Tag Archives: Health Care

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Why are we still fighting over birth control?

The Affordable Care Act aka Obamacare, included a provision for insurance to cover the cost of birth control.  After all, it has been estimated that 99% of all women use birth control at some point in their lives.  This is not just non-Catholic women.  Contraception is not cheap.  Without insurance, birth control pills can cost up to $100 a month.  Not affordable to lower income women who are also ones who can least afford to have unplanned children.  The pill is used for hormone regulation, not just birth control, a fact often ignored.

In fact, regardless of what the Pope and Cardinals and Archbishops in the United States think, Catholic women do use birth control.  I’m sorry, but no one has explained to me why a bunch of celibate men want to control women.  If you are against abortion, birth control would seem to be reasonable.  Of course, if you believe that life begins at the moment of conception, then some methods are problematic.  But we have no idea how many fertilized eggs just naturally abort, but I guess the distinction here is one is natural and the other has an artificial cause.  I should say that birth control also faces opposition from fundamentalist churches that are not Catholic.  The other thing that plays into the objection to birth control is that sex is to be reserved for marriage and for procreation.  There:   The objections to both birth control and gay marriage in one neat package.

The Obama administration has been twisting itself into knots to make sure that women who choose to use birth control have it covered under their health insurance.  The most recent proposal was outlined by the New York Times.

The Obama administration on Friday proposed yet another compromise to address strenuous objections from religious organizations about a policy requiring health insurance plans to provide free contraceptives, but the change did not end the political furor or legal fight over the issue.

The proposal could expand the number of groups that do not need to pay directly for birth control coverage, encompassing not only churches and other religious organizations, but also some religiously affiliated hospitals, universities and social service agencies. Health insurance companies would pay for the coverage.

The latest proposed change is the third in the last 15 months, all announced on Fridays, as President Obama has struggled to balance women’s rights, health care and religious liberty. Legal experts said the fight could end up in the Supreme Court

You can see the Department of Health and Human Services (HHS)  fact sheet here.

Religious groups dissatisfied with the new proposal want a broader, more explicit exemption for religious organizations and protection for secular businesses owned by people with religious objections to contraceptive coverage.

The tortured history of the rule has played out in several chapters. The Obama administration first issued standards requiring insurers to cover contraceptives for women in August 2011, less than a month after receiving recommendations to that effect from the National Academy of Sciences. In January 2012, the administration rejected a broad exemption sought by the Roman Catholic Church for insurance provided by Catholic hospitals, colleges and charities. After a firestorm of criticism from Catholic bishops and Republican lawmakers, the administration offered a possible compromise that February. But it left many questions unanswered and did not say how coverage would be provided for self-insured religious organizations.

Under the new proposal, churches and nonprofit religious organizations that object to providing birth control coverage on religious grounds would not have to pay for it.

Female employees could get free contraceptive coverage through a separate plan that would be provided by a health insurer. Institutions objecting to the coverage would not pay for the contraceptives.

Yesterday the Catholic Bishops weighed in

“The administration’s proposal maintains its inaccurate distinction among religious ministries,” said Cardinal Timothy M. Dolan of New York, the president of the United States Conference of Catholic Bishops. “It appears to offer second-class status to our first-class institutions in Catholic health care, Catholic education and Catholic charities. The Department of Health and Human Services offers what it calls an ‘accommodation,’ rather than accepting the fact that these ministries are integral to our church and worthy of the same exemption as our Catholic churches.”

The bishops’ statement, issued after they had reviewed President Obama’s proposal for six days, was more moderate and measured than their criticisms of the original rule issued by the White House early last year. Cardinal Dolan said the bishops wanted to work with the administration to find a solution.

The administration had no immediate reaction to the bishops’ statement, other than to say it was not a surprise.

One thing is clear, the Obama administration does not want to start saying the private business owners can opt out of paying for insurance that covers things they find objectionable.  What if we go from birth control to vaccinations to flu shots?

The birth control issue will end up in court and probably the Supreme Court.  For people who say they don’t want the ACA because they don’t want government controlling their health care, this the ultimate irony.  In case they haven’t noticed.  The Supreme Court is a branch of government.

So until the courts decide, Emily Douglas at the Nation has prepared this handy chart for you.

How to pay for your bith control

I guess I sound bitter, but I thought we already had this fight 40 years ago.  Contraception is supposed to be a routine option for women’s health care.

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Why we need univeral health care

I’ve written about this before particularly when the Affordable Health Care Act (aka Obamacare) was in the works, but this is a really good example of why we need it.  Yesterday the New York Times had a long story about the hospital crisis in North Dakota.  This is the same North Dakota where we are having an oil boom and where there is no unemployment.  But there is a health care crisis.

The patients come with burns from hot water, with hands and fingers crushed by steel tongs, with injuries from chains that have whipsawed them off their feet. Ambulances carry mangled, bloodied bodies from accidents on roads packed with trucks and heavy-footed drivers.

The furious pace of oil exploration that has made North Dakota one of the healthiest economies in the country has had the opposite effect on the region’s health care providers. Swamped by uninsured laborers flocking to dangerous jobs, medical facilities in the area are sinking under skyrocketing debt, a flood of gruesome injuries and bloated business costs from the inflated economy.

These are men is mostly unskilled jobs without health insurance.

Hospitals cannot simply refuse to treat people or raise their rates. Expenses at those 12 facilities increased by 15 percent, Mr. Bertsch added, and nine of them experienced operating losses. Costs are rising to hire and retain service staff members, as hospitals compete with fast food restaurants that pay wages of about $20 an hour.

“Plain and simple, those kinds of things are not sustainable,” he said.

Many of the new patients are transient men without health insurance or a permanent address in the area. In one of the biggest drivers of the hospital debt, patients give inaccurate contact information; when the time comes to collect payment, the patients cannot be found. McKenzie County Hospital has invested in new software that will help verify the information patients give on the spot.

To their credit, public officials in North Dakota are trying to do something.

Mr. Kelly has pushed for the state, which has a surplus of more than $1 billion, to allocate money intended for the oil region specifically to health care facilities in the area. He has also asked for the state to grant low-interest loans so hospitals can borrow money for facility improvements and for the governor to convene a task force to study health care issues in the oil patch.

Aides to Gov. Jack Dalrymple say he is taking steps to bolster medical training in the state, proposing to spend $68 million on a new medical school building at the University of North Dakota and $6 million to expand the nursing program at Lake Region State College. Mr. Dalrymple, a Republican, has also increased Medicaid financing for the state’s rural hospitals.

US residents with employer-based private healt...

US residents with employer-based private health insurance, with self insurance, with Medicare or Medicaid or military health care and uninsured in Million; U.S. Census bureau: Income, Poverty, and Health Insurance Coverage in the United States: 2007 (Photo credit: Wikipedia)

If we had universal health care, every one of those men would carry a card.  If we had computerized records that were actually accessible the doctors would have a medical history.  Right now the best we can hope for is that some of them will get employer paid insurance next year as the ACA continues to be implemented.  In the meanwhile, the health care system will struggle.

The cramped housing camps where many oil workers live can add to health issues. On a recent afternoon at McKenzie County Hospital, a man limped into the emergency room complaining about a dry, red patch of skin on his leg. Dr. Gary Ramage, the hospital’s sole full-time physician, said it was a bite from a brown recluse spider, which had most likely nested under the trailer where the man lives.

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But for now, Dr. Ramage, a gregarious Canadian who has worked here for 18 years, is left shouldering much of the load. Before the oil boom started a few years back, Dr. Ramage covered both the clinic and the emergency room. Now he mostly works at the clinic, while the hospital hires roving physicians to cover the emergency room. He is well known in the community, and people call him at home when they are sick. But now, he does not know many of the patients he sees.

“My work is no longer small-town work,” he said. “My work has now been transformed from that of a small family practitioner to basically an E.R. doc.”

Dr. Gary Ramage treating a patient at McKenzie County Hospital in Watford City, N.D. The hospital now averages 400 emergency room visits per month.

Photograph: Matthew Staver for The New York Times

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Roe v. Wade at Forty

Posted this morning on Maddow blog this new chart which includes information from an NBC/Wall Street Journal poll.

Exactly 40 years ago today, the U.S. Supreme Court issued its Roe v. Wade ruling. In a 7-2 decision, the court majority decided that Americans have a constitutional right to privacy, which includes being able to terminate an unwanted pregnancy.

I think that the Republican efforts to curtail abortion, to close clinics and to subject women who want to terminate an unwanted pregnancy are having an opposite effect than the one they want.  Kinda like voter suppression which just made people angry enough to stand in line for hours.

The high level of support for Roe comes with some underlying issues that we need to work on.  Bryce Covert just posted some interesting charts at the Nation about the economics of having an abortion.  The charts come from the Guttmacher Institute.  Here are two.

Guttmacher poor women

GuttmacherProviders

The support for keeping Roe has been steadily increasing.  Now we have to figure out how to implement the decision so it means something.

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Looking back at 2012 progressively

2012 was a pretty good year for those of a progressive/liberal political point of view and Winning Progressive has compiled a good summary.  You can read the entire article here, but I’ve pulled out some of my particular favorites – in my own order of significance.

First I have to talk about Mitch McConnell who not only lost his effort to make President Obama a one-termer, but last night voted to increase taxes.  (Although since it happened after we technically went off the cliff  at midnight, he will probably spin it as a decrease.)  I think he an John Boehner were the big losers last year, not Mitt.  Mitt is done with politics, but McConnell and Boehner have to continue to try to herd their Republican members and get re-elected.

President Obama re-elected

So now to some accomplishments.

* President Obama Re-Elected With A More Diverse and Progressive Congress– The November elections saw the re-election of President Obama and the election of four new progressive U.S. Senators – Mazie Hirono (D-HI), Elizabeth Warren (D-MA), Chris Murphy (D-CT), and Tammy Baldwin (D-WI).  In addition, Joe Lieberman (I-CT) is finally leaving the Senate!  On the House side, the Democrats elected in November will be the first major party caucus in US history that is majority female and people of color.  New House progressives will include Alan Grayson (FL-09), Jared Huffman (CA-02), Dan Kildee (MI-05), Ann McLane Kuster (NH-02), Grace Meng (NY-06), Patrick Murphy (FL-18), Rick Nolan (MN-08), Mark Pocan (WI-02), Raul Ruiz (CA-36), Carol Shea-Porter (NH-01), Mark Tacano (CA-41), Hakeem Jeffries (NY-08), and Kyrsten Simena (AZ-09).  On the flip side, tea party conservatives Allen West (FL), Chip Cravaack (MN), Bobby Schilling (IL), Roscoe Bartlett (MD), Ann-Marie Buerkle (NY), Francisco Canseco (TX), and Joe Walsh (IL) were all defeat and, hopefully, will never be heard from politically again.

* LGBT Equality– 2012 was, of course, a banner year for advancing LGBT equality.  For the first time in US history, equality was supported by a majority of voters facing ballot proposals approving marriage equality in Maine, Washington, and Maryland, and refusing to ban equality in Minnesota. The first openly lesbian U.S. Senator, Tammy Baldwin (D-WI) was elected in November as were a record seven openly-gay House members.  President Obama publicly supported marriage equality, and anti-equality forces in Iowa failed in their effort to recall a state Supreme Court justice who declared that state’s ban on marriage equality unconstitutional.  In February, a federal appellate court ruled California’s anti-marriage equality Proposition 8 unconstitutional, and two federal courts in 2012 did the same with the Defense of Marriage Act.

* Health Care Reform – In a decision that surprised many commentators, the U.S. Supreme Court upheld the Patient Protection and Affordable Care Act, aka “ObamaCare.”And while the GOP-controlled House has voted at least 33 times to repeal ObamaCare, President Obama’s re-election in November virtually guarantees that will never occur.   In implementing ObamaCare, the Obama Administration, standing up to strong opposition from conservative religious organizations, finalized rules requiring that contraception be included as a preventive health service that insurance policies must cover with no co-pay.  This will help millions of women afford access to birth control and also save money by reducing unintended pregnancies.

Those are my personal big three.

Yes, there is a lot left to do and a lot that happened that I didn’t particularly think was terrific, but on the first day of a new year, we should celebrate our successes!

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Obama and Women’s Healthcare

While I was working on the last post about Akin, Ryan etc., I ran across this great summary of what the Affordable Care Act does for women.  In a column titled Obamacare(s) for Women, Katha Pollitt published in the Nation she provided this handy list of benefits.

Women will get a lot out of the Affordable Care Act. Here are just some of the ways:

1. As many as 10 million will get coverage in 2014 under Medicaid expansion, and by 2016, thanks to other provisions of the ACA, that number will grow to 13.5 million women.

2. By 2014, all plans sold to individuals will be required to cover maternity care. According to the National Women’s Law Center, 12 percent of those plans include that. Remember when Arizona’s Jon Kyl said he didn’t think his insurance should have to cover pregnancy and childbirth because he would never need it? The ACA destroys the mindset that care needed only by women is of no general concern.

3. More than 20 million women will get expanded coverage of preventive services—prenatal care, mammograms, pap smears, breast-feeding supplies, testing for sexually transmitted diseases, well woman checkups, immunizations, birth control and more.

4. Insurance companies will be barred from dropping women’s coverage when they become pregnant or sick.

5. Companies will be barred from denying coverage because of “pre-existing conditions,” like having had breast cancer, being pregnant (funny how that keeps coming up), having had a Caesarean or being the victim of domestic violence.

6. No more “gender rating”—charging women more for coverage just because they are women. This practice, already banned in some states but permitted in thirty-seven others, costs women a staggering $1 billion a year.

7. Older women will receive expanded preventive services through Medicare, like bone-density screenings for those at risk of osteoporosis.

8. The expansion of Medicaid will cover people who make up to 133 percent of the poverty line (about $31,000 a year for a family of four). True, enabled by the recent Supreme Court decision, at least eight red-state governors have said they will reject it. Let’s see how that works out for them.

9. The birth control provision is mammoth all by itself. Not only will it be costless to the patient; all methods must be covered. That means women will be able to choose the kind of birth control that works best for them, which means they are more likely to use it consistently. In particular, it means insurance must cover the most effective methods, including the IUD, which many plans exclude. At up to $1,000 upfront, it is too expensive for many women to shell out for, even though the IUD is one of the cheaper methods when you consider that it lasts for ten years or more. If anti-choicers really wanted to lower the number of abortions, they would be cheering this huge expansion of access to contraception. But no.

If Romney wins, women can wave goodbye to what Planned Parenthood has called “the single biggest advancement in women’s health in a generation.” Think about that next time someone tells you there’s no difference between the candidates. It’s just not true.

The President signs the Affordable Healthcare Act.  Photo by AP Photo/J. Scott Applewhite

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Akin, Ryan, Romney and Women’s Healthcare

I was cooking dinner and listening to a rerun of Tom Ashbrook’s On Point when I heard Mary Kate Cary say that she agreed with the President that rape was rape, but did not agree with him that male legislators were making health care decisions for women and that they should just let women decide for themselves.  The President’s exact words from a report from CBS News

“Rape is rape,” Mr. Obama told reporters at the daily White House briefing Monday. “And the idea that we should be parsing and qualifying and slicing what types of rape we’re talking about doesn’t make sense to the American people and certainly doesn’t make sense to me.”

Mr. Obama added that Akin’s remarks underscore “why we shouldn’t have a bunch of politicians, a majority of whom are men, making health care decisions on behalf of women.”

The president acknowledged that his GOP rival Mitt Romney and other Republicans have distanced themselves from Akin’s statements. However, he said, “The underlying notion that we should be making decisions on behalf of women for their health care decisions, or qualifying ‘forcible rape’ versus ‘non-forcible rape’ — those are broader issues….between me and the other party.”

Mary Kate Cary, a former speech writer for President George H. W. Bush, went on to confuse the fact that women probably do make more decisions about health care treatment than men since they are still most likely to take the children to the doctor, with the male legislators setting boundaries on what kind of treatment women can actually choose.  (Thanks to my husband for helping me clarify that.)

So what does all this mean?  It means that Todd Akin, Paul Ryan and the Republican platform are imposing their religious ideas on everyone and removing choice.  And here I thought that they were the party of small government!  What with banning abortion in all situations and/or requiring vaginal ultrasounds before an abortion, I think they are actually intruding in health care decisions.  At the same time, none of them cares about what happens to the child after this forced birth because there will be no available safety net for her or for her mother under the Ryan/Romney cuts to the safety net in the budget combined with the proposed repeal of the Affordable Care Act.  There will also be no way for women to prevent pregnancies as there will be no contraception available under the ACA and no funding for Planned Parenthood.

Todd Akin and all his pals who don’t believe that a woman can get pregnant during rape, make that forcible rape, may be on the extreme edge of an extreme edge but they do represent the majority view of the Republican party.  This from the New York Times this morning

As an orator, Representative Todd Akin of Missouri may stand out for his clumsiness. But as a legislator, Mr. Akin has a record on abortion that is largely indistinguishable from those of most of his Republican House colleagues, who have viewed restricting abortion rights as one of their top priorities.

It is an agenda that has enjoyed the support of House leaders, including Speaker John A. Boehner and Representative Eric Cantor, the majority leader, who has called anti-abortion measures “obviously very important in terms of the priorities we set out initially in our pledge to America.” It became inextricably linked to the near-shutdown of the federal government last year when an agreement to keep the government open was reached only after it was linked to a measure restricting abortion in the District of Columbia.

Even as Congressional Republicans, including Mr. Boehner, denounced Mr. Akin’s remark that victims of “legitimate rape” were able to somehow prevent pregnancy, an agenda to roll back abortion is one that House Republicans have largely moved in step with.

In an anti-abortion measure once sponsored by Mr. Akin, Mr. Ryan and scores of other Republican lawmakers, an exemption was made for victims of “forcible” rape, though that word was later removed.

On Tuesday, Republicans approved platform language for next week’s nominating convention that calls for a constitutional amendment outlawing abortion with no explicit exceptions for cases of rape or incest. That is a view more restrictive than Mr. Romney’s, who has said that he supports exceptions to allow abortions in cases of rape.

Ryan center and Akin to the right in a photograph by J. Scott Applewhite/Associated Press

So Democrats can now keep tying Paul Ryan, Todd Akin and the Republican Platform together while Mitt, as usual, tries to dance away from taking a position.  After all as Republican Party Chair, Reince Priebus said “this is the platform of the Republican Party, it is not the platform of Mitt Romney.”  I titled this “Akin, Ryan, Romney and Women’s Health Care” but if they have their way, women won’t have health care.  There is already a large gender gap.  We can enjoy watching it get bigger.

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Mittens the mean

Whether you are going to vote for him or not, Mitt Romney has kinda a nice but clueless rich guy image.  Don’t let that fool you.  Joan Vennochi reminds us of his history here in Massachusetts.

Massachusetts is where Romney first showed his appetite for running over any candidate who stands between him and political office. Here, it happened to be women.

When Romney decided to run against Ted Kennedy in 1994, Republican Janet Jeghelian, a former talk radio host, was in the race. Once Romney jumped in, he and the state GOP kept her off the primary ballot.

Jeghelian wasn’t a strong candidate, but she was a prescient one. After she was forced out, she predicted he would waffle on abortion rights. It took awhile, but he did.

Seven years later, Romney muscled out acting Governor Jane Swift, who had his pledge that he would not challenge her for the nomination. But fresh from running the winter Olympics, Romney jumped in, and without so much as a courtesy phone call, pushed out the politically weak Swift.

Realizing the delicacy of kicking aside the Bay State’s first female chief executive, Romney recruited another woman, Kerry Healey, to run as his lieutenant governor and vouch for his pro-choice credentials. Once elected, he relegated Healey to back channel roles, but she remains loyal and supports his presidential bid.

These tactics should be familiar to Rick Santorum and the other Republican candidates only there he did it with his super Pac and advertising.

Joan’s point is that all of this leads to a lack of trust which hurts him particularly among women.  And while he has flip-flopped on a number of issues two matter to women.  The first is his support of abortion rights during his Massachusetts Senate campaign.  And he has done a major flop on Massachusetts health care reform.

As Shannon O’Brien, the Democrat he defeated in 2002, points out, “The choice issue is just one glaring reason why women can’t trust Mr. Romney. The broader, more profound issue is about what he will do to protect and preserve family health care across the country. Where he had such promise as governor, setting the stage for using Massachusetts as a national model, now he’s saying he didn’t mean it, never said it, doesn’t want it. That’s the biggest flip-flop-flip that women should be concerned about.’’

Massachusetts Democrats are gleefully reminding voters of Romney’s singular role in health care reform. He pushed for the individual mandate. He personally escorted the first woman who signed up for Romneycare. At his request, his official State House portrait, which hangs in the reception area of the governor’s office, includes the artist’s rendition of Romney’s wife, Ann, and a stack of papers representing the state’s health care law.

Will he have his portrait replaced next?

Men and women run against each other with regularity these days.  Look at President Obama and Secretary of State Clinton.  The point is that Mitt doesn’t seem to care about the niceties.  He could have run in a primary against both Swift and Jeghelian and maybe he would have won.  Maybe it is just coincidence that the two candidates he ran over were women and we will never know whether he would have jumped in if they had been men.  I think he just would have competed in the primary and blasted his opponent with negative advertising.

So all of you fellow Obama supporters take heed:  this is not a nice guy and brace yourself for a negative campaign and he tries desperately to recapture the women’s vote he needs to win.  Luckily, I don’t think he can flip again on either abortion or health care as that flip will cost him his Republican support. 

We can only hope he stays perplexed.