Good news

I guess this is what my research methods professor meant when he was talking about regression toward the mean. There is so much back-asswardness left over, health and science wise, from the last administration that it seems like Obama is really churning out a lot of liberal policies when, in actuality, his policies are just righting some wrongs and supporting evidence and better outcomes.

Here is a good example: A federal court ruled the FDA was wrong when it dragged its feet over approving OTC (over the counter) availability of Emergency Contraception (EC). It will now be available to 17 year olds (good!). This was something that was recommended by the FDA’s own panel of doctors advised that it be available OTC for all ages way back in 2003. We are getting there. Slowly.

My conscience clause comment

My comment to the Department of Health regarding the proposed rescission of the Bush era conscience rule. For information on making your own comment, please visit Rachel at Women’s Health News.

This comment is in regards to the rescission proposal.
I am a medical student, a future ob/gyn, a mother, and a concerned citizen. I think there was no current need for the new conscience clause ruling. The former HHS secretary, Mike Leavitt, purposefully mischaracterized the state of licensing for ob/gyns in order to forward a political ideology. The American Board of Obstetrics and Gynecology publicly demanded that the HHS show even one case of discrimination against a practitioner who exercised his or her right to refuse to participate in an abortion, and Secretary Leavitt was unable to produce even a single example.

The Obama administration states that it is committed to changing the unfortunate recent history of overlooking science and truth in order to advance political ideology in health policy. In fact, most of these decisions have been based on opinions that only represent a minority ideological belief of the citizenry. The rescission of this ruling is imperative to reestablish faith in our national health policy.

The current conscience legislation is already too overreaching. I am concerned that requiring health care entities to pre-certify that they do not discriminate in hiring, specific to conscience refusal, will hamper the ability of certain organizations to fulfill their mission statements. For example, in my high risk area, South Florida, the Department of Health has family planning clinics established and funded for the sole purpose of providing birth control to the underserved. With the climate encouraged by this recent legislation, it is entirely plausible that these facilities would be forced to hire employees that are opposed to birth control.

In fact, some sections of the rule do not refer to abortion at all, and could be construed to apply to any practice that a potential employee finds unethical. Birth control is not abortion according to medical definitions of pregnancy and the methods of action of birth control, but many extremists see forms of birth control as abortion, and the law caters to such a worldview. How long until observant Christian Scientists are applying for jobs at surgery centers with the intent of obstructing surgical procedures? It seems like this rule is likely to increase costly lawsuits. It also seems like health care entities will be almost forced to hire employees that will expressly NOT fulfill their job duties in order to avoid such lawsuits. Where is the pressing need to increase such lawsuits? In actuality, there is a pressing need for more abortion providers and more contraception access, not less. There is a pressing need to reduce health costs, not increase them. There is a need to increase common ground, not accentuate difference and encourage uncooperation when there is already more than adequate provisions protecting conscientious objection in health care.

Rescission

Well, I thought I was only going to be learning new words in medical school. But, here comes the proposal for the “rescission” (I guess that is the act of rescinding?) of the so-called conscience rule that was passed at the end of the Bush administration. The new Department of Health and Human Services (HHS) has released the text of the proposal to rescind the rule.

The recommendation for rescission will be released officially on Tuesday, and the 30 day comment period will begin at that point. I know misinformation is already being spread that this proposal will lead to health care practitioners being fired for refusing to perform abortions. The Christian Medical and Dental Association (CMDA) at my medical school sent out a letter saying just that to its members, and urged them to comment.

I will be posting a link for comment when it is available.

I have to be honest, it is hard to get worked up after reading the proposed rescission or the original rule. It is really a bunch of posturing about multiple previous laws and statutes. The main issue I have with the recently adopted rule is the requirement of health care entities that receive department funds to provide written certification that they will and do not discriminate in employment against people who would exercise a conscience objection to a procedure. It also mentions posting information at these workplaces, much like you see posters describing worker’s compensation rules by time clocks. The biggest danger I can see is in its excessive and vague repetition of what is objectionable. At several points it does not even mention abortion specifically, and these sections of the rule could easily be taken out of context and be used to support costly lawsuits by people who are opposed to many other aspects of health care, from contraception (very plausible) to surgery (not as likely, but still entirely possible).

What I see this doing is further polarizing the two sides of the debate. Eight years of radical anti choice policies by the Bush administration has pushed the conversation about a myriad of reproductive health issues to the far right. The significant need claimed in the Bush HHS rule is nonexistent, but it has succeeded in making a bunch of anti-choice advocates think there is a significant need for this legislation. The American Board of Obstetrics and Gynecology (ABOG), the licensing group for ob/gyns in the United States, was supposedly the reason why former HHS Secretary Leavitt felt the need to create this new legislation. In a released letter (pdf) to Leavitt late last year, ABOG states:

In none of our various communications with you and your Department have you provided the American Board of Obstetrics and Gynecology with “even one” instance of the discrimination of which you have publically (sic) accused it in your Press Release, let alone any supporting documentation. My careful and comprehensive review of the ABOG files does not disclose “even one” instance of a physician who was denied certification or recertification, or whose certification was revoked, because the ABOG allegedly required that physician, as you have charged, to violate his or her conscience by referring patients for abortions.

So, what is left is a group of radical anti-choicers who have been emboldened to fight new fronts in reproductive health as the lines move farther to the right, regardless of the actual need or ethics of such actions. Simultaneous to the origination of the new rule last year was the Pill Kills campaign. The fight for anti-choicers to try to justify to preserve this legislation fuels the fire, especially as Obama is is planning on signing an executive order on Monday to resume funding more lines of stem cell research. I am waiting for an even further shift to the right by anti-choicers. Since all of the various conscience clause laws will still be in effect, even if this latest rule is rescinded, I am predicting the next great front will be vaccines. I would love to see some of these activists who object to vaccines that are made with embryonic tissue start getting their hardline approach to “rabies, some mumps, rubella, chickenpox, hepatitis a, smallpox (some), ipv” more popularized. Imagine if they sue because they want to be hired to work in a pediatric clinic and refuse to administer, discuss, or refer for any of these vaccines. What if they want to work in a school office but want to refuse to handle any health forms certifying that children are up to date on these vaccines?

Sigh.

Reversal of misfortune

I was happy to hear on NPR today that the Obama administration is finally getting around to reversing the Bush administration’s so called “conscience clause”. Unfortunately, it is hard to discuss the nuanced details of the HHS rule in soundbites. NPR failed to do this well when introducing the story and on their main page, by describing the rule by using this tag line: “The “conscience clause” allowed health care workers to decline to participate in abortions and other services.”

I have to give NPR credit, they did do a good job covering the issue in the full coverage. They pointed out that conscience exceptions have been protected for more than 30 years. They also pointed out (on the radio but not in this article) that the new rule permits people to anyone even tangentially related to the delivery of health care (including cashiers, receptionists and janitors) to refuse give information or referrals to care by someone who is not religiously opposed to whatever health care that person is opposed to, whether it be fertility treatment, contraception, abortion, blood transfusions, HIV drugs, you name it.

And, health care delivery systems have to certify that they are not discriminating against any people with religious objections to any medical treatment in hiring to receive any federal funds, like Medicare or Medicaid. So, theoretically, if Christian Scientists applied to work at a surgery center, they wouldn’t be able to discriminate against them in hiring. If they refused to do any sort of surgery, participate or facilitate any sort of surgery, and refused to refer to another staff member or another facility or even give any sort of information about surgery, they could not be fired or the facility would be discriminatory. In fact, if they were not hired, the surgery center would be open to loss of federal funds and reimbursement, and costly lawsuits. This certification of hiring people who would most certainly refuse to perform their job description was not mentioned in the NPR coverage, or most other coverage.

Rachel Maddow said this fails her “Amish bus driver” test today on her show. I was thrilled that she mentioned the words “contraception” and “abortion” in her coverage of the story. I love her to death, but I wrote her a letter recently complaining about her lack of coverage of reproductive rights issues. Glad she represented today.

Linky dinky doo

I haven’t had time to post recently, but I have been reading lots of great stuff on the interwebs.

Time magazine has published an article called The Trouble with Repeat Cesareans. (H/t Rixa at Stand and Deliver) The author also has a post up at Huffington Post entitled Childbirth Without Choice. Even better than these two wonderful articles, The International Cesarean Awareness Network (ICAN) has a new database of VBAC policies in US hospitals. What a fantastic resource.

Rachel at Women’s Health News spearheaded a lot of concern when she posted about a proposed bill in Tennessee to drug test women under a dizzying array of mom blaming reasons. I was very happy with the flurry of outrage and support on the feminist sites. I think pregnancy issues, especially ones that involve having a baby, not preventing one, don’t get adequate attention on many of these sites. The National Advocates for Pregnant Women generally have good information on the issue of drug testing and subsequent imprisonment of pregnant women.

Edited to add: Rachel has expanded on her discussion of this topic with a brilliant post examining the many troubling aspects of forced drug testing on select pregnant women.

The National Family Planning and Reproductive Health Association has a post up about a resolution being introduced to include *gasp* women’s reproductive health issues to the national debate on health care reform. It would be symbolic, but hey, it’s a symbol we need. I am sick of women’s reproductive issues being dropped like a hot potato any time someone points out that it is controversial. (I’m looking at you, Obama.) I had a discussion with the lobbying arm of the American Osteopathic Association during a presentation on grassroots activism at our school. She told me that they don’t advocate for women’s reproductive health issues because it is controversial. She pointed out to me there are lobbying groups specifically set up to oppose such legislation. I asked her why that wouldn’t make it more important for them to advocate for women’s issues? I also asked her who is going to defend women’s health care if groups representing physicians won’t. She also said they don’t really do anything regarding Medicaid. I was pretty disappointed with this presentation, to say the least. It should have been called “Grassroots activism for those where the grass is already greener.”

I loved this post on Shakesville with book recommendations for coming of age boys. Thanks! Again, impressed with the parenting style coverage from a site that normally caters more to the childless and gay men.

Finally, on a non health related item, there is the issue of horrific, racist political cartoon comparing Obama to a gunned down monkey. As usual, Ill Doctrine has a good analysis of the many problematic angles of this story. I am saddened by how non progressive some of his commenters are. It is very clear that the context of the rag, the New York Post, paints the stimulus as Obama’s stimulus. In fact, that same day, on the previous page, there was a huge picture of Obama’s face next to headlines criticizing the stimulus package. And, the same cartoonist has published previous cartoons with Obama standing at a pad presenting his stimulus bill. Racist apologists who try to nitpick that the author of the bill wasn’t literally Obama make me ill. (No offense, Jay Smooth, for the use of the word ill.)

Email and reply

From my uncle:

The financial crisis explained in simple terms:
Heidi is the proprietor of a bar in Berlin. In order to increase sales, she decides to allow her loyal customers – most of whom are unemployed alcoholics – to drink now but pay later. She keeps track of the drinks consumed on a ledger (thereby granting the customers loans).

Word gets around and as a result increasing numbers of customers flood into Heidi’s bar.

Taking advantage of her customers’ freedom from immediate payment constraints, Heidi increases her prices for wine and beer, the most-consumed beverages. Her sales volume increases massively.

A young and dynamic customer service consultant at the local bank recognizes these customer debts as valuable future assets and increases Heidi’s borrowing limit.

He sees no reason for undue concern since he has the debts of the alcoholics as collateral.

At the bank’s corporate headquarters, expert bankers transform these customer assets into DRINKBONDS, ALKBONDS and PUKEBONDS. These
securities are then traded on markets worldwide. No one really understands what these abbreviations mean and how the securities are guaranteed. Nevertheless, as their prices continuously climb, the securities become top-selling items.

One day, although the prices are still climbing, a risk manager (subsequently of course fired due his negativity) of the bank decides that slowly the time has come to demand payment of the debts incurred by the drinkers at Heidi’s bar.

However they cannot pay back the debts.

Heidi cannot fulfil her loan obligations and claims bankruptcy.

DRINKBOND and ALKBOND drop in price by 95 %. PUKEBOND performs better, stabilizing in price after dropping by 80%.

The suppliers of Heidi’s bar, having granted her generous payment due dates and having invested in the securities are faced with a new situation. Her wine supplier claims bankruptcy, her beer supplier is taken over by a competitor.

The bank is saved by the Government following dramatic round-the-clock consultations by leaders from the governing political parties.

The funds required for this purpose are obtained by a tax levied on the non-drinkers.

Finally an explanation I understand …

My reply:

This is the second email I have received comparing people who are having their homes foreclosed on to alcoholics. This is after 8 years of our country spending money like a drunken sailor. If my husband, a sober schoolteacher, gets laid off this year as threatened, we will most likely have to default on our home loan. The stimulus package is giving 8 billion to the school districts in our state, and his job may be saved. I am very grateful. Teachers have already been laid off at my mother’s school. My older brother worked for Lehman Brothers, and his position closing out that company will end soon. The stimulus package has provisions so he can get help paying COBRA payments to keep health insurance for his family, including his son with a health condition. This kind of hostile email is only serving to divide our nation even more. With unemployment rates rising to 10% and more, it’s getting pretty pathetic to continue pretending this is an us and them world. The unemployed alcoholics you non drinkers complain about may be your own family members.

Please take me off of your email list.

I also got an email from my cousin (from the other side of my entitled, privileged, conservative family) comparing income taxes to a rich guy coming and buying drinks for a bunch of unemployed drunks every night. The moral twist: What if he doesn’t show up to buy them drinks the next night? Then who will pay for them?

I wrote a similar reply.

Bursting with pride

I am so proud to be included as an ally in the wonderful Tell it WOC Speak blog carnival. Renee of Womanist Musings is a radical’s radical, a blogger’s blogger, and, dare I say, a feminist’s womanist. She is fiercely intelligent and, I am guessing, very picky. I am very proud that my post on teen births rates being up, and the analysis of the rise being blatantly racist, was included.

Please go check out the entire “Hear us roar” carnival of posts.

Attempted reply turned post, Malthus style

I tried to reply on a ridiculous Wall Street Journal editorial, “Speaker Nancy Malthus“. This editorial was written in response to the proposal to include funding for contraception under Medicaid in the stimulus package, which was projected to save hundreds of millions of dollars in state and federal funds. If you are unfamiliar with the philosopher Malthus, he advocated population control in order to prevent competition over resources. He complained that people produced geometrically, while resources like food increased arithmetically.

I tried to reply to the editorial (which I now see was published in late January) but I was informed that the topic is locked. Not sure why RH Reality Check waited until now to get me all riled up about it.

Here is my attempted reply:

“First of all, I think the premise that Speaker Pelosi thinks we should be controlling the number of offspring women have due to limited resources, a la Malthus, is ridiculous. Speaker Pelosi has five children herself.

Secondly, as a future ob/gyn, I know I will be able to serve more patients and hire more personnel if I can provide birth control to women and be reimbursed adequately by Medicaid. It will prevent UNPLANNED pregnancies, not control the population in some sinister way. 50% of pregnancies in the United States are unplanned. Poor women are much more likely to have unplanned pregnancies, and more than 40% of those pregnancies end in abortion. Safe, affordable birth control with support of the federal government not only prevents these unplanned pregnancies, but decreases state spending on welfare, WIC and Medicaid.

It makes sense jobs wise for clinics and pharmacies, it makes sense for state budgets, and it makes sense for the unplanned pregnancy crisis.”

Is this a good time to point out that Rupert Murdoch, the man who also owns such journalistic endeavors as Fox News and the New York Post, bought the Wall Street Journal?

I write letters

(h/t Shakesville for the title)

I was upset to hear that one of my senators, Mel Martinez (R – FL), sponsored an amendment to the SCHIP bill that would reinstate the Global Gag Rule, aka the Mexico City Policy. Luckily it got shot down, but still.

So, I wrote him a little email.

I was disappointed to hear that you sponsored an amendment to reinstate the Global Gag Rule. As you should know as a responsible politician who would research the effects of a policy before promoting it, it does not prevent money from going to abortions at all, which is still prevented by the Hyde amendment. What it does is prevent accurate information from being given out, and restricts funding for clinics who do not perform abortions at all.

Do a simple search for “deaths global gag rule” and you will see dozens of scientific reports showing that the Global Gag Rule contributes to maternal deaths world wide, and deaths of children and full families due to unsafe abortions, increased infection and lack of access to care. Shame on you, for someone who calls himself “pro-life”, for supporting such a policy.

Well, at least he has announced he isn’t running for reelection. Good riddance.

Surprise, surprise

Wow. The Republicans unanimously voted against the stimulus package. And I thought kicking low income women to the curb was going to convince them to vote for the stimulus package. Oh wait, that wasn’t me, that was President Obama.

Let’s hope women’s reproductive rights are not the perpetual sacrificial lamb of this administration.