Keep Your Powder Dry

Knowing the great degree of influence my posts have on my faithful readers, I want to take this opportunity to alert you to an upcoming post discussion about the merits of some potential 2012 GOP Presidential contenders. Actually I plan to go so far as to lay out my endorsement for the 2012 Republican nominee for President. I made the decision to donate money to his campaign just this weekend, and bumper stickers are ordered. I therefore know you'll all want to "keep your powder dry" until I have time to publish my post in the next couple of days.

It's possible that my reasoning will surprise you, though I'm confident you'll give due consideration to my points and to the man I plan to endorse.

Presidential primary time is fun for political junkies like me. So, people, study your candidates and their positions and be prepared to join me later in the week for my 2012 GOP Presidential Nomination field analysis.

Blessings, and I'll be back soon.

Warrior Obama, Master of Sonorous Small Words and Smaller Deeds

Do we really find ourselves flying military sorties over Libya, in the absence of any congressional vote to approve such an action?  Do we find ourselves flying these sorties with no properly constituted lines of authority?  And do we find our great military sent to, among other worthy goals, "stop the killing"?

Why at every turn am I flashing back to memories of Michael Dukakis riding in a tank with a goofy helmet, or of other memories of President Carter being attacked by a crazed rabbit near his ancestral home in Georgia?  I even recall in an unusual fit of honesty The Rev. Dr. Jesse Jackson commenting, during BHO's procession to his November 2008 coronation, on the Peace Prize recipient's apparent lack of two spherical anatomical organs generally thought to be critical for purposes of intimacy and procreation.  The reason for these flashback memories?  Simply put, the emperor has no clothes, and more and more Democrats are joining Republicans and conservatives in coming to this realization, which is why I expect polls to reflect a fairly sour American public, bipartisanly so, in the coming months.

The liberals' quarter-war policy is clear, once you understand certain touchstones for Democrat liberal policy makers.  George W. Bush was and remains the focus of evil in the modern world, so no strategy out of the Peace Prize recipient's administration can even remotely resemble a Bush coalition. Moreover, a multitude of partners is critical, and deferring operational command to one of these lesser powers is desirable.  Bonus points are awarded for prolonged dickering about the chain of command.  Next, the policy must hamstring its own forces by denying them their most lethal weapons and by putting forth rules of engagement that are complex and difficult to understand.  These ROEs will ensure no decision is made without opportunity for second and third guessing, with plenty of input by Department of Justice lawyers.  Further, a freewheeling loud public debate ought to take place regarding where any captured "suspects" may be held pending their civil trials.  It goes without saying that full access to lawyers and the press will be enjoyed by the detainee "suspects."

Unfortunately for the Ivy League frat boys running this show, and more unfortunately for the people of America, and most unfortunately for those brave men and women who may be called upon to give the ultimate sacrifice as they serve as the tip of our spear, this quarter-war that the Peace Prize recipient has gotten us into will not end well for America.  This is so for innumerable reasons, but the first and foremost is that no one has yet to define our mission.  Why are we there?  What does victory look like?  Are the rebels really our friends?  Can we identify our friends in the region?  I'm skeptical about that last question in particular.

For now, regular Americans are just lying low, watching in disbelief as the inmates run the asylum and hoping there'll be something left to salvage after the 2012 presidential elections.  We've got to get this train that is America turned around, my friends.  The future of our children and grandchildren depends on it.

Look for a post in the next week or so about Israel.  The issues facing that small nation so favored by God are of great interest to me, and what's more amazing is that Holy Scripture can guide us as we seek to learn about these issues confronting The Holy Land today.

Let's "Opt Out" To Victory

The travesty of ObamaCare has so discouraged me that I can't often post about it.  I'm proud of the House Republicans and wholeheartedly support their legislative efforts to kill the law with death by a thousand cuts.  At the end of the day, however, most of us believe it will take a new President to repeal this Orwellian monstrosity by ripping out its roots and casting it into the lake of fire, so that efforts at meaningful reform that empowers patients and their doctors can take shape.

It was in this context that I've been reflecting on how a catchy turn of phrase can make a profound impact on an idea's success in the marketplace of ideas.  Examples abound, such as "affirmative action" instead of "race-based preferences," or "investment in our children," instead of "pouring good money after bad down a rat hole of overpaid, incompetent, unmotivated teachers."  "Reform" is another useful noun that can mean anything, as in "tax reform" that lowers marginal rates and eliminates the double taxation of the death tax, versus "tax reform" that raises marginal rates, punishes entrepreneurs and investors, and generally incentivizes people to hide money under their mattress.  The same word, but two completely opposing meanings.

I suggest we who oppose ObamaCare down here in the trenches begin to call for allowing individual states to "opt out" of ObamaCare.  The term "opt out" is catchy and conveys clearly our goal, but with a positive connotation that suggests "freedom" and "choice" to citizens.  It lends itself to a number of slogans, such as "Just opt out!" or "Opt Out Now," and it can even be used as a stand alone motto.

The value of a catchy phrase, composed of two or three three letter words, that clearly communicates our values and goals cannot be overestimated.  Opting out is consistent with America's historic federalist principles, and ought to appeal to moderates and fence-sitters and others who might oppose outright federal appeal.

I envision a coordinated grass roots effort among roughly the same red and purple states which are participating in legal challenges to ObamaCare, which is more than half of the Union.  Existing conservative infrastructure would promote the idea publicly and pressure the individual states to pass "opt out" laws.  In turn this would generate further federal pressure against ObamaCare, and in fact the Opt Out movement might be viewed by President Obama as a face-saving compromise as he positions himself for his 2012 re-election race.  I dare even hope that federal legislation allowing for an Opt Out option might be perceived as reasonable enough to pass the Senate and avoid an Obama veto.

Granted, Opt Out does not by itself nullify all the damage done by ObamaCare, but it is an achievable goal in 2011 or 2012, and as policy would boost a number of favorable precedents, not least the broadening of the concept of federalism and state sovereignty.  Granted as well, Opt Out requires action at both federal level and in each state, but in accomplishing each legislative victory another nail is driven into the heart of the concept of centralized health care rationing.  No one said this would be easy, but with hard work I'm convinced we can achieve victory.

By all means let's press on toward the goal of repeal, but let's open another battle front against the forces of statism and stagnation with a new grassroots movement to Opt Out!  Far from diluting our efforts, Opt Out will strengthen our cause by adding new volunteers, persuading more voters, and encouraging those of us in the trenches with achievable victories in the short-term.  Conservative leaders, tea party activists, Republican officials, are you listening?  We the people are crying out for leadership on this issue.

Not This Time . . .

I've just read the news of the terrible tragedy in Arizona today.  Congresswoman Giffords was wounded, and a federal judge killed, by a lone shooter who is now in custody.  The congresswoman is now the second House member to be shot in the line of duty in my lifetime, as far as I know, the other being Congressman Leo Ryan who was killed by members of the Jim Jones cult in Guyana in 1978.  What a tragedy!  I'm reminded of the sacrifices so many of our nation's founders faced so that Americans have the freedom to govern ourselves, and at the same time how fragile and unique and precious are the values and liberties Americans share.  That this event shocks us is a sign of the inherent moral fiber that makes America a great nation.

Americans should not and will not allow events like this to deter us from involvement in politics and self-government.  I already see in news reports the linkage between the shooting and Congresswoman Giffords' support of Obamacare, and I'm reminded how President Clinton and the Democrats used another tragedy in 1995 to demonize conservatives and to try to deter and discourage us from taking part in partisan politics.  At the time, just after the 1994 Republican takeover of Congress, President Clinton linked the Oklahoma City federal building bombing to Rush Limbaugh and the "haters" encouraged by talk radio.  Republicans and conservative activists, shocked by the bombing and on the defensive from Clinton's attacks, allowed themselves to be painted as sympathizers and encouragers of terrorists, and the righteous activism faded away.  I fully expect a similar effort in the coming days from some quarters of the Democratic partisan attack machine.

Well, it won't work.  Not this time.  No one knows details yet, but only the shooter (and anyone who might have assisted him) is responsible for this crime.  Americans cannot allow terrorism to bar us from doing those things that make us Americans, and that includes standing up for those values and ideas we believe in as part of the political process.

Let me emphasize again that no one who participates in American political give and take need feel guilt about the shooting of Congresswoman Giffords and the other victims today in Arizona.  We should feel shock, sadness, and anger, and empathy for her and for her family and the other victims, but also resolve and fortitude to not let this tragedy be used by those who would advance their own agendas with the blood from their wounds and the tears of their families and the mourning of a nation.

For every left-wing partisan who tars conservatives with the taint of the Giffords shooter, I would counter with this:  Democrats passed Obamacare in the face of massive public resistance, with almost no Republican votes, taking advantage of every parliamentary trick in the book, essentially making a mockery of the will of the people.  This is in contrast to every other example of major social legislation in the last hundred years which were all passed on a bipartisan basis.  Was it foreseeable that someone who was already mentally unbalanced might take their frustrations too far?  I would say, yes, and I would say so no matter what motive is ultimately shown in the case of the Giffords shooter.

No, the blame belongs to the shooter and the shooter alone (and any possible conspirators), but if the Democrats want to use this horrendous event for their political advantage, they stand on very shaky ground.  I don't believe the American public will let them, not this time.  Let us today pray for Congresswoman Giffords and her family and the rest of the victims, mourn those who lost their lives, and resolve to honor them with our involvement in the political process and our refusal to let anyone trade on their sacrifice.

Health Care: Who Should Pay?

This is an updated and refreshed version of a post I originally published a few years ago (April 22, 2007).  Given the issues it addresses and the current debate over whether and how to repeal Obamacare, I thought it would be helpful to re-publish it.  My intent is to promote a solution to the current flawed health care payment system that is consistent with human nature and a conservative political philosophy.  Enjoy, or abhor, as your beliefs require:

Who makes your health care choices--you, your doctor, your insurance plan, or your government? Who should make such choices, and who should pay for the delivery of the chosen services? In truth, each of these four entities plays some role in the delivery of health care in America.  "He who pays, chooses," seems to be an empiric truth.  Therefore, who should be paying for the array of wonderful and advanced treatment choices available to us?  This is the critical question that faces Americans and our legislators today, and it seems no one in the Obama Administration is willing to even honestly face up to the true issues.

Our society has come to accept the notion of health care as a "right," and that it should be available for everyone regardless of their ability to pay. This principle collides, however, with the inconvenient truth that someone must pay. As a provider, I wouldn't be in business very long if I did not pay my staff and my office rent and all the other expenses associated with a medical practice.  Even in a Utopian single payer system, one can't magically legislate away cost, no matter how much one denies or ignores.  The tension evident in today's system results from the fact that the users of a given service, poor or not, are largely removed from directly paying for that service. This divergence drives up the costs of care and the demand for services.

In America the linkage between a health care service and its cost is now completely absent for most people, and the result is greater demand at greater cost.  The American people are only dimly aware that at every doctor visit, sitting invisibly in the room, listening, watching, taking notes, sits a third person, someone the patient and the doctor don't even know.  This invisible third person is the payor, and that's the unspoken penalty of de-linking the consumer from the cost of his choice.  The person who pays the bills winds up running the show.  I could give a multitude of examples of the huge and intrusive role of government and insurance company third party payors, but I'll try to illustrate my point with the following:   for every service or good one can think of, the market creates a balance between supply and demand, and cost (or price, more properly) is the expression of that balance. Assuming you're not on food stamps, who pays for your groceries? You do, of course, as you do your phone bill and your car payment and whatever else you buy. Now, again assuming you are part of America's great middle class, how did you choose which car you drive? The answer is that you bought the car you wanted, that fit your needs, and that you could afford. No one expects to pay their employer or the government a monthly premium, and to be given a choice of three different cars to pick from every March. And if my illustration were true, I'll assure you that not only would your car choice be limited, it would be more expensive, as well. Competition is a potent motivator and price cutter, and innovation is its fruit.

I'm a board-certified internal medicine specialist, and I deliver what I believe to be excellent care for my patients. Yet, last year I was only a participant in three of the four available Blue Cross plans in the area. Why was I not part of the fourth? It had nothing to do with my qualifications, but was because I was unwilling to provide my services at the price Blue Cross offered for that particular plan. Meanwhile, I provided exactly the same services for Blue Cross patients in the other three plans, for a fee that I found acceptable. Blue Cross, and employers, you see, are driven by different motivations than patients themselves might be. Why should the employer or the insuror determine whether a patient can see me?  It sounds like care is being rationed, and it is, by the employer who chooses to provide the less expensive plan for his employees.  Why in the world do we accept this ridiculous system?  Even more amazingly, why did the recently deposed Congress choose to make employer-based insurance the foundational basis for its "reform" plan? I submit that the cost, quality, and choice available to patients would be greatly improved if the patients were more directly responsible for the cost of their care.

The so-called "health care reform" pushed and passed by President Obama and congressional Democrats went in exactly the wrong direction.  Instead of true reform, this legislation built upon the worst aspects of the existing health care system by further removing consumers from the consequences of their choices and essentially starving by regulation the promising growth in high-deductible health plans, health savings accounts, and Medicare Advantage plans, each of which put the patient in more control of spending his own health care dollars.  Americans have been given a chance for a do-over of this egregious legislative mistake by virtue of an angry and motivated electorate, and it's my prayer that we're wise enough to take advantage of our second chance.   Let me emphasize here the crucial point of semantics that we're advocating reform of the broken health care payment system.  It is empirically true that health care in America, at the point of the clinical encounter, is generally superb, though such quality won't long survive a fundamentally broken payment system.

Unless we radically change the direction of our current reform efforts, patients will in the future have vast restrictions placed on their choice of doctors, hospitals, treatments, and medicines.  How many dollars won't be spent developing new medicines and treatments, because the money and brain power are diverted to less productive pursuits?  The bureaucracy even now often chooses which medicine to pay for, and which physicians to contract with, and those choices are driven by interests that are often at odds with the patients' best interests. Physicians, for their part, have little incentive to openly publish their fees or compete for patients based on convenience issues such as flexible appointment availability or timely message return. Employers, saddled with the job of picking insurance options for their employees in this inefficient system, are left with a responsibility and cost they'd rather not have, but which has developed, not out of any affirmative policy decision, but because of a World War II era tax loophole for Kaiser shipyard workers.   It's past time to declare that the emperor has no clothes, that the current health care payment system is built on a foundation of sand, and that American exceptionalism demands an exceptional health care system!

One of the least appreciated but most terrible results of our current "accidental" system is the erosion of the doctor-patient relationship.  In its ideal form this is one of the most precious and protected of human relationships, one that for the patient lends itself to a feeling of trust, security, and hope, and for the physician yields an incredible sense of duty, responsibility, and obligation to his patient.  I've had the privilege to have this relationship with some of my patients, but it is no longer the norm.  Do you as patients think you've lost anything with the loss of this type of relationship?  Do you even recognize that it's gone?  Do you get a glimpse of the magnitude of the lost job satisfaction of physicians whose practices have bridged this transition?

The surest path to a successful solution will be one in which the individual patient maintains maximal control over his own health care decisions, and that recognizes that it is the payor who has the control. I've chosen to be a physician for the freedom and blessings that are its fruit, both for me and for my patients.  On a broader scale, I hope Americans will continue to have a rich array of health care options in future years. It's not a given that we will.

In Praise of the Endomorphs

Political junkies always look toward the next election cycle more quickly than sane people, and conservatives are waxing optimistic this month as we savor the "shellacking" of the President's party in the late congressional elections.  Meanwhile, we watch in awe as his presidential poll numbers slide inexorably into Carter territory.  The election debacle was compounded by the very public diplomatic failures of the President's Asian trip this month and his administration's ham-handed handling of their message on (not?) extending the Bush tax cuts during the lame duck congressional session.  Such failures tend to build on one another, and, if unchecked by President Obama's willing but demoralized media apologists, can ultimately lead to irreversible public perceptions of incompetence.  It's but a short hop from there to a primary challenge, which no elected incumbent President in the 20th Century has overcome to win re-election.

As gratifying as it would be to see some left wing kook challenge the left wing kook-in-chief who currently occupies the White House, my more immediate interest is in surveying the Republican field of prospective presidential candidates.  The potential GOP nominees are an interesting and ideologically diverse group who pretty much cover the spectrum of conservative ideology, from Hamiltonian to Jeffersonian, libertarian to traditional law and order.   Most exciting, there's no clear front-runner and no past runner-up waiting in the wings for his traditional turn.  In theory at least, the GOP nomination is anyone's for the taking.

My two personal favorites for the GOP nomination at this point are Chris Christie and Haley Barbour, with Jeb Bush a close third.  Each man has unique qualities which would serve him well as President.  Tea partiers and indeed many other Americans have admired New Jersey Governor Christie's brash refusal to be bullied by his state's teachers' union, and they respect his tough budget cutting decisions in the face of great weeping and gnashing of teeth by those who gorge themselves at the public trough.  Mississippi Governor Haley Barbour was a Republican in Mississippi when all the Republicans in Mississippi could meet in a phone booth in Southaven with room to sit down, and there's a widespread belief amongst the GOP cognoscenti that his Republican Governors' Association fundraising arm saved Republican bacon this election cycle from Michael Steele's incompetence.  Finally, I'd be remiss if I didn't include Jeb Bush in a list of conservative presidential prospects whom I admire.  The Bush brand is further rehabilitated with each passing day of the Obama administration, and Jeb has always been the more conservative and more articulate of the Bush brothers.  If he wants to run he's an instant contender.

On a personal and admittedly shallower note, it's nice to see these accomplished and talented achievers, who clearly enjoy pizza or a burger as much and as often as I do, emerge as unapologetic defenders of a conservative worldview.  Some might doubt whether husky guys such as Christie, Barbour, and even Bush can connect with image-obsessed voters in a media age, but I suspect their images will serve them well when they are compared with an arrogant skinny-legged professorial incumbent who wears pressed blue jeans and throws like a girl and tends to talk down to anyone who disagrees with him.

For us political junkies, 2010 is history and it's on to 2012!  In the meantime, I wish a Happy Thanksgiving to every one.

Reflections on the Vote

With a week's perspective I feel reasonably comfortable in drawing some worthwhile conclusions from the recent elections.  Ever the optimist, I generally tend to predict that conservatives will perform better than they actually do, simply because the basic philosophies underpinning the two competing American political parties seem so cut and dried to me, and I have trouble understanding why some voters would choose a course of action harmful to themselves and our nation.  Even so, I never would have foreseen such a fall as I have seen in President Obama's standing in the space of two short years.  I hope Democrats really do believe the problem is one of communication and "messaging."  If so, then 2010 will serve only as a prelude to an even more cataclysmic result for Democrats in 2012.

The spontaneous rise of the tea party movement over the past eighteen months is probably the most consequential domestic political development in my lifetime.  The miraculous milieu which led to liberty's rebirth in American politics was kindled by the disillusionment of voters with the extreme leftist policies pursued by the Obama administration, which contrasted so clearly with the unifying post-partisan theme of his presidential campaign.  The Internet Age served to midwife and nurture the birth and early development of the movement.  Without the diffusion of news sources from the mainstream media, without the internet, without Facebook and other social media, without the interconnectedness now enjoyed by regular Americans, the tea parties would never have translated silent frustration into coordinated political action.  Finally, without the wisdom of leaders in the GOP and the tea party movement, the voters' anger could easily have been channeled into unproductive third party candidate efforts.  Instead, tea party activists largely worked within the Republican party framework and were able to essentially revolutionize and reinvigorate the GOP.  Whether the tea party movement develops into a permanent organized voting bloc, or instead fades as it is subsumed into the larger conservative movement, it has already accomplished much and found a generally receptive home within the Republican party.

Nationally the GOP's 60+ gain in the House of Representatives marks a second chance for the party of Mark Foley and Duke Cunningham and Bob Ney.  The final two years of President Obama's term will not see further leftward lurches that encroach on American liberty, and I'm optimistic that Republican House committee chairmen will be able to effectively use their subpoena power and control of the congressional agenda to hold the Obama bureaucrats accountable, to limit the reach of their regulatory tentacles, and to frame clearly for voters the issues that we face.   Unfortunately the most egregious work of Obama's presidency, the Orwellianly-named Patient Protection and Affordable Care Act, remains the law of the land.  It will take bold leadership and a persistent focus to limit the implementation of this travesty over the next two years, and I'm not bowled over with excitement given the actions of the last Republican majority.  Surely, however, Republicans have learned lessons from the 1995 government shutdown that was blamed on them, and with the refreshing enthusiasm of the new tea party-backed members I do have some hope.  True health care reform that empowers patients and expands their choices will have to wait for a different President, I'm afraid.

In my wildest dreams I never imagined that Tennessee's congressional delegation could flip from a 5 to 4 Democratic majority to 7 to 2 in favor of Republicans.  In addition, Stephen Fincher's victory in my own Eighth Congressional District marks the first time ever that Republicans have held this Northwest Tennessee seat, and I'm so proud to have a man of his caliber representing me.  I would have been delighted with victory by any reasonably conservative candidate, but with Stephen we are blessed with someone who is ideologically centered and who also has a background that fits well in the district and who is a man of unquestionable integrity.  I suspect that God has plans for Stephen that go beyond representing Tennessee's eighth district in Congress, but I'm thankful to have him there for now.

As for the Republican gains in Tennessee's General Assembly, no one predicted a gain of 14 House seats, nor the picking off of Democrat state senator Doug Jackson of Dickson.  What a clear and emphatic expression of Tennessee voters' revulsion with the policies of the national Democratic party!  These gains ought to cement GOP control of the General Assembly for the foreseeable future, in part because of the Republicans' ability to undo decades of Democratic gerrymandering in the next legislative session.  I believe the major benefit of Republican control of the General Assembly won't be seen in headline-making initiatives, but in thousands upon thousands of smaller victories that will ultimately serve to make Tennesseeans more free, more prosperous, and more secure.  It will be up to an informed electorate, including tea party voters, to make sure that Republican state legislators maintain their focus and don't get too comfortable with the power we've entrusted to them.

All in all, it's been a very satisfying week, and one that I did not foresee two years ago.  I'm reminded of the truth that a year is an eternity in politics, and of the even more profound truth that God is in control.  I should learn to trust Him more.