Predictions for 2010

Finally, we are about to put behind us 2009, a year which almost all of us will be happy to forget. As we look ahead to 2010, we can only hope that the next year, and decade, will be better than the last. Whether it will be, is open to question. With that in mind, here are my predictions for 2010 – some serious, some not so much:

The New Orleans Saints will rally in the second half to narrowly beat the Indianapolis Colts in a Super Bowl that will live up to its name.

The summer will be very mild and the winter will be harsh, conditions that the global warming advocates will use as proof that we are on the brink of global warming annihilation.

Ruth Bader Ginsburg will resign from the Supreme Court. President Obama will nominate a very liberal judge to the Supreme Court. This will be vigorously opposed by the Republicans, who will be able to do absolutely nothing about it.

A major terrorist attack in the United States will succeed. The Obama administration will use it as proof that the Bush administration’s policies failed. Janet Napolitano will assure us that “the system worked.”

Tiger Woods will return to golf and win the British Open. All the sponsors who previously dropped him will return.

The Republicans will win back many seats in the house in the midterm elections, but not enough to regain control. Those defeated Blue Dog Democrats who voted for Obamacare will all wind up with jobs in the Obama administration or in liberal think tanks.

Prior to the mid-term elections, at least four more Democrats will cross the aisle and become Republicans.

Some team will win the World Series and no one will really care.

Rap music will remain crap.

Janet Napolitano, up until now Teflon, will finally be fired.

Joe Biden will slowly be re-allowed back into the public eye. He will inevitably say something incredibly stupid and be yanked back into obscurity by the administration.

The Los Angeles Lakers will repeat as NBA champions. Kobe Bryant will remain the biggest whiner in basketball.

There will be a bailout of newspapers, thus ending any premise of subjective journalism.

Harry Reid and Chris Dodd will be soundly defeated in their Senate elections. They will promptly receive jobs in the administration or as lobbyists.

More scandals involving Rep. Charlie Rangel will come to light, but nothing will come of them.

The economy will continue to flatline. The President will blame the Bush Administration.

A major sex scandal will involve the Obama administration. This will be largely ignored by the Main Stream Media.

Tony Stewart will narrowly edge out Jimmy Johnson for the NASCAR championship, garnering far more attention and endorsements than Jimmy Johnson ever did, in spite of the fact that he has had one of the most incredible runs in sports history.

I will not be offered a position in the Obama administration.

John Thune and Mitt Romney will emerge as leading contenders for the Republican presidential nomination for 2012.

Notre Dame will be one of the year’s biggest surprises in college football, ending the season ranked in the top 10 under new head coach, Brian Kelly.

Secretary of State, Hillary Clinton, will resign in protest of President Obama’s continued conciliatory approach to Iran. She will prepare to run for her prior Senate seat or challenge Obama in 2012.

There will be another major scandal involving global warming scientists. It will receive about as much attention by the mainstream media as the first one did.

Realizing that criticizing Rush Limbaugh is a losing proposition, the new favorite whipping boy for the Obama administration will be Glenn Beck. In response, the Glenn Beck show will continue to rise in the ratings and at least two more major scandals will emerge as the result of Beck’s reporting.

ACORN will continue to function as if nothing ever happened.

In conference committee, unions will be exempted from the taxes on “Cadillac” health care plans in Obamacare. This will cost at least 3 representatives their seats in the midterm elections.

My golf game will not improve, my novel will only slightly progress, I will continue to be a Facebook addict, and I will lose 100 lbs. by the end of the year.

Have a happy New Year, everyone!

Letter to my Senators

This is a letter that I just sent one of my state Senators, Carl Levin. I will send Sen. Debbie Stabenow a similar letter.

Sen. Levin,

I am not entirely certain why I am writing this as I don't expect you to take it seriously, anyway. This Omnibus Health Care Bill is a travesty in many ways. It will doubtlessly raise the cost of medicine, add to the deficit (despite the mathematical maneuverings of Congress in paying for 10 years of medical care with 14 years of fees and increased taxes), it will decrease the quality of medical care, and it punishes those of us who work in the health care field.

Add to that the prostitution of Sens. Nelson and Landrieu (and who knows who else) and their vote selling, and this is a bill that should never see the light of day. We, the citizens of the United States, should be able to expect better from our elected representatives.

Jeff Chesnut, DO

Senators for Sale

A story has it that George Bernard Shaw walked up to a lady at a party and said, “Madam, if I gave you $50 million, would you sleep with me?”

“Of course,” she replied.

“How about if I gave you $10?” asked Shaw.

“Mr. Shaw,” she said, “What kind of woman do you think I am?”

Shaw replied, “We’ve already established what kind of woman you are. All we are doing now is haggling over the price.”

P.J. O’Rourke was correct when he termed the United States Congress “A Parliament of Whores”. Yesterday, Sen. Ben Nelson (D-NE) became just the latest United States Senator to demonstrate the price for which he is willing to sell his vote. Nelson was reputedly a pro-life Senator who had stated that his conscience would not allow him to support the latest iteration of the current Omnibus Health Care Bill unless it contained strong prohibitions against using taxpayer funds for abortions.

Most pro-life advocates are such because we feel that abortion is a moral evil, the taking of an innocent life. It is a deep-seated conviction, not one that is customarily used as a negotiating tool. Sen. Nelson, however, went into a back room with the Senate Majority Leader, Harry Reid, to discuss this issue of conscience. He didn’t come out with the anti-abortion language he desired. In fact, he didn’t come out with anti-abortion language, at all. The language to which Nelson acquiesced promises that each state may individually choose whether or not federal taxpayer money will be used to provide coverage of abortions in the government’s insurance exchange. (Incidentally, the mechanism for how the states will decide this issue is not detailed, but you can bet it will not be left up to the voters.)

Any residual pangs of conscience that Nelson may have felt were apparently assuaged by another little side agreement resulting from the closed-door meeting. It seems that Medicare will be extended to everyone who makes less than 133% of the poverty level. Now that may be perfectly reasonable but, with Medicare, every state has to pay a percentage, typically about 33-50%, of that expanded coverage.

Every state, that is, except Nebraska.

Yes, you read that correctly. That means that if you live, as I do, in the People’s Republic of Michigan, with the worst economy in the country and an unemployment rate of almost 15%, your tax dollars will be paying for Medicare for the citizens of the great state of Nebraska (11^th best economy; 4.5% unemployment rate.) Nelson also scored some additional concessions for Nebraska, some regulation exemptions for physician owned hospitals and others, but the Medicare deal is the biggie.

(By the way, can we just drop the phrase “Pro-life Democrat Senator”? I think it has been amply demonstrated that there is no such creature.)

Of course, it would be unfair to single out Sen. Nelson for this type of extortion. Earlier in this process, Sen. Mary Landrieu (D-LA), a “conservative” Democrat walked away with a deal so outrageous that it has earned the sobriquet, The Louisiana Purchase. It seems that Sen. Landrieu also had a crisis of conscience about voting for a bill that will almost certainly raise insurance rates, decrease quality and accessibility of health care, and cost the country trillions of dollars. Her guilt was salved by a provision written into the bill granting $100 million in Medicare subsidies to all states in which every county or parish were declared disaster areas within the preceding 7 fiscal years. Guess which one and only state in the US qualifies? If you said, “Louisiana,” you win the grand prize. And since these are matching funds, Landrieu correctly bragged, “I am not going to be defensive about asking for help in this situation and it is not a $100 million fix, it is a $300 million fix." Just to prove she has a sense of humor, Landrieu denied that this was the reason she decided to change her vote.

These are only the payoffs that we know of. Why don’t we know what other items may be in this bill? Because no one, except Harry Reid, has seen the bill, yet. That’s right, the bill over which the Senate has been debating is not the bill on which they will be voting. Only in Washington can this make an iota of sense. Sen. Reid plans of producing the bill at the last possible moment, just like the “stimulus” bill and the cap-and-tax bill, so that the Senators and, more importantly, the watchdogs and the media will not have time to study the bill before the vote.

Now, there is a huge rush to pass this bill before the Senate breaks for Christmas. In fact, according to Senate rules, the Senate cannot vote on the bill until Christmas Eve. Why the rush? Because health care is in such a crisis that people will be dying in the street until they get the new and improved Obamacare? If that were the case, why does the bill not even go into effect until 2014 (though we will start paying for it next year? How else can the Office of Management and Budget claim that it will not increase the deficit during its first 10 years? It is because we pay for 14 years and get coverage for 10.) No, the reason that Dirty Harry and crew are anxious to pass this is that it is a dog and they know it. They do not want to have happen what happened during the fall recess when members of Congress were confronted by their angry constituents over the bill. They want to go home with a fait accompli. Plus, 2010 is an election year and Congress is betting that the people’s memories will be short. They don’t want to be involved in this dispute in an election year.

Over the next several weeks, expect to hear of additional back-room deals, vote selling, and extortion. The Democrats know that passing this bill will cost them seats in Congress. Watch how many those “Blue Dog” Democrats that are voted out in 2010 land jobs in the Obama administration or liberal Washington think tanks. I suspect that if the public knew about all the deals that have been and will be struck, they would be appalled. This is the very reason that, according to the Gallup polling agency, Congressional approval ratings have been hovering around 25%. It is time for the public to get disgusted enough to send Congress to the unemployment line.

After all, it doesn’t matter how much she costs, beneath it all, a whore is still a whore.

President Obama's War

In what was certain to be a controversial decision, no matter what he decided, President Obama announced tonight that he will send 30,000 more troops to the war effort in Afghanistan. Much of the left wing, and a few conservatives, will lament that the US should totally pull out of Afghanistan. Most of the right wing will decry the decision, saying that the President has only gone “half-way” in meeting General McChrystal’s troop requests. And, maybe most importantly, the children of America will be angry because the President pre-empted the Charley Brown Christmas Special.

A refrain that has been heard from much of the right side of the aisle is that President Obama has an obligation to “listen to his generals.” In fact, while the President has a moral obligation to listen to his generals, he is definitely not obligated to follow those recommendations. Our founding fathers, in their wisdom, set up our government so that the ultimate control of the military was vested in civilian leaders. In fact, unlike many other countries, an active duty military man cannot even hold public office. This has served our country well for over 200 years. We have never had to undergo a military coup, as have so many other countries.

The founding fathers, remembering the dangers of power that is too centralized in one person or institution, set up our government to specifically avoid that problem. In fact, while the President of the United States is the commander-in-chief of the armed forces, it is the Congress that controls the purse strings and can choose to fund or not fund wars. As commander-in-chief, however, the President is granted very broad powers in how he handles the military.

As much noise as we are hearing about the President deferring to his generals, there are a number of precedents of Presidents ignoring, overruling, and even firing his generals. Probably the most well-known example is that of Abraham Lincoln, who went through an entire panoply of generals until he came upon one, U.S. Grant, who would finally prosecute the Civil War the way Lincoln wanted it prosecuted. President Harry Truman famously fired war hero, Gen. Douglas MacArthur, who took his policy disagreements with Truman public. More recently, President George W. Bush was castigated by the left for favoring Secretary of Defense, Donald Rumsfeld’s, idea of a smaller force in Iraq in favor of the larger force requested by his generals. The success of the surge, in this case, proved the generals correct.

So, while it is not incumbent upon a President to take his generals’ recommendations, it takes a large measure of self-confidence and even hubris not to do so. Of course, we know that there is no lack of hubris in this President.

I don’t know whether the President’s decision is the correct one. I hope it is. But whether it is the right decision, or not, the decision belongs to President Obama, alone. It is his strategy, not President Bush’s that will decide whether we go on to victory or defeat in Afghanistan. This is now President Obama’s war.

My Take on the USPSTF Recommendations for Screening Mammography

For the couple of weeks, the United States Preventative Services Task Force new recommendations regarding screening mammography have sown confusion in the minds of many. I must say that, after reading the abstract (summary) of the article, I, too, am confused. Sometime in the next week or two, I will go to the medical library at our hospital and read the entire article. Until that time, I do have some preliminary concerns and opinions.

Those who know me or read my writing realize that I am very cynical of anything that comes out of Washington. In this case, I guess I am less cynical than most who think that this is a precursor to governmental rationing of health care under a government run health system. Don’t get me wrong, I think this will be used to ration mammograms, but I don’t think that was the purpose of this report.

My Facebook friends also know that I do a lot of mammography and, of every modality I do, it is the one I dislike the most. That is true for most radiologists. In fact, when a radiologist claims to like mammography, we generally make sure they never have access to sharp instruments in the workplace. In fact, mammography is drudgery. Reading mammograms is a 9 hr. eye test. It requires an incredible amount of concentration and the implications of a missed significant finding are great. Mammography has the poorest reimbursement rate of any studies we do, but is the number one cause of malpractice suits in radiology. My group barely breaks even on mammography and most groups actually lose money. Given these issues, I should be one of the happiest people in the world to have to do less mammography.

Breast cancer, though, can be a devastating disease. It is the leading cause of cancer deaths in women. Approximately 1 out of 10 women will develop breast cancer during the course of their lives. Even if not fatal, treatment can be disfiguring and disruptive. The earlier we can catch breast cancer, the less invasive treatment may be. For these reasons, I have great concerns about these new recommendations that I will attempt to address.

Purpose of Screening Studies

First, we need to understand the purpose of a screening study. A screening study is a study designed to detect pathology in an at-risk population in which there is no cause to suspect that the pathology exists, except for their membership in that population. In other words, screening studies are conducted on patients without symptoms. Therefore, if a woman or her doctor feels a lump in her breast, a mammogram to evaluate that lump is not a screening mammogram, it is a diagnostic mammogram and is not covered by this report.

By their very nature, screening studies are inefficient. They are designed for the highest degree of sensitivity, thereby necessarily sacrificing specificity. Allow me to illustrate the reason for this with the following, simplified, example drawn from mammography. One of the signs of cancer that I use when I look at a mammogram is calcifications. Now there are a lot of different types of calcifications in the breasts from various causes, most of which are not cancer. There are some calcifications that I see that I can almost 100% guarantee will be malignant, but there are also calcifications that I can 100% guarantee will be benign. If these were the only calcifications we saw in the breast, we would be golden, but unfortunately, there are a great number of calcifications between these two extremes of the spectrum, ranging from almost certainly cancerous to almost certainly benign and everything in between. If I were to refer only those calcifications that I knew 100% to be cancer for biopsy, I would have 100% specificity (every biopsy is positive for cancer), but very poor sensitivity (I would miss a lot of cancers among those equivocal calcifications). If I referred every calcification for biopsy, I would have 100% sensitivity (I would detect every cancer), but I would have poor specificity (we would have a lot of benign biopsies.) Because we consider having cancer worse than undergoing a biopsy for a benign condition, we intentionally try to sample all calcifications that have a chance of being malignant, only omitting those calcifications that we are certain are benign.

Every department that does mammography is required by law to conduct quality assurance of their screening examinations. In our practice, once or twice each week, a group of radiologists who read mammography conduct an audit of every biopsy that is performed at our institution and even those performed at another institution, if we read the initial mammogram. During this audit, each mammogram is reviewed and compared to the pathology report. If we recommended a biopsy that turned out to be malignant, we also look at previous mammograms to determine whether the abnormality was present on the previous studies. If we have ancillary studies (e.g. - breast ultrasound or MRI), those are also reviewed. Not only are these audits good on-going training for radiologists, but important data is collected, namely, statistics are generated on everyone who reads mammograms and are compared with national published averages, as well as compared to other radiologists in our practice. This allows us to see how we are doing as a group and individually and allows us to identify any outliers. Of the statistics that are generated, the most important is our false negative rate (i.e. - we read a mammogram as negative, but sometime within a year of that reading, a biopsy proven cancer was detected.) Another, almost as important, statistic we collect is our false positive rate (i.e.- we recommend a biopsy, but the biopsy reveals no cancer.) The national average for false positives, and for our group, is 80%. In other words, of every 10 biopsies we recommend, we expect 2 cancers. If we get more false positives, we are recommending too many biopsies and if we get less false positives, we worry that we are not biopsying enough and that we are missing cancers we should be detecting.

Why Don’t We Screen Everyone?

Now, the American Cancer Society recommends that women start receiving screening mammograms at age 40, yet we know of women in their 30’s and even in their 20’s who get breast carcinoma. So why don’t we conduct screening on women in these age groups? In fact, men can also get breast cancer, so why don’t we routinely screen men? If we truly wanted to catch all the breast cancers that are “catchable”, we would start screening both males and females at puberty and not stop until death. The reason we don’t is two-fold: 1) Mammograms have consequences, and 2) Money.

First, let’s look at the consequences of screening mammography. The consequence of false positives is the major reason given by the task force to stop doing mammography in women in their 40’s. Women who have a false positive report receive unnecessary procedures on their breasts, up to and including potentially disfiguring surgery. Biopsies are uncomfortable and the stress of a woman being told she needs a biopsy is not inconsiderable. There is always the possibility of complications, including infection or even anesthesia related death. Now, admittedly, most of these complications (excluding stress – which is near universal) are very rare, but they are possible.

There are also consequences to even true positives. There is the possibility that we may remove a very slow growing cancer in a woman that would never have become problematic. This is especially a problem with prostate screening in men. We know that many men develop prostate cancer that remains confined to the prostate and would remain subclinical all their lives, until they died of some unrelated illness. We don’t know how many breast carcinomas may remain subclinical, but it may be a not insignificant sum, especially among the cancer that we are most concerned about removing – ductal carcinoma in situ. In this case, a woman might undergo mastectomy, chemotherapy and/or radiation therapy for a cancer that would never have been a problem to her.

There are even consequences to normal mammograms. First, mammograms are uncomfortable for most women and can be very painful for some. Second, mammograms involve radiation. The fact of the matter is that we don’t know how much radiation is required to cause breast cancer, but we are almost certain that increasing radiation to the breasts increases the rate of breast cancer. This is especially true in those breasts that have not finished developing, especially in those women who have never been pregnant, and even among those women who are still subject to the hormonal influences of menstruation. The breasts of women who are post-menopausal are probably less susceptible to radiation (though hormonal replacement therapy may negate some of that protective influence.)

However crass it may sound, the second reason we don’t perform screening mammograms on everyone is that screening is very cost-inefficient. This is the reason, incidentally, that the idea that preventative medicine will save money in the long run is specious. In fact, for every breast cancer that is discovered by screening mammography in the United States, we, as a society, spend over $17,000. Now, just because we detect the cancer doesn’t mean the cancer can be cured. We know that screening mammography has reduced mortality (death rate) among women between 40-50 by about 4%. Thus, for every Quality Adjusted Life Year (QALY) saved, we, as a society, spend approximately $26,500 - $85,500, depending on the study.

Now, if your life or your loved-one’s life is the one saved, this is a small price to pay, but in these times of limited health care dollars, we need to consider cost to society of screening examinations. How much money is too much to save one life? One of the reasons that insurance costs have increased is that most states now require insurance to cover screening studies such as mammograms, PSA screens and colonoscopies.

Several years ago, I went to a major breast care conference during which a pioneer in the field of mammography was honored. This man was a giant in the field, contributing to many of the practices we use today and one of the researchers that proved that mammography saves lives (it was not always assumed so.) This was an annual award and the recipient of the reward traditionally would give a keynote address at the conclusion of the conference. In his keynote address, this mammographer stunned everyone in the audience when he stated that he concluded that it was not moral to continue to provide screening mammograms. His reasoning was that there are only a limited amount of health care dollars (he was a big proponent of a single-payer health care system) and that screening mammography was so expensive per life saved, that we would get more value for our buck if we would put that money into inner-city health clinics, vaccination programs, etc.

The fact is, younger patients have less breast cancer, so we get diminishing returns when we screen younger patients until, eventually, it becomes cost-prohibitive to do so. The problem is deciding where to draw that cost-effectiveness line.

Problems with the Task Force Recommendations

The Panel

One major problem I have with the task force recommendations is that the members of the task force did not include anyone that actually diagnoses or treats breast cancer. There was no radiologist, surgeon, or oncologist on the panel. In fact, I’m not even sure that there was anyone on the panel who still sees patients, at all. Most of the panel are epidemiologists, public health physicians and nurses, and mathematicians and economists. These people, therefore, are number crunchers and do not deal with the various concerns of patients dealing with breast cancer. This manifested itself most notably in the inflated value the panel assigned to complications of false positive studies. While there is no doubt that there is stress and discomfort involved with false positive results, these pale in comparison with the stress and discomfort, not to mention potential death that may occur in women who develop breast cancer that was potentially treatable.

This also caused the panel to lose sight of the real purpose of screening mammography, which is to detect those cancers that are potentially treatable and will extend the patient’s life, in favor of maximizing cost-effectiveness of the screening mammograms.

The References

Like I stated earlier, I have not read the complete paper, so I don’t know if there are reference studies that were used that were not cited in the abstract, though I don’t understand why there would be. When I reviewed the abstract, however, I was struck by the fact that most of the references cited were other organizations statistics concerning screening mammograms and cost-analysis studies. I didn’t recognize hardly any of the titles of the articles. What I did recognize, however, were notable absences of multiple landmark studies, including those that laid the groundwork for performing screening mammograms in women under 50 years of age.

Unusual Statements by the Panel

I was also struck by several statements by members of the panel that demonstrated their total lack of understanding of mammography. The task force abstract states, “Digital mammography detects some cases of cancer not identified by film mammography; film mammography detects some cases of cancer not identified by digital mammography.” This is false. While digital mammography can identify some cases of cancer that film mammography cannot, there is no evidence that film mammography may detect cancers not identified by digital mammography.

On a news show, one of the members of the panel stated that screening ultrasound is just as good as screening mammography and doesn’t have the risk of radiation. While he was correct about not using radiation, the statement that ultrasound is just as good as screening mammography is not only laughable, but it is a reckless statement for an “expert” to make in front of the public. In actuality, ultrasound is a complimentary study to mammography and is not adequate, by itself, to screen for breast cancer.

Recommendations Based on No Evidence

A very unusual recommendation of the Task Force is the recommendation that women over 74 not receive screening mammography. The reason given is that there is not enough research to prove that there is an increase in life span in those women that receive screening mammography. Now, there may be very good reasons not to screen women above a certain age, but the reason given that not enough research is available is just bizarre.

Recommendations Based on Less Than State-of-the-Art Equipment

In another move that is baffling to us that perform mammography is the reliance on studies using film mammography. In a time when most departments are replacing their film based mammogram systems with digital systems, that is kind of like basing a review of the fuel efficiency of cars on studies of the Chevy Nova. Sure, there may be a few still on the road, but they are antiquated and don’t provide a fair representation of the state-of-the-art today. Radiologists will tell you that digital mammography is superior to film mammography, but you don’t even have to take our word for it. In fact, multiple studies, contrary to the statements by the Task Force, also prove this contention. It is puzzling that, with a pronouncement of this magnitude, the latest research was not included.

Lack of Understanding of the Physiology of Breast Cancer

All of the above raise concern about the conclusions of the Task Force, but any, in and of itself, is not a disqualifying factor. What is most disturbing about the recommendations is that they lack an understanding of the physiology of breast cancer. Namely, while breast cancer is more rare in younger patients, the cancer that occurs in younger patients tends to be more aggressive than in older patients. Because of this, we can perform mammograms less often in older women, because the cancer grows more slowly. In a faster growing cancer, however, more frequent screenings are required since the longer interval between screenings allows the cancer to become larger and less amenable to cure. In addition, when talking about Quality Adjusted Life Years, a 40 year old has a longer expected life span than a 65 year old, so the screening in this case is actually more efficient per year of life saved.

My Recommendations

Until I see some new, more convincing data, my recommendations are to follow the American Cancer Society Guidelines. Women with no additional risk factors should have screening mammograms yearly, beginning at age 40. Women with increased risk factors, such as strong first-degree family history or the HrBCA gene should consult their doctor about when to begin screening mammograms.

Mammograms in Elderly Patients

Elderly or infirm women should consult with their physician regarding screening mammograms. It really does not make sense to perform a screening mammogram in a patient with only a couple of years of life expectancy remaining. To put an absolute age on when to discontinue screening mammograms makes very little sense. People are living healthy lives much longer now. There are many 75 year olds that may have a life expectancy of 20 years or more. To deny these women screening mammograms is a crime. On the other hand, if there is no intention to undergo treatment, should cancer be found, a screening mammogram is a waste of money.

Ramifications for Health Care Reform

We have been assured by the administration that this task force recommendation will not affect policy as regards PelosiCare. In fact, nothing could be further from the truth. Specifically, Section 2713 of the Senate Health Bill would give the recommendations of the U.S. Preventive Services Task Force the force of law by requiring all health insurance plans to provide coverage (with no patient co-pays) for “items or services that have in effect a rating of “A” or “B” [recommended] in the current recommendations of the United States Preventive Services Task Force.” White House budget director, Peter Orszag, states that with health care reform, "An independent Medicare commission … will ensure that reforming the health-care system is not a one-time event but an ongoing process that implements the most recent progress in medical science with the goal of improving care and lowering costs." (Washington Post; 11/20/09; Bills Offer Clear Path to Better Health Care; Orszag, Peter)

In addition, this is just the type of recommendation that insurance companies look for in order to deny services. So for the Obama administration to claim that these recommendations will not be used to "ration" medical services are mistaken, at best, and dishonest, at worst. All of us should keep this in mind when we consider increasing government involvement in our health care system.

Adopting these guidelines will cost lives. The media and Democrats went into a frenzy when Sarah Palin mentioned death panels. This may not be what she had in mind, but with recommendations like this, it is a death panel, nevertheless.

Terrorism Trials in New York, What Could Possibly Go Wrong?

In a continuing effort to prove that his administration is the most clueless of all time, President Obama and his Attorney General, Eric Holder, have decided to transfer hardened terrorists, caught on the battlefield and subjected to coercive interrogation techniques, to our country's largest city, into a legal system that presumes innocence and is heavily weighted in evidentiary rulings toward defendants. What could possibly go wrong?

There is so much that is wrong about this decision that it is difficult to know where to start.

According to the Attorney General, civilian courts are, “most likely to lead to a positive result,” for the conviction of Khalid Sheik Mohammed and his compatriots. Really? More likely than, say, KSM pleading guilty before a military tribunal and asking to be executed, as he did in late 2008, before Obama swept into office and put all military tribunals on hold?

In fact, as any of us who lived through the O.J. Simpson and Rodney King trials can attest, American jurisprudence can be very fickle. Our judicial system is geared to offer maximum advantage to the accused. The accused are presumed innocent and guilt must be proven beyond a reasonable doubt for conviction. Furthermore, there are very strict guidelines as to the evidence that may be presented. Except under very limited conditions, a search warrant is required to search a suspect’s property. There are very strict “chain of evidence” guidelines as to how that evidence is handled. Defendants cannot be compelled to testify against themselves and are, in fact, guaranteed the right to have an attorney present during their interrogation. Physical duress is strictly prohibited and even mental duress is very limited during an interrogation. In fact, these rights must be enumerated to the suspect or any evidence or confession that is obtained before the recitation of these Miranda rights may not be used during court proceedings.

Khalid Sheik Mohammed was captured on a battlefield by soldiers, not policemen. Miranda rights were not read. No warrants were issued. An extradition warrant was never issued. He asked for an attorney and was denied.

His confession was elicited by enhanced interrogation techniques, including waterboarding, which have been decried by this very administration as torture. Is there anyone who thinks that a judge might not have a little problem with this?

Holder and Obama profess that this will not be a problem. Holder told a Senate panel that, “Failure is not an option.” Oh really? Then why presume innocence? Is this just a show trial with a pre-determined outcome or are we really going to try these terrorists in a fair manner? And what happens if they are found not guilty? Will they be able to freely walk the streets?

President Obama, when asked whether it was offensive to try KSM in a civilian court stupidly said, “I don't think it will be offensive at all when he's convicted and when the death penalty is applied to him.” So now, the President of the United States has already publicly declared that the defendants of a civilian trial has pre-judged the outcome and declared an appropriate sentence. A defense attorney should have a field day with this. Remember, Charles Manson was almost granted a mistrial because Richard Nixon declared him guilty on a national news magazine show, thus tainting the jury pool. No doubt, the 9/11 terrorists’ lawyers will attempt the same tactic.

The fact of the matter is that civilian courts are poorly equipped to deal with prisoners of war. This is without precedent in our history, as Lindsey Graham (RINO-SC), no one’s idea of a raving right-wing nut job, pointed out to Eric Holder at a Senate hearing on the issue.

In addition, there are national security implications. By law, the prosecution must turn over any implicating evidence it possesses to the defense. In a military tribunal, the defense attorneys are military members with security clearances and experience handling classified material. There are no such safeguards in a civilian court. In fact, in a civilian court, the defendant may act as his/her own attorney and be granted unlimited access to this material. Andy McCarthy, the prosecutor of the Blind Sheik and his co-defendants in the first World Trade Center bombing and an avid opponent of civilian trials for terrorists, describes how he was forced to turn over a list of unindicted co-conspirators in the Blind Sheik case which, within 48 hrs., had spread throughout terror networks, alerting members that they were under suspicion causing them to flee the country. Likewise, the 9/11 terrorists will have access to documents describing our counter-terrorism intelligence, possibly putting confidential sources and techniques at risk.

So, why bring terrorists who wanted to plead guilty in a military court into a civilian court where the outcome is far from assured? Simple. This is a sop to Obama’s far-left base. Obama knows that putting the Bush administration and the CIA on trial directly, as the left-wing nut cases would like, would be political suicide. This is a method to indirectly put the Bush administration and their techniques for fighting the war on terrorism on trial. In my opinion, it would not displease Obama if the terrorists were acquitted on a technicality. This would be the ultimate vindication of the left against the Bush administration.

It would also be a travesty of justice.

A letter from Janet Napolitano

Janet Napolitano, Secretary

Dept. of Homeland Security

Washington, DC

My Fellow Citizens of the World in the United States,

As you know, we recently suffered a man-caused disaster at Ft. Hood, Texas, when an oppressed member of the Religion of Peace, apparently suffering from pre-post-traumatic stress syndrome, was driven to commit an act of violence after receiving orders to deploy to an overseas contingency operation.

The President and I would like to express that we are very disappointed and find this type of activity totally unacceptable. But look on the bright side, at least he wasn’t expressing his opposition to the President’s desires in a town hall meeting.

While we may never know what his motives were, you may be assured that it has nothing to do with the hijacked Religion of Peace or their Prophet (pbuh.) Our working theory right now is that Maj. Hasan was marginalized by President Bush, which drove him to take subliminal orders from Rush Limbaugh.

We extend our sympathies to the victims of this tragedy – those members of the Religion of Peace that will undoubtedly feel the backlash from those gun-toters and Bible-clingers that make up the Republican Party.

I would, however, like to take this opportunity to say, “I told you so.” I was mocked for describing the terror threat from military veterans earlier in the year. Well, who’s laughing now? (Not that I’m laughing, you understand.) Doubtless, this poor, confused victim was also brainwashed by Glen Beck to be a pro-life wacko, too.

The Obama administration is being very pro-active to ensure that another man-caused disaster like this doesn’t happen again. Effective immediately, soldiers will no longer be allowed to use guns. An Army base is no place for firearms. This order will be extended throughout our Overseas Contingency Operation. It may be inconvenient to go to battle without a firearm, but we cannot be too careful, someone may get hurt with those things.

These steps will allow the administration to concentrate on the real extremists – Fox News.

Your nanny,

Janet “Big Sister” Napolitano

In Class, Obama Doesn't Hold A Candle To Bush

Last Thursday, a radical Muslim extremist walked into a building packed with unarmed American soldiers, jumped up on a table, and shouted, “Allahu Akbar!” (Allah is great!) and started shooting. When the gunfire was brought to an abrupt halt by a courageous policewoman, 13 people had died and 41 were wounded.

Less than 24 hours following this treasonous attack, President Obama warned the country, “Not to jump to conclusions.” This from the President who firmly jumped with both feet into a controversy by saying Cambridge Police “acted stupidly” in the arrest of his friend. I don’t know if we’re still not supposed to jump to any conclusions, but considering facts that have been revealed, some of which have been known by the CIA for as long as six months, make the conclusion about as much of a jump as stepping over a chalk line.

Less than 24 hours later, President Obama, addressing the Democratic caucus before the PelosiCare vote, President Obama, according to Democratic Congressman, Earl Blumenauer, said the following: “Does anybody think that the teabag, anti-government people are going to support them if they bring down health care? All it will do is confuse and dispirit [Democratic voters] and it will encourage the extremists.

Even disregarding the pornographic epithet of “teabaggers” (which use, incidentally seems to have started with the news anchor, Anderson Cooper, of that “real” news network, CNN), this is a frankly offensive statement. Mr. “Let’s Not Jump to Conclusions” is branding anyone who doesn’t support the Congress’s radical care takeover (which, incidentally, according to the most recent polls, is the majority of the country), extremists and anti-government.

This shouldn’t be surprising. The President has already called Americans who have opposed his policies liars, Nancy Pelosi has called people expressing their opposition to the health care “Un-American”, and Harry Reid has called them “Evil-mongers”. These are not political pundits. These are the top three Democrats in Washington openly expressing their contempt for those people who would oppose their policies. It is clear that they feel that the American people are to, as the President puts it, “Get out of the way . . . and don’t do a lot of talking.”

There were a lot of things to dislike about George W. Bush’s policies, but you didn’t see him disparaging the citizens like this. When it comes to grace and class, Bush had more in his little finger than Obama does in his entire body. Of course, almost everybody does.

The White House War Against Opposition Media

Several months ago, on another site, I wrote an article on why I felt that the Obama administration is not socialist, it is fascist, an opinion for which I took some heat from some quarters. In follow-up discussions, I predicted that the next step would be for the President to try to control the media. I felt that the first step would be a bail-out of the newspaper industry, thereby granting the administration essential ownership of the paper media. I still believe that is a distinct possibility, but I was wrong about it being the first step. The first step has been to try to isolate, alienate, and obstruct FOX News.

Of course, the Obama administration made no secret of its antipathy to FOX News, but it has taken on a new dimension over the last month. In the first part of October, the Obama administration informed FOX News that no member of the administration would appear on any FOX News program. On October 11, the attempt to isolate FOX News became public when White House Communications Director, Anita Dunn, went on CNN and declared that the administration doesn't consider FOX News a legitimate news source.

This is the same Anita Dunn who stated that, during the campaign, the Obama campaign totally controlled the media and that they made sure that the media reported what Obama said and not why he was saying it. (This is also the same Anita Dunn who declared that one of her favorite political philosophers and one that she always turns to is mass murderer, Mao Tse Tung.)

Today, it was reported that the White House is now urging other networks to sever any ties with FOX News. As you may or may not know, it is common for news networks to share clips. That is how you see highlights of Meet the Press on FOX News or Sunday Morning with Chris Wallace on CNN. It also explains why you see the same Balloon Boy video on all the networks. For the White House to insist that other networks no longer have ties with FOX News, puts FOX News at a serious competitive disadvantage.

Why does the White House so dislike FOX News? Well, it could be that FOX News is exposing things going on in this administration that the other networks will not. Things like having a radical, communist, truther in the administration, or the ACORN prostitution scandals, or even that the White House Communications Director lists Mao Tse Tung as one of her two "favorite political philosophers." The fact is that the Obama administration does not like opposition viewpoints and is willing to play "hardball" politics in order to silence them. Karl Rove accurately likened this to Richard Nixon's enemy list. In other words, FOX News is the one news outlet that the administration cannot, in Anita Dunn's words, "control."

So now, the Obama administration has admitted that it controls the news media and if the media doesn't play according to the administration's rules, it will be isolated and punished. Is there no mainstream outlet that finds this offensive, or are they too afraid that they will be next?

Roundup of blogs and news - 10/10/09

The big news of the week is that President Obama won the Nobel Peace Prize for . . . uh . . . being hopey-changey. What was lost in all this was the other prizes the President won.

John Podhoretz thinks that Obama was the logical choice for the Nobel Peace Prize.

Mark Steyn offers his own unique view of the Nobel Prize and Obama's vision.

Even the very liberal Richard Cohen is scratching his head.

And the Obama/Clinton State Department, classy as always.

The Wall Street Journal describes the Obama administration's war on medical specialists. This punishes some of the most highly trained and hardest-working physicians out there.

During the Clinton administration, the prosecution of Medicare "fraud" became a point of emphasis. The trouble is, the regulations (not laws) enacted by the Clinton administration did not allow for mistakes. There was only fraud or not fraud. This is what can happen with that type of mindset. (Oh, by the way, if someone is undercharged, that is Medicare fraud.)

The sleight of hand required to make the Baucus bill "deficit neutral". Remember, deficit neutral does not mean free. It has to be paid for. In this case, with higher taxes and fees, transferring costs to the states, and cutting Medicare reimbursement 25%, meaning that more docs won't accept Medicare and subsequent rationing.

Another, maybe easier to read, analysis of the Baucus plan.

A second stimulus bill means that the first one did not work. What makes us think a second will work any better? And, more important, how do we pay for it?

Sometimes truth is stranger than fiction. Saudi Arabia wants financial aid if a UN climate control pact lessens fossil fuel dependence.

Andrew Klavan asks, "Is Barack Obama Jesus Christ?"

Jonah Goldberg discusses CNN "fact-checking" a Saturday Night Live sketch.

For those who think that global-warming is settled science, this is an interesting article.

Uh-oh! A reliably Democratic interest group might make the President look bad. Can't have that.

Barack Obama – Still Over His Head

A few weeks into his Presidency, President Obama had already had to throw Tom Daschle under the bus for tax problems, was taking heat for seating a tax-cheat, Timothy Geithner, as his treasury secretary, and several lesser luminaries he wanted for his administration had to back out because of tax problems. He had to break his own campaign promises about not allowing lobbyists roles in his administration by granting several waivers. He insulted one of our closest allies, Great Britain, by sending back a bust of Winston Churchill that had been a gift by the British government to the American President after 9/11, and had essentially snubbed British Prime Minister, Gordon Brown, on an official diplomatic trip to the United States. In an article I wrote at that time, I opined that Obama was "way over his head", an opinion for which I was excoriated by a couple of people and that lead me to being called a racist because I was "obviously judging him on his appearance."

Now, several months later, I see absolutely no reason to change my opinion. In the interim, Obama signed a hurriedly passed "stimulus" bill, breaking at least a couple more campaign promises on the way, that has failed to stimulate anything except the national debt and Democratic interest groups. He consistently sides with dictators and tyrants while insulting allies and ignoring democratic popular movements. Under his watch, North Korea continues to test missiles and atomic bombs and Iran, a regime that has vowed to destroy Israel AND the United States, openly defies international opinion to develop the atomic bomb. Under the Obama administration, the government now owns a large chunk of the domestic auto industry and, flouting existing protocol, the unions received favorable status over preferred shareholders to gain ownership of much of the remainder. Now, it looks like Chrysler and GM will be bankrupt again in about a year. Unemployment continues to climb and there is no end in sight. No matter what you think about the President's health care reform, he has shown himself particularly inept in getting it through Congress or creating a demand for it in the public. Now, the latest embarrassment was to fly to Copenhagen, tell the Olympic committee that they should award Chicago the Olympics primarily because he wants them.

It is time to realize that Barack Obama is the perfect embodiment of the Peter Principle - that a person rises to the level of their incompetence. He is an attractive man who reads a teleprompter well, but who is, at best, a mediocre politician. This should come as no surprise to us. While the left, and particularly the fringe media (ABC, NBC, CBS, CNN, etc.), fretted over Sarah Palin's inexperience for the Vice-Presidency, only being the governor of a state, they completely disregarded the lack of any real-life experience possessed by Obama.

This is a man who has never run a business in his life. His job prior to entering politics was as a community organizer, trying to see how much government money he could wrangle for his own special interest group. He was tagged early by the Chicago political machine (and no one runs machine politics like Chicago) as a potential star. He won his first election to the Illinois State Legislature after his three opponents were kicked off the ballot for technicalities in their ballot petitions - things like people printing their names rather than writing them, valid signatures but unregistered collectors, etc - which left him running unopposed. In his election for US Senate, his Democratic opponent withdrew after his "sealed" divorce papers were leaked to the press. In the general election, Republican Jack Ryan also withdrew after his "sealed" divorce papers were leaked, causing a scandal. What are the chances? Obama then made short work of carpetbagger, Alan Keyes, from Maryland.

In his short, less than one term, Senate career, Obama was totally unexceptional other than being named the Most Liberal Senator by National Journal Magazine in 2007. His big break onto the national scene was in delivering the keynote address to the Democratic National Convention in 2004, thus demonstrating his prowess in reading a teleprompter. Obama was being groomed for the Presidency following a Hillary Clinton administration, in 2012 or 2016 but, apparently, the Democratic National Committee forgot to send him the memo.

There is no doubt that Obama is a brilliant campaigner. As Rush Limbaugh said, "He says nothing better than anyone." And it is true. On the campaign trail, a candidate can say whatever they like. You don't like lobbyists? There will be none in my administration. Want Guantanamo closed? It will be within a year. We will withdraw from Iraq within a year. Afghanistan is the good war - I will concentrate on winning there. I will change the tone in Washington. I am a uniter, not a divider. Yadda, yadda, yadda.

Unfortunately, when the election is over, you have to actually govern and this is where Obama has been exposed. He has no real world experience outside of politics and his para-political community-organizing gig. He doesn't have even a rudimentary grasp of history or economics. For all of Obama's vaunted intelligence, I have yet to see evidence of it. He hasn't deviated one iota from the far left socialistic/fascistic playbook since coming into office. He doesn't seem to understand that the average American doesn't hold with the liberal philosophy he has been entrenched with all his life. He spouts platitudes about social justice that any sophomore sociology major at his former alma maters, Harvard and Columbia, would instantly recognize and nod his head, but that the average rancher in Kansas or construction worker in Georgia, people with real-world experience, would recognize as insanity. Instead, Obama regularly ridicules his opponents and accuses them of ill will whenever he is opposed. Instead of using his bully pulpit to persuade and inspire, he uses it to lecture, browbeat and declare from on high what is and what is not "acceptable." He wants "conversation and ideas" but, if those ideas don't agree with his viewpoint, he decries them as "partisan politics as usual."

Our President is now in perpetual campaign mode, certain that his charm and erudition can overcome objections to his far-left policies. Unfortunately, while you may be able to get away with promising unicorns that fart rainbows in campaigns, when it comes to governing, people become a little more discerning. That is why, no matter how many times he promises it, people know that you can’t dramatically expand the government health care rolls while simultaneously decreasing the deficit and increasing accessibility to health care providers. People understand that the President is blowing smoke up their skirts and that is why the public support for Obama’s health care reform is tanking, not because of lies and misleading statements from Obama’s opponents. Just try to convince someone that the way to increase efficiency of anything is to have more government involvement and you’ll understand why Obama is having a difficult time selling his program.

All of this might be comical if it wasn’t so serious. Our economy continues stagnate while unemployment rates continue to climb. Indecision on Afghanistan may very well cost us the war or, at the least, more American lives. Iran is on the cusp of becoming a nuclear power and Russia is, once again, flexing her muscles.

A more humble man might regroup, learn some lessons from his failures, and come back as a strong and decisive leader. Of course, humility and Obama do not even belong in the same sentence. If there is anyone who has a high opinion of himself, it is Barack Obama. George Will says, “Presidents often come to be characterized by particular adjectives: "honest" Abe Lincoln, "Grover the Good" Cleveland, "energetic" Theodore Roosevelt, "idealistic" Woodrow Wilson, "Silent Cal" Coolidge, "confident" FDR, "likable" Ike Eisenhower. Less happily, there were "Tricky Dick" Nixon and "Slick Willie" Clinton. Unhappy will be a president whose defining adjective is "vain."

We were promised a President who was post-racial, post-partisan and who would change “politics as usual.” What we got was an ungracious, egotistical, highly partisan, radically left-wing President who is way over his head.

Roundup of blogs and news - 10/01/09

If abortion isn't going to be covered by the Health Care Bill, why do Democrats keep voting down amendments to specifically prohibit it? According to Sen. Baucus, "This is a health-care bill. This is not an abortion bill."

What good does it do to prohibit government funded health care if we are prohibited from asking them for ID? This is why Joe Wilson was right.

Hollywood is full of degenerates. Whoopi Goldberg is an absolute idiot. It is a good thing that she is a child advocate.

Racism Revival: How to be a 21st Century Bigot, by Sonja Schmidt.

Ann Althouse asks, "Why slam those of us with great health benefits? We worked for it. We earned it. And we're the middle-class people Obama said he wasn't going to hurt.

Speaking of raising taxes on the middle class (and everyone else), can you say, "VAT"?

The President doesn't seem to want to be the leader of a world superpower. Ruben Navarrette, at Real Clear Politics, gives his take.

Daniel Henninger explores this same topic. When we hold out our hand to dictators, what does that say to those brave dissidents of those regimes.

Remember all those countries who were going to like us once we got rid of the Bush braggadocio? Well, now they don't like us because we're weak. Who would have ever thought France would be asking us to man up?

Let's try some strong sanctions and see if they work.

Victor Davis Hanson argues that many of our international problems would go away if we would develop our existing energy sources.

Rep. Alan Grayson (D - Moron) elevates the level of discourse on the floor of the House of Representatives. Where is the outcry for a resolution of condemnation? Anyone? At least he didn't accuse anyone of lying.

Don't you feel bad for Michelle and Oprah's sacrifice by taking a trip to Copenhagen? But no sacrifice is too much if it's for the children. (And just how will the Olympics inspire kids to become the next Oprah Winfrey?)

Multi-millionaire, Michael Moore, claims, "Capitalism never did anything for me." Again, why does anyone take this hypocrite seriously?

Stephen Spruiell at NRO takes on our favorite anti-capitalist.

The newly non-politicized Department of Justice is being awfully slow in releasing information about dismissing the case against those New Black Panther Party.

George Will describes how difficult it is to create a sense of crisis about global warming when temperatures haven't risen for 11 years.

In 2009, 47% of Americans will pay $0 income tax. That means that half the people deciding on how we spend money as a nation will be spending the money earned by the other half. I think that everyone who votes should have to pay taxes. Otherwise, there is no disincentive for reckless spending.

Roundup of blogs and news - 9/29/09

Where is the outrage from NOW? To discredit Giles and O'Keefe, the investigative journalists who brought down ACORN, libs are trying to find sexually suggestive pictures of Hannah Giles.

Speaking of ACORN, Harry Reid (Sleazeball-NV) is blocking a Senate probe into ACORN's activities, claiming that they would be a "distraction".

A simple explanation as to why "Health Care Reform" is simply income redistribution. Marxism in sheep's clothing.

Fact-checking Obama's claims about Health Care Reform in this NRO article by Michael Cannon and Ramesh Ponnuru.

Robert Samuelson, in the Washington Post, declares that what is driving Health Care Reform is not public needs or wants, but simply ego-gratification.

Until the Democrats take on Medical Liability Reform, any Health Care Reform bill is not serious about saving money.

You lie! Oops! Wait a second. Now, liberal Dems want to include illegal aliens in our shiny, new government run health-care system.

As the United States moves toward a public health care option, Canada moves toward a private option.

Patrick Kennedy, the dumbest of the clan, says that with the new government mandated medical records, patients may dictate what goes into them. As a physician, let me just say that this is totally INSANE!

And not content to provide one totally idiotic news story of the week, Kennedy goes for two as he provides the inevitable warning against conservative violence.

Mark Hemingway explores what is hidden in the Baucus Health Care bill.

Gosh! Who'd a thunk it? The Obama administration, in spite of all their promises and deadlines and excoriation of the Bush administration, finds that closing Gitmo more complicated than they thought.

The President doesn't have time to meet with his hand-picked General in Afghanistan or to "form a strategy", but he has time to go on a month's vacation, golf, chair a UN session, and now fly to Denmark to shill for the Olympics. Glad to see his priorities are in order.

This abuse of the Voting Rights Act by the Department of Justice is just one more example of how highly politicized this administration's DOJ is. Remember when the Dems complained about the politicization of the Bush DOJ?

I don't often link to Jay Nordlinger's recurring NRO column, Impromptus. Not because I don't like it, in fact, it is one of the columns on NRO I most like and the only one to which I subscribe by RSS. But it covers such a wide range of topics that it doesn't really fit into a round-up like this. I offer a link today because I want to introduce you to this wonderfully pithy and well-written feature, but also because of his first topic, "Everything begins with O".

The funniest man in the world, Dave Barry, turns serious as he talks about the squelching of free speech on our nation's campuses.

And here in our great state of Michigan, it seems that neighbors can't watch their neighbor's children without a license. You won't believe this. Or, sadly, maybe you will.

Tell your children to GET A GOVERNMENT JOB!

Frank Fleming is concerned about the angry conservatives and gives hints on how to make conservatives less angry.

Why in the world is the US giving Libya any money at all, let alone funneling it through the Qadaffi family? Especially after the Lockerbie bomber debacle.

Lloyd Marcus, the African-American musician who sings at the Tea-Parties tells us to stop allowing the left to set the rules.

A very important column by David Limbaugh regarding Obama and globalism.

David Brooks is the New York Times' idea of a "good conservative" which means I have very little use for him and his views normally. This article, on The Next Culture War, however, is very good.

When you've lost Richard Cohen . . . An Obama supporter tells Obama to start acting like a President.

This may need to be a recurring item. More public school indoctrination.

Dog Feces Ice Cream - by Mark Steyn

I don't usually just link to one article, but this article by Mark Steyn is especially good.

Roundup of blogs and news - 9/25/09

This is a very thought-provoking article by Victor Davis Hanson at National Review Online. If you think of Barack Obama as a college administrator, it all becomes clearer.

Barack Obama's UN address was typical Obama - typically vapid, narcissistic, and pandering to the worst elements of the world.

Rich Lowry offers another take on the UN speech. Obama Triangulates His Country.

Mona Charen offers her take on the President who seems to feel as though American history began with his election.

Meanwhile, this is how a real leader speaks to the U.N. The transcript of Benjamin Netanyahu's speech, in which he rakes the UN over the coals.

This is why some people were so upset about the Obama speech to school children - because in some of our schools, our kids are being indoctrinated. This is a public school. "Red and yellow, black and white, all are equal in his sight." Hmmmm. That sounds familiar.

Speaking of indoctrination, this video is being shown in many of our schools. It is very anti-American and anti-capitalist. The problems are just too many to mention. It is 20 min. long, but you really should see what our children are being taught.

A good article by Pete DuPont in the Wall Street Journal about why Obamacare is bad for your health.

Oh, and how about this? The IRS confirms that if you don't purchase health care insurance under the Baucus plan, you may be sent to jail!

Want to read the Baucus bill before it is voted on? You can't. Baucus claims it is too difficult to put the bill online. Is there no staffer on Capitol Hill who knows how to use a computer?

So, what if all the data that global warming was based on was lost? Nooooo. There's nothing suspicious about that at all!

Wait! Didn't ACORN CEO, Bertha Lewis, say she was glad that the corruption in ACORN came to light? So why is ACORN suing the filmmakers? And why are two of the fired employees joining in the suit for unlawful termination? And why should anyone take anyone from this organization seriously, ever again?

Obama has reportedly asked Gen. Petraeus and Gen. McChrystal, the commander in Afghanistan, to "scrub" their assesments on the war in Afghanistan. I get tired of saying it, but can you imagine what would happen in Bush had done that? And while we're at it, Obama says he doesn't want to commit more resources to Afghanistan until we have a strategy in place. How long has this man been President?

The US government can't get GI bill checks out to veterans who are depending on them for school. But they will do much better with health care. Right?

From TigerHawk, "A few clowns shout at a "tea party" and the media starts worrying about the resurgent Klan, but the left literally attacks the police at the G20 protests and nobody says anything." Could it be that there is a double-standard? Nah!

The President's "Diversity Czar" at the Federal Communications Commission is a Hugo Chavez admirer. The same Hugo Chavez who has systematically shut down media outlets in Venezuela who oppose him and his policies.

If you haven't read them, yet, I have posted the first two essays in my series on Health Care Reform. Part 1 is here. Part 2 is here.

And finally, another international incident as Pakistan condemns the U.S. for pre-emptive use of Hillary Clinton.