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Obama administration decides to exempt Obamacare from fraud prevention rules

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From the radically left-wing New York Times, of all places.

Excerpt:

The Affordable Care Act is the biggest new health care program in decades, but the Obama administration has ruled that neither the federal insurance exchange nor the federal subsidies paid to insurance companies on behalf of low-income people are “federal health care programs.”

The surprise decision, disclosed last week, exempts subsidized health insurance from a law that bans rebates, kickbacks, bribes and certain other financial arrangements in federal health programs, stripping law enforcement of a powerful tool used to fight fraud in other health care programs, like Medicare.

The main purpose of the anti-kickback law, as described by federal courts in scores of Medicare cases, is to protect patients and taxpayers against the undue influence of money on medical decisions.

Kathleen Sebelius, the secretary of health and human services, disclosed her interpretation of the law in a letter to Representative Jim McDermott, Democrat of Washington, who had asked her views. She did not explain the legal rationale for her decision, which followed a spirited debate within the administration.

It’s all exempt from oversight laws:

Most of the buyers are expected to be eligible for subsidies to make insurance more affordable. The subsidies, paid directly to insurers from the United States Treasury, start in January and are expected to total more than $1 trillion over 10 years.

Ms. Sebelius said the Health and Human Services Department “does not consider” the subsidies to be federal health care programs. She reached the same conclusion with respect to federal and state exchanges, built with federal money, and with respect to “federally funded consumer assistance programs,” including the counselors, known as navigators, who help people shop for insurance and enroll in coverage through the exchanges.

What could go wrong? What could go wrong if the government hires “federal consumer assistants” like ACORN workers and other “community organizers” in order to administer federal subsidies? I think it will be fine. It will all work out great.

Oh, wait. I suppose that it’s possible that something like this might happen:

The Centers for Medicare and Medicaid Services (CMS) spent almost $29 million to cover Medicare Part D prescription drugs for 4,139 individuals “unlawfully present” in the U.S. and thus ineligible to receive federal health care benefits, according to an audit by Daniel Levinson, inspector general of the Department of Health & Human Services.

[…]CMS “inappropriately accepted 279,056 PDE [prescription drug event] records with unallowable gross drug costs totaling $28,990,718” between 2009 and 2011, Levinson reported. Total federal expenditures under Medicare Part D during that same two-year time period came to $227 billion.

Medicare Parts A and B cover hospitalization, skilled nursing care, doctor visits, and other medical services and supplies. The IG previously reported in January that CMS had also paid $91.6 million to health care providers to cover 2,600 ineligible illegal aliens.

Now failure like this could never take place in the private sector, because companies would go out of business. But in the government, they just borrow a trillion or two more from your children and call it even. That’s why we should never let the government get involved in things that are best handled by free trades between buyers and multiple sellers who must compete with each other. Health care is not something you hand off to a monopoly. At least, not if you expect transparency, affordability and quality.

Polemics

What makes a planet suitable for supporting complex life?

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The Circumstellar Habitable Zone (CHZ)

What do you need in order to have a planet that supports complex life? First, you need liquid water at the surface of the planet. But there is only a narrow range of temperatures that can support liquid water. It turns out that the size of the star that your planet orbits around has a lot to do with whether you get liquid water or not. A heavy, metal-rich star allows you to have a habitable planet far enough from the star so  the planet can support liquid water on the planet’s surface while still being able to spin on its axis. The zone where a planet can have liquid water at the surface is called the circumstellar habitable zone (CHZ). A metal-rich star like our Sun is very massive, which moves the habitable zone out further away from the star. If our star were smaller, we would have to orbit much closer to the star in order to have liquid water at the surface. Unfortunately, if you go too close to the star, then your planet becomes tidally locked, like the moon is tidally locked to Earth. Tidally locked planets are inhospitable to life.

Circumstellar Habitable Zone
Circumstellar Habitable Zone

Here, watch a clip from The Privileged Planet: (Clip 4 of 12, full playlist here)

But there’s more.

The Galactic Habitable Zone (GHZ)

So, where do you get the heavy elements you need for your heavy metal-rich star?

You have to get the heavy elements for your star from supernova explosions – explosions that occur when certain types of stars die. That’s where heavy elements come from. But you can’t be TOO CLOSE to the dying stars, because you will get hit by nasty radiation and explosions. So to get the heavy elements from the dying stars, your solar system needs to be in the galactic habitable zone (GHZ) – the zone where you can pickup the heavy elements you need but not get hit by radiation and explosions. The GHZ lies between the spiral arms of a spiral galaxy. Not only do you have to be in between the arms of the spiral galaxy, but you also cannot be too close to the center of the galaxy. The center of the galaxy is too dense and you will get hit with massive radiation that will break down your life chemistry. But you also can’t be too far from the center, because you won’t get enough heavy elements because there are fewer dying stars the further out you go. You need to be in between the spiral arms, a medium distance from the center of the galaxy.

Like this:

Galactic Habitable Zone
Galactic Habitable Zone and Solar Habitable Zone

Here, watch a clip from The Privileged Planet: (Clip 10 of 12, full playlist here)

The GHZ is based on a discovery made by astronomer Guillermo Gonzalez, which made the front cover of Scientific American in 2001. That’s right, the cover of Scientific American. I actually stole the image above of the GHZ and CHZ (aka solar habitable zone) from his Scientific American article (linked above).

These are just a few of the things you need in order to get a planet that supports life.

Here are a few of the more well-known ones:

  • a solar system with a single massive Sun than can serve as a long-lived, stable source of energy
  • a terrestrial planet (non-gaseous)
  • the planet must be the right distance from the sun in order to preserve liquid water at the surface – if it’s too close, the water is burnt off in a runaway greenhouse effect, if it’s too far, the water is permanently frozen in a runaway glaciation
  • the solar system must be placed at the right place in the galaxy – not too near dangerous radiation, but close enough to other stars to be able to absorb heavy elements after neighboring stars die
  • a moon of sufficient mass to stabilize the tilt of the planet’s rotation
  • plate tectonics
  • an oxygen-rich atmosphere
  • a sweeper planet to deflect comets, etc.
  • planetary neighbors must have non-eccentric orbits

By the way, you can watch a lecture with Guillermo Gonzalez explaining his ideas further. This lecture was delivered at UC Davis in 2007. That link has a link to the playlist of the lecture, a bio of the speaker, and a summary of all the topics he discussed in the lecture. An excellent place to learn the requirements for a suitable habitat for life.

News

What is ENDA? The Employment Non-Discrimination Act and religious liberty

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Here are two assessments of the Democrat-sponsored ENDA legislation, the first conservative, the second libertarian.

Here’s Ryan Anderson from the Heritage Foundation, a conservative D.C. think tank.

Excerpt:

ENDA would impose liability on employers for alleged “discrimination” based not on objective employee traits but on subjective and unverifiable identities. It would create new protected classes—based on an “individual’s actual or perceived sexual orientation or gender identity”—that would expose employers to unimaginable liability. ENDA could require employment policies that undermine common sense about a host of workplace conditions, especially regarding issues surrounding gender identity.

The bill defines “gender identity” as “the gender-related identity, appearance, or mannerisms…of an individual, with or without regard to the individual’s designated sex at birth.” In other words, it creates special rights for transgendered individuals—males who dress and act as females, and females who dress and act as males—and forbids employers from considering the consequences of such behavior in the workplace.

Issues concerning gender identity are difficult. All ought to agree that young children should be protected from having to sort through questions about gender identity before an age-appropriate introduction. ENDA, however, would bar employers from making certain decisions about transgendered employees.

Although ENDA includes some exemptions for religious education, it provides no protection for students in other schools who could be prematurely exposed to questions about gender identity if, for example, a male teacher returned to school identifying as a woman.

Moreover, we can’t deny the relevance of biological sex in many contexts. An employer would be negligent to ignore the concerns of female employees about having to share bathrooms with a biological male who identifies as female. Failing to consider these repercussions raises a host of concerns about privacy rights. But ENDA would prevent taking these concerns into account.

And here is a post from Hans Bader of the Competitive Enterprise Institute, a libertarian D.C. think tank.

Meritless lawsuits that favor the plaintiff:

ENDA would harm even businesses that hire and fire based on merit, not sexual orientation. It would also erode free speech in the workplace about sexual-orientation-related political and religious issues.

Since ENDA is modeled on other employment laws that have produced many meritless discrimination lawsuits (through one-way fee shifting), ENDA, too, is likely to result in wasteful litigation and settlements paid out by employers that are actually innocent of discrimination (most employment discrimination claims turn out to be meritless). ENDA’s attorney fee provision, Section 12, uses the same language as other federal employment laws that incorporate the Christiansburg Garment standard for awarding attorneys fees — a sort of “heads I win, tails you lose” scheme under which the plaintiff gets his attorneys fees paid for by the other side if he wins, but the employer has to pay its own attorneys fees even if it wins (a win at trial typically costs an employer at least $250,000). While the language of ENDA’s attorney-fee provision is seemingly neutral on its face, similar provisions in other federal employment laws have consistently been interpreted by the courts as favoring plaintiffs under the Supreme Court’s 1978 Christiansburg Garment decision. Moreover, even if the plaintiff’s case is so insubstantial that the plaintiff only wins $1 at trial, the employer can still be ordered to pay tens of thousands of dollars in attorneys fees. For example, an appeals court ruling awarded $42,000 in attorneys fees to a plaintiff who suffered only $1 in damages. (See Brandau v. Kansas, 168 F.3d 1179 (10th Cir.1999).) These attorney fee provisions will lead to some employers paying thousands of dollars to plaintiffs just to settle weak or meritless discrimination claims.

Censoring employees who might create a “hostile environment”:

While the typical private employer has no reason to hire or fire based on sexual orientation (and few do), ENDA’sSection 4(a)(1) reaches beyond hiring and firing to vaguely defined “terms, conditions, or privileges of employment,” which courts interpret as requiring certain restrictions on speech. In Meritor Savings Bank v. Vinson, 477 U.S. 57 (1986), the Supreme Court interpreted the same vague “terms or conditions” language in another statute, Title VII of the Civil Rights Act, as requiring employers to prohibit employee speech or conduct that creates a “hostile or offensive work environment” for women or blacks. The employer is liable for damages and attorneys fees if a court decides that it was negligent in failing to detect, prevent, or punish such speech or conduct. Such “hostile work environment” liability applies to each and every protected class covered by federal law, such as race, religion, national origin, and disability, not just gender. See, e.g., Amirmokri v. Baltimore Gas and Electric Co., 60 F.3d 1126 (4th Cir. 1995) (employer was liable for national-origin based taunts and harassment by plaintiff’s co-workers).

If ENDA were enacted, such liability would also cover “sexual orientation”-based hostile work environments, meaning that a company would potentially be liable for a “hostile work environment” resulting from anti-gay things its employees say (even if those employees’ sentiments are at odds with the company’s own views or policies). Thus, to avoid liability, an employer might have to silence employees with political opinions that are perceived as anti-gay, and prevent such employees from expressing political views such as opposition to gay marriage or gays in the military that could contribute to a “hostile work environment.”

Quotas in hiring:

It is conceivable that if ENDA is passed, a civil-rights agency could use it to pressure some employers to adopt sexual-orientation-based hiring goals or veiled quotas, notwithstanding the language of Section 4(f) of ENDA.  Activists have already pressured President Obama to mandate sexual-orientation-based hiring goals for government contractors.

Bathroom privacy:

Finally, in addition to banning sexual-orientation discrimination, ENDA also contains “transgender rights” provisions that ban discrimination based on “gender identity.” Similar prohibitions in state laws created legal headaches for some businesses.

I have to admit, I have been operating for the last decade as if this law was already in effect, since I don’t want to be singled out for reprisals by management if a law like this is enacted. If you already have a reputation as being pro-marriage and pro-chastity in your workplace and this law gets enacted, you will become a target for censorship and even termination. It would be much easier for your employer to pre-emptively fire you under some pretext than to have to get stuck with millions of dollars in legal fees and penalties for one of these “hostile work environment” lawsuits. I can envision scenarios in which people on the left will solicit your opinion openly in the workplace on controversial issues like gay marriage, etc. and then prosecute you for anything less than full affirmation and enthusiastic celebration of their views. It’s already happening in the military now.

It’s very important for Christians to consider who they talk to and what they talk about in the workplace. You might think that you have free speech rights in America, but you don’t. That is all going away now because of the gay agenda and the judicial activism in the courts. This is especially true for men who have to provide for their families. If you are going to say anything critical of the secular left, understand that they are fascists, and they will hurt you any way they can. These are not people who believe in human rights. They believe in using power to destroy anyone who offends them by mere disagreement.