Scott Spiegel

What kind of benevolent dictator would declare his love for Britain’s stingy, depressing, complicated, cold and arbitrary National Health Service by describing it as “generous, hopeful, confident, joyous and just”?

That would be Harvard-based pediatrician Donald Berwick, who recently received a recess appointment as Administrator of the Centers for Medicare and Medicaid Services by the benevolent dictator who describes his pessimistic and stale vision for America as “hope and change.”

Recess appointments are an executive procedure used, for better or for worse, when the Senate gives a presidential appointee a difficult time during confirmation hearings—for example, when they filibuster a nominee.  Obama’s appointment of Berwick bears the distinction of having been given without a confirmation hearing having even been scheduled.

It’s as though Obama decided that the very requirement that his nominee appear before a Democratic-controlled Senate constituted an unreasonably difficult hurdle.  This isn’t a recess appointment—it’s a vacation to Bermuda appointment.

As the Wall Street Journal noted, “Circumventing Senate confirmation to appoint the new Medicare chief is part of the same political willfulness that inflicted ObamaCare on the country despite the objections of most voters.”  CBS News observed, “The debate over Berwick’s recess appointment makes clear what the White House knew all too well—Berwick may not have survived the Senate confirmation process, which would have turned into a proxy debate over health care reform.”

Berwick, who will be put in charge of the health care of 100 million Americans without so much as a public query about his plans in office, has been quoted saying, “I am romantic about the N.H.S.; I love it.”  He has called himself “an American fan” of the system, “distant and starry-eyed.”

In his London speech commemorating the N.H.S.’s 60^th birthday, Berwick delivered such pro-American pronouncements to his audience as “Do not trust market forces to give you the system you need…  I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care.  That is for leaders to do.”

When it comes to Berwick’s affection for health care systems centered around use of death panels, apparently absence makes the heart grow fonder.  After returning home and mooning over the UK’s National Institute for Health and Clinical Excellence, the operational arm of the N.H.S., Berwick realized that “All I need to do to rediscover the romance is to look at health care in my own country.”

That country would be the United States, which has the greatest health care system in the world, and would be a profound source of inspiration for anyone who truly loved medicine.  Berwick’s own place of employment is Harvard Medical School, where you would think there would have been a few medical advances in recent years to set his heart aflutter.

But no—Berwick’s passion is for euthanasia counseling and quality-adjusted life years.

Berwick of course has never had to live under the jurisdiction of the N.H.S.  You might call his affair with the British health care system a long-distance relationship.

Describing the supposed British backlash against American conservatives’ depiction of the N.H.S. during the health care reform debate last summer, the New York Times gushed, “A Twitter campaign, We Love The N.H.S., is still going strong, with supporters sending messages about their own good experiences.”

In fact, said campaign didn’t even last 30 days from its first Tweet to its last, and has attracted a piddly 520 followers internationally.  This is despite such helpful but unheeded administrative prompts as “What do you love about the nhs?” and “Please Retweet: 10,000 supporters visualised.”

Admittedly, the riotously popular N.H.S. does have a Facebook fan page with 3,500 members.  Then again, an ill-worded N.H.S. sign implying that contraception would be facilitated by anal rather than vaginal intercourse has a Facebook fan page with 124,475 members.  So perhaps fan counts are not such a flattering measure of the N.H.S.’s popularity.

Even the New York Times admitted that Brits “complain endlessly about the National Health Service…  They deplore the system’s waiting lists, its regional disparities in treatment, its infection-breeding hospitals and its top-heavy bureaucracy.”  I guess the grass is greener on the other side of the pond!

If Donald Berwick wants to swoon over endless waiting lists, fatally protracted wait times, diminished access to specialized care, craven efforts to shield patients from learning about or acquiring costly life-saving drugs, dismal heart attack and cancer survival rates, depersonalized patient treatment, and centralized bureaucratic decision-making about individual health care options, that’s his prerogative.  But forgive the rest of the U.S. if we aren’t quite as smitten as he is.



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ObamaCare supporters who claim that opposition to the recently passed health care legislation is motivated by hatred of empowered minority group members are right about one thing: those who oppose the bill and want it repealed are in fact motivated by hate.

They hate a lot of things they’ve witnessed over the past year, none having anything to do with African Americans, Latinos, or women wielding power in Washington.

Among other things, they hate:

The health care bill:

•    Its unconstitutional individual mandate and general abridgment of liberty

•    Its ban on non-government-sanctioned health care plans, including catastrophic coverage that many young people prefer, and its usurious taxing of “Cadillac plans”

•    Its boneheaded enforcement mechanism which, in addition to being miswritten, would simply lead people to pay a relatively piddly fine instead of buying health insurance until they needed it

•    Its paying only six years of benefits while levying ten years of taxes and claiming to be a deficit reducer

•    Its stubborn and complete absence of free market reforms, such as malpractice tort reform, removal of the ban on selling insurance across state lines, and health insurance tax credits for the self-employed

•    Its excessive length and complexity, and the insufficient time the public and even Congress has been given to read and understand its various iterations

The way in which the bill was passed:

•    The stipulation of repeated, and repeatedly missed, arbitrary deadlines for holding this or that vote, including the infamous Christmas Eve session, for no reason other than political expediency for Democrats

•    The abuse of the Congressional Budget Office’s authority, whereby Democrats fed the CBO misleading parameters, then bragged to the public that the bill saves money, based on the evidence that the CBO was forced to say so, according to the Democrats’ rules of the game

•    The shady deals made to bribe reluctant Congressional Democrats to support the bill

•    The use of a phony, unenforceable, last-minute executive order banning federal funding of abortions, which contradicts the text of the bill, in order to get the last few votes needed for passage in the House

•    The inappropriate use of the budget reconciliation procedure to get the bill over the finish line

Politicians’ willful ignorance of the consequences of socialized medicine elsewhere, including:

•    The horrific rationing of care and substandard service in Britain resulting from regulations enforced by the National Institute for Health and Clinical Excellence

•    The decline in rates of drug and medical device development in countries that nationalize health care, and the frequent use of the U.S. health care system by foreign travelers who can afford it

•    The spiraling costs that follow the addition of a massive entitlement program to a precariously debt-laden economy

Politicians’ refusal to heed the will of the American people:

•    Their shunning the results of polls that for months have shown a majority of Americans opposing the bill, and far more Americans strongly opposing than strongly supporting it

•    Their avoidance of constituents at townhall meetings and their evasion of constituents’ questions

•    Their attempt to obfuscate the public’s understanding of the bill by blurring the definitions of such terms as “tax,” “preexisting condition,” “profit,” and “government-run healthcare”

•    Their insulting the public’s intelligence by claiming that the bill will provide insurance to 32 million more people, yet somehow save money

•    Their disingenuous protestations that they are not looking to expand government control of health care to a single-payer system in the future

•    Their condescending lecturing and patronizing attempts to explain and sell the bill to us thickheaded constituents

•    Their paternalistic insistence that they know better than us what we need, and that we’ll like the bill once we find out what’s in it

The ugly mischaracterization of ObamaCare opponents:

•    As “teabaggers,” a vulgar term never used by any Tea Party patriot

•    As simpleminded, emotional, easily manipulated fear mongers and rabble rousers

•    As racists who supposedly shouted the n-word and spat at black lawmakers marching to Selma—er, to the House vote

Apparently unnoticed by the mainstream media is the fact that numerous, prominent, pasty white males have been instrumental in getting ObamaCare passed, including Senate Majority Leader Harry Reid, Vice President Joe Biden, and most of the Democrats in Congress, not to mention the cheerleaders at MSNBC, The New York Times, and every other left-leaning news organization in the country.

Americans are indeed starting to mobilize peaceful armies and reload for another round of the fight against the bill they hate.  But their motivation is not to stigmatize supporters of Obamacare.  It is to stop them.



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History in the making, indeed.  The 100,000 constituents who signed the Senate Conservatives Fund’s Repeal ObamaCare Pledge in the first 48 hours since the House passed Obamacare suggest that historic efforts are about to be made to kill this bill before it can inflict its intended and unintended damage.

Here’s a roadmap of priorities for Obamacare opponents in and out of Washington, to get us from this dispiriting week to January 2013:

1. Challenge the constitutionality of H.R. 3962. Work to invalidate its requirement that all individuals purchase a good or service—in this case, health care—as a condition of being alive, something the federal government has never forced its citizens to do.  Contest the federal government’s ability to unload an unfunded mandate onto states, many of which are experiencing budgetary crises and couldn’t afford a new permanent entitlement even if they wanted one.

2. Encourage states to file lawsuits against the bill. Twelve states have already pledged to do so, including Virginia, Florida, South Carolina, Texas, Washington, Alabama, North Dakota, South Dakota, Pennsylvania, Utah, Oklahoma, and Nebraska.  H.R. 3962, unlike many other comprehensive bills previously passed by Congress, fortunately contains no severability clause that leaves the remainder of the bill intact if one part is struck down in court.  Thus, getting a court to nullify just one part of this bill would overturn the entire thing.  Take these court challenges all the way to the Supreme Court.

3. Encourage states to pass laws preventing residents from being required to buy insurance. Thirty-eight states are considering passing such legislation, and 33 have already introduced bills.  These 33 states include Washington, Minnesota, Michigan, New Jersey, and Pennsylvania—all large states that went for Obama in 2008, which disproves liberals’ inevitable charge that rebel states are just rural flyover country filled with racist rednecks.  Virginia (another Obama state) is the first state to have passed such legislation, through an effort led by Attorney General Ken Cuccinelli.  Idaho has also passed legislation protecting its residents from the federal mandate.

4. Encourage states to block enforcement of the bill. Refuse to fund it.  How can states that are millions of dollars in the red pay for a massive new program dumped on them by the Fed?

5. Give Congressmen an earful during their spring Congressional recess. Make last summer’s townhalls look like giddy autograph signings.  Jam Congressmen’s schedules with meetings; pressure Senators not to sign the House’s reconciliation measure; pressure House members not to sign any reconciliation measure revised by the Senate.

6. Challenge the reconciliation process. Get the Senate parliamentarian to rule (correctly) that the House’s Social Security-related provision is inappropriate for inclusion in a reconciliation bill, per the Byrd Rule, and must be removed.

7. Change the reconciliation bill. Force the Senate to make changes to the reconciliation bill before voting on it, so that the House has to vote again on the Senate’s version; then force the House to make changes so the Senate has to vote again; and back and forth.  Strip away enough dissatisfied votes from at least one chamber to prevent the reconciliation measure from being passed, thus letting the ugly Senate bill with its backroom deals and tax on costly union health plans stand intact and paving the way for repeal.

8. Hold up the reconciliation process. Encourage GOP Senators to tie up voting on the reconciliation bill in the Senate by proposing an indefinite number of amendments.  Although debate on a reconciliation bill is limited to 20 hours (about one second per 43,000 citizens affected by the legislation), there are no limitations on the number of amendments that may be proposed.

9. Take over the House, Senate, and Presidency. Vote Democrats out of Congress in 2010 and 2012, and Obama out of office in 2012, and elect conservative Republicans who promise to repeal Obamacare.  Support candidates who campaign on the promise to repeal Obamacare as their first act of the 113th Congress in January 2013.  In the same way that Scott Brown annihilated his opponent in Massachusetts by campaigning on one promise—to vote against the Senate health care bill—all Republican Congressional candidates in November 2010 and 2012 should campaign on the sole promise to repeal Obamacare.  Dozens of Representatives and Senators have already pledged to repeal the bill, as have hundreds of 2010 Congressional candidates, including Senate hopefuls Marco Rubio in Florida, Chuck DeVore in California, Michael Williams in Texas, and Pat Toomey in Pennsylvania.

10. Repeal H.R. 3962.

11. Amend the Constitution. If necessary, get three-quarters of the states—perhaps the same 38 considering legislation banning the mandate—to amend the U.S. Constitution to prohibit the federal mandate, thus invalidating the bill.

12. Encourage noncompliance with the bill as a form of civil disobedience. There may be 17,000 new IRS agents under H.R. 3962, but there are 170,000,000 of us who oppose the bill.

As Paul Ryan said in the House Sunday night: “If this passes, the quest to reclaim the American idea is not over.  The fight to reapply our founding principles is not finished; it’s just a steeper climb.  And it is a climb that we will make.”

Let’s give ourselves a boost on the backs of the complacent and wholly unprepared socialized health care supporters who think the fight is over and they have won.



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Senator Barbara Boxer recently declared that, before the current round of town hall meetings on health care reform, the last time she had seen such suspiciously well-dressed protestors was during the 2000 Florida election recount.  Well, yes—until Obama’s presidency, that’s the last time Republicans showed up en masse to get really angry about something; screaming and chanting are political tactics more naturally suited to the left.

As for the couture angle—here’s a newsflash for Boxer: Republicans have higher standards than Democrats.  A typical left-wing protest involves twenty-somethings and washed-up hippies in ratty T-shirts and shredded jeans breaking windows at a local Starbucks during the midmorning rush.

The average right-wing protest—invariably held in the evening, since attendees have jobs in the daytime—involves adults who dress as though they would like to elevate community standards, not degrade them.  Participants address their concerns directly to those in power, such as legislators, rather than assailing defenseless third parties, such as coffee franchise employees.  The fact that most conservative protestors come directly from work may explain why they wear suits and skirts, but apparently Senate Democrats believe opinions are valid only if expressed by people sporting Birkenstocks and buttons urging presidential assassinations.

When Boxer and other Congressional Democrats realized that Americans don’t view “well-dressed” as an epithet, they moved in the opposite direction: they claimed that the protestors were scruffy rabble-rousers after all.  House Leader Nancy Pelosi insisted that she had seen demonstrators “carrying swastikas and symbols like that to a town meeting on healthcare.”  Translation: One protestor had a swastika with a slash through it, and others were displaying American flags and ‘Don’t Tread on Me’ banners—you know, symbols like swastikas.

Saddling protestors with the “brownshirt” label didn’t work, so Obama’s Deputy Chief of Staff Jim Messina warned Democrats who were planning town hall meetings, “If you get hit… punch back twice as hard.”

Evidently some representatives took this message literally: at a town hall meeting in Ohio, Representative Russ Carnahan hired union organizers to deny entry to citizens who looked as though they might oppose health care reform legislation, several of whom were promptly mauled by union thugs and sent to the hospital.  Outside, black conservative Kenneth Gladney was racially slandered and physically attacked and sent to the emergency room by an unidentified opponent for handing out ‘Don’t Tread on Me’ flags.  Protestors were also roughed up at a meeting held by Florida Representatives Kathy Castor and Betty Reed.

Naturally, Democratic Senate leader Harry Reid’s response to this onslaught of leftist violence and intimidation was… to blame Republicans for not minding their manners.  Reid accused protesters of attempting to “sabotage” the process; he said, “These are nothing more than destructive efforts to interrupt a debate…  They are doing this because they don’t have any better ideas.”

Well, yes, actually, we do have one or two, which you may not have heard, because we’ve only been ranting about them for the past, oh, two decades: malpractice tort reform, Medicare reform, health savings accounts, healthcare tax credits, vouchers for private insurance, and pay for performance.  More generally, competition in the private market for health insurance, and individual autonomy regarding level and type of coverage and risk tolerance.  Other than that, we’re flush out of ideas!

In an effort to quell dissatisfaction among constituents, Democrats in Congress finally decided to listen to town hall participants’ ideas and give thoughtful responses that address their concerns.  Just kidding!  The latest tactics being employed by congressmen across the nation are: (1) showing up at town hall meetings, reciting a few talking points, claiming the crowd is too boisterous when they open their mouths, and leaving; (2) announcing meetings at the last minute in the hope that no one will attend; and (3) holding “virtual” town hall meetings.

For example, Representative Kathy Castor’s spokeswoman defended Castor’s abbreviated appearance in Florida by stating, “We said all along our role was to come and give an update on the bill in Congress…  [T]hat’s what we did.”  And that’s what websites are for.

Michigan Representative John Dingell waited to announce last Thursday’s 6pm town hall meeting until Thursday morning.  Word of mouth spread throughout the day, however, and that evening Dingell faced hundreds of constituents who were not impressed by his deceitful maneuver.

At least Castor and Dingell showed up in person; other congressmen, such as Representative Brian Baird of Washington, are planning virtual meetings with constituents.  According to The Columbian, “If you happen to be sitting near a publicly listed Clark County telephone line on the right day at the right time, your phone will ring…  [T]he exact date and time will be kept secret from the public…  [A]n automated message will ask whether you have a question…  Sitting at his own telephone at an as-yet-undisclosed location, Baird then will choose a name based on its location and the topic…  After the call is over, the recording will be posted on his Web site.”

Baird helpfully notes that this system will allow for “a much better cross-section of the public,” by which he means “a cross-section of the public that is not knowledgeable or concerned enough to attend a town hall meeting.”  Note to Baird: There’s a reason they’re called “town hall meetings,” not “prescreened anonymous secret one-way teleconference recordings.”

In the end, some congressmen have decided to simply give up on their constituents.  New York Representative Tim Bishop chose to suspend town hall meetings in his district until late August—you know, when just everyone will be around—because he concluded there was no point in facing an “unruly mob.”  Senator Claire McCaskill similarly issued a last-minute cancellation of a scheduled event due to “safety” concerns.

In the same way that Democrats denigrate protestors who adhere to a “No Shirt, No Shoes, No Service” standard, they have sunk to a new low: projecting their party’s historic propensity for mob rule and violent agitprop onto frail, elderly grandparents in bowties and cardigans.