In Health Care, it’s “CAVEAT EMPTOR! “

Recently, CNN has run a series about “shopping” for the best bargains in health care. With increasing deductibles and co-pays, this has become more and more important to the average patient, and I commend CNN for their series, but want to offer some “caveats.”

First, and foremost, remember that when it comes to health care, quality trumps price every time. An inexpensive test is overpriced if it is incorrectly interpreted, and surgery is too expensive if a lower price brings increased risk. Many services should be “shopped,” but with the understanding that you need to compare apples to apples. Is the center doing the MRI for half price using the same generation equipment? Will it find the same problems? Can they charge less because less time is taken with each patient? Do the doctors at a hospital charging less for a particular surgery perform less than half of that type of surgery than the physicians at the higher priced hospital (usually a university center or teaching hospital)? If so, their complication rate may be higher simply because the OR staff lack the experience of the higher priced center.

The time has come for patients to shop for the lowest prices for health care services, especially when they are paying with their own money (no, I’m not getting into the debate as to what is “their own money” now), but each of us should remember the ancient admonition, “Caveat Emptor;” let the buyer beware!  ALWAYS choose quality over price in health care. That way, you’ll live to pay it off.

RATIONAL LITIGATION, NOT MERELY MORE . . .

During the last week, the story of a single High School student and his laptop computer has echoed across the nation, with advocates lining up on both sides of the issue. Perhaps the most telling lineup, however, is the polarization of a large group of parents and students who do not want any class action lawsuit to go forward.

We in the Unites States are known to have one of the most litigious societies in the world and, in the past, I have commented that this is not always a bad thing. I would rather be sued by someone who is angry at me than shot (the frequent result in countries where people have no access to the courts).  The reaction of the parents in this case, has given me pause, however. Perhaps we are coming out of the other end of the litigation tunnel.

Some lawsuits are mandatory, some are needed, and some are just window dressing, but some simply need not be brought. That, in a nutshell is the thinking of the parent group opposing the class action lawsuit. We know the school district did things wrong, and they need to be stopped; in fact they have stopped and the people involved are now on administrative leave until the facts are sorted out. One thing is clear, though; the parents in the high ranking, affluent Lower Merion school district have realized a truth – if a class action lawsuit were to be settled in their favor, they would have to take the money from one pocket (taxes) to pay it to another (their settlement or award), with a great deal of the money going to attorneys’ fees.

I commend them on their choice – fix the problem and make sure it doesn’t happen again. Let’s be clear; a student and his family were wronged, and they disserve their day in court. If they prove damages, they disserve to be compensated. More to the point, government agencies, like school districts must be made to realize that they are not above the law, become less authoritarian, and remember that the 4^th Amendment applies to them. On the other hand, legitimate, well meaning errors need not occupy a court’s time and more of the taxpayers’ money. We need rational litigation in this country , not merely more.

To the parents opposing the class action; WELL DONE.!

THE FORREST FOR THE TREES . . .

Yesterday, I wrote about the  “Roberts” Court overturning a century of jurisprudence to allow the country to be put up for sale, while refusing to do the same thing when it came to Chicago’s gun laws by refusing to reverse the Slaughterhouse cases. Sometimes, in our haste to see the “right” thing done, though, we overlook the outcome of the “Law of Unintended Consequences.” I was guilty of that.

On further reflection, I urge the Court to overturn Chicago’s gun law, solely on the basis of the Due Process clause of the Constitution  To invoke the “Privileges and Immunities” clause would be to open the door to the proverbial “slippery slope” that could seriously compromise our system of Federalism; one of the cornerstones of our system of checks and balances. While the good might initially outweigh the bad, there is no guarantee it would remain so.

My apologies to the Court on this one, especially since they haven’t yet handed down a decision. I erroneously based my own opinion upon other observers’ opinions of the justices’ attitudes, which themselves, were based solely upon the questions asked.

It won’t happen again.

GUNS, SLAUGHTERHOUSES AND YOU

The United States Supreme Court heard arguments, today, in McDonald v. Chicago; a case involving the right to own guns in the City of Chicago. The arguments, however, rose to a much higher level.

Most people remain unaware that the 14th Amendment to the US Constitution, which applies the rights guaranteed to US citizens in the 5th Amendment to the citizens of each state (thereby ending slavery throughout the country) does not mandate that each state guarantee all of our rights in each state. This is particularly true of the “Privileges and Immunities” clause of the 4th Amendment.

In a group of cases that came to be known as the “Slaughterhouse Cases,” the Supreme Court, in 1873 ruled that the 14th Amendment only applies to federal rights, not the “privileges and immunities” guaranteed by a citizen’s home state. It was this argument, in addition to the Due Process clause, that was used to argue in favor of overturning Chicago’s ban on gun ownership. Now, whether you are for or against “the right to bear arms,” it is instructive that the Court seemed OK with the “Due Process” argument (and will probably invalidate the law), but not the “Privileges and Immunities” clause.

Although CJ Roberts had no difficulty in reversing a century’s worth of jurisprudence to allow corporations to purchase our country, he quickly shied away from the prospect when it came to applying this clause, stating that McDonald had a “heavy burden" because his approach entailed striking down the Slaughterhouse cases of 1873.” For the uninitiated, nearly every modern legal scholar agrees that these cases were decided incorrectly.

Why would Chief Justice Roberts be so quick to grant privileges to corporations but not to individual citizens? Perhaps because if the Court applies the “Privileges and Immunities” clause through the 14th Amendment, it would open the floodgate to everything that conservatives are against. EVERY state would have to recognize a gay marriage performed in another state, just as EVERY state would have to grant every US citizen within its borders the rights and privileges granted to them by their home states (oh my God, they could smoke their medical marijuana anywhere!).

Come on, Mr. Chief Justice; stick to your guns and if you insist upon overturning good precedent, don’t be afraid to overturn the bad as well.

A LEGACY OF OLIGARCHY & JUDICIAL HYPOCRACY

I have waited a brief period before commenting upon the U.S. Supreme Court’s decision in Citizens United v. FEC because a) I wanted time to read the decision and, b) I wanted time to “cool down.” I’ve had both and here is my analysis.

The “Bush packed” ultra conservative “Roberts” Court is packed not with true conservatives, but Bush era corporate lackeys whose obligation appears to be to their corporate friends rather than to the People of the United States or their Constitution. A true conservative Court would not have washed away more than a century of legislative protections from the corporate dominance that Thomas Jefferson feared, and Americans enjoyed – until now. A true conservative Court would have shown deference to a century of precedent, as C.J. Roberts promised during his confirmation hearings, not decide to legislate from the bench, as this decision does.

In retrospect, (then) “Judge” Robert’s testimony at his confirmation hearings reveal a disingenuous conservative that seems completely insensitive to the realities of our Republic. I’m sure, in reviewing previous jurisprudence of the Court, he can find other precedents that “need” to be overturned. I know he’s aiming at Roe v. Wade, but perhaps this Court will continue by first reversing Brown v. Board of Education.

If there is one lesson to be learned from this decision, and from the oligarchic  legacy of G.W. Bush, it is to reinforce the aphorism that “power corrupts, and absolute power (in the form of a Republican majority/”rubber stamp” in both houses of Congress and the Presidency) corrupts absolutely.”