JULY 15, 2011

Ninth Circuit Hears Challenge to Health Care Mandate

PASADENA, Calif. The United States Court of Appeals for the Ninth Circuit today heard oral arguments in a lawsuit filed by Pacific Justice Institute and former Assemblyman Steve Baldwin against the sweeping federal health care overhaul signed into law by President Obama last year. PJI affiliate attorney Pete Lepiscopo, of the San Diego firm Lepiscopo & Morrow, argued the case.

The PJI suit challenges the constitutionality of the individual mandate in the new law, which requires that nearly all Americans to buy health insurance, whether they want it or not. The Ninth Circuit is currently weighing whether to allow the suit to go forward. PJI President Brad Dacus commented on today's hearing, "The disastrous federal takeover of health care has already been weighed and rejected by the American people, and now it is time for the courts to rein in this unprecedented government power grab."

The Ninth Circuit covers more territory and population than any other federal circuit court. So far, one federal court of appeals, the Sixth Circuit based in Cincinnati, has upheld the health care law, while decisions from several other federal courts of appeal are expected before the end of the year. Ultimately, the U.S. Supreme Court is expected to decide the constitutionality of the individual mandate.


Logic 101

doctor daveA. I have spent no shortage of time in hospitals.

B. Readers say to me, “Dave, I’ve read your columns and frankly, you are sick.”

Ergo, hospitals make you sick? Here are ten reasons that could be true.

Nosocomial infections are infections picked up in the hospital. Institutions like hospitals, prisons, Charlie Sheen can be bug brewing factories. MRSA(superbug), scabies, viruses and the evil C. difficile. “Welcome to Ward 3, Bloggins. Here are your dinner choices and over here you can pick your nosocomials.”

Medication errors. Whether by a nurse or a doctor, I should point out that if there is any question, then it is preferable to blame the nurse. Doctors write beautifully and legibly as any pharmacist will attest. I once ordered 6 U of insulin for a patient who was mistakenly “given 60,” as the panicked nurse gasped to me over the phone. “How’s he doing?” I asked. “Shaky.”

Surgical errors do not always refer to the surgeon cutting off the wrong leg, testicle or heart, but can also mean accidentally cauterizing the graplihornswaggle artery rather than the intended snorghoplaster vein. And of course there is the occasional object left behind in the patient such as a swab, scissors, scrub nurse.

Adverse drug reactions are the 8th leading cause of death in North America, as, until genetic drug screening is available, drug therapy can be a bit of a shotgun approach. Be alert, aware and a tad suspect should you be ordered a new drug with names like Widocillin, Nokhel, Kriplex and Urispas (actual names of drugs)

Wrong diagnosis. Just watch any episode of HOUSE where the staff usually takes the patient to the brink of death before House’s epiphany de jour as a basketball hits him in the left uvula giving him the idea that they’ve been treating the wrong problem all along.

Falls/trauma. Hospital cleaners seem trained to add extra wax in the rooms of the most frail and confused patients. Sick and often drugged patients have to get up to take a poop and end up performing a triple lutz, ending with an unceremonious splat.

Complications of investigations. One apparent abnormality can lead to another to yet another. These so called “incidentalomas” can trigger aggressive or invasive investigations. “Well Dr. Sealey, looks like that zit really was a zit. OK I’ll sew the patient up, you put the catheter in and we’ll send him to ICU.”

Bedsores. Decubitus ulcers can get infected and very nasty, which is why I write in the orders, “apply turning over the patient like a lamb on a spit.” But, my beautiful penmanship aside, this can get interpreted as “apple turnover the patient until they spit.”

Blood clot. Anytime a patient is not doing hot yoga and dancing the macarena sixteen minutes after completing surgery, there is a risk that they could develop a blood clot in their legs. This clot can pop off and go to the lungs, uvula or Sudbury. It is vital, post operatively, to move your limbs and shake what your plastic surgeon gave ya’, as we’d hate to have to crack open the Widocillin.

Wrong pathology results. This actually happened to me when I was a patient. I recognized the mistake when my biopsy report said I was expecting twins in six months! But being the astute physician I am, I quickly recognized this as a lab error. I could only hear one heart beat. Yes readers ... I might be sick.

Contact Dr. Dave or read more at www.wisequacks.org.