Health Care

Should We Call the Midwife?

AP Images/Katie Collins

Earlier this month, a bill advanced in the Arizona state legislature that would ban the use of midwives in the state during births where the mother has had previous caesarean sections, is delivering multiples or might face breech birth. How best to give birth is, needless to say, a topic of perennial interest. What follows is a conversation between two Prospect staffers who stand on different sides of the midwife debate.

The ACA Can't Fix Our Mental Health Crisis

AP Images/Bob Wands

As more people sign up for insurance under the Affordable Care Act, the next few months will usher in a fundamental change in mental health care. Under the ACA, insurers are for the first time required to cover mental health and substance abuse treatment as one of ten “essential benefits.” This is good news for the millions of Americans who suffer from some form of mental illness but don’t seek treatment. The question now is whether the country’s mental health infrastructure is equipped to deal with an avalanche of new patients. The answer? Probably not.

Arkansas's Medicaid Folly

AP Images/Brian Chilson

On Tuesday, the Arkansas state legislature failed to renew a bill authorizing its expanded-Medicaid plan, an innovative approach to Obamacare that allowed the state to use federal funds to purchase private insurance for the state's low-income residents. Arkansas's unique plan was a compromise between the state's Democratic governor, Mike Beebe, and the Republican-led legislature, and made the state one of the few ultra-conservative ones to bother expanding Medicaid. In the 25 states that didn't expand, many of the poor are still doing without insurance, because the federal subsidies weren't designed to kick in until people made above a certain threshold. If Arkansas doesn't renew its Medicaid program, 85,000 people who've gotten insurance this year will suddenly lose it again.

Needling for Change

AP Images/Jae C. Hong

For the first few years Liz Evans worked at the Portland Hotel Society, a network of homeless shelters in central Vancouver, she would arrive at her job already exhausted. On her morning walk through Downtown Eastside—a neighborhood infamous as the poorest zip code in Canada—she stepped over drug addicts passed out in doorways and sidled around alleys where people would cook dope and shoot up in broad daylight. It was 1993, and Vancouver was in the throes of an HIV epidemic. Tens of thousands of impoverished injection drug users were crammed into a fifteen-block radius. The Portland Hotel Society was one of the few housing projects in the city that welcomed drug addicts, and working there felt like triage. Evans, a nurse, trained her staff to intervene when the residents overdosed. “It was such a painful time,” Evans says. “These weren’t people who were partying or using drugs to have fun. They were poor and sick and dying.”

Why Don't We Have Viagra for Women Yet?

AP Images/Allen Breed

Last week, a small drug company called Sprout Pharmaceuticals announced that its version of “female Viagra”—a medication designed to enhance women’s libidos—was going back for yet another battery of tests. The Food and Drug Administration (FDA) wants more data on how Sprout’s drug, the whimsically named “flibanserin,” affects driving ability.

Horrible Bosses

AP Images/John P. Johnson

Do you believe everything your boss tells you? The answer probably depends—if he tells you the Cubs are going to win next year's World Series then maybe not, but if he tells you your benefits are being cut and explains the reason why, you'll probably take him at his word. After all, he's in charge of the business, so he should know.

Affordable Care Act Gives Workers Freedom; Republicans Enraged

No, they didn't take er jerbs.

Since I wrote about postal banking this morning, I've decided to continue the day's shameless, lowest-common-denominator clickbaiting by talking about a new Congressional Budget Office report and the Affordable Care Act. Hang on to your hats.

With all the hype of a new Beyonce album, the CBO dropped its latest report on government finances and other related topics, which includes the news that the deficit has dropped to its lowest level since Barack Obama took office. This may prove inconvenient for Republicans still invested in fomenting deficit panic, but they'll be helped by the fact that most Americans actually believe the deficit has gone up in the Obama years. According to a new poll from the Huffington Post, not only do 54 percent of people think so, but 85 percent (!) of Republicans think so.

In any case, the part of the CBO's report that's getting more attention is their projection that as a result of the ACA, the labor force will be reduced by 2 million in 2017, rising to 2.5 million in 2024.

Why Anti-Choicers Can’t Take Credit for the Falling Abortion Rate

On Monday, the Guttmacher Institute released a study that seemed, at first blush, to vindicate the anti-choice movement’s increasingly feverish attempts to end abortion through state-level restrictions on women and providers. Using survey data from 2011, the research organization—which leans pro-choice—found that abortion rates have plummeted to a 30-year low. Since 2008, the number of abortions performed in the U.S. fell 13 percent.

Remembering What Matters About the Affordable Care Act

Flickr/Laura Smith

On the Affordable Care Act front today, there's very good practical news, and not-so-good political news. That gives us an excellent opportunity to remind ourselves to keep in mind what's really important when we talk about health care.

Let's start with the good news.

The Six Constituencies the State of the Union Actually Mattered To

AP Images/Charles Dharapak

It was a strange State of the Union Address—mixing emotional tugs on the heartstrings with anodyne rhetoric that made it seem like everyone from Barack Obama to the angriest Tea Party Republican was bored with the annual exercise. The speech had no over-arching theme save (yawn) America’s enduring greatness. There were hard-hitting sentences and paragraphs, but no dramatic policy proposals nor even bold, if unattainable, dreams. The State of the Union address was unlikely to anger anyone whether it was financial titans fearing economic Kristallnach or Bashar al-Assad.

GOP to Working Poor: Drop Dead

AP Images/Charles Dharapak

In one of the better lines in last night's State of the Union address, President Obama chided House Republicans for their endless series of votes to repeal the Affordable Care Act: "[L]et's not have another 40-something votes to repeal a law that's already helping millions of Americans ... The first 40 were plenty." He followed up by observing that "we all owe it to the American people to say what we're for, not just what we're against." As it happens, last week three Republican senators outlined a plan that can be fairly described as a Republican plan to replace Obamacare. (The basic features of the plan are clearly described by Sarah Kliff of Wonkblog here.) Because most of the Republican Party convinced themselves in 2009 that a tax penalty for people who don't carry health insurance was a grave threat to the American constitutional order, the plan does not include an individual mandate. But otherwise, in its general priorities the plan strongly resembles the Heritage Plan of the late 1980s. That is, it's radically different than the ACA, and it's horrible, immoral public policy.

Vaccine Fear Mongers Are Wrong, But They're Not Ideological

President Obama possibly being injected with Kenyan socialist nanobots. (Flickr/ Rene Najera)

It's been true for some time that conservatives are far more likely that liberals to hold a number of false beliefs about the world, some of which were always political (e.g. Saddam had weapons of mass destruction, evolution is a myth) and some which became more political over time, particularly the belief that the planet is not warming and its subsidiary beliefs, which include the idea that there is a great deal of disagreement among climate scientists as to whether warming is occurring. Sometimes when this is brought up, someone will mention that liberals believe some demonstrably false things too, like the idea that childhood vaccines cause autism.

The trouble is, there has never been anything other than anecdotal evidence for this contention. Yes, there may be a parent at your kid's organic vegan locally sourced small-batch co-op nursery school who thinks it's true, and dangerous lunatic Jenny McCarthy, the nation's most prominent propagator of this theory, is a Hollywood celebrity and many Hollywood celebrities are liberals, but that doesn't mean that liberals in general are more likely to believe in the fictional vaccine-autism link.

The GOP, Guardians of Health Security

Mitch McConnell chats with some folks about health care 'n stuff.

This morning, Greg Sargent calls our attention to this new ad for Mitch McConnell, in which a man who got cancer from his job at a uranium enrichment plant in Paducah. The man testifies that it was McConnell, fierce advocate of worker safety and health security, who made sure that workers got cancer screening and compensation.

That'll never work, a liberal might say. McConnell is not only one of the nation's foremost opponents of any and all regulations to protect worker safety, but he wants to repeal the Affordable Care Act, which would take away the health coverage tens of thousands of Kentuckians just got. As you may know, Kentucky has been more aggressive in taking advantage of the ACA than probably any other conservative state. They set up their own exchange, and it has proven to be one of the best in the country; they also accepted the Medicaid expansion (these developments can be attributed mostly to the fact that the governor is a Democrat). According to this site tracking signups under the ACA, in Kentucky, nearly 40,000 people have signed up for private insurance via the exchange, and another 100,000 have enrolled in Medicaid. All of those people would be tossed off their coverage if McConnell got his way. So surely no one will believe this ad, right?

The Penultimate Watergate Baby

georgemiller.house.gov

The 1974 midterm elections, held in the wake of Watergate, were a Democratic landslide. The party increased its strength in the House of Representatives by more than 50 new members, many from suburban districts that had previously elected Republicans.

Rebuffing the Zones?

Outside Planned Parenthood’s clinic in downtown Boston, a painted yellow line swoops across the sidewalk and into the well-trafficked street, marking a 35-foot half-circle around the entrance. Most days, anti-abortion demonstrators gather on the edge of the line, holding signs and rosaries, and clutching bundles of pamphlets. As women approach the half-circle, the demonstrators spring into action. The goal is getting the women to pause and talk to them before they cross into the “buffer zone” on the other side of the line, which Massachusetts law declares a protest-free space.

The Supreme Court will hear oral arguments about the constitutionality of these buffer zones tomorrow, in McCullen v. Coakley. The arguments won’t tackle the polemical question of whether abortion should be available; instead, the justices will be asked to consider whether the buffer zones violate anti-abortion demonstrators’ First Amendment rights.

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