J. D. Kleinke is a medical economist, author, and health information industry pioneer, and the author of a new book, Catching Babies.

Over at The Health Care Blog, he has published one of the best essays I have ever read revealing “how little obstetricians really know – and how limited the specialty is in its ability to test and expand that knowledge – thanks in part to the visceral fear inspired in patients by statements like ‘a normal pregnancy is a retrospective diagnosis.’”

While protecting the name of his sources, he describes what happens when “Hannah’s” labor does not proceed as quickly as expected:

“Hannah is starting to weary of the process, and she’s hungry; they have put her on a restrictive diet, of course, assuming she will soon go into labor and deliver. When her blood sugar starts dropping, they let her go back on solid food. Her energy picks up, enough to start arguing that maybe she should just go home and wait. ‘Maybe this is a sign that Sam is fine,’ she says, ‘and he just doesn’t want to be born yet.’

“The Kaiser people get wind of our conversation when they walk in to check her IV, and send in the CNM who has just begun her shift.

“She runs through the same argument that had brought Hannah in two days earlier “This time, Hannah argues back.

“’Do you know what could happen, if you wait?’ the CNM finally says with an impatient sigh. ‘Your baby – he could be – stillborn.’”

What can Hannah say?  She is put through the agony of an induced labor:

“The artificially induced contractions are severe, throwing her from the bed. The pain is too intense, and Hannah finally relents and agrees to an epidural, which will numb her from the midsection down and cut her off from the core sensations of the birthing process . . .”

Read the entire post here.

Well, Wisconsin Attorney General, J.B. Hollen didn’t use those words exactly. But on Wednesday, his office released this brash statement; “for Wisconsin, the federal health care law is dead—unless and until it is revived by an appellate court. Effectively, Wisconsin was relieved of any obligations or duties that were created under terms of the federal health care law.”

Hollen was no doubt emboldened by this week’s ruling in Florida by district court judge Roger Vinson that the entire health care reform law is unconstitutional. This decision went beyond Judge Henry Hudson’s ruling in a Virginia court in December that found only the individual mandate to be unconstitutional. “This is a radical decision,” Timothy Jost, a law professor at Washington and Lee University School of Law writes in his analysis of the ruling in Health Affairs. “Judge Vinson has a clear vision of the limited federal government the founders intended that is very much in line with that espoused by the Tea Party Movement…He has thrown down the gauntlet.”

The ruling has emboldened others besides Wisconsin to swear off implementing reform. Florida Governor Rick Scott announced that he would wait for further court rulings before beginning to take any action to carry out the health law. And the Florida insurance commissioner Kevin McCarty wrote to federal officials on Tuesday letting them know that the state will return a $1 million grant intended to help it prepare for reform by setting up a system that would let consumers compare insurance plans. Wisconsin also announced it’s sending back the money. Finally, Minnesota’s Governor Tim Pawlenty issued an executive order barring state officials from participating in the ACA without express approval from his administration.

Continue reading →