There’s No Such Thing as Just Short on the GOP Health-Care Bill

by Rich Lowry

This feels like one of those dynamics where if there are three hard Republican “no’s” on the bill (which is quite plausible), another dozen or so senators will oppose it, too. So, it’s either 50 votes for it, or 35.

‘It is not sufficient for us simply to add more people to Medicare or Medicaid to increase the rolls, to increase coverage in the absence of cost controls and reform.’

The U.S. Should End Its OECD Subsidies: It’s Good Policy and Self-Protection

by Veronique de Rugy

Tomorrow, the Committee on Appropriations’s Subcommittee on State, Foreign Operations, and Related Programs is having a “United Nations and International Organizations — Budget Hearing.” The witness will be U.N. ambassador Nikki Haley.

I, for one, am very much looking forward to this hearing. As a reminder, the Trump budget called for reducing spending on contributions to international organizations by approximately $786 million. We will still be spending $900 million in Fiscal Year 2018 on international bureaucrats, according to the Major Savings Document (pg. 71). But that’s down from the $1.68 billion we spent in Fiscal Year 2017. For the figures from the analytics tables, check pg. 14 of this document (or pg. 778 of the book).

It called for an interagency strategic review to prioritize payments to organizations “that most directly support U.S. national security interests and American prosperity. NATO, for instance, would continue to be fully funded. In contrast, funding for organizations that work against U.S. foreign policy interests could be terminated.”

As I wrote a few weeks ago, while the level of spending cuts as envisioned by the Trump administration is unlikely to occur, the Organisation for Economic Co-operation (OECD) should be placed first on the chopping block for its use of American taxpayer dollars to push for higher taxes and bigger government in the U.S. and around the world. In that post, I wrote about many of the ways the OECD works against U.S. interests.

This morning, Dan Mitchell at the Cato Institute has a good summary of why we are so eager to see America’s OECD subsidies cut. He writes:

My main gripe is that the OECD, in hopes of propping up the European welfare states that dominate its membership, tries to enable big tax increases by undermining tax competition.

It also galls me that the bureaucracy reflexively embraces just about every kind of tax hike, including class-warfare taxes on income, big new energy taxes, business taxes, and money-vacuuming value-added taxes.

Additionally, I get irked when the OECD advocates other big-government policies such as Keynesian spending, green energy, and government-run healthcare.

I also don’t like the OECD’s dodgy, dishonest, and misleading use of data on issues such as poverty, pay equity, inequality, and comparative economics.

And, to add insult to injury, the bureaucrats at the OECD get a special exemption so their gold-plated salaries are tax free, even though they spend so much time trying to impose higher taxes on the rest of us.

For all of you who wonder why we should care about a report-writing organization, I would say that the OECD, which is dominated by Western European welfare states, has actually been leading aggressive real-world campaigns such as he anti-tax-competition one mentioned above. The reality is that their efforts have had very negative ramifications for lower-tax jurisdictions. In addition, the OECD continues pushing an awful multilateral convention that was signed by President Obama, which if ratified by U.S. Senate (down the road when the Democrats are back in power), would force us to automatically share personal-financial information with some of the most corrupt and unsavory governments around the world.

In other words, no, the OECD isn’t just your usual wasteful international bureaucracy with a preference for big government. These bureaucrats are actively meddling in the world of policy, always on the side of bigger government and less privacy, with real-world consequences for the rest of us.

Hopefully, tomorrow’s hearing will get us closer to the goal of defunding them.

Finding the Roots of Violent Campus Protests

by George Leef

As our campus “progressives” (actually, they’re primitive tribalists) grow increasingly bold and violent, it’s worth asking where such behavior has its roots. In Friday’s Martin Center article, Assumption College political-science professor Geoffrey Vaughan suggests that it has been taught to them. After noting that Vice President Pence had a large number of students walk out of his commencement address at Notre Dame last month, Vaughan writes,

The real power of political correctness that legislators and even the vice president would like to combat does not reside in particular offices or paid positions. The power resides in faculty and administrators who almost universally support it and increasingly see their jobs as developing support for it among students.

He’s right. Many professors and administrators see themselves as “change agents” who care more about inculcating what they think are the correct values rather than to have them master fields of knowledge and understand how to use reason. (All the talk you hear about how colleges teach students “critical thinking” is just a smokescreen for indoctrination.) They want to change students, not educate them.

There lies the root of the problem. Higher education has been thoroughly infiltrated by the Left, which uses it for its goals of remaking America according to its collectivist/authoritarian notions.

Vaughan concludes, “Free speech is important, but without a culture willing to engage in what others say, it merely provides a podium in an empty room. So two cheers for legislation that protects our freedom to address it, but hold that third cheer for a while. We need to address the very idea of what education is before this problem can be solved.” The “progressives” have their idea about what education is and (using vast amounts of other people’s money), they have pretty much succeeded in imposing it on the entire nation. Those of us who have a different idea need to either retake the institutions or create new educational models that don’t involve immersing students in the leftist view of the world.

Why Argue That ‘Collusion with Russia’ Isn’t a Crime?

by Jonah Goldberg

So far there is no evidence of “collusion” between the Russian government and the Trump campaign. And if they ever find any, I suspect the culpability will land at the feet of politically expendable characters such as Roger Stone or Paul Manafort and not the president.

To date, the best argument the Russia-obsessed have is Donald Trump’s own words and actions: His obsession with the unfairness of the investigation, his refusal to acknowledge that Russia meddled in our election (at least until his latest tweets on the subject), and his odd reluctance to speak ill of Vladimir Putin and his desire to be more chummy with the dictator.

None of that, however, is proof of anything other than the well-documented habit of the president to say things that don’t help him.

But there’s a new argument coming down the pike these days that I find particularly odd. A number of people are starting to make the case that even if Trump did collude with the Russian government, that wouldn’t be a crime. My friend Brit Hume made that case on Fox News Sunday. From a Newsweek story:

“Can anybody identify the crime? Collusion, while it would be obviously alarming and highly inappropriate for the Trump campaign, of which there is no evidence by the way, of colluding with the Russians,” said Hume, “It’s not a crime.”

Last week on his radio show, Sean Hannity made a similar argument:

“They might say as a Trump campaign representative, ‘wow you have that? Tell the American people the truth. Let them see it themselves, release it.’ Is that a crime, to say ‘release it’? To show the truth? To show damaging information?”

Now, the Newsweek article asks a bunch of legal experts who think this is wrong: Colluding with Russia could run afoul of several laws. Maybe those experts are wrong. I honestly don’t know, but it’d hardly shock me if Newsweek went quote-shopping for the story.

Still, I think this argument is a dead-end. One could also just say, as many have, that it doesn’t matter because the Department of Justice as a rule won’t indict a sitting president. The fact remains that if Donald Trump did actually work with the Russians — again there’s no evidence that he did — it would be an enormous calamity for his presidency. It would certainly fall under the entirely elastic and political definition of impeachable offenses — at least if the Democrats take over Congress.

Moreover, I don’t see how this argument helps the Trump White House. “Even if I did it . . . ” is never a strong defense and it comes across as a grudging confession of wrongdoing.

We know the president often takes his cues from Fox News and supportive pundits elsewhere. Mainstreaming the argument that it’d be no big deal if Trump conspired, even after the fact, with the Russians over the hacking of the DNC server etc. amounts to giving the president terrible political advice.

A Groundbreaking Minimum-Wage Study

by Robert VerBruggen

Basic economics holds that when you mandate a higher price for something, you get less of it. But reality is a bit messier than that, and there’s a robust debate over the effect that the minimum wage has on employment. Few deny that, say, a $30 wage floor would cause enormous job losses, but it can be hard to detect much of an impact from smaller increases.

A working paper released today improves on prior research and suggests that there are indeed substantial employment losses as you approach the Left’s target of $15 an hour — and that those losses far outweigh the higher wages paid to the workers who stay employed.

Economists at the University of Washington were given access to administrative data that include the earnings and hours of individual workers in Washington State, allowing them to precisely identify workers by the wages they made. (Previous studies usually relied on more roundabout methods, like looking at stereotypical low-wage workers such as teens or those in the retail or restaurant industries.) They were able to see what happened to low-wage workers — defined as those making up to $19 an hour — as Seattle’s minimum wage grew from $9.47 to $11 in 2015 and then to $13 the next year.

Generally, what you expect to see from the minimum wage is that (A) wages increase, because legally they have to; and (B) workers put in fewer hours, some losing their jobs entirely, because it has become more expensive to employ them. The relationship between these two effects — the “elasticity” — tells you whether more or less money is flowing to low-wage workers in general.

An elasticity of -1, for example, means that when wages go up 1 percent, hours fall 1 percent and this group of workers breaks even money-wise. Even that may not be a good tradeoff, of course, because losing money can hurt more than gaining money helps. If two people make the same amount of money, you will do more harm than good if you double one of their salaries but put the other out of work and break up his marriage.

The new study says that Seattle’s first minimum-wage increase, to $11, created an elasticity of right around -1: break-even at best. The next one, to $13, had an elasticity of -3, with hours falling 9 percent while wages grew just 3 percent. This “lowered low-wage employees’ earnings by an average of $125 per month in 2016.” A policy with this latter effect is obviously indefensible.

But there are a couple of caveats here. One, Seattle started from a high minimum wage; the federal minimum is just $7.25. Since the overall effect gets worse as the mandated wage gets higher, it’s likely that more modest increases (say, to $8 or $9) would have elasticities closer to 0 and would thus be easier to justify on cost-benefit grounds.

Second, there was a big limitation to the authors’ data. Many employers have multiple sites, some inside Seattle and some outside, and they have the option of reporting data for all their operations at once, instead of separately for each location. Employers that did this are excluded from the analysis, which ends up including 89 percent of employers but only 62 percent of employees.

However, survey data suggest that bigger employers were more likely to reduce employment in response to the wage hike. (Single-site employers, after all, by definition don’t have the option of moving jobs to a different site; their only choices are to pay workers more or let them go.) Of course, that might turn out differently if a minimum-wage hike were enacted on the state or federal level instead of just the local one.

Third, and finally, the authors “estimate an effect of zero when analyzing employment in the restaurant industry at all wage levels, comparable to many prior studies.” This suggests that restaurants, at least, replaced low-wage employees with those earning more than $19 an hour. This evokes the old cliché about sawing off the bottom of the income ladder; when low-skilled workers are too expensive to hire, they lose opportunities to higher-skilled employees.

This isn’t the end of the discussion. But it’s a rigorous and groundbreaking study that strongly suggests a $15 minimum wage, which Seattle is still phasing in, would be a really, really bad idea.


SCOTUS’s Good News for Medical Conscience

by Wesley J. Smith

The State of Missouri cannot discriminate against a church school’s request for a generally available grant based on religion, the SCOTUS has ruled.

Having very quickly read the ruling–I won’t get into most of its intricacies–the Court’s ruling seems to be very good news for situations involving religious liberty that extend well beyond the rather mundane facts of the case at bench about which I am concerned–such as medical conscience.

Specifically, the following positive assertion offers great hope.  From Trinity Lutheran Church v Comer (my emphasis):

Neither do I see why the First Amendment’s Free Exercise Clause should care. After all, that Clause guarantees the free exercise of religion, not just the right to inward belief (or status)…And this Court has long explained that government may not “devise mechanisms, overt or disguised, designed to persecute or oppress a religion or its practices.”

Yes! So much for the “freedom of worship” shriveling of the First Amendment so often posited by Barack Obama and the political left.

And this statement is an even more directly relevant to medical conscience:

The Free Exercise Clause protects against “indirect coercion or penalties on the free exercise of religion, not just outright prohibitions.”

Thus, the ruling should give great pause to those who would seek to pass laws, promulgate regulations, or publish medical association ethics rulings that punish medical professionals who refuse to abort, assist suicide, and/or participate in other controversial actions in the medical context that violate their religious beliefs.

It’s a Fake, Fake, Fake, Fake World

by Rich Lowry

Matt Continetti had a good column last week on the group think, speculation, and innuendo that inform so much of our political world at the moment. Add to the count the story CNN had to retract fingering Anthony Scaramucci as under investigation in the so-called Russia scandal. CNN is now establishing new standards for its Russia coverage. This comes on top of James Comey’s debunking of one of the explosive New York Times reports that spread widely. And Chuck Grassley’s remarks the other day that Chuck Schumer was deliberately misleading about the Russia probe. Further to all this, don’t miss Andy’s column from over the weekend.

Victory for Trump: SCOTUS Restores Vast Majority of Travel Ban

by David French

Today, in a per curiam ruling, the Supreme Court restored the vast majority of the Trump administration’s temporary travel ban — including the temporary ban on refugee entry. The lower courts’ injunctions remain only in the narrowest of categories — where the person seeking entry has a “bona fide relationships with a person or entity in the United States.”

And what is a “bona fide relationship?” The court’s guidelines were strict:

For individuals, a close familial relationship is required. A foreign national who wishes to enter the United States to live with or visit a family member, like Doe’s wife or Dr. Elshikh’s mother-in-law, clearly has such a relationship. As for entities, the relationship must be formal, documented, and formed in the ordinary course, rather than for the purpose of evading EO–2.

In other words, SCOTUS made short work of the claim that a person’s desire to bring their mother-in-law to the U.S. (or a university’s desire to admit a few students or have a lecturer travel for a seminar) granted them the ability to stand in for every single citizen of every affected country:

Denying entry to such [an unconnected] national does not burden any American party by reason of that party’s relationship with the foreign national. And the courts below did not conclude that exclusion in such circumstances would impose any legally relevant hardship on the foreign national himself.


At the same time, the Government’s interest in enforcing §2(c), and the Executive’s authority to do so, are un- doubtedly at their peak when there is no tie between the foreign national and the United States. Indeed, EO–2 itself distinguishes between foreign nationals who have some connection to this country, and foreign nationals who do not, by establishing a case-by-case waiver system primarily for the benefit of individuals in the former category . . . The interest in preserving national security is “an urgent objective of the highest order.” Holder v. Humanitarian Law Project, 561 U. S. 1, 28 (2010). To prevent the Government from pursuing that objective by enforcing §2(c) against foreign nationals unconnected to the United States would appreciably injure its interests, without alleviating obvious hardship to anyone else.

Notably absent from the court’s decision is any analysis of Trump’s campaign statements. Moreover, the only dissenters from the opinion (justices Gorsuch, Alito, and Thomas) wanted the injunctions vacated in their entirety. They are correct that the court’s ruling will invite further litigation as litigants test the boundaries of the “bona fide relationships,” but the difference between the dissenters and the six remaining justices was only over the proper extent of Trump’s legal victory. For now, the constitutional and statutory primacy of the executive and legislative branches over national security and immigration has been restored.

The judges in the courts below have been celebrated as heroic resistance figures. Yet now even the Supreme Court’s most liberal justices have rejected the lower courts’ overreach. The Trump administration is free to conduct its global review to determine whether foreign governments provide sufficient information about foreign nationals applying for entry to the U.S., it’s free for now to impose its new refugee caps, it’s free to temporarily pause entry from Iran, Syria, Libya, Yemen, Sudan, and Somalia, and it’s free to pause refugee entry (unless refugees and applicants for entry have a “bona fide” U.S. relationship.) That’s a win for Trump.

The court will hear the full case during its October term, but the majority of the case may well be moot by that time (indeed, that’s one question the court will consider). The administration will have had time to complete its reviews, and in the meantime the travel pause will apply to the vast majority of the citizens of the affected states. Indeed, the administration will have time to issue new immigration guidance based on the results of its review. The resistance’s greatest legal victory has been gutted, and not even Ruth Bader Ginsburg accepted its most extreme arguments.

Death and the Parties

by Ramesh Ponnuru

Hillary Clinton said passing the health bill would make Republicans the “death party.” I don’t think it has quite the same ring as The Party of Death, the title of a book I wrote about a decade ago about abortion and related issues. At Bloomberg View, I defend provocative rhetoric such as hers and mine: The problem with what she said isn’t that it’s uncivil, but that it’s wrong.

Nancy MacLean vs. Tyler Cowen

by Ramesh Ponnuru

Nancy MacLean has a book on the libertarian economist and political theorist James Buchanan. It seems to conduct a drive-by on another libertarian writer, Tyler Cowen (who is among other things a fellow columnist for Bloomberg View). Russ Roberts has the goods.

Here, for example, is Cowen commenting on proposals to change the Constitution for libertarian ends: “While weakening checks and balances would increase the chance of a very good outcome, it also would increase the chance of a very bad outcome.”

And here’s MacLean’s description of Cowen’s views: “The economist was creating, it seems fair to say, a handbook for how to conduct a fifth-column assault on democracy.

“‘The weakening of checks and balances’ in the American system, Cowen suggested, ‘would increase the chance of a very good outcome.’”

Roberts documents several other distortions, none of which lend themselves easily to innocent explanations. It’s enough to make you wonder whether MacLean’s attacks on her main subject, Buchanan, which have been credulously received by liberals, are on the level.

Bill at the Ballgame

by Jay Nordlinger

Impromptus today is a variety show, traversing politics, policy, Islam, Russia, Seattle, music, and more. Something to please and displease everyone.

I spend a little time anathematizing the ACLU — but I note that Ira Glasser, its onetime head, was a friend of WFB’s. “In fact, it was Glasser who took Bill to the only baseball games he ever attended: a Yankees game and a Mets game. (I think Bill was at each game only very briefly.)”

Here on the Corner, I thought I’d say a little bit more. To one of those games, Glasser made WFB take the subway, in order to have a more “authentic” experience, I suppose. But I’m pretty sure that Bill agreed to take the subway only one way. He went home by his more accustomed means.

And something happened at one of those games, which relates to the nutty fussiness of our age. Quick as he could, Bill went to get a beer. And the girl behind the counter asked for ID. Bill looked at her blankly and said, “I’m 74 years old.”

I remember him saying something else, relating to a nutty security-consciousness (as opposed to the wise kind). After 9/11, he’d enter a building and a guard would say, “Hello, Mr. Buckley, great to see you. Could I see your ID?”

Rules are rules. But sometimes rule-following is strange, or embarrassing.

The Trump Non-Catastrophe

by Rich Lowry

The coverage of Trump has had a catastrophic tone since the election, shared by some of his critics on the right. In the NBC poll at the end of last week, according to First Read at NBC News, I was struck by this breakdown of where the parties stand on the question of “which party would do a better job”:

Dealing with health care: Democrats 43 percent, Republicans 26 percent (D+17)

Looking out for the middle class: Democrats 42 percent, Republicans 29 percent (D+13)

Dealing with immigration: Democrats 38 percent, Republicans 32 percent (D+6)

Dealing with transit, roads, and highways: Democrats 24 percent, Republicans 22 percent (D+2)

Dealing with foreign policy: Democrats 34 percent, Republicans 33 percent (D+1)

Dealing with taxes: Democrats 29 percent, Republicans 33 percent (R+4)

Dealing with the economy: Democrats 29 percent, Republicans 36 percent, (R+7)

Changing how things work in Washington: Democrats 18 percent, Republicans 27 percent (R+9)

Dealing with ISIS: Democrats 17 percent, Republicans 35 percent (R+18)

There is softness here to be sure. You’d hope Trump would be doing better on the middle class, and the tie on foreign policy is a poor showing for the GOP. But this isn’t exactly the picture of a party in a state of collapse.

As for Trump’s approval rating, it’s at 40 in the NBC poll. We always hear that that number is a historic low for a president at this point. True, but no president has ever been elected despite his unpopularity the way Trump was last November. If the next presidential election were held tomorrow, Trump would start about where he was last year at 46 percent, with a fighting chance at reelection.

Finally, there’s the state of the 2018 midterms. Democrats are up 8 on the generic ballot. This is good for them, but not great. As First Read notes:

When Democrats have scored big midterm wins, their advantage in congressional preference has been in the double digits. What’s more, Republicans on this measure enjoy a 52 percent–41 percent lead in GOP-held districts vs. Democrats’ 62 percent–28 percent lead in Dem districts, which helps explain what happened in GA-6 on Tuesday. Democrats may very well have the political winds at their backs, but those gusts haven’t blown into Republican areas — at least not yet.

In short, Trump has hurt himself in all sorts of unnecessary ways and is in middling shape, but, as usual, the catastrophic tone is unwarranted.


Did Obamacare Boldly Redistribute Wealth?

by Rich Lowry

Further to David’s point below, it is a theme in the coverage and the criticism of the Republican health-care bill that it will redistribute wealth upward. Here is a typical example from a Washington Post story today:

That dramatic shift and the bill’s bold redistribution of wealth — the billions of dollars taken from coverage for the poor would help fund tax cuts for the wealthy — is creating substantial anxiety for several Republican moderates whose states have especially benefited from the expansion of Medicaid that the Affordable Care Act has allowed since 2014.

The thing about this is that it’s not really possible for the repeal bill to be a “redistribution” in this sense unless the underlying law was a redistribution the other way. But it was very difficult to get supporters of Obamacare to admit this about the bill at the time. Byron York wrote a column in 2010 about some Democrats and analysts beginning to tout the redistributive aspects of Obamacare after its passage.

Now they tell us. For many opponents of the new legislation, the statements confirmed a nagging suspicion that for Barack Obama and Democrats in Congress, the health fight was about more than just insurance – that redistribution played a significant, if largely unspoken, part in the drive for national health care.

Well, now we know beyond a doubt that Obamacare was a “bold” redistribution of wealth, sold under false pretenses.

Kate’s Arlington Cemetery Burial

by Kathryn Jean Lopez

The family of my dear friend and former Washington editor of National Review and president of the National Review Institute sends along the details of her upcoming burial at Arlington National Cemetery on Friday.

Both her husband and their eldest son served in the Army and she wrote frequently about military policy and heroes on the pages of National Review – always working to keep political ideology from putting America’s bravest from further danger.

Details below: 

The Good, the Bad, and the Senate Health-Care Bill

by Yuval Levin

The health-care bill now before the Senate has been shaped by a number of lessons that Republicans have learned in the course of a six-month, bicameral legislative process. It is a function of some things they’ve come to prioritize about the individual health-insurance market and Medicaid, and some things they’ve learned about the intricacies of the Byrd rule and Senate procedural constraints. But mostly it is a function of something they have learned about themselves: After seven years of saying they want to repeal and replace Obamacare, congressional Republicans have been forced to confront the fact that many of them, perhaps most, actually don’t quite want to do that.

Keep reading this post . . .

A Conservative Brain (and Excellent Teacher)

by Jay Nordlinger

John J. Pitney Jr. — less formally, Jack — is a famous conservative political scientist. He teaches at Claremont McKenna College, in California. And he is the latest guest on my Q&A podcast. We talk about his life, his thought, and America, basically. And in a half-hour or so!

Pitney grew up in Saratoga Springs, N.Y., on the wrong side of the tracks. Parents in this area tended not to have gone to college. But their children did.

Jack went to Union College in Schenectady, the alma mater of Chester A. Arthur (“the Al D’Amato of his day,” says Pitney). Then he went to Yale, where he studied under Robert Dahl, the eminent political scientist. A lefty but a gentleman, says Pitney (and a true scholar).

On our podcast, we talk about Pitney’s teaching career. Among his students has been Heidi Cruz, incidentally. We talk about activism and ideology on campus. Are students too drugged, ideologically, to learn? Obsessed with their race, sex, and pronouns and all that?

We also talk about the conservative movement and the GOP. Pitney once worked for the Republican party, and he describes himself as a conservative in the Jack Kemp style. He left the party last year. He is now an independent.

I ask him about his media diet (“Whaddaya read?”). About California (“Still a golden state, despite the terrible problems?”). About statesmen he admires (beginning with Lincoln). About “the politics of autism” (on which he is an expert). And more.

Jack Pitney is a conservative brain and an excellent teacher. Again, to listen to him, go here.

One more thing, if you will allow a little home-state boosterism, so to speak: His conservatism was formed when he started reading National Review at age 13. He corresponded with WFB. His mother still keeps the letters from WFB.

And why not?

Illinois Compels MDs to Discuss ‘Benefits’ of Abortion

by Wesley J. Smith

I have predicted that “medical conscience” will become a huge social controversy in the next decade, as culture of death proponents seek to force pro-life and Hippocratic Oath-believing doctors out of medicine by compelling them to be complicit in life-taking acts such as abortion and assisted suicide.

I just learned that a law enacted last year in Illinois compels doctors to counsel patients about the “benefits” of all legal medical procedures–the prime target is pro-life doctors about abortion, but it is not limited to that–and if unwilling to do the deed, to become complicity by helping patient find a doctor who will.

First, the amended conscience law pretends to protect conscience, but requires counseling on benefits of legal procedures regardless of conscience beliefs. From Public Act 099-0690 (my emphasis):

Nothing in this Act shall relieve a physician from any duty, which may exist under any laws concerning current standards, of normal medical practice or care practices and procedures, to inform his or her patient of the patient’s condition, prognosis, legal treatment options, and risks and benefits of treatment options, provided, however, that such physician shall be under no duty to perform, assist, counsel, suggest, recommend, refer or participate in any way in any form of practice or health care service that is contrary to his or her conscience.

This means that if a woman is told she is pregnant, the doctor must counsel on the abortion option. It would require a doctor to counsel on the benefits of sex reassignment to their patients with gender dysphoria. (The ACLU has already brought such a lawsuit against a Catholic hospital for refusing to permit sex change surgeries.)

It would also mean, were assisted suicide legalized, a doctor would have to tell a terminally ill patient about the option of receiving a lethal overdose.

The conscience protections in the law–that existed prior to this amendment–are then stripped from doctors by requiring them to procure and refer:

(2) When a health care facility, physician, or health care personnel is unable to permit, perform, or participate in a health care service that is a diagnostic or treatment option requested by a patient because the health care service is contrary to the conscience of the health care facility, physician, or health care personnel, then the patient shall either be provided the requested health care service by others in the facility or be notified that the health care will not be provided and be referred, transferred, or given information in accordance with paragraph (3).

And here’s the kick to the conscience solar plexus:

(3) If requested by the patient or the legal representative of the patient, the health care facility, physician, or health care personnel shall: (i) refer the patient to, or (ii) transfer the patient to, or (iii) provide in writing information to the patient about other health care providers who they reasonably believe may offer the health care service the health care facility, physician, or health personnel refuses to permit, perform, or participate in because of a conscience-based objection.

That means forced complicity in abortion and other morally controversial medical acts, akin to the failed attempt by Vermont–thwarted by litigation–to force doctors there to counsel about the availability of assisted suicide to their terminally ill patients. (Except this is by statute, not a regulation that conflicted with a statute).

I suspect that pro-life conscientious objectors can find protection against this authoritarianism in the safe harbor of the Church Amendment, a federal statute that forbids any facility or health care professional working in a facility that receives federal funds from being punished for refusing to participate in abortion or sterilization. But that law does not protect against compelled participation in other procedures, and thus needs to be expanded.

This is an example of how medicine is being weaponized by law as a means for committing cultural imperialism. 

Litigation has commenced. Let us hope it succeeds.

Republican Health Care Plans Don’t ‘Steal’ from the Poor

by David French

Here’s the Washington Post’s Eugene Robinson with an odd attack on Republican health care plans:

The “health-care bill” that Republicans are trying to pass in the Senate, like the one approved by the GOP majority in the House, isn’t really about health care at all. It’s the first step in a massive redistribution of wealth from struggling wage-earners to the rich — a theft of historic proportions.

Not to be too pedantic about this, but the government isn’t “redistributing” wealth when it lets a citizen keep more of his money, and it isn’t “stealing” from the poor when it cuts benefits they didn’t actually own. Welfare programs like Medicaid represent a forcible transfer wealth. Welfare is the redistribution. And if there’s any actual argument for “theft,” it’s the theft of money from the private citizen by the government.

But that would be hyperbole. In civilized societies, people understand that a certain degree of taxation is necessary for a nation to function. Safety nets are compassionate and prudent. But it is dangerous and wrong to get confused about who owns what. I own the money I earn. America’s less fortunate citizens don’t own Medicaid. It’s a privilege, not a right — a privilege that is subject to the same budgetary and fiscal concerns inherent in any other government program, including national defense. 

Entitlement culture plagues this nation, and it plagues America’s poorest communities. So let’s speak accurately about ownership and redistribution. Medicaid is a program, not property, and it’s not theft to attempt to moderate its enormous financial cost. 


Drawing a Line on Federalism: Who Should Do It?

by Ramesh Ponnuru

Jake Curtis, writing on the home page, brings attention to an issue that deserves it: the way the federal government uses money to get the states to do what it wants. But I don’t think he makes the case for having the federal courts curtail the practice.

He’s writing on the thirtieth anniversary of South Dakota v. Dole, a case in which the Court upheld the federal government’s power to condition highway funding for the states on their adoption of a law prohibiting alcohol purchases for those under 21. I agree that it was wrong for Congress to pass that law and for President Reagan to sign it. It’s less obvious to me that the seven justices who allowed the law to stand—including the two most conservative justices on that court, Chief Justice William Rehnquist and Justice Antonin Scalia—were wrong.

The problem, as I see it, is a simple one: The Constitution lays out no explicit rule for distinguishing between permissible and impermissible conditions for federal aid to states, and no such rule can be plausibly inferred from it.

To my mind, the Court illustrated this point in NFIB v. Sebelius (2012), when it forced a modification of Obamacare’s provisions on Medicaid. The law said that states had to expand Medicaid or lose all their Medicaid funds. The Court—with seven justices in the majority, admittedly including all the conservatives—said that the federal government could not force the states to make that choice. It could, however, tell states that refusing to expand the program would keep them from getting some new Medicaid funds from the federal government. The distinctions the Court drew between permissible and impermissible conditions, however, are labored and their grounding in the constitutional text basically non-existent.

For the Court to become more active in striking down conditions on federal funding for the states, the justices would have to rely on some extra-constitutional sense that “this condition seems to go too far, while that one doesn’t.” There being no constitutional basis for drawing that distinction, responsibility for the line should be left to the legislature, the president, and the voters who elect both.