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Reports

Department of Health Care Misinformation

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Posted on Nov 11, 2009

By Ruth Marcus

I’m hoping, for your sake, that you didn’t spend your Saturday night as I did: watching the C-SPAN broadcast of the House debate on health care reform.

Pathetic, I know. The outcome wasn’t in doubt, and the arguments were as familiar as an old pair of slippers. Moral imperative! Government takeover! Long-overdue protections! Crippling mandates!

I’m not a huge fan of the House measure, but I was glad to see it straggle across the finish line, if only to keep the process going. And, by the end of the long debate, I was cheering for it even more because of the appalling amount of misinformation being peddled by its opponents.

I don’t mean the usual hyperbole about “a children-bankrupting, health care-rationing, freedom-crushing $1 trillion government takeover of our health care system,” as Texas Republican Jeb Hensarling put it. Or the tired canards about taxpayer-funded abortion or insurance subsidies for illegal immigrants.

Or the extraneous claims about alleged Democratic excesses, as in this from Georgia Republican Jack Kingston, “Let’s remember the Pelosi plan for jobs: an $800 billion stimulus plan that caused unemployment to go from 8.5 percent to over 10 percent.”

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Caused? We can debate whether the stimulus was effective, although the best evidence is that it prevented things from being even worse. No rational person believes the stimulus “caused” unemployment to rise. 

The falsehood-peddling began at the top, with Minority Leader John Boehner: “If you’re a Medicare Advantage enrollee ... the Congressional Budget Office says that 80 percent of them are going to lose their Medicare Advantage.”

Not true. The CBO hasn’t said anything of the sort. Boehner’s office acknowledges that he misspoke: He meant to cite a study from the Medicare actuary estimating that projected enrollment would be down by 64 percent—if the cuts took effect. Choosing not to enroll in Medicare Advantage is different from “losing” it. 

But Boehner wasn’t alone.

Kentucky Republican Brett Guthrie: “The bill raises taxes for just about everyone.”

Not true. The bill imposes a surtax on the top 0.3 percent of households, individuals making more than $500,000 a year and couples making more than $1 million.

Georgia Republican Tom Price: “This bill, on Page 733, empowers the Washington bureaucracy to deny lifesaving patient care if it costs too much.”

Not true. The bill sets up a Center for Comparative Effectiveness Research “in order to identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically.”

Are Republicans against figuring out what works? There’s nothing in there about cost, and certainly nothing about denying “lifesaving patient care.”

Rep. Price, again: “This bill, on Page 94, will make it illegal for any American to obtain health care not approved by Washington.”

Not true. The vast majority of Americans get their insurance through their employers. The bill envisions setting minimum federal standards for such insurance, in part to determine who is eligible to buy coverage through the newly created insurance exchanges. This is hardly tantamount to making it “illegal” to obtain “health care” without Washington’s approval.

Michigan Republican Dave Camp: “Americans could face five years in jail if they don’t comply with the bill’s demands to buy approved health insurance.”

Not true. The bill requires people to obtain insurance or, with some hardship exceptions, pay a fine. No one is being jailed for being uninsured. People who intentionally evade paying the fine could, in theory, be prosecuted—just like others who cheat on their taxes. 

California Republican Buck McKeon: “I offered two amendments to try to improve this bill—one to require members of Congress to enroll in the public option like we’re going to require all of you to do.”

Not true. No one is required to enroll in the public option. In fact, most people won’t even be eligible to enroll in the public option or other plans available through the exchanges. 

Florida Republican Ginny Brown-Waite: “The president’s own economic advisers have said that this bill will kill 5.5 million jobs.”

Not true. Christina Romer, chair of the Council of Economic Advisers, has estimated that the bill would increase economic growth and add jobs. Republicans misuse Romer’s previous economic research on the impact of tax increases to produce the phony 5.5 million number.

You have to wonder: Are their arguments against the bill so weak that the Republicans have to resort to these misrepresentations and distortions?

Ruth Marcus’ e-mail address is marcusr(at symbol)washpost.com.

© 2009, Washington Post Writers Group


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By DaveZx3, November 13 at 2:59 pm #

Outraged, November 13 at 3:27 am


All the posts I have made are anti-insurance as a mechanism for health care.  I don’t believe they can force a person to buy health insurance or go to jail.  I don’t believe that insurance is a good way to fund routine expenses like doctor visits. 

I actually don’t contradict much of what you are saying.  My comments are really about the forced purchase of commercial insurance being unconstitutional. 

Don’t know how we got on opposite sides of the fence, but in rereading all posts, it was not my intention.

Report this

By Outraged, November 13 at 3:27 am #

Part 2.

There are others who’ve also investigated these tactics in depth.  One of them, Melody Petersen does an excellent analysis of the many tactic employed by drug companies in her book, “Our Daily Meds”.  In her book she quotes Robert Chandler and Gianfranco Chicco whom she exposes as experts at creating a buzz regarding pharmaceutical products.  “Our Daily Meds”, pg. 32 (hardcover) copyright 2008, she explains:

While buzz should always appear to be spontaneous”, they wrote in 2002.  “it should, in fact, be scientifically crafted and controlled as tightly as advertising in the New England Journal of Medicine”....

.... The ultimate goal,” they said, was for the company to “sell the consurmer a message or product without the consumer even being aware that a “sell” is taking place.

Melody Petersen also appeared on Bill Moyers Journal, an excerpt:

“If you want your drug to look safer than an older drug you boost the dose up of the older drug in the volunteers so they have more side effects. If you have one study that showed it worked, and one study showed it didn’t, you publish the first study over and over again with the help of your advertising agency. And you don’t publish the second one.

BILL MOYERS: Are we being deliberately misled?

MELODY PETERSEN: Yes.

BILL MOYERS: Intentionally?

MELODY PETERSEN: Yes, looking at documents from inside the drug companies, yes. I would say we’re being misled deliberately.

BILL MOYERS: I was fascinated to read an attack on your book. A seething review in THE NEW YORK POST right here in New York. “Hard Pill to Swallow.” It’s very critical of your book. By Robert Goldberg. It says nothing about who Robert Goldberg is. But when you do a little investigation he turns out to be vice president of a group that receives funding from the drug industry. But, he does not disclose this fact in this review in THE NEW YORK POST.

MELODY PETERSEN: Exactly.

BILL MOYERS: Now, what does that say?

MELODY PETERSEN: This is what they do over and over again. The drug companies are very good at putting their words in the mouth of someone who looks independent to get their message across.”
http://www.pbs.org/moyers/journal/05162008/transcript4.html

We also know:  “Nov. 9 (Bloomberg)—Insurers such as WellPoint Inc. and Blue Cross Blue Shield and drugmakers are redoubling their efforts to fight proposals to overhaul the U.S health-care system, adding another obstacle as legislative hurdles mount.”
http://www.bloomberg.com/apps/news?pid=20601103&sid=aIf.qcebZQ5Q

Your depiction of me as “uptight” lacks merit, what dictionary do you use?  Possibly you might consider the word “observant”.....a much better choice, IMHO.

Report this

By Outraged, November 13 at 3:26 am #

Part 1.

Re: DaveZx3,

Your comments: “You are altogether too uptight.  Relax.  My comment was tongue-in-cheek,”

“is shows your inability to deal with a discussion without throwing judgemental generalities up.  You make a decision about a person based on a single tongue-in-cheek paragraph.”

I haven’t any idea why you feel that I made “a decision about a person based on a single tongue-in-cheek paragraph”.  This is not the case, most likely you are simply internalizing it in this manner erroneously.  For the record, in the post under discussion you had also in the paragraph above your supposed “tongue in cheek” paragraph made this comment: “if any options will be given, short of paying fines and going to jail.  Maybe that’s why I keep hearing all these rumors of detention centers being built.” 

Add to that, the fact that we definitely had protesters paid by insurance companies disrupting town hall meetings.  We also have FOX News propagandizing (or more blantantly LYING…. which is what propaganda truthfully is).  Joe Conason’s recent article also engages the premise:

“As for Luntz, he specializes in political prophecies that are self-fulfilling. When he says voters are infuriated by the cost of health care reform, for instance, that merely indicates he is trying to make them feel that way. He will succeed—all three will succeed—only by drawing attention away from actual facts and figures.”
http://www.truthdig.com/report/item/20091111_testing_next_years_lies_today/

Report this

By goedel, November 12 at 7:44 pm #
(Unregistered commenter)

Ms. M:  Interesting piece, though sad and somewhat alarming.  In my opinion, the GOP favors slogans
(death panel, death tax, government between you and your doctor, crushing burden on grandchildren,
kill jobs, etc.), because their constituents can understand them for the most part, as opposed to
explanations.

Alarming because democracy works poorly in the absence of an intelligent and informed citizenry: 
compare Finland and Iraq, for instance.

Also, although it was some time ago, I seem to recall that when I worked at the DOJ I had the
opportunity to buy health insurance from the government through the FEHB just like every government
employee, including members of Congress.  Actually, not directly from the government but from a
carrier that bid for a contract to insure a relatively large population (the government threw in a
sweetener, so to speak—it automatically deducted premiums from our paychecks and instantly
credited the carrier).  If FEHB stills works that, ask your rep. and sen. whether they chose to
participate and, if so, isn’t FEHB virtually and single-payer plan.  And so forth.

OK

Report this

By DaveZx3, November 12 at 10:46 am #

Outraged, November 12 at 4:36 am

You are altogether too uptight.  Relax.  My comment was tongue-in-cheek, throwing out the attitude of the cynic which will pop up at some point in the discussion anyway.  It softens their attack if you steal their thunder. 

My post was about the pro’s and con’s, legalities and illegalities of forced purchase dictated by government of a commercial product.  I did not endorse anything, whatsoever, nor take any sides in the issue. 

But since you summoned me back to the discussion, I will state my opinion.  I believe the government will not be able to make people buy health insurance and fine them or lock them up if they don’t.  It is unconstitutional in my opinion.  And if you need me to I will explain the 100 reasons why.

And what has my car got to do with my opinion?  Anybody and the bank can own an Escalade.  Just don’t try to own a house at the same time.  And quit prejudging me, because is shows your inability to deal with a discussion without throwing judgemental generalities up.  You make a decision about a person based on a single tongue-in-cheek paragraph.  I am sure your mother did not teach you to do that.

Report this

By Outraged, November 12 at 4:36 am #

Re: DaveZx3

Your comment: “Maybe this health insurance ruse is only a covert effort to round up all the poor people, who will not be able to afford the insurance or the fine, and have the authority to finally lock them up and throw away the key.  It would be one of the strategies to rid the country of the lower third of the economy, who are getting too expensive anyway.”

Ooooo….. fear tactics.  Really…, that’s soooo 20th century.

Yep. It must be blantantly obvious how you’ve scared the shit out of me…..right?  What do you do for an encore, sell “Restless Leg Syndrome” remedies from your 20th century minivan?  (“Step right up folks, it’s as good as the opium in the old days….!”  Here ye, here ye….!)

“What’s that…?”

“You have an Escalade..?”

“Shut up…”

“I am so flippin empressed”..... Truthfully, the words well…well… oh, nevermind, it’s probably best…..  My mother used to say, “If you don’t have something nice to say about somebody, don’t say anything at all.”  Of course, I’m not exactly like my mother, so for me….well, it’s a challenge.  OTOH, surely I score pts. for trying.

Report this

By Outraged, November 12 at 4:03 am #

Re: Ms. Marcus

It certainly appears you engaged in that EVIL ABOMINATION of saying the Republicans are full of twaddle.  The result: All the “anti-Dem” folks (who would that be….) come a’ runnin’ and a spittin’ and spewin’ too.  You are a brave soul.

Re: Samson

Your comment regarding Ms. Marcus: “She manages to gloss over what almost any senior will tell you.  That straight flat Medicare sucks.  And that’s only the ‘medicare advantage’ private policies that seniors buy that makes it into anything like a real health plan.  What 64% of seniors will be ‘losing’ is this ability to turn Medicare into something useful.”

Could you please link to the evidence of “what almost any senior will tell you”....?  Obviously, there MUST BE LOADS OF EVIDENCE regarding “what almost any senior will tell you”.  Please give the link for verification, just so we can all sleep at night…. knowing what according to you is “what almost any senior will tell you”.

In case you misunderstand, I’m talking about ALL THOSE SENIORS who are in support of medicare advantage plans......you know….THE ONES THE INSURANCE COMPANIES SELL that according to you are so popular and “well liked”.

(sniff…sniff….does anyone else smell a rat?)

Report this

By JohnMcD, November 12 at 2:07 am #

@Samson, I’m glad I’m not the only one who heard blatant party propaganda coming out of this piece.  Gems like this reveal the linguistic tactics of such:  “No rational person believes the stimulus “caused” unemployment to rise.”

Right, “no rational person” would consider opportunity costs, efficiency of spending, and the panicked message sent by massive “emergency” stimulus.  “No rational person” would compare the trillions going to the banks with the few piddly bucks going to working folk.  “No rational person” would connect the dots between inflation and real wages.  Yeah, right.

The rest of it is just evidence that Republicans are too crazy to offer a sane alternative to the corrupt Democrats.  I just don’t think any of that is good enough to make the Democrats or their welfare plan for corporate insurance look good.

Report this

By marryprice, November 12 at 1:39 am #

Any law of the United States is backed up by that threat. If its not, then its just like our leaky and useless election laws where no one goes to jail.

http://www.goarticles.com/cgi-bin/showa.cgi?C=2159637

Report this

By DaveZx3, November 12 at 12:58 am #

SaveTheTenth, November 11 at 5:58 am #

“Marcus writes: The bill requires people to obtain insurance or, with some hardship exceptions, pay a fine.  Were does the Federal Government get the authority do do this, which has never been done before? Require Citizens to purchase a product from a profit earning company?”

I recall a number of years ago posing the same question about automobile insurance.  In looking into the law, it did not force the purchase of insurance.  What it did was force the driver to prove the ability to pay for a potential accident if he was found at fault or lose his license. 

So two things were different there. 

1. A drivers license is not a right.  You have to have certain qualifications to get one, including the ability to pay for the expenses of someone that you run in to. 

2.  Insurance was only an option to proving the ability to pay.  Other options were to post a bond or put up cash.  Insurance was actually the best option at the time, because tying up cash was very expensive. 

The point I am making is that purchase of insurance was not mandatory, there were many choices. 

It will be interesting to see how they manage to mandate the purchase of health insurance, and what, if any options will be given, short of paying fines and going to jail.  Maybe that’s why I keep hearing all these rumors of detention centers being built. 

Maybe this health insurance ruse is only a covert effort to round up all the poor people, who will not be able to afford the insurance or the fine, and have the authority to finally lock them up and throw away the key.  It would be one of the strategies to rid the country of the lower third of the economy, who are getting too expensive anyway.

You gotta love politics in America.

Report this

By Mike, November 11 at 5:12 pm #
(Unregistered commenter)

I think the Republicanas know single-payer universal healthcare is the answer to remedy this broken system; after they know the benefits (you don’t see any of them denouncing their “socialized medicine” coverage).  But the existing system fits their ideology of benefitting a few at the expense of everyone else and the campaign donations pay for this view.  So disinformation, misinformation, anything to win is what we’re hearing.

I think the proposed reforms will ultimately result in single-payer universal coverage.  Not being able to discriminate on the basis of pre-existing conditions and not being able to drop those who buy insurance but become sick, the insurance companies will raise premiums significantly, especially for those with little power (individuals and small businesses), as usual.  This will result in a huge crisis, making it clear that a nationwide pool, with everyone paying and benefiting and cutting admin. and eliminatng profit is the only answer. Eventually, the U.S. will have to join the civilized world on healthcare.

Report this

By Samson, November 11 at 4:04 pm #

The Democracy Now! piece this morning was brilliant.  Go to http://www.democracynow.org when they get it up. Its the interview with the Doctor from Harvard Med School.  Definitely worth listening to.

————————-
The problem is that this bill would make it much harder to get any real health reform in the future.

We are about to give a $500 billion bailout with public money to the big health insurance companies. And long experience has shown that a part of that money will come back into politics.  Now that the insurance companies will be so completely hooked up with both laws mandating that citizens pay them tribute, as well as with public tax credits flowing to them, you know the insurance companies are going to spend whatever money required to keep this and expand it.

We’ll see this $500 billion coming back to hit us again as campaign contributions for pro-insurance company politicians.  As lobbying fees, gifts and trips designed to reward pro-insurance company politicians.  As ‘non-partisan’ political committees spending unlimited money to support pro-insurance company politicians.  As cushy jobs to reward former congresspeople who helped the insurance companies get this windfall of public money.

So, not only will we be so broke from paying extortionist rates for mandated health insurance that we won’t have any left to give to candidates that would help us, but our opposition in future campaigns is going to be funded against us using our own money.

This is an awful bill.  As one writer pointed out the other day, our best hope as a nation is actually to pray that the Senate filibusters it and kills it.  But, in reality, we know the only thing the Senate will to is to tilt the bill even further towards the big health corporations.

We are screwed.  Mainly screwed by our own hand and our own votes if you voted for Obama and the Democrats last year.

Don’t blame me, I voted for McKinney.  Now I get to say “I told you so”.

Report this

By Samson, November 11 at 3:52 pm #

PS ... I also love that message number one in her propaganda piece is to tell readers that they absolutely should not pay any attention to the details of politics themselves, say by watching C-span.  No, go do something else, and count on the WaPo corporate spin machine to tell you all that they think you should no.

The one thing they love is people who don’t pay attention.

Report this

By Samson, November 11 at 3:50 pm #

Ms. Marcus is obviously the head writer for Democratic Party propaganda at the Post.

A week ago, she was the one writing the pre-election Democratic spin pieces that pre-announced that the 2009 elections didn’t mean a thing.  My first sure sign the Democrats were sure to lose last week.

Now, she’s peddling the same talking point spin line that you can find from Democratic party commenters on the various websites.

First we get the ... “yes, this is a horrible, awful bill, but its progress” line.  That must be number one on the official Democratic Party talking points email, and one especially aimed at progressive audiences who are upset at this ‘bailout with a blue cross’.

She manages to gloss over what almost any senior will tell you.  That straight flat Medicare sucks.  And that’s only the ‘medicare advantage’ private policies that seniors buy that makes it into anything like a real health plan.  What 64% of seniors will be ‘losing’ is this ability to turn Medicare into something useful.

And of course what she doesn’t mention, and won’t go near with a ten foot pole is that the Democrats are just going to take this money that used to help seniors get decent health care, and instead they’ll make sure it goes straight into the pockets of the health insurance companies as tax credits.

A year ago, would anyone have said that the biggest problem we faced as a nation related to health care was that the insurance companies were broke and struggling and needed a $500 billion bailout?

To bad, I’d love to have seen Obama take an honest pill last year on the campaign trail and explain to voters frustrated and angry at being bilked and denied care by insurance companies that Obama and the Democrats’ big plan was going to be to take $500 billion of public money and just give it to the insurance companies as tax credits.  I’m guessing outside of employees of the insurance companies that this would have gotten like zero support.  Which is why in our psuedo-democracy our politicians never tell us what they are going to do at the time when we have a chance to make a choice.  We only get to vote for the pop-star, and then pray he doesn’t ram it up our rear too hard while serving the people who paid his campaign.

This piece also helps reinforce the myth that is also being widely spread on the internet by the readers of the Democrats’ talking point emails that the only objections are coming from Republicans who are lying just because they are obstructionists.

And of course, the she dances and finesses like any good Democrat is doing these days around the threat of going to jail.  Any law of the United States is backed up by that threat. If its not, then its just like our leaky and useless election laws where no one goes to jail.

Even she admits this.  Step one if you fail to pay proper tribute to the insurance companies is to face a fine.  Of course, since the main reason that most people don’t have insurance today is because they can’t afford it, this is just cruelty in service of greater insurance company profits.  If you don’t pay tribute, we come and take your money anyways. If you can’t afford tribute, we leave you in debt with the fines.

Then of course she gets to the fast two-step move.  Any fine by the government is enforced by the threat of jail time.  If you don’t pay the fine, you get cited for contempt of court and go to jail.

Of course, since the people who didn’t buy health insurance because they couldn’t afford it probably won’t have the money to pay the fines either, we can see where this is rapidedly heading.

But hey, the bill guarantees that the insurance companies that gave millions to Obama and the Democrats last year get the profits and return on that investment that they demand.  For that reason, you’ll see the entire Democratic spin machine, including Ms. Marcus as an obvious member, go into full drive to make sure the health insurance companies get the billions they demand.

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By Hulk2008, November 11 at 12:27 pm #

SaveTheTenth:

So true. 
    It is the States, 48 of them anyway, that REQUIRE us to buy car insurance. Most require us to not only pay income taxes but multiple levels of sales taxes and property taxes and luxury taxes and inheritance taxes and local city taxes and taxes on automobiles and fees for every service the States provide (even though taxes are supposed to cover the cost of those services) and various food and beverage taxes and taxes on transporting goods even on Federal highways.  It is, in fact, the States that have already legislated in such a way as to preclude citizens from buying health insurance across State lines - the insurance laws in one state obviate the policies bought in other states.  The States (and the mis-named “free” market) have failed to provide adequate health coverage for the citizens.  The 10th amendment has repeatedly been used to give insurance companies de facto monopolies in health insurance and to block attempts to allow cross-state-line purchasing of same.
    Isn’t it odd that those who would oppose health care for all citizens on the basis of a single Amendment ignore the Preamble goal “...to promote the general welfare…” ?
    And ironically those who oppose national health care on the basis of cost almost unanimously back exhorbitant “defense” appropriations - even for weapons that are no longer useful - even one system of which would pay for all of national health for a decade and more.  (e.g. F-22 program)
  Some would label this attitude as being “a dog in a manger”.

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By NYCartist, November 11 at 12:23 pm #

The Dems built a Potemkin Village with this bill.
A good analysis is on DemNow this morning, with one of the physician founders of Physicians for National Health Program.  The bill stinks and folks will be very upset - those of us who have paid attention and want SinglePayer.  See http://www.democracynow.org

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By sollipsist, November 11 at 11:59 am #
(Unregistered commenter)

Thank you, SaveTheTenth—“required” has troubled me all along.

I deeply wish there was either a majority or an opposition that addressed this coercion in a reasonable way. Our choices seem to have shrunk to a bad all or a bad nothing.

Report this

By Miko, November 11 at 11:10 am #
(Unregistered commenter)

“This is hardly tantamount to making it “illegal” to obtain “health care” without Washington’s approval.”

Sure it is.  The unapproved insurance plans (your note that the bill creates minimum “standards” explicitly agrees that such plans exist) are illegal, hence it is illegal to obtain a plan without Washington’s approval.  For example, studies have shown that high-deductible catastrophe insurance plans are usually priced low enough that consumers can save money by paying their small medical expenses out-of-pocket as opposed to buying a more expensive policy which covers the day-to-day expenses.  Since insurance companies make most of their money through overpriced coverage of such routine transactions, they aren’t fond of such plans.  Not surprisingly (given how much money the insurance corporations throw at both major parties), such plans are illegal under the so-called “standards” created in this bill.

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By surfnow, November 11 at 10:43 am #
(Unregistered commenter)

Not just on healthcare, Republicans are never concerned about the truth on any issue. But truth and facts are not assets in a MSM-dominated political forum that is based on emotion and bumper-sticker mentality. But the Republicans are shrewd enough to use this terrain to win elections. Conservatives have two distinct advantages- they own the MSM media and they are ruthless- progressives have no chance in being allowed access to the MSM so they have to learn how to start taking no prisoners.

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By SaveTheTenth, November 11 at 5:58 am #

Marcus writes: The bill requires people to obtain insurance or, with some hardship exceptions, pay a fine.

Were does the Federal Government get the authority do do this, which has never been done before? Require Citizens to purchase a product from a profit earning company?

A real journalist might ask, but guess what. Not a single question resembling the above from ABC, CBS, NBC, CNN, MSNBC or even FOX.

No. It took a 3rd rate news organization called CNS News to ask Ms. Pelosi—Here’s the unbelievable account:

http://www.cnsnews.com/news/article/55971
(audio clip available at link)
When Asked Where the Constitution Authorizes Congress to Order Americans To Buy Health Insurance, Pelosi Says: ‘Are You Serious? Are you serious?

One of her press thugs reinforces Nancys delusion:
“You can put this on the record,” said Elshami. “That is not a serious question. That is not a serious question.”

Pelosi’s press secretary later responded to written follow-up questions from CNSNews.com by emailing CNSNews.com a press release on the “Constitutionality of Health Insurance Reform,” that argues that Congress derives the authority to mandate that people purchase health insurance from its constitutional power to regulate interstate commerce.

The Tenth Amendment:
“The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”

Amend the constitution. Read the words of Franklin: A Republic if you can keep it”

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