Medical Industries DA
1NC shells
Organ Sales
1NC Obamacare Bad
Uniqueness: Perception of cost savings preserves Obamacare now
McCarter 14 Daily Kos staff reporter
Joan, Daily Kos, April 15, http://www.dailykos.com/story/2014/04/15/1292183/-Treasury-bonds-getObamacare-boost-as-health-care-costs-nbsp-slow#
Health care costs increased just 2 percent last year, the slowest rate of growth in 65 years, in large
part because of the cost controls created with the Affordable Care Act. That means inflation is curbed,
and it also means that U.S. treasury bonds are a good bet for investors.
Less inflation, which boosts the purchasing power of fixed-rate payments, may help attract buyers to
Treasuries as the economy strengthens and the Federal Reserve pares its own bond buying. While yields
have fallen this year, the compensation 10-year notes provide after inflation is close to the highest in
five years. Excluding food and energy, health care accounted for about a third of the slowdown in
consumer prices, which rose 1.1 percent in the past year from 2 percent in the prior 12 months.
“This is good news” for bonds, Kathy Jones, a New York-based fixed-income strategist at Charles Schwab
& Co., which has $2.25 trillion in client assets, said in a telephone interview on April 4. By holding costs
down, “it may be a benefit to inflation, longer-term.” Jones, who has been advising clients on the bondmarket implications of the health-care law, is recommending that investors buy 10-year Treasuries
because low inflation will keep the Fed from lifting interest rates. […] Inflation has remained below the
Fed’s 2 percent target for 22 straight months and “a couple” of policy makers said at its March meeting
that “unusually slow growth” in health-care prices has played a “notable role” in holding back prices,
minutes of the gathering released on April 9 show. These cost controls in the law are largely through
cuts in Medicare payouts to poor-performing hospitals and through the incentives it created to curb
readmission rates, as well as and changed payment programs to reduce unnecessarily expensive
procedures. Just think what savings could be achieved if Medicare could negotiate prescription drug
prices. Or how much could be saved in a public option where the government was setting
reimbursement rates for all care. The Republican mantra that the law is a total disaster that will doom
the nation is sounding more and more ridiculous. This news, combined with the latest projections
from the Congressional Budget Office on the cost savings ($104 billion over previous projections in the
next decade), is going to make a hard sell for Republicans with their traditional allies in the financial
sector, not to mention the millions of people who would lose access to health care.
Threat of cost increases could kill Obamacare
Norman 14 health care reporter for POLITICO Pro. Before joining POLITICO, he
worked as a science writer at The Rockefeller University. He previously covered the
politics and policy of Medicare for Part B News and started out at the Pensacola News
Journal.
Brett, “Obamacare: Anger over Narrow Networks,” Politico Pro, July 22,
http://www.politico.com/story/2014/07/obamacare-health-care-networks-premiums-109195.html
Americans for Prosperity is hitting on these “narrow networks” against Democrats such as Sen. Jeanne
Shaheen of New Hampshire, whose GOP opponent Scott Brown has made the health law a centerpiece
of his campaign to unseat her. And Republicans have highlighted access challenges as another broken
promise from a president who assured Americans they could keep their doctor. It’s not just a political
problem. It’s a policy conundrum. Narrow networks help contain health care costs. If state or federal
regulators — or politicians — force insurers to expand the range of providers, premiums could spike.
And that could create a whole new wave of political and affordability problems that can shape
perceptions of Obamacare.
Link: Plan reduces health care costs
Smith 08 online writer for Yahoo Contributor Network
John, April 11, “Legalizing the Sale of Human Organs: Necessary for Survival.”
http://voices.yahoo.com/legalizing-sale-human-organs-necessary-for-1368813.html?cat=5
John has been writing online for several years. An avid hockey player and fan, he is enjoys writing sports
articles, but is familiar with a wide variety of topics.
Oftentimes the cost of a transplant ends up costing less than the lifetime cost of dialysis for a patient with kidney problems, so it would be
cheaper for insurance companies to purchase an organ on behalf of their clients, rather than having to
pay lifetime costs. This would reduce the cost of insurance rates across the board as the companies
would not need as much to cover their costs, but will continue making the same, if not a larger
amount of profit (Nelson 1). Countries overseas have started to realize this fact. "In Israel, there is even tacit government acceptance of
the practice [of selling human organs] -- the national health-insurance program covers part, and sometimes all, of the cost of brokered
transplants" (Finkel 1).
Preserving Obamacare will kill the economy – loss of low wage jobs and
marginal excess burden of taxation
Conover 12 Research Scholar in the Center for Health Policy & Inequalities Research
at Duke University, an adjunct scholar at AEI, and a Mercatus-affiliated senior scholar.
Christopher, August 10th, “Health care law will cost 1 million or more jobs”
http://www.aei.org/article/health/healthcare-reform/ppaca/healthcare-law-will-cost-1-million-ormore-jobs/)
Moreover, the biggest losers under the ACA will be the least educated and least skilled workers in
society. Under the law, large employers who do not provide health coverage will be fined $2,000 per
full-time worker not counting the first 30. This increase is equivalent to about $1 an hour or a 14 percent increase in
the minimum wage-a relative increase larger than nearly all others over the past 50 years. ¶
Voluminous studies have demonstrated that minimum wage laws-however well-intentioned-actually increase
unemployment among the very group they are intended to help. Even the CBO analysis acknowledges
this negative impact [2]. Yes, some low-wage workers will benefit from the Medicaid expansions and exchange subsidies, but this will
be little consolation to those who lose their job as a result of this mandate. How many such low wage workers will be put
out of work by their employers? A reasonable estimate is more than 110,000 [3]. As AEI President Arthur Brooks
has shown in his latest book The Road to Freedom, taking away someone's chances at earned success isn't good for them or for society.¶ Still,
the direct job losses imposed by the ACA pale in comparison to the hidden losses that will result from
its more than $500 billion in new taxes. I have elsewhere calculated that in its first ten years, the ACA
would shrink the economy by a minimum of $157 billion (if its scheduled tax increases all are
implemented) and perhaps by as much as $550 billion (if, as is likely, Congress elects to soften the
blow of draconian cuts in Medicare payment rates to doctors and hospitals by raising taxes to avoid
having to impose them) [4]. Since GDP per worker is roughly $59 per hour, and the average U.S. worker
works 1,787 hours, these GDP losses are roughly equivalent to the loss of 150,000 to 520,000 jobs on
an annualized basis [5]. The CBO has never calculated the impact of higher taxes on lost output, so there is no special significance to its
ignoring this impact in its cost estimate of ACA. The point is that when we consider both the direct and "hidden" costs of ACA, the adverse
impact is 19 to 65 percent higher than the formally estimated 800,000 jobs figure.
Economic downturn risks great power nuclear war
Mead 09 Senior Fellow in U.S. Foreign Policy at the Council on Foreign Relations
(Walter Russell, New Republic, http://www.tnr.com/politics/story.html?id=571cbbb9-2887-4d81-854292e83915f5f8&p=2), Feb. 4
If current market turmoil seriously damaged the performance and prospects of India and China, the current crisis could join the Great Depression in the list of economic events that changed history, even if the recessions in the
United States should stand ready to assist Chinese and Indian financial authorities on an emergency basis--and work very hard to help both countries escape or at least weather any
economic downturn. It may test the political will of the Obama administration, but the United States must avoid a protectionist response to the economic slowdown. U.S. moves to
limit market access for Chinese and Indian producers could poison relations for years. For billions of people in nuclear-armed countries to emerge from this crisis believing
West are relatively short and mild. The
either that the United States was indifferent to their well-being or that it had profited from their distress could damage U.S. foreign policy far more severely than any mistake made by George W. Bush. It's not just the great powers
whose trajectories have been affected by the crash. Lesser powers like Saudi Arabia and Iran also face new constraints. The crisis has strengthened the U.S. position in the Middle East as falling oil prices reduce Iranian influence and
increase the dependence of the oil sheikdoms on U.S. protection. Success in Iraq--however late, however undeserved, however limited--had already improved the Obama administration's prospects for addressing regional crises.
Now, the collapse in oil prices has put the Iranian regime on the defensive. The annual inflation rate rose above 29 percent last September, up from about 17 percent in 2007, according to Iran's Bank Markazi. Economists forecast
that Iran's real GDP growth will drop markedly in the coming months as stagnating oil revenues and the continued global economic downturn force the government to rein in its expansionary fiscal policy. All this has weakened
Ahmadinejad at home and Iran abroad. Iranian officials must balance the relative merits of support for allies like Hamas, Hezbollah, and Syria against domestic needs, while international sanctions and other diplomatic sticks have
been made more painful and Western carrots (like trade opportunities) have become more attractive. Meanwhile, Saudi Arabia and other oil states have become more dependent on the United States for protection against Iran,
and they have fewer resources to fund religious extremism as they use diminished oil revenues to support basic domestic spending and development goals. None of this makes the Middle East an easy target for U.S. diplomacy, but
thanks in part to the economic crisis, the incoming administration has the chance to try some new ideas and to enter negotiations with Iran (and Syria) from a position of enhanced strength. Every crisis is different, but there seem
to be reasons why, over time, financial crises on balance reinforce rather than undermine the world position of the leading capitalist countries. Since capitalism first emerged in early modern Europe, the ability to exploit the
advantages of rapid economic development has been a key factor in international competition. Countries that can encourage--or at least allow and sustain--the change, dislocation, upheaval, and pain that capitalism often involves,
while providing their tumultuous market societies with appropriate regulatory and legal frameworks, grow swiftly. They produce cutting-edge technologies that translate into military and economic power. They are able to invest in
education, making their workforces ever more productive. They typically develop liberal political institutions and cultural norms that value, or at least tolerate, dissent and that allow people of different political and religious
viewpoints to collaborate on a vast social project of modernization--and to maintain political stability in the face of accelerating social and economic change. The vast productive capacity of leading capitalist powers gives them the
ability to project influence around the world and, to some degree, to remake the world to suit their own interests and preferences. This is what the United Kingdom and the United States have done in past centuries, and what
other capitalist powers like France, Germany, and Japan have done to a lesser extent. In these countries, the social forces that support the idea of a competitive market economy within an appropriately liberal legal and political
framework are relatively strong. But, in many other countries where capitalism rubs people the wrong way, this is not the case. On either side of the Atlantic, for example, the Latin world is often drawn to anti-capitalist movements
and rulers on both the right and the left. Russia, too, has never really taken to capitalism and liberal society--whether during the time of the czars, the commissars, or the post-cold war leaders who so signally failed to build a stable,
open system of liberal democratic capitalism even as many former Warsaw Pact nations were making rapid transitions. Partly as a result of these internal cultural pressures, and partly because, in much of the world, capitalism has
appeared as an unwelcome interloper, imposed by foreign forces and shaped to fit foreign rather than domestic interests and preferences, many countries are only half-heartedly capitalist. When crisis strikes, they are quick to
decide that capitalism is a failure and look for alternatives. So far, such half-hearted experiments not only have failed to work; they have left the societies that have tried them in a progressively worse position, farther behind the
front-runners as time goes by. Argentina has lost ground to Chile; Russian development has fallen farther behind that of the Baltic states and Central Europe. Frequently, the crisis has weakened the power of the merchants,
industrialists, financiers, and professionals who want to develop a liberal capitalist society integrated into the world. Crisis can also strengthen the hand of religious extremists, populist radicals, or authoritarian traditionalists who
are determined to resist liberal capitalist society for a variety of reasons. Meanwhile, the companies and banks based in these societies are often less established and more vulnerable to the consequences of a financial crisis than
more established firms in wealthier societies. As a result, developing countries and countries where capitalism has relatively recent and shallow roots tend to suffer greater economic and political damage when crisis strikes--as,
inevitably, it does. And, consequently, financial crises often reinforce rather than challenge the global distribution of power and wealth. This may be happening yet again. None of which means that we can just sit back and enjoy
the recession. History may suggest that financial crises actually help capitalist great powers maintain their leads--but it has other, less reassuring messages as well. If financial crises have been a normal part of life during the 300year rise of the liberal capitalist system under the Anglophone powers, so has war. The wars of the League of Augsburg and the Spanish Succession; the Seven Years War; the American Revolution; the Napoleonic Wars; the two
The list of wars is almost as long as the list of financial crises. Bad economic times can breed
wars. Europe was a pretty peaceful place in 1928, but the Depression poisoned German public opinion and helped bring Adolf Hitler to power. If the current crisis
turns into a depression, what rough beasts might start slouching toward Moscow, Karachi, Beijing, or New Delhi to be born? The United States may not, yet, decline, but, if
we can't get the world economy back on track, we may still have to fight.
World Wars; the cold war:
Physician-Assisted Suicide
1NC Obamacare Bad
Uniqueness: Perception of cost savings preserves Obamacare now
McCarter 14 Daily Kos staff reporter
Joan, Daily Kos, April 15, http://www.dailykos.com/story/2014/04/15/1292183/-Treasury-bonds-getObamacare-boost-as-health-care-costs-nbsp-slow#
Health care costs increased just 2 percent last year, the slowest rate of growth in 65 years, in large
part because of the cost controls created with the Affordable Care Act. That means inflation is curbed,
and it also means that U.S. treasury bonds are a good bet for investors.
Less inflation, which boosts the purchasing power of fixed-rate payments, may help attract buyers to
Treasuries as the economy strengthens and the Federal Reserve pares its own bond buying. While yields
have fallen this year, the compensation 10-year notes provide after inflation is close to the highest in
five years. Excluding food and energy, health care accounted for about a third of the slowdown in
consumer prices, which rose 1.1 percent in the past year from 2 percent in the prior 12 months.
“This is good news” for bonds, Kathy Jones, a New York-based fixed-income strategist at Charles Schwab
& Co., which has $2.25 trillion in client assets, said in a telephone interview on April 4. By holding costs
down, “it may be a benefit to inflation, longer-term.” Jones, who has been advising clients on the bondmarket implications of the health-care law, is recommending that investors buy 10-year Treasuries
because low inflation will keep the Fed from lifting interest rates. […] Inflation has remained below the
Fed’s 2 percent target for 22 straight months and “a couple” of policy makers said at its March meeting
that “unusually slow growth” in health-care prices has played a “notable role” in holding back prices,
minutes of the gathering released on April 9 show. These cost controls in the law are largely through
cuts in Medicare payouts to poor-performing hospitals and through the incentives it created to curb
readmission rates, as well as and changed payment programs to reduce unnecessarily expensive
procedures. Just think what savings could be achieved if Medicare could negotiate prescription drug
prices. Or how much could be saved in a public option where the government was setting
reimbursement rates for all care. The Republican mantra that the law is a total disaster that will doom
the nation is sounding more and more ridiculous. This news, combined with the latest projections
from the Congressional Budget Office on the cost savings ($104 billion over previous projections in the
next decade), is going to make a hard sell for Republicans with their traditional allies in the financial
sector, not to mention the millions of people who would lose access to health care.
Threat of cost increases could kill Obamacare
Norman 14 health care reporter for POLITICO Pro. Before joining POLITICO, he
worked as a science writer at The Rockefeller University. He previously covered the
politics and policy of Medicare for Part B News and started out at the Pensacola News
Journal.
Brett, “Obamacare: Anger over Narrow Networks,” Politico Pro, July 22,
http://www.politico.com/story/2014/07/obamacare-health-care-networks-premiums-109195.html
Americans for Prosperity is hitting on these “narrow networks” against Democrats such as Sen. Jeanne
Shaheen of New Hampshire, whose GOP opponent Scott Brown has made the health law a centerpiece
of his campaign to unseat her. And Republicans have highlighted access challenges as another broken
promise from a president who assured Americans they could keep their doctor. It’s not just a political
problem. It’s a policy conundrum. Narrow networks help contain health care costs. If state or federal
regulators — or politicians — force insurers to expand the range of providers, premiums could spike.
And that could create a whole new wave of political and affordability problems that can shape
perceptions of Obamacare.
PAS will reduce the cost under Obamacare
NYS Health Department 11
(New York State Department of Health Task Force on Life and the Law, “When Death is Sought,”
https://www.health.ny.gov/regulations/task_force/reports_publications/when_death_is_sought/
chap6.htm, NG)
Physicians are also increasingly aware of and subject to pressures generated by the need to control
costs. Limits on hospital reimbursement based on length of stay and diagnostic group, falling hospital revenues, and the
social need to allocate health dollars may all influence physicians' decisions at the bedside. In many
respects, physicians serve as gatekeepers in medical practice. Risk managers, administrators, and third-party payers also
now have a less visible, but still significant role in treatment decisions. The growing concern about health care costs will
not be diminished by health care reform. Under any new system of health care delivery, as at present, it
will be far less costly to give a lethal injection than to care for a patient throughout the dying process.
(12) The current debate about medical futility reflects, in part, the extent to which the cost of treatment is
viewed as relevant to decisions at the bedside. Some physicians have argued that they should determine when the benefits
of treatment are too low to justify the cost in order to allocate health care resources. To date, the futility debate has focused on
certain aggressive treatments, such as cardiopulmonary resuscitation, or on continued treatment for certain patients, such as those
who are permanently unconscious. But once a decision is made not to pursue cure or treatment, and assisted
suicide and euthanasia are available, the economic logic will be inescapable. The care provided to
dying or very ill patients, not just their treatment, is expensive and demanding for health care
professionals. The extra weeks or months of caring for patients who do not opt for assisted suicide or
euthanasia will seem all the more "futile" and costly.
Preserving Obamacare will kill the economy – loss of low wage jobs and
marginal excess burden of taxation
Conover 12 Research Scholar in the Center for Health Policy & Inequalities Research
at Duke University, an adjunct scholar at AEI, and a Mercatus-affiliated senior scholar.
(Christopher, August 10th, “Health care law will cost 1 million or more jobs”
http://www.aei.org/article/health/healthcare-reform/ppaca/healthcare-law-will-cost-1-million-ormore-jobs/)
Moreover, the biggest losers under the ACA will be the least educated and least skilled workers in
society. Under the law, large employers who do not provide health coverage will be fined $2,000 per
full-time worker not counting the first 30. This increase is equivalent to about $1 an hour or a 14 percent increase in
the minimum wage-a relative increase larger than nearly all others over the past 50 years.¶
Voluminous studies have demonstrated that minimum wage laws-however well-intentioned-actually increase
unemployment among the very group they are intended to help. Even the CBO analysis acknowledges
this negative impact [2]. Yes, some low-wage workers will benefit from the Medicaid expansions and exchange subsidies, but this will
be little consolation to those who lose their job as a result of this mandate. How many such low wage workers will be put
out of work by their employers? A reasonable estimate is more than 110,000 [3]. As AEI President Arthur Brooks
has shown in his latest book The Road to Freedom, taking away someone's chances at earned success isn't good for them or for society.¶ Still,
the direct job losses imposed by the ACA pale in comparison to the hidden losses that will result from
its more than $500 billion in new taxes. I have elsewhere calculated that in its first ten years, the ACA
would shrink the economy by a minimum of $157 billion (if its scheduled tax increases all are
implemented) and perhaps by as much as $550 billion (if, as is likely, Congress elects to soften the
blow of draconian cuts in Medicare payment rates to doctors and hospitals by raising taxes to avoid
having to impose them) [4]. Since GDP per worker is roughly $59 per hour, and the average U.S. worker
works 1,787 hours, these GDP losses are roughly equivalent to the loss of 150,000 to 520,000 jobs on
an annualized basis [5]. The CBO has never calculated the impact of higher taxes on lost output, so there is no special significance to its
ignoring this impact in its cost estimate of ACA. The point is that when we consider both the direct and "hidden" costs of ACA, the adverse
impact is 19 to 65 percent higher than the formally estimated 800,000 jobs figure.
Economic downturn risks great power nuclear war
Mead 09 Senior Fellow in U.S. Foreign Policy at the Council on Foreign Relations
(Walter Russell, New Republic, http://www.tnr.com/politics/story.html?id=571cbbb9-2887-4d81-854292e83915f5f8&p=2), Feb 4
If current market turmoil seriously damaged the performance and prospects of India and China, the current crisis could join the Great Depression in the list of economic events that changed history, even if the recessions in the
United States should stand ready to assist Chinese and Indian financial authorities on an emergency basis--and work very hard to help both countries escape or at least weather any
economic downturn. It may test the political will of the Obama administration, but the United States must avoid a protectionist response to the economic slowdown. U.S. moves to
limit market access for Chinese and Indian producers could poison relations for years. For billions of people in nuclear-armed countries to emerge from this crisis believing
West are relatively short and mild. The
either that the United States was indifferent to their well-being or that it had profited from their distress could damage U.S. foreign policy far more severely than any mistake made by George W. Bush. It's not just the great powers
whose trajectories have been affected by the crash. Lesser powers like Saudi Arabia and Iran also face new constraints. The crisis has strengthened the U.S. position in the Middle East as falling oil prices reduce Iranian influence and
increase the dependence of the oil sheikdoms on U.S. protection. Success in Iraq--however late, however undeserved, however limited--had already improved the Obama administration's prospects for addressing regional crises.
Now, the collapse in oil prices has put the Iranian regime on the defensive. The annual inflation rate rose above 29 percent last September, up from about 17 percent in 2007, according to Iran's Bank Markazi. Economists forecast
that Iran's real GDP growth will drop markedly in the coming months as stagnating oil revenues and the continued global economic downturn force the government to rein in its expansionary fiscal policy. All this has weakened
Ahmadinejad at home and Iran abroad. Iranian officials must balance the relative merits of support for allies like Hamas, Hezbollah, and Syria against domestic needs, while international sanctions and other diplomatic sticks have
been made more painful and Western carrots (like trade opportunities) have become more attractive. Meanwhile, Saudi Arabia and other oil states have become more dependent on the United States for protection against Iran,
and they have fewer resources to fund religious extremism as they use diminished oil revenues to support basic domestic spending and development goals. None of this makes the Middle East an easy target for U.S. diplomacy, but
thanks in part to the economic crisis, the incoming administration has the chance to try some new ideas and to enter negotiations with Iran (and Syria) from a position of enhanced strength. Every crisis is different, but there seem
to be reasons why, over time, financial crises on balance reinforce rather than undermine the world position of the leading capitalist countries. Since capitalism first emerged in early modern Europe, the ability to exploit the
advantages of rapid economic development has been a key factor in international competition. Countries that can encourage--or at least allow and sustain--the change, dislocation, upheaval, and pain that capitalism often involves,
while providing their tumultuous market societies with appropriate regulatory and legal frameworks, grow swiftly. They produce cutting-edge technologies that translate into military and economic power. They are able to invest in
education, making their workforces ever more productive. They typically develop liberal political institutions and cultural norms that value, or at least tolerate, dissent and that allow people of different political and religious
viewpoints to collaborate on a vast social project of modernization--and to maintain political stability in the face of accelerating social and economic change. The vast productive capacity of leading capitalist powers gives them the
ability to project influence around the world and, to some degree, to remake the world to suit their own interests and preferences. This is what the United Kingdom and the United States have done in past centuries, and what
other capitalist powers like France, Germany, and Japan have done to a lesser extent. In these countries, the social forces that support the idea of a competitive market economy within an appropriately liberal legal and political
framework are relatively strong. But, in many other countries where capitalism rubs people the wrong way, this is not the case. On either side of the Atlantic, for example, the Latin world is often drawn to anti-capitalist movements
and rulers on both the right and the left. Russia, too, has never really taken to capitalism and liberal society--whether during the time of the czars, the commissars, or the post-cold war leaders who so signally failed to build a stable,
open system of liberal democratic capitalism even as many former Warsaw Pact nations were making rapid transitions. Partly as a result of these internal cultural pressures, and partly because, in much of the world, capitalism has
appeared as an unwelcome interloper, imposed by foreign forces and shaped to fit foreign rather than domestic interests and preferences, many countries are only half-heartedly capitalist. When crisis strikes, they are quick to
decide that capitalism is a failure and look for alternatives. So far, such half-hearted experiments not only have failed to work; they have left the societies that have tried them in a progressively worse position, farther behind the
front-runners as time goes by. Argentina has lost ground to Chile; Russian development has fallen farther behind that of the Baltic states and Central Europe. Frequently, the crisis has weakened the power of the merchants,
industrialists, financiers, and professionals who want to develop a liberal capitalist society integrated into the world. Crisis can also strengthen the hand of religious extremists, populist radicals, or authoritarian traditionalists who
are determined to resist liberal capitalist society for a variety of reasons. Meanwhile, the companies and banks based in these societies are often less established and more vulnerable to the consequences of a financial crisis than
more established firms in wealthier societies. As a result, developing countries and countries where capitalism has relatively recent and shallow roots tend to suffer greater economic and political damage when crisis strikes--as,
inevitably, it does. And, consequently, financial crises often reinforce rather than challenge the global distribution of power and wealth. This may be happening yet again. None of which means that we can just sit back and enjoy
the recession. History may suggest that financial crises actually help capitalist great powers maintain their leads--but it has other, less reassuring messages as well. If financial crises have been a normal part of life during the 300year rise of the liberal capitalist system under the Anglophone powers, so has war. The wars of the League of Augsburg and the Spanish Succession; the Seven Years War; the American Revolution; the Napoleonic Wars; the two
The list of wars is almost as long as the list of financial crises. Bad economic times can breed
wars. Europe was a pretty peaceful place in 1928, but the Depression poisoned German public opinion and helped bring Adolf Hitler to power. If the current crisis
turns into a depression, what rough beasts might start slouching toward Moscow, Karachi, Beijing, or New Delhi to be born? The United States may not, yet, decline, but, if
we can't get the world economy back on track, we may still have to fight.
World Wars; the cold war:
1NC Racism K
PAS legalization ensures societal racism is manifest in violence and pressure
against black and poor bodies to prematurely end their lives, reifying racist
violence
Pittman 97 Assistant Professor of Law at Mississippi Law
(Larry J., Physician-Assisted Suicide in the Dark Ward: The Intersection of the Thirteenth Amendment and
Health Care Treatments Having Disproportionate Impacts on Disfavored Groups, pp. 792-793, NG)
Therefore, the only state interest that arguably might outweigh a terminally ill person’s desire for selfinduced death is the interest in protecting a patient from the adverse consequences of legalized
physician-assisted suicide. This interest assumes added importance where the protection of disfavored African
Americans and other minorities are concerned because they are generally more vulnerable to physicians’ abuses
and coercion. In furtherance of their patient- protection interests, states might be concerned about the undue influence and coercion
that physicians, family members, and other persons might assert to force or improperly persuade terminally ill persons
to relinquish their remaining lives in order to reduce health care expenditures, speed up the conferment of inheritances,
and conserve health care resources for healthier patients. In Compassion in Dying, the Ninth Circuit held that the State’s interest in preventing those abuses did not outweigh a terminally ill
patient’s interest in having physician-assisted suicide. That conclusion was based primarily on an assumption that physician-assisted suicide does not expose patients to the above-stated risk
any more than the withdrawal of life-sustaining treatments. This analysis sounds more like an equal protection argument than a balancing of the state’s interests in avoiding abuses against the
Even if one were to accept the Ninth Circuit’s conclusion that the
terminally ill patient’s short life expectancy and the presence of an “impartial physician” mitigate
against family abuses, there is still the possibility of physicians’ and hospitals’ unmitigated potential
for abuses in advocating physician-assisted suicide to conserve health care costs and to perpetuate
their own racial prejudices.
terminally ill patient’s interests in physician-assisted suicide.
It is our apriori ethical obligation to reject racism in all instances- any other
reaction ensures endless violence
Memmi 2k Professor Emeritus of Sociology at the University of Paris
Albert, “RACISM”, translated by Steve Martinot, pp.163-165)
The struggle against racism will be long, difficult, without intermission, without remission, probably
never achieved, yet for this very reason, it is a struggle to be undertaken without surcease and without
concessions. One cannot be indulgent toward racism. One cannot even let the monster in the house,
especially not in a mask. To give it merely a foothold means to augment the bestial part in us and in
other people which is to diminish what is human. To accept the racist universe to the slightest degree is
to endorse fear, injustice, and violence. It is to accept the persistence of the dark history in which we
still largely live. It is to agree that the outsider will always be a possible victim (and which [person] man is not
[themself] himself an outsider relative to someone else?). Racism illustrates in sum, the inevitable negativity of the
condition of the dominated; that is it illuminates in a certain sense the entire human condition. The antiracist struggle, difficult though it is, and always in question, is nevertheless one of the prologues to the ultimate passage from animality to
In that sense, we cannot fail to rise to the racist challenge. However, it remains true that one’s
moral conduct only emerges from a choice: one has to want it. It is a choice among other choices, and
always debatable in its foundations and its consequences. Let us say, broadly speaking, that the choice to conduct
humanity.
oneself morally is the condition for the establishment of a human order for which racism is the very negation. This is almost a redundancy.
One cannot found a moral order, let alone a legislative order, on racism because racism signifies the
exclusion of the other and his or her subjection to violence and domination. From an ethical point of
view, if one can deploy a little religious language, racism is “the truly capital sin.”fn22 It is not an accident that almost all of
humanity’s spiritual traditions counsel respect for the weak, for orphans, widows, or strangers. It is not just a question of theoretical counsel
respect for the weak, for orphans, widows or strangers.
It is not just a question of theoretical morality and
disinterested commandments. Such unanimity in the safeguarding of the other suggests the real utility
of such sentiments. All things considered, we have an interest in banishing injustice, because injustice
engenders violence and death. Of course, this is debatable. There are those who think that if one is
strong enough, the assault on and oppression of others is permissible. But no one is ever sure of
remaining the strongest. One day, perhaps, the roles will be reversed. All unjust society contains within
itself the seeds of its own death. It is probably smarter to treat others with respect so that they treat you with respect. “Recall,”
says the bible, “that you were once a stranger in Egypt,” which means both that you ought to respect the stranger because you were a stranger
It is an ethical and a practical appeal – indeed, it is a contract,
however implicit it might be. In short, the refusal of racism is the condition for all theoretical and
practical morality. Because, in the end, the ethical choice commands the political choice. A just society
must be a society accepted by all. If this contractual principle is not accepted, then only conflict,
violence, and destruction will be our lot. If it is accepted, we can hope someday to live in peace. True, it
is a wager, but the stakes are irresistible.
yourself and that you risk becoming once again someday.
1NC Ableism K
The aff ensures the supremacy ablest discourse equating disability with a fate
worse than death- the impact is social death and genocide
Golden 05 Policy Analyst for the Disability Rights & Education Fund
(Marilyn, “Why Assisted Suicide Must Not be Legalized,” http://euthanasia.procon.org/
view.answers.php?questionID=000207, NG)
Fear, bias, and prejudice against disability play a significant role in assisted suicide. Who ends up using
assisted suicide? Supporters advocate its legalization by arguing that it would relieve untreated pain
and discomfort at the end of life. But all but one of the people in Oregon who were reported to have
used that state's assisted suicide law during its first year wanted suicide not because of pain, but for
fear of losing functional ability, autonomy, or control of bodily functions (Oregon Health Division,
1999). Oregon's subsequent reports have documented similar results. Furthermore, in the Netherlands,
more than half the physicians surveyed say the main reason given by patients for seeking death is "loss
of dignity" (Birchard, 1999). This fear of disability typically underlies assisted suicide. Said one assisted
suicide advocate, "Pain is not the main reason we want to die. It's the indignity. It's the inability to get
out of bed or get onto the toilet ... [People] ... say, ‘I can't stand my mother – my husband – wiping my
behind.' It's about dignity" (Leiby, 1996). But as many thousands of people with disabilities who rely on
personal assistance have learned, needing help is not undignified, and death is not better than
reliance on assistance. Have we gotten to the point that we will abet suicides because people need help
using the toilet? Diane Coleman, President and Founder of Not Dead Yet, a grassroots disability
organization opposed to legalizing assisted suicide, has written that the "public image of severe
disability as a fate worse than death … become(s) grounds for carving out a deadly exception to
longstanding laws and public policies about suicide intervention services … Legalizing assisted suicide
means that some people who say they want to die will receive suicide intervention, while others will
receive suicide assistance. The difference between these two groups of people will be their health or
disability status, leading to a two-tiered system that results in death to the socially devalued group"
(Coleman, 2002).
Ableism operates as foundational tactic of oppression that must be resisted
Siebers 09 University of Michigan, Professor of Literary and Cultural Criticism
(Tobin, “The Aesthetics of Human Disqualification”, Oct 28, Lecture,
http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCoQFjAA&url=http%3A
%2F%2Fdisabilities.temple.edu%2Fmedia%2Fds%2Flecture20091028siebersAesthetics_FULL.doc&ei=LW
z4T6jyN8bHqAHLkY2LCQ&usg=AFQjCNGdkDuSJkRXMHgbXqvuyyeDpldVcQ&sig2=UCGDC4tHbeh2j7Yce9lsA, accessed 7/7/12, sl)
Oppression is the systematic victimization of one group by another. It is a form of intergroup violence. That
oppression involves “groups,” and not “individuals,” means that it concerns identities, and this means, furthermore, that oppression
always focuses on how the body appears, both on how it appears as a public and physical presence and on its specific and
various appearances. Oppression is justified most often by the attribution of natural inferiority—what some call “inbuilt” or “biological” inferiority. Natural inferiority is always somatic, focusing on the mental and physical features of
the group, and it figures as disability. The prototype of biological inferiority is disability. The
representation of inferiority always comes back to the appearance of the body and the way the body
makes other bodies feel. This is why the study of oppression requires an understanding of aesthetics—not only because oppression
uses aesthetic judgments for its violence but also because the signposts of how oppression works are visible in the history of art, where
aesthetic judgments about the creation and appreciation of bodies are openly discussed. One additional thought must be noted before I treat
some analytic examples from the historical record. First, despite
my statement that disability now serves as the
master trope of human disqualification, it is not a matter of reducing other minority identities to
disability identity. Rather, it is a matter of understanding the work done by disability in oppressive
systems. In disability oppression, the physical and mental properties of the body are socially
constructed as disqualifying defects, but this specific type of social construction happens to be integral
at the present moment to the symbolic requirements of oppression in general. In every oppressive
system of our day, I want to claim, the oppressed identity is represented in some way as disabled, and
although it is hard to understand, the same process obtains when disability is the oppressed identity. “Racism” disqualifies on the
basis of race, providing justification for the inferiority of certain skin colors, bloodlines, and physical
features. “Sexism” disqualifies on the basis of sex/gender as a direct representation of mental and
physical inferiority. “Classism” disqualifies on the basis of family lineage and socioeconomic power as
proof of inferior genealogical status. “Ableism” disqualifies on the basis of mental and physical
differences, first selecting and then stigmatizing them as disabilities. The oppressive system occults in
each case the fact that the disqualified identity is socially constructed, a mere convention,
representing signs of incompetence, weakness, or inferiority as undeniable facts of nature. As racism,
sexism, and classism fall away slowly as justifications for human inferiority—and the critiques of these
prejudices prove powerful examples of how to fight oppression—the prejudice against disability
remains in full force, providing seemingly credible reasons for the belief in human inferiority and the oppressive systems built upon it.
This usage will continue, I expect, until we reach a historical moment when we know as much about the
social construction of disability as we now know about the social construction of race, class, gender,
and sexuality. Disability represents at this moment in time the final frontier of justifiable human inferiority .
2NC/1NR Obamacare Bad
2NC Brink
The plan fulfills Obamacare’s mandate for end of life care savings- national
policy spills over
Cahill 13 Editor of VISTA Health Solutions
(Michael, Could Obamacare Inadvertently Legalize Physician-Assisted Suicide?,
http://snoringscholar.com/2013/07/could-obamacare-inadvertently-legalize-physician-assistedsuicide/,NG)
While we cannot say what the real purpose of Section 1553 is, we can deduce that it might eventually
be used to offer protection to doctors who assist in ending a patient’s life in states where it is illegal.
It also has the potential to set the stage for a national policy on physician-assisted suicide . It’s not farfetched to consider that the whole nation could experience something similar to what happened in Montana. In the 2009 court ruling of the
case of Baxter v. Montana, the court found no public policy exists against assisting suicide. So doctors in the state can use patient’s consent as a
defense during trial. It may not be what the law truly intends, but it’s a likely consequence. If the administration wants the public to support its
health care bill, then it should lay its cards down and let the people know where it stands on sensitive issues like this one. It’s likely that the
government will move away from controversy and let the Supreme Court decide on the matter. However, when
we look back at an
interview during the 2008 campaign, then presidential candidate Barack Obama shared his view about physicianassisted suicide. When asked about Oregon’s decision to legalize the procedure he said that the state “did a service for the
country in recognizing that as our population gets older, we’ve got to think about issues of end of life
care, and people having autonomy to make these decisions.” In the same interview, he also conveyed his belief that terminally ill patients
should be given the right to decide whether or not to end their suffering.
2NC Uniqueness
Overenrollment by the chronically sick and high costs means Obamacare is
doomed now- cost-cutting is the only way
Balyeat 14 Guest Columnist for the Misoulian and Public Accountant
(Joe, http://missoulian.com/news/opinion/columnists/understanding-obamacare-and-why-it-willfail/article_e6afc854-a2dd-11e3-84b7-001a4bcf887a.html, NG)
This “cost redistribution” is achieved via three new mandates on all health insurance. 1. No pre-existing
condition exclusions: Even people waiting till after they’re sick to buy insurance can’t be denied coverage. 2. Community rating: With
few limited exceptions, unhealthy people can’t be charged more than healthy people. 3. All policies must cover all issues; i.e., a
60-year-old man’s policy must cover pregnancy, nuns’ policies must cover abortion, and nobody can
choose which illnesses they want covered. These three cost socialization mandates are what Barack Obama means
when he says “It’s better insurance.“ But they’re also a three-pronged pitchfork prodding insurance costs skyward.
How? This turns insurance’s mathematical sense into nonsense. Pre-existing conditions are 100 percent probability. Follow my math – 100
percent x $1 million is $1 million. Forcing
these three redistribution mandates into everyone’s insurance not
only eventually doubles cost – it dooms health insurance to destruction. Why? The “square deal” has become a
bad deal. No one who understands financial math will buy insurance costing twice what the actuarial
equation dictates – except the chronically sick. Because the healthy won’t voluntarily buy it, that’s
precisely why Obamacare mandates everyone must buy insurance. Hence, Obamacare’s noncompliance penalties: In
2014 – 1 percent x your income; 2015 – 2 percent x your income; 2016 – 2.5 percent x your income.
AT: Narrow networks make the plan link nonunique. No narrow networks if
costs continue to decline.
Norman 14 health care reporter for POLITICO Pro. Before joining POLITICO,
he worked as a science writer at The Rockefeller University. He previously
covered the politics and policy of Medicare for Part B News and started out at
the Pensacola News Journal.
Brett, “Obamacare: Anger over Narrow Networks,” Politico Pro, July 22,
http://www.politico.com/story/2014/07/obamacare-health-care-networks-premiums-109195.html
As it turns out, the market — not politics — may be taking care of the problem in New Hampshire,
although the political perceptions may not change. “I think the whole question about narrow networks
may turn out to be kind of a flash in the pan,” said Alex Feldvebel, deputy commissioner of the state’s
insurance department. “There is a big change from year one to year two,” he said. Five insurers have
said they will be on the exchange next year, and every hospital in the state is expected to have contracts
with at least three of them, he said. The new competition may drive down prices as well.
2NC Organ Sales Links
Link- $$$
Legalizing organ sales would relegitimate private health care industry
Smith 08 online writer for Yahoo Contributor Network
John, April 11, “Legalizing the Sale of Human Organs: Necessary for Survival.”
http://voices.yahoo.com/legalizing-sale-human-organs-necessary-for-1368813.html?cat=5
John has been writing online for several years. An avid hockey player and fan, he is enjoys writing sports
articles, but is familiar with a wide variety of topics.
One of the main objections of people who do not support the legalization of the sale of human organs is the idea that only the rich will be able
to have access to organs. Nelson writes, "Within the
current climate of health care reform, financial incentives
have become a part of medicine (Drs, preferred providers, etc.) and it might be reasonably assumed will
become a greater part of health care delivery in the future (1). Since individuals and companies looking
to make a profit currently run the health care industry in the United States, the sale of organs should
fall in to the same category as other medicinal services. The field of medicine is constantly evolving and doctors and
researchers are constantly developing new ways to save lives; however, they do not freely give these ideas and developments away. The willing
sale of human organs should be no different, in that it takes the same approach that other medical
developments currently take.
Even in the least efficient allocation system organ sales reduce healthcare
costs and save the government tens of thousands per organ
Monti 09 M.D. Internal Medicine at Case Western Reserve University
(Dr. Jennifer, http://cei.org/sites/default/files/Jennifer%20Monti%20-%20The%20Case%20for%20
Compensating%20Live%20Organ%20Donors.pdf, NG)
Economists at the University of Chicago have estimated a kidney to be worth $15,200. These estimates
were compared to the average price agreed upon among 305 sellers in India in 2005 ($1,177).18 This
estimate corroborates very well with the underground kidney market in India. When adjusted for
standards of living, the price paid in India for a kidney equals $17,000. Similar modeling estimates a
liver donation to be worth $37,600 to the donor. Current costs of procuring an organ for transplant in
the United States are over $50,000. These estimates demonstrate that the cost of transplants would
effectively go down in a well-supplied market system. Legislative action to legalize direct payment for
organ donation would result in substantial cost savings to a government spending exorbitantly for
dialysis treatments. Cost savings occurs if a recipient lives free of dialysis for more than 1.5 years; 95
percent of organ recipients would fall into this category.19 In the United States, a direct payment
system for live organ donation could be regulated and managed by the United Network for Organ
Sharing (UNOS), in a similar manner to the non-profi t organization established in Iran. UNOS currently
manages the waiting list for potential organ recipients. It has over 20 years of experience in managing
the cadaveric donor pool and could easily extend its jurisdiction to include donation by living donors.20
Even if a system of payment for organ donations were instituted in the United States, UNOS could
continue to allocate organs to recipients on the basis of medical, not social or economic, criteria, in
line with NOTA guidelines.
2NC PAS Links
Perception Link extension
Legalizing PAS helps ensure the perception of program solvency
Smith 13 Staff Writer for the National Review
(Wesley J., http://www.nationalreview.com/human-exceptionalism/360303/will-obamacare-boostassisted-suicide-wesley-j-smith, NG)
I rarely agree with assisted suicide proponents. But an article in Salon may be onto something–that the passage of the Affordable Care Act
could boost assisted suicide legalization. From the article: Currently
only three states have Death With Dignity laws – a
the Affordable
Care Act change that? Peg Sandeen, executive director of the National Death With Dignity Center, speculates: “I think the ACA
is going to change how we access healthcare and that change is going to come slowly. What I hope it
means is that people have access to a wide span of options across the health spectrum.” In other words, that
is the plan! Assisted suicide is not only about so-called “death with dignity”–a gooey euphemism swallowed whole by
the reporter–but despite the article’s spin to the contrary, ultimately about saving money. Do you remember Barbara Wagner and
surprisingly low number given that there isn’t a one among the other 47 in which somebody isn’t dying right now. Could
Randy Stroup? Both were on Medicaid and terminally ill with cancer. Their doctors prescribed life-extending chemotherapy. But Oregon’s death
panel rationers refused to pay for their prescriptions. Both received letters telling them not to worry, while the state wouldn’t pay to extend
their lives, it would readily fund their assisted suicides.
Link- Industry $$$
The plan ensures healthcare cost-cutting perception
Marker and Hamlon 10 J.D and Policy Analyst for International Task Force on
Euthanasia and Assisted Suicide,
Rita and Cathy, http://www.patientsrightscouncil.org/site/frequently-asked-questions/, NG)
Could euthanasia or assisted suicide be used as a means of health care cost containment? Yes. Perhaps
one of the most important developments in recent years is the increasing emphasis placed on health
care providers to contain costs. In such a climate, euthanasia or assisted suicide certainly could become a
means of cost containment. These implications were acknowledged during a historic argument before the U.S. Supreme Court.
Arguing against assisted suicide, acting solicitor general Walter Dellinger said, “The least costly treatment for any illness is
lethal medication.”(34) In the United States alone, millions of people have no medical insurance and studies have shown that the
elderly, the poor and minorities are often denied access to needed treatment or pain control.(35) Doctors are being pressured by
HMOs to reduce care; “futile care guidelines” are being instituted, enabling health facilities to deny
necessary and wanted interventions; and health care providers are often likely to benefit financially
from providing less, rather than more, care for their patients.(36) In Oregon, some patients have been told by
their health insurance provider that a costly drug prescribed by a doctor to treat the patient’s illness
would not be covered but inexpensive lethal drugs for assisted suicide would be. (37) See: “Oregon’s Suicidal
Approach to Health Care”
More Ev- Financial Pressure ensures widespread use of PAS is the key relief
for perceived financial strains on the health care system
Nimcheski 03 under Marla DeSota, Professor of English at Glendale College
Steven, Physician Assisted Suicide: A Slippery Slope,
http://web.gccaz.edu/~mdinchak/101online_new/assistedsuicide1.htm, NG)
Physician-assisted suicide should not be a legal option as it may readily lead to a societal acceptance
of euthanasia. By adopting euthanasia our society may next condone the mercy killings of anyone who is or is perceived to be disabled,
depressed, or elderly. The Netherlands is one place that has already moved from assisted suicide to euthanasia and “mercy killings.” Doctor
Herbert Hendin, director of the American Foundation for Suicide Prevention, argues that legalized
assisted suicide in the
Netherlands confirms his fears that suicide will eventually be extended to people who are not
terminally ill. He cites a case in the Netherlands where a woman who suffered from depression was helped to die by her psychiatrist.
Hendin also co-authored a 1997 article in the Journal of the American Medical Association were he cited studies conducted in the Netherlands
that argue toleration has led to wide spread abuses there. He said, “The most disturbing fact to emerge from the studies was that in close to
1,000 cases annually, Dutch doctors admitted to ending lives without the patient’s consent. While many of those patients were not mentally
competent,” he says, “many were” (“Assisted Suicide Update” 9). What kind of a message are we sending our elderly, poor and sick when we as
a society embrace any form of euthanasia? We are telling them to pass on unless they have the financial resources to pay the medical bill to
stay around a little longer. The
legalization of physician-assisted suicide could place financial pressures on
healthcare providers and patients to choose assisted suicide, when they otherwise might not have. In a recent survey,
“93% of physicians in Oregon thought that a patient might request physician-assisted suicide because
he or she feared being a burden on others; 83% thought that the request might result from financial pressures on the patient”
(Dickamer, Lee, and Ganzini, 2). The USA is in the midst of a medical insurance crisis. In today’s managed care
environment there are realistic concerns that health care providers such as doctors, already faced
with increasing financial incentives to cut costs, will pressure patients into assisted suicide. In the article
"Economic Motives for Physician-Assisted Suicide," Mehlman writes that: Hospitals are under economic constraints similar to managed care
plans. In some cases, the hospital actually may be part of a managed care plan. In other cases, such as Medicare, the
hospital may be
paid a fixed amount for a patient regardless of how long the patient stays…. This may lead hospital
administrators to encourage their medical staffs to recommend physician-assisted suicide to hospital
in-patients.
Link- Family $$$
Family pressures will fuel the perception
Forsythe 97 lecturer at St. John’s School of law
(CD, http://scholarship.law.stjohns.edu/cgi/viewcontent.cgi?article=1344&context=jcred, NG)
Other disincentives will be social. Certainly legalization will change the incentives and the
psychodynamics for patients and family members. While this may be overt in a case or two, it is most
likely to be subtle and unconscious in most cases. Still others will be economic. At a time when
managed care is more and more common, and some form of explicit rationing seems more and more
likely, the disincentives against alternatives should be fought rather than promoted. The economic
pressure for assisted suicide will be heightened if assisted suicide is publicly subsidized, as Oregon has
moved to do. Because of these incentives and disincentives, I think it is appropriate to say that legalizing
assisted suicide would simply create more physical and psychological suffering than it would alleviate.
Ironically, legalizing assisted suicide would both aggravate the primary fears that drive public opinion
on this issue and create disincentives for addressing those fears. It would do this in four ways: By
undermining the provision of pain medication and the developments of new treatment; by undermining
incentives for the diagnosis and treatment of depression; by increasing financial pressures on patients
to opt for assisted suicide; and by creating financial and social pressures on family members, which
will be inevitably deflected onto patients. Consequently, legalizing assisted suicide for any will
undermine healthcare for everyone.
Impact EXT- Obamacare bad
The aff stops Republicans from undercutting Obamacare by persuading the
public that it will reduce health are costs, that’s NYS Health Department; the
impact is Obamacare kills the economy by penalizing small businesses and
slowing growth in the hospital industry, causes reversal of growth kills
employment and ensures nationalistic waves result in escalatory wars and
nucs, that’s Mead.
The ACA kills the economy – small businesses
Vollmer 12 principal with Hyde Park Wealth Management.
Jeff S., The Butterfly Effect Of The Affordable Care Act, July 11th,
http://seekingalpha.com/article/714461-the-butterfly-effect-of-the-affordable-care-act)
Many business owners say it may, in fact, be more cost-effective for them to pay the $1,800 per year penalty tax than to provide healthcare for
every employee. Yet another backdoor way to soak the American business owner via another penalty tax. This comes at a time when many
businesses are grappling with the challenge of saving the jobs of current employees.¶ Can
assessing yet another mandated
expense (or penalty) be positive with the economy still smoldering? This leads to my last point. One must consider the
context in which this reform was enacted.¶ When the current administration took over, our nation's economy was in conflagration. The
American Skyscraper was burning. Productivity was nil. Unemployment was rampant. And the small business owner could see no further than
the week's economic releases to discern when he might begin to hire and spend.¶ Given the economic wild fire, did the administration ensure
that everyone was safely clear of the building? Did the administration then endeavor to extinguish the fire through forward looking, stimulusbased economic policy? Efforts focused on helping small- and mid-sized business owners to escape from the tar pits of fiscal paralysis in which
they were entrenched?¶ No. Amidst the flames, the administration took the opportunity to overhaul the human resources department. DoddFrank. Healthcare reform. Suddenly, the primary employers of the nation's economy, small business owners, went from blurry eyed to bat-cave
blind. No spending. No lending. No hiring. No growth.¶ Still curious as to why this economic recovery has been anemic?¶ In the end, the ripples
go well beyond the healthcare pond. The
Butterfly Effect of the SCOTUS decision, potentially upheld or
overturned by November's election, will have consequences throughout the U.S. economy. Jobs.
Strategy. Capex decisions.¶ As you read this, a business owner somewhere is trying to decide how to keep
his team intact. He's struggled to keep his doors open these past four years. Now, he wonders
whether it is better to buy the healthcare or pay the penalty. Could he offer each of his thirty employees a $2,000
salary reduction, and then divert those funds to the $60,000 penalty tax he'll be assessed for not providing everyone with healthcare? That
way, at least he can keep his staff employed.¶ Realize that most
of the nation's business owners do not have a choice.
These risk takers, these employers, these stewards of the American economy, cannot simply drop a
country club membership, sell a yacht and a vacation home in order to provide for the cost of the
Affordable Care Act. Most of these entrepreneurs are struggling just to get by. To keep staff. To make payroll.¶
Would you rather have a job without healthcare or no job and no healthcare? That's the conundrum facing many at this moment. Healthcare
needs a reformation. But, first things first. The fire should have been extinguished. The nation's economy lifted from its knees.
Small businesses are a key internal link to economic recovery
Leo 10 writer for Wall Street Journal
Luca Di, November 10, 2011, “Bernanke: Small Businesses Important To Economic Recovery”,
http://blogs.wsj.com/in-charge/2011/11/10/bernanke-small-businesses-important-to-economicrecovery/, 8/4/12, atl)
Small businesses are important to the economic recovery and to U.S. global competitiveness, Federal
Reserve Chairman Ben Bernanke said Wednesday in welcoming remarks at a Fed conference on small business entrepreneurship
during the recovery.¶ “We need to think carefully about how, in the current economic environment, our
nation can best provide small businesses and entrepreneurs with the support they need to expand job
opportunities,” Bernanke said in prepared remarks.¶ Bernanke said that small businesses support their local communities while also
helping the U.S. compete globally.¶ “They often offer a level of agility in bringing innovative products to the
global marketplace that larger firms cannot match,” Bernanke said.¶ Bernanke also said that entrepreneurship
offered “an important option for people confronting economic challenges in their lives, such as insufficient
retirement savings.”
Extra Impact to Obamacare Bad- Pharma
Obamacare devastates the pharmaceutical industry — prevents research and
drugs
Smith 11 former vice president for U.S. public affairs and policy at Pfizer, Inc.,
currently managing director at NSI, a D.C.-based consulting firm,
William S., “Obamacare vs. Drug Innovation,” National Review Online, 2/16/2011, Available Online:
http://www.nationalreview.com/blogs/print/259846, Accessed: 09/04/2012
With the release of the president’s budget, it is now beyond dispute — Beltway spin notwithstanding — that the decision by the
Pharmaceutical Research and Manufacturers of America (PhRMA) to support the health-care bill was
one of the worst self-inflicted wounds in the history of lobbying. For biotech and pharmaceutical companies, the president’s
budget repudiates one of the most important benefits of their “deal” with the White House: the ability to market biotech drugs without
generic competition for twelve years. The president would reduce that period to seven years,
precisely the position of the generics industry and a position that the pharmaceutical industry had
fought aggressively before it decided to make a deal with the president. This embarrassing repudiation of the deal follows another hostile act from the
Obama administration. On February 3, health and human services secretary Kathleen Sebelius released a letter to all the governors encouraging them to modify
their states’ Medicaid rules so as to use more generic drugs and to make deeper price cuts for drugs purchased in Medicaid. Since the industry had already agreed,
when it signed onto the health-care bill, to cut deeply their prices for Medicaid drugs, Sebelius’s inclusion of this advice in her letter to the governors was a
gratuitous slap. In fact, the best thing that could happen to the industry — and therefore to all those individuals, here and around the world, who benefit from the
strides it has taken in research — would be an unraveling of PhRMA’s deal. Since the president has walked away from the deal, now is the moment for the industry
to walk away from a law that will significantly weaken the all-important U.S. market for pharmaceuticals. What will Obamacare do to America’s premier health-care
research industry? First,
Obamacare inflicts a series of balance-sheet hits on pharmaceutical companies. Last
year, companies scrambled to write large rebate checks to satisfy the new price controls that the law imposed
in the Medicaid program. In total, the price-control provisions of Obamacare will cost the industry $38 billion
over the next ten years. During 2011, pharmaceutical companies will again be required to take out their checkbooks to pay a new $2.5 billion excise tax for this
year, a tax that will grow to over $4 billion by 2018; this will cost the industry another $23 billion. Also, every January 1 the drug companies
will be required to provide a 50 percent price discount for seniors who have reached the “doughnut
hole” (i.e., the coverage gap in Medicare Part D); this represents about $30 billion in industry revenue that will need to
be recovered elsewhere. While these hits to the balance sheet will undoubtedly weaken the industry,
cost U.S. jobs, and hinder further research, Beltway lobbyists persuaded Wall Street analysts that the industry “got off easy” because
these extortion payments allowed it to fend off more serious congressional threats such as imposing price controls in Medicare and permitting unrestricted drug
importation. But the lobbyists missed the forest for the trees. These taxes and fees are less important than the implications of the law’s gargantuan reordering of
the pharmaceutical marketplace. Over the long term, Obamacare will cause a significant degradation of the private-sector market for pharmaceuticals, a market
that has been the best in the world. In the United States, 150 million citizens get their prescription drugs through their health insurance rather than directly from
the government. Employers (and unions) contract with private health insurers to deliver the drug benefit, and the insurers negotiate with the pharmaceutical
companies to decide which drugs they will cover and at what price. Employees and retirees generally want access to the newest and best medicines, and their
companies want to keep them happy and healthy. Therefore, the health plans serving employers do their best to balance cost with the need to provide high-quality
medications. Thus, the U.S. employer-provided insurance market offers the primary feature that drug companies need: a market that has incentives to reimburse
for new medicines. When Medicare Part D was created, Congress attempted, with some success, to re-create these market forces for seniors through a
government-financed, but privately managed, health benefit. Under Part D, if a plan doesn’t cover the particular drugs that a senior may want, he can sign up for
another plan. Seniors will seek out new medicines that work, and so plans have reason to provide them. Combined, employer-based and Part D health plans account
for over 70 percent of the U.S. market for pharmaceuticals, meaning that the overwhelming majority of the U.S. market is a healthy one, where prices are
established by buyers and sellers negotiating innovation versus cost. Obamacare
would undermine this market by creating
considerable incentives for employers to drop coverage for both employees and retirees. Douglas Holtz-Eakin,
former director of the Congressional Budget Office, has estimated that the employer segment of the market may lose 35 million customers. The law also rescinds a
tax deduction for employers who provide drug coverage to their retirees. Even those private-sector employees who keep their coverage will see their
pharmaceutical benefits degraded as so-called “Cadillac plans” — the plans with the best pharmaceutical coverage — will take a huge 40 percent tax hit, giving
employers significant cause to scale back drug benefits. The
law also contains two provisions that will weaken the market
features of the Part D program: a Medicare payment commission that has the authority to set prices,
and an “evidence-based” research institute that will tell Medicare patients (and everyone else) that they do not need all these new drugs.
While the healthy part of the pharmaceutical market will be pounded, the government-run segment
of the market, Medicaid, will be expanded by 16 million patients. Medicaid has the worst pricing structure and the worst
track record in paying for innovations of any sector in the United States market. Like government health-care systems around the world, Medicaid must be dragged
to pay for medical advances. Unlike employers and seniors in Part D, Medicaid patients cannot vote with their feet if their health plan does not provide the new
medicines they want. The incentives in Medicaid all run against paying for pharmaceutical innovations.
So, Obamacare significantly expands
the worst sectors of the pharmaceutical market while degrading the best.
Despite these body blows to the
pharmaceutical marketplace, Beltway business “experts” provide soothing reassurance that there will be “so many new customers” that no one should worry about
the health of the industry. These new customers will appear in the so-called state exchanges that are slated to cover tens of millions of the currently uninsured. In
fact, the exchanges are a market that does not yet exist and, one can surmise, will be a bad market for pharmaceuticals. Because of adverse selection and costly
subsidies for lower-income participants, these exchanges will be plagued with cost overruns, as the Massachusetts exchange program currently is. Such a fiscal train
wreck can only portend a market where pharmaceutical benefits are lousy, prices are controlled, and innovation is not rewarded. Many of the Medicaid bureaucrats
who currently impose price controls are the very people designing the state exchanges. So,
in exchange for a Beltway “win,” PhRMA
agreed to restructure the entire U.S. pharmaceutical marketplace, to its considerable disadvantage.
U.S. pharmaceutical companies already face huge legal, scientific, and regulatory challenges and have shed
more than 100,000 jobs in the last two years. PhRMA committed lobbying malpractice by agreeing to the Obamacare deal. How did this happen? At the time the
deal was struck, PhRMA was headed by a wheeler-dealer former congressman from Louisiana, Billy Tauzin, who was unfamiliar with the pharmaceutical business.
Most of the CEOs of individual companies who might have stood up to Tauzin were either Democrats eager to please the administration, or Europeans without a
sound footing in American politics. It is not too late. The 2010 election, new leadership of PhRMA, and the
movement to repeal Obamacare
had already offered hope that the worst might be avoided. Now that the president has repudiated a central pillar of the deal,
the industry is free to support a wholesale repeal of the law, not through clever back-room deals or partisan maneuvering, but through an open declaration that
drug innovation is at stake. The pharmaceutical industry will never be popular, but if Beltway dealmaking replaces innovation, it will simultaneously court public
opprobrium and commercial disaster.
Pharmaceutical innovation is critical to stop the next global epidemic — kills
40-50 million
Bandow 05 senior fellow at the Cato Institute
(Doug, “A strong pharmaceutical industry is the best defense against pandemics,” The San Diego UnionTribune, 3/27/05, Available Online: http://www.signonsandiego.com/uniontrib/
20050327/news_lz1e27bandow.html, Accessed 09/04/2012)
For a time SARS, severe acute respiratory syndrome, seemed to threaten a deadly new global epidemic. But, thankfully, SARS faded away after
Bird, or avian, flu now worries many medical professionals. Outbreaks have
been reported in Indonesia and North Korea, and the disease has killed two score people in Thailand and Vietnam. Should the
killing fewer than 800 people.
disease mutate and infect humans, we could see a phenomenon like the flu pandemic that swept the world in 1918 and 1919, killing 40 million
or 50 million people. Indeed,
former Health and Human Services Secretary Tommy Thompson called the
avian flu "a really huge bomb" that could kill upward of 70 million people. Diseases like SARS and
avian flu, which have proved resistant to drugs commonly used to fight influenza viruses, demonstrate
how we all benefit from profitable drugmakers and abundant pharmaceutical research. Although
governments have an important role to play in fighting any disease pandemic, necessary for developing any effective treatment and putting
into mass production any vaccine or other medicine is private industry.
A/T PAS #’s Small
Even if that’s true, health care structures ensures families will use suicide to
reduce costs and payouts, still proves the link
Bopp 97 law graduate, University of Florida
(James P., Just the Medical Facts: An Argument in Support of the Continued Ban on Physician Assisted
Suicide, http://scholarship.law.stjohns.edu/cgi/viewcontent.cgi?article=1336&context=jcred&seiredir=1&referer=http%3A%2F%2Fscholar.google.com%2Fscholar%3Fq%3D%2522assisted%2Bsuicide%2
522%2Band%2Bhealthcare%2Bcosts%26btnG%3D%26hl%3Den%26as_sdt%3D0%252C3%26as_ylo%3D2
010%26as_vis%3D1#search=%22assisted%20suicide%20healthcare%20costs%22, NG)
Medical fact number six: Pressure to contain healthcare costs will cause people to seek suicide. 55 The
American Medical Asso ciation also addressed this issue:56 Pressure to contain health care costs
exacerbates the problem. Even if, as one would expect, health care insurers would consciously seek to
avoid suggesting to patients or physicians that they consider financial costs in making a decision to
hasten death, the continuing pressure to reduce costs can only constrain the availability and quality of
palliative care and support services that patients and families need. These limitations on the availability
of proper care clearly can place pressure on patients to express a wish for suicide that they might not
otherwise feel. Moreover, poor and minority individuals are at the greatest risk of receiving
inadequate care. 58 Thus, they feel the greatest pressure to request physician-assisted suicide.
s
2NC PAS Racism and Ableism Ks
Link- Targets Minorities
Discrimination DA- PAS reshapes healthcare into a culture of death and
ableism which disproportionality affects minorities and those in poverty
NYS Health Department 11
(New York State Department of Health Task Force on Life and the Law, “When Death is Sought,”
https://www.health.ny.gov/regulations/task_force/reports_publications/
when_death_is_sought/chap6.htm, NG)
These subtle but potentially pervasive changes will have the most significant impact on certain groups
of patients - patients most likely to be considered "hopeless," such as those with acquired immunodeficiency syndrome (AIDS);
patients who pose a risk to health care providers and family members, including those with multidrugresistant tuberculosis; or patients
who are least compliant, such as those who are mentally ill or drug addicted. Some health care
professionals already regard caring for these patients as a special burden. Given the overall life circumstances of
some of these patients, both health care professionals and family members may find it easy to rationalize that
euthanasia or assisted suicide would be in these patients' best interests.(13) Establishing a quick, painless death as
a state-sanctioned option may also mean that society becomes less committed to creating ways for patients, especially those who are socially
disadvantaged, to live longer and better. Finally, it must
be recognized that assisted suicide and euthanasia will be
practiced through the prism of social inequality and prejudice that characterizes the delivery of
services in all segments of society, including health care. Those who will be most vulnerable to abuse, error, or indifference are
the poor, minorities, and those who are least educated and least empowered. This risk does not reflect a judgment that physicians are more
prejudiced or influenced by race and class than the rest of society - only that they are not exempt from the prejudices manifest in other areas of
our collective life.(14) While
our society aspires to eradicate discrimination and the most punishing effects of
poverty in employment practices, housing, education, and law enforcement, we consistently fall short of our goals. The costs of this
failure with assisted suicide and euthanasia would be extreme. Nor is there any reason to believe that
the practices, whatever safeguards are erected, will be unaffected by the broader social and medical context in
which they will be operating. This assumption is naive and unsupportable.
Impact Extension- Racism
The plan ensures the worst racist abuses in society are amplified and given
state sanction, that’s Pittman, racist pressures to withhold treatment from
black and poor bodies for financial gain ensures that the most marginalized in
society will be killed off at greater rates than the privileged sick the aff was
meant to assist, the impact is an apriori ethical obligation, all violence is
predicated off of the division and tribalism inherent in the racist act, any
complicity ensures that violence is reentrenched in more insidious forms,
that’s Memmi.
More ev- Empowering racist physicians with the power of life and death over
disadvantaged bodies ensures the perpetuation of racism in its most violent
form
Pittman 97 Assistant Professor of Law at Mississippi Law
(Larry J., Physician-Assisted Suicide in the Dark Ward: The Intersection of the Thirteenth Amendment and
Health Care Treatments Having Disproportionate Impacts on Disfavored Groups, pp. 795, NG)
The majority’s conclusions stem from its comparison of race- based arguments against abortion with similar arguments against physicianassisted suicide.84 At first blush, the
majority’s discounting of those arguments seems well-grounded because
African-American women have not undergone the number of abortions that some ob¬servers
feared.85 Instead of being a tribute to the powerlessness of racial discrimination, however, the lack of coercive abortions
might be due to an absence of financial resources.86 Even racist physicians will not give free
abortions.87 On the other hand, racist physicians who lack financial re¬sources to treat African Americans
and other minorities properly and fully will have an opposite incentive when it comes to physicianassisted suicide. In a health care environment dominated by man¬aged care, it will be cheaper for physicians to
proscribe a lethal dose of medication than it will be to keep a terminally ill African Ameri¬can or other
disfavored minority patient hospitalized for a day, a week, or a month, especially if continued treatment is not profitable
for the hospital or other medical provider. Some commentators are already looking at physician-assisted suicide as
a means of rationing health care resources.88 The Ninth Circuit’s failure to prop¬erly acknowledge the racially motivated
dangers emanating from physician-assisted suicide is consistent with a societal norm that minimizes the concerns of minority groups and the
dangers that the health care industry poses to African Americans It is somewhat encouraging, however, that the Ninth Circuit in Compassion in
Dying recognized that minorities and poor people “have historically received the least adequate health care.” Never¬theless, unlike its
exhaustive historical analysis of suicide, the
court did not spend a great deal of time discussing the perceived
racism that exists in the health care industry. A better historical analysis of racism in the health care industry should have
influenced the court’s balancing of a terminally ill patient’s interest against the state’s in¬terest in protecting African Americans and other
minorities from physician-assisted suicide. The
historical persistency of racial dis¬crimination in the health care
industry warrants extreme caution when evaluating whether physicians should be given more power
over the life and death of terminally ill patients.
Extra Impact to PAS bad- Genocide
Extra Impact- plan provides the legal/medical mechanism for alleviating
healthcare costs by killing the elderly- the impact is genocide
Thomasma 94 Michael I. English Professor of Medical Ethics, Loyola University
Chicago
(Dr. David C., Medicine Unbound: The Human Body and the Limits of Medical Intervention: Emerging
Issues in Biomedical Policy Volume 3, pp. 223-224, NG)
How soon would we turn our attention from other issues to the high cost of caring for extremely elderly and debilitated persons? Already the
discus- sion of euthanizing the demented elderly has begun in the United States (Thomasma 1992). At
first blush, what would
appear to be the explicit downgrading of the intrinsic value of human life seems very foreign to our
way of thinking. Most Americans would react with dismay, even horror, at such a state- ment. We also have the advantage of hindsight
into the devastating consequences of such thinking. The stench of the death camps is a pall that still hangs over Western civilization. Yet
attitudes of superiority and of devaluing individual lives creep into our own thinking as well , for instance,
while constructing what we consider to be rational allocation plans for health are. While we intend to
min- imize suffering and maximize the common good, large numbers of indi- viduals face neglect. Perhaps the
biggest worry about euthanasia today is the forthcoming crisis in health care that will be created by
an increasingly elderly population. Those over eighty-five years of age in the next fifty years will increase fivefold, from three
million to fifteen million citizens. Many of these people will be dependent on long-term nursing home care. Such are is the most expensive
medical cost for the elderly. In all state budgets, Medicaid is the second largest budget item after education. Peo-
ple over eighty-five,
four times as much money to cover a hos- pitalization than those under eighty-five. There
will be fewer individuals "in the middle," able to bear the burden of caring for the young and the elderly. The phenomenon of
the elderly (seventy to eighty-five years of age) caring for the "old old" (those over eighty-five) has already begun. Recall that the
fundamental argument for forcible euthanasia is almost invariably economic. Once the official
mechanism for active voluntary euthanasia is in place, habits of finding other areas for "mercy/'
coupled with hard economic times, could easily lead to involuntary euthanasia. This is yet another form of the
in fact, take
traditional slippery slope argument, based on fears about the violence in American society and the natural human propensity to find technical
solutions to difficult social problems, ones we can only imagine for the future, but ones that our children must face soon enough. If
we set
the wrong precedents in the present, why would we think the same sort of thinking that occurred in
Nazi Germany would not arise again? Proponents of direct euthanasia usually argue that fences can
be built on the slope, legal requirements that would eschew even the most remote possibility of a society tuming mercy into murder
once more (Cassel and Meier 1990). The United States is a nation under the rule of law. If anything, we tend to
appeal too readily to law to resolve disputes. It is one of our strengths, that in a highly pluralistic culture, we are able to
resolve funda- mental disagreements by such an appeal. Does the evidence so far support the view that concerns about misuse and abuse can
be met by establishing those "fences" in the law? While
no immediate conclusion can be drawn at this time, it is
important for acade- mic debate to include an awareness of the level of social violence in Amer- ican
society today, where individuals are killed simply because another person wants their sports jacket, or
small children are killed in projects on their way to school. This violence not only manifests itself in the inner city. lt is a
pandemic of our society. It infects us even when we are wary of it, it barrages us in "coming attractions" in the movie theaters.
Hence, the smile of reason from the Enlightenment is, today, an anachronism. Humanism itself , it seems
to me, does not take sufficient account of the power of evil in human society and in human hearts, an
acknowledgement we must make. It is the respect we must pay to all those who did lose their lives in the
Holocaust. Thus, it is not entirely inconceivable that the Nazi experience could be a preview of our
own coming attractions.
Extra impact to PAS bad --Palliative Care DA
Plan disempowers physician-decision making, destroys health care quality
and boosts healthcare
Golden 05 Policy Analyst for the Disability Rights & Education Fund,
Marilyn, “Why Assisted Suicide Must Not be Legalized,” http://euthanasia.procon.org/
view.answers.php?questionID=000207, NG)
Perhaps the most significant problem is the deadly mix between assisted suicide and profit-driven
managed health care. Again and again, health maintenance organizations (HMOs) and managed care bureaucracies have
overruled physicians' treatment decisions. These actions have sometimes hastened patients' deaths. The cost of the
lethal medication generally used for assisted suicide is about $35 to $50, far cheaper than the cost of
treatment for most long-term medical conditions. The incentive to save money by denying treatment already poses a
significant danger. This danger would be far greater if assisted suicide is legal. Assisted suicide is likely to accelerate the
decline in quality of our health care system. A 1998 study from Georgetown University's Center for Clinical Bioethics
underscores the link between profit—driven managed health care and assisted suicide. The research
found a strong link between cost—cutting pressure on physicians and their willingness to prescribe
lethal drugs to patients, were it legal to do so. The study warns that there must be "a sobering degree of caution in legalizing [assisted
suicide] in a medical care environment that is characterized by increasing pressure on physicians to control the cost of care" (Sulmasy et al.,
1998). The
deadly impact of legalizing assisted suicide would fall hardest on socially and economically
disadvantaged people who have less access to medical resources and who already find themselves discriminated against by the health
care system. As Paul Longmore, Professor of History at San Francisco State University and a foremost disability advocate on this subject, has
stated, "Poor
people, people of color, elderly people, people with chronic or progressive conditions or
disabilities, and anyone who is, in fact, terminally ill will find themselves at serious risk " (Longmore, 1999).
PAS destroys palliative care, downgrades healthcare quality
Bopp 97 law graduate, University of Florida
James P., Just the Medical Facts: An Argument in Support of the Continued Ban on Physician Assisted
Suicide, http://scholarship.law.stjohns.edu/cgi/viewcontent.cgi?article=1336&context=jcred&seiredir=1&referer=http%3A%2F%2Fscholar.google.com%2Fscholar%3Fq%3D%2522assisted%2Bsuicide%2
522%2Band%2Bhealthcare%2Bcosts%26btnG%3D%26hl%3Den%26as_sdt%3D0%252C3%26as_ylo%3D2
010%26as_vis%3D1#search=%22assisted%20suicide%20healthcare%20costs%22, NG)
Medical fact number eight: Assisted suicide undermines the trust patients have in healthcare providers .6l Here,
an associa- tion representing some one-thousand nursing homes gave their opinion:62 Many medical ethicists have written that
introducing phy- sician-assisted suicide into the physician·patient relation- ship will seriously
undermine patients’ trust that physicians are committed to preserving life, which is at the core of the
relationship. This breakdown of trust has even more drastic effects on the relationship between [nursing homes] and the people they serve.
Unlike the selection of a doctor, the
choice to enter a nursing home or other facility for the aging entails a
fundamental life shift—uprooting one’s home and placing large areas of One’s life into the hands of others. Many seniors choose to
make this move even when their physical state does not make it necessary because they view it as beneficial; they can trust in a facility’s
mission of pre- serving life and health when they entrust their lives to it. One
of this nation’s most vulnerable populations
relies on [nursing homes] to show a compassionate commitment to life at one of its most trying yet
precious moments. Especially if residents feel that the choice will be subtly forced upon them,
physician-assisted suicide will threaten this relation- ship and poison the environment in which longterm care and services are provided. 63
Apriori ethical obligation to reject it- quality end of life care is key to the
medical profession
Paulus 08 Undergraduate Honors Thesis Writer at Santa Clara University
(Stephanie, http://www.scu.edu/ethics/practicing/focusareas/medical/palliative.html, NG)
Studies on palliative care reveal numerous positive outcomes for patients, their families, and hospitals, yet
only thirty-percent of American hospitals have some sort of palliative care program. After seeing the highquality, beneficial, patient-centered care provided to patients at the end of life through O'Connor's Palliative Care Team, I realized that the
lack of palliative care programs in American hospitals is a complete ethical failure-a failure on the part
of hospitals to attend to the needs, and to relieve the pain and suffering, of their patients when it is
entirely possible to do so. The basic philosophy of palliative care is to achieve the best quality of life for patients even when their illness cannot be cured. Palliative care
is provided through comprehensive management of the physical, psychological, social, and spiritual needs of patients, while remaining sensitive to their personal, cultural, and religious values
and beliefs. Hospital palliative care services are often provided through an interdisciplinary team of health care professionals including, but not limited to: physicians, nurses, psychologists,
social workers, and chaplains. There is a great need for palliative care services in American hospitals. The Study to Understand Prognoses and Preferences for Outcomes and Risks of
Treatments (SUPPORT) and many subsequent studies discovered poor quality of care at the end of life in many hospitals and in-hospital death characterized by uncontrolled pain and
prolonged suffering. I have found palliative care to provide many positive outcomes for hospitalized patients including: expert pain and symptom management, assistance with difficult
decision making, and assistance in establishing goals of care and appropriate treatment plans. In-patient palliative care services better coordinate patient care, ensure and respect patient
autonomy, and improve patient-physician communication. Overall, palliative care improves quality of life for patients suffering incurable, progressive illness in accordance with their values and
preferences. In addition, palliative care helps hospitals to provide cost-effective, high-quality care by placing patients in the most appropriate level of care, decreasing hospital length of stay,
Hospital palliative care services are significant in
realizing that "the task of medicine is to care even when it cannot cure." Patients deserve the best
quality of health care hospitals can provide at all stages of illness. The complex needs of dying
patients in particular can be met most effectively through dedicated palliative care programs.
Hospitals are ethically obligated to offer such programs because the principles of beneficence and
nonmaleficence require that hospitals, in addition to clinicians, seek to improve the quality of life and relieve
the pain and suffering of all patients to the best of their ability. Meet Mrs. Smith Mrs. Smith, a 71 year old female, was admitted to the
expediting appropriate treatment, and reducing the use of non-beneficial resources.
hospital with an exacerbation of her chronic obstructive pulmonary disease (COPD) and pneumonia. Her symptoms were cough, fever, headache, and shortness of breath. Mrs. Smith also had
a history of diabetes and was in the hospital with pneumonia three weeks prior. Over the next few days, Mrs. Smith's condition worsened. She was transferred to the intensive care unit (ICU)
when the infection spread to other organs of her body, inducing shock. Her care was transferred to the on-call resident who was unfamiliar with her case. She continued to complain of
headache and shortness of breath, and the nurses noted that she was increasingly irritable and hardly slept. During the night, Mrs. Smith suffered an acute nose bleed and aspirated blood into
her lungs, causing respiratory distress, and she was intubated. Once a fairly independent woman, Mrs. Smith now lay in the ICU with a spreading infection and a ventilator pumping air into her
lungs to keep her alive. Mrs. Smith's son and daughter-in-law came to visit every afternoon. They noticed a significant change in Mrs. Smith's health status and spirit, but remained hopeful that
she "was a fighter," and would turn around. By writing on a pad of paper, Mrs. Smith communicated to her son that she was very uncomfortable and particularly worried about missing Sunday
Mass. As Mrs. Smith's condition continued to decline, she became confused and disoriented. She did not have an advance health care directive, and when the doctor initiated a discussion
about her code status, the family was uncertain of what to do because they had never discussed it before. The family did not understand why her condition was not improving and became
increasingly worried about the cost of the hospital stay. The case of Mrs. Smith presents several concerns: First, Mrs. Smith failed to receive adequate pain and symptom management-she
continued to be short of breath while her headache and insomnia were completely overlooked. Second, inadequate communication between the patient, family, and clinical team meant that
goals of care were not discussed while Mrs. Smith was still able to communicate, and the family never realized the severity of Mrs. Smith's condition. This led to uncoordinated care that
compromised Mrs. Smith's quality of life and her autonomy when decisions needed to be made. Mrs. Smith received suboptimal care that failed to meet her physical, psychosocial, and
spiritual needs. What if Mrs. Smith were your mother? You would want her to have the best quality of life possible. Ideally, you would want to see her battle the pneumonia, come off the
respirator, and return home to a happy life. In the meantime, you would want her pain to be relieved, her breathing to be eased, and her spiritual and financial concerns to be recognized. If
recovery to her previous state of health was not possible, you would want to assure that your mother received care that was consistent with her personal values. All physicians want to be able
to provide such holistic care for their patients, but the reality is that hospital stays are expensive and physicians simply do not have the time to provide adequate psychosocial and spiritual
care, especially in acute care settings such as the ICU.1 The ethically responsible solution to providing quality care for Mrs. Smith, and others in similar circumstances, is to provide in-patient
palliative care services through a dedicated interdisciplinary health care team. What is Palliative Care? The basic philosophy of palliative care is to achieve the best quality of life for patients
In contrast to hospice care, palliative care is offered at any stage of illness: in
conjunction with life-prolonging therapy or as comfort care at the end of life.2 Palliative care is provided through
even when their illness cannot be cured.
comprehensive management of the physical, psychological, social, and spiritual needs of patients, while remaining sensitive to their personal, cultural, and religious values and beliefs.3 In
order to accomplish such holistic care, hospital palliative care services are most often provided through an interdisciplinary team that draws on the expertise of a variety of health care
professionals. Palliative care teams require knowledgeable, skilled, and experienced clinicians and may consist of physicians, nurses, psychologists, pharmacists, chaplains, social workers,
nutritionists, and physical therapists.4 A distinctive palliative care unit may be set up within a hospital to care for patients, but more often a specific Palliative Care Team will provide services to
patients throughout the hospital. Either way, a clearly identified, accessible, and accountable team is essential in order to coordinate care, facilitate communication, and ensure that changing
needs and goals of patients are met throughout their hospitalization.5 Studies on palliative care reveal numerous positive outcomes for patients, their families, and hospitals, yet only thirtypercent of American hospitals have some sort of palliative care program.6 In my opinion, this is a complete ethical failure-a failure on the part of hospitals to attend to the needs, and to relieve
the pain and suffering, of their patients when it is entirely possible to do so. Hospitals are ethically obligated to offer palliative care services because the principles of beneficence and
nonmaleficence require that hospitals, in addition to clinicians, seek to improve the quality of life and relieve the suffering of all patients to the best of their ability. Ethics and Palliative Care
The ethical principle of beneficence states that "we should act in ways that
promote the welfare of other people."7 In a very basic way, beneficence is implicit to the role of all health
care professionals as part of the "helping professions:" doctors, nurses, and other health care workers daily accept the
duty to seek to benefit their patients. Similarly, the principle of nonmaleficence claims that "we ought to act in
ways that do not cause needless harm or injury to others."8 While we recognize that the practice of medicine is not
perfect, and all medical therapies involve some risk of harm, we trust and expect that health care professionals are
cautious, diligent, and thoughtful when providing care. In the same way, hospitals and health care
organizations are also held to certain ethical standards. Hospitals have an ethical obligation to
support their staff, as well as manage their organization, in ways that ensure patient safety and patient rights,
The Principles of Beneficence and Nonmaleficence
and in ways that promote quality health care. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
holds its accredited hospitals to national standards for health care quality, including effective pain management.9 Most hospitals recognize
these duties and have mission statements claiming a dedication to high-quality health care, and often a specific dedication to patient-centered
care. Hence, patients
admitted to hospitals with acute medical conditions expect appropriate, highquality health care.
AFF ANSWERS TO OBAMACARE DA
Perception Uniqueness takeouts
GAO Report overwhelms the link. Republicans and Fox News will use it in the
midterms to kill Obamacare support. Their link is too long-term to affect
perception
Howard 08-05-14 digital artist and graphic designer. Publisher and proprietor of
Crass Commerce, an enterprise dedicated to promoting an alternative consumerism
Mark, “FOX NEWS ALERT: ObamaCare Website Rollout Had Problems (Who Knew?),
http://www.newscorpse.com/ncWP/?tag=obamacare
Not too long ago, the Affordable Care Act (aka ObamaCare) dominated the political landscape in both
Congress and the media. It virtually sucked the oxygen out of every other issue that didn’t involve
Benghazi. But lately there has been a conspicuous absence of news about the program. And
Republicans, once devoted to its demise, have all but banished it from their public communications.
Until today. That’s right. Fox News has brought ObamaCare back into the spotlight to announce that a
Government Accounting Office report has found that “management failures” led to the botched
rollout of the website. The network banged their signature gong and ran their “Fox Alert” graphics to
broadcast this breaking news. After all, who would have ever imagined that a lack of managerial
oversight and efficiency were responsible for the debacle that accompanied the launch of the
ObamaCare exchange? Thank goodness Fox News is here to enlighten us with their probing journalism.
Such tenacity is representative of their professionalism and surely has nothing to do with trying to shove
an old and obvious story into the news cycle in order to damage the President’s standing. Perhaps they
are just nostalgic for the good old days when they had a juicy drama with which they could smear the
administration. Back when Congress held over fifty votes to cripple or repeal the legislation. At the same
time, multiple committees were investigating everything from the faulty website, to alleged security
risks, to threats of criminal navigators, to allegations of false audits, and the ever-present fantasy of
death panels. The media, led by Fox News, obsessed over the same issues as they emerged from the
GOP committees investigating them. But they added their own scare mongering in an effort to frighten
citizens away from the program and hasten its failure. The press falsely reported conservative
assessments that claimed millions would lose their insurance, that premiums would skyrocket, and that
their personal health and financial records would be compromised.
People will remember the GAO Report indictment
New Bern Sun Journal Editorial, 08-01-14 North Carolina newspaper
“Editorial: Obamacare problems, a lesson in government.”
http://www.newbernsj.com/opinion/editorials/editorial-obamacare-problems-a-lesson-in-government1.353804
A months-long study of the problems marring the Obamacare website has turned up a host of culprits.
From ineffective planning to poor oversight, the Government Accountability Office points to a number
of flaws in the Obama administration’s handling of the website, which went public last fall.
Despite administration claims that the website would be heavily used as soon as it opened, the site
stumbled for weeks, at times frozen by the traffic. The administration encountered problems as
numerous people gave different orders to government contractors, incurring huge costs even in dozens
of cases when the people giving the orders lacked the authority to approve cost overruns. In just two
and a half years, the cost of the program more than tripled. Altogether, the study paints a picture of
government ineptitude and inefficiency — some of the very characteristics opponents of the health care
law cited in arguing against it. By the end of last year, most of the software problems were cleared up,
and the site now functions well, according to reports. The questions, though, remain.
Why didn’t the government agencies responsible for overseeing the process stumble so badly?
Why was such a sub-par product accepted by the government at vast expense to taxpayers?
How often do these same mishaps play out in the federal government without the public scrutiny that
this incident incurred?
In this case, while the website rollout initially harmed the public perception of Obamacare, the eventual
fixes ironed out much of the political fallout. What is left is a lesson in oversight and public
administration that should not be localized on this one news story. Instead, government planners in
Washington, D.C., should take it as a cautionary tale. Any public project requires clear lines of authority
and careful oversight to avoid waste, contradiction and repetition. HealthCare.gov required much more
time, expense and inconvenience than it should have to become fully functional. The whole ordeal
was a lesson in government waste. Unfortunately, it is unlikely that those responsible for these
glaring failures will learn from them, since the waste and delay was paid for by the public, not by
them. The people they serve, though, should have a painful and lasting reminder of why Washington
solutions should be the last resort.
PAS Doesn’t Link to Obamacare
AFF CARD: The Link doesn’t account for the high cost of PAS in the U.S., their
methodology is wrong and PAS doesn’t save money
Golden 05 Policy Analyst for the Disability Rights & Education Fund,
(Marilyn, “Why Assisted Suicide Must Not be Legalized,”
http://euthanasia.procon.org/view.answers.php?questionID=000207, NG)
Rex Greene, M.D., Medical Director of the Dorothy E. Schneider Cancer Center at Mills Health Center in San Mateo, California and a leader in
bioethics, health policy and oncology, underscored the heightened danger to the poor. He said, "The
most powerful predictor of
ill health is [people's] income. [Legalization of assisted suicide] plays right into the hands of managed
care."2 Supporters of assisted suicide frequently say that HMOs will not use this procedure as a way to deal with
costly patients. They cite a 1998 study in the New England Journal of Medicine that estimated the savings of allowing people to die before
their last month of life at $627 million. Supporters argue that this is a mere .07% of the nation's total annual
health care costs. But significant problems in this study make it an unsuitable basis for claims about
assisted suicide's potential impact. The researchers based their findings on the average cost to Medicare of patients with only
four weeks or less to live. Yet assisted suicide proposals (as well as the law in Oregon) define terminal illness as having six months to live. The
researchers also assumed that about 2.7% of the total number of people who die in the U.S. would
opt for assisted suicide, based on reported assisted suicide and euthanasia deaths in the Netherlands.
But the failure of large numbers of Dutch physicians to report such deaths casts considerable doubt on
this estimate. And how can one compare the U.S. to a country that has universal health care? Taken
together, these factors would skew the costs much higher (Rowen, 1999).
Oregon modeling proves- the aff also removes malpractice requirements from
PAS, solves key source of insecurity among physicians
Becker 06 Assistant Professor in the University of Kansas Medical Center
(David W., Problems with Death reporting in Opposing viewpoints in Context,
http://ic.galegroup.com/ic/ovic/ViewpointsDetailsPage/DocumentToolsPortletWindow?displayGroupNa
me=Viewpoints&jsid=22a201952de6dd9e0de079097de35ea1&action=2&catId=&documentId=GALE%7C
EJ3010160250&u=gotitans&zid=2838830242978b1d4527a1d076151303, NG)
Specifically, the Act disallows recourse to malpractice suits by these patients and their family
members in that it exempts assisted-suicide doctors from the requirement of meeting the ordinary
standards of medical care in like communities nationally, and instead holds them only to a "good
faith" standard, which is something heretofore unknown in a medical-legal sense, and inapplicable to
any legitimate medical treatment. [The Act] states, "No person shall be subject to civil or criminal
liability or professional disciplinary action for participating in good faith compliance with [the Act]."
The statute actually replaces traditional "standard of care" requirements with a "good faith" standard
that is, in essence, totally subjective, and virtually impossible to evaluate within the established context
of medical practice, and treats assisted-suicide as different from any legitimate medical purpose or
treatment.
2AC PAS Obamacare Link Turn
Majority of American Physicians Oppose PAS
Healthday 13 (Medical Polling/Information Service, http://consumer.healthday.com/generalhealth-information-16/doctor-news-206/most-doctors-don-t-favor-physician-assisted-suicide680082.html, NG)
WEDNESDAY, Sept. 11, 2013 (HealthDay News) -- Whether doctors should help patients die continues
to be a hotly debated topic within the medical community, a New England Journal of Medicine poll
finds. The journal questioned readers about a hypothetical near-death case and received more than
2,000 valid responses. Roughly two-thirds worldwide -- including 67 percent of replies from the United
States -- said they disapprove of physician-assisted suicide. Most readers of the journal are doctors.
Some said assisting a suicide violates a physician's oath to do no harm and might lead to euthanasia -intentional killing to relieve suffering and pain.
The plan causes mass quitting by physicians- ethical polling proves
CNewswire, 2009
(Citing CMA CEO David Stevens, M.D., accessed on deaconforlife.com,
http://deaconforlife.blogspot.com/2009/10/cma-doctors-sen-harry-reids-well-put-up.html, NG)
"Such a sellout would be the watershed event that historians would point to as marking the deprofessionalization of medicine, when physicians traded convictions for cash. If physicians abandon
their professed commitment to the patient's welfare in order to solely pursue financial reward,
patients will pay the price--some with their lives. "The fact that Mr. Reid would stoop to backroom bargaining tactics is an indication
of desperation, an acknowledgement that physicians are roundly opposed to his healthcare legislation. As polling has shown, an impressive 45
percent of physicians say they actually are ready to quit medicine if current healthcare legislation passes. "Add to that data what a national
survey of faith-based physicians found: That
95 percent are ready to leave medicine if a weakening of conscience
protections would force them to violate their conscientiously held convictions. "Mr. Reid and his allies may be
working behind closed doors on a clever way to pass healthcare legislation, but maybe they should be working on who's
going to carry out their new scheme if over half the nation's physicians quit medicine. "Cold cash
offers are not going to sway principled physicians. The question that Mr. Reid and his colleagues should be
asking is not how to buy off the ever-shrinking AMA or a small cadre of cash- conscious doctors, but how to accommodate the
concerns of the vast majority of principled physicians who value conscience rights and want to keep
the government from interfering with the physician-patient relationship."
That causes a shift toward unsustainable RN-centered care, which collapses
perceptions of Obamacare.
O’Reilly 12 Medical Ethics Correspondent at amednews.com
(Kevin B., http://www.amednews.com/article/20121008/profession/310089946/1/, NG)
Shortage sparks debate over NPs’ role The looming physician shortage is drawing more attention to
the use of nurse practitioners, physician assistants and other midlevel health professionals to help
maintain access to care. But the shift toward more team-based care in patient-centered medical
homes should occur in a physician-led environment, the AAFP said in a Sept. 18 report. The American
Academy of Nurse Practitioners objected to the report, arguing that NPs could help fill the physician
gap by independently treating patients. Dr. Stream, of the AAFP, said a two-tier system of primary care
— physicians for some, nurse practitioners for others — is untenable. “To the people who propose
that to fill this gap that we should somehow alter our expectations of the kind of care people should
get — that is not what we want in this country,” he said. “It’s not a viable, ethical or reasonable
solution.” Primary care doctors complete 21,700 hours of education and training over 11 years, said the
AAFP report. That compares with 5,350 hours of training and education NPs get during five to seven
years. The AMA backed the academy’s report, noting a recent survey showing that 86% of patients
believe they benefit from a physician-led primary care team. “Physicians and other health
professionals have long worked together to meet patient needs for a reason — the physician-led team
approach to care works,” said AMA President Jeremy A. Lazarus, MD. “Patients win when each member
of their health care team plays the role they are educated and trained to play.”
Physician Opposition Link Turn extensions-Nurses
Doctor Nurse conflict high now- plan ensures even more doctors leave
Obamacare
Modern Healthcare 10 Health Care News Source
http://www.modernhealthcare.com/article/20101220/MAGAZINE/312209917, NG)
The long-simmering struggle between doctors and nurses over the national patchwork of laws on
nurses' powers in healthcare finally boils over into a public skirmish, on the heels of a healthcare
reform law that puts a premium on patient-centered primary care. Nurses' groups push their case in a
586-page tome from the Institute of Medicine, titled The Future of Nursing and released in October, in
which the authors assert that the country can no longer afford to let its nurses not practice up to the
fullest extent of their training. They argue that nurses are quicker and cheaper to produce than doctors,
and that they make no more medical errors than physicians. Meanwhile, doctors, who in 2009
published their own massive set of reports opposing changes in state scope-of-practice laws, say that
if the reform law ends up pushing lesser-trained clinicians into positions of higher authority in
medicine, the change will only fuel public resentment of the law.
PAS elevates the position of nurses over physicians- reshaping the
relationship
Nursing Spectrum 2k American Nursing Newsletter
http://www.consciencelaws.org/background/procedures/assist003.aspx, NG)
"This man was not the picture of suffering as I know it," says Allene, who, though she did not witness the death, was a party to it all the same.
Since
Oregon broke new ground with its 1997 Death with Dignity Act - becoming the only state in the nation to
legalize PAS - nurses there are assuming roles they may not have anticipated, sometimes uncomfortably so. Ironically,
Oregon's nurses are finding themselves, not physicians, on the front line of PAS. It's a place where
physicians might actually prefer them and one to which some nurses have already gone. Better You Than
Me "Initially, when the law was designed, the assumption was that physicians would be the first ones to explore
PAS with patients," says Pam Matthews, RN, BSN, administrator for Evergreen Hospice, Albany, OR, "but in reality, nurses are
usually the ones in the line of fire. Patients often feel nurses understand their wishes for good quality of life
and good quality of death, too." Much of nurses' roles lies behind the scenes long before the drama of PAS
unfolds. Home care and hospice nurses actively help patients understand their rights, acting as advocates for those who are considering
PAS. "Patients often ask about PAS," says Allene. "They want to learn more and feel comfortable asking
their nurses about it." Allene's agency has cared for four patients who have opted to use PAS. Gus was Allene's first such patient. "Our
entire hospice team was involved in this patient's case - all trying to pick his brain, making sure he had no unmet needs we could fill or pain that
was going untreated," she says. "We wanted to be sure that he saw all possible options before using PAS." It's
that kind of strong
patient advocacy that has physicians - in general opposed to PAS - speculating whether nurses are
better-suited to a more direct role in the process. Some physicians have stated publicly that they may
not be the best members of the healthcare team to lead assisted dying, confessing that they are not always the
most properly prepared for the task. A recent article in the Annals of Internal Medicine (AIM) stated PAS violates physicians'
professional integrity and suggests that other disciplines, such as nursing, may be more capable of
leading assisted-dying efforts.1 "To say that physicians alone are the only ones capable of assisting a patient's suicide is not that
easy," says Jason Karlawish, MD, of the University of Pennsylvania Center for Bioethics' Assisted Suicide Consensus Panel, and coauthor of the
AIM article. "The
problem is that it [PAS] requires skills that the average physician does not have - and
shouldn't have. We [physicians] should be able to treat those who are dying, relieving their pain and
symptoms, but not helping them kill themselves."
Legalization debates focus exclusively on doctors; elevating their agency to
primacy even though nurses spend more time with patients, ethical PAS
requires nurse-centric approaches
Olin 12 Resident Nurse and lead writer at RN Central
(Jennifer, http://www.rncentral.com/blog/2012/nursings-role-in-assisted-suicide/, NG)
In ethical debates about euthanasia and assisted suicide the focus is usually on the involvement of
doctors; nurses are seldom given much thought at all. Yet, it is a topic that greatly affects nurses.
Nurses are the ones at the bedside of the dying—24 hours a day, every day. Nurses are there for the
patients, assessing and managing pain, and other symptoms. They are there for the patients and their
families addressing their spiritual needs, their anxieties, and their questions. Nurses often find
themselves in a quandary. While many of the professional nursing and hospice associations have come
out publicly against the legalization of and participation in euthanasia or assisted suicide, this doesn’t
usually help the nurse who is standing in front of the patient asking to die with an appropriate response.
Surveys over the years show that somewhere between 17-40 percent of nurses working in critical care
and hospice have received requests from patients or family members to perform euthanasia or assist
in suicide. One of these surveys showed that 16 percent of nurses responding have participated in
these practices. And, while there is debate over the actual validity of the number and the actual acts
(the administration of opiates to dying patients, a practice that generally is considered different from
assisted death and morally acceptable) a significant number of nurses have said they have provided or
prescribed drugs to a patient knowing the patient intended to use them to end their own lives. These
studies have highlighted a number of important issues surrounding nurses and euthanasia, assisted
suicide and relief of suffering: Nurses are witness to tremendous suffering. – Nurses need to be
supported and educated in ways to lessen suffering. Also, RNs need to identify their own responses to
suffering and distress or they won’t be able to identify which patient’s suffering is being addressed
through assistance in dying. There is confusion about the differences between euthanasia, assisted
suicide and relief of suffering. – If nurses are unable to discriminate between these actions they may
unwittingly place themselves at risk for unexpected emotional and legal consequences. Nurses need
guidance in discerning the moral and legal distinctions among various nursing actions at the end of
life.
2AC Obamacare Impact Turns (Obamacare
Good)
Obamacare repeal tanks the economy by destroying business confidence
Cutler 11 Otto Eckstein Professor of Applied Economics, Harvard University, and a
Senior Fellow at the Center for American Progress,
(David,“Repealing Health Care Is a Job Killer: It Would Slow Job Growth by 250,000 to 400,000
Annually,” January, http://www.politico.com/pdf/PPM182_110107_cutler.pdf)
The implications of repealing health care for national medical spending (public and private) are shown in
Figure 1. Repealing health reform would add $25 billion to spending in 2014 and $185 billion to
spending in 2019. The impact on family premiums will be equally large (see Figure 2). Repealing health
reform would add 9 percent or nearly $2,000 annually to family health insurance premiums in 2019. Any
proposal that adds $200 billion to our medical spending after a decade will have enormous economic
implications. The employment impacts of health care repeal will be particularly severe because many
of these costs will fall on businesses. As we’ve already seen, employers facing higher health costs will
hire fewer people, lay workers off, and pay lower wages. To estimate these employment impacts, I
followed the methodology of myself and Neeraj Sood.13 That paper took estimates of the medical
spending change associated with health reform and combined that with the econometric model of Sood,
Arkadipta Ghosh, and José Escarce that estimated the employment impacts of changes in medical costs.
I use the model to estimate the employment impact of repealing reform. Figure 3 shows the net impact
of repealing health reform on total employment. The baseline estimates show that 250,000 jobs will be
lost annually if health reform is repealed. Annual job losses would average 400,000 using the greater
estimate of 1.5 percentage point cost increases annually resulting from repeal. Figure 4 shows the
estimated employment change by industry in 2016 (omitting health care, which will have more
employment). More than 200,000 jobs will be lost in manufacturing and nearly 900,000 jobs will be
lost in nonhealth care services. A total of 250,000 jobs will be lost annually if health reform is repealed.
These job losses are not the only impact of repealing health reform, however. Family incomes would fall
by as much as $2,000 annually as medical costs increase beyond forecasted levels. Federal deficits also
would rise. The Congressional Budget Office has predicted that repealing health reform would add
$230 billion to federal deficits in the next decade because provisions in the law intended to bring
down costs would be repealed. Job transitions would also be affected. Millions of people are “locked”
into their current job because they fear becoming uninsured or underinsured if they were to change.
Repealing health reform would thus stifle job transitions, new business startups, and movements into
and out of the labor force. Millions more workers would be affected.
Obamacare is key to prevent Bioterror
Sklar 02 Coauthor of “Raise the Floor,” Knight Ridder/Tribune News Service
Holly, “Rolling the Dice on Our Nations’ Health”, December 19,
http://www.commondreams.org/views02/1219-07.htm
Imagine if the first people infected in a smallpox attack had no health insurance and delayed seeking care for their
flu-like symptoms. The odds are high. Pick a number from one to six. Would you bet your life on a roll of the dice?
Would you play Russian Roulette with one bullet in a six-chamber gun? One in six Americans under age 65 has no
health insurance. The uninsured are more likely to delay seeking medical care, go to work sick for fear of losing
their jobs, seek care at overcrowded emergency rooms and clinics, and be poorly diagnosed and treated. The longer
smallpox--or another contagious disease--goes undiagnosed, the more it will spread, with the insured and uninsured
infecting each other. Healthcare is literally a matter of life and death. Yet, more than 41 million Americans have no
health insurance of any kind, public or private. The uninsured rate was 14.6 percent in 2001--up 13 percent since
1987. The rate is on the rise with increased healthcare costs, unemployment and cutbacks in Medicaid and the State
Children's Health Insurance Program (SCHIP). One in four people with household incomes less than $25,000 is
uninsured. One in six full-time workers is uninsured, including half the full-time workers with incomes below the
official poverty line. The share of workers covered by employment health plans drops from 81 percent in the top
fifth of wage earners to 68 percent in the middle fifth to 33 percent in the lowest fifth, according to the Economic
Policy Institute. As reports by the American College of Physicians, Kaiser Family Foundation and many others have
shown, lack of health insurance is associated with lack of preventive care and substandard treatment inside and
outside the hospital. The uninsured are at much higher risk for chronic disease and disability, and have a 25 percent
greater chance of dying (adjusting for physical, economic and behavioral factors). To make matters worse, a health
crisis is often an economic crisis. "Medical bills are a factor in nearly half of all personal bankruptcy filings," reports
the National Academy of Sciences Institute of Medicine. The U.S. is No. 1 in healthcare spending per capita, but
No. 34--tied with Malaysia--when it comes to child mortality rates under age five. The U.S. is No. 1 in healthcare
spending, but the only major industrialized nation not to provide some form of universal coverage. We squander
billions of dollars in the red tape of myriad healthcare eligibility regulations, forms and procedures, and secondguessing of doctors by insurance gatekeepers trained in cost cutting, not medicine. Americans go to Canada for
cheaper prices on prescription drugs made by U.S. pharmaceutical companies with U.S. taxpayer subsidies. While
millions go without healthcare, top health company executives rake in the dough. A report by Families USA found
that the highest-paid health plan executives in ten companies received average compensation of $11.7 million in
2000, not counting unexercised stock options worth tens of millions more. The saying, "An ounce of prevention is
worth a pound of cure," couldn't be truer when it comes to healthcare. Yet, we provide universal coverage for
seniors through Medicare, but not for children. We have economic disincentives for timely diagnosis and treatment
of diseases. Universal healthcare is a humane and cost-effective solution to the growing healthcare crisis. Universal
coverage won't come easy, but neither did Social Security or Medicare, which now serves one in seven Americans.
Many proposals for universal healthcare build on the foundation of "Medicare for All," albeit an improved Medicare
adequately serving seniors and younger people alike. Healthcare is as essential to equal opportunity as public
education and as essential to public safety as police and fire protection. If your neighbor's house were burning,
would you want 911 operators to ask for their fire insurance card number before sending--or not sending--fire
trucks? Healthcare ranked second behind terrorism and national security as the most critical issue for the nation in
the 2002 Health Confidence Survey released by the Employee Benefit Research Institute. The government thinks the
smallpox threat is serious enough to start inoculating military and medical personnel with a highly risky vaccine. It's
time to stop delaying universal healthcare, which will save lives everyday while boosting our readiness for any
bioterror attack.
Bioweapons attacks cause extinction
Steinbruner 97 Senior Fellow, Brookings Institution, and Vice Chair, Committee on
International Security and Arms Control, National Academy of Sciences,
John D. 12/22/1997 (“Biological Weapons: A Plague Upon All Houses” – Foreign Policy) p. lexis
Although human pathogens are often lumped with nuclear explosives and lethal chemicals as potential weapons of
mass destruction, there is an obvious, fundamentally important difference: Pathogens are alive, weapons are
not. Nuclear and chemical weapons do not reproduce themselves and do not independently engage in adaptive
behavior; pathogens do both of these things. That deceptively simple observation has immense implications. The use of a
manufactured weapon is a singular event. Most of the damage occurs immediately. The aftereffects, whatever they may be, decay rapidly over
time and distance in a reasonably predictable manner. Even before a nuclear warhead is detonated, for instance, it is possible to estimate the
extent of the subsequent damage and the likely level of radioactive fallout. Such predictability is an essential component for tactical military
planning. The use of a pathogen, by contrast, is an extended process whose scope and timing cannot be precisely controlled.
For most potential biological agents, the predominant drawback is that they would not act swiftly or decisively enough to be an effective
weapon. But for a few pathogens - ones most likely to have a decisive effect and therefore the ones most likely to be contemplated for
deliberately hostile use - the risk runs in the other direction. A
lethal pathogen that could efficiently spread from one victim to
ultimately threaten the entire
world population. The 1918 influenza epidemic demonstrated the potential for a global contagion of this
sort but not necessarily its outer limit.
another would be capable of initiating an intensifying cascade of disease that might
Obamacare Impact Turn Extensions
Obamacare key to economy – employment and consumer spending
Gruber 12 professor of economics at MIT,
(Jonathan, July 12, 2012 “New Republic: Obamacare Means Higher Employment”
http://www.npr.org/2012/07/12/156660203/new-republic-obamacare-means-higher-employment)
Forget death panels. Lately critics of the Affordable Care Act have been promoting a different claim — that "Obamacare" is a job-killer.
Specifically, they say, it will stifle the economy with regulations and taxes. But the economic
literature doesn't support this claim. If
anything, it suggests the opposite: The Affordable Care Act will boost the economy. By now, most people who follow
politics know that the law will result in more than 30 million additional Americans getting health insurance. But what few realize is that, by
expanding insurance coverage, the law will also increase economic activity. These newly insured
individuals will demand more medical care than when they were uninsured. And while it takes many years to
train a family physician or nurse practitioner, it doesn't take much time to train the assistants and technicians (and
related support staff) who can fill much of this need. In many cases, these are precisely the sort of
medium-skill jobs that our economy desperately needs — and that the health care sector has already been providing,
even during the recession.¶ More immediately, the increase in economic security for American families will
also mean an increase in consumer spending. Many uninsured consumers are forced to set aside
money in low interest liquid accounts to make sure they have enough to cover unexpected medical
costs. With the security provided by health insurance, they can free that money up for consumption
that is much more valuable to them. When the federal government expanded Medicaid in the 1990s,
my own research has shown, the newly insured significantly increased their spending on consumer
goods. More purchases of consumer goods will provide short-run stimulation to the economy and
more hiring.
Also solves small businesses
Russell 10 Menzies Foundation fellow at the Menzies Centre for Health Policy at
Australian National University & the University of Sydney, PhD, John Curtin School of
Medical Research at ANU, Visiting Senior Fellow at the Center for American Progress
Lesley, “Health Reform Means More Jobs for Small Businesses”, http://www.americanprogress.org/
issues/ healthcare/news/2010/04/05/7610/health-reform-means-more-jobs-for-small-businesses/)
The Small Business Majority commissioned a study by Professor Jonathan Gruber that examined how health care
reforms would affect businesses with fewer than 100 employees. This study concluded that small businesses
will fare far better under the substantially reformed health care system, which includes appropriate levels of
assistance to small businesses to help them meet their health care obligations.¶ The SBM study shows that health care reform will
help small business by dramatically reducing the costs small businesses pay to provide health
insurance coverage to their employees. If Congress had not passed reform, small businesses would have had to pay nearly $2.4
trillion over the next 10 years in health care costs for their workers. With reform, the study shows that small businesses
can save as much as $855 billion, a reduction of 36 percent.¶ It is estimated that 178,000 small business jobs would have been lost
in 2018 as a result of escalating health care costs. Health care reform can save up to 128,000 of these jobs, reducing job
losses by as much as 72 percent, and will contribute to increased profits, competitiveness, and higher
wages. The SBM study found that health care reform will save workers up to $309 billion in wages over the
next 10 years.¶ But perhaps the biggest benefit for small business employers and employees is that health care reform will
eliminate “job lock,” the situation that arises when people, especially those with pre-existing conditions, are fearful of
changing jobs and losing their health insurance coverage. Approximately 1.6 million small business
workers are in this situation—that’s roughly one in 16 people currently insured by their employers. Health care reform will
ban exclusions on the basis of pre-existing conditions and enable individuals and families to purchase
health coverage at an affordable rate, likely bringing the new rate of job lock close to zero.¶ Several recent
studies highlight how health care reform will boost jobs growth across all business sectors. David Cutler and Neeraj Sood estimate in a study for
the Center for American Progress that health care reform could boost employment by 250,000 to 400,000 a year over the next decade. Their
findings are very similar to those of President Obama’s Council of Economic Advisors, which estimated that health care reform will create
approximately 500,000 new jobs a year, remove unnecessary barriers to job mobility, and help to “level the playing field” between large and
small businesses.¶ Small
businesses are the “engines of the economy.” Firms with fewer than 500
employees accounted for 64 percent, or 14.5 million, of the 22.5 million net new jobs between 1993 and the third quarter
of 2008. These small businesses will benefit significantly from these new pieces of legislation and are likely to claim a majority of the new jobs
that are generated from it.
AFF ANSWERS TO ABLEISM K
2AC Ableism K
Their analysis of ableism only recreates oppressive binaries, turns the K
Humphrey 2k, Faculty of Applied Social Sciences, The Open University UK
(Jill C., Disability & Society, Vol. I5, No. I, “Researching Disability Politics, Or, Some Problems with the
Social Model in Practice”, Proquest, p. 64-65)
In academic texts, the social model begins with an appreciation of the individual and collective experiences of disabled people (e.g. Swain a al,
1993). It goes on to elaborate the nature of a disabling society in terms of the physical environment, the political economy, the welfare state
and sedimented stereotypes (e.g. Barnes et ah, 1999). Finally, it endorses a critical or emancipatory paradigm of research (e.g. Barnes & Mercer
1997a). This analysis lends itself to a recognition of the array of diverse experiences of disabling barriers; a realistic appraisal of the need for
broader political coalitions to combat entrenched structural inequalities and cultural oppressions; and an openness about the potential for nondisabled people to contribute to critical theory and research.
In activist discourses, the emphasis is upon the fact that it
is non-disabled people who have engineered the physical environment, dominated the political
economy, managed welfare services, controlled research agendas, recycled pejorative labels and images, and
translated these into eugenics policies. This analysis lends itself to a dichotomy between non-disabled
and disabled people which becomes coterminous with the dichotomy between oppressors and
oppressed; and this tightens the boundaries around the disabled identity, the disabled people's
movement and disability research. Whilst this hermeneutic closure is designed to ward off incursions
and, therefore, oppressions from non-disabled people, it may also have some unfortunate
consequences. I would like to illustrate these consequences by drawing upon a research project involving the four self-organised groups
(SOGs) for women, black people, disabled members, and lesbian and gay members in UNISON (see Humphrey, 1998, 1999). Material drawn
directly from conversations and observations in the disabled members' group is supplemented by interview transcripts with members of the
lesbian and gay group, my own personal experiences of and reflections upon disability and discrimination, and recent developments in various
social movements and critical research texts. The rest of the article depicts three
problematic consequences of the social
model in practice and redirects them back to the social model as critical questions which need to be addressed by its proponents. First,
there are questions of disability identity where a kind of 'purism' has been cultivated from the inside
of the disability community. Here, it can be demonstrated that some people with certain types of impairments
have not been welcomed into the disabled members1 group in UNISON, which means that the disability community is not yet
inclusive, and that its membership has been skewed in a particular direction. Second, there are questions of disability
politics where a kind of 'separatism' has been instituted. Whilst the UNISON constitution allows for separatism to be
supplemented by both coalitions and transformations, these have been slow to materialise in practice, and the dearth of such checks and
balances in the wider disabled peoples* movement implies that the danger of developing a specific kind of disability ghetto is more acute.
Third, there are questions of disability research where a kind of 'provisional-ism1 is suspended over
the role of researchers. The most obvious dilemmas arise for the non-disabled researcher as would-be
ally, but it is becoming clear that disabled academics can also be placed in a dilemmatic position, and
it is doubtful whether any researcher can practise their craft to their own standards of excellence
when operating under the provisos placed upon them by political campaigners.
Traditional medical discourses of disability are useful in raising awareness
and recovering from loss
Barker & Murray 10 English Professors University of Birmingham, University of Leeds
[Clare Barker, Stuart Murray, Journal of Literary & Cultural Disability Studies Volume 4, Number 3, 2010
“Disabling Postcolonialism: Global Disability Cultures and Democratic Criticism,” accessed 7-13-12 BC]
Given that the history of colonialism (and its post/neocolonial aftermath) is indeed a history of mass
disablement, and that the acquisition of disability may be tied into wider patterns of dispossession—
the loss of family, home, land, community, employment—there is a pressing need, as we see it, to
resist the too-easy censure of narratives that construct disability as loss. We would caution especially
against the blanket rejection and/or critique of medical discourse and medicalized terminology, which
may be strategically important when campaigning for resources and raising awareness of
(neo)colonial abuses. What individuals in such circumstances experience as loss should not be
rendered an invalid response by arguments that fail to recognize the wider contexts and material
environments in which disablement occurs.
2AC Racism K
Regulatory checks would prevent PAS discrimination against minorities
Park 13 American author and existentialist philosopher from Minneapolis,MN
James Leonard, http://www.debate.org/opinions/would-legalizing-physician-assisted-suicide-endangerminorities
An advocate of that minority group could review the life-ending decision. When medical care is
provided by doctors and nurses primarily from one racial group, then there are justifiable fears from
members of minority groups that they will not receive medical care of the same quality as patients
who belong to the same group as the providers. To prevent even the appearance of discrimination,
one of the safeguards might be to have the life-ending decision reviewed by an (open-minded) leader
of that minority community: http://www.tc.umn.edu/~parkx032/SG-ADVOC.html.
Doctors are not racists
Park 13 American author and existentialist philosopher from Minneapolis,MN
James Leonard, http://www.debate.org/opinions/would-legalizing-physician-assisted-suicide-endangerminorities
No, legalizing physician assisted suicide would not endanger minorities anymore than it would
endanger any other segment of the population. There is no reason to believe that all of the doctors
out there are a bunch of racists who want to kill off minorities. Physician assisted suicide carries a high
likelihood of abuse, but it is not targeted towards minorities.
Informed consent would check racism
Park 13 American author and existentialist philosopher from Minneapolis,MN
James Leonard, http://www.debate.org/opinions/would-legalizing-physician-assisted-suicide-endangerminorities
This would not be a concern. No, there would be no widespread culling of minorities if physician
assisted suicide was allowed. For one thing, it wouldn't be considered suicide if a medical professional
could simply terminate human life, we'd call it murder. The permission would have to be granted
beforehand, by the patient, understanding what is going on.
Reject the Kritik as an absurd idea. Previous legalization proves it.
Park 13 American author and existentialist philosopher from Minneapolis,MN
James Leonard, http://www.debate.org/opinions/would-legalizing-physician-assisted-suicide-endangerminorities
Legalizing physician assisted suicide would not endanger minorities. This make absolutely no sense at
all. If it was legal, do you think doctors everywhere would start killing minority groups just because of
physician assisted suicide was legal? No, and why is that? Because that is an absolutely absurd way of
thinking.
Right to die with dignity outweighs the risk of the kritik
Park 13 American author and existentialist philosopher from Minneapolis,MN
James Leonard, http://www.debate.org/opinions/would-legalizing-physician-assisted-suicide-endangerminorities
Legalizing physician assisted suicide would not endanger minorities. Legalizing physician assisted
suicide would not endanger minorities. Minorities are not more subject to this law than any one else.
Every one, under this law, would have a right to die with some dignity. Every one dies, so it is not like
the law is favoring one race over another.