Key Obamacare questions were never asked

Like ‘How is this going to work when it gets implemented?’

In the crush of media coverage of the politics of the government shutdown, and political jockeying in government itself, a bit of common sense stands out.

Like this little snip about CNN’s Wolf Blitzer saying maybe we could benefit from a little delay on Obamacare. First, CNN correspondent Brian Todd reported on the problems with the healthcare law rollout:

“We’re also hearing now that the administration was warned about these potential problems months in advance,” Todd continued. “We spoke to a health care consultant who has clients who are insurers. He says his insurers, who dealt with the administration in the months ahead of time, had contentious meetings with people at [Health and Human Services] and other health care officials who were in charge of this, warning them, ‘This isn’t working, it’s not going to be smooth, don’t do it.’ He says those warnings were ignored, they went full speed ahead, and said we’ll work these problems out. There’s been a bit of pushback from the White House, we’ll hope to get more later from them.”

Right now, that’s just protocol for network correspondents to say, because they know they’re not going to get more from them later.

Here’s Slate with a little more specificity about what the pre-launch warnings were likely about. I can’t remember right now where I read it, but one techie was quoted in a news story a few days ago as saying that using two different contractors to build the “front end” and “back end” of the site is sort of like trying to build a bridge by starting on opposite shorelines and trying/hoping to meet in the middle:

“So we had (at least) two sets of contracted developers, apparently in isolation from each other, working on two pieces of a system that had to run together perfectly. Anyone in software engineering will tell you that cross-group coordination is one of the hardest things to get right, and also one of the most crucial, because while programmers are great at testing their own code, testing that their code works with everybody else’s code is much more difficult.

“Look at it another way: Even if scale testing is done, that involves seeing what happens when a site is overrun. The poor, confusing error handling indicates that there was no ownership of the end-to-end experience—no one tasked with making sure everything worked together and at full capacity, not just in isolated tests. (I can’t even figure out who was supposed to own it.) No end-to-end ownership means that questions like “What is the user experience if the back-end gets overloaded or has such-and-such an error?” are never asked, because they cannot be answered by either group in isolation.”

This is a good, grabbable, concise message. So is‘s conclusion.

Blitzer’s offhand endorsement of a one-year delay is an intriguing bit of anecdotal evidence that Glitchapalooza might be nudging public opinion towards supporting a postponement of the law for a few months or a year while the bugs are worked out. But then that raises the question — why isn’t “delay” the GOP’s core message right now? Boehner’s holding one or two press conferences a day to complain that Obama won’t talk to him when he should be using that free media to hammer the point that O-Care isn’t ready for primetime. Frankly, unless I missed it, this has been a minor point from Ted Cruz and Mike Lee lately too. Whenever I’ve seen them on the news the past few days, they’re more likely to be talking about using small funding bills to restart parts of the government than the many, many catastrophic technical problems with the exchanges.

This all needs attention. Because while everyone is on talking points, the right questions aren’t being asked, answered, covered, or explained to the American public.

As Ed Morrissey so well points out here.

Dear Department of Health and Human Services

You are wielding unchecked power, and you are out of control. Please pay heed.

A couple of months ago, HHS announced a new “preventive care” package of services for women to be included in insurance coverage that defied reason and morals. It drew plenty of outcries for review and oversight. HHS left open a window of time for “public comment” that closed at midnight September 30th.

In the waning hours of that alleged openness to reaction by American citizens and organizations and institutions, more and more voices have come out criticizing that federal department’s decision to require most health insurers to cover contraceptives, the morning-after pill, and elective sterilization.

The US Bishops Conference has been on this major campaign of awareness and initiative of engaging Congress for some months, since word got out that HHS was even considering such a move. It caught on, across the country.

How open will HHS be to the public input they got? Two thoughts…

The first is how inconsiderate they were to a broad spectrum of opinion when devising this plan to begin with. HHS did not consult the nation’s largest provider of healthcare services, which is Catholic hospitals and medical centers and institutions. The narrow group they convened foretold the conclusion.

The medical committee behind the federal government’s impending mandate that insurers cover birth control without co-pay is populated by board members of NARAL and Planned Parenthood, as well as major donors to politicians favoring legal abortion.

The pro-life organization HLI America says public records show the ideological roots of the Institute of Medicine (IOM) committee, which recommended virtually all private health insurers pay for FDA-approved contraception as essential “preventive care” under the new health care law, including drugs that can cause early abortions.

IOM, a non-governmental organization tapped by federal health officials to recommend the new guidelines, describes itself on its website as “provid[ing] unbiased and authoritative advice to decision makers.”

That flies in the face of truth. Here’s the breakdown:

Among the 15-member IOM Committee on Preventive Services for Women are Claire Brindis, a member of the board of directors of the NARAL Pro-Choice America Foundation; Angela Diaz, former board member of Physicians for Reproductive Choice and Health; Paula A. Johnson, Chairwoman of the Planned Parenthood League of Massachusetts and upcoming recipient of NARAL’s 2011 “Champion for Choice” award; Magda G. Peck, the former board chairwoman of Planned Parenthood of Nebraska and Council Bluffs; and Alina Salganicoff, Vice President and DIrector of Women’s Health Policy at the Kaiser Family Foundation, which strongly favors abortion and contraception on demand.

In fact…

Dr. Anthony Lo Sasso, the lone member of the IOM committee dissenting from the report, concurred that the findings were tainted by advocacy goals.

“Troublingly, the process tended to result in a mix of objective and subjective determinations filtered through a lens of advocacy,” he wrote. “An abiding principle in the evaluation of the evidence and the recommendations put forth as a consequence should be transparency and strict objectivity, but the committee failed to demonstrate these principles in the report.”

This is the time to right that. Which brings up the second thought:

We have ample evidence of the body and weight of public comment HHS received in the final days last week. And it’s not going to stop becoming public.

There’s a large alliance of professional organizations who issued this. Bottom line: the mandate violates the US Constitution, among other things.

The National Catholic Bioethics Center issued this letter to HHS Secretary Kathleen Sebelius. It is exhaustively detailed, but gets to the same bottom line. The mandate is unconstitutional.

In summary, treating pregnancy as a disease that should be prevented is medically, socially, and anthropologically inaccurate and sexually biased. By treating pregnancy as a disease to be prevented one can only conclude that the treatment for such a “disease” is an abortion. Thus, the Rule is acting against the very provision in the PPACA and its legislative history, that state that abortion is not one of the “preventive services” to be included in the “services” provided. Yet the Rule clearly mandates coverage at no cost for contraceptives and sterilizations to prevent the “disease” of pregnancy, genetic screening of existing pregnancies whose ”treatment” will for some include abortion, and abortifacients which cause the termination of the newly conceived human being. These and other contraceptives are presented inaccurately as a deterrent to unplanned pregnancies, when the very data presented by the IOM to support such claims belie these claims. Empowering women to know and act with their bodies to manage their fertility in a responsible manner is the real answer to the physiological, social, and psychological problems created by a culture encouraging women to engage in unhealthy life styles. Then, forcing others to participate in and to pay for the life style choices of others, which clearly and demonstrably have been detrimental, is the utmost violation of the United States Constitution.

In the waning hours of “public comment”, Notre Dame joined the swelling chorus of voices.

President Father John Jenkins, C.S.C., wrote in a Sept. 28 letter to HHS Secretary Kathleen Sebelius that the mandate places the school in the “impossible position” of having to defy Church teaching…

The mandate “would compel Notre Dame to either pay for contraception and sterilization in violation of the church’s moral teaching, or to discontinue our employee and student health care plans in violation of the church’s social teaching,” Fr. Jenkins said.

Notre Dame joins 18 other Catholic universities and colleges, as well as the U.S. bishops and numerous other Catholic organizations that have reacted strongly against the proposition.

Like the Catholic University of America.

If we comply, as the law requires, we will be helping our students do things that we teach them, in our classes and in our sacraments, are sinful — sometimes gravely so. It seems to us that a proper respect for religious liberty would warrant an exemption for our university and other institutions like it…

It does not take a college education to see the hypocrisy in offering to pay for the very services we condemn in our theology classes and seek forgiveness for in our sacraments. It should not be the business of the federal government to force Catholic schools and other Catholic institutions into such a collective violation of our own conscientious beliefs.

The list goes on. Countless individuals wrote HHS. Like nurse Nancy Valko, a noted bioethics expert and human rights activist.

I have been an RN for 42 years and I currently work in an intensive care unit in St. Louis, Mo. I must protest the current mandate regarding women’s health and conscience rights. Conscience rights serve not only a bulwark against workplace discrimination and harassment for us health care providers but also as a protection for our patients. When we cannot refuse to participate in or even discuss practices we deem unethical, we also deprive our patients of informed choices based on comprehensive information. When health care providers become mere technicians of government mandates, we cease to be ethically grounded professionals dedicated to the welfare of our patients. Right now, the topic is abortion and contraception but the dismantling of conscience rights will inevitably extend to other areas such as assisted suicide and euthanasia. This leaves our patients vulnerable to coercion, manipulation and even death in an ever-changing health care system. I implore you to rethink this mandate.

So now what? HHS can close their window and tune out or reconsider. But the real public comment is only growing, and they cannot control that.

What’s wrong with HHS birth control mandates?

Let’s count the ways…

So why is the federal deparment charged with the health and human services of its citizens suddenly requiring a massive implementation of an ideologically based scheme to cover birth control, sterilization and morning-after pills at great cost to insurers and taxpayers, and at a time when the federal government is in a budget crisis already?

To say this makes no sense is to state the obvious.

Go back for a moment to that AP report on the HHS announcement in the post below. The one that refers to this as a “broad expansion of coverage for women’s preventive care under President Barack Obama’s health care law.” Let’s parse this, according to the story as it originally appeared, because it’s gone through so many revisions and renditions, it no longer says the same thing at that same link.

Here’s what the AP said Monday:

Indeed, a government study last summer found that birth control use is virtually universal in the United States, according to a government study issued last summer. More than 90 million prescriptions for contraceptives were dispensed in 2009…Generic versions of the pill are available for as little as $9 a month. Still, about half of all pregnancies are unplanned. Many are among women using some form of contraception, and forgetting to take the pill is a major reason.

So. It’s not a matter of availability. And there’s no need for the government to provide this form of active population control under the guise of ‘women’s health preventive services’ or some variation therof. Why does the government see a need to provide what’s already available cheaply or freely, and allegedly being used by the vast majority of women? Which, important to note, is not preventing pregnancies in a large percentage of cases.

That point came up in a debate on radio this week between bioethics nurse Nancy Valko and a Planned Parenthood director. She went on to cite statistics from the Guttmacher Report online (a research arm of Planned Parenthood).

Fifty-four percent of women who have abortions had used a contraceptive method (usually the condom or the pill) during the month they became pregnant. Among those women, 76% of pill users and 49% of condom users report having used their method inconsistently.

Forty-six percent of women who have abortions had not used a contraceptive method during the month they became pregnant…according to this report, cost was not a factor in not using contraceptives.

Valko went on to say “fertility is not a disease and powerful hormones are not vitamins, and many women are not aware of the sometimes life-threatening complications. She cited two cases of healthy young women hospitalized in the past year for life-threatening blood clots in their lungs. “Doctors attributed this to the pill,” she said. She went on to note the irony that women are choosing hormone-free food but don’t think about taking powerful hormones to “treat” fertility.


The Health and Human Services Department commissioned the report from the Institute (of Medicine), which advises the federal government and shut out pro-life groups in meetings leading up to the recommendations.

“These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need,” HHS Secretary Kathleen Sebelius, an abortion advocate, said…

Science? What science?

Here’s some science, which another nurse concerned with women’s issues made available, since most media won’t. And Dr. Angela Lanfranchi, of the Breast Cancer Prevention Institute, has plenty of science Sebelius should be aware of.

This is not health care. It’s blind ideology.

And it’s a threat to healthcare providers with religious believes and moral convictions that oppose that ideology, convictions that have long been protected by law. This new mandate requires a new law, and two congressmen co-authored one that deserves attention. The Respect for Rights of Conscience Act started in the House and has now been introduced in the Senate. This is a good time to remind elected representatives what the people do not want, and cannot afford. In more ways than one.