The US Supreme Court refused this week to rush through a lawsuit by Virginia Attorney General Ken Cuccineli that would declare the madate to buy health insurance unconstitutional.

With just 11 words: "The petition for a writ of certiorari before judgment is denied," the court sent the suit back to wind its way through the federal court system.

This is good news. I was afraid the conservative wing of the court might knock down health reform the first chance it got; instead the court insisted the suit work its way through the system like any other.

Only rarely does the court allow a case to be fast-tracked, and it usually is a case involving national security, and it must be urgent. The court didn't agree with Cuccineli that this case was urgent.

The longer it takes to get to the Supreme Court, the more time the law's provisions will have to become part of American health care -- provisions such as allowing adult children to stay on parents' plans until age 26, the mandate that insurance companies pay fully for diagnostic tests such as colonoscopies and mamograms, the removal of annual, and eventually, lifetime caps on coverage and more.

Given the chance, the Affordable Care Act will allow more people access to quality care -- provided the state health insurance exchanges aren't allowed to sabotage the law as they are attempting to do in North Carolina.

One good bit of news is that Justice Elana Kagan did not recuse herself from the case. She was Solicitor General, so she did participate in some court cases and has recused herself from them. But she did not present any cases on the health care reform law, so she will participagte in the final decision, which could work its way back to the court sometime in 2012.


I'm in Raleigh today to attempt to speak before the legislature before they pass this  bill giving power of the health benefits exchange to the insurance companies.

I don't know what the logic is, aside from a system of you-scratch-my-back-I'll-scratch-yours. The legislators who were elected to mind the interests of the people they represent are instead minding the interests of the big money that paid for their elections.

The bill's sponsor, Rep. Jerry Dockham, has scheduled time to allow big money to talk, but almost no time for consumers to speak. That's probably because he and his cronies know it's bad for consumers, but they don't care.

I'll be there with my picture of Mike, whether they allow us to speak or not.

I haven't come to be shrill or mean; I just believe that insurance companies are looking out for themselves and their bottom line because that's the very nature of business. As a writer, I need an editor; as businesses, insurance companies need oversight, and not from themselves. It's a clear (to most people, at least) conflict of interest. This bill, H115, offers almost no oversight.

This is the same legislature that just dumped 39,000 people in a ditch because they wouldn't change the language in the unemployment benefits law to allow jobless people a few more weeks with an income. They tied the unemployment issue to their insanely inappropriate budget proposal, which isn't even finished yet and said Gov. Perdue would have to take both or neither. Wisely, she vetoed the bill.

I hope she has the sense to reject this one when it comes to her as well.



Rep. Paul Ryan, (R.-Wis.) chairman of the House Budget Committee, proposes letting seniors pay up to two-thirds of their own medical costs under a new model of Medicare that he unveiled the other day.

He calls it asking people to help defray the rising costs of care.

But under his plan, people who are under age 55 now would get smacked with up to 70 percent of the cost of their care come 2030, says the nonpartisan Congressional Budget Office.

Costs wouldn't come down; they'd just get shifted, and once again, working-class Americans woiuld get shafted.

Medicare has served its recipients well for nearly a half century. Politicians like Ronald Reagan predicted in 1963 that to pay the costs of health care for seniors would destroy the Constitution and break the Treasury.

Of course, nothing like that happened. Medicare costs are going up because the government can't negotiate for better drug prices, for one thing. We Americans pay more for the same pharmaceuticals than any other country on Earth because we alone don't regulate prices.

Doctors and hospitals keep being asked to take less and less in compensation, but medical device manufacturers can hike their prices all they want.

The abuses aren't coming from patients seeking too much care, and they aren't coming from most of the doctors and others who care for the elderly; they're coming from big corporations.

Ryan's plan is based on the belief that seniors making their own decisions about health insurance can do a better job of keeping costs in check than Washington bureaucrats.

That's different from the approach in the Affordable Care Act, which relies on government to police the market and would ban insurers that jack up premiums from signing up customers who get taxpayer subsidies.

The GOP budget "will preserve Medicare through competition among health plans for the business of millions seniors," Ryan said.

Once again, here's the claim that the free market can handle it.

We've seen how well that works in the health insurance market. How many more people will die before their time before the American people see the folly in this?

After the NC Republicans pulled the bill that would give insurance companies control of the health benefits exchange, we health care advocates believed we had won a small battle.

As it turns out, the bill, H115, was pulled so it could be amended in secret.  Not a single advocate has been allowed to even see the bill, and it appears the House has put it on a fast track for passage. It passed through committee without even allowing for public comment.

The Republicans and the insurance industry have gained the advantage, and now all we can do is work to kill this bill.

Creating a health benefits exchange run by and overseen by the insurance industry would be devastating. If this bill passes, the appeals process would favor the insurance companies. In other words, if you're denied chemotherapy for cancer because it would be done as an outpatient and the company says you're only covered for in-hospital care, they'll get away with it.

They can sell policies that seem great on the surface but contain small print denying you coverage for even vital tests without pre-authorization.

There is no process in this bill for throwing a company out of the exchange for bad behavior.

The bill would strengthen Blue Cross/Blue Shield's virtual monopoly in the state, even though the federal law created the exchanges to be level playing fields.

The bill has to be stopped.

I guess we can call it a tradition now. Each Mike Day (April 1), we dress in plaid and go somewhere to eat Cadbury Creme Eggs, and we leave one for Mike. The first anniversary, it was the mountaintop where we scattered his ashes; the next year it was next to a mountain river, and this year it was at the beach on Sullivans Island in South Carolina.

I'm here with Mike's favorite cousin, Shannon and her husband Matt and their two kids, Cassie and Liam, who has decided he loves the eggs as much as  Mike did, even though he doesn't remember Mike.

I found myself looking at my watch today and living it moment-by-monent. But sharing the day with Shannon helped a lot.  We all wore plaid, and we pointed it out every time we saw someone else in plaid.

"They apparently got the memo," we said.

As for doing something silly, that's easy with a 4-year-old boy begging you to poke him and tickle him and chase him and challenging you to catch him and plant a kiss on him. He stuck his head into the ends of the cannons at Fort Moultrie and hollered so he could listen to the echo. Cassie went to look in each one and announced that people had thrown trash in all of them. She put the whole Cadbury egg in her mouth and drooled a little chocolate.

Yup, it was a good day for silly, which is how Mike wanted us to spend it.. Otherwise he wouldn't have died on April Fool's Day.