“Unlicensed Doctors”: Politicians Swinging Stethoscopes
Let’s take a look at sex and state legislatures.
Never a good combo. Lawmakers venture into murky waters when they attempt to deal with the mysteries of human reproduction. The results are generally short of scientific. Once, when I was covering the Connecticut House of Representatives, a bill introduced at the behest of professional musicians, “An Act Concerning Rhythm Machines,” was referred to the Public Health Committee under the assumption that it was about birth control.
That was a long time ago, but a definite high note. Normally when these matters come up in a state capitol, the result is not chuckles.
New Hampshire, for instance, seems to have developed a thing for linking sex and malignant disease. This week, the State House passed a bill that required that women who want to terminate a pregnancy be informed that abortions were linked to “an increased risk of breast cancer.”
As Terie Norelli, the minority leader, put it, the Legislature is attempting to make it a felony for a doctor “to not give a patient inaccurate information.”
And there’s more. One of the sponsors, Representative Jeanine Notter, recently asked a colleague whether he would be interested, “as a man,” to know that there was a study “that links the pill to prostate cancer.”
This was at a hearing on a bill to give employers a religious exemption from covering contraception in health care plans. The article Notter appeared to be referring to simply found that nations with high use of birth control pills among women also tended to have high rates of prostate cancer among men. Nobody claimed that this meant there was scientific evidence of a connection. You could also possibly discover that nations with the lowest per capita number of ferrets have a higher rate of prostate cancer.
Bringing the prostate into the fight was definitely a new wrinkle. But it’s getting very popular to try to legislate an abortion-breast cancer link. I suspect this is at least in part because politicians in some states are being forced to stretch to find new ways to torture women who want to end an unwanted pregnancy. It’s sort of like gun control — once your state already has guaranteed the right to wear concealed weapons into bars and churches, you’re going to have to start getting really creative to reaffirm a commitment to the Second Amendment.
Last year, South Dakota — which has a grand total of one abortion provider — instituted a 72-hour waiting period, plus a requirement that the woman undergo a lecture at one of the state’s anti-abortion pregnancy counseling centers.
This law is tied up by litigation. While they’re waiting, the legislators have improved upon their work, requiring the doctor to ask his patient — who may have already traveled for hours, waited for three days and gone through the counseling center harangue — questions including what her religious background is and how she thinks her family might react to the decision to end the pregnancy.
“South Dakota has taken the I.R.S. audit model and applied it to women’s reproduction,” said Ted Miller of Naral Pro-Choice America.
But about this cancer business.
“Now we’re seeing why legislatures getting into the practice of medicine is dangerous,” said Barbara Bollier, a Republican state representative in Kansas, where a bill requiring doctors to warn abortion patients about the breast cancer connection is pending.
Bollier is a retired anesthesiologist, who also formerly taught bioethics. If you wanted to have a résumé guaranteed to drive you crazy in the Kansas State Legislature, she’s got it.
We had a very interesting discussion over the phone about good science — what makes a reliable study, and how an early suggestion of a possible connection between abortions and breast cancer was overtaken by larger, better studies that showed no evidence of a link whatsoever. All of this has been shared with the Kansas Legislature, to no effect whatsoever.
Bollier has her finger on the moral to all this. When faced with a choice between scientific evidence and their personal and political preferences, legislators are not going to go with the statistics. I have warm memories of the committee of the Texas House of Representatives that last year rejected a bill to require that public school sex education classes be “medically accurate.”
Let’s refrain from discussing how the people who are preparing to legislate medical science are often the very same ones who scream about government overreach when health experts propose taxing sugary beverages.
Just try to envision yourself in a doctor’s office for a consult. Then imagine you’re joined by a state legislator. How many of you think the situation has been improved? Can I see a show of hands?
Thought so.
By: Gail Collins, Op-Ed Columnist, The New York Times, March 16, 2012
“Irrational Actors”: Republican State Legislators Shoot Selves In Foot, Help Citizens
One of the main features of the Affordable Care Act is the creation of 50 state-based health-insurance exchanges, online marketplaces where people and small businesses will be able to easily compare competing plans and select the one they prefer. If you’re buying insurance on the individual market after the beginning of 2014 (but not if you get your insurance through your employer like most people), your state’s exchange is where you’ll go. While the federal government establishes a baseline of requirements for what plans offered through the exchange must contain, each state will determine exactly how theirs will work.
But after the ACA was passed, and especially after the 2010 election where Republicans won huge gains at the state level, a lot of states run by Republicans refused to take any action to create their exchanges. Like a Catholic bishop looking at a package of birth-control pills, they retched and turned away, not wanting to sully their hands at all with involvement in President Obama’s freedom-destroying health-care plan. But the law also provides that if a state doesn’t get around to creating its exchange, then the federal government will just do it for them.
Which is why I’ve always found the actions of Republicans on this issue puzzling. They all say they hate the federal government, and states can do things better. But in this case, they’re letting the federal government take over. Which is probably a good thing.
Let’s say you live in Arkansas. Who would you trust to create an exchange that works well and empowers consumers: a state government run by Republicans who think any government involvement in health care is vile, or the Obama administration’s Department of Health and Human Services, which has a huge reputational stake in making the Affordable Care Act work as well as possible? Well, you’re in luck, because Arkansas has explicitly refused to create an exchange. Plenty of other states with Republican-controlled legislatures have simply dragged their feet in the hopes that either the Supreme Court will strike down the ACA when it hears the case later this year, or that a Republican will win the White House in November and successfully repeal the law (this is a list of where exchanges stand in each state, if you’re curious).
Conservative health-care wonks seem to be divided on the issue. Here’s one (h/t Sarah Kliff) making exactly the case that I made—if Republicans just ignore this, it’ll be turned over to an administration they hate (I just happen to think that’s a good thing, while he doesn’t). But here’s another testifying before the New Hampshire Legislature, telling them not to do anything and hope it just goes away.
This offers a reminder, in case you needed one, that elected officials are not always rational actors. They’ll even do things that undermine the principles they hold, for reasons of emotion or pique or false hope. In this case, that means a lot of people living in Republican-dominated states will probably have access to an exchange that works substantially better than whatever their state would have set up. So it’ll be a happy ending!
By: Paul Waldman, Contributing Editor, The American Prospect, March 14, 2012
The Real Voter Fraud Scandal: Conservatives Are Trying To Restrict And Distort The Will Of The Voters
Well over a year before the 2012 presidential election, there’s a battle going on over next year’s ballots—how they’ll count and who will get to cast them. At stake is an attempt to distort the voters’ will by twisting the rule of law.
Most recently, Pennsylvania has been the focus of this battle. Dominic Pileggi, the state Senate majority leader, wants to change the way the Keystone State distributes its electoral votes, divvying them up according to how each presidential candidate performed in each congressional district, with the remaining two electoral votes going to the candidate who won the popular vote.
So while Barack Obama’s 55 percent of the vote in Pennsylvania in 2008 netted him all 21 of its electoral votes, the Pileggi plan would have shaved that figure to 11 electors. (Nationwide, Obama won 242 congressional districts while John McCain got 193.) The change would be even sharper as Pennsylvania’s new congressional map is expected to have 12 of the state’s 18 seats drawn to favor the GOP. Obama could win a majority of the Keystone vote again but only score eight of the state’s 20 electors. Do we really want to bring gerrymandering into presidential elections?
The politics here aren’t obscure: Every Democrat since Bill Clinton in 1992 has won Pennsylvania. This is a naked attempt to undercut Democratic nominees. (And while Pennsylvania would join Nebraska and Maine with such a law, Nebraska Republicans are trying to return to the unit rule after Obama won a single elector there in 2008.) But the Pennsylvania gerrymander gambit is only one aspect of a broader push to rig the game.
The 2010 elections marked a huge shift in control of state legislatures from Democrats to Republicans. The result, according to Tova Wang, a Senior Democracy Fellow at the progressive think tank Demos, has been “an attack on voting rights in this country like we haven’t seen in years and years.”
So far this year, bills have been introduced in at least 38 state legislatures designed to make it harder for Americans to exercise their right to vote. Fourteen have actually enacted such laws, according to a report released this week by the Brennan Center for Justice at New York University School of Law, which found that the new rules could make it “significantly harder for more than five million eligible voters to cast ballots in 2012.” As Rolling Stone reported recently, Kansas and Alabama, for example, now require proof of citizenship to register to vote; Florida and Texas have raised barriers to groups like the League of Women Voters conducting voter registration drives; Florida and Iowa barred ex-felons from voting, instantly removing nearly 200,000 voters from their states’ rolls; Florida, Georgia, Ohio, Tennessee, and West Virginia have cut back on early voting; and Maine repealed its law allowing citizens to register and vote on Election Day or on the two business days immediately preceding it (even though GOP Gov. Paul LePage had himself used that law to register the day before the 1982 election).
Perhaps the GOP’s most popular vote suppression tool is a set of new laws requiring voters to present photo identification before they cast ballots. Seven states—Alabama, Kansas, Rhode Island, South Carolina, Tennessee, Texas, and Wisconsin—have enacted such measures this year. At first glance this may seem reasonable. Who doesn’t have a valid photo ID? The answer may surprise you. A 2006 study by the Brennan Center found that 11 percent of U.S. citizens lack one, a figure in line with a 2005 report by an election reform federal commission which suggested 12 percent of U.S. citizens lack driver’s licenses. Drilling down, the Brennan Center found that the groups worst off in this regard tend to be core Democratic constituencies: 25 percent of voting age African-Americans and 15 percent of voting age citizens who make less than $35,000 annually lack valid photo IDs.
In Ohio, where such a law is pending, roughly 940,000 citizens lack valid IDs, according to a study by a nonpartisan voters group. Or take Wisconsin: Less than half of Milwaukee County African-Americans and Hispanics have driver’s licenses, according to a study from the University of Wisconsin-Milwaukee, and the figures are worse for younger voters. Indeed, the Wisconsin law is especially pernicious, specifically not accepting student IDs, even from state institutions. Texas’s voter ID law is even more blatant in who it’s aimed at. State gun permits are acceptable, but student IDs and government employment cards are not.
And these laws are a solution searching for a problem. Conservatives have long bemoaned the menace of voter impersonation, but the evidence for this threat is nonexistent. George W. Bush’s Justice Department spent years ferreting out voter fraud and managed to prosecute not one voter for impersonating another. “Out of the 300 million votes cast [between 2002 and 2007] federal prosecutors convicted only 86 people for voter fraud,” Rolling Stone reported. A 2007 study by the Brennan Center found the instances of voter fraud to be literally infinitesimal. “You’re more likely to get killed by lightning than commit in-person voter fraud,” says the Brennan Center’s Michael Waldman. Which only makes sense: That thousands of people are casting illegal votes in others’ names while evading determined detection (always managing to choose people who weren’t going to vote anyway) doesn’t pass the smell test.
Knock away the spurious reasons for the push to restrict voting and you’re left with bare-knuckled partisanship. “There has never been in my lifetime, since we got rid of the poll tax and all the Jim Crow burdens on voting, the determined effort to limit the franchise that we see today,” former President Bill Clinton told a group of young political activists over the summer. He’s right, and it must be fought at every level.
By: Robert Schlesinger, U. S. News and World Report, October 6, 2011
If Republicans Love States’ Rights So Much, Why Do They Want to Be President?
Whatever their differences, the leading Republican candidates all swear that they love states’ rights. If elected president, Rick Perry vows to “try to make Washington as inconsequential as I can.” Mitt Romney declares his faith in the Constitution, which, he says, declares that the government “that would deal primarily with citizens at the local level would be local and state government, not the federal government.” Michele Bachmann “respect[s] the rights of states to come up with their own answers and their own solutions to compete with one another.” With lots of help from the Tea Party, the Tenth Amendment which, not so long ago was familiar mainly to constitutional lawyers and scholars, may now be as popular as the First or the Second. But, what this resurgence of federalism overlooks is not just the historical consolidation of federal power but also the inanity of attempts to reverse it.
For most of U.S. history, the primacy of federalism was taken for granted. Except during major wars, states exerted far more power over the daily lives of their residents than did any of the three branches of a national government located in a swampy river city on the Mid-Atlantic seaboard that most Americans had never visited. In the nineteenth century, as the historian Gary Gerstle explains, states funded canals, highways, and railroads. They decided which groups could vote and which could not. Some tried to regulate working hours. Others outlawed a variety of private acts—interracial marriage, drinking, and theater-going. In 1837, Illinois even forbade “playing at ball or flying of kites” as public nuisances.
All these policies fell under the legal sanction of “the police power,” which one influential Massachusetts judge in 1851 defined broadly as insuring the “good and welfare of the Commonwealth.” For its part, the Supreme Court, until after World War I, rather consistently ruled that the celebrated protections of the Bill of Rights—from the freedom of speech and the press to the right to a speedy trial—applied only to acts by the federal government and not to those of the states.
But, by the middle of the twentieth century, this arrangement no longer served the needs or desires of most Americans. During the Great Depression, state revenues, based mainly on property taxes, plummeted. The federal government stepped in to provide relief, and citizens everywhere began to count on Washington to keep the economy afloat and their Social Security checks arriving promptly. Then World War II and the cold war bound Americans to a national-security state that financed education for veterans and interstate highways as well as aircraft carriers and nuclear weapons. In the 1960s and ’70s, Congress passed laws to safeguard the civil and voting rights of every citizen, regardless of where he or she might live. Policies to protect the environment and regulate hazards at the workplace further diminished the sway of state governments. The Supreme Court, even with a conservative majority, has done little to reverse these changes.
Yet, states’ rights never lost its appeal to that minority of Americans who are ideologically committed to lambasting the federal state as both overweening and ineffective. (It should come as no surprise that these conservatives were so alarmed at the emergency measures taken by the Bush and Obama administrations to address the financial meltdown of 2008: the formation and rapid growth of the Tea Party was the predictable result.) However, any Republican elected to the White House in 2012 will find it impossible to lead a headlong charge back to the past, and not just because of the difficulty of undoing a half-century of tradition and Supreme Court precedent.
Voters unhappy with the inability of the federal government to restore prosperity may like the sound of “states’ rights.” But how many would trust their governors and state legislators to pay their Medicare and Social Security checks on time and at current or higher levels? How many really want 50 separate immigration policies or 50 different standards for what constitutes clean air and clean water? Or the possibility that state, seeking to lure business away from its neighbors, could cut the minimum wage in half and not requiring employers to pay for overtime?
When you look more broadly at their promises, the GOP hopefuls reveal the emptiness of their own rhetoric. Bachmann, never a paragon of consistency, supports a federal constitutional amendment banning gay marriage, as well as the right of individual states to legalize it. In 2007, before Romney got in trouble for his Massachusetts health care law, he predicted, “that all these states … who follow the path that we pursued will find it’s the best path, and we’ll end up with a nation that’s taken a mandate approach.” Rick Perry favors federal action to stop gay marriage and restrict abortion—and, last month, asked President Obama to speed up aid to stop wildfires from burning up whole sections of his vast state. Like a lot of other Americans, these ambitious conservatives like to rail against Washington in the abstract but cannot imagine how the nation would operate without a strong central government. And the specifics of their smaller hypocrisies are underscored by one giant irony: They’re all running for president.
The U.S. has long ceased to be a country in which most people look to their state instead of to the national government to address and solve their most vital problems. State pride is pretty rare these days, except for residents and alumni who dress in the old-school colors and root hard for a college football or basketball team from a major public university.
Of course, state governments still perform a vital role in education and economic development and can still be “laboratories of democracy,” sites for testing out new policies that aren’t yet ready for national consumption. Progressives who cheered when New York legalized gay marriage and look forward to the day when Vermont begins operating the single-payer health care system it passed this spring can hardly object, at least in principle, when red states pass laws they abhor. But, as an alternative philosophy of governance in a modern nation, states’ rights is very wrong. In fact, it’s ridiculous.
By: Michael Kazin, The New Republic, September 20, 2011
Oh Really!: Gov Scott Walker Reports Net Gain Of 9,500 Jobs
Wisconsin added 9,500 jobs last month, in part because of a renewed focus on drawing tourists to the state, Gov.Scott Walker said Thursday.
The state added 12,900 jobs in the private sector but lost 3,400 government jobs in June, according to seasonally adjusted numbers released by the state Department of Workforce Development. The net gain of 9,500 jobs accounts for more than half the 18,000 net jobs created across the nation during the month.
The governor credited the state’s numbers to “a rebirth of tourism” following broad efforts to publicize Wisconsin’s state fairs, ethnic festivals and sporting events.
“Tourism is more than a $12 billion industry in the state of Wisconsin,” he told reporters in Milwaukee. “This is about putting people to work.”
He said he didn’t have details on which specific industries gained jobs. However, the Department of Workforce Development confirmed that almost half the private-sector growth was in the leisure and hospitality industry. There were 6,200 jobs created in that sector last month, and 3,300 more jobs than in June of last year.
A reporter asked whether the new jobs were seasonal and would be gone in several months. Walker replied that some were summer jobs but that an unspecified number would carry over into subsequent months.
“You certainly have a summer blitz when it comes to lakes and our other attractions, but you come back in the fall for hunting and you come back in the winter for snowmobiling and skiing,” he said.
When asked if the new jobs pay livable wages Walker said the job numbers released Thursday were sorted only by industry, not income. He added that his focus has always been to attract well-paying jobs.
Walker was joined at his news conference by Tourism Secretary Stephanie Klett. She said Walker’s budget increased the department’s funding by 20 percent, allocating an additional $2.5 million toward attracting visitors from other states.
“We ran a $3 million marketing campaign this summer,” she said, “and I think today with this announcement we are seeing the results in a big way.”
She said some of the new jobs were year-round positions at popular resorts.
Even though Wisconsin added nearly 10,000 jobs in June, the state’s unemployment rate actually nudged upward for the month to 7.6 percent, up 0.2 percentage points from the previous month. That’s because the job numbers and employment numbers come from two separate surveys, DWD spokesman John Dipko said in an email.
The jobs number comes from workplace data, while the unemployment rate is based on a survey of households, he said.
Unemployment figures encompass Wisconsin residents who are available for work and actively seeking jobs.
The state Democratic party said the preliminary job numbers look promising, but party chairman Mike Tate said it is important to know specifically what types of jobs were being created.
“Will these jobs support Wisconsin families or will they bolster the profits of corporations that benefit from the downward pressure on wages and benefits that comes at the hands of Scott Walker’s attack on collective bargaining?” he said in a statement.
The state’s unemployment rate has hovered around 7.4 percent for the first five months of the year. The state figure generally has been about 1.5 percentage points better than the national rate. That trend continued last month as the U.S. unemployment rate rose 0.1 percentage points to 9.2 percent.
By: Dinesh Ramde, Associated Press, July 22, 2o11
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