NEW @ THCB PRESS: Surviving Workplace Wellness. Spring 2014. Al Lewis and Vik Khanna. e-book edition. # LIGHTHOUSE Healthcare. Illuminated.

Abortion

This November, voters weighed in on an array of state ballot initiatives on health issues from medical marijuana to health care reform. Ballot outcomes by state are listed below (more after the jump).

Voters in Alabama, Montana, and Wyoming passed initiatives expressing disapproval of the Affordable Care Act, while a similar initiative in Florida garnered a majority of the vote but failed to pass under the state’s supermajority voting requirement. Missouri voters passed a ballot initiative prohibiting the state executive branch from establishing a health insurance exchange, leaving this task to the federal government or state legislature.

Florida voters defeated a measure that would have prohibited the use of state funds for abortions, while Montana voters passed a parental notification requirement for minors seeking abortions (with a judicial waiver provision).

Perhaps surprisingly, California voters failed to pass a law requiring mandatory labeling of genetically engineered food. Several states legalized medical marijuana, while Arkansas voters struck down a medical marijuana initiative and Montana voters made existing medical marijuana laws more restrictive.

Colorado and Washington legalized all marijuana use, while a similar measure failed in Oregon.

Physician-assisted suicide was barely defeated in Massachusetts (51% to 49%), while North Dakotans banned smoking in indoor workplaces. Michigan voters failed to pass an initiative increasing the regulation of home health workers, while Louisiana voters prohibited the appropriation of state Medicaid trust funds for other purposes.

Continue reading “Roundup of State Ballot Initiatives on Health Issues”

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Do you hate abortion? Me too. Every form of the procedure sickens me, and has since the first one I ever heard about, when I was 10 years old.

My mother had come home early, distraught and bathed in tears, from her job as a teacher in a special high school for pregnant teenagers. Her school had let out early, following the news that a 15-year-old student had just died in the hospital from sepsis, a few hours after delivering a second-trimester, stillborn fetus she had impaled the night before with a knitting needle. It was 1972, a year before Roe vs. Wade.

No, it was not appropriate to explain abortion to a 10-year-old. And perhaps it was my overexposure as a child to the nasty realities of the world that continues to inspire my utter impatience with the nonsense running out of some peoples’ mouths, in particular moralizing politicians who are probably cheating on their wives, but that’s another story. The starkness and radicalization of my upbringing gave me a hair-trigger for spotting and calling out hypocrisy and collective self-delusion – especially when both are so obvious, no one else in the room seems to see them.

To wit: those who claim to be “pro-life,” whatever the hell that means, should get real about how the real world works. The “pro-lifers” in Congress leading the charge to dismantle Planned Parenthood should try listening to their own rhetoric about the inexorable power of market forces. Demand will always seek and find supply; and as demand for abortions will never go away on its own, neither will those who “supply” them, be they overseas physicians for the wealthy, discreet, chart-buffing physicians for the middle class, back-alley butchers for the poor, or desperate, do-it-yourself teenagers. Anyone who thinks I am kidding – and who has not had the benefit of an OB/GYN rotation in a public hospital and/or a politically furious mother with poor boundaries – should read or watch the blistering Revolutionary Road through to its bloody end. Continue reading “The Other Scarlet Letter”

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Mark-Mellman-resized A few months ago, I warned that some folks were attempting to misuse healthcare reform to restrict access to abortion. They have come a long way since then, endangering the vital struggle for healthcare — indeed, torpedoing reform is a key goal for many involved in this effort.

Americans oppose using abortion as a means of derailing health care reform and oppose using health care reform as a means of restricting abortion. The more voters find out about what is happening on Capitol Hill with respect to this issue, the angrier they are getting, because language inserted in the House bill will take away coverage for abortion that tens of millions of women already have.

Taking away existing coverage not only violates the public will, but also does fundamental violence to Democrats’ explicit promise that if you like what you have, you will be able to keep it.

Continue reading “Voters Want Abortion-Neutral Health Care Reform”

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MelissaReed resized

The House vote to establish near-universal health-care coverage came at a steep cost to women. That cost, issued as an amendment by Rep. Bart Stupak (D-Mich.), eliminates abortion coverage by private insurance companies even when women are paying for all or most of the premium.

Stupak’s amendment is a cynical attempt to push an anti-choice agenda that imperils badly needed reform. His amendment restricts women’s access to abortion coverage in the private health insurance market as well as in a “public option,” undermining the ability of women to purchase private health plans that cover abortion. It reaches much further than the Hyde Amendment, which has prohibited public funding of abortion in most instances since 1977. Continue reading “Abortion Should Not Imperil Health Care Reform”

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Al LewisBy Al LEWIS

Let us start by acknowledging that those who think abortion is a sin must be respected, and not forced into a risk pool that covers abortion. Let us also acknowledge that those who are pro-choice need to acknowledge that abortion (except in the case of rape or incest or potential significant harm to the mother) is a personal choice (albeit usually as a result of an accident) rather than a health issue in the narrow sense of the word.

Therefore, leaving all the politics aside and just focusing on the question of what should be covered in a basic benefit, it is not unreasonable to require an actuarially appropriate rider to cover abortion.

What would that “actuarially appropriate rider” be? Probably only a dollar or two a month to begin with. Figure that there are 800,000 abortions per year. They cost maybe $1000 apiece. That’s $800,000,000. Divided by the 21-65 year-old health-insurance-buying population, we are talking about roughly $4/year. Next, figure some self-selection into the rider, so that people with the rider might, on average, think they have (for instance) three times the probability of an unwanted pregnancy than people without the rider, which is why they get the rider. Therefore their likelihood of abortion is three times higher than the average on which the above calculation was based. So that $4 becomes $12/year or $1/month, to begin with.

Continue reading “Abortion Coverage Is About Math As Well As Politics”

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It does seem to take a health care bill to remind us all how incredibly screwed up the political process is in these here United States. The Medicare Modernization Act was railroaded through by Tom Delay and friends using all their charm and finesse. And last night the House passed its version of the health reform bill. It includes employer mandates, exchanges, subsidies, public option and taxes on those earning more than $500,000 to close the cost gap. And CBO in its wisdom says that it doesn’t increase the deficit.But it didn’t pass by much. 40 Democrats opposed it. These were the Blue Doggers who needed some political cover to be able to say in 2010 that they were against the bill before they were for it. Their expected course of action is that a less liberal bill comes back from final conference with the Senate which they can support. Apparently out there in purple state land uninsurance and egregious health plan behavior are not a problem—at least not compared to the desire of the people to protect the incomes of those earning over $500,000 a year.

But in order to stop even more Democrats opposing it at the last moment Pelosi had to let some previously unheard of Congressman called Stupak become the mouthpiece of the Catholic Bishops who decided that they needed to impose their views about reproductive medical care into the debate. Cynics like me may wonder about the validity of views on that issue from a bunch of old men who’ve allegedly never been married or had sex with a woman, and whose main contribution to child welfare over the past few decades has been to ignore and assist in flagrant abuses of it by their colleagues. But no matter, over recent days they started putting pressure on various Democrats to tighten restriction on Federal funding of abortion. Continue reading “Modest step in the reform journey shows the idiocy of our political system”

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