Health Care

When the Fringe Shapes the Center

During the AIDS crisis, ACT UP's radicalism forced more mainstream gay-rights groups to step up their game.

(AP Photo/Tim Clary, File)
(AP Photo/Tim Clary, File) Act Up protestors lie on the street in front of the New York Stock Exchange in a demonstration against the high cost of the AIDS treatment drug AZT in September of 1989. S tarting with my inability to believe Mitch McConnell isn't one of Disney's talking teapots gone rogue, there are plenty of good reasons I don't and shouldn't run the zoo. But if I did, How To Survive A Plague would be mandatory viewing for Occupy Wall Streeters. First-time director David France's new documentary about the 1987-'93 glory years of ACT UP—aka AIDS Coalition To Unleash Power, in case you've forgotten—is a wrenching remembrance of a gay holocaust that's already dimmer than it should be in our memory. The movie is also an exhilarating portrait of human beings discovering what they're capable of in a crisis. But above all, it's the story of how a never too numerous band of obstreperous activists successfully changed public policy. On that count, France may gild the lily somewhat...

"One Thing I've Learned: We're All Vulnerable."

You want another reason I hate presidential campaign season? It obscures real problems, the very problems the election is about . Okay, so that’s the same gripe I had yesterday . So let me introduce you to someone who's not just griping, but is doing something about it. Harold Pollack is a health policy analyst who, despite his terrifyingly smart and accomplished credentials , has an extraordinary ability to see social policy the way ordinary humans do: as a series of needlessly frustrating encounters with indifferent bureaucratic machinery. Over and over, he tells the stories of how ordinary human beings of limited abilities or limited means get dropped by the systems our society set up to help them. His stories have a liberal heart—in the sense that he clearly believes societies have a responsibility to help the weakest and most vulnerable—but contain no apologies for system failure. He lets the stories speak for themselves. And that is an extraordinary skill. For quite some time,...

What Romney Left Behind

Flickr/Gage Skidmore
One of the common misconceptions about the presidential candidate version of Mitt Romney is that he disavowed his greatest achievement in public office, health care reform, in an attempt to appeal to his party's base. The truth is that he never actually disavowed it or said it was a failure or a mistake. What he did was tell primary voters that Romneycare was really nothing at all like Obamacare, and anyway Romneycare shouldn't be tried in any other state. His comments were utterly unconvincing, but since they were always accompanied by a thunderous denunciation of Obamacare, Republican voters were assuaged enough to let it slide. Which means that had he wanted to, Romney probably could have entered the general election making a positive case on health care beyond "Repeal Obamacare!" By continuing to maintain that Romneycare was in fact a good thing when he was challenged on it (even if he didn't want to talk about it all that much), he gave himself enough rhetorical room that he...

We're Wasting $750 Billion a Year on Health Care

Institute of Medicine
The Institute of Medicine just came out with a report showing that the American health care system wastes an astonishing $750 billion dollars a year, one out of every three health care dollars spent. As Sarah Kliff explains , "So much wasteful spending leaves a lot of space for fixes. The Institute of Medicine recommends a number of solutions and many boil down to a pretty simple idea: Health care should be better-coordinated." There are a lot of ways to do that, but one particularly thorny problem is that doctors don't want anyone telling them what to do. I remember as a kid watching "St. Elsewhere," and there was a scene in which a hospital administrator angrily chewed out a doctor over something or other. My mother, who spent most of her career as a hospital administrator, said ruefully, "Oh please. No administrator would ever get away with talking to a doctor like that." Part of the reason is that doctors are trained to believe that they're better and more important than ordinary...

First Night of the DNC: A TV & Twitter Review

Did you watch it last night? It was an amazing night of TV, of Twitter (that instant snark convo), and of politics. My twitter feed was full of journos saying to each other: Wow, there’s a lot of energy here! Don’t you feel more buzz than in Tampa? I thought this was supposed to be the dispirited convention, but these folks are excited. You could see that in every breakaway shot of the convention floor: Folks were cheering, nodding, yelling back in witness. Over and over again, the Dems boasted proudly about standing up for health care, equal pay, LGBT rights (including the freedom to marry), and yes, reproductive rights, without apology. (CNN political commentator Erick Erickson got roundly swatted for tweeting, "First night of the Vagina Monologues in Charlotte going as expected.") Whoa. Way to respect your lady viewers! But he was right about this: The Dems were indeed standing up for the ladies’ power over their own bodies and paychecks. Up on stage, the speeches were just on fire...

Paul Ryan Is Way More Anti-Abortion Than You Thought

(Speaker Boehner/Flickr)
Since the Todd Akin affair entered the national conversation, many commentators—myself included—have noted the extent to which Akin’s views are in line with the mainstream of the Republican Party, and nearly identical to ones held by Paul Ryan, the GOP vice presidential nominee. This video, unearthed by Buzzfeed’s Andrew Kaczynski, illustrates the point. In it, a younger Ryan denounces a women’s health provision that was included in a bill to ban “partial-birth” abortion. Exceptions to the ban, he argues, would make it “meaningless”: If you live in a swing state, don’t be surprised if this video appears with a short endorsement from President Obama. More seriously, if there’s anything that places you on the radical end of the abortion debate, it’s opposition to measures meant to save mothers from dying as a result of pregnancies gone wrong. Indeed, this is actually the least of Ryan’s anti-abortion extremism. During his 12-year career in the House of Representatives, Ryan has endorsed...

Texas Says "No Thanks" to Women's Health Care

(AP Photo/San Angelo Standard-Times, Patrick Dove)
If you haven't been worn down reading about Todd Akin's bizarre and ignorant views about the female reproductive system, now turn to Texas, where women's uteruses may soon have to move out of state to find health care. Late Tuesday night, a federal court of appeals ruled that Texas can exclude Planned Parenthood from the Women's Health Program, which provides basic preventative care—like birth control and cancer screenings—for low-income women. The decision has terrifying implications in a state where women's access to health care is already poor. One in four women in Texas is uninsured, and the state also has the third-highest rate of cervical cancer in the country. In Texas, women's health-care clinics serving low-income populations rely on two sources of funding: the Women's Health Program and general state family-planning dollars. Lawmakers have attacked both streams. In 2011, the state legislature slashed state funding for family planning—you know, the thing that prevents...

Rep. Akin and Fun with Fake Facts

Honestly, some days I can’t tell real news from The Onion . Representative Todd Akin’s staggering comment on Sunday about the female body’s amazing ability to reject unwanted sperm actually made my jaw drop. If only it didn’t represent what so many people believe, as Amanda Marcotte explained so clearly here yesterday. The good news is that it flushed those beliefs out into the open. As she said, it’s not a gaffe; it’s an insight into the anti-choice movement’s distrust of women and its ignorance of science. (The fact that Akin’s on the House Science Committee is just one of those hilariously horrifying Onion -style bits of data: Do we really live in a country where a “don’t confuse me with the facts” anti-science ideologue makes policy about … science?) That magical thinking behind Akin's statement arises from an attitude similar—in ideology, not in degree—to that behind honor killings, in which raped girls who refuse to marry their rapists are killed by male relatives for sullying...

Five Things Government Does Better Than You Do

We know a lot less about how to manage money than we think.

(Flickr / Sheffield Tiger)
When Wisconsin Congressman Paul Ryan and other hard-line conservatives talk about cutting the government’s budget, their primary rationale is that individuals can make better decisions with their own money than the government can. As Ryan himself said to an audience at Georgetown University, “We put our trust in people, not in government. Our budget incorporates subsidiarity by returning power to individuals, to families and to communities.” It sounds reasonable—of course we want individuals to have power, and of course we want communities to take care of their neediest members. And since conservatives have done a fine job of portraying the government as full of heartless, inept bureaucrats, allowing people to make their own decisions sounds better than the alternative. The conservative approach to government stems from a basic tenet of free-market economics: that people always act rationally to maximize their own benefits, and that from this rises a general state of well-being for...

Medicare Myths, Debunked

(Flickr/Ann Lobb)
At the moment, the hot issue of the 2012 presidential campaign is Medicare, with the Obama and Romney campaigns trading charges and counter-charges over the health-insurance program for the elderly. Since we at the Prospect love clarifying the muddy and making the complex understandable, we thought we'd unpack the arguments the two sides are making and provide some context so we can all grasp this a bit better. We'll start with the campaigns' claims. Does Mitt Romney actually want to "end Medicare as we know it"? That's the charge Democrats are now making; here's a video the Obama campaign just released: Is it true? The answer depends on your definition of "as we know it." There is no question that Romney would fundamentally transform the Medicare program from what it is now—a single-payer insurer that guarantees coverage to all American seniors—into a "premium support" program in which the government gives seniors vouchers they can use to buy private insurance or stay in traditional...

I Know You Are But What Am I? Medicare Edition

In the good old days, you could get political speeches on LP.
Republicans' pleasure over Mitt Romney picking Paul Ryan for his running mate is tempered by their nervousness that Democrats will use Ryan's budget to hammer them on Medicare, particularly in Florida. And yes, they will. So how are Republicans going to respond? The answer is that they'll employ the time-honored "I know you are, but what am I?" strategy. The National Republican Congressional Committee—the House Republicans' campaign arm—is sending out memos to its members telling them to, in the title of one, "Stay on offense on Medicare." And how do you do it? You say, we're not the ones who want to destroy Medicare, the Democrats are the ones who want to destroy Medicare! We're already hearing it from Romney and Ryan, and it'll be coming from all kinds of other places as well; here's the Heritage Foundation saying "Obamacare ends Medicare as we know it." (How? Because it's all governmenty.) This kind of muddying of the waters has worked before. Here's one of my favorite ads from...

Who Said Women Can Have It All?

Remember that Anne-Marie Slaughter article in The Atlantic about a month and a half ago, whose title—"Why Women Still Can't Have It All"—drove feminists bonkers, while the substance nevertheless rang true for roughly 70 gazillion working parents in this country who are doing the impossible every single day? Rebecca Traister proposed forever retiring the phrase " having it all " here, and I chastised the magazine for the framing. But the article's core idea was right, as I wrote at the time: She’s right about this core truth: Being both a good parent and an all-out professional cannot be done the way we currently run our educational and work systems . When I talk to friends who’ve just had children, here’s what I tell them: Being a working parent in our society is structurally impossible. It can’t be done right, so don’t blame yourself when you’re failing. You’ll always be failing at something—as a spouse, as a parent, as a worker. Just get used to that feeling. Slaughter’s entire...

If Only the President Would Make Speeches, Everything Would Be Different

President Obama delivers a speech on health care to a joint session of Congress.
Yesterday, psychologist and political consultant Drew Westen had yet another op-ed in a major newspaper (the Washington Post this time) explaining that all of Barack Obama's troubles come from a failure to use rhetoric effectively. Don't get me wrong, I think rhetoric is important—in fact, I've spent much of the last ten years or so writing about it. But Westen once again seems to have fallen prey to the temptation of believing that everything would be different if only a politician would give the speech he's been waiting to hear. There are two problems with this belief, the first of which is that a dramatic speech almost never has a significant impact on public opinion. The second is that Barack Obama did in fact do exactly what Drew Westen and many other people say they wish he had done. This is only one part of Westen's piece, but I want to focus on it because it's said so often, and is so absurd In keeping with the most baffling habit of one of our most rhetorically gifted...

Your Guide to "Ending Medicare As We Know It"

Paul Ryan is very sincere.
Yesterday, President Obama went to Florida and told seniors that Mitt Romney wants to end Medicare as we know it, and it appears that this argument (and some related ones) will be a central feature of the Obama campaign's message in the coming days. It's entirely possible, as Jonathan Chait has suggested , that all the Obama campaign's attacks on Romney's finances and record at Bain Capital are the first stage of a two-stage strategy that culminates with an attack on the Ryan budget. Since we'll be talking about this a lot soon, I thought it might be worthwhile to refresh our memories on what this is all about, particularly with regard to Medicare, and how it relates to the current campaign. First: Is it fair to tar Mitt Romney with the Ryan plan? No question. While Romney's own policy proposals are quite a bit more vague than the Ryan plan is, they follow the same contours, and when Romney is asked about the Ryan plan he never hesitates to praise it. When asked about it last month,...

Political Procrastination

Republican legislators keep pushing back plans to create health-care exchanges, and the HHS contemplates fudging the deadline.

For nearly two years, Republicans have railed against the Affordable Care Act (ACA), with many a state-level politician going so far as to call for nullification. But even after the Supreme Court voted to uphold the ACA on June 29, state legislatures and governors in states from Florida to Wisconsin are refusing to implement the law's health-care exchange provisions, while other states are running far behind schedule. The deadline for states to submit their exchange blueprints to the Department of Health and Human Services (HHS) is only four months away, and several states are scrambling to draft them. Fewer than 20 states have even legislatively authorized health-insurance exchanges. Several state governments decided to wait until the Supreme Court ruled on the law to move forward with the exchanges, and now their legislatures will have to convene in special sessions to decide what path to take before the year is out. HHS has announced that it would begin implementing “ federally...

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