A few nice medicare forms images I found:

What’s In My Bag…


Image by Amy Dianna
…everything! My bag is like Mary Poppin’s carpet bag, except I don’t have furniture in there…yet

It is a lot of stuff, but everything has a certain spot in my bag as I like to be organised. Not pictured (but always present) is my hard sunglasses case and my fold up reusable green bag (so I don’t need to use plastic bags).

My notes have a lot of detail, but I find it really interesting why people have certain things in their bags!

HERES YOUR TOP TEN


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Judicial Watch, the public interest group that investigates and prosecutes government corruption, today released its 2009 list of Washington’s "Ten Most Wanted Corrupt Politicians." The list, in alphabetical order, includes:

1. Senator Christopher Dodd (D-CT): This marks two years in a row for Senator Dodd, who made the 2008 "Ten Most Corrupt" list for his corrupt relationship with Fannie Mae and Freddie Mac and for accepting preferential treatment and loan terms from Countrywide Financial, a scandal which still dogs him. In 2009, the scandals kept coming for the Connecticut Democrat. In 2009, Judicial Watch filed a Senate ethics complaint against Dodd for undervaluing a property he owns in Ireland on his Senate Financial Disclosure forms. Judicial Watch’s complaint forced Dodd to amend the forms. However, press reports suggest the property to this day remains undervalued. Judicial Watch also alleges in the complaint that Dodd obtained a sweetheart deal for the property in exchange for his assistance in obtaining a presidential pardon (during the Clinton administration) and other favors for a long-time friend and business associate. The false financial disclosure forms were part of the cover-up. Dodd remains the head the Senate Banking Committee.

2. Senator John Ensign (R-NV): A number of scandals popped up in 2009 involving public officials who conducted illicit affairs, and then attempted to cover them up with hush payments and favors, an obvious abuse of power. The year’s worst offender might just be Nevada Republican Senator John Ensign. Ensign admitted in June to an extramarital affair with the wife of one of his staff members, who then allegedly obtained special favors from the Nevada Republican in exchange for his silence. According to The New York Times: "The Justice Department and the Senate Ethics Committee are expected to conduct preliminary inquiries into whether Senator John Ensign violated federal law or ethics rules as part of an effort to conceal an affair with the wife of an aide…" The former staffer, Douglas Hampton, began to lobby Mr. Ensign’s office immediately upon leaving his congressional job, despite the fact that he was subject to a one-year lobbying ban. Ensign seems to have ignored the law and allowed Hampton lobbying access to his office as a payment for his silence about the affair. (These are potentially criminal offenses.) It looks as if Ensign misused his public office (and taxpayer resources) to cover up his sexual shenanigans.

3. Rep. Barney Frank (D-MA): Judicial Watch is investigating a million TARP cash injection provided to the Boston-based OneUnited Bank at the urging of Massachusetts Rep. Barney Frank. As reported in the January 22, 2009, edition of the Wall Street Journal, the Treasury Department indicated it would only provide funds to healthy banks to jump-start lending. Not only was OneUnited Bank in massive financial turmoil, but it was also "under attack from its regulators for allegations of poor lending practices and executive-pay abuses, including owning a Porsche for its executives’ use." Rep. Frank admitted he spoke to a "federal regulator," and Treasury granted the funds. (The bank continues to flounder despite Frank’s intervention for federal dollars.) Moreover, Judicial Watch uncovered documents in 2009 that showed that members of Congress for years were aware that Fannie Mae and Freddie Mac were playing fast and loose with accounting issues, risk assessment issues and executive compensation issues, even as liberals led by Rep. Frank continued to block attempts to rein in the two Government Sponsored Enterprises (GSEs). For example, during a hearing on September 10, 2003, before the House Committee on Financial Services considering a Bush administration proposal to further regulate Fannie and Freddie, Rep. Frank stated: "I want to begin by saying that I am glad to consider the legislation, but I do not think we are facing any kind of a crisis. That is, in my view, the two Government Sponsored Enterprises we are talking about here, Fannie Mae and Freddie Mac, are not in a crisis. We have recently had an accounting problem with Freddie Mac that has led to people being dismissed, as appears to be appropriate. I do not think at this point there is a problem with a threat to the Treasury." Frank received ,350 in campaign contributions from Fannie Mae and Freddie Mac between 1989 and 2008. Frank also engaged in a relationship with a Fannie Mae Executive while serving on the House Banking Committee, which has jurisdiction over Fannie Mae and Freddie Mac.

4. Secretary of Treasury Timothy Geithner: In 2009, Obama Treasury Secretary Timothy Geithner admitted that he failed to pay ,000 in Social Security and Medicare taxes from 2001-2004 on his lucrative salary at the International Monetary Fund (IMF), an organization with 185 member countries that oversees the global financial system. (Did we mention Geithner now runs the IRS?) It wasn’t until President Obama tapped Geithner to head the Treasury Department that he paid back most of the money, although the IRS kindly waived the hefty penalties. In March 2009, Geithner also came under fire for his handling of the AIG bonus scandal, where the company used 5 million of its bailout funds to pay out executive bonuses, resulting in a massive public backlash. Of course as head of the New York Federal Reserve, Geithner helped craft the AIG deal in September 2008. However, when the AIG scandal broke, Geithner claimed he knew nothing of the bonuses until March 10, 2009. The timing is important. According to CNN: "Although Treasury Secretary Timothy Geithner told congressional leaders on Tuesday that he learned of AIG’s impending 0 million bonus payments to members of its troubled financial-products unit on March 10, sources tell TIME that the New York Federal Reserve informed Treasury staff that the payments were imminent on Feb. 28. That is ten days before Treasury staffers say they first learned ‘full details’ of the bonus plan, and three days before the [Obama] Administration launched a new billion infusion of cash for AIG." Throw in another embarrassing disclosure in 2009 that Geithner employed "household help" ineligible to work in the United States, and it becomes clear why the Treasury Secretary has earned a spot on the "Ten Most Corrupt Politicians in Washington" list.

5. Attorney General Eric Holder: Tim Geithner can be sure he won’t be hounded about his tax-dodging by his colleague Eric Holder, US Attorney General. Judicial Watch strongly opposed Holder because of his terrible ethics record, which includes: obstructing an FBI investigation of the theft of nuclear secrets from Los Alamos Nuclear Laboratory; rejecting multiple requests for an independent counsel to investigate alleged fundraising abuses by then-Vice President Al Gore in the Clinton White House; undermining the criminal investigation of President Clinton by Kenneth Starr in the midst of the Lewinsky investigation; and planning the violent raid to seize then-six-year-old Elian Gonzalez at gunpoint in order to return him to Castro’s Cuba. Moreover, there is his soft record on terrorism. Holder bypassed Justice Department procedures to push through Bill Clinton’s scandalous presidential pardons and commutations, including for 16 members of FALN, a violent Puerto Rican terrorist group that orchestrated approximately 120 bombings in the United States, killing at least six people and permanently maiming dozens of others, including law enforcement officers. His record in the current administration is no better. As he did during the Clinton administration, Holder continues to ignore serious incidents of corruption that could impact his political bosses at the White House. For example, Holder has refused to investigate charges that the Obama political machine traded VIP access to the White House in exchange for campaign contributions – a scheme eerily similar to one hatched by Holder’s former boss, Bill Clinton in the 1990s. The Holder Justice Department also came under fire for dropping a voter intimidation case against the New Black Panther Party. On Election Day 2008, Black Panthers dressed in paramilitary garb threatened voters as they approached polling stations. Holder has also failed to initiate a comprehensive Justice investigation of the notorious organization ACORN (Association of Community Organizations for Reform Now), which is closely tied to President Obama. There were allegedly more than 400,000 fraudulent ACORN voter registrations in the 2008 campaign. And then there were the journalist videos catching ACORN Housing workers advising undercover reporters on how to evade tax, immigration, and child prostitution laws. Holder’s controversial decisions on new rights for terrorists and his attacks on previous efforts to combat terrorism remind many of the fact that his former law firm has provided and continues to provide pro bono representation to terrorists at Guantanamo Bay. Holder’s politicization of the Justice Department makes one long for the days of Alberto Gonzales.

6. Rep. Jesse Jackson, Jr. (D-IL)/ Senator Roland Burris (D-IL): One of the most serious scandals of 2009 involved a scheme by former Illinois Governor Rod Blagojevich to sell President Obama’s then-vacant Senate seat to the highest bidder. Two men caught smack dab in the middle of the scandal: Senator Roland Burris, who ultimately got the job, and Rep. Jesse Jackson, Jr. According to the Chicago Sun-Times, emissaries for Jesse Jackson Jr., named "Senate Candidate A" in the Blagojevich indictment, reportedly offered .5 million to Blagojevich during a fundraiser if he named Jackson Jr. to Obama’s seat. Three days later federal authorities arrested Blagojevich. Burris, for his part, apparently lied about his contacts with Blagojevich, who was arrested in December 2008 for trying to sell Obama’s Senate seat. According to Reuters: "Roland Burris came under fresh scrutiny…after disclosing he tried to raise money for the disgraced former Illinois governor who named him to the U.S. Senate seat once held by President Barack Obama…In the latest of those admissions, Burris said he looked into mounting a fundraiser for Rod Blagojevich — later charged with trying to sell Obama’s Senate seat — at the same time he was expressing interest to the then-governor’s aides about his desire to be appointed." Burris changed his story five times regarding his contacts with Blagojevich prior to the Illinois governor appointing him to the U.S. Senate. Three of those changing explanations came under oath.

7. President Barack Obama: During his presidential campaign, President Obama promised to run an ethical and transparent administration. However, in his first year in office, the President has delivered corruption and secrecy, bringing Chicago-style political corruption to the White House. Consider just a few Obama administration "lowlights" from year one: Even before President Obama was sworn into office, he was interviewed by the FBI for a criminal investigation of former Illinois Governor Rod Blagojevich’s scheme to sell the President’s former Senate seat to the highest bidder. (Obama’s Chief of Staff Rahm Emanuel and slumlord Valerie Jarrett, both from Chicago, are also tangled up in the Blagojevich scandal.) Moreover, the Obama administration made the startling claim that the Privacy Act does not apply to the White House. The Obama White House believes it can violate the privacy rights of American citizens without any legal consequences or accountability. President Obama boldly proclaimed that "transparency and the rule of law will be the touchstones of this presidency," but his administration is addicted to secrecy, stonewalling far too many of Judicial Watch’s Freedom of Information Act requests and is refusing to make public White House visitor logs as federal law requires. The Obama administration turned the National Endowment of the Arts (as well as the agency that runs the AmeriCorps program) into propaganda machines, using tax dollars to persuade "artists" to promote the Obama agenda. According to documents uncovered by Judicial Watch, the idea emerged as a direct result of the Obama campaign and enjoyed White House approval and participation. President Obama has installed a record number of "czars" in positions of power. Too many of these individuals are leftist radicals who answer to no one but the president. And too many of the czars are not subject to Senate confirmation (which raises serious constitutional questions). Under the President’s bailout schemes, the federal government continues to appropriate or control — through fiat and threats — large sectors of the private economy, prompting conservative columnist George Will to write: "The administration’s central activity — the political allocation of wealth and opportunity — is not merely susceptible to corruption, it is corruption." Government-run healthcare and car companies, White House coercion, uninvestigated ACORN corruption, debasing his office to help Chicago cronies, attacks on conservative media and the private sector, unprecedented and dangerous new rights for terrorists, perks for campaign donors — this is Obama’s "ethics" record — and we haven’t even gotten through the first year of his presidency.

8. Rep. Nancy Pelosi (D-CA): At the heart of the corruption problem in Washington is a sense of entitlement. Politicians believe laws and rules (even the U.S. Constitution) apply to the rest of us but not to them. Case in point: House Speaker Nancy Pelosi and her excessive and boorish demands for military travel. Judicial Watch obtained documents from the Pentagon in 2009 that suggest Pelosi has been treating the Air Force like her own personal airline. These documents, obtained through the Freedom of Information Act, include internal Pentagon email correspondence detailing attempts by Pentagon staff to accommodate Pelosi’s numerous requests for military escorts and military aircraft as well as the speaker’s 11th hour cancellations and changes. House Speaker Nancy Pelosi also came under fire in April 2009, when she claimed she was never briefed about the CIA’s use of the waterboarding technique during terrorism investigations. The CIA produced a report documenting a briefing with Pelosi on September 4, 2002, that suggests otherwise. Judicial Watch also obtained documents, including a CIA Inspector General report, which further confirmed that Congress was fully briefed on the enhanced interrogation techniques. Aside from her own personal transgressions, Nancy Pelosi has ignored serious incidents of corruption within her own party, including many of the individuals on this list. (See Rangel, Murtha, Jesse Jackson, Jr., etc.)

9. Rep. John Murtha (D-PA) and the rest of the PMA Seven: Rep. John Murtha made headlines in 2009 for all the wrong reasons. The Pennsylvania congressman is under federal investigation for his corrupt relationship with the now-defunct defense lobbyist PMA Group. PMA, founded by a former Murtha associate, has been the congressman’s largest campaign contributor. Since 2002, Murtha has raised .7 million from PMA and its clients. And what did PMA and its clients receive from Murtha in return for their generosity? Earmarks — tens of millions of dollars in earmarks. In fact, even with all of the attention surrounding his alleged influence peddling, Murtha kept at it. Following an FBI raid of PMA’s offices earlier in 2009, Murtha continued to seek congressional earmarks for PMA clients, while also hitting them up for campaign contributions. According to The Hill, in April, "Murtha reported receiving contributions from three former PMA clients for whom he requested earmarks in the pending appropriations bills." When it comes to the PMA scandal, Murtha is not alone. As many as six other Members of Congress are currently under scrutiny according to The Washington Post. They include: Peter J. Visclosky (D-IN.), James P. Moran Jr. (D-VA), Norm Dicks (D-WA.), Marcy Kaptur (D-OH), C.W. Bill Young (R-FL.) and Todd Tiahrt (R-KS.). Of course rather than investigate this serious scandal, according to Roll Call House Democrats circled the wagons, "cobbling together a defense to offer political cover to their rank and file." The Washington Post also reported in 2009 that Murtha’s nephew received million in Defense Department no-bid contracts: "Newly obtained documents…show Robert Murtha mentioning his influential family connection as leverage in his business dealings and holding unusual power with the military."

10. Rep. Charles Rangel (D-NY): Rangel, the man in charge of writing tax policy for the entire country, has yet to adequately explain how he could possibly "forget" to pay taxes on ,000 in rental income he earned from his off-shore rental property. He also faces allegations that he improperly used his influence to maintain ownership of highly coveted rent-controlled apartments in Harlem, and misused his congressional office to fundraise for his private Rangel Center by preserving a tax loophole for an oil drilling company in exchange for funding. On top of all that, Rangel recently amended his financial disclosure reports, which doubled his reported wealth. (He somehow "forgot" about million in assets.) And what did he do when the House Ethics Committee started looking into all of this? He apparently resorted to making "campaign contributions" to dig his way out of trouble. According to WCBS TV, a New York CBS affiliate: "The reigning member of Congress’ top tax committee is apparently ‘wrangling’ other politicos to get him out of his own financial and tax troubles…Since ethics probes began last year the 79-year-old congressman has given campaign donations to 119 members of Congress, including three of the five Democrats on the House Ethics Committee who are charged with investigating him." Charlie Rangel should not be allowed to remain in Congress, let alone serve as Chairman of the powerful House Ways and Means Committee, and he knows it. That’s why he felt the need to disburse campaign contributions to Ethics Committee members and other congressional colleagues.

MAKE YOURSELF AWARE ——— THEY’RE SUPPOSED TO BE WORKING FOR YOU, IT’S YOUR GOVERNMENT AND GOVERNMENT IS TOO IMPORTANT TO BE TRUSTED TO LIFELONG POLITICIANS ——-

www.judicialwatch.org/

OBAMAS DEATH PANEL—— GUESS WHAT FOLKS IT’S ALIVE AND WELL—”CRAZY PALIN” NOT SO CRAZY NOW


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Berwick Sets Up Death Panels By Fiat
By Jeffrey Lord on 12.28.10 @ 6:09AM

"If they would rather die they had better do it, and decrease the surplus population." — Ebenezer Scrooge in Charles Dickens’ A Christmas Carol

Sarah Palin was right.

John Boehner — make that Speaker-elect of the House John Boehner — was right.

While Americans were busy celebrating with family and friends and presumably not paying attention to the news, the New York Times, in a story ironically dated Christmas Day — a holiday celebrating the birth of the Prince of Peace — reported the following:

Obama Returns to End-of-Life Plan That Caused Stir

WASHINGTON — When a proposal to encourage end-of-life planning touched off a political storm over "death panels," Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.

In other words, the 2009 charge leveled by former Alaska Governor Sarah Palin and the then-House Minority Leader Boehner that Obama fully intended to set up what Palin termed government "death panels" — panels that Boehner said would set the government on the road to euthanasia — is no longer a charge.

It’s reality. By executive fiat — in this case a new Medicare rule issued by Obama Medicare chief Dr. Donald Berwick.

Palin, who made the charge on her Facebook page on August 7, 2009 during the health care debates, came under a fusillade of scornful and demeaning political attacks from political opponents after pointedly saying this about the prospect of death panels:

And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s "death panel" so his bureaucrats can decide, based on a subjective judgment of their "level of productivity in society," whether they are worthy of health care. Such a system is downright evil.

Her famous sharp criticism was enough for the plan to be quickly dropped by Congress.

Now, with Americans absorbed in a festive holiday and ignoring Washington momentarily, the Obama administration has found a way to achieve its death panel goal anyway, as the Times now admits. Says the paper of the new Christmas death panel regulation that replaces medical science and voluntary private judgment with the inevitable pressure of politicized health care :

Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill.

Which is another way of saying something else:

Governor Palin has been vindicated. Speaker Boehner has been vindicated.
And Palin’s critics in particular now have more than holiday eggnog all over their faces. Obama’s Dr. Berwick has re-ignited one of the most hotly controversial issues of the entire health care debate just as a conservative ascendancy prepares to take power in the next Congress. With no less than Boehner himself taking the gavel from Nancy Pelosi as the new Speaker of the House.

What does this new rule say and do, exactly?

It inserts the federal government in end-of-life planning, precisely as Palin said was Obama’s intention. Not, as was true of its original legislative formulation, every five years. But annually. No one of any sense objects to an individual and doctor having end-of-life discussions about living wills and such whenever they wish. Only the Obama administration and its obsession for control wants the government to incentivize the issue so that doctors must raise it annually, a system that on its face pressures the most deeply vulnerable of Americans in the most Orwellian of terms to end their lives.

Control and pressure. Pressure and control. This is the only two-step philosophical/political dance liberals know. It is, as it were, primal. And the Berwick Medicare rule, constructed in secret and released on Christmas Day when it no one is looking, is a perfect example — if hardly the only example — of how the Obama Administration views its role. Control and pressure. Pressure… and control.

Versus the conservative concept (shorthand version) of liberty and freedom.

Says the Times of the Obama Administration’s justification for its secretive move to mandate death panels by regulatory fiat:

In this case, the administration said research had shown the value of end-of-life planning.

Research? What research could possibly justify a government-sponsored annual attempt to pressure a poor, disabled, or elderly American into believing that they would be better off dead because they’re costing society too much money?

British research. Says the Times:

"Advance care planning improves end-of-life care and patient and family satisfaction and reduces stress, anxiety and depression in surviving relatives," the administration said in the preamble to the Medicare regulation, quoting research published this year in the British Medical Journal."

You read that right.

British research is being cited in the preamble of this Medicare death panel rule as a justification for the new rule — a stunning turn of events that will surely launch a firestorm over trying to remodel the American health care system after the hotly criticized British health care system. A system that makes no pretense of politically rationed health care.

Part of the furor launched over Palin’s remarks was the discovery by millions of frightened Americans that Obama health care bureaucrats admired the British health care system — where the government in fact rations health care on a political basis and decides who should live or die based on what is called the "QALY" — Quality-Adjusted Life Year. This has been discussed previously in this space — in fact just over a week before Governor Palin wrote her Facebook statement. It has also been discussed by health care consultant David Catron here where he explained how the QALY system worked.

In Catron’s words: "A year of perfect health, for example, is given a value of 1.0 while a year of sub-optimum health is rated between 0 and 1. If you are confined to a wheelchair, a year of your life might be valued at half that of your ambulatory neighbor. If you are blind or deaf, you also score low. All that remains is to assign a specific dollar value to the QALY and, voilà, your life has a price tag."

Princeton’s controversial Dr. Peter Singer, a liberal and big believer in the British health care system, happily related the British politicization of medical decisions in a New York Times Magazine article during all of this, an instance in which "Britain’s National Institute for Health and Clinical Excellence gave a preliminary recommendation that the National Health Service should not offer Sutent for advanced kidney cancer." Why? The government said it was too expensive and therefore simply denied the drug. This in turn led to a furious reaction even from stiff-upper-lip Brits with charges their government was "immoral" and willing to let patients die. Grudgingly, the drug was eventually approved. But not before one angry British woman, whose husband’s life was at stake, angrily asked: "What price is life?"
As this is written the Obama Food and Drug Administration is now taking Americans down this same path, rejecting the breast cancer drug Avastin with what many are citing as unbelievable science — but very believable political concerns that the drug is, in the bureaucrats’ view, too expensive. Thereby inserting the judgment of political bureaucrats for medical science — and the freedom of patients to order the drug. Here’s this from the Heartland Institute:

According to Sally Pipes, president of the Pacific Research Institute, the FDA’s decision is not based on the best outcome for patients but instead on the expense of Avastin, produced by Genentech, which can run as high as ,000 per year for a single patient.

The FDA claims its decision had nothing to do with Avastin’s cost and was based solely on the drug’s medical effectiveness," Pipes said. "This isn’t believable. Every year about 40,000 American women die from breast cancer. Avastin is the last hope for many not to meet that fate. While the drug is costly, it often provides immense benefits to patients.

Somewhere an American woman with breast cancer is surely saying the same thing as her British counterpart: "What price is life?"

Singer had an answer. Really. Said the famous Bioethics professor: "Life as a whole has no meaning. Life began, as the best available theories tell us, in a chance combination of gasses; it then evolved through random mutation and natural selection. All this just happened; it did not happen to any overall purpose."

Thus, since life really has no overall purpose, the government should be in the business of using Medicare to pressure the poor, the disabled and the elderly that — nudge, nudge — isn’t it time to bid the planet hasta la vista?

WHICH BRINGS US TO DR. DONALD BERWICK himself, the Obama administration’s Medicare recess-appointed head of the Center for Medicare and Medicaid Services. Dr. Berwick personally issued the Christmas Death Panel Rule, confirming in spades why he received a recess appointment from Obama. It was clear to Senate Democrats that Berwick’s chances of surviving a Senate confirmation battle were iffy at best. Why? Precisely because Berwick was well on record as expressing his deep admiration — make that lust — for the British government run system, saying: "I am romantic about the National Health Service; I love it. … The NHS is one of the astounding human endeavors of modern times."

So Obama waited until he could skip a Senate debate and vote entirely and just recess-appoint Berwick — who in turn is doing exactly what his record suggested he would do.

Sure enough, the philosophy used by the British is precisely what Berwick used to describe the new Berwick Rule. Reported the Times of Berwick:

"Using unwanted procedures in terminal illness is a form of assault," Dr. Berwick has said. "In economic terms, it is waste. Several techniques, including advance directives and involvement of patients and families in decision-making, have been shown to reduce inappropriate care at the end of life, leading to both lower cost and more humane care."

So.

What do we have here?

• The death panels were written into the original version of ObamaCare.

• Governor Palin, speaking out in her famous Facebook post, pulled back the shroud surrounding this horrifying idea. Less noticed at the time — but undoubtedly a headline grabber now — Minority Leader Boehner agreed, citing alarm over government sponsored euthanasia. Said Boehner:

Section 1233 of the House-drafted legislation encourages health care providers to provide their Medicare patients with counseling on "the use of artificially administered nutrition and hydration" and other end of life treatments, and may place seniors in situations where they feel pressured to sign end of life directives they would not otherwise sign. This provision may start us down a treacherous path toward government-encouraged euthanasia if enacted into law.

Obama protested he had no intention of "pulling the plug on Grandma" — but the idea, embodied in Section 1233 of the House version of the bill, was pulled from the final bill in part because of Palin’s — and Boehner’s — focused attention.

• Obama installs Dr. Donald Berwick to head the Medicare program as a recess appointment because Berwick’s controversial enthusiastic embrace of the British health care system and its death panel procedures would have prevented his confirmation.

• On Christmas day 2010, the Times reports the death panel idea will become a Medicare rule on January 1, 2011 — that would be four days from today. How? By fiat. As a government Medicare "rule" or "regulation" as put forth by the government agency now run by Dr. Berwick. The rule is justified because Berwick believes the government must "reduce inappropriate care at the end of life" A Berwick spokesman says the government should be saying to elderly patients, vulnerable patients, disabled patients — patients like Sarah Palin’s famous Down’s syndrome son: "When the time comes, do you want us to use technology to try and delay your death?" Nudge.

• Elizabeth D. Wickham, executive director of LifeTree, a pro-life educational organization, says of the new rule: "The infamous Section 1233 is still alive and kicking. Patients will lose the ability to control treatments at the end of life."

Oh yes. Did we mention no one was supposed to know about all of this?

Congressman Earl Blumenauer, the Oregon Democrat who wrote the original provision in the House version of ObamaCare that was unmasked by Sarah Palin, has put the word out to his allies. Says the Congressman’s office in an e-mail to his allies:

While we are very happy with the result, we won’t be shouting it from the rooftops because we aren’t out of the woods yet. This regulation could be modified or reversed, especially if Republican leaders try to use this small provision to perpetuate the "death panel" myth.

We would ask that you not broadcast this accomplishment out to any of your lists, even if they are "supporters" — e-mails can too easily be forwarded…Thus far, it seems that no press or blogs have discovered it, but we will be keeping a close watch and may be calling on you if we need a rapid, targeted response. The longer this goes unnoticed, the better our chances of keeping it.

No wonder Blumenauer wants to keep this quiet.

Did you catch that word "us" in the sentence from Dr. Berwick’s spokesperson?

Here’s the sentence again:

When the time comes, do you want us to use technology to try and delay your death?

The word "us" refers not to a doctor and his patient. It refers to the government..

When Obama health care adviser Dr. Ezekiel Emanuel was cited by longtime health care expert Betsy McCaughey as discussing the idea that patients with dementia should be denied treatment, Emanuel’s defenders (he is also the brother of ex-Obama White House chief of staff Rahm Emanuel) floated a Time magazine story saying Emanuel "only mentioned dementia in a discussion of theoretical approaches, not an endorsement of a particular policy." Oblivious to the fact that that no less than the President himself expressed a version of the same sentiment (as has Berwick) when he went on national television to answer a woman’s observation that at over a hundred her mother was very vital with a lot of spirit, and shouldn’t that be taken into account in any government health care decision? Said Obama: "I don’t think that we can make judgments based on peoples’ spirit. That would be a pretty subjective decision to be making. I think we have to have rules…."

Government rules. Like the rule just issued by Dr. Berwick.
A rule that effectively is now going to bully individuals — doubtless many of them poor, disabled or elderly. Ironically creating a system where you will only escape Obama’s government sponsored Big Chill if you are, say, a rich liberal.

In effect the administration is trying to bully Congress by making an end-run with a regulation because Congress said no to Section 1233.

The Heritage Foundation has accurately noted yesterday that, quite aside from the substance here — the new Berwick death panel rule or the FCC’s new net neutrality rules and so on — the real issue is the Obama administration’s clear intent to govern by executive fiat now that it has lost control of the House and, effectively, the Senate as well. Government-by-Obama fiat will be the subject of a furious struggle in the new Congress.

Says Heritage by way of focusing on a return to government by elected officials rather than a central government of rule-making un-elected bureaucrats:

"There is also the Congressional Review Act, which allows Congress to review and overrule regulations issued by government agencies."

Which is to say, the Berwick rule can be undone — if the Congress orders it undone.

This episode is a reminder that Governor Palin took a lot of heat for bringing attention to this issue. No one expects her critics — now proven wrong by Berwick — to give her any credit for being right. Or for that matter to the new Speaker Boehner.

But the fact remains that Palin has shown leadership here — one might call it presidential-style leadership — in persisting with an issue that is now coming back to bite the American people in the form of a new Medicare rule on death panels — reported of all days on Christmas day.

No wonder John Boehner will be Speaker of the House.

spectator.org/