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Bob McMillanAn Opinion

By Bob McMillan
Presidents v. The Supreme Court

The recent political chatter about “Obamacare” before the Supreme Court of the United States got a great deal of media attention.  President Obama added fuel to the fire when he declared, “Ultimately, I am confident the Supreme Court will not take what would be an unprecedented, extraordinary step of overturning a law that was passed by a strong majority of a democratically elected Congress.”

For someone who was a law professor those words were absurd.  Even if a bill passed unanimously in the house and senate, it could still be overturned – if the law was in violation of the Constitution.


Michael Miller

Viewpoint

By Michael Miller
Yellow Margarine And A Pitch For The Ages

In early 1946, a brouhaha erupted between the AFL and the CIO, the state’s rival federations of labor groups. Republican leaders in the state legislature endorsed the upstate-oriented AFL’s proposal that New York license and regulate barbers and cosmetologists. The downstate-oriented CIO, which had members who couldn’t document the required formal education, launched opposition so fierce and threatened political retaliation so severe that the legislation was considered dead. And then, as the 1946 session was drawing to a close and the CIO was concentrating on other things, the “barber and hairdresser bills” started moving through both houses, with almost total Republican support and Democratic opposition. Member of Assembly Genesta Strong, first-termer from Nassau County, dependable, safe and already expected to step aside, was asked to be the official sponsor of the cosmetologist licensing bill.

Governor Dewey’s signing of the bill cemented support for his re-election from the powerful AFL, which had been the whole point. To those in political inner circles, Mrs. Strong had proved herself a reliable team player whose dignity was useful in deflecting potential attack.


Mike BarryEye on the Island

By Mike Barry
Sustainable LI: Getting Good Things Done

Farmingdale-based Sustainable Long Island is hosting its eighth annual Sustainability Conference on Friday, April 4, at Carlyle on the Green, at Bethpage State Park.

The event will run from 8 a.m. to 2 p.m., and traditionally draws hundreds of people from all walks of life: government, business and not-for-profits. This year’s theme is “Accomplishing More Together.” Tickets are $75 per person, which includes the cost of lunch.


End of Life Care

With all the debate over “Obamacare,” Medicare, the economics of healthcare and taxes, take a look with me at some of the issues, which will become front and center over the next five years.

First, examine some of the statistics with me. In the United States – Medicare and private insurance spend some $60 billion each year on hospital bills during the last two months of a dying patient’s life! For example, one day in an intensive care hospital bed costs around $10,000.

The challenge we face is that some of the medical procedures used in the end of life care may very well have no meaningful impact on the life of dying patients. At the same time, some modern day medical treatments do prolong life. Some people are now asking whether prolonging life is too expensive. And that turns into both a moral and economic question, just like whether every American is entitled to health insurance.

With the costs for medical treatment skyrocketing – healthcare expenditures are four times the size of the Department of Defense’s yearly budget. Last year healthcare expenditures in the United States were some $2.6 trillion. All of this reminds me of a comment made by the head of a Florida hospital a few months ago. The hospital administrator was in England and reviewing hospital administration there compared to the United States. As the tour of the English hospital was underway, they came to the intensive care unit. There were only 12 beds. The Florida administrator asked “Why, when you have twice as many regular beds as my hospital, do you have only 12 beds in intensive care?” The English administrator said, “Death is an option.”

With Medicare in deep financial difficulty, and the Administration looking for ways to trim Medicare spending, is “death an option” in the United States?

All of this leads to one area where the new healthcare law is gaining more scrutiny. That is the Payment Advisory Board. There is growing medical opposition to that board, because doctors feel medical decisions should be left to doctors and their patients. Doctors are concerned that government bureaucrats will determine a general standard of care when doctors feel each patient should be dealt with individually.

In the final analysis, as I said before, this all boils down to a moral vs. economic debate. We cannot stop caring for people as they begin to die; yet, the sums of money being spent on end of life care are growing to staggering amounts. Is there any moral middle ground between “dying is an option” and spending is growing out of sight?

Whatever happens in June when the Supreme Court decides Obamacare, we have not heard the end to the issues discussed in this piece. And as more of the nation ages and more spending is at the end of life, the debate could become very fierce.