With all the issues breaking this week with the government shut-down, WWII vets having to cross barricades to visit their own memorial and the effective date of Obamacare only 24 hours old, one would think it unusual for someone who has mouthed off so much against this administration and their fiasco to be silent. And it is, but for a reason – good or not would be in the eye of the beholder.

My little eight pound Chihuahua, whom I fondly refer to as "the terrorist," has injured her back somehow and now has a bulging almost herniated disc. She has to be carried up and down stairs, picked up to be put on and off the bed and given medication to help the inflammation. Good news is surgery is unlikely to be needed. While this may sound trivial to some, it is very busy work when one must cater to a princess, who insists on terrorizing strangers and unfamiliar creatures that enter her domain, and occurs even during the night time making restful sleep impossible.

Needless to say, this increased care has resulted in so many broken trains of thought that an article started, rarely gets finished as it is difficult to retrace the thought pattern once broken. Couple that with mental fatigue from lack of rest, and you can imagine where that can lead one. Not only has this situation inhibited my ability to produce coherent written thought. The building anger resulting of incredulous stupidity of government and the American Kool-Aid drinking citizens have produced a mild writer's block that has been difficult to surmount considering the care my cherished companion now requires.

So, while I have a few brief minutes, let's look at one of my biggest pet peeve (pardon the pun) – The Affordable Care Act or as some refer to it, Obamacare.

The Affordable Care Act (Obamacare) has taken effect as of yesterday, October 1, 2013. What does this truly mean for America? Everyone has their stance on the subject from increased costs, beginning of health care rationing through the Independent Payment Advisory Board (IPAB), loss of employer sponsored insurance, and the realization that the 30 million uninsured this law targeted will still remain uninsured afterward.

The biggest issue for me is the rights of the patient. Everyone should be familiar with the Patient Bill of Rights. Remember, rights come from God and are unalienable. Obamacare has the potential to change patient freedoms or rights that could impede an individual's medical care. Let's look at what these patient rights are.

The Patient Bill of Rights is a list of guarantees, whether in the form of a law or non-binding declaration, for those receiving medical care. When an individual enters a healthcare facility for medical treatment, the individual is provided a copy of the facility's Patient Bill of Rights and Responsibility of Patients. This document informs the individual receiving care from that particular facility of what they can expect during receipt of care and the responsibility the individual assumes in order to get the most comprehensive care. While the Patient Bill of Rights and Responsibility of Patients varies among facilities, there is a recognition of "basic" patient's rights and responsibilities among the medical community.

The American Hospital Association (AHA), in 1973, establishes an original Patients Bill of Rights for hospital care of individuals with a revision occurring in 1992. The AHA changes the Patient Bill of Rights of 2005 to a more patient friendly, easy to read and understand pamphlet. In 1990, the Association of American Physicians and Surgeons (AAPS) asserts that medical care must be rendered under conditions that are acceptable to both patient and physician leading to the adoption of a list of patient freedoms. After modification, the AAPS adopts a revised list that became known as the Patient Bill of Rights in 1995. This designation of patient rights from the AAPS deals generally with ethical and moral issues involving patient care. However, the Health Insurance Portability and Accountability Act (HIPAA) in 1996 establishes national standards regarding privacy and security of protected health information (PHI) to individuals receiving medical care under its Privacy and Security rule. In a broad sense, PHI includes individual health/medical records. The Consumer Bill of Rights and Responsibilities of 1998 and the Patient Safety Act of 2005 are among the legislative acts that comprise a legally binding Patient Bill of Rights. Now, the Affordable Care Act establishes further patient rights through legislation. Another source of understanding patients' rights can be found here. Trust is also a key component in medical care; patients trust the healthcare community to provide safe, quality, cost effective, confidential, efficient medical treatment while the healthcare community trusts patients to provide comprehensive medical information in order to receive care.

The list of patient rights and responsibilities are too numerous to be listed and reading some of the government rulings can be daunting. Remember, any time you are receiving care from a healthcare organization, that entity provides each patient a copy of their patient's rights and responsibilities. Some facilities post their Patient Bill of Rights and Responsibilities on their website, if they have one. It is prudent reading.

While facilities list of patient rights may differ, the rights of patients are not limited. What we must understand is: patient rights are not always listed; and, when put into a simplified form, some important rights remain but are not disclosed; patient rights vary among entities providing medical services; patient rights cover legal, moral and ethical issues involving patient care; and, a symbiotic relationship of trust is formed between patient and healthcare provider where medical services are concerned.

What happens to these patient rights once the government gets involved?

One only has to look at the God-given rights being trampled by our government today in violation of the limitations placed upon it by the Constitution to see what will happen to a patient's rights in healthcare.

You will no longer have the right to refuse third-party interference in your medical care, and be confident that your actions in seeking or declining medical care will not result in third-party-imposed penalties for patients or physician. The IPAB will be there to tell you if you can receive certain medical care while the IRS will be ready to penalize you should you and your doctor become noncompliant with the IPAB ruling.

Your sex life will no longer be private; neither will your ownership of a firearm. You will not have the right to use your own resources to purchase and receive the care you desire or need. You will have lost the right to see a provider of your choosing and possibly to seek a second opinion or consultation with a specialist. Your right to privacy regarding medical records will be almost nil with the IRS and any other government agency who is deemed worthy having access to your records. Who do you appeal to when care is denied: the IRS, the IPAB, the government, the insurance carrier? Do you really believe these appeals would be conducted by independent review panels? It's something to think about.

To add insult to injury, if you don't purchase healthcare insurance, you will be fined or taxed a penalty. Remember, insurance does not guarantee access to medical care nor does it guarantee payment of medical care services. Remember, information regarding healthcare will have to be provided to the IRS on individual tax returns.

The AAPS, in recognition of the intrusion of certain third-party sources regarding patient freedoms, seeks to bring back freedom in medicine by keeping big government and government-controlled insurance plans out of their medical offices. This includes Obamacare. Tim Brown, in his article "US Doctors Drop Private & Govt Insurance – Provide Better Healthcare and Lower Prices," covers very well how a group of doctors is combating an intrusion on a patient's rights.

This payment advisory board is to consist of 15 individuals who are appointed by the President and confirmed by Congress. Will these individuals be the best and brightest among medical experts? I wouldn't hold my breath. Will all of the appointments be made according to the established criteria? Questionable. Under the Affordable Care Act, it is possible the allocation of medical resources will be limited to certain individuals by specific stipulations. It is also possible those whose care will cost the most will have limited options for treatment or not receive treatment at all in order to reduce the cost of healthcare services. Individuals in this category could include the severely ill or injured, those with certain medical conditions and the very young or old.

When dealing with emergency services, a triage system is in place following a guideline of "the worst go first." In wartime, where resources are limited and certain injuries might require more heroic measures, the guideline of "the worst go last" prevail. Soldiers who can be saved to possibly return to battle are given priority over those whose survival is questionable. By using this guideline, the more productive members are saved in order to continue to provide a service to the entity in charge. Clearly, I can see this happening with Obamacare. Healthcare receipt could be based on the wartime principle or how productive an individual would be versus the cost of the treatment. Healthcare professionals serving during wartime can have tremendous difficulty dealing with this philosophy of rationing treatment which goes against their teaching or beliefs; but, in time of war, the military principle applies. However, Obamacare covers individuals who are civilians and do not follow the military rules of triage.

Supposedly, this board will be answerable and accountable to Congress. It is already obvious that government agencies who currently are accountable to Congress participate in activities hidden from Congress, cover up wrong-doing, stonewall investigations, refuse to answer questions or just out and out lie, all without seemingly any consequences. What would make the IPAB any different? Nothing from what I can see. The IRS and NSA, along with those involved with Benghazi, Fast and Furious and targeting of the press, have made fools of Congress and the American people.

To be fair, the total impact of this board and function has not been fully disclosed and much about Obamacare remains guarded even past its implementation date. My question is: If all this is so good, why are the details still undisclosed? If it's that great, lay it all on the table and let us look at it. I fear that full details will only be disclosed after the boat has sailed and taking on water faster than the Titanic, but there are no lifeboats to be had.

Personally, I have talked to my companion's vet about getting care. He did say his rates for humans were higher, and if that was acceptable, we had a deal.

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