Health Care

Friday Miscellany

It's Friday! Time for a little bit of this, a little bit of that: Barney Frank is engaged! How sweet is that? Chris Geidner at MetroWeekly put up this : The two have been together since the spring of 2007, according to Frank's office. [Jim] Ready, who is 42 years old, lives in Ogunquit, Maine, where, per Frank's office, he has a small business doing custom awnings, carpentry, painting, welding and other general handyman services. He also is a photographer. And yet, ironically enough, the retiring U.S. Congressman's marriage won't be recognized by federal law. If (god forbid) Frank should predecease Ready any time soon, his widower will have no rights to collect the spousal benefit of his husband's federal pension. In fact, as Geidner writes: One of the plaintiffs in the Gay & Lesbian Advocates & Defenders's ongoing lawsuit challenging Section 3 of DOMA, Gill v. Office of Personnel Management , actually is the same-sex widow of a former member of Congress. Although they married...

The Difference Between Viagra and The Pill

Starting in August, women will no longer have to pay more than men for the prescriptions (the Pill, Viagra, Cialis) that enable them to have active sex lives. That was the big news this past Friday, when Department of Health and Human Services Secretary Kathleen Sebelius declared that almost* all employers must now pay for contraception in their health plans under the Affordable Health Care Act's requirement that insurers cover all preventive services. No co-pays. No deductibles. Whether or not women should pay for having sex—whether financially or through pregnancy—has been, shall we say, a hot topic for centuries. In the late 19th and early 20th centuries, the U.S. birth rate dropped dramatically because of new technologies (rubber condoms, that invention of Goodyear). Teddy Roosevelt decried contraception as "race suicide." Margaret Sanger went to jail for keeping women from withering and dying from gestating and delivering one after another bundle of joy. Late-19th- and early-20th...

In Dire Health

Despite the passage of the Affordable Care Act, the U.S. medical system is near collapse. What will save it is a single-payer system and physicians in group practice.

M ost people assume that insurance is an essential part of the health-care system. Some think it should be provided through public programs like Medicare, while others prefer to see it purchased from private insurance companies, but the majority believe that insurance is needed to help pay the unpredictable and often catastrophic expenses of medical care. That is why so much public policy focuses on extending coverage to as many people as possible and controlling its cost. I think this emphasis on insurance is mistaken. We would have a much better and more affordable health-care system if the reimbursement of medical expenses through public or private insurance plans was replaced by tax-supported universal access to comprehensive care, without bills for specific services and without insurance plans to pay those bills. Insurance is not simply a mechanism for spreading financial risks and paying for medical care. Because it usually tries to limit payments to providers, insurance often...

Payment Where Payment's Due

The uninsured cost the health-care system $120 billion a year. All the individual mandate does is make them pay for it.

The Republicans who argue that the Affordable Care Act (ACA) violates the Constitution have based their argument around the idea that the law will result in a remarkable new expansion of federal power that will lead us on a path to total government tyranny. As the brief filed by the Obama administration in defense of the ACA makes clear, however, the mandate to purchase insurance in fact falls squarely within the framework of federal power that the Supreme Court has consistently advanced since the New Deal. It’s a clear explanation of the history and goals of the legislation and the relevant constitutional issues that everyone interested in this important question should read. Arguments against the ACA center on the assertion that the bill’s requirement that most individuals obtain health insurance or pay a tax penalty goes beyond the power Congress has under Article I Section 8 to regulate “interstate commerce.” According to the bill’s constitutional critics, because the health-...

Bye Bye Bachmann

AP Photo/Chris Carlson
WEST DES MOINES, IOWA —Less than 12 hours ago, Michele Bachmann seemed determined to prove all the haters wrong and vowed to waste the next several weeks of her life in South Carolina. Turns out it was all a ruse to gather the media for one last headline-grabbing event. Bachmann announced that she would suspend her presidential campaign this morning at the Marriott in west Des Moines. For the first time in her career, Bachmann seemed to have landed on planet Earth. "Last night, the people of Iowa spoke with a very clear voice, so I have decided to stand aside," she said. Boy, they sure were clear. She came in second to last, just ahead of Jon Huntsman, who drew 5 percent of the vote. That equals 6,073 votes, only a slight increase from the 4,823 people who supported her at the Ames Straw Poll in early August. Back then it looked as if Bachmann could threaten Mitt Romney for the GOP nomination. But the entry of Rick Perry into the race stole her momentum, and she never recovered. Her...

Loveable Extremist

CEDAR RAPIDS, IOWA —Adoring crowds packed rooms to capacity across Iowa the last two days to hear the leader of their revolution. Dr. Ron Paul, as he his loving referred to by his supporters, went on an eight-stop jaunt through eastern Iowa to rile up his supporters two weeks before they vote in the caucuses. He is poised to win the 2012 Iowa caucuses: He leads in the latest polls, has a developed campaign infrastructure, and can count on true believers to show up to vote on January 3. Now seems like a good time to remind people that Paul is, in most ways, the most extreme of the Republican candidates. Many liberals have developed a soft spot in their hearts for the libertarian over the course of the campaign. On civil liberties and foreign policy, Paul provides the lone bright spot during debates, rebuking the other candidates for supporting the Patriot Act and advocating bombing every country that glances askew at the United States to the high heavens. His Iowa events have featured...

Time for Plan B on Plan B?

New research proves progressives were right to be upset by restrictions on emergency contraceptives.

"Modest" restrictions on reproductive freedom don't ever work the way their centrist supporters intend. They always end up hurting women least capable of shouldering the burden. Two new studies underscore this point. First, Amanda Marcotte points out research in the Journal of the American Medical Association showing that the Plan B restrictions supported by the Obama administration—against the advice of its medical professionals—will have effects more far-reaching than keeping the emergency contraceptive out of the hands of 11- and 12-year-olds . The JAMA study shows that this decision not only requires 15- and 16-year-old young women to get a prescription to obtain Plan B; it makes it harder for adult women to obtain Plan B as well. In theory, putting Plan B behind the counter allows access, but also incentivizes consultation with a pharmacist about proper use. But in practice, not making Plan B available over the counter because of regulations put in place without understanding the...

How We'll Talk About the Affordable Care Act in the Fall

Since these are the Republican primaries, the GOP candidates talk about the Affordable Care Act as though it were making your life a living hell, getting you fired from your job, and maybe kicking your dog as well. They all pledge to repeal it the instant they get into office, though they're vague on how exactly they'd go about it, since in our system, the president doesn't get to cancel duly elected laws he doesn't like. This is obviously what the Republican base wants to hear. But what about when we get to the fall? The broader electorate's views on the ACA are both more positive and less clear than those of the GOP base. They don't have the same kind of visceral reaction against it, but neither are they likely to believe it's been a boon to them. That's because most of the key provisions, particularly the mandate to carry insurance, the subsidies for people to get it, and the creation of the insurance exchanges, won't take place until 2014. But that doesn't mean the ACA hasn't...

Occupy Our Ovaries

Here's a prediction: The Plan B backlash is going to reverberate for quite a while. The ladies are furious that, once again, the administration has backed the bus right over their ovaries, overruling scientific research in the name of patronizing paternalism. If boys and men can pick up condoms as easily as a bag of Skittles, why can't girls and women also bypass a potentially conscience-ridden pharmacist and buy an easy-to-use pill to prevent pregnancy after—after — having sex? Come on, people, it's already happened; if she's too young to have sex, surely she's also too young to have a baby and raise a child. As for wanting parental oversight, well, if the 11-year-old is potentially pregnant by her father or stepfather or uncle, wouldn't it be terrific for her to be able to skip that little nicety? There have been some brilliantly scathing pieces written about the decision. Katha Pollitt announces that the Department of Health and Human Services has decided to treat all women like...

B Is for Betrayal

At a time when women's reproductive rights are under attack on many fronts, the last thing we need is for the Obama administration to join in.

Less than a day after President Barack Obama’s soaring speech on restoring the American middle class, progressives who felt that the administration was finally heading in the right direction stumbled back to reality Wednesday with a baffling decision from Health and Human Services (HHS) Secretary Kathleen Sebelius. Sebelius overruled the Federal Drug Administration (FDA) on its recommendation to make the contraceptive Plan B—a morning-after pill that reduces the risk of pregnancy after unprotected sex—available over the counter alongside contraceptives like condoms. Even girls younger than 16 would have had access to Plan B under the FDA's recommendation. In a statement explaining her decision, Sebelius argued that the FDA had not studied the potential impact on girls as young as 11 who could misunderstand the effects of the pill. As a result, she determined it was premature to make the pill available over the counter. "After careful consideration of the FDA summary review," Sebelius...

Obama Administration Restricts Plan B Access

The Food and Drug Administration was on the verge of approving the emergency contraceptive known as "Plan B One Step." Access to emergency contraceptives is important to the reproductive freedom of women, and having to obtain a prescription or get past a pharmacist with reactionary moral beliefs can be a substantial burden on women. As the FDA's decision reflected, denying over-the-counter access to emergency contraception increased unwanted pregnancies without any good medical reason. The two-tiered system that required young women under the age of 17 to obtain a prescription was also determined to increase unwanted pregnancies in the for whom they are most burdensome. But in a decision that RH Reality Check's Jodi Jacobson calls "astounding," Health and Human Services Secretary Kathleen Sebelius has overruled her own medical experts and denied American women over-the-counter access to Plan B. This action is, quite simply, a disgrace. It's awful on the merits, and politically...

Made in America — Again

Leaders discuss returning manufacturing to the U.S. in a Prospect roundtable.

AP Photo/Madalyn Ruggiero
Andy Grove was, successively, the director of engineering, president, CEO, and Chairman of Intel Corporation. In an article last year, Grove proposed levying tariffs on goods produced offshore and dedicating the funds to help companies scale up production in the United States. Andy Grove was, successively, the director of engineering, president, CEO, and Chairman of Intel Corporation. There are three distinct causes for the jobs we’ve lost. First, the declining demand for products. So everybody focused on the stimulus—they assumed that the demand cycle and the employment cycle are related like they used to be. But they’re not. I don’t understand pure Keynesianism at a time of global flows like we have now. If we turn on a spigot to increase demand for consumer products, we need to have some factor that measures the portion that goes to a domestically made product. That portion in the last ten years must have changed in a very major way. You want a measure? How about asking for the...

Crazy People Running for President

AP Photo/Andy Dunaway
Every four years, many people decide to run for president. You don't hear about most of them, because the news media decide, and reasonably so, to ignore folks like the immortal Charles Doty . Even among those who have held major political office, however, some are deemed serious and some are not. For instance, Buddy Roemer — a former member of Congress and governor of Louisiana — is considered not serious, as is Gary Johnson, the former governor of New Mexico. Both are running for the Republican nomination, but neither gets invited to debates or has journalists reporting on their campaigns. Yet Michele Bachmann is considered one of the "real" candidates, even as she languishes in the mid-single-digits in polls. Of course she won't be president, but I think it's worth pointing out that someone like Bachmann can still be treated as a real candidate. Since we've almost gotten used to her, at times one has to step back and marvel at just how incredibly nutty this person is, and the fact...

Health Care Supreme

The Supreme Court, as expected, has decided to take up the question of whether the Affordable Care Act violates the Constitution, and has allotted five and a half hours for oral argument. This is far longer than the typical 30 minutes lawyers get to argue before the Court, but it represents the magnitude of the case. Supreme Court opinions striking down acts of Congress are rare. To find a case where the Supreme Court struck down the centerpiece of a sitting president’s legislative agenda, you would have to go back to the New Deal, when reactionary holdovers like Willis Van Devanter and James McReynolds—the latter a justice so racist and anti-Semitic he would refuse to shake the hands of Jewish colleagues and turn his back on African American lawyers making oral arguments—created a constitutional crisis by repeatedly striking down key New Deal legislation. The Supreme Court's decision to hear the ACA challenge raises three key questions: Should the Supreme Court strike down the...

The Court Will Rule—and Then?

AP Photo/Alex Brandon
The Supreme Court’s decision today to take up the constitutionality of President Obama’s health-care reform in this session—they’ll hear oral arguments in March and rule by session’s end in June— means that the issue will be revived for voters just a few month before next November’s presidential election. This is probably good for Republicans no matter which way the justices rule. And, no matter which way the justices rule, I can’t see how this helps the Democrats. There are basically three ways the court could go. They could uphold the individual mandate; they could strike it down, which would essentially negate the rest of the law; or they could rule the issue can’t be litigated until 2015, when the federal government would levy the first penalties on persons who refuse to purchase insurance. Additionally, the court will rule on the important but still subsidiary issue of whether the feds can require the states to pick up additional Medicaid expenditures starting in 2016—but the...

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