One of the lynchpins of Obamacare is the health insurance mandate. It survived the lawsuits and remained in place.

The Internal Revenue Service (IRS) has been tasked with tracking the mandate. It has also been tasked with following and implementing all of the new taxes inside Obamacare. It is fitting that a taxing organization has so much control. It is also ironic since Obama claimed the mandate was not a tax to save it.

This is part of an ongoing series to try and address cost issues inside medicine.

Patients often are surprised when I tell them I will see them in 10 years after a normal colonoscopy. They often ask whether they will be safe if they wait that long.

It usually takes years for colon polyps to turn into cancers. If a patient is at average risk the data has been used to show a model of a colonoscopy every 10 years leaves risk in an acceptable range.

Today the National Pressure Cooker Association released an angry statement. They are concerned legislation may be introduced that will require people to undergo background checks before they can purchase pressure cookers. Their main point was, "Pressure cookers don't kill people, people kill people."

Gun advocates have also been active. Some are complaining that people would have been safer at the Boston Marathon if everybody had been "packing heat." The reasoning is no terrorists with pressure cookers would have ever gone near the Boston Marathon if everybody was armed.

The American Society For Gastrointestinal Endoscopy (ASGE) has guidelines for sedation and anesthesia during endoscopy. The guidelines are designed to help physicians make decisions. In the United States most endoscopic procedures are done under moderate or conscious sedation.

Don Young has always been a joke of a conservative. Any so-called "conservative" who brings hundreds of pork projects to his state should be scrutinized. He exemplifies why most true conservatives question what the Republican party claims to be.

Alaska has had many such false conservatives. Senator Ted Stevens was DY's partner in excess for years. Sarah Palin practiced near socialism as governor before quitting. And Lisa Murkowski proved she is a true panderer-in-training in the last US Senate election.

"Human sacrifice, cats and dogs living together, mass hysteria."

- Dr. Peter Venkman in Ghostbusters

The sarcastically delivered line came at the tail end of an argument about ghosts invading New York. It was the kind of thing you should see in movies and not in the real world.

If you have been listening to Barack Obama lately the sequester passing will mean children will starve. Rotten food will be on the market. Planes will crash into each other. And violent criminals will be allowed on the street. How long will it be before cats and dogs start living together?

"Human sacrifice, cats and dogs living together, mass hysteria."

- Dr. Peter Venkman in Ghostbusters

The sarcastically delivered line came at the tail end of an argument about ghosts invading New York. It was the kind of thing you should see in movies and not in the real world.

If you have been listening to Barack Obama lately the sequester passing will mean children will starve. Rotten food will be on the market. Planes will crash into each other. And violent criminals will be allowed on the street. How long will it be before cats and dogs start living together.

I went to a talk once about HMG-CoA Reductase Inhibitors when I was a resident. This class of medications is commonly referred to as "statins" and the primary use is to lower LDL ("bad cholesterol") levels.

In the late 1990s, First Lieutenant Kelly Flinn faced a court-martial after she had an affair with the husband of an enlisted member in her chain of command. The real trouble started when she told her commander she had ended the affair and had continued to see the man.

The stealing of intellectual property in the entertainment industry had led to all kinds of lawsuits and changes. In 2000, Metallica stirred ire among their fans by being at the front of the effort to shut down Napster. In 2013, Napster founder Sean Parker and Metallica drummer Lars Ulrich have found common ground in endorsing Spotify.

President Barack Obama, in his failure to lead, claimed that Republicans should just pass a bill raising taxes on just high income earners as a "fiscal cliff" solution. In his view everyone agreed with leaving taxes the same on everybody else. He claimed the rest of the "cliff" be dealt with later. It was classic limousine liberalism from the Ivory Tower.

I spent many a night as a resident trying to prepare my interns for the infamous cardiac care rounds. It was during these rounds that the peppering pressure drove an intern once to pass out. Mercy? Sure, the cardiologists showed up with a code cart the next day so the intern could push it around in case he fainted again.

A well-regulated militia being necessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed.

It is hard to imagine that when Thomas Jefferson ratified the Second Amendment he had visions of a crazed man shooting kindergartners in a Connecticut elementary school. Is that a "well-regulated militia?"

The left wing mainstream media is gushing over Mark Begich. They are using words like "strengthen" and "shore up" to describe his plan to eliminate the cap for social security taxes.

At present 4.0% of earnings up to $110,100 are taxed for social security. That is based on a temporary reduction in rate scheduled to expire at the beginning of 2013. The rate would return to 6.2% at that time. Employers match that money and are still paying 6.2%.

When I was in high school I would get up, grab the San Diego Union-Tribune, and sit down to read it over a bowl of cereal. The process continued all through college with The New York Times. The news was generally new to me and it was always the way to get sports scores from the day before.

In 2012 I am bombarded with news every time I turn on my computer or pick up my phone. It is stories that flash across search engines or the links on social media. I noticed a long time ago that most of the stories in the hard copy of the The Anchorage Daily News (ADN) I had already seen on line.

"This [Attack on Benghazi] is a response to a hateful and offensive video that was widely disseminated through out the Arab and Muslim world...

I pulled up the Anchorage Daily News website today and at the top was a story about a general who followed David Petraeus in Afghanistan. This evidently in the eyes of the media is a "widening" of the scandal.

A partial list of liberal terms so you can get inside of what they are thinking.

Livable Wage- The term is used to express an entitlement to money as opposed to working for it. The last thing to be concerned about is whether the person actually does the job or not.

Alaska is no closer to a natural gas line now than it was when Sarah Palin was around campaigning about how evil Frank Murkowski was. It is also having to go through a process to try and ebb the tide of reducing oil production which has been exacerbated by tax structure.

The common thread behind the failing policies of Alaska's Clear and Equitable Share (ACES) and the Alaska Gasline Inducement Act (AGIA) was populist pandering pushed by The Palin. The oil companies were demonized and anybody who wanted to in any way work with them in a cooperative fashion was vilified.

There is a can being kicked down the road in Washington DC right now. It turns out the road ends on a cliff. The fear is that when the issue is finally addressed after the election that the last kick may have already put us over the edge.

The "fiscal cliff" is the term you hear thrown around on CNBC every day. It refers to both mandatory spending cuts set for 2013 that were set in place when bipartisan agreement could not be reached as well as the sun setting on the Bush tax cuts. The Obama payroll tax cut is also set to expire.