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There’s More To Women’s Health Than Contraception

If you have been listening to the contraception debate in Washington (sort of hard to avoid, isn’t it?), you may be under the impression that preventive health for women equals contraception. Or contraception equals women’s preventive health. (We’re putting aside, for the purpose of this post, the debate about religion, conscience and the role of government).

The Senate has defeated one bid to overturn the administration rule requiring employers to provide an insurance plan with first-dollar coverage of birth control, and it’s not clear what the House will do. But the issue is likely to percolate in Washington, state legislatures and the courts for some time to come.

The health reform law, and the regulations being developed to implement it, has a far more expansive definition of prevention and what it means for women’s health. Here are more details on the new regulations and a tutorial from Kaiser.edu. According to the new women’s preventive health rule, new health plans must cover, without cost-sharing, a lot more than the pill:

  • well-woman visits;
  • screening for gestational diabetes;
  • human papillomavirus (HPV) DNA testing for women 30 years and older;
  • sexually-transmitted infection counseling;
  • human immunodeficiency virus (HIV) screening and counseling;
  • FDA-approved contraception methods and contraceptive counseling;
  • breastfeeding support, supplies, and counseling; and
  • domestic violence screening and counseling.

These requirements will go into effect in August (with another year allowed to finalize how the religious exemptions will work). Grandfathered plans won’t have to follow the new rule, while they maintain their “grandfather” status. Over time, many health plans will go through changes that will mean that they will no longer be “grandfathered.” Then they too will have to follow the new regulations.

Of course, more women will get these benefits, simply because more women will be insured. Approximately one in five women of reproductive age is currently uninsured. Most of them will get coverage, including preventive services, starting in 2014 whether through Medicaid, through subsidized coverage in the exchanges or by buying coverage. Right now, coverage of maternity benefits is spotty on the individual insurance market, but the plans in the health exchanges will cover it.

The law also requires many other preventive services – some free – for men, women and children. They have not gotten much attention in the polarized birth control debate.

The conversation (and press coverage) about the contraceptive rules have included lots of misinformation about abortion. Politicians who misstate policy don’t help, but reporters need to know what the law does and does not do.

The health law does not mandate abortion coverage and this preventive health rule does not change that. In fact, states under health reform have the explicit ability to limit abortion coverage in policies sold in state exchanges and several have already taken action to do precisely that. Plans that do cover abortion in the exchange will have to wall that off in a way to keep it apart from the federal subsidies.

A few more stray but relevant facts:

According to the Kaiser.edu materials, about two-thirds of women aged 15 to 44 use contraception – and do so for about 30 years.

Most employer-based insurance plans do cover contraception, though there are often co-pays. Among large employers, more than 80 percent cover contraception.

Federal Medicaid dollars do not cover abortion under the Hyde Amendment (except for rape, incest or when the life of the mother is in danger) – although some states use their own money to cover abortion in some circumstances. But Medicaid does cover contraception. In fact, Medicaid pays for more than 70 percent of publicly financed family planning services.

And Title X funds family planning clinics (created in 1970 under the Nixon presidency). According to HHS, about 5 million women and men get family planning services through more than 4,500 community-based clinics. Someone with religious objections to providing contraceptives for employees is indirectly paying for Medicaid birth control coverage – and indirectly for the tax subsidies of employer-sponsored insurance – just as we all pay taxes that fund some things we agree with and some we don’t.

 

By: Joanne Kenen, Association of Health Care Journalists, March 1, 2012

March 2, 2012 Posted by | Women's Health | , , , , , , , , | 1 Comment

“The Real Romney”: The Danger Of Mitt Being Mitt

Political consultants tell candidates to be authentic — to “be yourself.” In Mitt Romney’s case, that might not be such good advice.

Once again, for what seems like the umpteenth time, Romney is being crowned as the presumptive Republican nominee. His victories in Michigan and Arizona took much of the wind out of Rick Santorum’s sails; Newt Gingrich is lost at sea; and Ron Paul is, well, Ron Paul. As long as Romney keeps winning, talk of some kind of a deus ex machina  plot twist at the convention — someone just like Jeb Bush surfaces, but with a different last name — remains pure fantasy.

Given the Romney campaign’s huge advantages in money and organization, and given the has-been nature of his opposition, the only reason he hasn’t wrapped this thing up is the “authenticity” issue: Not just “is he a real conservative” but “is he even a real person,” in the sense of having some idea of how most Americans live.

The campaign has sought to answer that question with stunts such as sending Romney to the Daytona 500. The optics were good until a reporter asked the candidate if he follows NASCAR. Romney’s response will live forever.

“Not as closely as some of the most ardent fans,” he said, “but I have some great friends that are NASCAR team owners.”

Well, who doesn’t? In Romney’s world, I mean.

There was a similarly clueless moment in Michigan. Romney was trying to atone for his vocal opposition to President Obama’s bailout of the auto industry. He said that he liked seeing so many Detroit-made cars on the streets — to be expected in Detroit — and noted that he drives a Ford Mustang and a Chevrolet pickup. As icing on the cake, he added that his wife Ann “drives a couple of Cadillacs, actually.”

Again, who doesn’t?

The explanation of why Ann Romney can’t get by with one did not advance the candidate’s quest for regular-guy authenticity: The cars are garaged at different residences.

And who can forget the way that Romney, whose wealth is estimated at $250 million, described one of his sources of income. “I get speakers’ fees from time to time, but not very much,” he said.

His tax returns showed earnings from speaking engagements of more than $370,000. Indeed, that’s “not very much” compared to Romney’s income from his investments. To most Americans, it’s a fortune.

I could go on and on with examples of Romney’s Marie Antoinette rhetoric, but you get the point. It’s not just what he says that tends to distance him from voters, but the whole way he carries himself. He’s just not believable as a NASCAR fan, ardent or otherwise.

Advisers tried putting him in jeans. At the end of a long day, they still have a crease.

Romney has been running for president for the better part of a decade yet still hasn’t made a personal connection with the Republican base, let alone the wider electorate. The conventional advice, at this point, would be: Quit pretending. Don’t try to convince voters that you’re a red-meat social conservative when your record on social issues screams “moderate.” And please, don’t pretend to be Average Joe if your proof of identity is that you keep American-made luxury cars at two of your mansions.

Romney took this kind of I-am-who-I-am stand this week when he said that, while “it’s very easy to excite the base with incendiary comments,” he was “not willing to light my hair on fire to try and get support.” He even joked later about his immaculate coif, saying that “it would be a big fire, I assure you.”

That was charmingly authentic. The problem is that the effect of Romney’s comment is to dismiss the Republican Party’s activist base as an unsophisticated rabble. Which is perhaps not the best attitude for a Republican candidate to display.

Romney’s “gaffes” look unmistakably like glimpses of the real Romney — not a bad person but a man with no ability to see beyond the small, cosseted world of private equity and great wealth that he inhabits. He has to be reminded that most voters live in a world where people drive their Cadillacs one at a time.

From the Romney campaign’s point of view, it may be that while fake authenticity is bad, real authenticity is much worse. If I were an adviser, I’d send out a memo to all hands: Whatever you do, don’t let Mitt be Mitt.

 

By: Eugene Robinson, Opinion Writer, The Washington Post, March 1, 2012

March 2, 2012 Posted by | Election 2012, GOP Presidential Candidates | , , , , , , , | 1 Comment

Contraception Primer: Here’s How It Works Guys

I am not going to link to the Rush Limbaugh “slut” comment. I have too busy a day ahead to spend the next six hours furiously scrubbing myself in the shower whilst rocking and weeping.

I will, however, attempt a substantive point, since this idea that young women are having so much sex they are going broke and want taxpayers to bail them out seems to be solidifying into an actual, real-life meme (which is a bit astounding given what year it is).

That’s just not how it works! Reading the comments that have been made recently, you get the sense that the people—mostly older guys—puking out these sorts of arguments haven’t quite grasped the basics of circa-20121960s contraceptive technology.

So, to all the people making this argument: Hi! Here’s a quick primer. This debate is mostly about the pill, not condoms. It’s not the case that every time a woman has sex she has to take a pill (though something like that also exists for emergency situations, and I’m aware that this enrages you). Rather, women get a prescription for these things called birth-control pills that are generally taken every day. So it’s a fixed prescription cost, and like many such costs, if insurance doesn’t cover it it can get  out of hand really quickly because our medical system is an octopus riding a donkey riding a skateboard into a sadness quarry. But there is no proportional relationship between the amount of sex a woman has and the number of standard birth-control pills she consumes. Why, there are even women who aren’t sexually active who take the pill for medical reasons. Whoa!

I know this is a lot to take in all at once, guys. But there are plenty of online resources available if you have any questions.

 

By: Jesse Singal, Washington Monthly, Political Animal, March 1, 2012

March 2, 2012 Posted by | Women's Health | , , , , , , | Leave a comment

Four Fiscal Phonies: GOP “Irresponsible Deficit Hysteria” Presidential Candidates

Mitt Romney is very concerned about budget deficits. Or at least that’s what he says; he likes to warn that President Obama’s deficits are leading us toward a “Greece-style collapse.”

So why is Mr. Romney offering a budget proposal that would lead to much larger debt and deficits than the corresponding proposal from the Obama administration?

Of course, Mr. Romney isn’t alone in his hypocrisy. In fact, all four significant Republican presidential candidates still standing are fiscal phonies. They issue apocalyptic warnings about the dangers of government debt and, in the name of deficit reduction, demand savage cuts in programs that protect the middle class and the poor. But then they propose squandering all the money thereby saved — and much, much more — on tax cuts for the rich.

And nobody should be surprised. It has been obvious all along, to anyone paying attention, that the politicians shouting loudest about deficits are actually using deficit hysteria as a cover story for their real agenda, which is top-down class warfare. To put it in Romneyesque terms, it’s all about finding an excuse to slash programs that help people who like to watch Nascar events, even while lavishing tax cuts on people who like to own Nascar teams.

O.K., let’s talk about the numbers.

The nonpartisan Committee for a Responsible Federal Budget recently published an overview of the budget proposals of the four “major” Republican candidates and, in a separate report, examined the latest Obama budget. I am not, by the way, a big fan of the committee’s general role in our policy discourse; I think it has been pushing premature deficit reduction and diverting attention from the more immediately urgent task of reducing unemployment. But the group is honest and technically competent, so its evaluation provides a very useful reference point.

And here’s what it tells us: According to an “intermediate debt scenario,” the budget proposals of Newt Gingrich, Rick Santorum, and Mitt Romney would all lead to much higher debt a decade from now than the proposals in the 2013 Obama budget. Ron Paul would do better, roughly matching Mr. Obama. But if you look at the details, it turns out that Mr. Paul is assuming trillions of dollars in unspecified and implausible spending cuts. So, in the end, he’s really a spendthrift, too.

Is there any way to make the G.O.P. proposals seem fiscally responsible? Well, no — not unless you believe in magic. Sure enough, voodoo economics is making a big comeback, with Mr. Romney, in particular, asserting that his tax cuts wouldn’t actually explode the deficit because they would promote faster economic growth and this would raise revenue.

And you might find this plausible if you spent the past two decades sleeping in a cave somewhere. If you didn’t, you probably remember that the same people now telling us what great things tax cuts would do for growth assured us that Bill Clinton’s tax increase in 1993 would lead to economic disaster, while George W. Bush’s tax cuts in 2001 would create vast prosperity. Somehow, neither of those predictions worked out.

So the Republicans screaming about the evils of deficits would not, in fact, reduce the deficit — and, in fact, would do the opposite. What, then, would their policies accomplish? The answer is that they would achieve a major redistribution of income away from working-class Americans toward the very, very rich.

Another nonpartisan group, the Tax Policy Center, has analyzed Mr. Romney’s tax proposal. It found that, compared with current policy, the proposal would actually raise taxes on the poorest 20 percent of Americans, while imposing drastic cuts in programs like Medicaid that provide a safety net for the less fortunate. (Although right-wingers like to portray Medicaid as a giveaway to the lazy, the bulk of its money goes to children, disabled, and the elderly.)

But the richest 1 percent would receive large tax cuts — and the richest 0.1 percent would do even better, with the average member of this elite group paying $1.1 million a year less in taxes than he or she would if the high-end Bush tax cuts are allowed to expire.

There’s one more thing you should know about the Republican proposals: Not only are they fiscally irresponsible and tilted heavily against working Americans, they’re also terrible policy for a nation suffering from a depressed economy in the short run even as it faces long-run budget problems.

Put it this way: Are you worried about a “Greek-style collapse”? Well, these plans would slash spending in the near term, emulating Europe’s catastrophic austerity, even while locking in budget-busting tax cuts for the future.

The question now is whether someone offering this toxic combination of irresponsibility, class warfare, and hypocrisy can actually be elected president.

 

By: Paul Krugman, Op-Ed Columnist, The New York Times, March 1, 2012

March 2, 2012 Posted by | Election 2012, GOP Presidential Candidates | , , , , , , , | 2 Comments

“Not So High Standards Of Conduct”: Federal Judge’s Racist Email May Have Violated U.S. Ethics Code

A racist email sent around by Richard Cebull, the chief US district court judge in Montana, not only showed blatant disrespect for the president of the United States but also may have broken federal ethics rules. Cebull, who was appointed to the court by George W. Bush in 2001 and became chief judge in 2008, appears to have violated the US Code of Judicial Conduct on at least one count with his behavior, legal experts say.

Cebull sent the nasty email about President Obama on Feb. 20  to six of his “old buddies,” as he put it. The subject line read: “A MOM’S MEMORY.” He used his official court email account, according to the Great Falls Tribune, which first exposed the email on Wednesday. “Normally I don’t send or forward a lot of these,” he wrote, “but even by my standards, it was a bit touching. I want all of my friends to feel what I felt when I read this. Hope it touches your heart like it did mine.” The enclosed “joke”—suggesting that the racially mixed president is the spawn of a dog—read:

“A little boy said to his mother; ‘Mommy, how come I’m black and you’re white?’

“His mother replied, ‘Don’t even go there Barack! From what I can remember about that party, you’re lucky you don’t bark!'”

Cebull denies he’s a racist, and says that the email wasn’t intended to be public. But on Wednesday he admitted publicly that the email was both racist and motivated by partisan politics. “The only reason I can explain it to you is I am not a fan of our president, but this goes beyond not being a fan,” he said. “I didn’t send it as racist, although that’s what it is. I sent it out because it’s anti-Obama.”

The US Code of Judicial Conduct mandates that a judge “should personally observe high standards of conduct so that the integrity and independence of the Judiciary are preserved.” It also says that a judge “should avoid impropriety and the appearance of impropriety in all activities”—which applies to both professional and personal conduct. With regard to politics, it says judges “should refrain from partisan political activity” and “should not publicly endorse or oppose a partisan political organization or candidate.”

Where to draw the line between appropriate and inappropriate speech by judges is a complicated matter, says Jeffrey M. Shaman, a judicial ethics expert at DePaul University College of Law. But there seems to be little doubt that Cebull crossed over the line. “Offensive, racist speech such as this clearly diminishes public confidence in the integrity and impartiality of the judiciary, and therefore should be considered a violation of the Code of Judicial Conduct,” Shaman told me. “Judge Cebull ought to know better, and his circulation of such a disgusting message makes one wonder if he is competent to serve as a judge.”

What might the consequences be for Cebull?

“While I certainly see why this type of joke raises serious and legitimate concerns, I am not convinced that it warrants punishment beyond the current (and justified) public criticism,” wrote George Washington University legal scholar Jonathan Turley on Thursday. “The judge is claiming that he thought he was sending this to a handful of friends. It would be akin to a bad joke at a party being repeated later.”

Turley notes that in 2009 a judicial council cleared Chief Judge Alex  Kozinski of the 9th US Circuit Court of wrongdoing after an  investigation into sexually explicit materials (involving farm animals)  found on the judge’s personal website. But the council did officially find that  Kozinski had acted with “carelessness” and was “judicially imprudent.”

In Cebull’s case, Turley concedes that the Montana judge clearly  failed to adhere to a tenet of the Code of Judicial Ethics, that a judge “must  expect to be the subject of constant public scrutiny and accept freely  and willingly restrictions that might be viewed as burdensome by the  ordinary citizen.”

Shaman sees a serious offense. “It is very difficult to predict what  sanctions a reviewing authority will apply in any given case,” he says.  “But I certainly think that at least a reprimand is appropriate here.”

Update, 3pm PST: AP reports that the 9th U.S. Circuit Court of Appeals will carry out a judicial misconduct review. The complaint process apparently was initiated by Cebull himself, who says he also plans to send President Obama a formal apology.

By: Mark Follman, Mother Jones, March 1, 2012

March 2, 2012 Posted by | Racism | , , , , , , | Leave a comment

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