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Archive for the ‘Health Care’ Category

WorldNetDaily brings us insight into some of the inner workings of the Patient Protection and Affordable Care Act (H.R. 3590).  The new health care legislation creates a new “health army” out of the U.S. Public Health Service reserve force.

Obamacare prescription: ‘Emergency health army’

Force subject to ‘involuntary calls to active duty’ during ‘public crises’


Posted: March 25, 2010
11:40 pm Eastern

By Chelsea Schilling
© 2010 WorldNetDaily

President Obama’s recently passed health-care reform legislation includes a surprise for many Americans – a beefing up of a U.S. Public Health Service reserve force and expectations that it respond on short notice to “routine public health and emergency response missions,” even involuntarily.

According to Section 5210 of HR 3590, titled “Establishing a Ready Reserve Corps,” the force must be ready for “involuntary calls to active duty during national emergencies and public health crises.”

The health-care legislation adds millions of dollars for recruitment and amends Section 203 of the Public Health Service Act (42 U.S.C. 204), passed July 1, 1944, during Franklin D. Roosevelt’s presidency. The U.S. Public Health Service Commissioned Corps is one of the seven uniformed services in the U.S. However, Obama’s changes more than double the wording of the Section 203 and dub individuals who are currently classified as officers in the Reserve Corps commissioned officers of the Regular Corps.

The following is the previous wording of the act as of 2004, before Democrats passed the health-care legislation:


Wording of Section 203 of Public Health Service Act before Obamacare amendment

The U.S. Public Health Service website describes its commissioned corps as “an elite team of more than 6,000 full-time, well-trained, highly qualified public health professionals dedicated to delivering the nation’s public health promotion and disease prevention programs and advancing public health science.”

According to its mission page, officers of the commissioned corps may:

  • Provide essential public health and health care services to underserved and disadvantaged populations
  • Prevent and control injury and the spread of disease
  • Ensure that the nation’s food supply, drinking water, drugs, medical devices and environment are safe
  • Conduct and support cutting-edge research for the prevention, treatment and elimination of disease, health disparities and injury
  • Work with other nations and international agencies to address global health challenges
  • Provide urgently needed public health and clinical expertise in response to large-scale local, regional and national public health emergencies and disasters

Members are trained to respond to public health situations and national emergency events, such as natural disasters, disease outbreaks and terrorist attacks.

As stated in the health-care legislation, “The purpose of the Ready Reserve Corps is to fulfill the need to have additional Commissioned Corps personnel available on short notice (similar to the uniformed service’s reserve program) to assist regular Commissioned Corps personnel to meet both routine public health and emergency response missions.”

The Democrats’ legislation recently added the following text to Section 203 of the Public Health Service Act:

‘(b) Assimilating Reserve Corp Officers Into the Regular Corps- Effective on the date of enactment of the Patient Protection and Affordable Care Act, all individuals classified as officers in the Reserve Corps under this section (as such section existed on the day before the date of enactment of such Act) and serving on active duty shall be deemed to be commissioned officers of the Regular Corps.'(c) Purpose and Use of Ready Research-

‘(2) USES- The Ready Reserve Corps shall–

‘(A) participate in routine training to meet the general and specific needs of the Commissioned Corps;'(B) be available and ready for involuntary calls to active duty during national emergencies and public health crises, similar to the uniformed service reserve personnel;

‘(C) be available for backfilling critical positions left vacant during deployment of active duty Commissioned Corps members, as well as for deployment to respond to public health emergencies, both foreign and domestic; and

‘(D) be available for service assignment in isolated, hardship, and medically underserved communities (as defined in section 799B) to improve access to health services.

‘(d) Funding- For the purpose of carrying out the duties and responsibilities of the Commissioned Corps under this section, there are authorized to be appropriated $5,000,000 for each of fiscal years 2010 through 2014 for recruitment and training and $12,500,000 for each of fiscal years 2010 through 2014 for the Ready Reserve Corps.’

Commissioned officers of the ready reserve corps are appointed by the president, and commissioned officers of the regular corps are appointed by the president with the advice and consent of the Senate.

Robert Book, a senior research fellow in health economics at the Heritage Foundation, said the service has been around some time but is not well known.

In the past, its responsibilities have included work related to the National Institutes of Health, the Indian health service and providing physicians for Coast Guard operations, he said.

As first reported by WND during his campaign, Obama called for a “civilian national security force” July 2, 2008, in Colorado Springs, Colo.

“We cannot continue to rely on our military in order to achieve the national security objectives that we’ve set,” he said. “We’ve got to have a civilian national security force that’s just as powerful, just as strong, just as well-funded.”

WND also reported in January when a Rand Corporation report proposed the federal government create a rapid deployment “Stabilization Police Force” that would be tasked with “shaping an environment before a conflict” and restoring order in times of war, natural disaster or national emergency.

The blogosphere is buzzing with speculation about the amendment. Some comments include:

  • This cannot be publicized enough!
  • Remember before the election when Obama said we need to have a civil defense corps as well funded and as well armed as the armed services?
  • Is it Hitler and the Brown Shirts all over again? It is time for all who love our freedom to stand up and be counted.
  • Perhaps ACORN with a different name?
  • What about FEMA. Does this mean FEMA is to be disbanded?
  • Healthstapo!
  • I guess this is how they’ll keep all the doctors from quitting the profession and becoming window washers.
  • Amazing isn’t it, they can’t afford to secure our borders, but we can afford this nonsense – dangerous nonsense.
  • Let’s all sign up. It will be much easier to take the country back if we do it from within.
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Fox News gives us a report that, unfortunately, isn’t an unusual one for the times we live in now.

School-Assisted Abortion a Shocking Lesson

March 25, 2010 – 10:37 AM | by: Dan Springer

Parents of school children in Seattle are learning a shocking lesson, when it comes to some very important decisions they don’t have a say. The mother of a 15-year old girl recently discovered that Ballard High School helped her daughter get an abortion and never informed her.

But it doesn’t end there. The school can also send children off campus for mental health care and drug addiction treatment without their parents ever knowing. Supporters say the confidentiality allows teens who are too afraid to tell mom and dad to get necessary treatment.

Parents signed consent forms for off-school treatment thinking it was limited to emergency health care when the parents could not be reached.  But the teen health clinics at 14 Seattle schools are about much more. They have a full-time registered nurse, counselor and nursing assistant on hand to help kids with more sensitive issues.

When the 15-year old girl’s pregnancy was confirmed, they counseled her on the options. The mother says they encouraged her to have an abortion and not tell her parents. She claims her daughter was told that if she informed her parents they would have to pay for the abortion, otherwise it’s free.

The teen clinics are administered by the King County Health Department. Officials say school clinic workers are supposed to encourage girls to include their parents in the decision. They will not comment on the specifics of the case.

As for the fact the girl was called a taxi and transported by herself to a clinic to have her abortion then driven back to finish her school day, officials say that’s not unusual. They would not say how many girls have been helped to have an abortion.

Washington State is one of thirteen states that does not have either a parental consent or parental notification law. Girls of any age can obtain an abortion without having to tell a parent.

State lawmakers included mental health care and drug counseling on the list of services kids can get without parental notification.

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CNSNews has this story.  Instead of sticking to his (apparent) principles, Rep. Stupak folded into pressure from his fellow demons Democrats and voted for H.R. 3590 because Obama promised to sign an executive order affirming the ban of federal dollars funding abortions.  The problem with this is that federal law can override executive orders (the “law” isn’t permanent), and they can be rescinded at any time by the President.  Obama also promised to be more transparent and to change the way politics were conducted in Washington, D.C.  We’ve all seen how well that has gone.

Stupak Decision Blasted As ‘Unconscionable’

Monday, March 22, 2010
By Susan Jones, Senior Editor

(CNSNews.com) – Pro-life activists call it “regrettable” that Rep. Bart Stupak (D-Mich.) ended up abandoning those who stood by him in his opposition to taxpayer funding of abortion in the Democrats’ health care bill.

Brian Burch, president of CatholicVote.org, said Stupak’s decision to accept the promise of a presidential executive order as a solution to the abortion-funding issue is “unconscionable.”

“The Executive Order fix is a band-aid solution that fails to solve the fundamental problems in this bill, and can be repealed at any time, for any reason, by the president or future presidents. The order is likely to be challenged by pro-abortion groups, and could be struck down by the courts,” Burch said in a news release issued Sunday night.

“The Catholic Bishops along with CatholicVote.org and every major pro-life organization oppose this ‘fix.’  We have defended Rep. Stupak for months, but today we stand in protest of his decision,” Burch added.

Stupak’s last-minute decision to vote in support of the health care bill he opposed for so long made all the difference in Democrats’ getting enough votes for passage.

“Since I was first elected to Congress I have fought to provide quality, affordable health care for all Americans and I am proud to be able to vote for this historic legislation,” Stupak said Sunday in a message posted on his Web site. He said he’s witnessed the struggles that families and employers in his northern Michigan congressional district face under the current system.

“Although this legislation is not perfect and does not do everything I believe is necessary to reform our health insurance industry, it is a tremendous step forward for northern Michigan residents and for our nation,” Stupak said.  He said he looks forward to the president signing the health care bill into law.

Stupak has insisted from the beginning that no federal funding be used to subsidize insurance plans that cover abortion. Abortion should not be recognized as a benefit in federal health plans, he said.

To mollify Stupak, President Obama announced he would sign an Executive Order reaffirming that the Hyde amendment can not be circumvented and that no taxpayer dollars would be used to pay for health plans that cover abortion.

“I have said from the start I would not vote for health care reform without adequate protections in place to make sure the current law of no federal funding for abortion is maintained,” Stupak said on Sunday.  “The president’s Executive Order upholds the principle that federal funds should not be used to subsidize abortion coverage.”

President Obama promised to sign the Executive Order following passage of H.R. 3590.

But pro-life activists say the Executive Order on abortion funding will further politicize the issue. It will put decisions on taxpayer funding for abortion as well as conscience protections in the hands of Obama, future presidents, and Health and Human Services Secrtary Kathleen Sebelius, Burch said.

“Catholics have worked hard to make the protection of the unborn a two-party effort, and pro-life members of the Democratic Party encouraged these efforts over the last year, Burch noted. He said Stupak’s decision to accept an Executive Order “will be difficult to overcome.”

“We are convinced Rep. Stupak will come to deeply regret today’s decision,” Burch said.

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CNSNews has two different stories here and here saying that the lawsuits against the U.S. Government are about to begin as soon as Obama signs the health care legislation (H.R. 3590) into law.  The lawsuits are an attempt by States and other agencies to strike down the required health care insurance law in the latest bill.

Update (1/22 @13:29): Reuters reports that 11 Attorneys General are geared to sue the Government after it is signed.  The full story is at the bottom.

Health Care Legislation: Here Come the Lawsuits

Monday, March 22, 2010
By Susan Jones, Senior Editor

(CNSNews.com) – The American Center for Law and Justice, a conservative civil liberties group, says it is preparing to file a federal lawsuit challenging the “flawed” health care package that passed the House 219-212 on Sunday night.

The law “fails the American people and does not provide permanent protections for the life of the unborn,” the group said in a Sunday night news release.

The ACLJ said it would file a lawsuit “soon” in federal court, challenging the forced mandate that penalizes Americans who choose not to participate in universal health care. “That is unconstitutional, and we believe ultimately it will be overturned by the courts,” it said.

“The fact remains that the actual health care bill just approved does fund abortion,” ACLJ said.

“Those self-proclaimed pro-life Democrats put their trust in an executive order — subject to being rescinded by the president — a move that is not only short-sighted but does not provide the guarantees and pro-life protections secured by statutory language in a law approved by Congress.”

Which President Obama do you believe? ACLJ asked: The president who repeatedly and publicly opposed the pro-life language in the earlier House-passed bill, or the president who now promises an Executive Order to secure the votes he needed to pass a very dangerous health care package?

ACLJ noted that an executive order “is not a legislative fix and does not carry the force of congressionally approved legislation.  It does not supersede law.  It can be rescinded.”

Another concern, the group said, is that the executive order promised by President Obama will put Health and Human Services Secretary Kathleen Sebelius in charge of the funding process – and she is a cabinet member “who has a long and documented history of supporting abortion.”

also:

Virginia Is First to Announce Lawsuit Over Health-Care Bill

Monday, March 22, 2010
By Bob Lewis, Associated Press

Richmond, Va. (AP) – Less than eight hours after Congress passed sweeping healthcare reforms, Virginia’s Attorney General became the first to announce a legal challenge against it.

Republican Ken Cuccinelli said early Monday that he will file a court challenge against what he and other conservatives decry as an unconstitutional overreach of federal authority.

Cuccinelli said he would file the lawsuit as soon as President Barack Obama signs the bill passed Sunday night into law.

Earlier this month, Virginia became the first state to finish legislative passage of a law that bucks any effort by President Barack Obama and an allied Democratic Congress to impose federal health care reform in the states.

Similar measures were filed or proposed in 34 other state legislatures.

Cuccinelli is expected to argue that the bill, with its mandate that requires nearly every American to be insured by 2014, violates the commerce clause of the U.S. Constitution. The attorney general’s office will file suit once President Barack Obama signs the bill into law, which could occur early this week.

“At no time in our history has the government mandated its citizens buy a good or service,” Cuccinelli said in a statement Sunday night.

Word of the impending legal action came as the U.S. House debated late into the evening and passed the landmark reform legislation, 219-212.

Update from Reuters:

States launch lawsuits against healthcare plan

CHICAGO
Mon Mar 22, 2010 1:21pm EDT
Opponents of the proposed U.S. health care bill are pictured  during a rally outside the U.S. Capitol Building in Washington, March  21, 2010. REUTERS/Jason Reed

CHICAGO (Reuters) – Less than 24 hours after the House of Representatives gave final approval to a sweeping overhaul of healthcare, attorneys general from several states on Monday said they will sue to block the plan on constitutional grounds.

Republican attorneys general in 11 states warned that lawsuits will be filed to stop the federal government overstepping its constitutional powers and usurping states’ sovereignty.

States are concerned the burden of providing healthcare will fall on them without enough federal support.

Ten of the attorneys general plan to band together in a collective lawsuit on behalf of Alabama, Florida, Nebraska, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington.

“To protect all Texans’ constitutional rights, preserve the constitutional framework intended by our nation’s founders, and defend our state from further infringement by the federal government, the State of Texas and other states will legally challenge the federal health care legislation,” said Texas Attorney General Greg Abbott, in a statement.

The Republican attorney generals say the reforms infringe on state powers under the Constitution’s Bill of Rights.

Virginia Attorney General Kenneth Cuccinelli, who plans to file a lawsuit in federal court in Richmond, Virginia, said Congress lacks authority under its constitutional power to regulate interstate commerce to force people to buy insurance. The bill also conflicts with a state law that says Virginians cannot be required to buy insurance, he added.

“If a person decides not to buy health insurance, that person by definition is not engaging in commerce,” Cuccinelli said in recorded comments. “If you are not engaging in commerce, how can the federal government regulate you?”

In addition to the pending lawsuits, bills and resolutions have been introduced in at least 36 state legislatures seeking to limit or oppose various aspects of the reform plan through laws or state constitutional amendments, according to the National Conference of State Legislatures.

So far, only two states, Idaho and Virginia, have enacted laws, while an Arizona constitutional amendment is seeking voter approval on the November ballot. But the actual enactment of the bill by President Barack Obama could spur more movement on the measures by state lawmakers.

As is the case on the Congressional level, partisan politics is in play on the state level, where no anti-health care reform legislation has emerged in Democrat-dominated states like Illinois and New York, according to the NCSL.

Florida Attorney General Bill McCollum, a Republican candidate running for governor, said the mandate would cost Florida at least $1.6 billion in Medicaid alone.

All states would receive extra funding to cover Medicaid costs that are expected to rise under the reform, including 100 percent federal coverage for new enrollees under the plan through 2016.

Medicaid is the healthcare program for the poor jointly administered by the states and federal government.

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CNSNews brings us a report explaining that a new study conducted in Chile finds that the pro-abortionist’s arguments that banning abortions will lead to more maternal deaths is false, cutting one if their greatest counterpoints to banning abortions.  In fact, the study finds that maternal deaths decreased after abortions were banned.

Abortion Ban Does Not Mean More Maternal Deaths, Chilean Study Finds

Tuesday, March 02, 2010
By Karen Schuberg

(CNSNews.com) – Initial findings by a prominent biomedical researcher which examines the drastic drop in maternal deaths in the last 50 years in Chile challenges the claim made by global abortion lobbyists that broad abortion laws are necessary to guard women’s health.

“This study provides evidence that the legal status of the therapeutic abortion is not related with maternal mortality reduction. Moreover, after abortion was prohibited, an additional reduction in maternal and abortion mortality was observed in Chile,” Dr. Elard Koch, an epidemiologist on the faculty of medicine at the University of Chile, said in an e-mail to CNSNews.com.

Illegal abortions do not necessarily correlate with unsafe abortions, Koch continued.

“Although (it) is frequently considered that illegal abortion is related with ‘unsafe abortion’—especially in developing countries with restrictive abortion laws, our preliminary findings suggest that although in Chile abortion is fully clandestine, it occurs in very low-risk sanitary conditions,” Koch explained.

Koch said that education and improved health care access appear to fuel the decrease in maternal deaths in Chile.

“The increasing education level appears as the most important factor predicting maternal mortality reduction in this developing country, likely influencing other factors such as reproductive behavior (fertility rate) and maternal health facilities,” Koch said.

To assess if legal abortion is associated with lower rates of maternal deaths in Chile, Koch examined vital statistics data for maternal deaths from 1960 to 2007.

“Historically, an active epidemiological surveillance in maternal mortality has been carried out in Chile, including deaths by abortion,” Koch said.

Abortion was legal in this Latin American country until 1989 when it was completely outlawed. Abortion was legal from 1931 to 1988.

Koch observed that maternal mortality peaked in 1961, abortion causing 34% of maternal deaths. From 1960 to 2007, total reduction in maternal mortality rates equaled 97.9% – regardless of whether or not abortion was legal.

“The present study provides preliminary evidence that indicates that in Chile, the elimination of therapeutic abortion did not translate into increases in maternal mortality.  Thus, access to legal abortion does not appear to be necessary to achieve low rates of maternal deaths,” Koch said.

Koch added that the association between poor education and high maternal mortality should be studied further.

Dr. Susan Yoshihara, vice president for research at Catholic Family and Human Rights Institute (C-FAM), told CNSNews.com that Koch’s study is significant because global abortion lobbyists equate illegal abortion with unsafe abortion and claim maternal deaths would decline with liberal abortion laws.

“(Global abortion lobbyists claim) illegal abortion, or unsafe abortion, is causing a certain number of deaths—anywhere between 13,000 and 80,000 a year in the world—and therefore, abortion has to be legalized in order to make it safe. And (they claim) that will save women’s lives,” Yoshihara said.

Yoshihara called the data which abortion supporters cite to make that claim “unsubstantiated” and “unverifiable.”

Yoshihara called the Chilean study “very exciting” because though preliminary, its data is “outstanding,” setting it apart from other studies on maternal mortality rates in developing countries.

“This study is remarkable because Chile, although it is considered a developing country, has outstanding maternal health data dating all the way back to the beginning of the 1900s,” Yoshihara said.

Because this study shows a steady decline in abortion after 1961, it undercuts the abortion lobbyists’ claim that liberal abortion laws are needed to protect women’s health, Yoshihara said.

“And it’s pretty clear that maternal mortality decreased whether or not abortion was legal in that country,” she added.

Yoshihara said both sides of the abortion debate agree that there is a dearth of reliable data on maternal mortality rates in developing countries.

“The reason for that is that the developing world doesn’t keep good records,” she said, explaining, “It’s very rural, (and) they don’t have good health infrastructures.”

Yoshihara said that to make claims based on weak data is unreasonable because “we all know you just can’t get that kind of good data in the developing world.”

She predicted that Koch’s study will be published this year.

Last September, Guttmacher Institute, which supports abortion access, said in a report titled “Estimates of Health Care System Costs of Unsafe Abortion in Africa and Latin America” that 19 million unsafe abortions occur each year in developing countries, resulting in approximately 5 million women treated for “serious medical complications.”

The study concludes that the costs of treating medical complications from unsafe abortions significantly burden the public health care systems of the developing world and that post-abortion injuries “are a significant cause of maternal morbidity.”

In a report from last October, Guttmacher Institute President Dr. Sharon Camp states, “Legal restrictions do not stop abortion from happening, they just make the procedure dangerous. Too many women are maimed or killed each year because they lack legal abortion access.”

The report, titled “Abortion and Unintended Pregnancy Decline Worldwide as Contraceptive Use Increases, But Progress Over Past Decade Has Been Uneven, and Unsafe Abortion Remains a Key Challenge to Women’s Health,” also states, “Unsafe abortion causes an estimated 70,000 deaths each year, and an additional five million women are treated annually for complications resulting from unsafe abortion. Approximately three million women who experience serious complications from unsafe procedures go untreated.”

Guttmacher Institute Communications Associate Rebecca Wind declined to comment on the initial findings of Koch’s study.

“(Chile) is not a country we have expertise in, so it’s not something we would comment on,” Wind said.
Koch presented his preliminary findings at the inaugural meeting of Women and Children First: International Working Group for Global Women’s Health Research last January in Washington, D.C.

A consortium of region specific working groups,  Women and Children First  brings together maternal health researchers from the United States, Peru, Chile, Mexico, Jamaica, Kenya, Nigeria, Lithuania, France and several other nations to address the critical need for evidence-based research on maternal mortality causality and methods to decrease maternal mortality.

————-

ABSTRACT FROM KOCH’S STUDY

Is there an association between maternal mortality reduction and abortion legalization? Preliminary data from time series analyses in Chile, 1960 – 2007.

Elard Koch1 on behalf of The Chilean Maternal Mortality Group
1Department of Family Medicine, Faculty of Medicine, University of Chile, Santiago, Chile.

Background: Nowadays, the impact of abortion prohibition on maternal mortality trends in developing countries is unknown. Chile offers the opportunity for assessing the impact of different factors related with maternal mortality reduction, including two periods before and after abortion was prohibited in this Latin American country.

Methods: Time series of maternal mortality ratio (MMR) and abortion mortality ratio (AMR) from 1960 to 2007 were analyzed using multiple autoregressive moving average (ARIMA) models. Therapeutic abortion was legal until 1989 and was considered as a dummy variable in statistical analyses along time series of social and demographic factors and maternal health facilities.

Results: During the study period, MMR decreased from 293.7 to 18.2 per 100,000 live births (-93.8%); AMR decreased form 92.5 to 1.7 per 100,000 live births (-98.1%). No significant effect of legal and illegal abortion periods on these decreasing trends was observed in ARIMA models. After abortion was fully prohibited, MMR and AMR decreased from 41.3 to 18.2 (-44.1%) and 16.5 to 1.7 (-10.3%) per 100,000 live births respectively. The average of education years, illiteracy rate, GDP per-capita, and the percentage of delivery by skilled attendants were all significant predictors of MMR. The same factors along decreasing fertility rate were significant predictors of AMR trends.

Conclusions: Reductions in MMR and AMR are not related with legal/illegal therapeutic abortion periods in Chile. The increasing education level appears as the most important factor predicting maternal mortality reduction in this developing country, likely influencing other factors such as fertility and maternal health facilities.

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LetterFromTheCapitol brings us a post explaining that the current threat by Democrats to use reconciliation to bypass a Republican filibuster would violate the Senate’s “Byrd Rule”.  Reconciliation was designed to only be used for bills dealing with the budget and nothing else.

February 26, 2010

LFTC – ObamaCare: Filibuster Flim-Flam

As for Democrats threatening to use the “nuclear option”–bypassing the 60-vote cloture number that cuts off filibusters, using special rules designed for budget reconciliation votes, which require only 51 votes to pass and cannot be filibustered–Human Events collected quotes from top Democrats, including then-Senators Obama & Biden, warning against ending hallowed Senate tradition.  Enjoy the quotes & watch the video (4:48) at the end.  There is much more to the flim-flam involved here….

The Congressional Research Service (CRS) published “The Budget Reconciliation Process: The Senate’s ‘Byrd Rule'” in March 2008; the CRS paper makes clear that the 2001 & 2003 Bush tax bills were exempt from the Byrd Rule because they included sunset provisions that kept the bills within budgetary bounds–they expired within the budget reconciliation time window.  Senator Byrd sent a Feb. 23, 2010 “Dear Colleague” letter urging that supporters not use his Byrd Rule to bypass cloture.  In his Feb. 12, 2009 testimony before the Senate Budget Committee Sen .Byrd lambasted both parties for slipping non-germane amendments into reconciliation bills.  Sen. Byrd’s single-page April 2, 2009 “Dear Colleague” letter text contains the operative language (which I could not copy & paste).  Sen. Byrd, author of a history of the Senate, with more than a half century of service that makes him the longest serving senator, is legendary as an authority on the Senate Rules.

Former GOP Senate Majority Leader Bill Frist (TN) explains why GOP tax cuts in 2001 & 2003 could use reconciliation without violating precedent: they did not increase a deficit, but rather returned an estimated revenue surplus to taxpayers:

The first use of this special procedure was in the fall of 1980, as the Democratic majority in Congress moved to reduce entitlement programs in response to candidate Ronald Reagan’s focus on the growing deficit. Throughout the 1980s and ’90s, reconciliation was used to reduce deficit projections and to enact budget enforcement mechanisms. In early 2001, with projected surpluses well into the future, it was used to return a portion of that surplus to the public by changing tax rates.

Senators of both parties have assiduously avoided using budget reconciliation as a mechanism to pass expansive social legislation that lacks bipartisan support. In 1993, Democratic leaders—including the dean of Senate procedure and an author of the original Budget Act, Robert C. Byrd— appropriately prevailed on the Clinton administration not to use reconciliation to adopt its health-care agenda. It was used to pass welfare reform in 1996, an entitlement program, but the changes had substantial bipartisan support.

In 2003, while I was serving as majority leader, Republicans used the reconciliation process to enact tax cuts. I was approached by members of my own caucus to use reconciliation to extend prescription drug coverage to millions of Medicare recipients. I resisted. The Congress considered the legislation under regular order, and the Medicare Modernization Act passed through the normal legislative procedure in 2003.

Byrd, for his part, rejects Frist’s analysis, because he believes that the Bush 43 tax bills added to the deficit, which if true would violate the Byrd Rule.  Eyeballing a chart showing the federal budget deficits from 1940- 2009 shows tax revenues slightly higher in 2009 than in 2001, with a dip in the middle; the deficit as a percentage of Gross Domestic Product narrowed to about 1.5 percent of GDP in 2007, before the financial meltdown began and sent the deficit soaring into the stratosphere.

More on the Senate filibuster’s origin & use: Here is Wiki’s filibuster entry–the word comes from European antecedents meaning “freebooter,” giving rise to the imagery of pirating or hijacking a bill.

George Will adds fascinating historical filibuster perspective:

The summit’s predictable failure will be a pretext for trying to ram health legislation through the Senate by misusing “reconciliation,” which prevents filibusters. If the Senate parliamentarian rules, as he should, that most of the legislation is ineligible for enactment under reconciliation, the vice president, as Senate president, can overrule the parliamentarian. This has not happened since 1975, but liberals say desperate times require desperate measures.

Today’s desperation? Democracy’s majoritarian ethic is, liberals say, being violated by the filibuster that prevents their enacting health legislation opposed by an American majority.

GW adds telling numbers:

Liberals also say the filibuster exacerbates the Senate’s flaw as “inherently unrepresentative.” That is, the Founders — who liberals evidently believe were dolts or knaves — designed it to represent states rather than, as the House does, population.

Liberals fret: 41 senators from the 21 smallest states, with barely 10 percent of the population, could block a bill. But Matthew Franck of Radford University counters that if cloture were blocked by 41 senators from the 21 largest states, the 41 would represent 77.4 percent of the nation’s population. Anyway, senators are never so tidily sorted, so consider today’s health impasse: The 59 Democratic senators come from 36 states containing 74.9 percent of the population, while the 41 Republicans come from 27 states — a majority — containing 48.7 percent. (Thirteen states have senators from each party.)

Since there have been 50 states, Republicans have never had 60 senators. There were 60 or more Democratic senators after seven elections — 1960 (64), 1962 (66), 1964 (68), 1966 (64), 1974 (61), 1976 (62) and 2008 (60, following Arlen Specter’s discovery that he is a Democrat and the protracted Minnesota recount). But both parties have been situational ethicists regarding filibusters.

There is more, including, GW notes, that President Obama’s deficit commission requires a 14 out of 18 vote to adopt recommendations!  GW adds: filibusters (a) serve a valid purpose and (b) have never prevented adoption of legislation ardently desired by the majority of the American public:

Filibusters are devices for registering intensity rather than mere numbers — government by adding machine. Besides, has a filibuster ever prevented eventual enactment of anything significant that an American majority has desired, strongly and protractedly?

There is more.  In the quotes linked above my favorite is actually Chris Dodd’s, which underscores Will’s point about major legislation winning bipartisan support:

Chris Dodd 5/18/2005: “I’ve never passed a single bill worth talking about that didn’t have a lead co sponsor that was a Republican. And I don’t know of a single piece of legislation that’s ever been adopted here that didn’t have a Republican and Democrat in the lead. That’s because we need to sit down and work with each other. The rules of this institution have required that. That’s why we exist. Why have a bicameral legislative body? Why have two chambers? What were the framers thinking about 218 years ago? They understood Mr. President that there is a tyranny of the majority.

WSJ columnist Kimberley Strassel explains why passage of ObamaCare is far from a slam dunk, even if the Senate manages to use the 51-vote trick to pass its version, due to a very dicey head count in the House.  Bil Kristol’s mini-blog captures House Speaker Nancy Pelosi’s disdain for incrementalism.  Nonetheless, Peggy Noonan casts her gimlet eye on the 7-hour summit and finds Democrats prepared to try to ram their bill through and risk voter wrath in November.

Bottom Line.  The filibuster is a valuable tool of Senate rules. The House runs on majority diktat; the Senate on consent of 100.  While both parties have been guilty of playing footsie with filibusters, using parliamentary sleight-of-hand to ram through the restructuring of one-sixth of the American economy is without comparable precedent.  Voters do not track procedural niceties, but if ObamaCare is rammed through Democrats will answer come November.

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