Monthly Archives: April 2016

Hardcastle’s twin: The National Nurse

jackboot-2(My letter to Senator John Boozman)

I didn’t know this but apparently we need a nurse to preside over the country’s health as called for in house and senate bills HR379 and S.1205 respectively. What about the Surgeon General? This would be a supporting role to the SG within that office, of course.

I have taught my daughter with regard to identifying tyranny to always keep your eye on the number two in charge. They are the ones through whom the blows come. Hitler had Heimler and Xerxes had Haman. Mr. Wither had Ms. Fairy Hardcastle as his enforcer who ran the private police force for the National Institute for Coordinated Experiments or N.I.C.E. in C.S. Lewis’s allegory: That Hideous Strength.

One of the key objectives for the National Nurse would be to:

  • Bolster efforts to focus the public on healthy living.

Now this sounds like a universally good idea doesn’t it? The trouble is that the qualifying adjective “healthy” as well as the verb “focus” enjoy here a vagueness allowing for many innovations.

As found in the HR379 house bill summary the number one responsibility is:

(1) participate in identification of national health priorities

So apparently some medical conditions requiring treatment should be prioritized over others. I wonder what this will look like? If the “health priority” currently receiving the attention of the Chief Nursing Officer of the US Public Health Service is any indication, then I have some questions:

  1. If the reason for this appointment is to prevent “chronic and preventable” diseases like type II Diabetes on the basis that treatment is consuming an intolerable proportion of health care spending, does this mean that programs like the $2.3B HIV/AIDS bureau (HAB) currently run by the Rear Admiral will get overhauled er.. “bolstered to focus” its beneficiaries on “healthy living” instead? Will cold economic argument suddenly strip from the AIDS patient his/her special status and replace compassion with prevention for their disease?
  2. By what means and to what lengths will government force be applied to “focus the public on healthy living”? History has so far shown that force is the only instrument available to a government. How will it be used in this case?
  3. This bill is justified by the so called “general welfare” clause. This is not a clause unto itself but a qualifier for the congressional power to collect taxes so as to set the agenda for any money collected to carry out under the enumerated powers. The progressive interpretation allows for nearly any act of legislation to be defensible as being for the “general welfare” forgetting entirely what the tenth amendment says. Why as clearly, uncalled for in the Constitution, is this authority not reserved for the states and their counties who already have public departments of health?
  4. What sort of carrot and stick plan would this new power have that would not be similar to Common Core, the ACA and HITECH legislation?

I am sure that this bill is no where near receiving serious consideration without a CBO estimate having such a frugal government as we do. But as a physician I just thought you might have an interesting view on this.