Irish,

An interesting article. While I must concede some points to Mr. Connelly, I respectfully disagree with others.


This is highly probable.



Of course it does. All health care systems ration their services. Some do it by price, others do it by time. Another way of saying this is that in some health care systems, you must pay more to receive some services, while in others, you must wait longer. We are all going to die. The demand for interventions that might postpone that inevitability outstrips the supply. Of course no sane politician will admit this. It is easier to promise that all will receive whatever is medically necessary. Has Mr. Connelly (or most people for that matter) stopped to ask what that means? Should doctors seek to save the largest number of lives, or the largest number of years of life? Even here in the U.S., resources are limited. No one doubts that spending a thousand dollars to save the life of a child is a good idea. However, what about five hundred thousand dollars to prolong a terminally ill patient’s painful life by a month?

There are no easy answers. Unfortunately, some of the President’s advisors have published their opinions about the questions. Cass Sunstein has written extensively about which life-saving rules are most cost-effective. Ezekiel Emanuel, a doctor whose brother is the President’s chief of staff, wrote a paper (The Lancet, 373) in which he proposed a system for determining who should be first in line for such things as liver transplants or vaccines during an epidemic. Among other factors, he suggested taking age into account, with adolescents and young adults getting priority, because they have fully developed personalities and many years of life ahead. Dr Emanuel even included a graph on page six showing voters above and below the ideal age how much less their lives are worth. I note with some amusement that the slope of the curve is negative at my age.



While distasteful to many, there is nothing unconstitutional about providing these services to anyone.



Most unlikely. As some readers of this forum may recall there was a sometimes animated thread in re an injunction issued by a federal judge in Washington state preventing that state from compelling pharmacists to issue abortifacients when doing so would violate their religious beliefs per the First Amendment to the Constitution.



Mr. Connelly should have used “might” or “could”, rather than “will”. The future of the insurance companies is contingent upon how much the federal plan costs. Given the spendthrift ways of the current congress, he may well have a point here, but it is not a given.



Pure nonsense; completely unsupported conjecture.



Strictly controlled federal expenditure is often considered an oxymoron. If it is, in this instance, achieved, the plan administers should be applauded, not condemned.



I take up the gauntlet Mr. Connelly has thrown down. Seventy-two years ago, in the ruling Helvering v. Davis (1937), the Supreme Court found Social Security constitutional. There is little reason to believe that the current court will rule differently on another piece of social legislation.

Further, in re the constitutional scope of Legislative Power, Article I, Section 8 of the Constitution reads “... To regulate commerce with foreign nations, and among the several states, and with the Indian tribes ...“ Health care in these United States is a multi-billion dollar per year commercial activity. As such it may be regulated (or warped/twisted/mutilated, depending upon one’s point of view) by Congress.

For what it is worth, Mr. Justice McReynolds and Mr. Justice Butler in their dissenting votes shared Mr. Connelly’s opinion in re the 10th Amendment.

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Eudaimonia