A Problem with non-FDA Approved Lab Developed Tests Under the Federal Government

Here is a link to an update on the DoD Lab Developed Test Demonstration (LDT) Project written by syndicated columnist Tom Philpott.

http://www.military.com/benefits/2014/02/06/dha-ops-chief-vows-relief-from-surprise-lab-fees.html

I first blogged about this demonstration project back when it was initiated in 2012.  As an occasional pundit of government waste, I was and maintain a troubled opinion that an entity working under the umbrella of the federal government would utilize regulatory red tape to guide healthcare policy decision making that would seek to limit patient access to likely proven medical care that could save lives.  If other federally run health plan programs such as Medicare and Medicaid and other health plans operating under the FEHB program ALREADY utilize LDTs that are not FDA approved and these tests are found NOT to be unsafe while possibly saving lives, then I struggle to relate to how in good conscience, TRICARE can use bureaucratic red tape under the guise of a timely and costly demonstration project to try and prove their appropriateness for use in practice.

Rather than force patients to wait for the outcome of its DoD study (potentially wasting precious time needed to get an early jump on a diagnosis) at the very least, TRICARE should seek to utilize already existing healthcare utilization data analytics derived from CMS and other data warehouses to do a case control look back as to the effectiveness of any LDTs in question.  There is likely a whole repository of experience under CMS using LDT’s.

Why force current TRICARE beneficiaries to do without are deemed standard of care tests unnecessarily?  I am glad to see that the issue of the direct care aka Military Treatment Facility (MTF) managed sector having the ability to use its own operation and management funds to pay for LDTs is being examined.  In the end though, if federal tax dollars are still being used to cover the cost of LDTs is on the MTF side or the purchased care side, then is it really a matter of FDA approval and effectiveness or is it just really a matter of where DoD MHS dollars are being spent?  The whole problem is borne from bureaucratic red tape entanglements.  So to a patient who needs the test to survive, it is easy to see the frustration of bureaucratic red tape getting in the way of good medicine.

It is time that congressional lawmakers get involved and set some legislative requirements to streamline data sharing for health programs and plans that operate under its jurisdiction using federal tax dollars.  A good place to start would be to recognize regulatory inconsistencies under ALL federal law, such as the use of LDT’s not yet cleared by the FDA and to begin requiring department and agency heads to work together to eliminate legislative barriers that do the public harm.

While congress is at it – (God willing) some additional  regulatory alignment type house work certainly be done with respect to who under TRICARE can prescribe Durable Medical Equipment and how much physical, occupational, and speech therapy is actually medically necessary.  That and ABA Therapy are huge expenditures that would appear to be requiring reigning in.  The courts have not done TRICARE any favors in that regard and DHA to its credit is trying to work out a practical solution.  I sure would hope to see capitated benefit limits on utilization of those services as in the private sector.  But all of that is a blog post for another day.  Hopefully they can get LDTs on track for less nonsensical management under federal control.

Patient Protection and Affordable Care Act and Morals

October 1, 2013 came and went as the first day open enrollment began for the Patient Protection and Affordable Care Act, or more commonly known as Obamacare.  Problems with accessing the enrollment website at http://www.healthcare.gov have been widely reported and commented by pundits pro and con.

I read today that the health insurance industry giants have partnered up (yet again) to offer aid to the embattled Obama administration to see if they can lend their expertise in getting the http://www.healthcare.gov website off the ground as bipartisan calls are starting to be made to hold senior government leaders accountable to the debacle.  Besides power lusting progressive politicians, the health insurance industry stands to lose the most with the government’s prolonged inability to corral the “sheeple” into its health insurance holding pen.

Mine is a moral and ethical objection that an industry(in this case mine) has partnered with the government to enact a tax penalty against all citizens simply for being alive and not wanting to purchase health insurance.  Who could have ever imagined that America would ever see a tax on the living imposed on its people?  The government does not care if there are segments of citizens who opt to live healthy and practice wellness in their daily living outside the prevailing healthcare system – making a conscience decision to not purchase something that they do not want nor need.  Instead, masking as a parent, it coerces them to buy something that they otherwise might not want to buy simply because the it has the might of the IRS to enforce penalties.  Might is not always right.  Countless polls show vast numbers of Americans (tens if not hundreds of millions) do not want this healthcare mandate to purchase insurance.  While the PPACA may be the law of the land, ushered in by a political party majority that obtained power via elections, it still does not make it a just law – even if the Supreme Court upheld it as some bullshit taxing power interpretation.

From Chief John Robert’s Ruling:.

“The Affordable Care Act is constitutional in part and unconstitutional in part. The individual mandate cannot be upheld as an exercise of Congress’s power under the Commerce Clause. That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage in it. In this case, however, it is reasonable to con­strue what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without health insurance. Such legislation is within Con­gress’s power to tax.”

“The Framers created a Federal Government of limited powers, and assigned to this Court the duty of enforcing those limits. The Court does so today. But the Court does not express any opinion on the wisdom of the Affordable Care Act. Under the Constitution, that judgment is reserved to the people.”

Mr. Chief Justice, let my judgement be known that I deny my consent to this government requirement/tax shakedown on the grounds that it is morally and ethically wrong to coerce a person to purchase something simply because they are alive, regardless of their income or wealth status or lack thereof.

Daily Press Editorial Staff Knows Truth About Our Unhealthy Dependence on Government

The message is clear and many citizens have known this problem for years. So now what do we do? http://www.dailypress.com/news/opinion/dp-edt-spending-editorial-20120708,0,2415744.story

What is the Answer to the Question: “Now What?” (to Do About Government?)

An acquaintance of mine here in Yorktown, VA emailed me this morning. He simply writes: “Robert, I just re-read your letter……you have it right……now what?”  GG

GG is a highly successful businessman in real estate who has been working hard to revamp our local Republican Committee for the last several years.  Back in early April of this year, I sent the below email to our local Board of Supervisors and cc’d the “who’s who of conservatives” here in York County, VA. It was a reply to GG having emailed us about a tragic story of property rights being violated by a local government in GA to the point that the property owner took his own life (see below).

So GG left me thinking, “Now what?”   If you are reading this, do you have any ideas?  If you do, please post them here to share with me and any other readers.

Thanks,
Robert E. Lehman                                                                                              #WakeUpAmerica!

Subject: RE: What county does this sound like? You will be shocked to read this !!
Date: Thu, 5 Apr 2012 08:46:39 -0400

From the below linked article http://lfb.org/today/death-by-regulation/ :

“The political class is not really running things. As I’ve written many times, the political class is only the veneer of the state; it is not the state itself. The state is the permanent bureaucratic structures, those untouched by elections. These institutions make up the real ruling apparatus of government.”

I have no doubt that every individual who works for York County government as either an elected official or as a paid employee is just as much in support of the Constitution and individual liberty as most ordinary people.  They want to live their lives the way they want as free citizens of these here United States.

But what often goes unnoticed by most people is that despite these individuals who work for the county government being in favor of limited government, as direct workers for the government, they can’t help, no matter how hard they try to not grow the government bureaucracy , to do the exact opposite.

The government at any form at any level is a cancer to freedom.  It naturally grows even without conscious awareness on the part of those otherwise good people who work for it who think themselves to be in fact a proponent of limited government.  The mere act of participating in a political party and/or serving as an employee for government leads to MORE government and LESS freedom.  Why is this?  After all, isn’t York County composed of a majority of so-call limited government conservatives?

Why is York County government more of a citizen burden than it has ever been before and inserting itself more and more into the private lives and encroaching on violating the freedoms of its citizens? Because that is what government is supposed to do by its very nature – even when we think we are electing conservatives to keep it limited.
Here is the county BOS mission from its website:

As stewards of the public trust and resources, the Board of Supervisors will maintain and improve the quality of life for all County citizens.

The Board will:

• emphasize efficiency, effectiveness, and openness of County government
• protect the physical, historical, and environmental heritage of the County
• ensure that growth and development are positive forces on the quality of life
  
• value and respect the individual

(emphasis added)

I have to laugh, as how are they to even truly know how they can improve the quality of life for anybody other than themselves as individuals?  Even with their good intentions, they trample the individual, despite the last bullet.  The last bullet is complete hogwash when coming from any government.  Government by its natural definition is anathema to the individual’s rights.

When good liberty minded, limited-government people get involved in running the government, the government still grows, because those good natured people mean well and through their good deeds as servers to the “cause of government” that is the mission above, get sucked into the black hole leviathan that is liberty killing government bureaucracy.

Yes, you read it right.  The otherwise good and caring people who run York County government are conscientious and hard working and successful.  They do not fail.  So naturally, they become good at running government. After all, working to support government is how most of them make their living and support their families. They need to do a good job to keep earning their paychecks.  But make no mistake, no matter what they try to do to prevent it, the government will grow.  Nothing they do to try not to grow it will work.  They are powerless to stop it.

Only the citizens who support the government through their hard earned tax dollars and by their voting for elected members of the governing board can stop the growth of government.  The only tool the citizens have between their freedom and the heavy hand of government is its elected board members.  For the BOS members to be successful at keeping government growth at bay, they MUST dig deeper and look past the administrator or attorney and other appointed leaders of the government staff to see the waste and to truly see the initiatives that lead to less citizen freedom and that add to citizen burdens.  BOS members cannot rely solely on senior administrative staff for the real picture.  After all, they administrative leaders of county government are working to save their jobs.  Does it make sense that any of them will commit harakiri with respect to their careers?  No, of course they wouldn’t!

Government, no matter how well intentioned its conservative leaders are is a cancer to freedom.   If you have read Atlas Shrugged or Animal Farm, you can appreciate the  very natural tendency that government has to take otherwise good people who work for it and almost hypnotize them into having to do whatever it takes to grow it.  It is a very real system that has the structure of a self-reinforcing feedback loop that inevitably leads to MORE government and LESS freedom.

When permitted to run unabated, you get the tragedy of Death by Regulation and the sad story Andrew Wordes of Roswell, GA.  Ladies and gentlemen of York County, VA:  do no think that we are immune to the ills of uncontrolled big government.  It is happening to us now and many people are blind to it.  Use this sad story as a lesson.  What will be your role in York County’s history?

Respectfully Yours,

Robert E. Lehman
Yorktown, VA

From: GG
Date: Wed, 4 Apr 2012 22:37:22 -0400
Subject: What county does this sound like? You will be shocked to read this !!
To: list

I am sending you this because you are on my short list as a local patriot….

If you have 4 minutes, you will want to cry about this story…

If you do, please let me know which County this reminds you of and where you think this type of tyranny could exist? …………………we have to decide if WE are going to allow it to get to this level here !!!

A tragic story resulting from bureaucratic bullying.
http://lfb.org/today/death-by-regulation/

GG

Land of the Free and Home of the Brave

As we celebrate another Memorial Day weekend, let’s give pause to pay homage to the brave men and women who paid the ultimate price to secure our freedoms.  There was a time long ago when the government of the United States of America respected the natural rights of man to be free.  As a result of the American Revolutionary War that saw great sacrifice, bloodshed, and loss of life, our nation was established on the principles of limited government.  It was recognized and respected that the people are endowed with certain unalienable rights and the government is given its limited authority from the people through very specific and enumerated powers as charted in our Constitution.

Fast forward to today.  The world is a much smaller, more connected, and very different place from what it was in the late 18th century when our country was founded and the Constitution was enacted.  Despite the changes in international relations and the technological advances that have advanced human civilization, the natural rights of man remain a timeless philosophy backed by the principles of liberty.  These concepts serve as the bulwark of our society of freedom loving people.  The rights and the laws that protect them should not be tampered with, regardless of geopolitical current events.

Recent congressional votes from 1st District Republican representative Rob Wittman can only lead to the conclusion that he no longer believes that the USA is the land of the free and the home of the brave.  How else can he explain his “yea” vote on the NDAA with its American citizen terror suspect detention authority given to the military as directed by the President?  How else can Wittman explain his “nay” vote that would have amended that provision just 2 weeks ago to remove the unconstitutional power of the military to detain American citizens without due process?  It was reported that he thought long and hard about his “nay” vote on the Smith-Amash amendment but decided it was more important to violate the constitution in the name of safety so as to assure that terror suspects would not have more rights on our soil than U.S. military service members under the United Stated Code of Military Justice.

Being afraid to uphold and defend the constitution as per the once revered congressional oath of office now seems to be a prerequisite to serve as a member in congress.  With all of the “protection” and “security”  federal laws already on the books (TSA full body pat downs and searches at airports, NSA wire tapping under FISA, and Real ID to just list a few), American people have a better chance of winning the jackpot lotto, drowning in their bath tub, or getting struck by lightening than they do getting harmed or killed by a terrorist here in the United States.

Wittman’s and congress’s spineless and gutless approach to securing our liberty through the destruction of the 4th Amendment to our Constitution is yet another sad and disrespectful way to memorialize the Patriots who fought for our freedoms and founded our nation.  Ironically, liberally appointed Federal district Judge Katherine B. Forrest issued a preliminary injunction barring such detentions of American citizens on the ground that the law is unconstitutional. Unlike the supposedly constitutionally conservative Wittman, perhaps she appreciates the warnings that founder Benjamin Franklin alluded to when he opined that those who sacrifice liberty in pursuit of security are deserving of neither.  Wittman fails to realize that we will have to pay hell to regain our freedoms that he just voted away.  Home of the brave…yeah, right….apparently not any more when it comes to our Congress.  Try and feel proud about your Memorial Day tomorrow.

Legal Argument: Use of Case Law or Refer to the Constitution as Supreme Law of Land in Analysis of ACA

Here is an amazingly thought provoking argument against the Affordable Healthcare Act that uses the Constitution and not established Commerce Clause case law as its underpinning.  Several blog posts ago, I wrote that I wondered how much of my rights were left due to erosion from bad court decisions serving as precedent such as Wickard v. Filburn or Gonzales v. Raich before I actually became a full fledged ward of the state. In my amateur judicial mind, new case law appeared to just keep being based and built upon errant case law that was centered on politically expedient court decisions rather than constitutional interpretation.  If every new or subsequent challenge of unconstitutional law was brought before the court and weighed by the court only against established case law that was – to be frank, a bad opinion, then I postulated that our freedoms are quite doomed.  Supreme Court case law of the early to mid 20th century is not exactly a bulwark of pro-Constitutional rulings.  Fortunately, true legal scholars and professionals who understand the Constitution thought the same thing and banded together to write this argument as to why the Affordable Healthcare Act is unconstitutional. These friends of the court include one of my favorite organizations that support Liberty, The Downsize DC Foundation and DownsSizeDC.org

Amicus Curiae – DEPT. OF HEALTH AND HUMAN SERVICES, ET AL., Petitioners, v. STATE OF FLORIDA ET AL., Respondents.

The analysis in this amicus urges the Supreme Court Justices to discard the bad habit of relying on Commerce Clause case law since much of the key decisions were from a politically packed court during FDR’s administration.  Instead, the respondents urge the court to look at the health mandate with a fresh new perspective, going back to the actual textual law that is the Constitution – The Supreme Law of the Land.  It really is an argument to behold with awe and great appreciation.  Hopefully a majority of the court will see the wisdom in this argument and overturn the low courts upholding of this constitutional abomination.  The Congress does not have free rein to do what it wants under the Commerce Clause.

Former Ronald Reagan solicitor general Charles Fried, now a Harvard Law Professor, thinks the opposite and that the current Supreme Court led by Chief Justice John Roberts should follow the bad precedent set by previous Supreme Courts and not overturn the ACA law as unconstitutional. “It would be plainly at odds with precedent, and plainly in conflict with what several of the justices have said before.” Here is a link to this opinion of the former conservative lawyer who served under Ronald Reagan.

It would be my hope that a fresh check against the text of the Constitution take place.  I don’t understand exactly what Fried is worried about if today’s court makes its own assessment of the Constitutionality of the law.  What is exactly is wrong if this court abandons the poorly thought out decisions from its predecessors?  Are not mistakes permitted to be corrected?

Obama Care Gets its Day in Court and a Few Other Things on My Mind

My writing has slowed quite dramatically this past month or so.  It seems that not much is really happening that inspires me to write.  I mean, how much can any body rail against socialism and big government before it becomes redundant? So what else is there to write?

Things taking place now for which I am paying attention none the less are:

• Supreme Court hearing the constitutionality of Obama Care.  Hopefully they will find limits to the government’s powers with respect to the commerce clause.  Once they find it legal to compel an individual to have to purchase something from a private entity, then I am sure our constitutional republic is dead.  Charles Krauthammer’s recent article call Obama Care: The Reckoning has me so very optimistic.
• The stock market and its pointless fluttering day in and day out.  Maybe the above will cause it to do something – anything to give an indication of where this economy is headed.  I still harbor convictions that holding gold and silver are necessary to not falling prey to the federal reserves  monetary policy.
• The reconstitution of the York County Republican Committee here in Virginia.  I have left the committee in protest the last 2 bienniums as a result of the committee refusing to admonish the big government embracing on the part of supposed limited government members of the party (see https://livinghereinamerica.wordpress.com/2012/02/02/the-necessary-evil-of-local-gop-party-politics-to-engage-or-not-to-engage/ )  The Committee has a pro-Ron Paul supporter who is running for the chairmanship and there a numerous pro-Constitutional and Ron Paul supporters looking to make the party more conservative in terms of limited government than the other times I participated.
• The remaining period of free agency in the NFL
• The NCAA final four
• The NFL Draft

So as the above plays out, I lay low.  I get up, go to work, come home, enjoy some rest and relaxation with my family and do it again…wondering how long all of it is going to last.

Sovereign Citizens, the Watchful Eye of the FBI, and the Founding Fathers

Recent news accounts like this of the FBI’s announcement that it has concerns with people who claim themselves to be Sovereign Citizens evokes thoughts of our country’s founding.  The patriots who were associated with country’s founding fathers had to consider the threat of apprehension by the authorities when they were contemplating whether or not to break free from the rule of King George and Great Britain.  It is no small thing to break free from an established government.  That is why the American Revolution was so historic in the annals of human history.

Sovereign Citizens have taken a different interpretation of current prevailing viewpoints of what it means to be an American and living in the United States. In essence, they seem to want to separate themselves from the current laws of the land and live by a different set of rules from the mainstream citizens.  They appear to describe the current laws as illegitimate when pitted against the rights American are described as having as written in the Constitution.  In the video that runs on their website, the woman makes a reference to the USA as a corporation to which the Sovereign Citizens do not want to participate.  I have come across other references about this Corporation over the years and have been interested in learning more about it but then abandoning the issue altogether due to time constraints and thoughts about what does it really matter any way?  Maybe the Sovereign Citizens just had more time and interest in seeing what it is all about.  I am not sure.

Today in the year 2012, the vast majority of citizens are law abiding taxpayers of which many have serious concerns and objections about how our elected / appointed representatives are managing our national, state, and local governments.  It would be members of this segment of American society who organized the Tea Party and /or might be active in the Libertarian political party.  Many people who follow the current rules of the  electoral and political system have expended a good many years of their lives and personal resources to try and get more Constitutionally compliant leaders into government at all levels.

Anybody who has followed American political events over the past 70 years knows that the Republicans and Democrats backed by highly financed special interest groups have claimed wins in most if not all major political campaigns for public office.  It would be very frustrating for any normal person to begin to think that there has to be a better way to push back the problem of the wrong people being elected to run the government because they have what appears to be an inappropriate ability to wield greater influence than a majority of most individual citizens in the election.

Maybe that is what led to this group that calls themselves Sovereign Citizens.  When I think of them and why they do what they do, there is a part of me that can sort of relate and understand and maybe even agree with the rationale as to why they would want to “not play by the rules” of the prevailing form of government.

Let me be clear, I do not condone violence and aggression against other people including the lawful authorities.  That noted, for purposes of trying to understand their behavior and actions so as to learn and maybe improve the situation that is causing the FBI to escalate their surveillance of this group, perhaps Sovereign Citizens simply have more courage to push back and defend themselves from the government in a fashion that based on their political beliefs, can lead to what looks like violence and aggression against the State.

Obviously there is a stigma that mainstream society attaches to people who are members of such fringe groups.  But I get a sense that the fringe is growing.  Maybe the Sovereign Citizens are just an early version, a way-out in-front organized group ahead of the game.  Sooner or later it seems inevitable that more and more supposedly Free People who have become frustrated with their government run amok would form in this coalesced fashion if unable to realize the changes they see as being needed to save their way of life because of a corrupted and unconstitutional electoral and political system and government.

What I wrote above does not seem to differ much with what Thomas Jefferson and the Founders had to wrestle with when they decided to break free from Great Britain.  On the outset of the Revolutionary War, they wrote and affirmed with sacred honor the Declaration of Independence.  The words below from that historic document tied to our country’s founding seem to mimic in some part at least, to what might be compelling the Sovereign Citizens to opt out of the current rule of law.

Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.

Framed in this light, are the Sovereign Citizens really that bad or just that misunderstood by the current authorities?

Daily Press Editorial Staff Continues to Impress

Make it two consecutive days that the Daily Press editorial team has impressed me.  Yesterday they wrote of the recent failure on the part of the GOP.  (See immediate preceding blog post).

Today, they share their criticism of the York County Board of Supervisors / administrator for announcing a real estate tax hike on already financially reeling citizen tax payers.  I could not agree more with their admonishment.

Digby Solomon the publisher and Rebeeca Troyer the Editor of the editorial page both deserve credit and positive acknowledgement for their willingness to provide relevant and provoking commentary that is so unlike the majority of mainstream media outlets.

The societal struggles we currently face are doomed to perpetuate unless leaders of our communities are willing to boldly face the brutal facts of our current situation and bring light to the problems  when they need to be aired.  What Mr. Solomon and Ms. Troyer are doing with their editorials the last two days is nothing short of heroic leadership for their community.  I hope they continue to be a leading voice of reason as it will spark the debates needed to advance the solutions.

Here is their opinion today.  http://www.dailypress.com/news/opinion/dp-edt-yorkbudget-editorial-20120222,0,1773062.story

Daily Press Editorial: RIP, GOP Republican Party….

…needs to come to its senses; right now it’s circling the drain

http://www.dailypress.com/news/opinion/dp-edt-ripgop-editorial-20120221,0,7473479.story

How refreshing to see a major media source that shares my very Libertarian like opinion.  Before too long, I wouldn’t be surprised to see them giving Ron Paul more attention.