Affordable Care Act Issues at the Supreme Court, in Tweet Style

The Tweets:

Monday/The Anti-Injunction Act – Pay taxes now, sue later, delays the decision. Decide about penalties now.

Tuesday/Individual Mandate for Minimum Coverage – The mandate is too much or too little for the Commerce Clause.

Wednesday – Severability and Medicaid Expansion – Strike down the ACA if the mandate is unconstitutional because it’s all part of one plan or save as much as possible. Strike down the Medicaid expansion because the states foresee it will cost and confuse them as have past expansions.

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Amid Differences, a Call to Work Together to Improve Mental Health Treatment

It wasn’t part of her prepared remarks, but Prof. Lucinda Roy of Virginia Tech University may have offered an especially important point as she began her keynote address at a conference Wednesday at Eckstein Hall on mental illness commitment laws and other issues related to mental illness.

It had been an intense, and at times tense, morning before a full house of more than 200 in the Appellate Courtroom. Meg Kissinger, a reporter for the Milwaukee Journal Sentinel, described “Imminent Danger,” the large project she authored which ran in the newspaper in recent weeks. It described how a revolution in American mental commitment laws, which began with a federal court ruling in a case involving a West Allis woman in 1972, had led to far more people with mental illnesses living outside of mental institutions. Some of them refuse treatment and a few have committed violent acts.

Kissinger and the newspaper had been strongly criticized by some members of the audience who thought the series was sensationalistic and left people with a harmful and wrong image of those with mental illnesses as dangerous. One speaker, Tom Zander, a psychologist, lawyer, and long-time prominent advocate for alternatives to mental commitment, had sharply attacked the series as based on what he regarded as false premises, including the notion that the West Allis case had led to specific horrible crimes. (Zander is an adjunct professor at Marquette University Law School.)

Throughout the morning, which included presentations by experts and by family members of people who had long-term mental illnesses, the difficulties of dealing with mental illness, the failings of the current system for helping people, and the high emotions that the subject raises were clear.

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A Non-terminal Man

I was asked to talk about the law’s view of the case of Dan Crews, age 27, who wants to die as soon as possible. You may have read about him last fall in the Journal-Sentinel, and in spring in the Chicago Tribune as the story unfolded. You might hear about him on the WISN 10 o’clock news on Sunday, November 6.

Dan has had quadriplegia since a traffic accident when he was three years old, and uses a ventilator because his chest muscles don’t allow him to breathe on his own. He’s mentally sharp, and verbal since the ventilator is attached through a trachea tube. He has earned an AA degree.

He wants to switch off the respirator so he will stop breathing. Specifically, he wants help from Froedtert Hospital, where he has received his care over the years, to switch off the respirator.

My totally unscientific poll revealed that the well-settled law in this area is about as well-known as speed limits. Dan has a right to refuse medical treatment, and no one thinks the use of a respirator is anything other than medical treatment.

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