Health Care

Washington's Weed Whackers

For most of Stephanie Kahn’s life, medical marijuana was a tempting remedy that remained just out of reach. Her father, who suffered from multiple sclerosis, was told by doctors as early as the 1970s that medical marijuana could alleviate his symptoms. At first, he was repelled by the idea of using an illegal drug. But as the pain and muscle spasms grew worse, he eventually tried marijuana and found that, as the doctors said, it provided almost-miraculous relief. Decades later, when her mother was undergoing chemotherapy for lung cancer, Kahn, a nurse, heard the same refrain. “She lost 45 pounds in a month and a half,” she recalls. “And the doctor kept saying, marijuana could help her handle the chemo, could help her get her appetite back.” Months after her mother’s death in 2009, Kahn’s husband of 37 years, Jeffrey, a Reform Jewish rabbi who had retired from congregational ministry a few years earlier, floated an unorthodox idea: What if they opened a medical marijuana dispensary? “...

A Bold Obamacare Prediction

An ad from Organizing For America
Love may not mean never having to say you're sorry (what a dumb idea, anyway), but being a blogger means being able to make predictions and not really worrying about whether you turn out to be right or wrong. Oh sure, if you're spectacularly wrong, and wrong on television (see Kristol, Bill ), people might make fun of you. But usually, nobody remembers. And if you're right, you can remind everyone of how clever you were. In that spirit, let me offer a prediction. The implementation of the Affordable Care Act, a.k.a. Obamacare, begins with open enrollment for the state exchanges on October 1, with coverage beginning on January 1. Sarah Kliff, who knows as much about the law as pretty much any reporter, returned from a cruise to report that the regular folks she encountered, when they heard what she does for a living, all wanted to know whether Obamacare was going to work. This was true of supporters and opponents alike. Not that the people Sarah met on the Lido Deck are a...

How Long Do You Want to Live?

Flickr/Yann Gourvennec
Attentive readers will recall that I'm rather interested , as a human whose body stubbornly continues to age, in the prospect that science will one day enable us to extend our lives far beyond what is possible today. Throwing the "immortality" word around tends to turn people off, since it sounds so absurd (after all, nothing lives forever, not even our sun), but what about just living a whole lot longer than most of us expect to even when we're being optimistic? Is that something you'd want? My answer has always been, "Of course—are you kidding?" If advancements in medicine and technology can dramatically extend our lives—and assuming that we don't end up like Tithonus, the figure from Greek mythology who was granted eternal life but not eternal youth, so lived forever in a tortuous ever-increasing decrepitude—then I'm all for it. There are strong arguments that living for an extra 50 or 100 years (or more) might be great for you as an individual, but bad for society as a whole, but...

Big Pharma's Private War on Drugs

Pharmacy robberies have spiked in large part thanks to illegal demand for OxyContin. A look inside the drugmaker's efforts to protect its product and the pharmacists at the front lines.

AP Images/Graeme Roy
AP Images/Graeme Roy O n a Wednesday afternoon this spring, with overcast skies and gas-slicked puddles on Utopia Parkway, some two hundred pharmacists gathered on the fourth floor of St. John’s University in Jamaica, Queens, for the Fifty-Fourth Annual Dr. Andrew J. Bartilucci Pharmacy Congress. The plainclothes professionals sat around tables draped with red tablecloths, sipping plastic cups of coffee and occasionally glancing at their phones. At approximately two o’clock that afternoon, John P. Gilbride, Caucasian male, five foot six, medium build, clean-shaven, wearing a dark suit and glasses, entered a rear door of the room carrying a leather satchel. He stood with his head down before walking to the lectern and opening a PowerPoint presentation. Four massive bulls-eyes were splayed out on the conference room walls. “Pharmacy robberies and burglaries are taking place across the country at an alarming rate,” he said. “Do you talk about it? Do you prepare for it? We all had fire...

On Abortion, a Tale of Two Countries

Texas state senator Wendy Davis, whose unsuccessful attempt to stop a restrictive abortion law drew national attention. (Flickr/Texas Tribune/Todd Wiseman)
Conservatives may be in retreat on many different fronts these days, but in one area, they're having smashing success: restricting the ability of women—particularly non-wealthy women—from accessing abortion services. And they're doing it with a new tool: the 20-week abortion ban, offered as cover for a raft of restrictions that aren't about stopping later-term abortions but about stopping all abortions. They're succeeding not because of some change in Americans' views on the subject, but because of the exercise of raw political power. As you may have heard, opinions on abortion, unlike those on many other subjects, have been remarkably stable for decades. But that stability masks some stark differences on abortion, differences that create just enough space for Republicans in parts of the country to make abortion all but illegal. Yesterday the Pew Research Center came out with a new poll , showing some rather dramatic gaps by region on what people think about abortion. Check out this...

Iowa's High-Tech Abortion Battle

Free Verse Photography (http://www.flickr.com/photos/ennuipoet/5479828006/sizes/l/in/photostream/)
O ne night in 2007, Jill June, CEO of Planned Parenthood of the Heartland, couldn’t sleep. She was grappling with a problem that vexes rural pro-choice advocates everywhere: the lack of access to abortion. At the time, Planned Parenthood of the Heartland, which performs most of the abortions in Iowa, had 17 clinics in its network but only three with an on-site physician. Doctors would travel, sometimes as far as 200 miles, to three other clinics in the state to perform intermittent care. The remaining 11 clinics did not offer abortion services. In all, 91 percent of Iowa’s counties, the more sparsely populated regions that are home to more than half the state's women, lacked an abortion provider . For June, providing access to medical abortion—the termination of an early pregnancy using a pill, rather than a surgical procedure—was especially challenging. In a few states, nurse practitioners or other midlevel medical staffers are allowed to dispense medical abortion pills, widening the...

Is Obamacare a Republican Job Creator?

flickr/divaknevil
AP Photo A lmost 50 years ago, Congress passed and Lyndon B. Johnson signed the law establishing Medicare. It was, soon, wildly popular—so much so that to this day Republican opposition to the program can only be expressed in terms of “saving” Medicare from supposed instability. In the next congressional elections, liberals took a beating—and the Democrats lost the White House in 1968. Scratch that—Democrats lost five of the next six presidential elections. That’s not the only story I could tell like that. Social Security? It passed in 1935, during what turned out to be a very good election cycle for the Democrats. Implementation began after the 1936 election, and the 1938 election began a string of conservative coalition control in Congress that lasted 20 years. Want another one? Let’s try foreign policy. The Cold War was over time a bipartisan policy, but it was the Republicans who were in office when the Cold War ended and the Soviet Union dissolved … a policy outcome universally...

The Next Phase of the Obamacare Battle Begins

President Obama speaking yesterday on health care. (White House photo by Chuck Kennedy)
We're beginning a new phase of the battle over Obamacare—and the fact that we can continue to refer to it as a "battle" tells you something—one that in some ways takes on the appearance of an electoral campaign, with television ads, media events, PR stunts, and a universal assumption that the whole thing is zero-sum. If anything related to Obamacare goes well—like, say, people getting health insurance at affordable prices—then that's bad for Republicans and something they'll do what they can to stop. What we have here is something truly unprecedented: an opposition party not just insisting that a significant government program was a bad idea, not even just hoping that in its implementation it doesn't work, but committing itself to actively working to make sure the program fails and that as much human misery as possible can be created along the way, so that eventual repeal of the program will become possible. The Obama administration is facing a huge administrative task, laid on top of...

Rhode Island’s Small Victory

AP Photo/Susan E. Bouchard, File
AP Photo/Mel Evans W hen Governor Lincoln Chaffee signed the Temporary Care Giver’s Insurance law last week, Rhode Island became the third state—along with California and New Jersey—to grant paid time off to care for a sick loved one or a new baby. Rhode Island’s law, which goes into effect in 2014, will not only provide most workers with up to four weeks off with about two-thirds of their salaries (up to $752 a week), it will protect employees from being fired and losing their health insurance while they’re out. Workers will be able to use the time to care for a broad range of people, including children, spouses, domestic partners, parents, parent-in-laws, grandparents, and foster children. And, though the maximum single leave is four weeks, each parent can take four weeks off to bond with a new baby. A mother recovering from birth could combine that with an additional six weeks paid through an existing state program, bringing her total paid time off to ten weeks. An entire family...

Under Obamacare, Millions Will Die

Barack Obama may be trying to kill this woman's son.
I have questions. For instance, are Charles and David Koch aliens from the planet Fnerzblax 6, come here to feast on the entrails of Earth humans to give them strength for their coming war with the barbarians of Fnerzblax 4? We don't know, and that's what has me so concerned. I ask because Americans for Prosperity, the group through which the Kochs channel much of their political activism, is initiating a new television campaign to get people afraid of and angry about Obamacare, and this seems to be the method of the campaign. The first ad, called "Questions," asks whether Obamacare is going to take money from a worried-looking young mother and deprive her sick child of the care he needs to survive. Not that it would truly do these things, but hey, she's just asking: Beyond the just-asking format, there's a preview here of something else we'll be seeing as Obamacare gets implemented over the next couple of years. Every problem that anyone has with anything related to health care will...

The Part-Timer Problem

The Obama Administration’s decision to delay for a year the penalty that employers (in firms of 50 or more employees) must pay if they don’t provide health insurance to their workers shines a light on a problem that may be even more profound than getting health coverage for every American: that is, the decline of the American job. The employer mandate was designed for an economy in which American workers were employed in what had been normal jobs. In firms of 50 or more, all workers who put in at least 30 hours a week were either to receive coverage from the firm or else the firm would have to pay the government a $2,000 yearly penalty. Problem is, fewer and fewer workers are putting in 30 hours a week. To begin with, labor-force participation is at its lowest level since women increased their work-force participation in the 1970s. It has declined even during the past four years of so-called recovery. The past four years have also seen a rise in the percentage of workers who are part-...

Should the Employer Mandate Be Eliminated Altogether?

President Obama signing the Affordable Care Act.
This week the Obama administration announced that it was delaying implementation of the "employer mandate" part of Obamacare, so companies won't be required to cover their workers until the beginning of 2015 instead of the beginning of 2014. Their stated reason is that they need more time to work with employers to implement the somewhat complex reporting requirements, and they're trying to be flexible and respond to employers' concerns. Which is probably true, but it's also true that the issue has become something of a political headache, with lots of news stories profiling employers saying the mandate is going to destroy their businesses or lead them to lay off workers and cut back their hours so they don't have to comply. We'll get to what's true and false about those news stories in a moment, but it's important to understand that the "mandate" isn't really a mandate at all. First, it only applies to businesses with 50 employees or more. And second, if employers still don't want to...

Progressives' Post-DOMA To-Do List

AP Photo/Alex Brandon, file
AP Photo/The Columbus Dispatch, Fred Squillante T wo of my favorite writers on legal subjects, Dahlia Lithwick and Barry Friedman, wrote a piece for Slate earlier this week wondering if the progressive agenda hasn't been exhausted by the victories on same-sex marriage. "While progressives were devoting deserved attention to gay rights," they argue, "they simultaneously turned their backs on much of what they once believed." I share their sense of frustration, but I interpret the landscape differently. To me, the problem isn't the lack of a robust progressive agenda. The problem is that progressives generally lack power. Last week, I saw strong defenses of progressive values at every level of politics—from ordinary citizens to the highest offices in the country. In a brief window of time, you saw heroic opposition to barbaric attacks on the welfare state in North Carolina and reproductive freedom in Texas, President Obama's climate change speech , and eloquent defenses of equality by...

Christian Employers Claim Their Religion Puts Them Above the Law

Sacred ground, where worldly laws don't apply. (Flickr/prariedogking)
Ready for the next court fight over Obamacare? Get to know Hobby Lobby, the chain of stores fighting the Affordable Care Act's requirement that the health insurance employers offer their employees cover contraception, and the next Christian martyr to the unholy scourge of health coverage for employees. Hobby Lobby's owners are conservative Christians, and though their company isn't a church, they'd like to choose which laws they approve of and which they don't, and follow only the laws they like. And a federal appeals court just ruled that not only can their suit go forward, but they're likely to win. Because apparently, "This law violates my religious beliefs" is now a get-out-of-jail-free card. The decision is simply mind-blowing, essentially finding that private business are just like religious institutions, and therefore they can decide which laws they have to obey: "Hobby Lobby and Mardel have drawn a line at providing coverage for drugs or devices they consider to induce...

The ACA's Obamacare Problem

The law is going to make health care better for many Americans. A lot of them just won't realize it's the same thing as the Obamacare they hate. 

AP Images/Evan Vucci
AP Images/Evan Vucci Obamacare is well on its way to being permanently unpopular. A problem for supporters of health-care reform? Not really—because the Affordable Care Act (ACA) could become just as untouchable as Medicare or Social Security. That’s right—get ready for “keep your Obamacare away from my Affordable Care Act!” Okay, not literally; they won’t actually know that the ACA exists. But that’s what they’ll be saying, in effect. From the very beginning, and certainly before Democrats also adopted “Obamacare” as the shorthand name for health-care reform, Republicans have strongly opposed a fantasy version of the landmark legislation. Whether it was “death panels,” or “government takeover,” or any number of wacky claims in chain emails, Republican opposition has rarely been focused on what’s actually in the ACA. And no matter how successful reform turns out to be, that’s unlikely to change. See, the funny thing about the Affordable Care Act is that a whole lot of it will either...

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