people), and part of it is that Swiss government: If you fail to comply with the mandate, the Swiss government will garnishee your wages and charge you a penalty equivalent to the cost of the premiums plus up to 50 percent, and, if you persist, the government will sign you up for an insurance policy and allow the provider to sue you for back premiums covering the period during which you were uninsured.

The American version is a little less robust, to say the least: The ACA mandate is “enforced” with a very small penalty that in most cases is nowhere near as expensive as signing up for insurance. That is, the Swiss have a system under which compliance makes economic sense, and we have a system under which non-compliance makes economic sense.

The Affordable Care Act was designed in a dishonest way, front-loading the revenue and backing in the expenses in order to get a nice budget score from the Congressional Budget Office. The CBO rolled its institutional eyes at this, and its report suggested very strongly that its analysts did not believe a word of what they were writing, inasmuch as the most popular parts of ACA were likely to be enforced while the unpopular bits — like the “Cadillac tax” — would be put off or softened, resulting in a program that in reality cost much more and produced less revenue than it did in the model version that CBO scored.

Sure enough, Hillary Rodham Clinton and Bernie Sanders both campaigned against the Cadillac tax (it hits their union foot soldiers first and hardest) while the House and Senate Republican plans would keep in, in theory, but put off collecting it until 2025 — at which point the smart money would be on its being put off again.

If you want a Swiss health-care system, then you have to be willing to accept ruthlessly efficient Swiss enforcement and an unsentimental Swiss bottom-line view of the program. Neither party is interested in that: The new Republican health-care plan would formally do away with the individual mandate while keeping a form of the preexisting-coverage rule, which is, the protestations of the bill’s drafters notwithstanding, probably going to be unworkable.

As long as you have a mandate that insurance companies cover preexisting conditions (i.e., that they place bets against events that already have happened) then you really have to have the mandate that people buy insurance, too; otherwise you create incentives to forgo buying insurance until you are actually sick, creating insurance markets composed mostly of sick people, a model that is not economically sustainable. If you want to cover preexisting conditions, then you have to have a mandate and enforce it strongly — Switzerland’s compliance rate is about 99.5 percent.

For comparison, the United States mandates that drivers carry automotive insurance, and about one in five drivers fails to comply with that mandate. And while the enforcement is tougher, the subsidies are less generous. Two-thirds of the Swiss receive no health-insurance subsidies at all, and the subsidies that are received tend to be relatively small except for the very poor.

But what is most critical may be that the Swiss model is free of one big problem that most Americans do not see as a problem at all: employer-based health-insurance programs. The Swiss market is an individual market, but most insured Americans get their insurance from their employers. Doing away with that would provide real benefits, but it would also bring a great deal of stress to risk-averse Americans who are, in large part, satisfied with their employer-based insurance plans. A Swiss system in the United States might — might — be a good idea, or at least better than the status quo ante of 2009.

A Swiss system with no real enforcement, sloppy economic thinking, and no dynamic, consumer-driven insurance market? A Swiss system that replaces Swiss efficiency with American sentimentality? It didn’t work when it was called Obamacare. It won’t work when it’s called Trumpcare or Ryancare or McConnellcare, either.

Reprinted from National Review. 

Kevin D. Williamson

Kevin D. Williamson

Kevin D. Williamson is roving correspondent for National Review.

Active and Engaged: Keeping Senior Citizens in Full Vigor

As we grow older, we might experience physical and mental conditions that may cause limitations in our activities. It becomes challenging to maintain physical and psychological strength because that is the nature of aging.

In this modern era, people tend to be less active because of all of the conveniences available to us. Social activity is also important in our older age, but most of the time we find that we just want to stay at home without realizing it. How can we remain active as we age?

As we love the older members of the society, we must always try to find out best possible ways to take care of them. But sometimes, we may not have the chance to help them ourselves. That’s why assisted living in Houston is one of the best ways to address this as they provide the services to take care of our aging loved ones.

The aim of this community is to provide support for the improvement of both physical and mental condition. a

In this post, we are going to look at some activities for the elder members of society that can help them to stay fit and active. Let’s begin!

Importance of physical activity to stay fit

We have the wrong assumption that physical exercise is just for young people. Having a fitness goal is important for aging people, too. Physical activity helps to in making sure that we live a healthy life.

When we get older, some physical problem can arise such as arthritis, fragile bones, stiff muscles, etc. Also, the coordination and balance may decrease. Fortunately, numerous physical exercises can help to prevent these problems.

Even light exercise can contribute to improving our health conditions. Let’s see how physical activity may help to fight aging problems.

Improve strength and liveliness

As we grow older, we become weak and less active. Strength exercises can improve our physical strength as well as liveliness. Strength exercises can prevent mobility problems.

Strength exercises are activities that make our muscles work harder than during normal conditions. It helps to make our muscles strong, and strong muscles support our bones and joints. It also aids in improving our stability and prevent joint problems to some extent.

Promotes Healing

Experts state that wounds take a longer time to heal, even small wounds when we become old. That might be a serious problem because as long as the wounds remain, the chances of infection can increase. But if we exercise properly, the healing power can be 25% faster than people who don’t exercise.

Prevents diseases

With age, many unwanted conditions come such as stroke, diabetes, stiff muscles, colon cancer, fragile bones, etc. Exercise can delay the onset of these diseases as well as prevent it. As per the National Institute of Aging, exercise can reduce overall hospitalization and death rates.

Improves the immune system

Physical activity is the most effective therapy to improve our immunity.  It is also scientifically proven. Regular exercise promotes circulation and keeps our body and mind relaxed. There is no need to do hard exercises, you can take a walk for 35-40 minutes, or you can join a yoga class, and it will effectively boost your immunity.

Improves digestive health

The digestive system includes the stomach, entrails, and the intestines. It breaks down the food we eat into nutrients. Wrong diet and bad lifestyle are sometimes the causes of problems in the digestive system. It reduces the energy that we need to operate our body.

Anyone can face digestion problems at any age. But seniors face it the most. Exercise can help to improve our digestion system and allow our body to absorb nutrients efficiently. Physical activity improves blood flow throughout the body.

Improves lung function

Breathing exercise can improve the lung function. As per the National Institute of Health, controlled breathing is more beneficial for older people. When we grow older, we don’t take the time to breathe deeply, that can cause us to feel uncomfortable and prevents us in leading a healthy life. Exercises is great for our lungs as we get to breathe in deeply and take in more oxygen.

Importance of mental activity for older people

Like physical activity, mental activity is important for aging people. With age, some mental changes occur like loss of neurons, deposits accumulating within brain cells, slower messaging between neurons, etc. Our brain becomes smaller with time, but it still can function effectively just like that of a younger person’s. You can do following things for mental activity:

  • Reading books, magazine and anything you love.
  • Play games like cards, chess, scrabble, etc.
  • Give more time for social activity.
  • Join clubs that you are interested in.
  • Do gardening to feel refreshed.
  • Practice using memory by playing puzzle games.
  • Join meditation classes.
  • Try to keep yourself busy. Discover new hobbies.
  • These are some task you can do to keep your brain working properly.

There are some benefits of mental activity during our older age. Here are some of them.

Improves cognitive skills

At an older age, we feel lonely, isolated, and bored because there is nothing much to do. Nothing can be better than reading books to prevent this scenario from happening. Books are great to pass our leisure time and acquire new knowledge. Reading helps us to improve our cognitive skills as well.

Improves memory

Senior people can play cards, chess, checkers, and many other games to improve mental clarity. It helps the seniors to make them more social, give them plenty of chances to meet new people to play with and helps in the interaction.

Increases creativity

Senior citizens can be assets instead of being a burden to the society if they use their experience and expertise in different creative works. The creativity of a person flourishes only when he or she is active mentally.

Eliminates anxiety

Anxiety in older age can be a dangerous thing. Many diseases can come out of stress because of anxiety. If we are active mentally, it will reduce our stress and will help us from being anxious.

Improves self-confidence

Being mentally active enhances self-confidence. We can use our leisure time in doing mental exercises. Knowing new things can make us feel that we are still actively learning and that we can keep up with the younger generation. Doing this will help us to have an increased sense of self-confidence.

Boosts brain power

Aging people have a lot of time to boost their brain power. Many activities can keep us mentally active. We can spend our time reading or even surfing the web and learning about new things. It is useful in many ways. It will allow us to spend our time more productively and so many things can be learned along the way.

Takeaway

Seniors can do so much with their time. Keeping them fit both mentally and physically, we can get the assurance that they will be living quality lives. We have so much to learn from them as well. If we can take the time to connect with them, they can teach us so much as they have the life experience and expertise as well. It’s our duty to keep them fit to build a better future together.

 

President Trump and Senator Rand Paul: Pass a clean repeal of Obamacare [Video]

Rebecca Shabad in a CBS News article titled “Rand Paul says splitting up health care bill could improve chances of Obamacare repeal” reports:

Sen. Rand Paul said Thursday that the health care bill should be split into two pieces of legislation in order to pass an Obamacare repeal.

“I think if we take this bill and split it into two pieces, we pass one that is more, looks like repeal that conservatives like. And then the other one you load up with all kinds of Christmas ornaments and gifts and money and just pile money on it that the Democrats will vote for and some of the Republicans will vote for,” the Kentucky Republican said in an interview on MSNBC’s “Morning Joe.”

Paul predicts that “both [would] end up passing” if Senate Republicans pursued that path.”It may not be completely good for the country, but you at least get the repeal that way,” Paul added.

The repeal bill, he said, could repeal Obamacare’s taxes and regulations and include Medicaid reform, but he said it would be “much narrower” and “much cleaner.”

President Trump tweet on Senate healthcare bill:

It’s Democrats who have embraced the policy of death and thousands of people are dying!

As Republicans in the U.S. Congress are debating the pluses and minuses of their repeal and replacement legislation for Obamacare, the Democrats are accusing their colleagues of  wanting “thousands of people to die.”

Senator Bernie Sanders (I-VT)

It was The Agenda Project Action Fund that in 2011 released the video of a “Republican” pushing an old woman in a wheel chair off of a cliff. The Agenda Project Action Fund in 2016 endorsed Senator Bernie Sanders for President of the United States. The “thousands of people to die” rhetoric has been repeated on major news channels most recently by Senator Sanders and other Democrats, such as Senator Elizabeth Warren and Congresswoman Nancy Pelosi.

The scheme is to paint Republicans as murderers. It’s the “big lie.”

Master propagandist of the Nazi regime and dictator of its cultural life for twelve years, Joseph Goebbels wrote,

“If you tell a lie big enough and keep repeating it, people will eventually come to believe it. The lie can be maintained only for such time as the State can shield the people from the political, economic and/or military consequences of the lie. It thus becomes vitally important for the State to use all of its powers to repress dissent, for the truth is the mortal enemy of the lie, and thus by extension, the truth is the greatest enemy of the State.”

Watch the below video to understand how a variety of Democrats, and media pundits, are repeating the “big lie” that “thousands will die”:

TRUTH: It’s Democrats who have embraced the policy of death and thousands of people are dying.

Here are a few examples of policies and legislation supported by Democrats that are causing people to die:

In an LA Times article titled “111 terminally ill patients took their own lives in first 6 months of California right-to-die law”, Soumya Karlamangla reports:

A total of 111 people in California took their own lives using lethal prescriptions during the first six months of a law that allows terminally ill people to request life-ending drugs from their doctors, according to data released Tuesday.

A snapshot of the patients who took advantage of the law mirrors what’s been seen in Oregon, which was the first state to legalize the practice nearly two decades ago. Though California is far more diverse than Oregon, the majority of those who have died under aid-in-dying laws in both states were white, college-educated cancer patients older than 60.

The End of Life Option Act made California the fifth state in the nation to allow patients with less than six months to live to request end-of-life drugs from their doctors.

Five states and Washington, D.C., have “Death with Dignity” statutes:

  • California (End of Life Option Act; 2016)
  • Colorado (End of Life Options Act; 2016)
  • District of Columbia (Death with Dignity Act; 2017)
  • Oregon (Oregon Death with Dignity Act; 1994/1997)
  • Vermont (Patient Choice and Control at the End of Life Act; 2013)
  • Washington (Washington Death with Dignity Act; 2008)

These five states and the District of Columbia are controlled by Democrats.

Illinois is in a fiscal meltdown, the state is bankrupt. In 2016 the Illinois Obamacare co-op became 16th to collapse. Americans for Tax Reform reported:

Sixteen Obamacare co-ops have now failed. Illinois announced that Land of Lincoln Health, a taxpayer funded Obamacare co-op, would close its doors, leaving 49,000 without insurance. The co-op now joins a list of 15 other Obamacare co-ops that have collapsed since Obamacare has been implemented.  Failed co-ops have now cost taxpayers more than $1.7 billion in funds that may never be recovered.

Co-ops were hyped as not-for-profit alternatives to traditional insurance companies created under Obamacare. The Centers for Medicare and Medicaid Services (CMS) financed co-ops with startup and solvency loans, totaling more than $2.4 billion in taxpayer dollars. They have failed to become sustainable with many collapsing amid the failure of Obamacare exchanges.

Since September, 13 Obamacare co-ops have collapsed, with only seven of the original 23 co-ops remaining.  Illinois’ Land of Lincoln co-op faced losses of $90 million last year and is suing the federal government for the deficit caused by Obamacare.  Co-ops across the country have struggled to operate in Obamacare exchanges, losing millions despite receiving enormous government subsidies.

Tens of thousands of people in the Land of Lincoln are without healthcare. Illinois is ruled by Democrats.

In an article titled “Break the Baby’s Neck if Born Alive” Debra Braun reports:

St. Paul, MN, June 27, 2017 – Planned Parenthood abortionists in St. Paul, Minn. would “break the baby’s neck” if the child was born alive, according to a new video just released by Pro-Life Action Ministries. This would be a violation of both federal and Minnesota law.

Braun notes:

In the video, a former Planned Parenthood client says that when she went to Planned Parenthood earlier this year for a late-term abortion (at 22 weeks, 1 day), she asked the two abortionists, “If you guys were to take him out right now while he’s still, his heart rate is still, you know, going, what would you guys do?” According to the woman, one of the abortionists looked at the other one, then looked back at the client, “and she told me that we don’t tell women this, and a lot of women don’t even ask this question, but if we was to proceed with the abortion and the baby was to come out still alive and active, most likely we would break the baby’s neck.”

Read more.

Democrats fully support Planned Parenthood aborting the unborn, and now killing the born.

So who supports a culture of death? Who wants thousands of people to die? You be the judge.

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VIDEO: Is There a Health Care Crisis?

In the next week or so, the U.S. Senate may vote on a health care bill that would repeal and replace some parts of the Affordable Care Act, better known as Obamacare.

This 1993 lecture in Houston, Texas by FEE president Lawrence Reed (then president of the Mackinac Center for Public Policy in Michigan) is full of important fundamentals about both health care and government. In the quarter century since then, the bottom line remains unchanged: more government can hardly be the solution to problems that too much of it gave us in the first place:

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Democrats in La La Land, while Republicans are laughing their Ossoffs

Shortly after the Karen Handel win in Georgia’s 6th District race for the U.S. Congress the Democratic Congressional Campaign Committee (DCCC) sent out the following in an email to their supporters:

[W]e know yesterday didn’t go as we hoped.

Make no mistake, we’re disappointed, and we know you are too.

But this race should have never been this close. Republicans had to pour tens of millions into a race that should’ve easily been theirs.

That gives us so much hope as we look toward 2018.

Let’s look at what each candidate raised and spent in the Georgia 6th District race:

The fact is that it was the Democrats who “poured tens of millions” into this race. In fact Democrats poured $32 million into the 4 special congressional elections to date and lost all of them.

Most of Ossoff’s money came from outside of the 6th District. Ossoff spent 7 times what Handel spent and lost by 6 percentage points. Democrats are living in La La Land if they believe this gives them “hope” as they look forward to 2018.

But wait, not so! The DCCC believes the Congress is in play in 2018!

The DCCC email contains a link to a video made by DCCC Chairman Ben Ray Luján who declares that the Democrats have a “real shot” at taking back the U.S. House of Representatives in 2018:

In the Daily Wire column 4 Dumbest Democratic Reactions To Their Stunning Defeat In The Georgia 6th Ben Shapiro lists the following reactions to Ossoff’s loss:

  1. Republicans Are Just Evil.
  2. Democrats Must Move To The Left.
  3. We Need A Hug.
  4. Civility Will Never Work!

To date Democrats have lost 4 special elections. The DCCC and Luján made the Georgia District 6 race a referendum on President Trump and his make America great again (MAGA) agenda. The DCCC was right, it was a referendum on President Trump’s agenda. That’s why Handel won handily. The DCCC has lost every special election, against a President and Republican Party that has relentlessly been demonized in the media, by some Republicans and most all Democrats.

So the Democrat base wants the DCCC to do more of the same, expecting different results?

This reminds us of how the media and Democrats treated candidate Trump during the 2016 presidential election. They lost in November 2016. They continue to lose.

The DCCC message has not changed. Luján keeps singing the same tune. The Democrats will keep losing if they go down the path of hating Republicans, moving even further to the left, hugging one another and abandoning civility and resisting anything and everything proposed by Republicans.

Democrats are still in La La Land, while Republicans are laughing their Ossoffs.

When your opponent is committing suicide, don’t interfere.

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In Georgia’s 6th, Democrats couldn’t capitalize on an unusually well-educated electorate

Why Democrats keep losing

Florida’s Medical Use of Marijuana Law

SB 8-A — Medical Use of Marijuana implements the provisions of Art. X, s. 29, of the State Constitution. The bill builds on the existing compassionate use of low-THC and medical cannabis program with additional provisions to implement the Constitutional Amendment passed by Florida voters in the 2016 General Election.

Provisions in the bill relating to patients:

  • Exempt marijuana and marijuana delivery devices from sales and use tax that would otherwise be imposed under ch. 212, F.S.
  • Establish procedures for physicians to issue physician certifications to patients who have qualifying medical conditions. The bill includes all debilitating medical conditions listed in the State Constitution as a qualifying medical condition: cancer, epilepsy, glaucoma, HIV, AIDS, PTSD, ALS, Crohn’s disease, Parkinson’s disease, multiple sclerosis, or other debilitating medical condition of the same kind or class as or comparable to those enumerated. The bill also includes as a qualifying medical condition:
    • Chronic nonmalignant pain, which is defined as pain that is caused by or that originates from a qualifying medical condition and persists beyond the usual course of the qualifying medical condition.
    • A terminal condition.
  • Eliminate the 90-day waiting period before the qualified physician may register a patient as qualified to receive low-THC cannabis or medical marijuana.
  • Ensure that qualified patients can receive low-THC cannabis as well as full-THC marijuana.
  • Allow marijuana edibles and vaping, but prohibit the smoking of marijuana.
  • Establish residency requirements for patients to be issued a Medical Marijuana Use Registry Identification Card (ID card). The bill specifies documentation that must be provided to document residency, including documentation required for a seasonal resident.
  • Grandfather in existing patients from the low-THC and “right to try” programs registered in the compassionate use registry so that they may continue receiving their medication ordered through those programs.

Provisions in the bill relating to caregivers:

  • Establish qualifications to become a caregiver, which include:
    • Being at least 21 years of age and a resident of this state.
    • Agreeing in writing to assist the qualified patient and serve as the patient’s caregiver.
    • Passing a 2-hour caregiver course that is administered by the Department of Health (DOH).
    • Passing a background screening unless the patient is a close relative of the caregiver.
  • Limit the number of caregivers each patient may have and the number of patients each caregiver may assist.
  • Require a caregiver to be registered on the medical marijuana use registry and possess a caregiver identification card. The caregiver must be in immediate possession of his or her medical marijuana use registry ID card when in possession of marijuana or a marijuana delivery device and present the ID card upon the request of a law enforcement officer.
  • Require a caregiver to purchase or administer marijuana for medical use by a qualified patient who is younger than 18 years of age.
  • Prohibit a caregiver from receiving compensation, other than the actual expenses incurred, for any services provided to the qualified patient.

Provisions in the bill relating to qualified physicians and physician certifications:

  • Require a physician to complete a 2-hour course and examination relating to the requirements of this law for approval as a qualified physician. A qualified physician must also comply with a 2-hour continuing education requirement for licensure renewal.
  • Prohibit a qualified physician from being employed by, or having a direct or indirect economic interest in, a medical marijuana treatment center or marijuana testing laboratory.
  • Establish standards for a qualified physician to issue a physician certification to include:
    • Conducting a physical examination while physically present in the same room as the patient and a full assessment of the patient’s medical history.
    • Diagnosing the patient with at least one qualifying medical condition.
    • Determining, and documenting in the patient’s medical record, that the medical use of marijuana would likely outweigh the potential health risks for the patient. If a patient is younger than 18, a second physician must concur with this determination and this determination must be documented in the patient’s medical record.
    • Determining, and documenting in the patient’s medical record, whether the patient is pregnant. A physician may issue a physician certification for low-THC cannabis only, to a patient who is pregnant.
    • Reviewing the patient’s controlled drug prescription history in the prescription drug monitoring program database.
    • Reviewing the medical marijuana use registry to confirm that the patient does not have an active physician certification from another qualified physician.
    • Registering as the issuer of the physician certification for the named qualified patient on the medical marijuana use registry.
    • Updating the registry with specified relevant information concerning the physician’s certification for the patient’s medical use of marijuana.
  • Limit certifications to no more than three 70-day supply limits of marijuana.
  • Require a qualified physician to evaluate an existing qualified patient at least once every 30 weeks before issuing a new physician certification for that patient.

Provisions in the bill relating to Medical Marijuana Treatment Centers (MMTCs):

  • Require the DOH to license the seven existing dispensing organizations as MMTCs. These MMTCs may begin dispensing marijuana pursuant to this law on July 3, 2017.
  • Require the DOH to license as MMTCs 10 applicants by October 3, 2017.
    • The first group of licensees, which are to be licensed as MMTCs by August 1, 2017, include applicants that submitted an application under the compassionate use law in 2014, which was reviewed, evaluated, and scored by the DOH; which had an administrative or judicial challenge pending as of January 1, 2017, or had a final ranking within one point of the highest final ranking in its region; which meets the requirements of this law; and can document that it has the ability to begin cultivating marijuana within 30 days after registration as an MMTC.
    • The next group of licenses must be licensed by October 3, 2017. These applicants must submit an application to be reviewed, evaluated, and scored for selection to be licensed as an MMTC. Within this group, one license must be awarded to an applicant that is a recognized class member of specified litigation and a member of the Black Farmers and Agriculturalists Association-Florida Chapter. All applicants must meet the requirements of this law. In the scoring of applications, the DOH is directed to give preference for up to two of these new licenses to applicants that demonstrate in their applications that they own and will use or convert a facility or facilities that are, or were, used for the processing of citrus fruit or citrus molasses for the processing of marijuana.
  • Require the DOH to license four additional MMTCs within 6 months after the medical marijuana use registry contains 100,000 active qualified patients, and upon each additional 100,000 active qualified patient registrations.
  • Limit MMTCs to 25 dispensing facilities statewide until the medical marijuana use registry contains 100,000 active qualified patients. When that occurs, an additional five dispensing facilities are authorized for each licensed MMTC.
    • Upon each additional 100,000 active qualified patient registrations, an additional five dispensing facilities are authorized for each licensed MMTC.
    • The bill also requires each MMTC to locate its authorized dispensing facilities within five regions statewide according to county population estimates for the counties within each region.
    • An MMTC that chooses not to establish a dispensing facility within a region as authorized, may sell that regional slot to another MMTC.
    • These limitations on dispensing facilities expire on April 1, 2020.
  • Detail requirements for MMTC applicants and standards that each MMTC must meet to obtain and maintain licensure; including a diversity plan that promotes and ensures the involvement of minority persons, minority business enterprises, or veteran business enterprises.
  • Authorize alternate forms of assets to satisfy the performance bond requirements.
  • Require an MMTC to perform all functions of cultivating, processing, transporting, and dispensing marijuana for medical use; including ensuring that low-THC is available for the medical use of qualified patients.
  • Require MMTC processing facilities to pass a Food Safety Good Manufacturing Practices inspection by a nationally recognized certifying body.
  • Require laboratory testing of MMTC products and create a certification program for medical marijuana testing laboratories.
  • Establish standards for advertising and requirements for a professional appearance and operation of dispensing facilities.
  • Require background screening of MMTC owners, officers, board members, managers, and employees, and of medical marijuana testing laboratory owners and managers.
  • Authorize a change of ownership for an MMTC under specified parameters and prohibit ownership in multiple MMTCs or certain profit-sharing arrangements.
  • Preempt the regulation of cultivation and processing of marijuana to the state.
  • Authorize local governments to ban MMTC dispensing facilities within their borders. However, if a local government does not ban dispensing facilities, it may not place any restrictions on the number of dispensing facilities allowed within its jurisdiction. Also, it may not adopt any regulations or fees for dispensing facilities that are more restrictive than its ordinances regulating pharmacies.

Additional provisions in the bill:

  • Establish administrative, disciplinary, or criminal penalties for prohibited acts by physicians, patients, caregivers, MMTCs, medical marijuana testing laboratories, and other persons. These prohibited acts include, but are not limited to:
    • A qualified patient or caregiver cultivating marijuana or acquiring marijuana from anyone other than an MMTC.
    • A qualified patient or caregiver in possession of marijuana or a marijuana delivery device who fails or refuses to present his or her marijuana use registry identification card upon the request of a law enforcement officer. However the bill includes certain mitigating actions that may enable a patient or caregiver to avoid prosecution.
    • An MMTC providing kickbacks to a qualified physician.
    • Unlicensed activity.
    • Counterfeiting marijuana or a marijuana delivery device purporting it to be from a licensed MMTC.
    • Possessing or making a counterfeit or otherwise unlawfully issued medical marijuana use registry identification card.
  • Authorize the DOH to pursue certain enforcement action for violations of this law.
  • Specify that this act does not limit an employer’s ability regarding a drug-free workplace program or policy, does not require an employer to accommodate the medical use of marijuana in the workplace or an employee working while under the influence of marijuana, does not create a cause of action against an employer for wrongful discharge or discrimination, and that marijuana is not reimbursable under ch. 440, F.S., relating to workers’ compensation.
  • Require the DOH and the Department of Highway Safety and Motor Vehicles to establish public educational campaigns related to the medical use of marijuana.
  • Require the Department of Law Enforcement to develop initial training and continuing education for law enforcement agencies relating to activities governed by this law and criminal laws governing marijuana.
  • Create the Coalition for Medicinal Cannabis Research and Education (Coalition) to conduct rigorous scientific research, provide education, disseminate research, and to guide policy development for the adoption of a statewide policy on ordering and dosing practices for the medicinal use of cannabis.
  • Include rulemaking and other provisions to aid the DOH in adopting rules and implementing the provisions of Amendment 2 within the time frame specified in the amendment.
  • Require each district school board to adopt a policy and procedure for allowing a student who is a qualified patient to use marijuana obtained pursuant to this law.
  • Rename the Office of Compassionate Use in the DOH, the Office of Medical Marijuana Use.
  • Rename the compassionate use registry, the medical marijuana use registry.
  • Provide a severability clause so that if any provision of the act or its application is held invalid, the invalidity does not affect other provisions or applications which can still be given effect.
  • Include appropriations for the state 2017-2018 fiscal year for the DOH, the education programs, and the Coalition.

A True American Healthcare System

As Obamacare continues to reveal itself as an economic and policy disaster, it strikes me that in undoing this healthcare mess, we are not following the path forged for us by the Framers of the Constitution.

For them, the overarching, driving concern was the protection of the liberties of the nation’s citizens from the intrusions of an excessively powerful government. Translated to healthcare, this would mean protecting patients and their doctors from government interference in their most private and personal dealings.

The Framers accomplished this by creating a national government of specific and enumerated powers that was prohibited from directly regulating the actions of the American people. This latter authority was retained by the states, and specifically not given to the federal government.

So, under this strategy, what would the nation’s health care system look like?

Protecting freedoms, not relying on government

In a truly American healthcare system, the responsibility for funding one’s medical care would fall squarely upon the treated individual. In cases where the cost of receiving treatment became excessive, the individual would be aided by his or her family, local churches, and community charitable organizations dedicated to helping those who couldn’t help themselves.

More importantly, healthcare would be delivered in a society where God and worship played a central role in human interaction. And no, not because the government demanded it, but because the people spontaneously shared this unyielding resolve in a state where an environment encouraging public worship existed and the family was viewed as society’s foundational building block.

It was a milieu where people were continuously reminded of their direct relationship with God and of His greatest commandment; that each person love God with all his might and that he love his neighbor as he does himself.

If the healthcare system needed to be more formalized so that hospitals and healthcare could be regulated or a risk-diverting network could be implemented, then such a structure would be generated and executed by the state, not by the federal government. In fact, if the Constitution were properly interpreted, the courts would hold that the federal government was prohibited from directing the states on creating, implementing, or administering a health care program, or taxing the people directly for the purpose of creating a healthcare insurance company.

Healthcare not part of limited federal government

Other than Dr. Benjamin Rush, who voiced his concern for the potential of healthcare being used as a tool in support of a dictatorial regime, it is likely that the Founders gave little thought to the design of the new nation’s healthcare system. Not only was it orders of magnitude beyond their primary concern of building a functional system of government, but they would have clearly maintained that such was not the role of the new federal government. In fact, they did. It was no enumerated, as mentioned above.

If asked, the Framers would have undoubtedly agreed that the solution to the nation’s healthcare challenges lay not in the acts of politicians, but in the moral compass provided to the people by their Creator and in the unyielding pledge that each and every person had instinctively made to his or her neighbor through his or her faith in God.

It is within these concepts that the true solutions to our healthcare woes is to be found, not in the machinations conceived by politicians or bureaucrats.

Hopefully, we as a nation will recall and apply these self-evident truths before we irreparably tarnish our Great Experiment and make true the warnings of Dr. Rush some 240 years ago.

EDITORS NOTE: This column originally appeared in The Revolutionary Act.

15 Faceless Bureaucrats Will Decide what Health Care You’re Allowed to Have by Eric Peters

President Trump and congressional Republicans have a second chance to take a whack at the Obamacare piñata – and the beauty of it is that this time, Democrats may want to take a swing at it, too.

“It” being the Independent Payment Advisory Board (IPAB), a.k.a the death panel that was much in the news during the debate over passage of the Affordable Care Act but which then quietly faded away. For the time being.

And for good reason – especially as far as Democrats are concerned.The IPAB/death panel is to be composed of 15 bureaucrats appointed to six-year terms by the President. Future tense because the 15 bureaucrats haven’t been appointed yet. Because the IPAB hasn’t been “constituted” yet. Thankfully.

It is, however, slated by statute to come online once Medicare spending reaches a certain threshold relative to the Consumer Price Index. Kind of like an alarm clock you hope never goes off.

Given the continued rise in health care costs, especially Medicare costs (the “Affordable” Care Act’s easy promises of reduced costs notwithstanding), this could happen as early as next year. As soon as the actuary for Medicare/Medicaid Services issues a report – already overdue for 2017 – that the “targets” have been exceeded, the IPAB automatically rises to life – in order to dispense death.

And that is what has Democrats worried.

Bureaucrats Directing Your Doctor

Nominally, the IPAB was created to control Medicare spending – supposedly by cutting red tape and so on. In practice, and notwithstanding assurance to the contrary, it would inevitably become a de facto price control/care-rationing body, cutting costs by unilaterally reducing “authorized” payments to doctors and other providers and by the simple expedient of declaring various treatments “not cost-effective,” thereby denying treatment outright.

To paraphrase Joe Stalin: No care, no problem.

It is Orwellian that the same Democrats who endlessly accuse Republicans of seeking to “deny care” to people have done exactly that by legislative and bureaucratic fiat.By statute, the IPAB is required to cut costs in line with arbitrary “targets” – regardless of the effect on care. There is no provision for judicial or administrative review. Even the President is powerless to remove IPAB bureaucrats, once they are appointed. The IPAB is effectively both omnipotent and unaccountable.

It is, in a very real sense, the not-yet-popped kernel of a UK-style single payer system in which neither you nor your doctor decide what care is needed, nor what care you’ll get. Instead, faceless bureaucrats – people neither you nor your doctor will ever meet or even talk with – would determine the care you’ll be allowed to get.

This, perhaps, is what former Speaker of the House Nancy Pelosi – an ardent backer of the Affordable Care Act – meant when she said, “You have to pass it in order to find out what’s in it.”

Well, surprise.

The Chance to End the IPAB Before It Happens

It’s no surprise that almost everyone who has found out – or will soon –  what the IPAB actually is either loathes it or is uneasy about defending it. Which presents a fantastic opportunity to do away with it.

Republicans have of course always objected in principle to the idea of empowering government bureaucrats to interpose themselves between patients and doctors and to the rationing of care – and to government death panels.

Democrats, on the other hand, are boxed into a corner. The whole point of Obamacare was to increase access to care – or so they claimed. But the ugly fact is that the IPAB will reduce access to care. Will ration care. Will deny people care. In particular, to older people – those dependent on Medicare.

This time, it won’t be hard-hearted insurance companies that pull the proverbial plug on grandma. It will be the much harder-hearted government. One can always change insurance policies. But there is no way to get away from government.

If the IPAB is ever “constituted,” it will be compulsory. You will not be allowed to say “no, thanks” to it. You will not even be asked. The 15 unelected bureaucrats will simply decree.

Democrats will have a tough time facing their constituents once they find out what the IPAB is all about.The good news – the huge news – is that it’s politically feasible to prevent the IPAB from ever being “constituted” if action is taken within the next couple of months. A provision was built into the arcana of the Affordable Care Act that makes it possible to hit the ”delete” button on the IPAB without broaching the broader issue of the ACA itself.

In other words, it is not necessary to repeal and replace Obamacare in order to get rid of the IPAB death panel. It’s an a la carte opportunity to nix a dangerous provision of Obamacare.

This must, however, be done by August 15, 2017 – just two months from now.

Republicans not only oppose the IPAB as a matter of principle, they very much need a legislative victory, particularly on the health care issue.

Democrats may not be particularly interested in helping them win one, of course. But they aren’t in a strong position to prevent one, either.

It will be very politically difficult for them to defend rationing health care – and denial of care outright – to their constituents. They may not smile and shake hands for the cameras over this, but it’s not likely they’ll mount a vigorous opposition, either. Democratic Sen. Ron Wyden of Oregon has already joined with Republican John Cornyn of Texas on bipartisan legislation to repeal the IPBA – and there is a companion repeal measure in the House that has 124 co-sponsors.

Republicans could easily jump-start the effort to get repeal and replace Obamacare by getting rid of it one piece at a time.

And with the help of Democrats this time.

Eric Peters

Eric Peters is an automotive journalist. Eric started out writing about cars for mainstream media outlets such as The Washington Times, Detroit News and Free Press, Investors Business Daily, The American Spectator, National Review, the Chicago Tribune and Wall Street Journal.

My Visit to Cuba — An American in Havana

I had the opportunity to visit Cuba. I flew via Southwest Airlines from Tampa International Airport to the José Martí International Airport in Havana, Cuba on June 4th and returned on June 9th, 2017.

After my short visit to Cuba I now fully understand why I spent my entire 23 years in the U.S. Army fighting against Communism.

Cuba is the poster child for Communism (i.e. socialism). It is a country with full control of its people by their government. Arriving was like an episode of the Twilight Zone where I was transported back to the 1950s. The 26th of July Movement began in July 1953 and ended when rebels finally ousted Cuban President Fulgencio Batista on 1 January 1959. Not much has improved for the Cuban people since then.

The graffiti, in the featured image above, reads, “Cuba, socialism or death!” I saw this graffiti along with pictures of Fidel Castro and Che Guevara throughout the country. On highway billboards, on the walls of buildings, in government museums and in the public square. It is a constant reminder to the Cuban people of where their loyalty lies – to defend Communism at all cost, and the cost is high, very high.

The greatest threat to the survival of the Cuban people is “socialismo.”

ITS THE ECONOMY STUPID!

As former Bill Clinton said, “It’s the economy stupid!” For the Cuban people it truly is the economy, stupid.

Perhaps a few of my first hand experiences in Cuba will help those who favor big government understand where “socialismo” leads.

One of the things some people, many of whom have never visited Cuba, tout is their “excellent” healthcare system. Let me explain about the Cuban single payer government healthcare system. First, every visitor to Cuba must purchase health insurance from the Cuban government. For example, the cost of my health insurance was automatically included in the price of my plane ticket. So how much does the Cuban government pay its doctors to provide universal healthcare? The salary of a doctor is $30 a month.

In 2013 Brazil hired 4,000 doctors from Cuba to “work in areas where medical services and physicians are scarce.” These Cuban doctors were to be paid approximately $30,000 a year to provide medical services to remote areas of Brazil. According to U.S. News & World Report, “Analysts say the export of medical services adds about $6 billion a year to Cuba’s economy.”

How does this work? Brazil paid the Cuban government the $30,000 annual salaries of the Cuban doctors and the Cuban government then paid the doctors $30 a month or $360 a year. This equates to an 83% profit for the Cuban government. Not surprisingly many of these Cuban doctors sought asylum in Brazil to be paid what they actually earned, $30,000.

In socialist governments the “minimum wage” inextricably becomes the prevailing wage.

It’s the economy stupid.

WORKING IN THE CUBAN TOURISM INDUSTRY

In 1991, after the fall of the former Soviet Union, the Cuban economy collapsed because economic aid provided by the Russians ended. More recently Cuba’s main international commercial partners—Venezuela, Brazil, China—have lost their appetites for subsidizing the anemic Cuban economy, lending a new urgency to grow perennially lethargic exports, and forcing the Cuban authorities to look for new sources of foreign exchange – tourism.

As U.S. News & World Report noted, “[T]ourism, the official No. 1 source of incoming cash, brought in $2.5 billion in 2011, according to the most recent statistics available.”

With the opening of tourism to U.S. citizens this incoming cash has increased. According to the Brookings Institute, “In the wake of the December 2014 rapprochement, the United States significantly relaxed restrictions on U.S. travel to the island, and prospective tourists in other nations saw Cuba in a new light. As a result, tourist arrivals jumped by over 16 percent in 2015 to 3.5 million. U.S. travelers, including those from the Cuban diaspora, now amount to roughly 14 percent of new arrivals, and are expected to nearly double in 2016.”

Our party was nine individuals, all U.S. citizens. We stayed in a large villa, owned by a Spanish citizen, located near embassy row in Havana. The villa could accommodate up to 14 people and came with a staff of five. The cost, including breakfast, for the villa was $10,000. We also hired two drivers with vans to take our party to various sites within Cuba. The cost to hire the two drivers amounted to an additional $2,000.

The manager of the villa was paid $15 a month, with individual staff members paid less. The manager went to Havana University and became a statistician. The manager for a number of years was a professor but decided to work in the tourism industry because the pay was better.

During our stay I went on a one-hour carriage ride through the heart of Havana. I paid the driver of the carriage $30 for two people to ride in his horse drawn carriage. The driver made $30 in one hour. This one carriage driver made as much in one hour as does a doctor working in a Havana hospital who earns $30 a month.

Given the price our party paid to rent the villa and the clear disparity between the wages of those in the tourism industry and the prevailing wage, in Communist Cuba it truly is the economy, stupid.

WORKING IN THE FARMING INDUSTRY

Tobacco rancho in the Vinales valley. Note the picture of Che Guevara on the water tank. Photo: Author.

To meet the Cuban people we decided to travel outside of Havana. Our group visited a tobacco rancho (farm) about 200 kilometers west of Havana located in the Vinales Valley, the heart of tobacco growing in Cuba. It is in Vinales Valley that Cuban farmers grow what is considered the finest cigar tobacco in the world.

The farm we visited has been owned by a Cuban family for generations. We went into a tobacco curing barn and we received a talk about how the tobacco seeds were planted, how the plants were cultivated and how the tobacco was grown, harvested and then cured for a full year or more. We then went to another gazebo type structure to see how cigars are rolled.

The tobacco farmer told us that every year he must send 90% of his tobacco crop to the government where it is processed and made into Cuban cigars for sale and export.

So how does the farmer survive with just 10% of his crop as his reward for all of his and his families hard work?

He produces his own cigars and sells them to tourists. This is a limited form of capitalism in a repressive socialist society. The farmer partnered with a local tour guide to bring foreign visitors to his farm to see his work, try and buy his cigars. His cigars do not have a label like the government brand Cohiba. The government forbids him from branding his cigars and putting them into boxes. This farmer sells his cigars in packets made from palm leaves holding 14 or 20 cigars.

A Cohiba cigar sold in Cuban government stores costs from $20 to $30 per cigar. This farmer sells his cigars for $3 each. His cigars are no different than those made in government factories, except his are better. His cigars are cured longer, he removes the stem of the tobacco leaf, which contains all of the nicotine, and wraps them in paper for five days to further age them.

This one farmer selling one pack of 20 cigars makes $60 or twice the monthly salary of a doctor. While there our party alone bought 6 packs of 20 cigars or $360 worth of cigars. There were a dozen other tourists at the farm when we arrived. Many of them also bought his cigars. Capitalism works, even in a socialist society.

It’s the economy stupid.

FINAL THOUGHTS

The Cuban people I spoke with were friendly toward us Americans. Those who provided us with personal services whether in local restaurants, while on tours, our drivers and those who took care of us where we stayed were professional, hard working and kind.

But Cuba’s desire to be a tourist attraction is waning. MarketWatch’s Kari Paul reports:

A flash of excitement about travel to Cuba after the country opened its borders to the U.S. in 2016 for the first time in decades may have lost some of its shine.

Americans are less interested in travel to Cuba this year than they were in 2016, a survey from insurance provider Allianz Global Assistance found. Some 76% of the 1,514 respondents said they were not likely to plan a trip to Cuba in 2017 compared to 70% in 2016. Only 2% of those surveyed planned to visit Cuba in the next six months or by the end of 2017, the same as 2016 despite a projected increase in travelers from the country’s ministry of tourism. It also found that 60% of Americans said “would not like to travel to Cuba” compared to just 58% in 2016.

[ … ]

Indeed, the initial excitement about the formerly closed off country gave way to moral dilemmas over food shortages and other problems caused by tourism, as well as disappointment over limited working internet, lower hotel standards, and lack of running water there. The Allianz study found lack of travel infrastructure was a major cause of anxiety about traveling to Cuba for 13% of Americans.

The slide in demand has led a number of airlines to reduce or completely eliminate flights to the country, including Silver Airways, a Florida-headquartered domestic airline that dropped all nine of its planned routes to Cuba. Frontier is dropping its Miami-Havana route by June 4, after costs in Havana “significantly exceeded our initial assumptions,” a spokesman told MarketWatch. Spirit Airlines will drop its last flight to Cuba by June 1: “The costs of serving Havana continue to outweigh the demand for service,” Spirit Airlines  president and chief executive officer of Bob Fornaro said in April.

Sumers suggested confusion over the approved reasons to go to Cuba is keeping the average American visitor away still. As of May 2017, visitors to the country have to select one of 12 categories for their visit, which include religious activities, humanitarian projects, “support for the Cuban people,” and journalistic activities. “You can’t go to Cuba to sit on the beach and have fun and that’s what Americans like to do on vacation,” he said. “Cuba is a bit of an outlier still — it is not easy to visit and for a lot of people it’s still a pain. You have to really want to go there.”

What I observed is that the Cuban people have great potential if they are unleashed and allowed to earn what they are truly worth. Socialismo is slowly but surely killing their lives and doing them great harm. I noticed on the ride West of Havana through the rural areas of Cuba hundreds of people waiting along the road trying to get a ride. Some were nurses in their white uniforms thumbing rides to the hospital where they are needed. I saw horse drawn carriages along the major highway carrying people because the public transportation system cannot keep up with the demand. The horses and cattle we saw were emaciated. The roads were in poor shape including the national highway system.

As one Cuban man put it, “the people have no love for their work.” They have no love for their work because Cuba needs a change in direction. Raul Castro has announced that he will step down as President of Cuba in February 2018. This is a chance for Cuba to change direction. To move to a capitalistic society where the individual benefits from what he or she produces, not the government. However, the Selous Foundation for Public Policy Research reports:

The Cuban media has been emphasizing that Raul Castro is leaving power. He announced in 2016 that he would be stepping down as President in 2018. Yet, he was reelected for five years as Secretary General of Cuba’s Communist Party and will remain as head of Cuba’s Armed Forces. The position of President, which will become mostly ceremonial, will be held by Miguel Diaz Canel, a low-level Communist Party bureaucrat with little military or public support.

In Cuba, power resides in the military and the Politburo of the Communist Party, both of which will continue to be controlled by Raul and his military comrades.

We shall see what happens in February 2018. The great fear among those to whom I spoke with is the new leadership will keep the ways of the old regime.

Socialismo o Muerte (socialism or death) must be replaced with Liberar al pueblo cubano (free the Cuban people).

RELATED ARTICLES: 

United Nations Honors Che Guevara—Yet Again 

Castro’s Killing Fields: A Pattern of Disregard for Human Life Lasting Six Decades (February)

Trump Tightens Cuba Embargo, Restricting Access to Hotels and Businesses

The Twelve Reasons Why Cuba Is A Terrorist Nation And Is A Security Treat To The USA

Cuban Doctors Revolt: ‘You Get Tired of Being a Slave’ – New York Times

American Diplomats Were Attacked in Cuba by Sonic Wave Weapons

Cuba Has “Occupying Army” in Venezuela, OAS Secretary General Claims – VIDEO

Trump’s New Foreign Policy of “Principled Realism”

Trump’s ‘Active Leadership’ Reverses Course on Obama’s Cuba Policy

Report: Trump Poised to Reverse Obama’s Cuba Policies – Townhall

Myths About Cuba

This is why American tourists don’t want to travel to Cuba

America’s Ramshackle Marijuana Laws

I was speaking to a legislator this week readying himself for his vote on Florida’s medical marijuana legislation when he posed an interesting question: How can we defend voting in favor of any medical marijuana legislation if in so doing we are essentially passing a state law that is prohibited by federal law?

It’s a great question! Not only because it cites a potential and obvious quandary, but also because it speaks of matters of preemption and federal supremacy.

Article I, Clause 2 of the United States Constitution reads that the Constitution and laws of the United States “shall be the supreme Law of the Land,” and clear as it may appear, it took a Civil War and hundreds of thousands of American deaths to settle this question. But although the question has been settled conceptually, controversies still arise about the extent of that doctrine and the limitations of its scope.

Enter the medical marijuana debate.

Clearly unconstitutional, but…

The Controlled Substances Act (CSA), first passed in 1970, is very clear in Congress’s intent to cover the field of regulating mood-altering drugs such as marijuana.

Citing the lack of any medically accepted use, its high risk of abuse, and its lack of accepted safety for use under medical supervision, the Food and Drug Administration classified marijuana as a Schedule I drug. As such, the use, possession, or manufacture of marijuana is a federal criminal offense, except when used as part of a federally supported research project. There is no exception in federal statutes for any medical use of marijuana.

It would appear, then, that federal law is completely clear on its prohibition of medical marijuana.

So, how is it possible that a state can pass a law, or even a constitutional amendment legalizing marijuana, for any purpose?

The short answer, of course, is that a state may not do so. The closest case to directly address this matter was decided by the Supreme Court of Colorado in 2015; Coats v. Dish Network, LLC.  In it, the Colorado Supreme Court summarized the concept of federal supremacy and said that an activity deemed lawful under state law, but unlawful under federal law, cannot be construed to be a lawful activity.

In other words, just because the state says medical marijuana is legal does not make it legal because such a declaration is superseded, and preempted, by federal law.

This being the case, it should be easy to argue that any state law, whether it is mandated by the state’s constitution or passed by a state legislature is unconstitutional because it would be offensive to the Supremacy Clause.

Maybe not unconstitutional

But here’s the rub.

In 2014, Congress passed the Consolidated and Further Continuing Appropriations Act prohibiting the use of any funds appropriated to the Department of Justice (DOJ) to keep a state from implementing laws relating to the use, possession, distribution or cultivation of medical marijuana. As a result, the federal government, specifically the DOJ, cannot interfere with a state sanctioned medical marijuana program.

So, is medical marijuana legal in a state that has implemented such a program? Odd as it may sound, the best answer I can give you is that it is not legal, but Congress has decided not to do anything about it — for now, or maybe forever.

Is it Constitutional under the Supremacy Clause? This question has not yet been decided, and it is ultimately up to the courts to make the call, but I will give you my opinion. In order for a law to be offensive to the Supremacy Clause, Congress must act in a manner that makes clear its intent to preempt all conflicting laws. Although the Controlled Substance Act qualifies as such a law, the injection by Congress of the medical marijuana provision in the Consolidated and Further Continuing Appropriations Act gave the states the autonomy they need to regulate medical marijuana.

As a result, if asked, I believe the courts will rule that state laws relating to medical marijuana are not unconstitutional despite the prohibition in the Controlled Substances Act.

Clear as mud!

EDITORS NOTE: This column originally appeared in The Revolutionary Act.

The Everyday Guide to Everyday Carry

Let’s have a frank discussion about EDC, the everyday carry. The internet is overflowing with pictures, threads, and suggestions from self-proclaimed experts on the subject. I have never considered myself a subject matter expert on EDC; however, much like Liam Neeson, I have had a unique set of life experiences and skills that may give some credibility to what I have to say.  I am a member of the Special Operations community. I have carried concealed weapons and mission essential equipment when lives have depended on it. I have protected diplomats all the way up to the vice-president of the United States. I am a qualified and current Advanced Tactical Paramedic, certified by Special Operations Command. I have treated life-threatening trauma at both the point of injury and at higher echelons of care. I teach various tactical skills to militaries, government employees, law enforcement, and private citizens. Lastly, and perhaps most important, I am in a constant state of learning in order to employ and teach the latest science, tactics, and techniques based on research and events.

Let’s strip away, the shemaghs, infidel t-shirts, and talk about what works. This will not be a conversation about what pistol to carry (Glock 19). That is a forum unto itself.  Today I will tell you what I carry and why. I will tell you what I think you should carry and why. This writing has zero product placement or endorsement of any kind. This is all my opinion. My opinion is probably better than yours. Buckle up.

EDC should not be about your gear. I know, that sounds counter-intuitive. Bear with me. There are multiple reasons we should not be dependent on our equipment. The biggest reason is that our environment does not typically allow us to carry the equipment we would like to. Anyone who drives in the Northern Virginia or West Virginia area knows this frustration. Drive across the wrong bridge and you are instantly transformed from a responsible law-abiding citizen to a felon. This concept applies everywhere. Can you carry a pistol in a bank? What about picking your kids up from school? Auditoriums, ball parks and other venues of mass congregation are typically no-carry zones. Every place I just listed are also historically targets for violent crime or terrorism. Your EDC needs to start with your thinking, not your gear. It is possible to go out and have a good time and still be situationally aware.

“Your EDC needs to start with your thinking, not your gear.”

Here’s some homework: without being the overly sensitive veteran who just has to have his back to the wall in a corner booth, go out to a coffee shop or a bar. Order your drink, sit down, and observe. How many entrances and exits do you see? Can you get to them in a timely manner? Does the bathroom lock? Where do people park? Is there anything stopping a vehicle from driving through the entrance? Is there security? How many? What, if anything, are they carrying? What are they looking at? Do they have communication? What are people around you wearing? Look at hands and shoes. Hands can show intention. Shoes can show planning (you ever hear of anyone robbing a bank in flip flops?). Now try the same thing in a mall.  Do this exercise a few times and you should notice your situational awareness in public settings increase. You may be amazed what you’ve never noticed.  *Note: don’t do this exercise in a bank unless you want to answer some uncomfortable questions.

Your Bag

Unless I am trying to present the picture of a tactically prepared individual, I do not carry anything in Coyote Brown, Multicam, or other tactical colors. Similarly, I stay away from bags that have molle loops and more velcro than I have morale patches for. This is a personal choice. I know my training. I know what capabilities I have. I prefer that to be a surprise to anyone that needs to bear the brunt of that training. I have two bags that I normally use for my EDC. Neither are designed for this purpose, but they work well. The first is my Timbukt2 laptop bag. Women generally have an advantage over men in EDC as it is normal for a woman to carry a purse. Well, my man purse…satchel…has been in some pretty sketchy areas and has held everything from a side arm to a full chest rack. I find the top zipper particularly useful as I do not have to open the flap to draw my weapon.  My second bag, a small Mountain Hardware padded ruck, also is meant to be a laptop case, and also has fast access via a zipper. Both of these bags have traveled the world with me. Neither has ever raised suspicion. When selecting your bag, go through this short checklist:

  1. Will I carry this?
  2. Can I get to what I need in a hurry?
  3. Does it have enough pockets to segregate my kit?
  4. Does it have so many pockets that I don’t know where anything is when I need it?
  5. Is the construction durable enough to stand up being carried everyday?

Your Tourniquet

Why do you not have a tourniquet? You have a full basic load and a four-hundred dollar reflex sight, but you didn’t drop a few bucks on a tourniquet. Look at that, you’ve made your little sister cry. Dammit Daryl. Here a few down and dirty facts:

  1. You can bleed to the point of no recovery in 3-5 minutes from an arm or leg wound.
  2. You will not lose your limb simply because you applied a tourniquet.
  3. Improvised tourniquets will likely take longer to gather and build than 3-5 minutes
  4. Your belt is not a tourniquet.
  5. Tourniquets save lives.

Now that we’ve established that you need a commercially produced one-handed tourniquet, the harder decision starts. The online tourniquet battle about what is best or what is crap is pretty heated. There are more people making comments about tourniquet effectiveness than are actually applying tourniquets. I’ll let you in on a secret: applied correctly, they all work. Every one of them. Anyone who tells you otherwise hasn’t used the product or is selling a product.  Like every medic, I have my preferences. I feel a Combat Application Tourniquet (CAT) is more reliable on the average arm and has a faster application time than the Special Operations Forces Tactical Tourniquet – Wide (SOFTT-W). The exact opposite is true for the leg. I know that both of these tourniquets require a minimum limb circumference for effective application, i.e. it may not work on your kid. The Stretch Wrap And Tuck Tourniquet (SWAT) will work on your kid or your dog, but good luck applying it to yourself with one hand. The Rapid Application Tourniquet (RATS) is fast and, on most limbs, effective.

In the interest of integrity, I need to disclose that I not only know the inventor of the RATS, but we served together. I count him as a friend. There is both political and medical controversy over this device. It is unwarranted and gets in the way of saving lives. I had my doubts about the RATS when it was first shown to me. For educational purposes, I had the RATS tested by Special Operations Medics using Doppler Radar to detect a distal (away from the heart) pulse. Applied to the arm, the RATS was 100% effective in eliminating a pulse. On the leg, the pulse was diminished, but not fully eliminated. The test subject was a Navy SEAL with “tree trunks for legs.” I have trained thousands of individuals in the use of tourniquets. What I have seen, without bias, is that the layperson is able to apply a RATS tourniquet faster and more effective than any other commercial tourniquet. After training, most students opt for the RATS over other commercial tourniquets. Again, this is not bias. This is what I have seen (called “empirical evidence” in the medical community).

I carry multiple CAT and SOFTT-W’s in my vehicles and aid bags. My EDC has the RATS. Based on what I have seen with my students, I recommend it for your carry.

Regardless of which tourniquet you choose, have it staged for easy access with one hand, and ready for one-handed application.  Take the tourniquet out of the wrapper. Adjust the slack (big for the CAT, smaller for the SOFTT-W, three finger for the RATS) for one-handed use. Watch the manufacturer’s videos. Practice, practice, practice. I have trained government employees that refuse to recognize violence is a real thing to the standard of a 15-second application. Shoot for that standard. If you are carrying a CAT, ensure that the CAT you are training with is not the CAT you are expecting to control actual hemorrhage. The parts are made for single use and weaken under torque. Buy a blue CAT for training and a black or orange CAT for real-world use.

Other Medical Supplies

I prefer to keep it simple in my EDC. I could easily make my EDC into an aid bag. I don’t want that. That’s why I have an aid bag. One pack of compressed gauze and a small roll of duct tape are enough to fix everything from a large laceration to detaining a dirt bag till I get to more supplies. I don’t have a preference for untreated gauze. Hemostatic agents are a longer discussion for another post. If you are carrying medical tape for anything other than making a name tag, go ahead and slap yourself. I’ll wait. Medical tape, despite it’s purpose, does not stick well to wounds or anything wet. I carry a small roll of Duck Tape purchased at Home Depot and a roll of Gecko Tape from North American Rescue Products. Pro-tip: if the tape is open, dog ear it. You will be shaky and limited to gross motor skills under stress. Not being able to find the end of your tape costs cool points.

If you choose to carry a commercial dressing in your EDC, I recommend the Olaes Dressing from Tactical Medical Solutions. The dressing has multiple uses in one package. The gauze can be removed from the dressing to pack wounds. A small sheet of plastic can be removed to seal chest wounds. The elastic bandage has velcro strips sewn in increments to counter shaky-operator syndrome. A side-note personal soap box on the Olaes: the dressing is named after my friend and classmate SSG Tony Olaes who was killed in action in 2004. He pronounced his name Oh-Lie-Es. Please do the same. Thank you.

Knife

Your knife needs to be sharp, durable, and short enough that it won’t be confiscated at a security check-point. Everything else is sprinkles on the ice cream. I carry a Benchmade Triage because of the blade quality, the rescue hook, the glass breaker, and because I didn’t have to pay for it.  It is worth the nearly $200 price tag, providing you’re not prone to leaving it with the bouncer at a West Virginia strip club (can I get that back? Asking for a friend.) I also carry a Leatherman Wave for all my multi-tool needs. I do have bias on these brands, as all three of us are from Portland.

Not every light needs to be tactical to be useful. This $5 LED light has multiple functions and affixes to metal for hands free use.

We have also proven ourselves on the job.

Light (Flashlights/Tactical Lights, etc.)

Flashlights are similar to knives, in that you can lose it faster than the hours it took you to make enough money to buy it. I have been carrying the same Surefire Z2 Combat Light for 10 years. It’s durable, fist size, and has worked every time I needed it to. I’m sure there are better, newer lights out there, but I haven’t needed to find out. I also carry a five buck construction job site light I bought in the checkout line at Home Depot. It takes conventional batteries, uses LED, has spot and flood functions, and has a convenient magnet on the back. Maybe not my first choice for room clearing, but it’s great for lighting up a work space (think trauma, not cars). Both of my bags have headlamps. My primary is my Petzl, that everyone in SOF has a few of. There is no need to go out and spend big money on a headlamp. You’re not spelunking. Go to Home Depot and buy the three-pack for 10 bucks. Most of them even have red light capability. I’ve used them.

Miscellaneous Items

Phone charger and External Battery Pack – In an emergency, communication is key. If you spent your battery SnapChatting LOL’s to your contact list right before shit hits the fan, you’re going to need some juice. I’ve opted for an Otterbox uniVERSE case with a modular accessory slot. The external battery pack for this case is made by Polar Pro and is about $50 on Amazon. I have two of them.

Sharpie Marker & 3×5 Index Cards – Make an incident timeline. Mark casualties. Pass a note. Don’t forget to buy milk on the way home.

Cash – Lower denominations. A couple hundred dollars or so. Bribing rarely works with a credit card. Credit card machines do not work in power outages.

Gum – I like to chew gum when I think I’m about to get in the mix. I’m sure I could say something medical like, “activates the salivary glands to counter dry mouth secondary to stress-induced acid reflux”, but it just gives me something to do while I wait.

After packing your EDC bag, test it. Do not fall in love with one particular set-up if it isn’t working as well as it should. Once you think you have it set, practice. Use multiple conditions: low light, darkness, loud background.

Now that you’ve seen my kit and read my secrets, I’ll need to destroy you. Best of luck out there.

EDITORS NOTE: This column originally appeared on the Black Rifle Coffee Company blog.

The Illusion of Marijuana As Medicine

Since speaking of the fantastical nature of medical marijuana, I have been bombarded with commentaries and concerns regarding the legal status of the plant in Florida. Sadly, most of the comments have been hateful, demeaning, and designed only to intimidate.

But hidden amongst the hate speech are some communications that honestly raise questions of a medical role for marijuana and report favorable experiences with its use.

So here’s the bottom line: As a physician, I completely acknowledge the pain and suffering of those afflicted with chronic and debilitating diseases and of the sometimes tragic shortcomings of our pharmacopeia, but the data supporting marijuana as a bona fide medicinal tool is simply lacking… and may always be.

Any honest discussion regarding medical marijuana must begin with the full acknowledgment of the secondary interests motivating it. Many pro-medical-marijuana advocates eagerly cite alleged conspiratorial efforts by pharmaceuticals to stifle its use, but they fail to acknowledge the millions of dollars pumped into the campaign for its legalization by the growing marijuana industry, and the even greater amounts of money some stand to gain from favorable policy decisions.

So, let’s be honest and admit that there are pecuniary interests on both sides of the issue striving to skew the conversation in their favor.

Asking the tough questions

With this admission in mind, I begin with one simple question: If marijuana is truly a medicine, then what about its pharmacology makes it so different as to allow it to bypass the scrutiny applied to all others medications? What is medically so different about marijuana that states can implement laws with insufficient study for the sole purpose of bypassing the FDA, and constitutional amendments are passed to allow for its use as a medicine?

The answer, of course, is nothing, which adds to the contention that something much bigger than the use of the plant as a medication — perhaps the quest to legalize its recreational use — is the true driver of the medical marijuana debate. If that be the case, then ransacking the nation’s health care system for the mere promotion of a recreational drug is dishonest, reckless, and dangerous.

Then there’s the pesky issue of the science.

First, marijuana is not one substance, but rather a complex of more than 400 biologically active compounds including, terpenoids, flavonoids, and over 70 cannabinoids. The interactions between these substances and their specific benefits are not understood. What’s more, their specific combinations vary between strains of the plant, growth conditions, the manner in which the plant is prepared for consumption, distribution methods, storage times, and storage conditions.

All this may be totally acceptable for a recreational product, but it is the death knell of a prospective medication.

What’s worse, there is very little data supporting the use of marijuana for many of the claimed indications.

What thorough marijuana study reveals

Perhaps the most thorough and objective review on this topic appeared in 2015 in the Journal of the American Medical Association.

Researchers studied 23,754 “hits” on their search engines. They arrived at 79 studies reported in 151 papers from all over the world (encompassing 6,462 participants) that the authors found were of sufficiently low bias and high scientific control to be taken seriously as scientific analyses.The researchers then stratified the collective results of the studies into varying levels of data quality to support a recommendation for the use of marijuana and its derivatives in health care. Neither, the cannabinoids nor marijuana, received a rating of high confidence in the treatment of a single symptom or condition!

Conclusion: the science supporting the use of marijuana or cannabinoids as a medicine is simply not there. In fact, only in the treatment of chronic neuropathic, cancer pain, and spasticity was any data found that rose to a level of moderate scientific quality.

Additionally, when marijuana was used for pain control it did not diminish the demand for opioids, thus eviscerating the contention that by allowing for the use of medical marijuana there would be fewer complications related to opioid use and opioid addiction.

Nausea and vomiting, HIV/AIDs, depression, anxiety disorder, psychosis, sleep disorders, and Tourette syndrome received either low quality support or very low quality support. Studies regarding other conditions such as the actual treatment of cancer, glaucoma, seizure disorders, Crohn’s disease, sickle cell disease, psoriasis, and Parkinson’s disease were so poor that they did not even rise to the level of meriting inclusion in the JAMA study.

Risks lacking known rewards

On the flip side, the risks of treatment with marijuana are not inconsequential.

First, dosing of smoked marijuana remains unpredictable. And although much of the medical marijuana debate centers on the effects of single exposures, insufficient information exists regarding the effects of repeated exposures. Approximately 10% of people routinely using marijuana become addicted, with a higher incidence amongst adolescents. Tolerance and down-regulation of receptors have been documented with repeated marijuana use. A marijuana withdrawal syndrome has also been recognized, as has an association with psychosis.

Despite the lack of scientific evidence to support the use of medical marijuana, the states have run the gamut on the list of scientifically unsupported treatments they will allow. For example, last year, Florida approved a constitutional amendment listing cancer, epilepsy, glaucoma, HIV/AIDs, PTSD, ALS, Crohn’s disease, Parkinson’s disease, MS, any medical condition similar to those listed above, and terminal conditions as ones for which marijuana may be used. And in Connecticut, the use of marijuana for the treatment of sickle cell disease and psoriasis is also allowed.

The endocannabinoid ruse

There are those, particular amongst the more vitriolic advocates, who misguidedly cite the endocannabinoid system as evidence for the benignity of marijuana use, suggesting that we should allow for marijuana’s medicinal use because cannabinoids are already existing inside our bodies. In fact, the existence of such a system should result in further caution against the proliferation of marijuana use.

The human body does produce cannabis-like substances, but they naturally exist in very small quantities, are precisely released, and linger for very brief periods of time. These endocannabinoids affect nerve growth and maturation, and guide intercellular connections during pruning (the process by which nerve cells find and refine their connections).

Exocannabinoids, on the other hand, those that are ingested or inhaled like marijuana, are long lasting, exist in higher quantities, and are relatively indiscriminate in their distribution.

The consequences of taking these substances from an external source are not only unknown, but potentially very disruptive to human development — an even more disturbing consideration since brain development continues until the age of 25 years. Such indiscriminate and physiologically disruptive effects may explain the negative behavioral and emotional changes associated with adolescents who are repeatedly exposed to marijuana.

Study and FDA approval needed

Yes, as a legislator, I am aware that in Florida, 71% of the electorate voted for the medical marijuana constitutional amendment. But such an outcome, promoted by monied interests, does not negate the fact that marijuana is not a medicine.

Like any other physiologically acting collection of substances, marijuana is a potentially dangerous, incompletely understood, and improperly controlled combination of chemicals whose benefits have not been found to sufficiently outweigh its risk.

I continue to call for the FDA and the federal government to devote resources to the study of this plant and its effects. With adequate support for well-controlled, scientific research, there may come a day when sufficient, meritorious information will be available to allow the FDA to provide health care providers with reliable prescribing information and for manufactures to create products known to be beneficial to patients.

But until such time, physicians need to shy away from the indiscriminate, and still illegal, use of marijuana in their patients, and states need to be leery of policies enacted in contradiction to federal law.

As for the advocates, if their goal is to legalize marijuana for recreational use, then let’s have that discussion and not use our nation’s health care system as a ruse for the promotion of marijuana’s greater acceptance as a recreational drug.

In the meantime, and despite the accusations, bully tactics, and vitriol, I will continue to evaluate the medical literature regarding marijuana with a scrupulous eye and a mind open to the strengths of both sides of the argument.

EDITORS NOTE: This column originally appeared in The Revolutionary Act.

The Other Europe

Robert Royal notes that the progressive future can’t be great since it doesn’t concern itself with the future of children and societies fertile enough to reproduce themselves.

Last week, when the leader of the free world was (depending on which sources you paid attention to) either destroying America’s carefully constructed system of international alliances or shaking up the policy establishment at home and abroad to deal with the new world environment, something equally consequential – and more fundamental – took place, almost unnoticed, in Hungary.

I’ve mentioned in passing several times in recent days that I spoke at the Eleventh World Congress for Families that has just finished in Budapest. But it’s difficult to convey what an inspiring and hopeful – and unexpected – event it was.

We almost never hear about it, mired as we are in our political obsessions, but there are thousands of family and marriage activists and organizations at work around the world. Most of them were present in Budapest last week. And most important of all, outside of Western Europe, North America, and their offshoots in places like Australia and New Zealand, countries are not at all following the absurd and suicidal trends on marriage and children that we (falsely) believe have gripped the whole world.

Hungary is a leading example in Europe itself. Prime Minister and former anti-Soviet dissident Viktor Orban has succeeded in starting to reverse the disastrous trends in marriage and births that Hungary, like Western Europe, had been showing for years. This has been the result partly of social commitment, partly of specific policies.

The 2011 Hungarian Constitution, the first one adopted since it regained freedom after the fall of the Soviet Union, states this:

Article L (1) Hungary shall protect the institution of marriage as the union of a man and a woman established by voluntary decision, and the family as the basis of the survival of the nation. Family ties shall be based on marriage and/or the relationship between parents and children. (2) Hungary shall encourage the commitment to have children.

That may seem an empty gesture given the dominant culture of our international elites, but ten years ago, Hungary had a marriage rate of around 3.6 per thousand, the same as Southern European countries like Italy, Spain, and Portugal. Now it’s nearly 4.75, and steadily climbing.

Click here to read the rest of Dr. Royal’s column . . .

EDITORS NOTE: Friends: Today we end nine years and tomorrow begin our tenth year of daily publication. I’ve been reading the very kind notes you’ve been sending along with your donations and am deeply grateful to all of you for your loyalty and encouragement over the years. As you know, we’re in a immense struggle, both in our society and in our Church – a struggle even worse than when we began in 2008. (By the way, I’ll be on EWTN again this evening at 8 PM ET – there are rebroadcasts and YouTube if you can’t tune in tonight – to talk with Raymond Arroyo and Fr. Gerald Murray about several recent developments in the Church.) Yet there are also hopeful signs and I write about one of the most hopeful in this column. Good and evil will be at war until the Second Coming. In the meantime, we all have to do our part. Mine is to call on you at this special moment to do yours, to make a financial contribution so that our special Thing may be even more present, more energetic, more effective in bringing Catholic truth to a world that is in turmoil for lack of it. – Robert Royal

A Vision for a Truly American Health Care System

As Obamacare continues to reveal itself as an economic and policy disaster, it strikes me that in undoing this healthcare mess, we are not following the path forged for us by the Framers of the Constitution.

For them, the overarching, driving concern was the protection of the liberties of the nation’s citizens from the intrusions of an excessively powerful government. Translated to health care, this would mean protecting patients and their doctors from government interference in their most private and personal dealings.

The Framers accomplished this by creating a national government of only specific and enumerated powers and prohibited from directly regulating the actions of the American people. This latter authority was retained by the states, and specifically not given to the federal government.

So, under this strategy, what would the nation’s health care system look like?

In a truly American health care system, the responsibility for funding one’s medical care would fall squarely upon the treated individual. In cases where the cost of receiving treatment became excessive, the individual would be aided by his or her family, local churches, and community organizations dedicated to helping those who couldn’t help themselves.

More importantly, healthcare would be delivered in a society where God and worship played a central role in human interaction. And no, not because the government demanded it, but because the people spontaneously shared this unyielding resolve in a state where an environment encouraging public worship existed and the family was viewed as society’s foundational building block. It was a milieu where people were continuously reminded of their direct relationship with God and of His greatest commandment; that each person love God with all his might and that he love his neighbor as he does himself.

If the health care system needed to be more formalized so that hospitals and health care could be regulated or a risk-diverting network could be implemented, then such a structure would be generated and executed by the state, not by the federal government. In fact, if the Constitution were properly interpreted, the courts would hold that the federal government was prohibited from directing the states on creating, implementing, or administering a health care program, nor could it tax the people directly for the purpose of creating a health care insurance company.

Other than Dr. Benjamin Rush who voiced his concern for the potential of healthcare being used as a tool in support of a dictatorial regime, it is likely that the Founders gave little thought to the design of the new nation’s health care system. Not only was it orders beyond their primary concern of building a functional system of government, but they would have clearly maintained that such was not the role of the new federal government.

If asked, the Framers would have undoubtedly agreed that the solution to the nation’s health care challenges lied not in the acts of politicians, but in the moral compass provided to the People by their Creator and in the unyielding pledge that each and every person had instinctively made to his or her neighbor through his or her faith in God. It is within these concepts that the true solutions to our health care woes lie, not in the machinations conceived by politicians or bureaucrats.

Hopefully, we as a nation will recall and apply these self-evident truths before we irreparably tarnish our Great Experiment.

EDITORS NOTE: This column originally appeared in The Federalist Pages.