Health Care

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...

Supreme Court to Hear Challenge to Affordable Care Act

Will the individual mandate survive?

It’s official; the Supreme Court will hear the a challenge to the Affordable Care Act, President Obama’s health care reform law. The Court’s decision is expected to come next June. Going by the tenor of conservative rhetoric and the decisions of lower courts, the key issue at hand is the “individual mandate,” which requires all Americans to purchase health insurance by 2014 or face financial penalties. Conservatives argue that the mandate is a gross overreach of federal power —by their lights, the Constitution doesn’t allow the government to tax “inaction.” Allowing the mandate to stand, they argue, would put the United States on a dangerous road toward unrestrained government. Indeed, in his ruling to uphold the individual mandate, Judge Lawrence Silberman of the DC Circuit Court of Appeals pointed out that while “the Government does stress that the health care market is factually unique,” it “concedes the novelty of the mandate and the lack of any doctrinal limiting principles.” As...

Health-Care Baloney from Mitt Romney

Massachusetts Gov. Mitt Romney, seated, smiles with, clockwise from top, Massachusetts Health and Human Services Secretary Timothy Murphy, Senate President Robert Travaglini, Sen. Edward Kennedy, D-Mass., and House Speaker Salvatore DiMasi as he signs into law at Faneuil Hall in Boston a landmark bill designed to guarantee virtually all state residents have health insurance, in this Wednesday, April 12, 2006, file photo. While Romney has received positive reviews of the sweeping health care initiative, it will be up to the state's next governor to sort through the details of the law. (AP Photo/Elise Amendola, File)
Let me do something weird and discuss a bit about the substance of last night's debate. (AP Photo/Elise Amendola) Massachusetts Gov. Mitt Romney in 2006, signing into law a landmark bill designed to guarantee virtually all state residents have health insurance There was some discussion of health care, and of course it was superficial and misleading. That was partly the fault of the candidates, and partly the fault of the moderators, who at one point gave the candidates 30 seconds each to solve America's health-care problems. Mitt Romney and Newt Gingrich both reasonably observed that this was kind of absurd. But here's something Romney said: I believe very deeply in the functioning of markets. The work I've done in health care, actually worked as a consultant to the health care industry, to hospitals and various health institutions. I had the occasion of actually acquiring and trying to build health care businesses. I know something about it, and I believe markets work. And what's...

Is There a "Bradley Effect" for Abortion?

Amendment 26 supporter Sandy Comer puts out a campaign sign at the polls at the Chamber of Commerce in Oxford, Mississippi, on Tuesday, November 8, 2011. Mississippians go to the polls today for state and local elections, as well as referendums including the so-called personhood amendment, a referendum on whether to define life as beginning at conception. (AP Photo/Oxford Eagle, Bruce Newman)
Yesterday, Mississippi voters soundly defeated Amendment 26, an anti-abortion ballot initiative that would have altered the state's constitution to define personhood as beginning at fertilization. Going into the election, a survey from Public Policy Polling showed 45 percent of voters in favor, 44 percent opposed, and 11 percent undecided—much closer than the vote turned out to be. A personhood amendment like the one in Mississippi has never been enacted and would have had radical implications, even in a strongly pro-life state like Mississippi. Not only would it have banned all abortions without exception, but popular forms of contraception like the morning after pill, IUDs, and even the pill would have been outlawed as well. In addition, miscarriages could be prosecuted as murder or manslaughter. But Mississippians won't have to deal with any of that, because Amendment 26 lost 58 percent to 42 percent. The discrepancy between what the polls said going in and the results means that...

DC Appeals Court Upholds ACA—With a Republican Taking the Lead

The influential Court of Appeals for the District of Columbia has issued an opinion affirming the Affordable Care Act (ACA) constitutional. In itself, this is not surprising, as several other courts have done so. What is surprising is that the Court's opinion was written by Republican favorite Laurence Silberman. The conservative Reagan appointee notes that the "activity/inactivity" distinction hatched to argue that the individual mandate violates the Constitution has no basis in the Court's precedents, and under those precedents the ACA is clearly constitutional: Today, the only recognized limitations are that (1) Congress may not regulate non-economic behavior based solely on an attenuated link to interstate commerce, and (2) Congress may not regulate intrastate economic behavior if its aggregate impact on interstate commerce is negligible. Those limitations are quite inapposite to the constitutionality of the individual mandate, which certainly is focused on economic behavior–if...

The Budget Prescription

Earlier this month, the European Commission launched a new round of investigations targeting the pharmaceutical industry for allegedly colluding to keep low-cost generic drugs off the market. As a result, regulators are looking into the 2005 contractual arrangements between U.S.-based pharmaceutical giant Johnson & Johnson and the generic branches of the Swiss-based company Novartis to see whether the agreements purposely delayed the introduction of a generic version of the painkiller Fentanyl to the Dutch market. The probe is the latest round in an ongoing battle between commission trade officials and Big Pharma over quasi-legal “pay to delay” deals—settlements forged between drug manufacturers and producers of generic alternatives with the goal of extending brand-name monopolies long after patents have expired. Four days after the Europeans moved against Johnson & Johnson, the Federal Trade Commission (FTC) Bureau of Competition issued its annual staff report on pay-to-delay...

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