Health Care

Mississippi's Last Abortion Provider

Flickr/kbrookes
T welve years ago, Dr. Willie Parker was at home listening to Martin Luther King, Jr.’s “I’ve been to the mountaintop” sermon. Parker had heard the words many times before. But this time, he found himself focusing on King’s interpretation of the Bible story of the “good Samaritan,” who stopped to help a man who had been left for dead by robbers. Though others had passed the man by, the Samaritan stopped, King explained, because he didn’t think about the harm that might befall him if he did. Instead, he asked what might happen to the dying man if he did not. Parker, an ob-gyn who had been practicing for 12 years at the time, suddenly felt that King’s words held meaning for his own work. Having grown up in a religious family that was active in the Baptist church (Parker was “born again” and preaching the gospel at 15), he had been brought up to believe that abortion was wrong. Up to that point, he had never provided one. He’d refer women to other providers, but was too conflicted about...

The Demographics of Abortion: It's Not What You Think

Why does the ’70s-era image of the white, middle-class teenager as the typical abortion patient persist?

AP Photo
In the 40 years since Roe v. Wade , quite a bit has changed about the abortion debate. Evangelicals have taken the helm of the anti-choice movement, once dominated by Catholics. The movement has shifted strategies repeatedly—from stoking moral outrage and blocking abortion clinics to feigning concern for women’s health and, most recently, passing innocuous-sounding building regulations aimed at eliminating access to abortion. For its part, the pro-choice movement has mellowed since the days radical feminists crash ed town halls into a professionalized juggernaut of lobbyists and lawyers with a mighty service arm known as Planned Parenthood. But one thing that hasn’t changed since 1973 is the public image of what a typical abortion patient looks like: A middle-class, white high-school or college student with no children whose bright future could be derailed by motherhood. Hollywood portrayals of abortion patients are few and far between, but largely reinforce this understanding; Juno...

Looking Back at Pro-Choice's Battles

AP Photo/Nick Ut
(AP Photo/Doug Mills, file) In this April 5, 1992 file photo, pro-choice demonstrators gather on the Ellipse near the White House in Washington. For many abortion-rights activists, the debate over health care reform has been frustrating, even disheartening, as they see their political allies on the defensive over the issue and their anti-abortion rivals on the attack. It's been 40 years since the Supreme Court's landmark decision over a woman's right to choose in Roe v. Wade . How has the landscape over the issue of abortion and the politics of reproductive health changed since? Here's a round-up of our best coverage over the past decade on the changing climate, both in public opinion and in legislatures inside the Beltway and out, over abortion. 2012's War on Women , E.J. Graff "For the ladies, the year’s sound track could have been a strangled gasp, followed by snorting and laughing out loud. The attacks on women’s health, on contraception, on abortion, on the definition of rape—it...

What's Left of Roe

Barack Obama's re-election might make the landmark decision safe for now, but its meaning has eroded over the years.

(AP Photo/Pablo Martinez Monsivais, file)
Since the ruling was handed down 40 years ago today, Roe v. Wade— which held that the constitutionally guaranteed right to privacy included a woman's right to choose to have an abortion—has been subject to an ongoing legal and political assault. This assault has not succeeded in getting the decision overturned. But it has caused the scope of the opinion to become narrower in ways that have disproportionately affected the rights of women of color, poor women, and women in isolated, rural areas. The re-election of Barack Obama might make Roe safe for the time being, but it is worth taking stock of how its meaning is being eroded and what the future battles would be. The first major conservative victory in the struggle to narrow Roe v. Wade was the Hyde Amendment, which prohibited Medicaid funds from being used to provide abortion services. The Hyde Amendment split the pro- Roe v. Wade coalition on the Supreme Court, and was ultimately upheld in a 1980 5-4 decision . Three of the...

The Great and Terrible News about American Health Care

This is how much people elsewhere love their health systems. (AP Photo/Jae C. Hong)
If you've been paying attention to debates on health care over the last few years, you're probably aware of how poorly the American system performs compared to other similar countries. We're the only advanced industrialized democracy that doesn't provide universal health coverage to our citizens, and though there are many variations in those systems ranging from the completely socialized (as in Great Britain) to the largely private but heavily, heavily regulated (as in Switzerland), they all do better than we do on almost every important measure you could come up with. That's the big picture. But a new report from the National Research Council and the Institute of Medicine compared the United States to 16 similar countries (mostly in Europe but including Canada, Australia, and Japan) on a range of health measures has some fascinating details. Unsurprisingly, the United States comes out at or near the bottom on most measures of health. We have the highest infant mortality, the highest...

Just What Workers Need: More Labor Civil War

AP Photo/Corpus Christi Caller-Times, Rachel Denny Clow
As a rule, most merger or affiliation announcements between two organizations tend to the celebratory: Each group brings a proud history and now have joined together to create an even prouder future, yadda yadda. But not last Thursday’s press release from the California Nurses Association/National Nurses United (CNA), which proclaimed its affiliation with the National Union of Healthcare Workers (NUHW) in an announcement largely devoted to attacking the presumed perfidy of the Service Employees International Union, with which NUHW has been engaged in a prolonged blood feud that puts the Hatfields and McCoys to shame. Broadly speaking, SEIU and CNA are the nation’s two pre-eminent health-care worker unions, with CNA the leading organization of registered nurses and SEIU representing close to one million hospital orderlies and nursing home attendants. In 2009, after the two groups had waged a number of bitter organizing campaigns against each other for the right to represent the same...

New Year, New Abortion Restrictions

Flickr/NARAL Pro-Choice Virginia
Virginia Governor Bob McDonnell obviously wasn't looking for any attention when he certified a set of new regulations last week that could shutter many abortion clinics in the his state. The Republican certified the new requirements on the Friday between Christmas and New Years, and chose to forgo a public announcement about his decision. But low-profile or not, the decision is an scary one for the state's 20 abortion clinics, which now must get to work to comply the 2010 building code for hospitals. That means a lot of very costly changes that have no bearing on the work these clinics do, like widening hallways and doorways and installing hands-free sinks (the kind that automatically turn on when you put your hands underneath the faucet). Advocates for reproductive rights say many of the state's 20 abortion facilities could be forced to close—which is, of course, the whole idea. But McDonnell's decision to make the move as quietly as possible indicates a significant change in the...

A Cleared Bill of Health

Flickr/Robert F. W. Whitlock
Flickr/Robert F. W. Whitlock T here have been few more consequential years in the history of health care in America than 2012. This year saw disasters averted, new problems identified, and hope triumphing over despair. The biggest health-care news in 2012 was the dramatic and surprising decision by the Supreme Court in late June to uphold (for the most part) the Affordable Care Act (ACA). Chief Justice John Roberts shocked his Republican admirers by siding with the liberals on the Court to affirm the constitutionality of the law's individual mandate as a tax, though he also gave Republicans a way to fight back by saying the federal government couldn't force states to accept what is arguably the law's most significant feature: its dramatic expansion of Medicaid. So, as the ACA began moving toward full implementation in January 2014, governors and legislators in Republican-dominated states did whatever they could to undermine its future success, or at the very least not contaminate...

Science versus the Courts

What role should government play in how doctors administer treatment?

Flickr / rad(ish)labs
This month, two California courts issued differing opinions deciding whether California could ban gay conversion therapy based on evidence of harm to minors. On the same day the Oklahoma Supreme Court struck down two laws requiring abortion providers to practice in accordance with the right wing-dominated state legislature. Immediately after, I was asked if these two decisions were essentially the same, protecting the free speech rights of health-care professionals and stopping the government from interfering in the patient–provider relationship. But, these issues don’t fit so neatly into a box. Let me begin by acknowledging that I am not a fan of the argument that health-care providers should be allowed to practice their trade unfettered by “government” intrusion. Rather, I believe that evidence-based regulation of health care should be the standard, and sometimes that means government action. But the burden is high, the science must be high quality, and the branch of government...

It’s a Mad, Mad Michigan

Right-to-work legislation was only the beginning. State Republicans have an entire docket full of legislation set to limit rights.

(AP Photo/The Detroit News, Elizabeth Conley)
Sure, lame-duck legislatures are bound to be a bit mad. But the session that just closed in Michigan was one for the ages. Aflush with the flurry of bills sent to the desk of Governor Rick Snyder—not so much speaking to his opinion on their quality—a politics-loving friend of mine in Detroit exclaimed, “It’s like Christmas in … well, in December.” The swift passage of right-to-work in Michigan picked up national and international headlines last week. But that overhaul of labor law is only one piece of the expansive legislative plan for the state that now awaits Snyder’s go-ahead. The lame-duck session was the final and powerful display of influence by GOP and Tea Party lawmakers that had a total and triumphant win in the 2010 election. Even as Michigan’s reputation as a “swing state” is diminishing—it’s voted Democratic for president since 1992, and both its U.S. senators are Democrats—local politics remain fractious. Not only does the GOP dominate both chambers in the state...

While You Weren’t Looking, Michigan Turned Into Texas

Flickr/CedarBendDrive
The Michigan legislature’s lame duck session is only three weeks long, but the state house didn't need more than 18 hours to move the state sharply to the right. During a marathon session Thursday and Friday, the state house passed a variety of very conservative bills on issues from abortion to gun control to taxes. You can’t say they’re not efficient. The state, which favored Obama by 9 points and has long been home to a moderate-progressive movement, may now have a set of laws that puts it on America’s more conservative end. Perhaps most shocking for pro-choice advocates was the effort to restrict abortion rights—or, as Mother Jones put it, “ the abortion mega-bill. ” Assuming the governor signs the bill into law, women in Michigan will now have to buy separate insurance policies to cover abortion. Otherwise, even in cases of rape or miscarriage, the abortion will not be covered. Clinics that provide more than 120 abortions a year will now face significantly more stringent licensing...

The Obama Administration Plays Hardball On Medicaid

President Obama signing the Affordable Care Act.
When the Supreme Court upheld the Affordable Care Act, it also gave Republican states a gift by saying they could opt out of what may be the ACA's most important part, the dramatic expansion of Medicaid that will give insurance to millions of people who don't now have it. While right now each state decides on eligibility rules—meaning that if you live in a state governed by Republicans, if you make enough to have a roof over your head and give your kids one or two meals a day, you're probably considered too rich for Medicaid and are ineligible—starting in 2014 anyone at up to 133 percent of the federal poverty level will be eligible. That means an individual earning up to $14,856 or a family of four earning up to $30,657 could get Medicaid. Republican governors and legislatures don't like the Medicaid expansion, which is why nine states—South Dakota, plus the Southern states running from South Carolina through Texas—have said they'll refuse to expand Medicaid (many other states have...

What Raising the Medicare Eligibility Age Means

President Johnson signing Medicare into law in 1965.
After a campaign in which Republicans attempted to pillory Barack Obama for finding $716 billion in savings from Medicare (via cuts in payments to insurance companies and providers but not cuts to benefits), those same Republicans now seem to be demanding that Obama agree to cuts in Medicare benefits as the price of saving the country from the Austerity Trap, a.k.a. fiscal cliff. Oh, the irony! You'd almost think that they weren't really the stalwart defenders of Medicare they pretended to be. And there are some hints that the Obama administration is seriously considering agreeing to raise the Medicare eligibility age from 65 to 67 as part of this deal. It's a dreadful idea, and as we discuss this possibility, there's one really important thing to keep in mind: Medicare is the least expensive way to insure these people. Or anybody, for that matter. In all this talk of the bloated entitlement system, you'd be forgiven for thinking Medicare was some kind of inefficient, overpriced big...

Who Wants Moar Medicaid?

Washington Post
At Wonkblog, Sarah Kliff has a revealing map of the states that have agreed to the Obamacare Medicaid expansion, are undecided, or have rejected it. Take a look: Eighteen states will accept the Affordable Care Act's Medicaid expansion—or are leaning towards it—17 are undecided, 7 are leaning "no," and 9 will not expand it. It's worth emphasizing how important this is: Of the 32 million people slated to receive health-care coverage under the ACA, just over 21 million will receive it by way of the Medicaid expansion. If states like Texas, Florida, Georgia, and Virginia decide to reject it, millions of people will go uninsured for no reason other than political pique. My hunch is that conservative states will be able to avoid the Medicaid expansion in the short run, but that longer-term pressure will force them to yield. Remember, the federal government is offering to cover 90 percent of the cost of the expansion, meaning—in effect—that states are receiving a huge award of free money...

Getting Away with Wage Theft

The 1938 Fair Labor Standards Act (FLSA), which ushered in many of the worker protections we enjoy today, was a major progressive victory. But as the century that followed it shows, it was by no means the end of the struggle to get workers treated fairly. Employers, aided by conservatives in the executive and judicial branches, have often found ways of ensuring these laws are not fully enforced. Symczyk v. Genesis Healthcare Corp. , which the Supreme Court considered yesterday at oral argument, presents another case in which conservatives on the Supreme Court might erect a barrier making FLSA harder to enforce. The case involves a lawsuit filed by Laura Symczyk, who alleged that Genesis Healthcare had committed wage theft against her and her co-workers. According to Symczyk, Genesis routinely docked the pay of workers (including herself) for lunch breaks that were not taken. Reflecting the strength of her claim, Genesis offered her $7,500 plus associated fees to settle. Symczyk,...

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