Republicans Threaten the 'Doctor-Patient
Relationship'

enlargeCredit: Washington Post

For two decades, Republican opponents of health care reform have turned to a tried if untrue talking point. In 1994, GOP strategist Bill Kristol warned that "the Clinton Plan is damaging to the quality of American medicine and to the relationship between the patient and the doctor." Twelve years later, President George W. Bush proclaimed, "Ours is a party that understands the best health care system is when the doctor-patient relationship is central to decision-making." Then in 2009, GOP spinmeister Frank Luntz told Republican obstructionists in Congress to "call for the 'protection of the personalized doctor-patient relationship.'"

Now with their ever-more aggressive nationwide crusade against Americans' reproductive rights, Republicans are determined to undermine the very doctor-patient relationship they pretend to cherish. Across the country, GOP anti-choice leaders are requiring procedures women don't need and their physicians don't want. And now in states like Arizona and Kansas, Republicans seeking to prevent abortion services are demanding doctors lie about them.

This week, the Arizona Senate voted 29 to 9 for a "wrongful birth bill" that would shield physicians from malpractice claims if they withhold vital information from their patients. As the AP explained:

Those are lawsuits that can arise if physicians don't inform pregnant women of prenatal problems that could lead to the decision to have an abortion.

But if Arizona Republicans want their state to join 9 others in encouraging that sin of omission, in Kansas anti-choice GOP legislators want doctors to participate in a sin of commission.

There, Governor Sam Brownback and his GOP allies don't merely want to raise taxes on women seeking abortions, even in cases involving sexual assault or a life-threatening pregnancy. Now, Republican legislators want state law to require that physicians mislead their patients about the non-existent link between abortion and breast cancer:

Kansas state lawmakers heard testimony this week saying there is a link between abortion and breast cancer. The testimony in front of the committee on Federal and state affairs came from Dr. Angela Lanfranchi, an oncologist specializing in breast cancer. The committee did not hear any other testimony before drafting H.B. 2598.

That link has been firmly rejected by organizations including the American Cancer Association and the National Cancer Institute, which concluded that "abortion is not associated with an increase in breast cancer." (Nonetheless, the Bush administration repeatedly claimed otherwise on federal government web sites aimed at teenagers and pregnant women. As a 2006 Congressional investigation found, 20 of 23 federally-funded "pregnancy resource centers"?facilities often affiliated with antiabortion religious groups?incorrectly told women "that abortion results in an increased risk of breast cancer, infertility and deep psychological trauma.")

But Republican governors and state legislatures aren't just requiring doctors to lie to their patients about real birth defects, bogus cancer risks and unproven claims about "fetal pain." (In Idaho, Jennie Linn McCormack was briefly charged with having an illegal abortion under that state's fetal pain law barring the procedure after 20 weeks.) Now, Texas, Virginia, Alabama, and other states are demanding that women seeking abortions undergo and pay for medically unnecessary ultra-sound tests their physicians oppose.

Even leaving aside the "forced rape" bills considered in Virginia and Alabama, Republican legislators are dictating the terms of the doctor-patient relationship with the ultra-sound laws. Recently, a Federal Appeals Court upheld Rick Perry's new statute in Texas requiring abortion providers "to show or describe an ultrasound image to a woman of her pregnancy and to play sounds of the fetal heart." As Reuters explained:

While a woman seeking an abortion can decline to view the legally required ultrasound, she cannot decline to hear the physician's description of it unless she qualifies for an exception due to rape, incest or fetal abnormality.

A coalition of medical providers sued in June to block the law, arguing that it made doctors a "mouthpiece" for the state's ideological message. The First Amendment includes protections against compelled speech.

The challengers, represented by the Center for Reproductive Rights, also argued that disclosure of the sonogram and fetal heartbeat was not "medically necessary" and therefore beyond the state's power to regulate the practice of medicine.

And in states like Virginia and Mississippi, the Republican intrusion into the doctor-patient relationship extends beyond mandating what unneeded and costly procedures must be performed, but where as well. Since in 2006, all Magnolia State facilities performing second and third trimester abortions must meet the same regulatory standards as full surgical hospitals, 36 pages of rules in all. As a result, the entire state of Mississippi, one of the poorest in the nation, now has only a single abortion clinic, the Jacksonboro Women's Health Clinic. A similar law signed in December 2011 by Governor Bob McDonnell will shutter most of the clinics providing abortion services by requiring they operate under the same regulations as ambulatory care centers:

The regulations treat abortion clinics as ambulatory surgery centers instead of doctor's offices, as they have been classified. Clinics must meet hospital-type standards mandating the size of exam rooms and the width of hallways. The regulations also establish new requirements for inspections, medical procedures and record-keeping.

Behind all of these Republican attacks on the supposedly sacred doctor-patient relationship is an arrogant and paternalistic assault on the dignity and moral agency of American women. That sneering condescension is at work both when conservatives pretend to care about women's health and when they don't. After all, one of the defining moments of the 2008 presidential campaign came when John McCain used "air quotes" to mock "the health of the mother" during a debate with Barack Obama:

"Just again, the example of the eloquence of Sen. Obama. He's [for] health for the mother. You know, that's been stretched by the pro-abortion movement in America to mean almost anything. That's the extreme pro-abortion position, quote, 'health.'"

That jaw-dropping statement came a year after Supreme Court Justice Anthony Kennedy issued his shocking opinion in Gonzales v. Carhart. Kennedy put the mythical "post abortion syndrome" at the heart of his reasoning in upholding the federal ban on what Republicans deemed "partial birth abortion." As Ruth Marcus lamented, Kennedy basically decided that doctors had no right to perform the rare but medically necessary procedure because, in essence, women might get the vapors:

"Respect for human life finds an ultimate expression in the bond of love the mother has for her child," Kennedy intoned. This is one of those sentences about women's essential natures that are invariably followed by an explanation of why the right at stake needs to be limited. For the woman's own good, of course.

Kennedy continues: "While we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude some women come to regret their choice to abort the infant life they once created and sustained." No reliable data? No problem!

In the five years since, a mountain of studies (including a new analysis in the Journal of Psychiatric Research this week) has debunked Kennedy's dangerous pseudo-science about abortion and mental health. Regardless, Republicans at the federal, state and local level will continue to interpose themselves between doctor and patient when it comes to women's reproductive health.

Apparently, the conservative idea of "protecting the doctor-patient" relationship is destroying it.

(This piece also appears at Perrspectives.)

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Regular Commenters

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Business Improvement District bill before the
House; big issue for Downtown Jackson

HB 968 is on the House's general calendar, and should be called up this week.  It would remove some of the more onerous provisions of the laws that allow for the creation of business improvement districts across Mississippi.  BIDs, as they are known, are areas where property owners vote to tax themselves for improvements and services provided within the district.  Downtown Jackson Partners runs the Downtown Jackson BID, providing additional security, beautification, community-building, and marketing efforts on top of those provided by the City of Jackson.  DJP has been successful, and was recently reauthorized by Downtown Jackson property owners.

The current legislation is onerous, though, as BIDs must be reauthorized every 5 years by 70% of property owners.  And that's 70% of all property owners, not just those choosing to vote. HB 968 would lower the required majority to 60% of the participating property owners, and extend the re-authorization period from 5 years to 10 years.

This is good legislation, as many areas in Mississippi that would benefit from BIDs are dealing with absentee landlords who refuse to participate in the process.  DJP has worked wonders for Downtown Jackson, and other areas of the state could benefit from similar entities.  Here's hoping HB 968 makes its way through the Legislature.

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Mexicos Silver Mines Shine: Mexico Mike
Kachanovsky

The Gold Report: Last September, you predicted gold would rise above $2,000/ounce (oz) by the end of the year. It didn’t quite get there. What do you see as a price limit now?

Mike Kachanovsky: I also suggested that silver would hit $50/oz before the end of last year. I was dead wrong on that prediction as well. But my outlook hasn’t changed. It’s difficult to put a specific timeline on price trends. It’s more important to have confidence that the factors that have contributed to the rise in both gold and silver prices for the last decade are still in effect. What we can accurately predict is how factors driving these prices will play out, while sometimes delays . . . → Read More: Mexico’s Silver Mines Shine: ‘Mexico Mike’ Kachanovsky

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‘Jobs Gap’ Stands At 11 Million

According to new estimates from the Brookings Hamilton Project, the nation’s “jobs gap” — the number of jobs necessary to get back to pre-recession level of unemployment — now stands at about 11 million. This includes five million jobs still lost from the Great Recession and six million for new entrants into the labor force. “At a job creation rate of 208,000 per month (the average rate for the best year of job creation in the 2000s), it will take until 2020 to close the jobs gap,” Brookings founds.

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Update: Dunkerton, Iowa School Superintendent Has
Action Plan After Anti-Gay School Performance

Last week, ThinkProgress LGBT reported that an Iowa public school accidentally invited an anti-gay band affiliated with Bradlee Dean’s You Can Run, But You Cannot Hide, a “designated hate group, to perform at a school assembly. Today, the school district’s superintendent told TPM that such a performance “will never happen again.” He pledged an “action plan” consisting of creating a committee to pre-screen all future school performances, making counseling available for students, and trying to recover the money paid to the hate group’s band.

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Reid Will File To End Seventeen GOP Filibusters
Of President Obama’s Judicial Nominees

Senate Majority Leader Harry Reid (D-NV) announced this afternoon that he will file cloture — the Senate procedure to break a filibuster — on seventeen judicial nominees currently being blocked by Republican obstructionism. Nearly all of these nominees were either unanimously approved in the Senate Judiciary Committee or were approved with Sen. Mike Lee (R-UT) as the only objection. Lee, of course, promised to block all of President Obama’s nominees and he also believes that Medicare and Social Security are unconstitutional.

Unfortunately, however, there is good reason to fear that the Senate’s Republicans will continue to obstruct these nominees, or at least force the Senate to waste days and days debating them. From the minute President Obama took office, obstruction of judicial nominees skyrocketed — the average Obama nominee must wait nearly four times as long for a vote as the average nominee at this point in the Bush presidency:

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Obama Administration Sets Final Rule For Health
Insurance Exchanges, With Substantial Flexibility For The States

The Obama administration and Department of Health and Human Services (HHS) has released the long-awaited “final rule” to assist states in establishing and operating Affordable Health Insurance Exchanges that will better serve their residents and get health plans interested in participating. The exchanges, when in full effect, will level the playing field for millions of American consumers and small businesses who are currently in the market to buy coverage, while driving down costs through competition.

The new rule is an incorporation and extension of provisions included within two separate proposed rules issued in 2011 that are “referred to collectively as the Exchange establishment and eligibility proposed rules.” Under the new standards, states are permitted to run exchanges through existing state-operated agencies or through non-profits established by the states, and states are given freedom to determine what role agents and brokers may have in the sale of insurance. States can open their exchanges to all insurers and health plans or place limits on the number of plans made available to consumers, and lastly, states are allowed to permit larger employers to particpate in their Small Business Health Options Programs (SHOP).

A few more elements included in the guidelines:

- States can receive conditional federal approval for their exchanges if their plans are far along but not final by Jan. 1, 2013. States can operate exchanges in partnership with other states. The federal government will provide funding for different types of exchanges to allow for flexibility.

- The state exchanges themselves will determine the number and type of health plans offered to consumers, within broad standards set by the federal government. Plans will have to comply with marketing rules to ensure they are not trying to cherry-pick the healthiest customers in the state.

- Consumers will be able to apply online for coverage in their state exchanges. To reduce paperwork, exchanges will rely on existing computer databases to verify basic personal information and eligibility. However, some key details, such as whether the consumer is a legal resident of the U.S., may have to be verified by the government. And the IRS will have final say on tax credits.

- Exchanges will be able to pick from two federally approved methods for coordinating with the Medicaid program in their states.

- Exchanges will be able to use intermediaries called “navigators” to help educate consumers and small businesses about how the new system works.

States are supposed to have their proposed exchange programs approved by HHS no later than January 1, 2013. Federal officials will set up and operate exchanges in states that refuse to comply. According to the most recent progress report released by the Obama administration, at least 28 states and the District of Columbia were already “on their way toward establishing their own Affordable Insurance Exchange,” with several more having expressed interest in setting up exchanges of their own. Two states already “had Exchange-like structures in place before the Affordable Care Act was enacted.” Utah will maintain its current insurance portal as-is, and Massachusetts is preparing to align its program with the ACA. The exchanges are slated to become fully operational by January 1, 2014.

– Fatima Najiy

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Making Sense Of The LGBT Community’s High
Rates Of Substance Use

Our guest blogger is Jerome Hunt, Research Associate for LGBT Progress.

Last week, the Center for American Progress released a new issue brief on “Why the Gay and Transgender Population Experiences Higher Rates of Substance Use” and what can be done to reduce these rates.  Specifically, the brief mentions that an estimated 20 to 30 percent of gay and transgender people abuse substances, compared to about 9 percent of the general population.

According to the brief, there are three main factors that contribute to these higher rates of substance use in the gay and transgender population.  The first factor is minority stress that comes from social prejudice and discriminatory laws in everyday life such as employment, relationship recognition, and health care.  Second, the lack of cultural competency in the health care system not only discourages gay and transgender individuals from seeking treatment, but can lead to inappropriate or irrelevant service.  Finally, targeted marketing by alcohol and tobacco companies are exploiting the fact that bars and clubs are not only safe spaces for socialization for gay and transgender individuals but provide easy access to tobacco products and alcohol.

As a result, gay and transgender people turn to tobacco, alcohol, and other substances as a way to cope with the challenges. The data that are available about substance abuse show just how much of an impact this is having on the gay and transgender population.  For example, gay and transgender people smoke tobacco up to 200 percent more than their heterosexual counterparts.  Additionally, twenty five percent of gay and transgender people abuse alcohol, compared to 5 to 10 percent of the general population.

The brief also mentions a number of administrative and legislative recommendations that if employed could help to reduce the high rates of substance abuse within the gay and transgender population, including several outlined by the Center for American Progress last year that the Department of Health and Human Services could take.   The legislative recommendations included the passage of the Employment Non-Discrimination Act (ENDA), the Housing Opportunities Made Equal Act, The Respect for Marriage Act, and the Health Equality Act.

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Inhofe: It Is ‘Arrogance Of People To Think
That We … Would Be Able To Change’ What God Is Doing With The Climate

Sen. James Inhofe (R-OK) told the Voice of Christian Youth America that God controls the climate, not humans.

Promoting his book The Greatest Hoax: How the Global Warming Conspiracy Threatens Your Future, Inhofe said:

Well actually the Genesis 8:22 that I use in there is that ?as long as the earth remains there will be springtime and harvest, cold and heat, winter and summer, day and night.? My point is, God?s still up there. The arrogance of people to think that we, human beings, would be able to change what He is doing in the climate is to me outrageous.

As TP Green points out:

Inhofe went on to attack evangelical leader Rich Cizik, the former Vice President of the National Association of Evangelicals, who has made the religious case for fighting climate change pollution. Inhofe said Cizik has been ?exposed as a liberal? and that he is like idolatrous Romans described in the Bible as those who ?give up the truth about God for a lie.?

In the interview, Inhofe did not mention he has received $1,352,523 in campaign contributions from the oil and gas industry, including $90,950 from Koch Industries.

VCY America also argues that Obama?s birth certificate is a fraud, Muslim extremists have infiltrated the federal government, and that the United Nations has engineered the Agenda 21 program to transform human society through population control and energy use.

(H/T Right Wing Watch)

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