Health Care

Needling for Change

AP Images/Jae C. Hong
AP Images/Jae C. Hong F or 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.” Desperate for a solution, city...

Why Don't We Have Viagra for Women Yet?

AP Images/Allen Breed
L ast 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. If this news sparked a little twinge of déjà vu, don’t be surprised. For more than a decade, pharmaceutical companies have trudged through round after round of clinical trials in pursuit of a drug that can alleviate some of the symptoms of female sexual dysfunction. Inevitably, a new set of tests makes headlines. Given Viagra’s blockbuster success since it was approved in 1998—in 2012, sales totaled more than $2 billion—there is a huge untapped market for a drug like flibanserin. More than 40 percent of women suffer from some form of sexual dysfunction in their lifetime. The most common complaint is hypoactive sexual desire disorder (HSDD), a...

Horrible Bosses

AP Images/John P. Johnson
AP Images/Warner Brothers D o 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. But Tim Armstrong, the CEO of AOL (company motto: "More Than Just Your Grandmother's Email, Really!") must have thought his employees were pretty darn stupid when he told them last week that he was cutting their 401(k) contributions and blamed the change on the Affordable Care Act. He explained in an interview that the company had incurred $7 million in "Obamacare costs," whatever that's supposed to mean, and later complained that two employees who had "distressed babies" had cost the company $1 million each. It's been said many times that once he passed significant health care reform, Barack Obama came to "own" the health care...

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...

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. Anti-abortion activists pounced to take credit, criticizing Guttmacher for “failing to acknowledge the impact of pro-life legislation” in its explanation for the sudden drop. The Guttmacher researchers point out, quite reasonably, that the most recent wave of anti-choice legislation began in earnest in the months after the 2010 midterm election, when abortion rates were already falling. If anything, abortion’s decline was in spite of anti-choice sentiment, not because of it. As the abortion rate was falling, so was the birth rate. Fewer women were seeking...

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. First, as Marketplace reported this morning, a new report from PriceWaterhouseCoopers shows that the average health insurance premium on the exchanges is actually lower than the average premium in employer-sponsored plans. And it isn't because the coverage is inadequate; according to a spokesperson, "even when you factor in all the out-of-pocket costs, the average top tier gold and platinum plans are similar to employer ones." It's hard to overstate what a success this is. If you've ever bought health insurance on the individual market before now, you know that if you could get covered at all, you were likely to get a plan that was expensive but had lots of gaps and lots of cost-sharing. The whole point of the exchanges...

The Six Constituencies the State of the Union Actually Mattered To

AP Images/Charles Dharapak
AP Images/Charles Dharapak I t 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 Kristallnacht or Bashar al-Assad. For all of Obama’s rhetorical gifts, it was another speech that was mangled beyond recognition by the State of the Union sausage grinder. Before the speech, the agony of White House wordsmiths struggling with the State of the Union was memorably captured by Jeff Shesol, a Bill Clinton alum, who described the standard text as “written by a flash mob—a sudden aggregation, inside and around the...

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...

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...

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...

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. The Watergate Babies, as the new members were called, were a different breed of Democrat than the veterans who represented more urban districts. They were not only more liberal on cultural issues and more committed to environmental causes than many more senior Democrats, but many of them were also less committed to the kind of bread-and-butter New Deal economic policies with which the party had been identified. In 1974, Jerry Brown was first elected governor of California preaching that the nation had entered an “era of limits,” by which he meant, limits to social spending. Gary Hart was first elected senator from Colorado, disparaging the politics of old labor Democrats. Today, just two Watergate babies remain in Congress, both from...

Rebuffing the Zones?

AP Images/Steven Senne O utside 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. The petitioners are a small group of...

New York’s Pot Legalization Is Still Kinda Square

J ust days after the first state-regulated marijuana shops opened in Colorado—to the delight of everyone who loves a good pot pun in their morning newspaper—reports began to circulate that New York’s Democratic governor, Andrew Cuomo, was poised to bring his state into line with the 20 others that have legalized marijuana for medical use. This week, according to the New York Times , Cuomo will announce an executive action allowing 20 New York hospitals to prescribe marijuana to patients with glaucoma, cancer, and a handful of other chronic diseases, to be determined by the Department of Health. The governor is skirting the state legislature, where four medical marijuana bills, including one that passed the House last spring, perished in the Republican-controlled Senate. The legislative proposals would have allowed patients with a dozen illnesses, including epilepsy, post-traumatic stress, diabetes, and arthritis, to possess two and a half ounces of cannabis, and set up a system for...

Why Medicaid Patients Using the ER More Isn't a Bad Thing

Flickr/Rob Nguyen
As they argued that we needed to get coverage for the millions of Americans without health insurance, one of the problems advocates pointed to was the fact that many of the uninsured ended up showing up at the emergency room with relatively minor ailments, because they don't have regular doctors they can see and they know the hospital will have to treat them regardless of whether they'll be able to pay. This leads to crowded ERs and lots of uncompensated care, which is bad for everybody. So what happens when you give a bunch of formerly uninsured people Medicaid? According to a new study from the Oregon Health Insurance Experiment, a unique data set around a randomized experiment made possible a few years back when the state of Oregon distributed new Medicaid enrollments by lottery, people went to the ER more once they got on Medicaid. Liberals might find this disheartening. But not only is it not all that surprising, it doesn't undermine the case for Medicaid expansion at all. Keep...

No, Obamacare Wasn't a "Republican" Proposal

flickr/Ralf Heß
The filmmaker Michael Moore has, through his fine documentary Sicko and other public arguments, done a great deal to bring attention to the deficiencies of the American health-care system. His New York Times op-ed on the occasion of the first day of the Affordable Care Act's exchanges repeats some of these important points. However, his essay also repeats a pernicious lie: the idea that the Affordable Care Act is essentially a Republican plan based on a Heritage Foundation blueprint. This argument is very wrong. It is both unfair to the ACA and far too fair to American conservatives. Before explaining why a central premise of Moore's argument is wrong, let me emphasize our points of agreement. It is true that the health-care system established by the ACA remains inequitable and extremely inefficient compared to the health-care systems of every other comparable liberal democracy. Moore, unlike some critics of the ACA from the left, is also careful to note that the ACA is a substantial...

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