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One of the biggest problems both my wife who runs the Baltimore Child Abuse Center as a forensic pediatrician and I as a community based urologist see is not lack of access to care as this administration talks about it is the unwillingness or inability of the people who are eligible to sign up. This idea that we are going to give insurance to those who do not have it is fallacious. Many of these people refuse to access it.

There are so many problems with this law that the best thing that could happen is the the SCOTUS finds the mandate unconstitutional and then says that it is so intertwined in the law that they need to junk the whole thing and start over again. We need reform. That is for sure. But stealing 500 million dollars from Medicare to cover an extra 20 million dollars and then not telling the truth about it does us no good. Medicare is broken and needs to be fixed. It is already underfunded and what you will find is doctors basically saying the heck with it, we just won’t see medicare patients. It is happening all over the USA. If I were not an employed doc I would no longer see medical assistance. I lose money seeing medical assistance payments when you figure in the cost of doing business. We are in an untenable situation and the only person even willing to discuss it is Paul Ryan. Obama and the Democrats act as if nothing is happening and everything is just rosy. The truth is much starker. They don’t care because what will end up happening is either massive tax hikes which they want or a socialized system which they want. Meanwhile in England and Canada they are finding that their socialized systems are eating them alive patients aren’t happy with delays, refusals, and lack of access to their doctors.

As I said before. All America has to do is look and decide if they are better off now than they were 4 years ago. Gas is $4 per gallon. Unemployment is over 8%. The government is picking winners like Solyndra and we are deep into the throws of crony capitalism. This is the worst economic recovery from a recession in history and Obama wants us all to keep marching off the cliff like lemmings. Sorry, not this guy.

I think the key is this: You and I might agree that the health care law under review is a bad idea, or it is unworkable, or it is too expensive, or that there are better ways to provide health insurance/health care to Americans. And, we might agree that physicians are being under reimbursed by insurers, who also use non-physicians to make medical care decisions.

But, the S. Ct. doesn’t analyze the question of whether it is a good law or a bad law, but whether the law violates the Constitution. 
It is certainly true that far more laws are found to be constitutional than are found unconstitutional by the S. Ct.
It certainly is true that the President (and anyone else who favors a law) hopes that it is upheld, and that anyone who is opposed to a law hopes it is defeated in the legislature or, failing that, held unconstitutional.

One of the ideas of the new law is something like this:  Uninsured people don’t get preventive health care so that when their problems become severe, they present to the ER with advanced issues that are more expensive to treat. So, the concept is, if we give people health insurance they’ll get preventive care.
I am not so sure that this is really going to happen. There are many examples (and as a doctor, you probably know of many more than I) of people who have insurance and yet defer getting colonoscopies, mammograms, prostate exams, PAP smears and other routine diagnostic tests because the tests are inconvenient, or they are afraid of the exam and/or of the results, or they are just lazy.  Putting an insurance card in the wallet of the uninsured will, I think, not have a magical effect.
In that regard, the law may be one with nice intentions that just doesn’t pan out. Doesn’t make it unconstitutional. Just dumb.
As for sitting down to chat, that would be fine. We’re both busy, but we’ll find a time. Let’s wait, obviously, until after Pesach. 
Have a zissen Pesach, doc.

well, i will agree with you that Nixon had a huge dose of self importance.

there is a large difference between me expressing my opinion based upon my lay person’s knowledge of the commerce clause and a board of unelected people, who have no one above them in terms of oversight, making medical decisions that impact on peoples lives. the two are not related at all, so i am not sure where you were trying to go with that.

the commerce clause by my understanding was desinged to allow the federal government to regulate commerce between the states. one of the huge judical over-reaches of our country was a tax on wheat irrespective of its use. i don’t remember the case name, but there was a farmer who grew his own wheat to feed his own livestock. It was held that he was liable for a large tax on the wheat because of the price supports at the time. Basically they told this man that in order to grow his own food for his own livestock, he was subject to taxation for exceeding governmental limits. that is over reach.

having the government tell you that you by virtue of the fact that you breathe are liable if you do not buy insurance is over-reach in my estimation. And the President, by trying to lobby or threaten the Supreme Court before they make their decision is arrogance to the extreme. His idiotic statement that it would be highly unusual for the SCOTUS to overrule the Congress is plain stupid or disingenuous. The whole purpose of the Supreme court is TO DECIDE whether or not laws made by legislative bodies meet the test of constitutionality. he basically doesn’t want the Supreme Court to do its job, that is unless he disagree with the law in question, then of course he is all for the Supreme Court ruling in his favor.

as far as the “people” being swayed by conservative talk radio or tv, i would say that mr. weiss is misguided. while Fox News is the most watched cable news network, the sheer volume of the liberal media between the Washington Post, NY times, all the liberal newspapers and the tv stations like NPR, CBS, NBC, ABC, MSNBC, and CNN dwarf the viewership of Fox News and those who listen to Rush or Sean Hannity.

A perfect example of that is the last election. When they compared the number of negative stories about Sen. McCain vs Sen. Obama done by the above liberal media there was a distinct difference. The Pew research center showed that over 70% of MSNBC’s stories regarding McCain were negative while less than 15% of the Obama stories were negative. That trend was seen in more than one outlet.

finally, the concept that this is an activist court if it overturns Obamacare is just silly. Activist courts find privledges in laws where there are none such as in Roe v Wade. (btw - I am a total supporter of a womans right to choose). The SCOTUS is responsible for making sure that passed legislation conforms to the constitution and prior legal precedent. (exception would be Brown vs the Board of education overturning Plessy vs Ferguson). I personally do not consider them activist if the find that a law is unconstitutional. i do find them activist if they divine rights and privledges that are not defined by our Constitution and Bill of rights.

Thanks again for responding Mr. Weiss. It would be fun to sit down and have a good converstation with you.

Oh…and one more thing….for sheer chutzpah in a President, I’d nominate Richard Nixon.
Watergate
The Ellsberg breakin
The White House guard’s imperial uniforms
The cover-up
“I am not a crook.”
And, the biggest one of all…..serving himself fine Bordeaux at state dinners while the guests drank plonk.

Dr. Leventhal accuses the President of “hubris”. He complains that a “board” of unelected non-health care professionals will decide some health care issues.
Yet, as a physician, Dr. Leventhal is not reluctant to say that “my personal belief is that the law is unconstitutional”. For sure, a physician is entitled to a personal belief on a legal issue, and if it is true that “a majority” of citizens think Obamacare is unconstitutional that is fine, but are those citizens trained in the law or rather, are they influenced by conservative talk radio and columnists who are untrained in the law.
The commerce clause says that Congress shall have the power to regulate interstate commerce. If you are on a trip and get sick in some other state and need emergency surgery, your local insurance company will pay the bill of the doctors and hospitals in the other state. That is interstate commerce. Frankly, broccoli implicates interstate commerce. The FTC regulates advertisements for broccoli, the Dep’t of Agriculture regulates the use of pesticides in broccoli fields, and there are numerous other government regulations relating to broccoli.
This week, in a 5-4 opinion, the S. Ct. ruled that it was not a violation of the 4th amendment freedom from “unreasonable” searches and seizures for an arrestee to be strip searched.  The man was strip searched after being arrested during a traffic stop. He was arrested for failure to pay a small fine years earlier. (Later it was determined that he did pay the fine—this was a computer error).
In so doing, the S. Ct. held that it should “defer” to the rule making wisdom of the NJ sheriffs and local law enforcement who know more than the S.Ct as to how to deal with prisoners in the jail environment.
Here is a link to the opinion:
http://www.supremecourt.gov/opinions/11pdf/10-945.pdf

In making this decision, the S. Ct. declines to take an activist stance.  Instead, they say that in this area, again, they “defer” to the local police. (This language appears at the top of p. 8 of the majority opinion).  The search was “reasonable” and not unconstitutional because the police procedure said so.

In a few months, I predict, these same 5 judges will take an activist position and refuse to defer to Congress, and overturn the “Obamacare” law, holding that it is UNconstitutional, with equal linguistic flourish.

I think I may have some broccoli for dinner tonight.