It’s one of the most controversial topics of the last 20 years. And before you ask, yes it is a matter of life and death.

Physician-assisted suicide is expanding in the United States. Last year after a statewide referendum, Colorado became the sixth state to allow assisted suicide, with 65 percent of Colorado voters casting a ballot in favor of the measure. According to Compassion & Choices, an advocacy group that supported the ballot initiative in Colorado, so far 10 people have received prescriptions from doctors giving them access to the life-ending drugs. So far there is no data on whether those who received prescriptions for the life-ending medication have actually gone through with the procedure.

But the practice, which was taboo to even discuss 25 years ago, enjoys a large base of support in the United States. According to Gallup, physician-assisted suicide is supported by nearly 70 percent of the population.

Just last year, California passed the End Of Life Option Act. The first analysis of the law, which the California Department of Public Health recently released, indicates that 173 doctors had prescribed life-ending drugs to 191 patients. Out of those 191 patients, 111 have used the drugs to end their lives since the law was passed in June of 2016. However, Compassion & Choices, says it knows of 500 deaths in California as of this year. We will not know the full information until California releases the data for 2017 next year.

Physician-assisted suicide is an issue that has been debated for a long time. It has been subjected to rounds of philosophical, ethical, and moral debate. But the issue came into the spotlight in the United States in the 1990s with the legal battle between the State of Michigan and Dr. Jack Kevorkian, aka “Doctor Death.”

Jack Kevorkian was a pathologist who wanted to challenge the status quo of the ethical guidelines of a doctor. He contended that if a doctor had a patient that was truly suffering in pain from a terminal or debilitating illness for which there was no cure, then why couldn’t that doctor help end their suffering? He contended that it a doctor’s moral duty to focus on the welfare of the patient, and if the option of death presented itself as a suitable form of welfare for the patient than it should be allowed.

Kevorkian invented his own “suicide machine” in 1989 and assisted over 130 patients in assisted suicide. However, the Michigan legislature made it illegal to perform an assisted suicide in 1998, but Kevorkian continued to practice and was arrested after he allowed “60 Minutes” to air a video that showed him injecting life-ending medication to a man with ALS. He was convicted in 1999 of second-degree murder and served eight years in prison.

While Kevorkian was controversial, particularly because in at least one case he administered the procedure himself, experts agree that he brought assisted suicide into the forefront of public debate.

Since Kevorkian’s conviction, five states and the District of Columbia have passed assisted suicide legislation. Only three of these states have voluntarily provided data on physician-assisted suicide so far. Since Oregon legalized the practice in 1997, 1,127 patients have died. In Washington, where legalization was approved in 2009, there have been 917 reported deaths. And in Vermont, physicians have filed reports for 53 patients seeking life-ending medication.

While assisted suicide has made great progress over the years, many still have issues with the way it is practiced.

Marilyn Golden, a Policy Analyst for the Disability Rights Education and Defense Fund opposed California’s law for a variety of reasons. She says that in theory it could discourage medical insurance companies from paying for new and expensive experimental treatments when providing assisted suicide medication is a cheaper option. She also argues that people in a vulnerable state of mind could be manipulated by heirs and caregivers to end their life, and that there is a lack of oversight for the current process–citing the fact that there is not an independent individual who is there that can confirm that the person who is taking the medication wants to end their life.

It should also be noted that assisted suicide can be a particularly expensive process. A pharmacist in California told the San Diego Tribune that doctors’ preferred drug, which makes the process of assisted suicide quick and painless, costs as much as $3,400 per dose. While the cost of life-ending medication is not cheap, it can be significantly cheaper than what it takes to provide care to someone with a terminal illness.

James Levinson

James Levinson is an Editorial intern at Law Street Media and a native of the greater New York City Region. He is currently a rising junior at George Washington University where he is pursuing a B.A in Political Communications and Economics. Contact James at staff@LawStreetMedia.com

The post Colorado and the Rising Trend of Assisted Suicide appeared first on Law Street.

Cyber Attack on Multiple Countries…Again

Another massive cyber attack has made it to multiple countries. The attack is believed to have originated in Ukraine. The ransomware has affected an estimated 64 countries so far, and is mainly targeting businesses. Infected computers show a message saying that all files have been encrypted. And just like the earlier ransomware attack in May, these hackers demand ransom payments in the form of Bitcoin to unlock the owner’s data. According to cybersecurity experts, this type of ransomware has never been seen before.

However, experts reportedly found a “vaccine” against the ransomware early this morning, that could cure individual infected computers. But they still have not found a kill switch, which would stop the computers from spreading the virus to others. Now, everyone is wondering who is behind the latest hack, and why. Some say it could have political motivations or that the hackers just want to cause widespread disruption. But because Ukraine was hit the hardest and its main antagonist is Russia, many people suspect the Kremlin is behind it.

The fast-spreading Petrwrap/Petya ransomware sample we have was compiled on June 18, 2017 according to its PE timestamp. pic.twitter.com/CHUYvsiQ08

— Costin Raiu (@craiu) June 27, 2017

Emma Von Zeipel

Emma Von Zeipel is a staff writer at Law Street Media. She is originally from one of the islands of Stockholm, Sweden. After working for Democratic Voice of Burma in Thailand, she ended up in New York City. She has a BA in journalism from Stockholm University and is passionate about human rights, good books, horses, and European chocolate. Contact Emma at EVonZeipel@LawStreetMedia.com.

The post RantCrush Top 5: June 28, 2017 appeared first on Law Street.

As Republican Senators prepared to release a version of their new health care legislation on Thursday, a group of protesters gathered outside Senate Majority Leader Mitch McConnell’s office. But many of them were eventually physically removed from the scene.

The rally was organized by ADAPT, a national disability rights organization, according to CNN. In their statement, the protesters said that they are “demanding [McConnell] bring an end to attacks on disabled people’s freedom which are expected in the bill.”

So, the majority of protesters were either advocates for those with disabilities or those directly impacted by a handicap, according to USA Today. Instead of calling their protest a “sit-in” they referred to it as a “die-in,” demonstrating their belief that the GOP health care bill would put many Americans in grave danger without dependable health care.

ADAPT’s statement also noted that the protest took place on the 18th anniversary of Olmstead v. L.C. – the Supreme Court decision that recognized disabled people’s right to live in communities rather than institutions.

After President Donald Trump took office and vowed to repeal the Affordable Healthcare Act, the Republicans have been trying to craft their own version of the bill. They faced harsh criticism from both sides of the aisle for their secrecy regarding the bill’s contents before unveiling it on Thursday.

Citizens nationwide were offended by both the process surrounding the creation of the bill and the contents of the bill itself. So, the protesters felt it was incumbent to voice their concerns to one of the most powerful Republicans in Congress.

While the protests remained mostly peaceful, Capitol Police were called in at some point and began to forcefully remove protesters despite their constitutional right to protest the government.

Capitol Police are physically removing protesters who are staging a “die-in” in front of McConnell’s office pic.twitter.com/8BU0dW63VI

— Andrew Desiderio (@desiderioDC) June 22, 2017

The police force ultimately arrested around 20 people, many of whom were either on respirators or confined to wheelchairs, according to the Huffington Post. Custodians also had to be sent to the hallway in order to clean up blood, according to Daily Beast reporter Andrew Desiderio.

The group took particular exception to the proposed cuts to Medicaid. At one point the crowd began chanting: “No cuts to Medicaid, save our liberty!”

“No cuts to Medicaid, save our liberty.” Group chants in front of @SenateMajLdr‘s office. pic.twitter.com/fVJpufMDgC

— Jessica Smith (@JessicaASmith8) June 22, 2017

The health care bill has to be voted on by the Senate and go back to the House, so it will likely be modified. But the violence that these protesters faced at the hands of Capitol Police is upsetting. Instead of having their voices heard, they had their free speech stymied and were physically injured.

Josh Schmidt

Josh Schmidt is an editorial intern and is a native of the Washington D.C Metropolitan area. He is working towards a degree in multi-platform journalism with a minor in history at nearby University of Maryland. Contact Josh at staff@LawStreetMedia.com.

The post Protesters Physically Removed from Outside Mitch McConnell’s Office appeared first on Law Street.

Six members of the Presidential Advisory Council on HIV/AIDS have resigned in frustration with the Trump’s Administration’s apparent lack of interest in “the on-going HIV/AIDS epidemic.”

Since its creation in 1995, the council has sought to craft national policy on the disease, prevent its spread, and promote effective treatment as a cure is developed, according to U.S. News and World Report.

The members of the council who quit began becoming concerned during the 2016 presidential campaign when the Trump team showed little interest in meeting with advocates for those struggling to survive the disease. At that point, while the council noted the Trump camp’s disinterest, they clung to the hope that he could be engaged on the issue once in office, according to U.S. News and World Report.

Things escalated when the White House site “Office of National AIDS Policy” was removed during Trump’s inauguration, said Scott Schoettes, a member of the council since 2014.

The final misstep was when the new American Healthcare Act was passed by the Republican-majority House of Representatives, despite pleas from marginalized communities that it would have disastrous impacts, especially for those with HIV/AIDS.

New HIV infections in America declined 18 percent between 2008 and 2014, according to estimates from the Center for Disease Control. The council worked with the previous administration to create the new healthcare system that provided easier access to diagnosis and treatment. Those who quit the council felt that the new GOP bill would take that away.

Schoettes, and his peers, wanted to provide input for the council, but said that they could no longer stand idly by as the Trump Administration ignored their recommendations. Schoettes wrote in a guest column for Newsweek announcing the resignations:

The Trump Administration has no strategy to address the on-going HIV/AIDS epidemic, seeks zero input from experts to formulate HIV policy, and — most concerning — pushes legislation that will harm people living with HIV and halt or reverse important gains made in the fight against this disease.

Trump has still not appointed anyone to head the White House Office of National AIDS Policy after 150 days, while former President Barack Obama appointed a leader after only 36 days. Schoettes penned the column, but it was cosigned by his partners in resignation Lucy Bradley-Springer, Gina Brown, Ulysses W. Burley III, Grissel Granados, and Michelle Ogle.

While the council can have up to 25 members, it currently has only 15. The council last met in March, at which point the members wrote a letter to Health and Human Services Secretary Tom Price expressing concern about the repeal of the American Healthcare Act and the impact it would have on access to HIV/AIDS treatment. Price responded with an uninspiring, “perfunctory” response, according to Schoettes, which further frustrated the council.

Still, Schoettes says he and his colleagues have a desire to help the community they have worked with for many years. They don’t foresee Trump mustering any more interest than he has shown, but they hope other politicians find it necessary to work on a serious public health issue. The column finished:

We hope the members of Congress who have the power to affect healthcare reform will engage with us and other advocates in a way that the Trump Administration apparently will not.

Josh Schmidt

Josh Schmidt is an editorial intern and is a native of the Washington D.C Metropolitan area. He is working towards a degree in multi-platform journalism with a minor in history at nearby University of Maryland. Contact Josh at staff@LawStreetMedia.com.

The post Six Members of the HIV/AIDS Council Resign in Frustration appeared first on Law Street.

The Congressional Budget Office announced in March that the American Health Care Act, the measure created to dismantle the Affordable Care Act that Senate Republicans worked to fast track their own version of on Thursday, will cause the number of uninsured Americans to increase by 14 million in 2018, nearly doubling the figure from 2015. While we don’t know yet what the Senate version will look like, it’s likely that millions will lose their insurance. Among those that have been preparing for the drop since then are crowdfunding platforms such as GoFundMe and YouCaring.

“Whether it’s Obamacare or Trumpcare, the weight of health-care costs on consumers will only increase,” Dan Saper, chief executive officer of YouCaring, told Bloomberg. “It will drive more people to try and figure out how to pay health-care needs, and crowdfunding is in its early days as a way to help those people.”

Sites have seen increases in the number of medical-related fundraisers and donations over the past few years, to the point where that category makes up a significant portion of both sites. In 2015, GiveForward, which was recently acquired by YouCaring, reported that almost 70 percent of all its fundraising campaigns were medical, averaging a fundraising goal of $7,500 per campaign.  Since 2010, GoFundMe has raised over $2 billion on its site and $930 million went to medical campaigns.

While some may find the American reliance on crowdfunding to pay off medical expenses to be troubling, GoFundMe CEO Rob Solomon finds it industry-defining. He has said that medical fundraising “helped define and put GoFundMe on the map” and helped accomplish the goal of becoming a “digital safety net.”

That safety net might need to grow wider because of the AHCA’s Medicaid plans. Preliminary results of a study done through the University of Washington/Bothell found that most personal medical fundraisers done through GoFundMe came from people living in states that chose not to expand Medicaid under the ACA, like Texas. The Huffington Post reported that even moderate Republicans are backing provisions that would eventually cut off federal matching funds for the law’s Medicaid expansion, which 31 states have taken advantage of.

This applies to more than just those who receive insurance through Medicaid, however. According to an NPR, Robert Wood Johnson Foundation, and Harvard T.H. Chan School of Public Health study, 26 percent of adults in the U.S. said they have serious financial problems due to health care costs, with 44 percent of them having to set up a payment plan with their provider. Additionally, the Kaiser Foundation found one in five of all working-age Americans with insurance reported having problems paying medical bills.

Saper believes in the potential of this safety net. He stated that medical crowdfunding is “highly, highly scalable and has a ton of runway. The growth rate of the industry is showing that this can absolutely be an impactful safety net for a lot of individuals and communities to help each other.”

But the current crowdfunding model has repeatedly proven that it is far from equipped to handle the campaigns of every person who could use one. Just over one in 10 health-related online campaigns reached their goal, according to a study at NerdWallet, and the study done at Bothell found that 90 percent of the campaigns they followed failed to reach their goal, only reaching 40 percent of what they asked for on average.

Dr. Edward Weisbart, who chairs the Missouri chapter of Physicians for a National Health Program, mentioned that a lot of these missed goals can be attributed to a sort of fatigue donors feel over time as they receive more and more requests to donate.

“When you get your first request, you probably give a high amount. But as you get besieged and realize how common these requests are, donations will go down. We can’t keep on giving to everyone who asks,” she said to Bloomberg.

Even when people do give, they’re more likely to give to the campaigns with stories that touch our hearts or are just outright extraordinary, according to the creator of GoFraudMe, a website that exposes fraudulent campaigns on GoFundMe, Adrienne Gonzalez. For example, two of the “most active” campaigns on Generosity.com are one raising money for a woman who was struck by lightning, and one for a woman hoping to cover “co-pays, travel expenses, food, lodging, essentials” as she takes care of her 19-year-old daughter who is awaiting a kidney transplant.

What this could create is droves of uninsured individuals all vying for donations toward their medical expenses, hoping that their story wins in a competition of moral equivalency in the minds of donors. As dystopian as this sounds, this would not necessarily be the worst scenario for crowdfunding sites. GoFundMe receives 7.9 percent for donation and processing fees, plus 30 cents per donation, according to its website, meaning it has received $158 million in revenue from its total donations, and just under $75 million from medical campaigns alone.

Saper is well aware of these figures and seemingly sees that there’s profit in helping people raise money for their medical expenses.

“We rely on voluntary contributions from donors [to run the company], so our big thrust now is how do we get the word out about it,” he said. YouCaring has ramped up its marketing and operations teams in preparation for a new wave of customers that will use that site as a platform to broadcast their need for help paying medical bills because the system in place will soon abandon them, if it hasn’t already.

Gabe Fernandez

Gabe is an editorial intern at Law Street. He is a Peruvian-American Senior at the University of Maryland pursuing a double degree in Multiplatform Journalism and Marketing. In his free time, he can be found photographing concerts, running around the city, and supporting Manchester United. Contact Gabe at Staff@LawStreetMedia.com.

The post Crowdfunding Sites Could Benefit Immensely from the AHCA appeared first on Law Street.

In a Senate vote on Thursday, Vice President Mike Pence stepped in and broke the 50-50 tie in favor of getting rid of an Obama-era rule that prohibits states from defunding health care providers for political reasons. Even after the Republicans managed to bring in Senator Johnny Isakson from Georgia, who is recovering from two back surgeries and had to use a walker and wheelchair, the vote ended in a 50-50 tie. Republicans Lisa Murkowski and Susan Collins, both known as moderates, joined the Senate Democrats and Independents in voting against the measure. Pence then cast the deciding vote.

Democrats criticized the GOP for the move, with Senator Patty Murray of Washington saying that the Democrats would spend Thursday afternoon speaking out against it. Doing this “would undo a valuable effort by the Obama Administration to ensure that health care providers are evaluated for federal funding based on their ability to provide the services in question, not on ideology,” she said.

Pres Trump is so focused on attacking women’s health, he sent women’s health advisor—@VP Pence—to break a tie vote on latest attack. #TitleX https://t.co/QOBHpY76Oz

— Senator Patty Murray (@PattyMurray) March 30, 2017

There was a procedural vote earlier in the day that also required Pence’s tie-breaking powers. The new measure will use the Congressional Review Act to repeal a rule that the Obama Administration introduced late last year that prohibits states from blocking Title X funding to healthcare providers that offer abortion services.

Title X is the only federal grant program where money goes exclusively to family planning and reproductive health services for low-income people and those without insurance. It dates back to the 1970s and President Richard Nixon. Title X money makes sure patients can go get tested for STDs or HIV, cancer screenings, treatments, and birth control. However, the Hyde Amendment prevents federal money from being used for abortions.

But, if the Republicans get their way, states will be able to withhold federal money from going to any family planning service that offers abortions at all, even if the money wouldn’t be used for abortion services. Republicans argued that Obama’s requirement that states distribute money to healthcare providers regardless of whether they also perform abortions hurt small, local communities. How and why is unclear. “It substituted Washington’s judgment for the needs of real people,” said Majority Leader Mitch McConnell on Thursday.

Obviously a lot of women and Democrats did not agree with this and spoke out forcefully on social media.

The VP was sent to break a tie vote on #TitleX.

Amazing what GOP leaders will do to make sure women’s health centers don’t get funded. https://t.co/SoHVxURl6H

— Kirsten Gillibrand (@SenGillibrand) March 30, 2017

Title X is a bipartisan program to provide birth control, cancer screenings & HIV tests, & @VP Pence cast the tiebreaking vote attacking it

— Elizabeth Warren (@SenWarren) March 30, 2017

When politicians interfere in women’s personal health decisions, women get hurt. Call your senator: https://t.co/V1XhwtywtW #TitleX

— Cecile Richards (@CecileRichards) March 30, 2017

Many women also took issue with the fact that Mike Pence received an award last week from the Independent Women’s Forum. That organization was formed after law professor Anita Hill accused Supreme Court Justice Clarence Thomas of sexual harassment in the 1990s. But it’s important to note that IWF formed because they didn’t believe Hill, which makes it less surprising that the group would award Pence for his work on behalf of women.

Emma Von Zeipel

Emma Von Zeipel is a staff writer at Law Street Media. She is originally from one of the islands of Stockholm, Sweden. After working for Democratic Voice of Burma in Thailand, she ended up in New York City. She has a BA in journalism from Stockholm University and is passionate about human rights, good books, horses, and European chocolate. Contact Emma at EVonZeipel@LawStreetMedia.com.

The post Mike Pence Casts Tie-Breaking Vote Allowing States to Defund Family Planning Services appeared first on Law Street.

GOP Health Plan Will Leave 14 Million Without Coverage in First Year

The Congressional Budget Office has released its analysis of the Republican healthcare plan, and the results don’t look very good. According to the CBO, 24 million people will be without coverage by 2026, and 14 million would lose their insurance in just the first year. While the plan would save about $337 billion in the coming decade, it would come largely at the expense of the poorest Americans–as the savings would mostly come from cutting Medicaid.

Democrats say that this should be enough to stop the bill. President Donald Trump, on the other hand, says that the media is trying to make Obamacare look great so that people will look back on it positively, but that “’17 will be the very worst year.” The Trump Administration has tried to downplay the importance of the CBO over the past few days and Health and Human Services Secretary Tom Price said, “We disagree strenuously with the report that was put out.”

CBO report on GOP health plan:
-24 MILLION fewer insured
-$880 billion cut from Medicaid
-Premiums 20% higher by 2018

Is this “winning?”

— Mark Takano (@RepMarkTakano) March 13, 2017

Emma Von Zeipel

Emma Von Zeipel is a staff writer at Law Street Media. She is originally from one of the islands of Stockholm, Sweden. After working for Democratic Voice of Burma in Thailand, she ended up in New York City. She has a BA in journalism from Stockholm University and is passionate about human rights, good books, horses, and European chocolate. Contact Emma at EVonZeipel@LawStreetMedia.com.

The post RantCrush Top 5: March 14, 2017 appeared first on Law Street.

This week, India’s National Pharmaceutical Pricing Authority (NPPA) imposed measures that significantly cut the prices of a variety of “essential” drugs, including drugs that treat cancer. These price controls are by no means unprecedented. For decades, the Indian government has worked to keep drug costs low, which has often meant bucking international drug patenting and pricing norms. In doing so India nurtured and developed a massive generic drug industry. While the Indian government must not be admonished for keeping drug costs low, its longstanding obsession with cheap drugs may distract from broader health care accessibility issues.

In 1970, India passed a newly revised Patents Act, which upended the Indian pharmaceutical industry. The act stipulated pharmaceutical patents would only be issued to drugs that exhibited “one or more inventive step(s).” While this language seems relatively innocuous, it totally changed the way in which pharmaceutical corporations conduct business.

Drug patents allow holders to charge high prices because patents ensure market exclusivity for a given period of time. However, in order to maintain market exclusivity, drug companies engage in a practice known as “evergreening.” In most countries, patent laws are such that pharmaceutical companies are able to extend patents and maintain monopolies by making trivial modifications to an already patented product. According to the American Medical Association, these slight alterations allow patent holders to claim they are releasing a new, innovative drug and extend their exclusive rights over said drug “despite the absence of any compelling pharmacologic difference.” In the United States, companies do all sorts of things to “evergreen” drugs including “obtaining additional patents on other aspects of a drug, including its coating, salt moiety, formulation, and method of administration.”

The language in India’s 1970 act is such that companies selling drugs in India would no longer be able to get a patent unless they were offering a new and “inventive” drug. Companies would no longer be able to patent known drugs in an attempt to extend a market monopoly. As a result, a drug that might have enjoyed patent protection elsewhere, would not be protected under Indian patent policy. Soon after this policy shift, India’s generic drug industry exploded, and domestic drug prices plummeted. Before long, India became one of the world’s largest pharmaceutical exporters.

India has made changes to its patent policy over the years, but its generic drug industry continues to operate and thrive under legal conditions set in motion by the 1970 act. Ironically, India’s largest manufacturers are beginning to push back against price-oriented policies that brought them into existence.

While India’s patent polices undermined evergreening practices, price controls were instituted as an additional means of keeping drugs affordable. The creation of a generic drug industry worked to cut costs by undermining market monopolies but, as time went on, India’s most prominent manufacturers of generic drugs were able to brand their products and charge premiums. Price controls were used to ensure these premium prices were not excessive compared to the average cost of other generics.

Whereas India’s patent laws prevent multinational corporations from charging exorbitant prices in monopolized markets, India’s price controls prevent domestic manufacturers of generic drugs from charging more for a drug that bears their brand. Just as multinational corporations argued India’s patent policies stifle innovation, domestic manufacturers arguing that price control affect their ability to operate. In 2012, the government even went as far as suggesting “a future where we will not issue any brand or trade names.”

India’s government should not be criticized for ending price gouging tactics. Multinational corporations should not be able to exclude swaths of people from access to drugs by manipulating patent policy and extending market exclusivity, and cheap generics are crucial in a country where around 78 percent of the population pays for health care out-of-pocket. However, while access to cheap drugs is vital, the government’s health care policy is largely defined by its longstanding obsession with the generic industry and domestic drug prices.

Decades of policies ensuring cheap and readily accessible drugs have helped improve access for many but may have distracted from more holistic attempts at improving health care accessibility. Yet, notwithstanding cheap drug prices, studies have show health care costs are responsible for half of all Indian households falling into poverty. This most recent round of price controls on essential generic drugs came as no surprise, and that might be an issue. India’s pushback to the international patent regime is commendable but cheap drugs should not be treated as the end all be all of health care accessibility.

Callum Cleary

Callum is an editorial intern at Law Street. He is from Portland OR by way of the United Kingdom. He is a senior at American University double majoring in International Studies and Philosophy with a focus on social justice in Latin America. Contact Callum at Staff@LawStreetMedia.com.

The post India’s Low Drug Prices: Do They Lead to a Struggle for Health Care Accessibility? appeared first on Law Street.

Welcome to RantCrush Top 5, where we take you through today’s top five controversial stories in the world of law and policy. Who’s ranting and raving right now? Check it out below:

Republicans Finally Introduce Their Obamacare Replacement

Yesterday, House Republicans presented their draft version of a replacement of the Affordable Care Act, which was one of President Donald Trump’s most ardent campaign promises. The new law would keep some of the ACA’s key components, such as prohibiting companies from denying coverage to people with pre-existing conditions and allowing people under 26 to stay on their parents’ health plan. However, it would reverse the expansion of Medicaid and drop the requirement that bigger companies must provide health insurance for full-time employees. It also does away with the provision that requires Americans to either have health insurance or pay a penalty fee. And it would get rid of federal subsidies for low-income individuals and, as many people have feared, defund Planned Parenthood for one year (more on that below).

According to Republicans, the ACA is “a sinking ship.” But Democrats are highly critical of this new plan. “Republicans will force tens of millions of families to pay more for worse coverage–and push millions of Americans off of health coverage entirely,” said Minority Leader Nancy Pelosi. And some on social media were also critical of the language used to refer to the new plan, claiming it was out of touch and didn’t acknowledge the real costs of care in the U.S.

Yes, the reason poor have trouble affording health care is all the new iPhones they’re buying. https://t.co/EJsZaejOH1 pic.twitter.com/SWoUp2nvAe

— Jamelle Bouie (@jbouie) March 7, 2017

Emma Von Zeipel

Emma Von Zeipel is a staff writer at Law Street Media. She is originally from one of the islands of Stockholm, Sweden. After working for Democratic Voice of Burma in Thailand, she ended up in New York City. She has a BA in journalism from Stockholm University and is passionate about human rights, good books, horses, and European chocolate. Contact Emma at EVonZeipel@LawStreetMedia.com.

The post RantCrush Top 5: March 7, 2017 appeared first on Law Street.

An Ohio man named Ross Compton, 59, was charged with arson and insurance fraud, based on information police obtained from his pacemaker. While the police had a warrant to look at the data, concerns about medical device privacy are becoming more prevalent, and this Ohio case may just be the beginning.

Compton’s house burned down last year. According to his 911 call when he discovered that his house was on fire, he packed some of his items in suitcases, broke one of his house windows with a cane, threw the suitcases out of the window, and then put them in his car. While investigating the fire, the police obtained a search warrant for the data from Compton’s pacemaker. The pacemaker revealed Compton’s heart rate and cardiac rhythm on the evening of the fire. Experts who analyzed the data came to the conclusion that “…it is highly improbable Mr. Compton would have been able to collect, pack and remove the number of items from the house, exit his bedroom window and carry numerous large and heavy items to the front of his residence during the short period of time he has indicated due to his medical conditions.”

Compton has now been arrested and charged with arson and insurance fraud. The fire caused an estimated $400,000 in damage to the house, and his cat perished. Compton claims that the charges are “utterly insane” and that “this investigation has gone way out of control.”

Concerns over medical device privacy are starting to spring up with a higher frequency, as more of us rely on high-tech devices to help manage our health and wellness. Tools like pacemakers, wearable tech like Apple watches, and the devices that hospitals use–they’re all vulnerable to privacy intrusions. Some concerns are more dire than others, for example, the hacking of medical devices, could hold individuals or entire hospitals hostage.

Generally, the use of medical devices by the police is relatively new. But it’s started to gain traction. Fitbits and other fitness trackers–though perhaps not technically medical devices–have already been used as evidence in court. In a Lancaster, Pennsylvania, case, attorneys used a Fitbit to prove that a woman had lied about being sexually assaulted, as the data from the tracker showed she was up and walking during the time that she alleged she was assaulted. Compton’s pacemaker evidence, while certainly a step further, seems like a likely path. But that doesn’t mean that there won’t be a fight over the use of this kind of data every step of the way. SC Magazine spoke to Electronic Frontier Foundation Criminal Defense Staff Attorney Stephanie Lacambra, who said:

Americans shouldn’t have to make a choice between health and privacy. We as a society value our rights to maintain privacy over personal and medical information, and compelling citizens to turn over protected health data to law enforcement erodes those rights.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Medical Device Privacy Concerns: Man’s Pacemaker Data Leads to Arson Arrest appeared first on Law Street.

In August, Aetna announced that it was dropping its participation in many of the Affordable Care Act exchanges that it had previously used to provide insurance, citing significant losses as its reason. While this decision may have been made for other reasons, it will have major implications for the president’s landmark legislation commonly known as Obamacare. This problem goes beyond Aetna, which followed UnitedHealth’s decision to leave the exchanges in 2017–also pointing to significant losses as the motivation for its withdrawal. Read on to find out the full story behind the departures from the Affordable Care Act marketplaces, why companies are pulling out of it, and what implications this may have for the law going forward.

Brief History of Obamacare

Passing and then implementing the Affordable Care Act, or ACA, was no easy feat. A wide range of politicians, including the Clintons, have made efforts to reform American health care for years, but these attempts largely failed. However, that began to change in 2009 when support for an overhaul began to swell and Democrats held the presidency and both chambers of Congress. Following the untimely death of Senator Edward Kennedy and opposition from Republicans, a complex legislative process involving a filibuster, cloture, and budget reconciliation eventually led to the Affordable Care Act’s passage in March 2010.

The health care law included a number of protections for consumers, like eliminating insurance companies’ ability to deny someone coverage because of a pre-existing condition, eliminated lifetime and annual limits on coverage, and prevented rescission. It also created an appeals process so people could challenge insurance companies’ decisions and allowed children to stay on their parents’ health plan for longer. The law attempted to cater to businesses as well by providing them a time frame to offer coverage to employees and also provided a number of tax credits. It let certain people continue with their existing coverage if purchased before a certain date and encouraged new enrollees through a tax if they did not sign up. Importantly, the legislation also allowed states to expand Medicaid coverage, which contributed to a dramatic decrease in the number of people without health insurance.

The ACA was quickly challenged in the courts and after a long fight was largely upheld by a Supreme Court decision in 2012. While this was a major victory it was not the last issue to plague the Act. It has had to endure a number of problems from the online marketplace not working when it was initially launched to repeated, high-profile challenges in the House and Senate. As of February, approximately 12 to 20 million people had enrolled in health insurance either provided by the marketplace or through coverage expansion such as the one with Medicare.

Why Providers are Leaving

Aetna is likely leaving public exchanges for many reasons, but particularly it posted a $200 million loss in the second quarter of 2016 in its individual products. While it is not pulling out of all the states it was operating in, it is leaving 11 of the 15. Aetna’s decision actually leaves one county in Arizona without any coverage at all. Some evidence suggests that Aetna’s decision to leave the exchanges may have amounted to payback for the Justice Department’s efforts to block its merger with Humana. But Aetna argues that the decision was purely based on its recent losses on the exchanges.

The following video looks at Aetna’s pullback from the marketplace in terms of the company’s possible motives and the implications going forward:

The issue might be left at that, but Aetna is not the only company leaving the exchange. Along with Aetna, UnitedHealthcare and Humana–the company Aetna recently tried to merge with–are both leaving exchanges. On top of these departures are those of smaller providers, including several government-funded carriers. For many of these providers, the biggest problem is demographics. Namely, the people signing up for the program are older and sicker than expected. Some people may also be taking advantage of insurers by waiting until they are sick or need medical help to sign up. These people require higher costs, which are not being balanced out yet by new, healthier enrollees. Because of these unanticipated developments, insurers have had a hard time setting their prices and, as a result, they are losing money.

Adding insult to injury, the Affordable Care Act is dealing with more than just the loss of insurance providers. In a recent study done by the New York Federal Reserve, one out of every five businesses in that district has reported hiring fewer people because of the law. Additionally, there are now allegations that some healthcare providers are steering patients to Affordable Care Act policies instead of Medicare and Medicaid because they receive higher reimbursements. This would raise costs for insurers because sicker patients end up on the exchanges instead of government-run healthcare plans.

Implications

While it definitely sounds bad, what exactly does the departure of major providers from ACA exchanges mean for the law? For starters, it means there will be a lot less competition in many places. In fact, 36 percent of markets now will have only one provider, which is up from just 4 percent at the beginning of the year. In five states–Alabama, Alaska, Oklahoma, South Carolina, and Wyoming–there will be only the one provider. On top of this, 55 percent will have only two or fewer providers, which is also up from 33 percent at the beginning of this year.

The biggest issue here, aside from the fact that one county in Arizona may wind up with no coverage options at all, is that competition was supposed to be an important way to cut healthcare costs. Without a competitive market, insurance providers can offer lower quality service at higher prices because there is no alternative. The accompanying video looks at what the major insurance companies are doing:

The news is not all doom and gloom, however, as other carriers are expanding in certain areas including Cigna in Chicago and a startup call Bright Health in Colorado, which was actually founded by the leaders of United Healthcare. Additionally, not all insurers are losing money either in the Affordable Care Act exchanges. In fact, many smaller insurers, who have more experience in government healthcare markets like Medicare and Medicaid, are actually thriving. They are succeeding because the experience they have gleaned has helped them operate on more moderate government-style plans than the more expansive employer-sponsored plans that larger insurers like Aetna are most familiar with.

Even if these large insurers ultimately decide to pull out of the market now that does not prevent them from reentering in the future. In fact, the opposite is true, as along with its announcement that it was leaving the government exchange, Aetna also hinted at the possibility of a return when the market was more receptive to its practices.

Conclusion

Republicans have attempted to repeal all or parts of the Affordable Care Act as many as 60 times since it was passed without success. While politicians may have been unable to sweep away President Obama’s crowning achievement, the market may have succeeded. Losing yet another major healthcare provider, such as Aetna, deals a major blow to the Affordable Care Act as it decreases competition and brings into question the viability of the entire system.

At least that is how some perceive it. To others, it is simply the result of survival of the fittest, where the companies best equipped to do business in a government exchange are and are doing well. While insurance giants balk over reported losses, these companies may fill in the gaps and grow their own brands further. Many, including President Obama, believe that the recent difficulties in the exchanges should revive efforts for a public option akin to Medicare or Medicaid. But as competition decreases in many local markets, the system has many issues that need fixing.

The Affordable Care Act is unlikely to go away entirely. Even if insurers continue to leave Obamacare exchanges, the law will have allowed for a dramatic expansion in health care coverage. Instead of revolutionizing the way health insurance is provided to individuals, the Affordable Care Act may end up looking like a traditional entitlement program that made insurance available to more Americans. After all, only 11 million Americans get their insurance through exchanges, while around 150 million have employer-provided plans. But in order to ensure that the marketplaces are viable going forward, more people will need to enroll and insurance providers will need to return to provide coverage. And that is by no means a simple task.

Resources

The Atlantic: Why Is Aetna Leaving Most of Its Obamacare Exchanges?

CNN Money: Choices Dwindling for Obamacare customers

MSNBC: On Groundhog Day, Republicans vote to repeal Obamacare

Business Insider: Obamacare has Gone from the President’s Greatest Achievement to a ‘Slow-Motion Death Spiral’

CNBC: Health Providers May be Steering People to Obamacare to get Higher Reimbursement

The Daily Caller: Another Huge Insurance Company Is Leaving Obamacare

eHealth: History and Timeline of the Affordable Care Act (ACA)

Obamacare Facts: ObamaCare Enrollment Numbers

Michael Sliwinski

Michael Sliwinski (@MoneyMike4289) is a 2011 graduate of Ohio University in Athens with a Bachelor’s in History, as well as a 2014 graduate of the University of Georgia with a Master’s in International Policy. In his free time he enjoys writing, reading, and outdoor activites, particularly basketball. Contact Michael at staff@LawStreetMedia.com.

The post What a Major Insurance Provider Leaving the Obamacare Exchanges Means appeared first on Law Street.

Jill Stein is the nominee of the Green Party, a left-wing party focusing on environmentalism, grassroots democracy, and social justice. Stein, from Chicago, attended Harvard Medical School and practiced internal medicine in Massachusetts for 25 years. She has run for Governor of Massachusetts, the House of Representatives, other local Massachusetts offices, and was the Green Party’s presidential nominee in 2012. She has served as a Town of Lexington Town Meeting Representative, but has lost her other bids for public office.

Where does Jill Stein stand on some of the prevalent issues of 2016?

Economy:

Jill Stein calls for an economic solution that alleviates economic inequality while simultaneously working toward a greener economy. She calls for such initiatives as a $15 minimum wage, job creation by urging the clean energy industry forward, and democratizing banks, the federal reserve, and public utilities.

Gun Rights and Control:

Stein advocates improving community mental health resources, ending the culture of drug violence, and legalizing marijuana as mechanisms to reduce gun violence. She is in favor of increased local regulation and background checks.

Healthcare:

Jill Stein hopes to replace the Affordable Care Act by extending Medicare to everybody with a single payer public health program. In Stein’s platform, she also advocates lowering the cost of prescription drugs, expanding access to contraceptives and abortion, and enhancing community health resources.

Immigration:

Stein hopes to establish a path to citizenship for undocumented immigrants, supports the DREAM act and deferred action for immigrants, and condemns the deportation of law-abiding undocumented immigrants.

Privacy and National Security:

In her platform, Stein expresses dedication to personal security and privacy. She supports the deauthorization of Guantanamo Bay, termination of the executive power to indefinitely imprison citizens, and other top-heavy gestures of national security. Stein also supports the repeal of the Patriot Act.

What are Jill Stein’s priorities?

Jill Stein places high priority on addressing climate change, an unfair economy that caters to corporations and the rich, and social injustice. Her platform consists of 12 points; transitioning to a green economy, establishing jobs, education, and health care as rights, ending poverty, creating a just economy, fostering racial justice, protecting mother earth, freedom and equality, justice, peace and human rights, and empowering the people.

How is Jill Stein polling?

According to the last national poll conducted by Public Policy Polling on July 30, Jill Stein is currently polling at 2 percent.

You can read here about the other third party candidate, Gary Johnson of the Libertarian Party.

Ashlee Smith

Ashlee Smith is a Law Street Intern from San Antonio, TX. She is a sophomore at American University, pursuing a Bachelor of Arts in Political Science and Journalism. Her passions include social policy, coffee, and watching West Wing. Contact Ashlee at ASmith@LawStreetMedia.com.

The post Who is Jill Stein? appeared first on Law Street.

Happy 4th of July Law Streeters! If you need help with your barbecue banter this Independence Day, look no further than Law Street’s top trending articles from last week. Beef up your small talk with facts on Britain’s historic Brexit vote, the integration of big data into women’s healthcare, and the Supreme Court’s decision to prevent domestic abusers from owning firearms. ICYMI–Check out the top stories below.

1. Brexit: What You Need to Know in the Aftermath of Britain’s Historic Vote

Britain voted on Thursday to end its 43-year membership in the European Union. The withdrawal process will be long–it will most likely be two years until Britain is entirely sovereign–and fraught with difficult decisions for the nation’s future, but the vote has sent tremors within the now-former EU member-state and beyond. Here is a briefing on Brexit and what it might mean for the future. Check out the full story here.

2. Big Data: A Revolution for Women’s Healthcare

Since 1990, the Society for Women’s Health Research (SWHR®) has been advocating for innovation in women’s healthcare. The organization is on the cutting edge of the newest research trends, and each year SWHR picks a different theme to highlight at its annual gala. At this year’s event, one message rang loud and true: we’re officially in the age of big data. Almost everything we do–from voting choices, to commercial purchases, to Netflix binge-watching, can be recorded and analyzed to glean patterns. But the incorporation of big data into healthcare is particularly exciting, and promises to revolutionize medical treatment for women. Read on for a sampling of how we’re now integrating big data into patient treatments, and what it means for women’s health. Check out the full story here.

3. Supreme Court Decision Prevents Domestic Abusers from Owning Firearms

The 6-2 ruling prevents anyone convicted of “reckless domestic assault” from being able to own firearms. This case involves two men from Maine, Stephen Voisine and William Armstrong III, who were convicted of unlawfully possessing firearms due to previous convictions for domestic assault. Under both state and federal law, anyone with a domestic violence conviction cannot possess firearms. Check out the full story here.

Alexis Evans

Alexis Evans is an Assistant Editor at Law Street and a Buckeye State native. She has a Bachelor’s Degree in Journalism and a minor in Business from Ohio University. Contact Alexis at aevans@LawStreetMedia.com.

The post ICYMI: Best of the Week appeared first on Law Street.

Sponsored Content

Since 1990, the Society for Women’s Health Research (SWHR®) has been advocating for innovation in women’s healthcare. The organization is on the cutting edge of the newest research trends, and each year SWHR picks a different theme to highlight at its annual gala. At this year’s event, one message rang loud and true: we’re officially in the age of big data. Almost everything we do–from voting choices, to commercial purchases, to Netflix binge-watching, can be recorded and analyzed to glean patterns. But the incorporation of big data into healthcare is particularly exciting, and promises to revolutionize medical treatment for women. Read on for a sampling of how we’re now integrating big data into patient treatments, and what it means for women’s health.

Big Data & Women’s Health

First Things First: What exactly is big data?

It’s a fair question. We hear the term thrown around a lot, but there’s certainly no cut and dry definition. Essentially, big data is the collection and use of large amounts of information that are naturally generated from our everyday activities. Big data and healthcare can include things like our use of smartphones (and other technology like FitBit or the Apple Watch) to track our fitness levels, the prescriptions we are given, the information generated by clinical trials, the analysis of our genetic material, and so much more.

So how can big data affect women’s health?

It’s no secret that there are sex differences in health. Medical research has only recently begun to recognize these differences and incorporate them into the diagnosis and treatment of illnesses. While our understanding of sex differences and how they affect health have improved, discoveries are still being made about the different ways that certain diseases and treatments affect women. The ability to collect data and pinpoint patterns specifically for women will help inform how to treat them moving forward.

Big Data in Action 

Take for example, a project at Baystate Medical Center, in Massachusetts–the Breast Cancer Registry. Researchers there are creating a large database based on data collected from 400 women who have had breast cancer. The data will help the researchers find patterns in how different women respond to treatments, by acknowledging factors like genetics, age, weight, lifestyle, and other aspects of health. According to Dr. Grace Makari-Judson, chair of the Baystate Health Breast Network and co-director of the Rays of Hope Center for Breast Cancer Research:

What’s nice about the experience with the registry, we have a diverse group of individuals participating and they aren’t the highly selected people in clinical trial. You get more meaningful data (looking at) what is the use of this drug like in the general population.

The inclusion of women (especially minority women) into clinical trials has been a long fought battle, so the ability to collect and analyze this kind of data in the real world is invaluable.

Electronic Health Records 

Electronic health records are another innovative way to use the data already at our disposal. To many, it probably seems archaic that until recently, almost all of our medical information was kept in file folders. We now have the technology to process and incorporate massive amounts of data on patients–from childhood illnesses and injuries to family histories and genetic information.

As electronic health records start being implemented, evidence has begun to show that these records help doctors more effectively manage women’s health. A report in the Journal of the Medical Informatics Association showed that the presence of electronic health records make it more likely that doctors order essential tests like pap smears and breast exams for their female patients–leading to an overall positive impact on women’s health.

Examples of Individual Applications

Genomics

Genomics is the practice of mapping an individual’s genetic material. It’s a data-intensive process that requires serious computing power. Genomics can help provide patients with a predictive and more individual picture of their health. For women, one of the most visible developments in the field of genomics is the ability to test BRCA1 and BRCA2. Certain genetic mutations in those genes greatly increase the risk of ovarian and breast cancer. According to the National Cancer Institute:

Together, BRCA1 and BRCA2 mutations account for about 20 to 25 percent of hereditary breast cancers and about 5 to 10 percent of all breast cancers. In addition, mutations in BRCA1 and BRCA2 account for around 15 percent of ovarian cancers overall. Breast and ovarian cancers associated with BRCA1 and BRCA2 mutations tend to develop at younger ages than their nonhereditary counterparts.

In cases where BRCA1 and BRCA2 mutations exist, steps like enhanced screening, chemoprevention (the use of drugs to reduce the likelihood of or delay the onset of cancer), or preventative surgery might be considered. For example, actress and filmmaker Angelina Jolie tested positive for a BRCA1 mutation, and as a result chose to get a double mastectomy in 2013.

Precision Medicine

Precision medicine is an exciting new development that ties a lot of the tenets of big data together. Precision medicine uses big data, as well as other tools like genomics, to create more individualized treatment for patients. The Obama Administration has spearheaded the precision medicine initiative, and explains the aim in a press release:

The future of precision medicine will enable health care providers to tailor treatment and prevention strategies to people’s unique characteristics, including their genome sequence, microbiome composition, health history, lifestyle, and diet. To get there, we need to incorporate many different types of data, from metabolomics (the chemicals in the body at a certain point in time), the microbiome (the collection of microorganisms in or on the body), and data about the patient collected by health care providers and the patients themselves. Success will require that health data is portable, that it can be easily shared between providers, researchers, and most importantly, patients and research participants.

Conclusion

The expanded use of data in healthcare is the future, and the developments that we’re seeing in the present are already incredibly exciting. As SWHR puts it:

Data initiatives are revolutionizing healthcare and helping to improve every aspect of medicine, from bench to bedside. This data, which is being collected and utilized by healthcare providers, pharmaceutical and medical device companies, insurance companies, hospitals, and researchers, provides a wealth of healthcare information that can be used to better inform healthcare decisions and delivery for every woman.

Resources

Primary

SWHR: SWHR’s 26th Annual Gala: “Revolutionizing Healthcare & Research Through Data”

National Cancer Institute: BRCA1 and BRCA2: Cancer Risk and Genetic Testing

The White House: The Precision Medicine Initiative

Additional

Law Street Media: Precision Medicine: The Future of Health Care?

CB Insights: 13 Startups Working in Women’s Reproductive Health

Forbes: How Big Data is Changing Healthcare

Boston Business Journal: Focus on Women’s Health: Big Data, Registries Help Docs Understand Cancer

Radar: Genomics and the Role of Big Data in Personalizing the Healthcare Experience

New York Times: Angelina Jolie; My Medical Choice

Modern Healthcare: EHR Use Tied to More Women’s Health Tests: Study

Society for Women’s Health Research

The Society for Women’s Health Research (SWHR®), is a national non-profit based in Washington D.C. that is widely recognized as the thought-leader in promoting research on biological differences in disease. SWHR is dedicated to transforming women’s health through science, advocacy, and education. Founded in 1990 by a group of physicians, medical researchers and health advocates, SWHR aims to bring attention to the variety of diseases and conditions that disproportionately or predominately affect women. For more information, please visit www.swhr.org. Follow us on Twitter at @SWHR. SWHR is a partner of Law Street Creative. The opinions expressed in this author’s articles do not necessarily reflect the views of Law Street.

The post Big Data: A Revolution for Women’s Healthcare appeared first on Law Street.

Two years ago, Congress created a new program, the Veteran’s Choice Program, to fix the well-publicized problems facing health services at the Veterans Affairs Administration, known as the VA. These problems ranged from poor care to wait times to see a doctor that were so long a person was likely to end up dead before they could be told why they were dying. Two years later, the program meant to put an end to these issues is experiencing the same problems and may be even worse than it originally was.

How did the VA healthcare system get to this point? Read more to find out how the VA system was originally crafted, and the issues it faced and continues to face as those in charge search for answers.

The VA System

Since the beginning of war, disease–not actual conflict itself–has been the number one killer of soldiers. With that consideration in place, the United States has offered benefits of some kind to veterans going all the way back to the Revolutionary War. While the system is still serving veterans of wars long over, it became more codified in 1930 when President Hoover created the Veterans Administration. At the time of its inception, the system had 54 hospitals, served 4.7 million veterans, and employed 31,600 people. Over the following years, a number of other agencies were created, including the Board of Veterans Appeals in 1933, the Department of Medicine and Surgery in 1946, and the Department of Veterans Benefits in 1953. All of these departments were eventually organized under the singular umbrella of the VA, which was also made a cabinet level department in 1989.

Over the years, the system has grown in size to become a massive department today. Now, the Veterans Health Administration operates with an annual budget of $59 billion. This budget covers a lot; according to the VA, it funds “150 medical centers, nearly 1,400 community-based outpatient clinics, community living centers, Vet Centers and Domiciliaries.” The system also employs over 305,000 health care professionals. On top of this, the VA is the largest Medical training system in the United States, serving the most graduate-level students and contributing greatly to continued medical research and discovery. This includes 76,000 volunteers, 118,000 trainees, and 25,000 faculty.

Overall, this massive system serves over 9 million veterans in the United States. Based on VA guidelines, once enrollment is initiated veterans undergo a means test to see if they are a priority and if they are able to afford the co-pays. Once these steps are completed, veterans then go to see a doctor within 14 days if they are new patients and between 14 and 30 if they are existing members.

Problems with the VA

The issues plaguing the VA primarily center on wait times. This concerns one of the three branches covered by VA system, namely the Veterans Health Administration. The other two primary branches deal with benefits and burials for veterans. The VA scandal involved a variety of issues, but wait times and the difficulty that many veterans have merely accessing medical care garnered most of the public’s attention.

Some veterans have had to wait for longer than 125 days to see a doctor, a stark contrast to the 30 days required by the system. In facilities across the country, there have been allegations that administrators falsified records to make it appear as though patient wait times were not longer than required. It had gotten so bad that some may have even died while waiting; however, due to record keeping issues, we don’t know exactly how many veterans with pending records were actually waiting for care when they died.

These complaints were not isolated to just one or a few places either, locations in Phoenix; Fort Collins, Colorado; Miami; Columbia, South Carolina; and Pittsburgh, to name a few, all reported problems. There were also issues with claims, especially as more Vietnam veterans were included in disability coverage. Claims have no time limit and can be filed at any point. The primary backlog that most are concerned with is not for decisions on claim appeals, but for the initial claim decisions themselves. These issues were severe enough that the head of the VA resigned in 2014 after the extent of the scandal became known.

Two years after the initial reports broke, results are still not much better for the VA system. This year there have again been reports from states about inaccurate wait times, cost overruns, poor care, and refusal to discipline employees despite poor care.

The following video looks at the scandal with the VA system:

The New System and Lingering Issues

In an attempt to solve the problem Congress created the Veteran’s Choice program. At a cost of $10 billion, this program was supposed to put an end to the problems facing the VA system, particularly long wait times to see a doctor. Under the program, eligible veterans are able to get healthcare from nearby medical centers rather than traveling to VA facilities if wait times or distance are an issue. However, instead of helping, the effort has by many measures made things worse. Wait times have actually increased under the new program, though, according to the VA that is in part because so many veterans are trying to use it. In some places, veterans were never referred to the program or the doctor they were designated to see was too far away.

Based on the system’s structure, the patient had to be the one to initiate appointments, not the provider. However, that wasn’t entirely clear for everyone involved and many veterans were left waiting for calls to schedule appointments. And even in cases where veterans are able to schedule an appointment and see a doctor, the Choice Program has a long backlog of payments that prevents doctors from being paid on time. Doctors have reportedly waited for 90 to 180 days after a long claims process to simply get paid for their services. The situation got so bad that thousands of veterans referred to the new program actually ended up going back to the traditional VA system because it was more efficient.

Why Isn’t it Working?

So how has the new system that was meant to address these problems only exacerbated them in many cases? The answer starts with how the program was set up in the first place. The program’s basic tenet was to give veterans care faster and closer to home, specifically, this meant that if patients had to wait more than a month to make an appointment or drive over 40 miles to the nearest VA facility, they would be eligible. But the system has largely failed to live up to those promises largely because of how quickly the program was created and implemented.

Namely, once Congress approved funding and the president signed the Choice Program into law, the VA was only given 90 days to implement it. This was a program that would affect millions of veterans, hundreds of thousands of medical care professionals, and the families of both. The deadline was so short, in fact, that the VA quickly excluded itself from the process because it knew it would be unable to meet the requirements. This forced the agency to look to the private industry. However, most companies in the private industry were also turned off by the 90-day timeline.  While the VA was ultimately able to settle on two organizations, they have been scrambling to build the requisite network of health care professionals and still rely on the VA for referrals leading to the delays. The system proved to be too complicated and difficult to use for everyone involved, from veterans to doctors and VA administrators.

The accompanying video looks at the problems with the Choice Program:

Conclusion

When the true reality of the VA scandal broke two years ago, everybody agreed that the system was broken and needed to be fixed, fast. However, this is not the type of system that can be repaired and streamlined in just a few months. Unsurprisingly, the quick fix has turned into a disaster in need of a fix of its own. So what is the appropriate action moving forward?

Some have called for a total dismantling of the VA healthcare system as it is known today. Instead of providing care directly to veterans, the new system would simply pay for their care. However, critics are quick to denounce a system that would leave veterans to their own devices. It does seem unlikely an organization as sprawling as the VA will be torn down completely. Consequently, more internal reforms are likely. While the situation is in dire need of a solution, new fixes should not be rushed. Lawmakers will need to create a system that works well and gives veterans the care they need when they need it.

Resources

NPR: How Congress and The VA Left Many Veterans Without A ‘Choice’

NPR: For The VA’s Broken Health System, The Fix Needs A Fix

U.S. Department of Veterans Affairs: 10 Things to Know About the Choice Program

House Committee on Veterans’ Affairs: History and Jurisdiction

U.S. Department of Veterans Affairs: Veterans Health Administration

The Washington Post: Everything You Need to Know About the VA–and the Scandals Engulfing it

The Washington Times: VA Still Plagued by Problems Two Years After Scandal

The Military Advantage Blog: Care Commission Shocker: The Push to End VA Healthcare

Michael Sliwinski

Michael Sliwinski (@MoneyMike4289) is a 2011 graduate of Ohio University in Athens with a Bachelor’s in History, as well as a 2014 graduate of the University of Georgia with a Master’s in International Policy. In his free time he enjoys writing, reading, and outdoor activites, particularly basketball. Contact Michael at staff@LawStreetMedia.com.

The post Did the Program Meant to Rescue the VA Healthcare System Make it Worse? appeared first on Law Street.

Every year 38,000 people in the United States kill themselves. In America, we have more people who are victims of suicide than are victims of homicide. Or car accidents. Or prostate cancer. Yet mental health care in the United States: how and whether it works, how it is funded, and  the challenges it faces, is rarely discussed. It isn’t something that we like to talk about.

In his book “A Common Struggle,” Patrick Kennedy goes into intimate detail about the alcoholism, drug addiction, and mental illness that he and his family have struggled with. As the title suggests it is a problem that is dealt with by millions of Americans–as patients, caregivers and loved ones. The book, in addition to trying to de-stigmatize mental illness, chronicles the passage of the Mental Health Parity and Addiction Equity Act of 2008. If you have no idea what that is you are not alone. According to a survey by the American Psychological Association, 96 percent of Americans have no idea that this law exists or that it requires insurance providers to treat a mental illness in the same way it would treat a physical one.

Mental Health and Mental Health Parity

Mental health care in the United States is faced with a two unique challenges: access and attitudes. The United States spends $113 billion a year on mental health care. Despite the significant investment, it is more difficult to get access to a provider for mental health services than it is to get access to a physical health provider. Nearly 90 million Americans live in a “shortage area” for mental health care providers–compared to 55.3 million Americans who live in a shortage area for primary care physicians. But an even greater barrier to treatment are the attitudes about mental health. When researchers looked into why people were refusing treatment, 71 percent said that they wanted to solve the problem on their own.

A response like that would be considered ridiculous if it was given after a cancer diagnosis. Yet, because mental illness is considered to be different from a physical illness, we don’t find this response as shocking in that context. Some people do deal with mental illness and addiction on their own, some people even do so successfully. But for individuals who want or need treatment, an attitudinal change that allows patients to believe they are entitled to receive it, and the ability to actually access it, is critical.

Take a look at this explanation of the situation given by Representative Jim Ramstad. This video was his commentary in favor of the Mental Health Parity and Addiction Equity Act of 2008. Essentially, this law requires that insurance providers treat a mental health issue the same way that they would treat a physical health issue, with the same co-pays, deductibles, and access to treatment, including treatment for substance abuse. Ramstad argues in favor of passing the law, citing himself as a success story for treatment.

The arguments dividing supporters and opponents on this issue are the same reasons that people don’t seek treatment: cost and attitude. The human cost of living with mental illness is very high but treatments for mental illness can also be extremely expensive. Treatment often includes therapy, which involves repeatedly engaging the services of a professional for hours each month. That’s a hefty price tag. When treatment involves medication, as it often does for serious mental illnesses like bipolar disorder and schizophrenia, the cost of the medications themselves can be staggering. This is often because the dosages need to be carefully calibrated, frequently adjusted, and generics are not always readily available. All of this involves more physicians and psychiatrists. Hospitalization and in-patient treatment can cost thousands of dollars for just a few days. Insurance companies are understandably reluctant to be responsible for providing these services.

The Costs of Mental Illness

It’s difficult to calculate society’s financial costs for the nearly 42 thousand deaths that were attributed to suicide in 2013. But a 2008 study by the National Institute of Mental Health attributed $193.2 billion dollars per year to lost earnings from mental health disorders in general–largely based on missed workdays because of mental health concerns. That study isn’t accounting for the lost productivity while at work or people who can’t work or are underemployed due to their mental illness. A more recent and more holistic view of the cost of mental illness would cite $444 billion, which includes treatment and the lost wages of patients but not caregivers, according to a report from USA Today. Even that isn’t taking into account the true total economic cost of mental illness.

In effect, what mental health parity does is shift some of the financial burden of treating mental illness to insurance companies, the same way that it does for physical illnesses. But it isn’t a bulletproof solution. One very key component in the bill, which Representative Ramstad addresses, is that mental health treatment would only be provided when it was considered a medical necessity. However, it isn’t clear what qualifies as a medical necessity.

Long-term therapy may be highly beneficial to an individual but may not be considered a medical necessity. A 72-hour psychiatric hold, also beneficial and potentially life-saving in terms of preventing immediate harm, might have a better chance of being considered a medical necessity. The long-term therapy, which could possibly prevent the need for the psychiatric hold, is in all likelihood the more expensive of the two options, just as physical therapy is a very expensive treatment for a chronic medical condition. Insurance companies can and do use medical necessity to thwart patients from using their insurance for treatment of mental illness.

The State of Mental Health Care in America

Mental health parity is an important step, but it does not do anything to address the problem of mental illness for the uninsured and doesn’t do enough to address mental health concerns for those on Medicare/Medicaid. It also does not deal with the much larger problems of access to appropriate treatment and the involvement of the criminal justice system.

The video below, an interview with Liz Szabo of USA TODAY about their series “The Cost Of Not Caring,” explains some of the economic costs of mental health care and how those costs are being borne by millions of Americans. The article that accompanies the series does an even better job of expanding on the concerns with the mental health care system in the United States.

Reduced investment in mental health services by state and local authorities produces a system where we still pay for the mentally ill, just in different ways than you might expect. The main effect of mental health parity is to move some of the burden from the individual to a private insurance provider. While the main consequence of reducing services for mental health shifts the burden from asylums, where the mentally ill used to go, and other institutions that were designed to deal with them, to hospitals and prisons. These already stressed institutions have difficulty coping with the added demands now placed on them, leading to a system that does an ineffectual job because it deals with the physically ill, the mentally ill, and criminals who actually need to be incarcerated as a unit–rather than dividing them into separate categories and treating them accordingly.

Better Alternatives

There are treatment options that can be tried, which may cost more at first, but produce better results in the long run for the individual with a mental illness and his or her community. To compare the problem to a physical one, if amputating a broken arm was cheaper than setting a broken bone and then using physical therapy to regain full range of motion–most of us would still not say that is the best treatment. Because in the long run, the loss of productivity to the individual and to society is much higher and the expense to fix the arm would be viewed as an investment in that person’s future. Why then, when someone comes to the hospital with a chemical imbalance in their brain, rather than misaligned bone fragments, do we not explore more expensive treatment options–ones that would be investments in that person’s most productive future given the nature of the illness.

In 2008, the National Institute of Mental Health began the RAISE project, to research Recovery After Initial Schizophrenia Episode. Researchers in the RAISE trial found that after the two-year study period was concluded, schizophrenic patients who received a model of treatment that included family counseling and help to secure a job–services that are not covered by insurance companies, which typically only pay for drugs and limited therapy for outpatient treatment–did better than patients who only got basic services.

The added cost for these services was about $3,600 a year for each patient and according to the researchers yielded a better quality of life for the patients. Which is, certainly, a difficult thing to quantitatively measure. Because the study only lasted for two years it is hard to say if, over the person’s lifetime with the illness, the initial investment will prove to actually prevent more costly complications like hospitalizations. But the initial results suggest that including this type of counseling and other services may be worth the long-term investment.

For a surprisingly cogent and unsurprisingly hilarious look at the issue of mental health and innovative treatment options, check out John Oliver’s segment on mental health:

Conclusion

Removing the stigma of mental illness by treating it in the same way you would treat a physical ailment is a positive first step towards dealing with the mental health care crisis in this country. But it is only the first step. Thousands of Americans die from mental illness every year. Millions suffer from it chronically and face the challenges of dealing with a mental disease daily.

Because it touches so many of us so intimately, mental health treatment in America is not an easy topic for most to discuss. Usually, it only becomes part of our public discourse in the wake of a mass shooting. But that’s like only talking about a disease if it is an air-born pathogen. Those diseases are the most obvious for us to see as a threat; nothing is sexier on the evening news than a flu pandemic. But it is the less glamorous food poisonings that might be more deserving of our attention. It’s messier and more embarrassing to talk about, but you are also more likely to be affected by it.

Resources

USA TODAY: Mental Health System Crisis

Goodreads: A Common Struggle 

American Psychological Association: Help Center: Parity Law Resources

Washington Post: Seven Facts About America’s Mental Health Care System 

The Kennedy Forum: Parity 

Centers for Disease Control: Mental Health 

The Huffington Post: US Mental Healthcare System

Slate: Is My Work Medically Necessary? How Insurance Companies Get Around Rules For Mental Health Care

New York Times: New Plan To Treat Schizophrenia Is Worth Added Cost, Study Says

Mary Kate Leahy

Mary Kate Leahy (@marykate_leahy) has a J.D. from William and Mary and a Bachelor’s in Political Science from Manhattanville College. She is also a proud graduate of Woodlands Academy of the Sacred Heart. She enjoys spending her time with her kuvasz, Finn, and tackling a never-ending list of projects. Contact Mary Kate at staff@LawStreetMedia.com

The post Mental Health Care: Should We Be Treating the Mind the Same As The Body? appeared first on Law Street.

Last Thursday marked the 50th anniversary of Medicare, a program instituted under the Social Security Act in 1965 by President Lyndon B. Johnson. To honor the anniversary of Medicare, the National Nurses United held a rally at which Presidential hopeful Bernie Sanders spoke. His comments shed further light on his positions on Medicare and American healthcare as a whole.

The rally brought together many different groups of people who all supported expanding Medicare. Many speakers from the National Nurses United spoke before Sanders and shared personal stories of why Medicare should be available for everyone.

Sanders, a big advocate of Medicare, stated, “healthcare is a right, not a privilege of all Americans.”

Sanders appears to strongly believe that everyone deserves health care and has worked hard during his time as a senator to make that happen. Sanders strongly supports Medicare for all, by transforming it into a single payer system. Under this system, a single or quasi-public agency would organize health care financing, but the delivery of care would stay privatized. Sanders’ home state of Vermont is one of the states that has moved forward with this arrangement.

For Sanders, Medicare expansion fits into his overall platform of equality for all. He strongly believes that all Americans should have equal rights and equal opportunities, and affordable healthcare for all is a necessary aspect of that equality. He’s attracting supporters with those kinds of goals, given that 48 percent of Americans polled in 2013 said the healthcare system needs fundamental changes, and 27 percent said the healthcare system should be completely rebuilt.

Medicare, and what to do about the current healthcare system in America, will be hot topics in the 2016 election particularly because this issue will continue to affect Millennials in the upcoming years. Most Millennials are children of baby boomers who are now becoming older, and need to have affordable healthcare in some capacity. The way the healthcare system is set up in America, the older generation depends on the younger generation to take care of them because young people are the ones who pay the most into Social Security, Medicare, and Medicaid. However, if Sanders’ plan to create a single-payer system reaches fruition, the younger generation will not be entirely held responsible for taking care of the older generation, as the government would play a larger role in organizing health care financing.

Overall, the rally was successful and discussed why Medicare should be reformed and expanded. It’s essential that the future president realizes the need for affordable healthcare for all Americans, and takes action to make it happen.

Jennie Burger

Jennie Burger is a member of the University of Oklahoma Class of 2016 and a Law Street Media Fellow for the Summer of 2015. Contact Jennie at staff@LawStreetMedia.com.

The post Bernie Sanders: Making Medicare an Issue in 2016 appeared first on Law Street.

Doctors need the proper resources to be able to treat their patients. But a new viral Facebook page started in Egypt illustrates that doctors and dentists in that country don’t necessarily have access to what they need. The page is shocking to many, as photos of multiple hospitals in Cairo, Egypt have been shared illustrating that they are unequipped and unsanitary for doctors to properly operate in.

On Saturday Egypt’s Prime Minister, Ibrahim Mahlab, surprised the National Heart Institute in Cairo with a visit. He was accompanied by TV cameras that showed him shouting at one hospital employee as he began to walk through the facility. Mahlab was truly surprised at the facility’s lack of medical equipment and the mistreatment of patients and ordered some of the facility’s top officials to be fired.

Egyptian doctors felt degraded and wrongly blamed for the poor state of health services and took  to social media to show people the true conditions in which they have to work. A Facebook page–the title translates in English to “So He is Not Surprised if He Comes”–was created. There are pictures of several of Egypt’s hospitals with snakes, cats, and rats roaming around inside and even on patients’ beds. The pictures also show patients lying on the floor for treatments, filthy bathrooms, broken equipment, and overcrowded rooms. Moreover, the Egyptian Centre for Economic and Social Rights (ECESR) has stated that only 33 beds are available for every 10,000 citizens in Cairo’s hospitals. The page reached over 100,000 likes within just a few hours and quickly went viral.

Can’t get over how depressed i feel from the moment i saw those photos of hospitals in Egypt ! God please take me away from all this mess !

— Lobna Ehab (@lobna_ehabb) June 9, 2015

 

Poor conditions of #Egypt‘s hospitals highlighted by humiliated health employees http://t.co/X2U0ZXHWsj pic.twitter.com/HD3xcgEmSE

— DAILY SABAH (@DailySabah) June 10, 2015

#Egypt hospitals pushed FB users to launch a campaign pointing out the severe neglection at government hospitals. pic.twitter.com/59X55OaSj1

— MMisrNetwork English (@MMisrNetwork_En) June 10, 2015

Following the Prime Minister’s visit, the military announced it would work to renovate the Heart Institute’s clinics, reception areas, and emergency rooms. Doctors in Egypt have held several strikes within the past few years demanding an increase in the state budget devoted to healthcare, but this request has been frequently ignored. Groups such as the Nursing Rebel Movement advocate for change in this regard; one of their members explained his frustrations with the current system:

There is total negligence to nursing centres in provinces, and whenever we voice our concerns to the syndicate, they suggest for us to join the syndicate instead of identifying a clear plan to solve the problem [from] its roots.

The Egyptian government is reportedly negotiating with the World Bank to receive a new loan of $300 million to support healthcare in government hospitals. This money would go toward things like new medical supplies.

Seeing the conditions of these hospitals were truly disturbing. How can people get treatments for their illnesses when they are surrounded by stray animals and filth? Egyptian doctors are trying to raise awareness and get help to improve healthcare and the circumstances in which they are being forced to work. Hopefully these pictures will lead to serious changes for the hospitals.

Taelor Bentley

Taelor is a member of the Hampton University Class of 2017 and was a Law Street Media Fellow for the Summer of 2015. Contact Taelor at staff@LawStreetMedia.com.

The post The Sad State of Egypt’s Hospitals: Shocking Pictures Released appeared first on Law Street.

The human trafficking industry involves 20.9 million people and $150 billion dollars each year. One new class at the University of Kansas School of Law is looking to lower those horrifying numbers. Led by KU School of Law Clinical Associate Professor and Director of KU School of Law’s Medical-Legal Partnership Clinic Katie Cronin, KU’s Human Trafficking Law and Policy course requires law students to work on real human trafficking cases and provide resources to attorneys, police, health care workers, and victims of human trafficking.

For example, Marci Mauch, one of Cronin’s students, devised training materials to help police and hospital staff recognize patterns consistent with human trafficking victims. According to the materials, signs that someone may be a human trafficking victim include avoiding eye contact, being unaware of their location, letting somebody else speak for them, having certain illnesses such as STIs, and having injuries that do not match their stories. Cronin came up with the idea of teaching hospital staff how to identify victims after learning that human trafficking victims often end up in emergency rooms.

Other examples of projects devised by Cronin’s students include working on the visa application of a human trafficking victim–the application most likely could not have been filled out by the victim as it was hundreds of pages long and required a certain level of expertise. Other students worked on the creation of a manual for attorneys working T visa cases–a visa afforded to victims who turn their human traffickers into authorities. Yet another worked on the creation of a Know Your Rights brochure for victims served by the Willow Domestic Violence Center.

“It’s sort of shocking how many areas of the law human trafficking does impact,” Cronin said in an interview with KU News Service. “Immigration attorneys can provide services to foreign national victims, and even those law students that go into corporate work can help their corporate clients to make sure that their supply chains remain free of human trafficking.”

The University of Kansas is not the first law school to expose its students hands on to human trafficking cases. For example, Boston University School of Law’s Human Trafficking Clinic offers its students the opportunity to provide legal representation for human trafficking victims and assist attorneys in shaping public policy. Columbia Law School’s Sexuality and Gender Law Clinic regularly prepares reports on human trafficking cases, while the George Washington University Law School and the University of Southern California Gould School of Law clinics directly litigate human rights cases in court.

Still, KU School of Law is unique in its efforts to attack human trafficking at the “nexus” of medicine and law. Director of KU’s Anti-Slavery and Human Trafficking Initiative (ASHTI) Hannah Britton said to the Lawrence Journal-World:

All of these survivors need immediate legal assistance… The problem is that this is a hidden population because it’s a criminal activity… Most victims are very scared to come forward because they are fearful of arrest or deportation. They’ve been isolated, and the traffickers are very skillful at creating fear.

Cronin and her students are doing good work creating much needed avenues for victims to overcome these fears.

Hyunjae Ham

Hyunjae Ham is a member of the University of Maryland Class of 2015 and a Law Street Media Fellow for the Summer of 2015. Contact Hyunjae at staff@LawStreetMedia.com.

The post KU School of Law Students Aid Human Trafficking Victims appeared first on Law Street.

At a time when the media is full of references to rising levels of childhood obesity and Diabetes, the debate over mandating physical education classes in elementary, middle, and high schools is a particularly passionate one for many teachers, parents, doctors, and students. But is mandatory physical education helpful, harmful, or a mixture of both?

“Just Do It”–Because Kids Won’t

Across the country, only one quarter of youths are engaging in physical activity for at least an hour a day: that means that three quarters of surveyed young people in the U.S. are arguably at increased risk for various health impairments often associated with weight gain and/or inactivity such as Diabetes and heart disease.

Whether it’s because of long commutes to school, piles of extra homework due to high-stakes testing, race- and class-based inaccessibility to play spaces, or the rise in mobile devices that keep many young people stationary, physical activity is often not prioritized for youths.

Schools are often not helping with this problem, as most schools across the country do not adhere to National Association of Sports and Physical Education standards that school children should participate in 150 minutes of physical education per week.

Advocates of mandatory PE in schools often argue that because school is where most young people spend the overwhelming majority of their time, a lack of gym requirements, combined with increasing restrictions on or complete eliminations of recess time, can be devastating for young people’s health. Proponents argue that schools should require PE classes not only for the present fitness benefits, but for the formation of long-term fitness habits.

The goal, for better and for worse, of much of the U.S. education system currently is to channel many students into jobs that will be stationary: jobs that require us to sit at our desks all day, every day. This is similar to being in school: in this work structure, time must be set aside for physical activity. Getting young people into this habit of going out of their way to exercise each day can help them form routines that will assist with avoiding some of the health risks of remaining stationary for so long.

This is especially important because as young people age, they become less physically active, especially if they enter the nine-to-five workforce. Additionally, young people usually have less independence than adults; while it is an option for an adult with a full-time job to go to the gym either before or after work, young people usually don’t have the same option. Therefore, setting aside mandatory time for them to move around while they are in school is arguably an excellent–and one of the only–options to provide students with access to physical fitness.

In addition to the importance of habit formation and access to spaces where healthy levels of activity are encouraged, mandatory PE is often touted as being emotionally and mentally healthy for young people. Exercise is known to reduce stress and anxiety, and especially when anxiety-inducing high-stakes testing is part of most students’ lives, making the time for PE classes can help reduce this stress, and go a long way toward improving the lives of students.

Not All Gym Classes Are Created Equal

Despite the acknowledged benefits of exercise itself, many argue against PE requirements in schools. Students themselves often bristle at the requirements–according to a major study of PE programs across the country conducted by Cornell University, most students believe that gym classes are ineffective.

Cathy Brewton of the Florida Department of Health surveyed students across five counties in her state and found that:

The reasons [the students] didn’t exercise in school was because they didn’t like getting dressed, getting sweaty during the day, and their classes were over-capacitated… Kids said if they were going to do phys ed, they wanted to do something fun.

And surely not all students have fun when the rest of their class is playing basketball. For example, many students in mandatory PE classes spend most of their time standing or sitting on the sidelines while more traditionally athletic students play. Not only does this exclude many students, but it illustrates that, even when PE classes are required, fitness goals are not being met for all or even most students.

Critics say that academic goals, too, are sidelined by mandatory PE classes. Mark Terry, the president of the National Association of Elementary School Principles, argues that while public school budgets are tightening to begin with, there are many impossible choices that must be made when choosing to require PE classes. He asks,

What are you going to do less of? Are you going to do away with art or cut back on music or cut back on the minutes you have in the classroom?

Bullying in Gym 

Furthermore, many students–even when PE is required–simply do not exercise during the classes, and many are in fact actively discouraged from doing so by mandatory PE classes, particularly through bullying.

A great deal of students are actively alienated in gym classes. These students are often those with dis/abilities, students from low-income families, students considered overweight, and/or LGBTQ students.

Public school teacher Jim Dilmon, who has Aspergers, has written of his experience with gym classes that,

Social settings, including physical education class, often heighten the stress or anxiety levels of kids with Aspergers. However, if properly addressed, the physical education classroom offers a good opportunity for kids with and without disabilities to interact with peers.

He goes on to enumerate and explain many useful strategies that PE teachers can use to make gym classes better and more effective spaces for students on the spectrum.

Short of implementing these recommendations and making curricula overall more accommodating to all students, PE classes may very well increase the stress and anxiety levels (not to mention decrease the physical activity levels) of many students. Even though, as mentioned above, exercise is known to reduce stress and anxiety, the setting of PE classes often induces anxiety for many students. The most basic Google search of “gym class anxiety” will reveal a plethora of cries for help from students and parents alike who make it clear that the stress and anxiety that accompanies mandatory gym classes can be extremely debilitating.

Students who experience this anxiety are often subjected to bullying during PE class. Students who endure maltreatment in their gym classes are shown to stop many forms of physical activity in the long term. LGBTQ students are especially prone to be targeted for bullying–most LGBTQ students report being bullied in PE classes–as are students considered to be overweight and/or dis/abled.

It is not just cruel children who are responsible for this bullying and anxiety, however: there is a larger structure at play in advocacy for mandatory gym classes that values thin, able-bodied, gender-conforming students over those who do not conform to societal standards. By placing such an emphasis on certain kinds of physical abilities and weight loss, mandatory PE increases the anxiety, stress, and feelings of extreme guilt and failure that often accompany the emphasis on obtaining a certain kind of body.

Missing the Bigger Picture?

Even if mandatory PE classes did not risk harming many students, critics argue that emphasizing PE classes as a means to “fight obesity” is completely missing the point.

Schools are struggling for resources as it is, and schools in impoverished areas–often in neighborhoods of color–are struggling more than others. It is precisely in these neighborhoods that young people are more likely to be subjected to the impacts of environmental racism that cause many health problems. That raises the question: would focusing on these structural problems of access be more effective than focusing on symptoms (by mandating physical education classes) rather than causes (which include massive food and diet corporations profiting off of each other)?

Another crucial question about structure relates to intra-school dynamics: would freeing children from being forced to be still at desks all day–changing the structure of education to be itself more holistically active–go a longer way toward encouraging activity than setting aside a half hour to an hour for specific kinds of activity every other day? Perhaps, but there’s no way to know for certain.

So, is PE Good or Bad?

As with everything in education, the answer depends on both the individual students and their circumstances. Overall, it seems that both critics and proponents of mandatory physical education classes agree that in order to be effective, existing PE classes need to exist in the context of broader changes and revamp their curricula to reach more students without alienating those who are often harmed by current PE class structures.

Resources

Time: Couch Culture: Only a Quarter of U.S. Youth Get Recommended Excercise

Time: Childhood Obesity: Most U.S. Schools Don’t Require P.E. Classes

Education.com: Physical Education is Critical to a Complete Education

Time: The Older Kids Get, the Less They Move

Anxiety and Depression Association of America: Physical Activity Reduces Stress

Public School Review: The Pros and Cons of Mandatory Gym Class in Public Schools

NBC News: So Just How Bad is Your Child’s Gym Class?

ABC News: No Sweat When Gym Class Cut

USA Today: More PE, Activity Programs Needed in Schools

University of Michigan: Physical Education in America’s Public Schools

Jezebel: Being the Last One Picked in Gym Class Really Messes You Up

My Aspergers Child: Aspergers Children and “Physical Education” Class

Study Mode: Physical Education Class: The Perfect Place to be Bullied?

Huffington Post: Majority of LGBT Students Bullied in Gym Class and Feel Unsafe

Slate: Food Deserts Aren’t the Problem

Guardian: Fat Profits: How the Food Industry Cashed in on Obesity

Jennifer Polish

Jennifer Polish is an English PhD student at the CUNY Graduate Center in NYC, where she studies non/human animals and the racialization of dis/ability in young adult literature. When she’s not yelling at the computer because Netflix is loading too slowly, she is editing her novel, doing activist-y things, running, or giving the computer a break and yelling at books instead. Contact Jennifer at staff@LawStreetMedia.com.

The post Phys Ed in Schools: Improving Health or Breeding Bullying? appeared first on Law Street.

Amid sustained calls to “fix this now” and the trending Twitter hashtag #boycottindiana, Indiana’s Republican leadership has quietly been maneuvering to maintain the increased discrimination against LGBT residents that Governor Mike Pence‘s “Religious Freedom Restoration Act” (RFRA) enabled. The Indiana legislature voted this week to deny protective provisions that would have ensured that religious protections cannot be used to discriminate against LGBT people. According to Think Progress editor Zack Ford, due to recent legal developments, “outside of the few municipalities with local protections, anti-LGBT discrimination is still legal throughout most of the state.”

And although #boycottindiana is trending hard on Twitter, the RFRA is hardly the only devastating bill to come out of Indiana recently.

But it’s the only one causing majors trends.

Why? One of the big reasons: mainstream (read: overwhelmingly white) LGBT advocates, organizations, and issues have largely gained the support of big businesses and corporations. (Yes, I know that the pizzeria that supported the RFRA made an absurd amount of money from the controversy. But that’s not the systemic trend, which favors corporations making profit off of and cooperating with upper- and middle-class, white LGB people and organizations.)

Whiteness must be decentralized from the LGBT movement. I’m sick of hearing about Leelah Alcorn and not Blake Brockington #HisNameWasBlake

— Ryan Mishler (@storyofryguy) April 9, 2015

So what could be trending under the hashtag #boycottindiana, but is not?

An incredibly scary amendment to Senate Bill 465, which addresses the operations of the Indiana Family and Social Services Administration, was passed in the Indiana House this week. Though much ire and rage have been focused on the Indiana Republican leadership that was responsible for the RFRA, it was Democratic Representative Terry Goodin who proposed adding the drug testing requirement to the bill.

Drug testing requirements in order to receive welfare fundamentally introduce even greater racism into welfare programs: even though white people tend to use illegal drugs at comparable or even higher rates than people of color, people of color are arrested and imprisoned at disproportionately higher rates for drug related “crimes” than white people. This means that people of color who are welfare recipients are going to be disproportionately targeted by the new provision’s requirement that recipients with histories of drug-related “crimes” be required to undergo testing. These folks will be stripped of their welfare benefits if they fail two tests.

So… Why is the #boycottindiana hashtag not blowing up with rage over this new twist to already-racist policies? Do my fellow white queers think racist laws are alright while homophobic laws are not?

Racial justice is LGBT justice.

So… Where are the trending boycotts against all kinds of racist laws across the country, like the resurgence of Jim Crow-esque laws that suppress the votes of Black and Latina people by mandating ID requirements for voting?

Where is the #boycottwhitenessinLGBTorganizations hashtag? The #boycottmassincarceration hashtag, or the #boycottracism hashtag? The #boycottwhitesupremacy hashtag?

Oh, yes. We can’t boycott those things. They’re too integrated into what makes this country operate.

Jennifer Polish

Jennifer Polish is an English PhD student at the CUNY Graduate Center in NYC, where she studies non/human animals and the racialization of dis/ability in young adult literature. When she’s not yelling at the computer because Netflix is loading too slowly, she is editing her novel, doing activist-y things, running, or giving the computer a break and yelling at books instead. Contact Jennifer at staff@LawStreetMedia.com.

The post There’s Something Scarier Than Religious Freedom Going on in Indiana appeared first on Law Street.

This won’t be news to anyone who experiences it, but this “just in”–being targeted and locked up by racism and the criminal justice system dramatically increases people’s experiences of depression, suicide ideation, and many other types of “mental illness.”

Except here’s the thing: like Bruce E. Levine over at AlterNet has shown, the U.S. government’s Substance Abuse and Mental Health Services Administration (SAMHSA) has shoved under the table a survey that demonstrates the explicit connections between high rates of mental illness and mass incarceration, racism, unemployment, heterosexsim, and classism.

One of the most damning aspects of the survey is that the rate and severity of experiencing mental illness is double for adults who have contact with the criminal justice system compared with adults who don’t. (Seriously. Check it out.) There seems to be the perception that this country locks up people because they experience mental illness: this is often true, and is repulsive. But if we want to look at the proverbial big picture, we also have to consider the ways that mass incarceration–and the solitary confinement often involved with imprisonment–and the virulent racism that shapes the prison-industrial complex actually cause mental health issues.

Levine writes, “[f]or decades doctors — and Big Pharma — have pointed to neuroscience [as explanations for “mental illness”]. Cultural variables are often more telling.” Indeed. But by SAMHSA’s logic, why damn the system that produces these mental illness-causing oppressions when you can convince people to buy overpriced, toxic pharmaceuticals drugs and therapy from it?

Of course, people who experience these oppressions don’t need government-sponsored studies and surveys to elucidate the ways that racism, mass incarceration, classism, and heterosexism make many of us live with severely impaired mental health.

Personal Example Time: I am certain that my being a white queer woman in this society fundamentally shaped my diagnoses as depressed and bipolar. Expected to be easily “corrupted” and traumatized because of my whiteness and white privilege; expected to be dedicated to others and feel guilty for putting myself first because of my womanness and heterosexism; expected to daily endure the structural and interpersonal impacts of sexism and queerphobia and always be “polite” about it…my diagnoses (and the feelings that precipitated seeking them) are not surprising.

White men–much like those who shoot people in schools and much like Germanwings co-pilot Andrea Lupitz–are routinely portrayed empathetically by mainstream media sources (instead of being called terrorists) because of their emotional angst and “understandable” mental illness when they kill over 100 people. However, people (especially working-class women) of color who defend themselves against attack are imprisoned, villified, and pathologized. In light of this, the consequences of not addressing racism, heterosexism, and classism in mental health are… well… life-threatening.

And far, far beyond depressing: the causes and consequences are outraging.

Jennifer Polish

Jennifer Polish is an English PhD student at the CUNY Graduate Center in NYC, where she studies non/human animals and the racialization of dis/ability in young adult literature. When she’s not yelling at the computer because Netflix is loading too slowly, she is editing her novel, doing activist-y things, running, or giving the computer a break and yelling at books instead. Contact Jennifer at staff@LawStreetMedia.com.

The post Mass Incarceration Leads to Depression, So Why Don’t We Stop? appeared first on Law Street.

In most cases, the law grants people autonomy over their own bodies, including a constitutional right to consent to or refuse medical treatment; however, for teenagers, that right is curbed by their parents, who have the right to control medical procedures in most cases until that child turns eighteen. There has been a lot of news lately where teens are fighting back against their parents over medical treatments, procedures, and even appointments. Read on to learn more about this issue, including mental health, substance abuse, and physical problems.

Parent – Child Medical Care

Traditionally when a teenager, child, or infant goes for medical treatment, including routine check-ups, parents are welcome in the room. Many doctors’ offices allow the parent in, while some do so only if the child says the parent can come in. This is especially true in more sensitive appointments. In most cases, a child’s parents or guardians are the ones who know the most about the child.

According to the University of Washington School of Medicine:

Parents have the responsibility and authority to make medical decisions on behalf of their children. This includes the right to refuse or discontinue treatments, even those that may be life-sustaining. However, parental decision-making should be guided by the best interests of the child. Decisions that are clearly not in a child’s best interest can and should be challenged.

The concern that a parent could make a decision that isn’t in their child’s best interest has led to some cases where children and teenagers start to fight back against their parents when it comes to medical care.

What are age of consent laws?

Doctors of all kinds, from dentists to ophthalmologists, have grappled for years with age of consent when it comes to mature adolescents. In a 2013 Pediatrics article, the authors stated:

It is well understood in the medical community that adolescents’ aptitude to make rational, responsible decisions changes over time and that older teenagers and young adults have substantially similar cognitive capacities.

According to Doctor Will See You Now, this question of maturity, and the automatic assumption of parent’s rights, endures as the general background rule that will apply in the majority of court cases regarding treatment of teens. The site points out that most frequently, parents are “free to sort among alternatives and elect the course of treatment based on his or her assessment of the child’s best interests.” This rule applies to any patient below the age of majority, 18 in most states, although in a small number of states, such as Delaware (19), Mississippi (21), and Nebraska (19),  it is higher. In Arkansas, Nevada, Ohio, Utah, and Wisconsin the age of majority varies due to high school graduation dates. Some health insurance plans also have rules associated with their policies.

Those who are evaluated to have a maturity over their physical age, however, have been deemed “mature minors” in some court cases. That concept, as psychologically valid as it is, is cloudier when it comes to state laws, which vary widely in their “mature minor” stances, including the ages at which one becomes a “mature minor.” SeverFew U.S. courts have already defined the term, and a few more will be tasked to evaluate it in coming months. Seventeen states do have some form of concession to the standard parental consent requirement, ranging from written exceptions from psychologists to emancipation rights. Most often, the exceptions are requested by minors seeking an abortion without parental consent or knowledge.

These rules have become increasingly open to exceptions aiming to protect minors’ privacy and bodily integrity, safeguard the public health, and respect older minors’ adult-like autonomy and decision making ability.

Sensitive Categories of Treatment: Exceptions to the Rule

All states have some exceptions to parental consent when it comes to medical care for minors. It can become public health issue if young people are scared to get medical treatment because they have to tell their parents about them. These include procedures like testing for STDs–something that all 50 states and D.C. allow minors to do without having parental permission.

In many states, but not all, minors can also give their personal consent without their parents’ input regarding reproductive health services, with regard to contraceptive services and prenatal care, as well as drug and alcohol abuse treatment and outpatient mental health services. However, there usually is a minimum age for this kind of care without parental consent–usually early teens. These laws also don’t preclude parents from being able to require them to submit to treatment.

Abortion

One specific area of concern when it comes to minor medical care is abortion. Most states require parental consent for a minor to receive an abortion, although Supreme Court precedent allows a pregnant minor to receive an abortion under certain circumstances, such as “if she is sufficiently mature or if it would be in her best interests mentally and physically.” “Tests of maturity can include questions about good grades or extracurricular activities, as well as other less-defined queries that would allow judges to see a young person’s thinking process and understanding of the procedure,” said Doriane Coleman, a law professor at Duke University. The law is pretty inconsistent state-by-state, however, in some states, another relative could be allowed to be present at the abortion, in others a young woman could go to court to fight for her right to have the medical procedure.

Substance Abuse

When it comes to substance abuse, some states allow minors to consent to treatment. However, the laws usually also require that minors have to receive treatment if their parents consent to it on their behalf. Allowing minors the option to consent is is an attempt to make sure the treatment sticks–after all, a person who consents to treatment or requests treatment is more likely to follow through and at least stay in the program until the end.

According to the Doctor Will See You Now:

For doctors, the issue is that even if a minor is empowered by state law to give consent, they still need to ensure that the minor is intellectually and emotionally capable of giving informed consent. Thus, even if there is no age limit under state law or the age limit is very low, at times doctors may find it is inappropriate to allow a minor to consent to his own care if he is too immature or otherwise incapable of understanding the procedure’s risks, benefits and alternatives.

Payment, Confidentiality, and HIPAA

Additionally, the Doctor Will See you Now points out:

The fact that some minors can consent to their own health care and treatments in certain areas does not always mean that they actually have a right to confidentiality with respect to that care. Under the Health Insurance Portability and Accountability Act (HIPAA), practitioners are basically required to follow state law regarding confidentiality for minors, and they are given discretion over parental notification when state law is silent on the issue. Most parents will find out eventually, whether it is from HIPAA or the patient’s own volition.

Particular federally funded programs also have certain confidentiality laws. For example, services subsidized by Title X, the federal family planning funding program, have to be provided confidentially, per federal law.

Case Study: Cassandra C.

The Connecticut Supreme Court ruled recently that the state was well within its rights to require a young woman named Cassandra C. to continue undergoing chemotherapy treatments even though it wasn’t what she wanted. Her mother wanted her to do whatever she thought was best.

Because of the nature of the case, and concerns about Cassandra’s wellbeing, the case has been featured in the national news. Unfortunately, Cassandra spent every day in isolation from other patients and was under constant supervision. “She hasn’t been convicted of a crime, but it’s kind of like she’s in jail,” said Joshua Michtom, an assistant public defender and Cassandra’s lawyer. “It’s an especially lousy way to go through chemo.”

Court Orders

There are very rare situations in which the court becomes involved, because parents aren’t acting in the best interests of their children. In addition, there are cases like those outlined in the novel My Sister’s Keeper, where parents seek to have a minor child donate an organ to a sibling, or to undergo any other significantly invasive medical procedure for the benefit of another child.

Conclusion

Medical decision making by and on behalf of children and teens is a subject that is ethically, mentally, physically, and legally complex. State laws vary considerably, and they often have vague standards and language. Children should generally be involved in medical decision making to the extent of their abilities. It is not only a teaching moment, but it is also a way to create autonomy. In the case of a conflict between a minor’s wishes and a parent’s wishes, however, everyone needs to proceed with caution, especially in life or death cases. As such, it is usually wise for them to seek the advice of legal counsel and, in some cases, to proceed to court for a judicial order authorizing the proposed course of treatment.

Resources

Primary

District Court of Appeal of Florida, First District: DEPT. OF HEALTH v. STRAIGHT, INC.

Eastern District Court of Pennsylvania: Parents United for Better Schools v School District of Philadelphia

Additional

The Doctor Will See You Now: Doctor-Patient Confidentiality: How Do We Define It and When Should We Waive It?

Journal of Health Care Law and Policies: Medical Decision Making by and on Behalf of Adolescents

Journal of Pediatric Psychology: Involving Children and Adolescents in Medical Decision Making: Developmental and Clinical Considerations

Guttmacher Institute: Minors and the Right to Consent to Health Care

Philly: Should Teens Get to Say “No” to Life-Saving Medical Treatment?

Pediatrics: The Legal Authority of Mature Minors to Consent to General Medical Treatment

Editor’s Note: This article has been edited to credit select information to the Doctor Will See you Now, and some portions have been edited for clarity. 

Noel Diem

Law Street contributor Noel Diem is an editor and aspiring author based in Reading, Pennsylvania. She is an alum of Albright College where she studied English and Secondary Education. In her spare time she enjoys traveling, theater, fashion, and literature. Contact Noel at staff@LawStreetMedia.com.

The post Medical Care for Minors: Who Calls the Shots? appeared first on Law Street.

It’s a new year, and I for one am excited to see what it will bring. No matter what, there will definitely be a lot of legal issues to discuss, debate, and bring changes to all of our lives. The five cases below are the top five to watch in 2015; some have already appeared before SCOTUS and await decisions in 2015, while others will be heard throughout the year. Here are five fascinating Supreme Court cases to watch in 2015.

Anthony Elonis v. United States

Law Street has actually been covering this interesting case for a while–check out our coverage of the case, the University of Virginia law clinic that’s gotten involved, and the all the legalese behind it. The reason we’ve followed it so closely is because it really is fascinating. Anthony Elonis was convicted of threatening multiple people, including his wife, an FBI agent, the police, and a kindergarten class. But these weren’t threats in the classical sense. They were written on his Facebook page in the form of rap lyrics. He claims the posts are art, protected under the First Amendment, and that he never intended to hurt anyone. It will be up to the Supreme Court to decide if such intent needs to be shown when convicting someone of making threats. The case was heard on December 1, 2014, but the court has yet to rule.

King v. Burwell

In King v. Burwell, SCOTUS will yet again be asked to weigh the Affordable Care Act. This time, it’s all about the tax subsidies, and weirdly, the central question in really depends on one word: “state.” The way that the ACA reads, in order for an individual to qualify for a tax subsidy, he needs to be receiving healthcare “through an exchange established by the state.” So, can people residing in states that haven’t set up their own exchanges, but instead rely on the federal program, get those tax subsidies? The IRS certainly thinks so and has been granting the subsidies. It’s an argument based pretty much on semantics, but it could have a huge effect on the ACA itself. This case will be heard in March.

Peggy Young v. United Parcel Service 

This case will ask the Supreme Court to weigh in on how pregnant employees are treated. Peggy Young, formerly a delivery driver for UPS, is arguing that the company violated the Pregnancy Discrimination Act (PDA). The PDA says that pregnant workers should be treated the same as any other worker who is “similar in their ability or inability to work.” Young and her lawyers argue that other employees who sustain temporary injuries or something of the like are moved to other positions, while she was forced to take unpaid leave. UPS claims that those other workers are given different jobs based on policies that don’t apply to Young, and she was treated the same as she would have been had she sustained an injury out of work. It will be up to the Supreme Court to decide who’s in the right here. The case was just heard in December 2014; an opinion is forthcoming.

Holt v. Hobbs

Holt v. Hobbs will require the justices to look into prison procedures that prevent inmates from growing a beard in Arkansas. The plaintiff, Gregory Holt, wants to be able to grow a half-inch beard in accordance with his Muslim faith. The state is arguing that it could be used to smuggle drugs or other contraband. SCOTUS will have to rule on whether or not those prison procedures violate the Religious Land Use and Institutionalized Persons Act (RLUIPA). The question that the justices will consider is whether or not there’s a compelling enough government interest to prevent Holt from expressing his religion. The case was heard in October 2014; the opinion will be issued this year.

Alabama Legislative Black Caucus v. Alabama

This case centers on the practice of gerrymandering. The justices will have to decide whether or not it was illegal for Alabama to redraw the districts in 2012 after the Census in a way that packed black voters into particular districts. The Alabama Black Caucus says that it relied too much on race when drawing those districts. While partisan gerrymandering is usually legal, racial gerrymandering is not–so the justices will have to decide which actually happened here. This case was heard in November 2014; the opinion is expected in the coming months.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post SCOTUS Cases to Watch in 2015 appeared first on Law Street.

For the majority of my life, war has been the norm in the United States. We entered Afghanistan in 2001 and Iraq in 2003. War is the new normal–and between 2004-2011 war was, as expected, mostly the leading cause of death for troops in the U.S. military. But for the last two years, that trend did not hold true. Suicide has surpassed war as the number one killer of American troops.

Suicide is also incredibly prevalent among veterans. According to a report released by the Department of Veterans Affairs, 22 veterans take their own lives every day. Given the way the VA collects that information it’s speculated that that number could be even higher. To put this in context, roughly 20 percent of suicides in the United States are committed by veterans, even though they make up just 10 percent of the population. That’s a startling and terrifying figure; as News21 put it:

Suicide rates within the veteran population often were double and sometimes triple the civilian suicide rate in several states. Arizona’s 2011 veteran suicide rate was 43.9 per 100,000 people, nearly tripling the civilian suicide rate of 14.4, according to the latest numbers from the state health department.

Now, the civilian suicide rate has also been rising. According to the New Yorker:

In the United States, suicide rates have risen, particularly among middle-aged people: between 1999 and 2010, the number of Americans between the ages of thirty-five and sixty-four who took their own lives rose by almost thirty percent.

Suicide is a gigantic issue among both our troops and our veterans. The ways in which we understand Post Traumatic Stress Disorder and the effects of war continue to evolve, but clearly we haven’t done enough. See the infographic below for just some of the ways in which veterans’ and active service peoples’ duties can affect them.

Courtesy of Blackwater Law.

PTSD is tricky because it can show up suddenly or gradually, sometimes a long time after the traumatic event. In addition, medical care for veterans hasn’t always been as top notch as it could be–we all remember the VA hospital scandals earlier this year. PTSD can fuel depression, alcoholism, and various other problems. There are other reasons that veterans and service members are at particular risk. For some, reacclimating to civilian life can be very difficult. While there’s no dispositive list of risk factors, it’s clear from statistics alone that this is a significant problem.

The argument that the suicide rate will go down once we’re fully out of Afghanistan and Iraq seems like it should make sense, but it’s not that simple. Even while those wars have been slowly de-escalated, suicide rates have remained pretty constant. That ties back to the fact that PTSD can develop over time along with those struggles that veterans face when they return. A troubling portion of our nation’s veterans become homeless, which makes getting them access to health care and help even more difficult. After all, since 2010, there has been a thirty-three percent increase in homeless veterans.

The fact is that anyone who is a member of our military forces–or former member–deserves the utmost respect, help, and care. But that simply isn’t happening–and until I started looking up these statistics today I didn’t quite realize how much we are failing them. Something has to change–and it starts with awareness.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post With 22 Veteran Suicides Each Day, Where Are Our Priorities? appeared first on Law Street.

This question might conjure chilling images of flavorless fixed rations, compulsory exercise regimes, and the foreboding scales of a totalitarian weight monitoring mechanism.

Take a deep breath. Mandatory weigh-ins have no place in your near future. However, the government already influences your weight in indirect ways using methods more subtle than scales. It’s not because they’re nosy or superficial, it’s because weight, specifically being overweight, is a burgeoning public health plight in the United States.

What’s the big problem with obesity?

In the not-too-distant past, being overweight was a harmless stigma — a matter of aesthetics and not health. Today we know that obesity comes along with a load of serious health complications like heart disease, high blood pressure, Type 2 Diabetes, and some types of cancer. The Centers for Disease Control and Prevention (CDC) estimate that 112,000 deaths a year are associated with obesity. Related medical expenses burden the United States with more than $100 billion annually. Ouch.

What’s even scarier? Obesity prevalence is overwhelming the United States population. According to the CDC, more than one third of American adults are obese. That’s more than double the rate of the last decade.

Before you brush it off as an unfortunate fact of life, here’s some visual perspective from the CDC on this explosive growth:

Obesity prevalence in 1990. The darkest blue represents a rate of 10%-14% population obesity.

Obesity prevalence in 2009. Note all of the completely new colors. Obesity rates of all states have surpassed those seen in 1990.

Previous efforts to confront obesity have focused on individual interventions like nutrition education. The climbing rate of obesity despite these efforts revealed some missing pieces in the strategy. Experts realized obesity wasn’t just a matter of willpower. Recognizing the multi-faceted approach needed to combat obesity, officials fixed their attention on underlying causes that escape an individual’s control.

How is obesity out of individual control?

Obesity isn’t just about individual choices, it’s about individual options. The fight against obesity is futile for those without the right options. For example, poor access to supermarkets because of zoning complications may make smart food choices a hopeless pursuit. A simple jog isn’t an option for those with nowhere to do it safely.

Furthermore, we have a hard time helping ourselves. One study found that concern over weight isn’t a sufficient catalyst for behavioral change. Concerned people who lack access to healthy foods are stripped of the power for change. The pervasiveness of fast food establishments peddling calorie-dense foods present an invincible double threat.

Government regulations can interfere when individual resolve falls short. Large-scale policies to create healthier communities could help those who can’t help themselves.

What can the government do?

The Standard Toolkit

The Commerce Clause of the Constitution bestows the federal government with the right to regulate state commerce. This translates practically to weight-related regulations like food labeling mandates and subsidies on foods. On a more local level, the Constitution grants states the power to regulate the health, safety, and welfare of their populations. This broad power translates to a variety of possible actions.

Here are some examples of perfectly legal government actions that affect what we eat and consequently what we weigh:

Taxes and Subsidies

Some cities and states already have taxes on sugary drinks. Opinions are split on extending taxes on junk food. James Carville thinks it might be a good idea to tax “Twinkies more than apples.”

The government subsidizes certain crops, often increasing their prevalence in our diets. Corn is a popular example of the power of subsidies. In Michael Pollan’s The Omnivore’s Dilemma, one researcher likens Americans to corn chips with legs.

Bans: New York City made history when it took measures to strike trans-fats from restaurant menus.  After the rule survived backlash, other states and cities followed suit. In the next few years, the FDA will undertake a national trans-fat phase out.

Labeling: New York City again led the way by requiring restaurants to disclose nutrition information on their menus. The federally-mandated nutrition label is probably the best known example of enforced food labeling.

Zoning and Land Planning: In some areas, large supermarkets and farmers markets are zoned out, making healthy food hard to come by. Developing parks and sidewalks is a proven way to get people moving without the conscious choice to exercise more.

Transportation: Some studies have shown that people who use public transportation weigh less than those who commute in cars. Unfortunately, more money is invested in highways than in public transportation.

Health Care and Benefits: Tennessee and West Virginia have reimbursement programs for Weight Watchers and 42 states provide gastric bypass surgery for the morbidly obese.

Alternative Approaches

Not all approaches that aim to reduce obesity target diet and exercise. Some of them appear unrelated to obesity at first glance. For example, a breastfeeding facility law requires employers to provide proper accommodations to encourage breastfeeding. While the law helps new mothers in many ways, it’s also a CDC priority strategy to prevent obesity as breastfeeding has been tied to reduced early childhood obesity.

Numerous policies and campaigns aspire to shrink obesity rates. They focus on a broad range of factors from diet specifically to overall health and wellness. CDC’s Division of Nutrition, Physical Activity, and Obesity database lists state-by-state activities if you want to get an idea of what’s in place.

What are lawmakers suggesting?

What does the future hold for the fight against obesity? Check out these examples of what policymakers have been cooking up:

Healthy Lifestyles and Prevention America (HELP) Act: Proposes a multi-pronged intervention strategy to enhance overall wellness of the American people. Children would enjoy enhanced nutrition and physical activity programs in schools and in childcare settings. Adults would benefit from workplace wellness programs. Everyone would benefit from proposed attacks on both salt and tobacco.

FIT Kids Act: Would fund grants for physical education programs that are based on scientific research. States would be required to analyze and identify specific student needs and develop their programs accordingly. The act would also require states to develop indicators of progress.

Reduce Obesity Act of 2013:  Suggests an amendment to title XVIII of the Social Security Act that would require the Medicare and You handbook to include information on behavioral therapy for obesity. It would allow physicians and other experts on Diabetes prevention to provide behavioral therapy outside of the primary care setting.

Stop Childhood Obesity Act of 2014: Seeks to deny financial benefits for companies to advertise and market certain food products to children. Tax deductions granted under the Internal Revenue Code would be barred for advertising to children that promotes consuming foods of poor nutritional quality. The Secretary of the Treasury and the Institute of Medicine would determine what constitutes foods of poor nutritional quality.

Beyond regulations and policies…

Some suggest that legal approaches may fill in the gaps left after regulations. The paper Innovative Legal Approaches to Address Obesity presents techniques that leverage law to  tackle obesity:

Regulating conduct: The Massachusetts decision to ban self-service displays of tobacco was upheld in the case of Lorillard Tobacco v. Reilly. Perhaps courts would uphold similar decisions to remove processed foods from checkout aisles.

Ingredient caps: The government can limit the alcohol content of beer. They might do something similar with sugar if it’s proven to be harmful and addictive.

Limits on food marketing: Advertising messages are protected under First Amendment rights. As early as 1978, the FTC attempted a rule to limit advertising of sugary products to children. The rule was struck down after massive industry opposition. Many hope to revisit similar rules as obesity-related health consequences surface.

Compelling industry speech: A near opposite to limiting advertising would be to compel industry speech and require companies to disclose information that might affect consumption. The United Kingdom’s traffic light system provides an extreme example.

Increasing government speech: Government speech could be leveraged to counteract the prevalence of advertising messages by encouraging the consumption of healthy foods. The “5 a Day” fruit and vegetable campaign in the United States is one such example.

Purchase limits: The Supreme Court has allowed individual purchase limits on items like prescription drugs. Perhaps a limit on the amount of sugary beverages a minor can purchase could also be enacted.

Penalties for causing addiction: The government has a right to restrict sales of certain products to minors that it finds harmful or addictive — like alcohol and cigarettes. Some studies have suggested certain food additives are addictive. Companies could be vulnerable to litigation if they have been knowingly manipulating ingredients to encourage overconsumption.

Nuisance law: Pollution is considered a public nuisance. Likewise, the creation of obesogenic foods proven to be harmful to health could be deemed a public nuisance, punishable by fines or criminal sentences.

Performance-based regulation: Performance-based regulations would put responsibility in the hands of industry. A company might be given a measurable goal related to reducing obesity rates. Businesses that fail to meet assigned outcome goals would be financially penalized.

Where do we go from here?

Let’s be honest, the obesity issue has been confounding us for years. Explosions of diet fads that vilify certain ingredients don’t help matters. Fat? Sugar? Gluten? Carbs? Most people just don’t know what to eat even though they’re being showered with ample advice.

Obesity lacks a simple cause, making it a convoluted case to crack. An array of dimensions in behavior, lifestyle, and environment contribute to it. Policy makers have their work cut out for them in innovating a range of initiatives that might control it. Consumers have their work cut out for them in sorting through all of the advice thrust at them to make sound decisions. Neither can stand alone. Consumers need all the help they can get from carefully designed government regulations that don’t infringe on privacy.

Should the government do more to help the population control their weight? Should they do less? Comment to tell us what you think.

Resources

Primary

CDC: State Legislative and Regulatory Action to Prevent Obesity and Improve Nutrition and Physical Activity

Yale University: Innovative Legal Approaches to Address Obesity

Additional

Millbank Quarterly: Public Health Law and the Prevention and Control of Obesity

Yale University: Improving Laws and Legal Authorities for Obesity Prevention and Control

CDC: Adult Obesity Facts

CDC: Overweight and Obesity Policy Resources

George Washington University: Review of Obesity Related Legislation & Federal Programs

Washington Post: U.S. Sugar Subsidies Need to be Rolled Back

The New York Times: Proposed Tax on Sugary Beverages Debated

Coalition for Sugar Reform: Reform Legislation

Intelligence Squared: Obesity is the Government’s Business

NIH: Evidence for Sugar Addiction: Behavioral and Neurochemical Effects of Intermittent, Excessive Sugar Intake

SAGE: The Role of Self-Efficacy in Achieving Health Behavior Change

Georgetown University Law Center: Assessing Laws and Legal Authorities for Obesity Prevention and Control

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post How the Government Regulates Obesity appeared first on Law Street.

Mankind’s greatest enemy is not war or hunger but infectious disease. Throughout history it has cost countless deaths, and even in the twenty-first century our defenses against it remain limited. Above all, it is the threat of outbreak that unsettles us so; it is not just suffering and death, but fear. Whether it’s the Black Plague, Cholera, Spanish Influenza, H1N1, or Ebola, disease is a dark cloud looming over our lives.

Most of the microscopic killers with which we contend have been transmitted to us through animals. In the early ages of settled agriculture, close contact with domesticated chickens, pigs, cows, and others exposed humans to pathogens to which their immune systems had no previous exposure and consequently minimal means by which to combat them. There are two primary behavioral patterns of diseases. Some ascribe to the category of “chronic.” In this case, as geographer and ornithologist Jared Diamond explains, “…the disease may take a very long time to kill its victim; the victim remains alive as a reservoir of microbes to infect other[s]…” The other category is “epidemic.” In this case, Diamond continues, there might be no cases for a while, followed by a large number in an affected area, and then none for a while more. Such behavior is a consequence of the intensity of the disease’s manifestation; it strikes with such force that it basically burns itself out because the potential hosts all either die or become immune.

“Epidemic” is a widely feared term. Rather than consider the fact that they can and have been occurring on very small scales throughout human history, many people associate epidemic with things like the Black Plague in Europe, Smallpox in the New World, or a global zombie apocalypse. Since people naturally fear most what they do not understand, insufficient knowledge of disease vectors and behavior results in widespread fear and panic.

Ebola is a relatively late arrival on the scene. Originally suspected to be yellow fever, it was discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Samples extracted from an ill nun who had been working in the region came to doctors and scientists in an Antwerp, Belgium laboratory. They eventually discerned that the infection behaved differently from what would be expected of the original diagnosis. After sending samples to the Center for Disease Control in Atlanta, their conclusions were confirmed and a new disease had been discovered. Shortly thereafter, another outbreak occurred relatively far away in Sudan. While knowledge of the initial source and starting location of the disease is still vague, it was determined that it had spread via unsterilized syringes and contact with bodies during funerals. Therefore a lack of knowledge of the nature of the disease lent itself to its spread.

Ebola in large dropped off the radar screen until the recent epidemic began in West Africa. Going hand in hand with lack of knowledge of the disease are incomprehensive and underdeveloped means of addressing it. On a recent edition of Global Public Square, the insightful international news show hosted by CNN’s Fareed Zakaria, international relations PhD Chelsea Clinton declared that the disease is spreading exponentially, necessitating exponential containment measures. This is very difficult to achieve, due to the poor technological and economic infrastructures of the region. As Dr. Paul Farmer — another guest on Zakaria’s show — expanded, the Liberian healthcare system is also very weak. Liberian Foreign Minister Augustine Ngafuan detailed how Liberians have deeply ingrained burial practices that involve close contact with bodies; this is an important aspect of cultural values in the region and not easily relinquished in the face of something that foreign experts, much less locals, barely understand.

A Liberian village, courtesy of jbdodane via Flickr.

Globalization and increased interconnectedness between individuals, societies, and locations has exacerbated the rate at which diseases spread. Many Americans cried out when infected aid workers were brought home to be treated. Appropriate measures were taken in this instance, with sanitary transportation vehicles bringing the patients to the Emory hospital in Georgia. Due to its affiliation with the CDC, this is one of the few facilities truly equipped to accommodate infectious diseases of this nature. Both those patients recovered, though they would likely have died if they were forced to remain in Africa. The situation was handled intelligently and effectively, without resounding negative consequences. Yet the outcry and fear demonstrates people’s lack of knowledge and tolerance of the unknown and perceived dangers. This was in fact the first occasion in which Ebola was present on American soil.

The situation changed with the death of Thomas Duncan. Having arrived from Liberia in late September, Duncan provided a new first by being the first patient diagnosed with Ebola in the United States. His illness was unknown during his transit, and so new fears arose as to the likelihood of Ebola crossing the ocean with traveler hosts. Now in a complete state of fear, Americans want more and more action taken in defense of the nation’s health, yet do not know what those measures ought to be because we do not know enough about the disease. Many airports have begun taking travelers’ temperatures. The CDC initially cited 101.4 degrees as the point at which one must be quarantined, but lowered it after some supposedly ill people were cleared. This demonstrates the uncertainty of the disease’s nature; in what ways does Ebola affect a person’s body temperature? At what point in their illness are they contagious? Is a body temperature an effective indicator of this? These questions have yet to be answered for the disease of whose existence we have known for less than 40 years.

Specialists clean up a Hazmat area, courtesy of sandcastlematt via Flickr.

The second set of problems that are causing fear are the alleged breaches of protocol that have enabled several other people to catch the disease in the United States. The Dallas hospital in which Duncan died was not equipped to handle this disease and consequently could not treat him effectively. Furthermore, the staff did not have the proper training insofar as interacting with Ebola, and this has been cited as the reason why nurse Nina Pham, who was treating him, became ill as well. A recent video surfaced wherein a patient is being transferred from one vehicle to another by four workers in “hazmat,” or hazardous material, uniforms. A fifth person, dubbed “clipboard man,” stands with them completely unprotected. Finally, CDC Director Dr. Tom Frieden has come under fire for making statements and then retracting them. Pennsylvania Republican Congressman Tom Marino has even called for him to step down. We have quickly forgotten, though, that in the early 1990s Frieden was instrumental in developing awareness and programs to combat a rising Tuberculosis epidemic in New York City. In addition to other stellar career highlights, Frieden is a highly capable leader experienced in engaging these concerns.

We are too wrapped up in fear of the unknown to do anything but demand immediate results. Ebola is a newcomer on the scene and will take some time to understand effectively. As we continue to discern our relationships with our surrounding environments, we do know that ebola is not nearly as contagious as other diseases. It requires direct contact with bodily fluids of infected patients. As we continue to learn how it works, and how our actions, societies, and cultures interact with it, we will become more effective at addressing it. In the meantime, we annually face airborne foes which are far more dangerous and contagious; do not forget to get your flu shot in the coming weeks.

Franklin R. Halprin

Franklin R. Halprin holds an MA in History & Environmental Politics from Rutgers University where he studied human-environmental relationships and settlement patterns in the nineteenth century Southwest. His research focuses on the influences of social and cultural factors on the development of environmental policy. Contact Frank at staff@LawStreetMedia.com.

The post Ebola and America’s Fears appeared first on Law Street.

If you are going to a pharmacy for a particular drug, you’re often offered a choice — do you want the name brand or the cheaper generic? Generics have long been lauded for their ability to provide the same benefits to patients while also offering a less hefty price tag; however, recently generics have been getting more expensive, and people are wondering why. Congress announced this week that it’s going to launch an investigation into why the price of generic drugs is rising.

When a drug company develops a particular drug, it gets to hold the patent for approximately twenty years (some nations or jurisdictions give protections for a bit longer). During that period, that company is the only one that can produce that particular drug. After the patent expires, however, other companies can make a “generic” version of the drug.

There are certain regulations created by the Food and Drug Administration (FDA) to make sure that the generic drugs are able to be distributed. The FDA requires that a generic drug has the same active ingredients as the one that it is imitating, but not necessarily the same inactive ingredients (such as coloring). A generic has to perform the same function as the name brand, and it must of course meet the same health and safety standards.

Generic drugs tend to be less expensive than the name brands — and given the high cost of American health care, offer great and affordable options for consumers. However, it seems like the cost of these drugs is increasing. For example, the patent for Ambien, a popular sleep aid, recently expired. Now it’s a lot easier to get a generic version of Ambien for a cheaper price, and more people are able to get the product they need.

A study completed in August discovered that some generic prices have been dropping, while others have been rising almost exponentially. According to the Wall Street Journal:

The prices paid by pharmacies more than doubled for one out of 11 generics. And in a few cases – notably, the tetracycline antibiotic and the captopril blood pressure pill – the cost increases not only exceeded 1,000%, but topped 17,000%…. Yes, 17,000%.

Doctors have reported how troubling this kind of price increase can be in certain generic drugs for the patients who rely on them. Some patients who are on fixed incomes, such as those on Medicaid, may not be able to pay for the non-covered costs of the drugs if prices skyrocket that much. They may try to skip their prescriptions in an attempt to make ends meet. Not only is this obviously problematic for the patients themselves, but it also leads to more emergency room visits and a less healthy society in general.

That brings us to the investigation that Congress is evidently undertaking to try to figure out why exactly these generic prices are climbing so sharply and how to reverse the trend. The analysis is being pushed by Senator Bernie Sanders of Vermont and Representative Elijah Cummings of Maryland. We can all say a lot about the inadequacies of Congress, but this is a good move on its part. It’s really important that we get the prices of generics under control, because price increases like this are almost always passed directly to the consumer. With as many healthcare problems as we have, this is an issue that needs to be nipped in the bud as soon as possible.

—

Anneliese Mahoney (@AMahoney8672) is Lead Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

Featured image courtesy of [Chris Potter/Stockmonkeys.com via Flickr]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Congress to Investigate Rising Generic Drug Costs appeared first on Law Street.

Health care costs have long been a hot topic of conversation in American culture. We’ve had problems with our health care system because the costs are high, of course, but also because sometimes they’re simply unknown. Often people who go in for a procedure, even with insurance, have no idea how much they’re going to owe until they receive a bill in the mail. One state has finally decided that that’s a bad way of doing things–starting this month, the state of Massachusetts is providing “price tags” for healthcare.

As of last week, if you are insured through a private company, you can go on that company’s website, type in what medical procedure you’re looking to get, and it will tell you how much it costs. This is part of an act that Massachusetts passed in 2012 that aimed to create greater transparency in healthcare costs, and make the system more efficient.

Now this system isn’t perfect, nor is it centralized. Not every single cost associated with a particular medical procedure will be listed–for example some places won’t list the cost of reading a scan or processing a test or an accompanying hospital stay.

The WBUR reporter who checked out the system, Martha Bebinger, also noticed some other interesting components. Health care costs vary by hospital or doctor, as well as by insurance provider. In some cases the difference was negligible, but in others, it was striking. For example, the cost of an Upper Back MRI ranges from around $600 to $1800, depending on where you go. Bebinger also noticed that the costs can change from day to day.

This is a valuable tool, because in addition to allowing patients to figure out where would be the best place to get a particular procedure, it also allows them to plan ahead. Some of the sites also create calculations of co-pays and the like, making the sites even more budget-planner friendly. Some of the sites allow the ability to leave patient reviews, so people can get some idea of the quality of the healthcare they will get before they actually commit. And while the system is by no means centralized, all of the big insurance providers in Massachusetts seem to have created some sort of online site with the ability to price-check.

The new requirements have also been applauded because of the hope that they may drive healthcare prices down. If people are able to readily access prices, they will shop around, and private doctors may offer slightly lower prices to incentivize customers.

The only possible concern I see is that people may be discouraged from going to the doctor’s office if they know in advance how much it will cost. However, I would imagine that those cases would be few and far between, and that overall, more transparency will benefit people who are on a budget.

Massachusetts has, in the past, introduced innovations in its health care system that ended up becoming national trends–the Affordable Care Act was loosely based on Massachusetts’s system of healthcare. Massachusetts may once again be in the position of testing an idea that could eventually end up a national norm.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Healthcare Procedures in Massachusetts Now Have Price Stickers appeared first on Law Street.

Earlier this year, the Environmental Protection Agency (EPA) released new guidelines for what gasoline can contain. The motive behind the new regulations was to create gasoline that minimizes the effects on the environment, improve public health, and mitigates the effects of climate change. One big change was that the EPA announced its desire to minimize the amount of sulfur in gasoline. Read on to learn about the effects of sulfur in gasoline, the debate, and the end results.

Why do we care about sulfur in our gasoline?

Sulfur is a smog-forming pollutant that has been linked to respiratory diseases and air pollution. The new regulations would require refiners to reduce the amount of sulfur in gasoline by 60 percent by 2017, from 30 parts per million to 10 parts per million. President Obama asked the EPA for cleaner gasoline standards in 2010, and since then the EPA has worked with scientists and automakers to develop these new regulations. However, the regulations would require oil refiners to install expensive new equipment in their refineries and would force auto manufacturers to install new pollution-control in car engines. While some argue that these new regulations will improve health at a minimal cost, oil refiners argue that the costs are unnecessarily expensive to their industry, thus hurting consumers, taking away jobs, and negatively impacting the economy as a whole.

What are the arguments for these new guidelines?

Advocates argue that the additional costs of the EPA regulations would pay for themselves by the year 2030 through decreased costs in health care. The EPA estimates that the reduction in sulfur emissions would save Americans between $5.7 and $19 billion by the year 2030 and would reduce the amount of sick days taken at school and work. The EPA also estimated that Americans could see the prevention of 770-2,000 premature deaths, 2,200 hospital admissions, 1,900 asthma attacks, and 30,000 reported cases of respiratory problems in children living near highways or urban centers. All of these health benefits, the EPA claims, would come at an increase of just 2/3 of a cent per gallon and the addition of just $75 to the sticker price of a new car.

Representative John Dingell (D-MI) explained the benefit behind the new law, stating,

We do have a serious problem with too much sulfur in gasoline. It screws up the mufflers, it screws up the catalytic converters, and it screws up a lot of other things, too.

Other advocates point to the emission standards of the European Union, Japan, and South Korea, which are far ahead of those in the United States, to argue that these regulations would bring the US up to speed with other developed countries. Lastly, some in the auto industry have argued that these sulfur emission standards would be beneficial to auto makers in enabling them to meet newer, stricter federal environmental regulations, which would more than make up for the additional cost of rigging their cars to emit less sulfur.

What are the arguments against the new guidelines?

Opponents argue that the EPA regulations would have minimal environmental impact while putting greater strain on the economy and ultimately hurting consumers. Since 2000, oil refiners have already been required to reduce the sulfur levels in gasoline by 90 percent; the new regulations would mandate the removal of the last 10 percent, which according to experts is much more difficult and costly to remove than the initial 90 percent. This process would cost the oil industry roughly $10 billion and would increase the cost of gas by nine cents per gallon. This increased cost would force the oil companies to cut employment and raise prices, which in the end hurts the average consumer. Additionally, opponents argue that these increased costs are unnecessary because they will have little impact on climate change and global warming. While sulfur emissions contribute to smog and some air pollution, there has been no link found between sulfur emissions and the factors that contribute to climate change, leading opponents to argue that the environmental impact of these regulations is just not worth the economic stress forced upon consumers and job seekers.

The American Petroleum Institute (API) disagreed with the new guidelines, complaining especially about the little time that producers will have to comply with the guidelines. The API’s Bob Greco claimed that the rules don’t allow enough flexibility for producers to switch over in both a timely and safe manner. Patrick Kelly, an API Senior Policy advisor, also said:

API opposes this discretionary rulemaking as we have serious doubts as to the Agency’s justification for it. We have been insisting that EPA demonstrate a scientific justification for two and a half years. API commissioned research on the costs and benefits associated with further reductions in gasoline sulfur. We found some clear conclusions: The proposed standard will yield little immediate or longer term air quality benefits. And, reducing average sulfur from 30 parts per million to 10 parts per million will impose enormous costs. Further reducing gasoline sulfur is not necessary for meeting more stringent vehicle emissions standards, and automakers are unlikely to introduce vehicle emission technology that is enabled by the lower sulfur fuel.

Conclusion

The implementation by the EPA of new guidelines regarding sulfur in gasoline made news this spring. As the guidelines continue to be phased into place, there is still disagreement about the viability and fairness of the rules, and whether or not they will have a concrete effect on our environment, health, and economy remains to be seen.

Resources

Climate Progress: A Comprehensive Guide to the EPA’s New Pollution-Reducing Gasoline Rules

Huffington Post: Sulfur, Sulfur, Toil and Trouble

TIME: EPA’s New Emission Rules Could Increase Gas Prices, Save Lives

Earth Day Network: EPA Finalizes Tier 3 Gasoline Standards

Environmental Protection: API Opposes EPA’s Tier 3 Rule

Bloomberg: Refiners Rebuff EPA Concessions In Rule to Cut Sulfur

Machinery Lubrication: New EPA Gasoline Regulations Costly, Counterproductive

Bloomberg: EPA Said Poised to Issue Lower Sulfur Limits On Fuel

The New York Times: EPA Set to Reveal Tough New Sulfur Emissions Rule

Utah Political Capitol: Tier 3 Gasoline: Air-Pollution Slayer or Tail Pipe Dream?

Convenience Store and Fuel News: EPA Finalizes Tier 3 Emission & Fuel Standards

Union of Concerned Scientists: The EPA’s Tier 3 Standards

Joseph Palmisano

Joseph Palmisano is a graduate of The College of New Jersey with a degree in History and Education. He has a background in historical preservation, public education, freelance writing, and business. While currently employed as an insurance underwriter, he maintains an interest in environmental and educational reform. Contact Joseph at staff@LawStreetMedia.com.

The post EPA Rules Aim to Phase Out Sulfur in Gas: What Does it Mean For Your Wallet? appeared first on Law Street.

The legal industry is changing and law schools are no exception. Applications and enrollment are both down, and the value of the traditional legal education with its current price tag is the subject of continual debate. Law Street Specialty Rankings are a detailed resource for prospective law students as they consider the many law schools across the country. Law Street Specialty Rankings blend the quantitative and qualitative in a way that accurately highlights the top law schools based on specialty programs.

Entertainment Law
Full List: Top Law Schools for Entertainment Law
—
1. Southwestern Law School
2. Columbia Law School
3. Loyola Law School, Los Angeles
4. UCLA School of Law
5. USC Gould School of Law
6. Fordham Law School
7. NYU School of Law
8. Villanova Law School
9. Vanderbilt University Law School
10. Stanford Law School

Environmental & Energy
Full list: Top Law Schools for Environmental & Energy Law
—
1. Lewis & Clark Law School
2. New York University School of Law
3. Pace University School of Law
4. Georgetown University Law Center
5. The George Washington University Law School
6. UC Berkeley School of Law
7. Tulane University Law School
8. UMD Francis King Carey School of Law
9. Harvard Law School
10. Stanford Law School

Business
Full list: Top Law Schools for Business Law
—
1. New York University School of Law
2. Harvard Law School
3. Columbia Law School
4. Northwestern University School of Law
5. University of Chicago Law School
6. Fordham University School of Law
7. Georgetown University Law Center
8. UCLA School of Law
9. Loyola University Chicago School of Law
10. Yale Law School

Healthcare
Full list: Top Law Schools for Healthcare Law
—
1. Loyola University Chicago School of Law
2. Georgetown University Law Center
3. University of Maryland Francis King Carey School of Law
4. Case Western Reserve University School of Law
5. Georgia State University College of Law
6. Harvard Law School
7. Yale Law School
8. Boston University School of Law
9. University of Houston Law Center
10. University of Virginia School of Law

Intellectual Property
Full List: Top Law Schools for Intellectual Property
—
1. The George Washington University Law School
2. University of New Hampshire School of Law
2. Santa Clara University School of Law
4. Benjamin N. Cardozo School of Law
5. New York University School of Law
6. The John Marshall Law School
7. Columbia Law School
8. Fordham University School of Law
9. University of California Berkeley School of Law
9. Stanford Law School

—

Research and analysis done by Law Street’s Law School Rankings team: Anneliese Mahoney, Brittany Alzfan, Erika Bethmann, Matt DeWilde, and Natasha Paulmeno. Click here to read the 2015 Law School Specialty Rankings.

Click here for information on rankings methodology.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Law School Specialty Rankings 2014 appeared first on Law Street.

I’m going to take a break from feminist issues today and discuss something that is, literally, life or death: America’s horrible healthcare costs.

Recently, just as I had my first run-in with military dress codes, I also got to experience a military doctor’s office. I went in for a physical exam, waited maybe ten minutes all around, and ended up leaving without having to pay a cent for the appointment or prescriptions. The only thought on my mind was: why can’t everyone’s health care be this great?

Outside of the United States, healthcare is that great in several countries. Just last summer while studying abroad in London, my friend rushed herself to the hospital thinking her appendix was bursting. Turned out to be just a pulled muscle, but an ER visit didn’t cost her a pence — and she wasn’t even a citizen!

So what’s wrong with American health care? For a country whose citizens claim it to be number one, we are way behind on things that really matter. According to the World Health Organization, America ranks thirty-fifth in life expectancy and thirty-seventh in healthcare systems.

Yikes.

Why are we so low in the rankings? The answer is not simple.

American healthcare costs are alarmingly higher than in other developed countries. An MRI in the U.S. averages $1,121, while in the Netherlands it’s only $319. Need an angiogram? That’ll be $914, but you could have gotten it for $35 in Canada! Are you on the drug Lipitor? Then you know it’s around $124 a month — it costs $6 a month in New Zealand. Some may argue that we are wealthier than these countries, so it makes sense that we would spend a bit more. Sure, but the amount the United States spends on health care is way above what it should be.

Then there is the argument that countries with free health care pay more in taxes. False. The average U.S. citizen pays more in taxes toward public health care than the United Kingdom, Canada, and a whole list of other countries with free health care.

Some blame insurance. American citizens not having health insurance was a factor in rising healthcare costs, yes. Those who didn’t have it still needed care, then went bankrupt from trying to pay for it, so our tax money ended up paying for it. The Affordable Care Act has alleviated some of the problem, but it is still being fought over in congress.

Still others point to over-utilization and malpractice spending, saying that Americans simply go to the doctor more and therefore spend more, but there is no data to support that either. Plus, who would want to go to the doctor more than they need to, especially when a doctor’s visit will soon cost more than a car?

None of these issues is the one thing that has skyrocketed our health care spending. In fact, all of them are to blame. Therefore, there will be no simple solution. Reaching a fix is made harder by the fact that the topic of health care is gridlocked in our government. Republicans block Democrats because they’re not Republican, and vice versa.

A lot of people like to gripe about Obamacare.

Half of Congress even decided to throw a hissy fit over not getting their way on the subject, and shut down the government. Sure, the Affordable Care Act might not be perfect, but at least it’s something. Those people most vehemently opposing it aren’t offering up any better solutions. Until both parties can get over their pride, sit down and say “what is going to be best, and cost less, for the American people?” healthcare costs will continue to be higher than they need to be.

My opinion? Healthcare should be free and easily accessible for everyone. Period.

Data and statistics for this post came from the WHO website and this article from The New York Times.

Morgan McMurray

Morgan McMurray is an editor and gender equality blogger based in Seattle, Washington. A 2013 graduate of Iowa State University, she has a Bachelor of Arts in English, Journalism, and International Studies. She spends her free time writing, reading, teaching dance classes, and binge-watching Netflix. Contact Morgan at staff@LawStreetMedia.com.

The post Debunking Common Myths About American Healthcare Costs appeared first on Law Street.

Happy Back to School, folks!

While I was traveling around Canada last month, all of you were clearly partying up your last few weeks of summer, right? RIGHT? I hope so, because law school is now officially back in session.

And you know what that means!

You need me back in the saddle to keep you informed about all the racist, sexist, homophobic legal bullshit that’s going on! (Also, to give you lots of procrastination material. Let’s be real.)

So! Let’s talk about the Republicans and women, shall we?

This is going to be good.

Now that President Obama is getting depressingly close to being a lame duck, all the politicians are really starting to get antsy about the 2016 election. Candidates are being tapped, strategies are being thought out, and groundwork is being laid to win over the decisive voting blocs.

For the Republicans, a key point of concern is the Beyoncé Voters. All the single ladies — and even plenty of the not-so-single ladies — are seriously skeptical of conservatives these days. According to a recent GOP report leaked by Politico, 49 percent of women hold a negative view of the Republican Party. It bluntly reported that women believe Republican policies to be misaligned with their own priorities and to be lacking in compassion and understanding.

As a result, the ladies are taking their votes elsewhere. And for good reason. Women aren’t wrong when they say that conservative politicians aren’t acting in their best interest. Republican policies advocate restricted access to birth control, virtually no access to safe abortion services, the continued entrenchment of rape culture and domestic violence, as well as a hearty LOL at equal pay.

So nope — we’re not voting for policies that take away our bodily autonomy, restrict our access to safe and affordable healthcare, leave us vulnerable to violence, and also make us poorer.

Goodness, what a mystery that more of us aren’t voting for you, conserva-turds!

Well, apparently, Republicans have solved the mystery, and are rolling out a new initiative to win the vaginal vote in 2016.

Are you ready for it?

They’re going to calmly explain to us little ladies that we’ve been mistaken this whole time — the Republican Party really is acting in our best interest — and now that we’ve cleared that whole mess up, won’t you please vote for us, darlin’?

They aren’t going to actually change any of their policies. They aren’t going to actually do anything different AT ALL.

The big, awesome, Republican strategy is to tell women that they know us better than we know ourselves, expect us to laugh good naturedly at our silly, womanly inability to understand the complex, crazy world of politics, and agreeably hand over our votes, glad to have been educated about our own feminine ineptitude.

What exactly will this episode of mansplaining look like? Republicans are going to attack the Democratic claim that their policies are unfair to women — without interrogating or changing those policies, mind you — and every time abortion comes up, they’ll change the subject as quickly as possible.

Conservatives seem to genuinely think this is a good plan.

R.R. Reno, an editor for the conservative journal First Things, wrote a completely serious, non-satirical essay about just how this plan would work in practice.

In it, he creates a fictional woman to use as an example of all the women who are mistakenly eschewing Republican policies. She’s a single, 35-year-old consultant, living in the suburbs of Chicago, “who thinks of herself as vulnerable and votes for enhanced social programs designed to protect against the dangers and uncertainties of life.”

Translation: She’s a misinformed damsel in distress who presumably owns about 12 cats.

Apparently, this woman is in favor of social safety net-type Democratic policies — not because she believes that all people should have access to a baseline quality of life — but because she has no man to provide for her, which is clearly TERRIFYING. She dislikes Republican policies that take away her bodily autonomy and expect her to lead a traditional life of wife and motherhood NOT because they’re sexist and terrible and render her, legally, as a quasi-human/permanent child, but because “she wants to get married and feels vulnerable because she isn’t and vulnerable because she’s not confident she can.”

So basically, all the women who aren’t voting Republican are in serious need of the D. And according to Reno, conservatives can and will deliver it.

He goes on to theorize that our fictitious cat lady should support Republican policies because a pro-marriage culture will increase her likelihood of getting married, therefore increasing her overall happiness. All we have to do is explain that to her! And then she’ll vote for us! Yay! Problem solved!

What Reno, and his conservative compatriots, fail to realize, is that women aren’t voting Democrat because of their inability to legally bind themselves to a penis.

We’re voting Democrat because we want to have control over our own bodies, our own reproductive systems, and our own lives. We want to be able to support ourselves. We want to lead lives that aren’t wracked with violence.

Also, they’re clearly forgetting that some of us don’t even like the D. (Fellow clam divers, I see you.)

So, Republicans, I totally applaud your strategy for locking down the vaginal vote in 2016. It’s a really great idea.

Because you’re buying Hillary a one-way ticket to the Oval Office.

Hannah R. Winsten

Hannah R. Winsten is a freelance copywriter, marketing consultant, and blogger living in New York’s sixth borough. She hates tweeting but does it anyway. She aspires to be the next Rachel Maddow. Contact Hannah at staff@LawStreetMedia.com.

The post LADIES: Vote Republican and You’ll Get the D appeared first on Law Street.

Hello! Welcome to my blog. I thought I’d start things off with a rather tame subject, so let’s talk about abortion!

Well not really, but sort of. Let me explain.

I was scrolling through my Facebook news feed the other day when I came upon a friend’s status, which read: “Pro-Choice is not Pro-Abortion.” I wanted to “Like” this bit of wisdom a thousand times over, but on my way to click the little thumbs-up sign I noticed the status had 57 comments.

Fifty-seven.

After expanding the comment section (which was rapidly growing to 60…61…62…)  and reading through them, it became immediately apparent that I had stumbled onto a heated political debate comprised completely of supposed “friends” text-yelling (ALL CAPS) at each other through their comments. It is a social custom I have tried hard to avoid, as it is known to feed on the ignorance and close-mindedness of its debaters, and really who has ever had their opinion changed by a Facebook argument?

This one looked to be no different, but I began reading through the paragraphs of hardly-thought-out arguments anyway, simultaneously amused and saddened by the lack of true information being shared. The friend who had originally posted the status had stopped commenting around number 20 when one of the more opinionated Conservatives in the thread had said: “Of COURSE the man hating feminist is against having babies.”

Whoa.

First of all: this person clearly did not know the difference between feminism and misandry (but that’s a topic for another post). Second: they demonstrate the problem with posting political arguments on your profile.

Now, I am all for sharing your political opinions on social media. Unfortunately, you rarely see people posting statuses that are level-headed and based on fact. Rather, you’ll find opinions rooted in anger and ignorance that employ such devices as name-calling (as seen above) or references to religion that have no relevance to the argument. Also, more often than not, these hot-button topics like abortion, or gay rights, or feminism, spur debates that don’t go anywhere or change anything. Those topics are just small facets of larger issues that need to be addressed: sexual education, women’s health, women’s rights, the definition of marriage, etc.

Let’s look at the short and sweet status that started all this: “Pro-Choice is not Pro-Abortion.” The reason I liked it so much is because it’s really not about abortion at all. What this status is saying in as few words as possible is that Pro-Choice is about a woman’s right to make decisions about her own body. Pro-Choice says that we, as free American citizens, do not have the right to make decisions for thousands of women we have never met. It does not mean that, if given the choice, we would choose abortion. It doesn’t matter. Every woman is different and every single one should be able to decide what happens to her body. And yes, until that baby comes out of her vagina, it is part of her body.

But the topic of Pro-Choice/Pro-Life is at the tail end of a problem that begins with sex ed. Yes, those awkward hours of listening to your school’s P.E. teacher telling you how to put on condoms and explaining STIs. Did you know that not every school kid had to have that class? And of those who did, only a fraction got medically accurate information?

We all laugh at that scene from Mean Girls when Coach Carr is talking about how pregnancy will kill you. You know the one.

The not-so-funny part is that some kids actually receive that type of education from their teachers. According to this map put together by the Huffington Post, in the year 2014 several states don’t even require their schools to share information on contraception.

Courtesy of the The Huffington Post.

If there’s one thing that’s true about teenagers it’s that if they want to have sex, they will. Especially if you tell them not to. How can we expect them to have safe sex, and prevent STIs and unwanted pregnancies, if they don’t have all the information they need to know? It is only logical that if the number of people using contraception goes up, the number of unwanted pregnancies — and therefore abortions — will go down.

Sex ed restrictions aren’t merely for schools, though. Organizations like Planned Parenthood exist to give women and men information about contraceptives, STIs, abortions, adoptions, and healthcare. Yet, people continue to fight these organizations because they perform abortions. The focus, for some reason, is on just one of the many helpful services offered. But, like drugs and firearms, if you make something illegal people will still get their hands on it — and illegal abortions are definitely not safe.

So, for the safety and sanity of all the sexually active people out there: stop arguing about abortion and instead provide some alternatives to the dismal state of sex ed in America. And remember, when arguing about political issues on social media, keep it calm, accurate, and open-minded.

Morgan McMurray

Morgan McMurray is an editor and gender equality blogger based in Seattle, Washington. A 2013 graduate of Iowa State University, she has a Bachelor of Arts in English, Journalism, and International Studies. She spends her free time writing, reading, teaching dance classes, and binge-watching Netflix. Contact Morgan at staff@LawStreetMedia.com.

The post Discussing Abortion Distracts From Root Issue: Sex Ed appeared first on Law Street.

Paterson, New Jersey erupted last month after a 12-year-old girl was shot and killed. People rallied for an end to the recent violence, demanding a safer city in the wake of Genesis Rincon’s death. The tragedy comes shortly after Jerry Speziale was appointed as the new police director. Advocating community policing, Speziale and Mayor Jose Torres think that dynamic approaches can help with the crime problem in Paterson. This may seem like a interesting new strategy for fighting local crime and violence, but successful community policing programs were successfully used in Paterson not that long ago.

One such community policing program, the Village Initiative, operated from 1998 to around 2010 and had some measurable benefits for local youth. What did the Village Initiative accomplish, can community policing prevent further deaths like Rincon’s, and what can other cities learn from Paterson?

Paterson has long been plagued by high crime rates. The year that the Village Initiative launched, its violent crime rate per 100,000 inhabitants was roughly 67 percent higher than the national average. The Village Initiative responded to the crime problem in Paterson by bringing the community to at-risk juvenile probationers, making them responsible for their court orders, and reducing their chances of committing a crime again.

In an interview, Dr. James Pruden said that it’s important “for [juveniles] to see the government functioning positively in their lives.” An emergency medical specialist at St. Joseph’s Regional Medical Center in Paterson, Pruden was an active contributor to the Village Initiative who rode along with officers to visit at-risk probationers. Along with police, teachers, and other community leaders, he saw the program in action and witnessed its effects firsthand.

The Village Initiative

The Village Initiative offered important opportunities to minors such as vocational courses; from business training to cosmetology and automotive repair, the courses gave them opportunities to build marketable skills. In addition, there were components that set juveniles up for part-time jobs. These are no longer available, though. Around 2010, the Village Initiative lost much of its funding, likely related to the city’s other budget cuts during the midst of the national recession. Fortunately, the “ride along with a medical evaluation” that Pruden participated in continued after the funding stopped, along with a few other pieces of the program.

“They had this educational piece, they had the medical piece, they had the business piece, all designed to turn these kids in a different direction and to show them that the interest in them was not only because they were misbehaving,” said Pruden. The community was not simply responding to the negativity surrounding the juveniles’ lives, it was about instilling something positive in them. This should be the central tenant of all community policing initiatives.

“It’s not like I’m providing much of a medical service. What I would do was go to the house, find out what was going on, talk to them about their health issues… At the end of it, I would go back with the data the next day and talk to a case manager at the hospital. She would call them up and make sure they made their cardiology appointment, or she would cut through the red tape to facilitate their entry to the teen pregnancy program. And we would do this not only for patients that came to our hospital, we do this for people who go to free-standing clinics or to other hospitals.”

– Dr. James Pruden

The Results

St. Joseph’s Hospital sometimes treats rival gang members simultaneously, and the hospital could become a spot for continued dispute between them. As that conflict can be detrimental to the doctors and families there, Pruden was tasked with making the hospital a neutral zone. Through the social infrastructure of the Village Initiative, he reached out to community leaders to establish correspondence and set up meetings with gang members. After eight months of work,Pruden succeeded in negotiating with the gangs so that St. Joseph’s would be a safer space.

Anecdotes like that help illustrate the positive community relationships formed by the Village Initiative. But what do statistics tell us about its effects? Despite sharing some criticism about how data on the program was collected, Dr. Pruden said that the available information shows impressive results. Prior to the Village initiative, juveniles with first-time probation had a 37 percent recidivism rate; however, kids involved in the Village Initiative had recidivism rates of only 5 percent. But, he reminded me, “then the funding went away!”

As Pruden says, maybe the effects of the Village Initiative could be judged solely by the difference between a 37 percent and five percent recidivism rate. Maybe it could have only made changes in the lives of the specific juveniles who were involved in the program. But it could also be judged by the potential, immeasurable impact that ripples throughout the community, starting with those juveniles.

Lessons from the Village Initiative

From local advocates to national movements, community policing is in high demand now. For instance, more cops are patrolling neighborhoods on bicycles as a part of a community policing initiative in Lowell, Massachusetts. Nationally, the Obama Administration has ramped up the Community Oriented Policing Services (COPS) office under the Department of Justice. A COPS report, Community Policing Defined, states that the approach “promotes organizational strategies, which support the systematic use of partnerships and problem-solving techniques.”

However, COPS is sometimes criticized for pushing policing in the opposite direction; reporter and author Radley Balko said that COPS supports many police chiefs who consider SWAT raids “to be a core part of a community policing strategy.” As police aggression only divides the police and the community, there is even more need to prescribe the Village Initiative. If Balko is correct and many have misconceptions, the country should find a model for community policing in the success of Paterson’s project.

Pruden’s work through the Village Initiative was not just a medical house call, but a social checkup. This should be how community policing looks, with community leaders working with one another. Police supervise medical evaluations, doctors help police at-risk youth, and the force of the community creates something positive together. Let’s prescribe the Village Initiative’s community policing in New Jersey to other cities in need.

—

Jake Ephros (@JakeEphros)

Featured image courtesy of [City of North Charleston via Flickr]

Jake Ephros

Jake Ephros is a native of Montclair, New Jersey where he volunteered for political campaigns from a young age. He studies Political Science, Economics, and Philosophy at American University and looks forward to a career built around political activism, through journalism, organizing, or the government. Contact Jake at staff@LawStreetMedia.com.

The post Community Policing in New Jersey: A Model for Stopping Local Violence appeared first on Law Street.

Mallory Loyola became the first pregnant woman to be arrested and charged with assault on her fetus under Tennessee’s new controversial law criminalizing the illegal use of drugs during pregnancy. Loyola was arrested July 8, 2014, one week after the law went into effect. The 26-year-old tested positive for methamphetamine (not technically a narcotic) before being released on bail. If convicted Loyola could be incarcerated for up to a year.

According to the new law, “a woman may be prosecuted for assault for the illegal use of a narcotic drug while pregnant, if her child is born addicted to or harmed by the narcotic drug.” If a woman does not enroll in a treatment program for the narcotic, she would be charged. According to RH Reality Check, a reproductive health news group, “the law was promoted by prosecutors against the recommendations of medical professionals.” Governor Bill Haslam says that the legislation is intended to encourage women to go to treatment centers; however, the effect of the bill may be different from its intended purpose.

Outcomes of Criminalizing Pregnancy

Imani Gandy of RH Reality Check suggests that Black women will be targeted by the law’s enforcement at a disproportionate rate. Based on ugly stereotypes with roots in Reagan-era “crack baby” rhetoric, more scrutiny would be placed on pregnant Black women, Gandy says. Whether or not these prejudices are acted on, there is a structural problem for disadvantaged, minority women.

State Senator Mike Bell explained that in his rural district “there’s no treatment facility for these women there, and it would be a substantial drive for a woman caught in one of these situations to go to an approved treatment facility. Looking at the map of the state, there are several areas where this is going to be a problem.” Healthy and Free Tennessee notes that the state has 177 addiction treatment facilities; yet only two “provide prenatal care on site and allow older children to stay with their mothers, and only 19 provide any addiction care for pregnant women.” For impoverished women, accessing and enrolling in treatment centers will be extremely difficult, if not impossible.

There is a discrepancy between the intention of the bill, as suggested by Haslam, and the likely effect of the bill. While it may have been passed to incentivize enrollment in treatment programs, it will likely result in the incarceration of women who cannot access those treatment centers. Because Tennessee did not expand Medicaid under the Affordable Care Act, the costs of such treatment may be overwhelming. Women who know that they cannot access addiction services will be discouraged from seeking help, lest they be charged with assault and have their children taken away.

Other Approaches 

In response to prenatal substance abuse, Tennessee passed the Safe Harbor Act about a year ago. The 2013 legislation, also signed by Haslam, was designed to ensure that women can access treatment centers without fear of incarceration or having their children removed. The more recent bill not only negates the benefits of the Safe Harbor Act, but regresses Tennessee even further.

This heavy-handed approach to prenatal substance abuse hints at another discrepancy: addiction is viewed by some as a disease, and by others as a crime. While the state and the governor embrace the latter with the passage and enforcement of this law, the federal government has taken a different approach.

Michael Botticelli, acting director of the White House Office of National Drug Control Policy, spoke about the federal government’s broad strategy in response to the recent Tennessee law: “Under the Obama administration, we’ve really tried to reframe drug policy not as a crime but as a public health-related issue, and that our response on the national level is that we not criminalize addiction.” The politics of considering substance abuse a criminal offense rather than a disease is amplified by the politics of federal-state relationships.

Support for the Law

The Tennessee Medical Association was supportive of the Safe Harbor Act, yet its president, Dr. Doug Springer, recently spoke out in favor of the new law. “The misdemeanor means it can be expunged by a judge, it means that the [Department of Human Services] doesn’t take your baby away. It has nothing to do with an application for a job because it doesn’t interfere with your job prospects, and that’s really important,” says Dr. Springer. Obviously, if a mother is incarcerated, she and her baby could not be together. But if the law makes it easy for the offense to be expunged, incarcerated mothers may not have to go through as many obstacles as other ex-convicts.

Because the law is so new, Mallory Loyola’s outcome will set precedent. The law is set to expire after two years, at which time Tennessee will evaluate its effects.

—

Jake Ephros (@JakeEphros)

Featured image courtesy of [Greyerbaby via Pixabay]

Jake Ephros

Jake Ephros is a native of Montclair, New Jersey where he volunteered for political campaigns from a young age. He studies Political Science, Economics, and Philosophy at American University and looks forward to a career built around political activism, through journalism, organizing, or the government. Contact Jake at staff@LawStreetMedia.com.

The post First Pregnant Woman Arrested Under Controversial Tennessee Law appeared first on Law Street.

The Affordable Care Act (ACA) never has a boring day in court, and today is no exception. Rulings were just made in two related ACA cases, and they couldn’t be more different. First, in a case called Halbig v. Burwell, the D.C. Circuit Court of Appeals ruled that people who get their insurance from the federal government exchange are not eligible for tax subsidies. More specifically, the 2-1 decision in Halbig says that subsidies are only permissible for those customers who enroll in health care exchanges run by individual states or the District of Columbia. Meanwhile, the Fourth Circuit Court of Appeals heard King v. Burwell on the same topic, this time ruling against the plaintiffs to hold the law as it stands. According to the Richmond, Virginia based Fourth Circuit Court, the federal government subsidies can stay. These rulings directly contradict each other, meaning that once again, the ACA’s status is uncertain.

As many states have opted to rely on the federal government’s exchange rather than establish their own programs, millions of Americans would lose tax credits for their health coverage if the D.C. Circuit Court’s decision stands. The ACA would lose much of its effectiveness in the 36 states that rely at least partially on the federal exchange. Before the Halbig decision was made, the Urban Institute reported that such a ruling, “would broadly undermine implementation of the ACA in [those] states, with substantial coverage and financial implications for their residents.” The report goes on to predict what monetary losses would be in 2016 for lower-income Americans who would have otherwise relied on those federal subsidies. Of the 11.8 million people projected to enroll in the federal government exchange, 7.3 million would likely receive tax subsidies. If the Halbig decision holds, those lower-income health care customers would lose $36.1 billion in 2016 alone, according to the Urban Institute report.

The Obama administration has now requested an en banc review of the case, in which all judges on the D.C. Circuit Court of Appeals would review the case. The fate of insurance subsidies in the states that rely on the federal exchange now rests in the hands of the 11 active judges on the D.C. Circuit Court.

In the Halbig case, the issue is the wording of the ACA. The law, as written, says that lower-income citizens are eligible for the subsidy if they receive insurance from “an Exchange established by the State under section 1311.” Because there is no mention of the federal government in the tax credit regulations, the D.C. Circuit Court’s interpretation limited subsidies to state exchange programs. Healthcare reporter Joe Carlson writes that such precise wording, “is widely seen as a drafting error.”

This discrepancy between the wording of the bill and the intention of the bill is what caused this debate. Jonathon Cohn of the The New Republic argues that at no point did lawmakers conceive that these tax credits should be limited to state exchanges. He wrote:

Not once in the 16 months I reported on the formal congressional debate did any of the law’s architects suggest they were thinking along these lines. It wouldn’t make sense in the context of the law, which depends upon those subsidies to accomplish its primary goal.

This was the same rationale behind the Fourth Circuit Court’s King decision. That ruling acknowledges the ACA’s linguistic ambiguity, and defers interpretation to the IRS, which did allow tax subsidies for people in the federal exchange. Further, the Fourth Circuit Court decision even included an analogy between Pizza Hut and Domino’s–comparing the similarities between the pizza chains to health coverage from a state and health care from the federal government. All argument aside, we all have to recognize that analogy is quite creative and apt–the two exchanges, like the pizza giants, are meant to provide the same service.

The conflicting arguments by the two appellate courts highlight the importance of the rift between semantics and intention. If the intention of a piece of legislation is so well understood that its literal wording is overlooked, are those who enforce that interpretation breaking the law? Or are they operating in accordance with the law? Furthermore, while the way that D.C. Circuit Court interpreted the law may seem overly strict, shouldn’t the legislature anticipate such questions and write laws exactly as they would like them to be enacted?

The cases are indicative of a philosophical disagreement between law as a means–the ACA was created to help insure those who can’t access health care–and the law as an end–the strict language of the ACA must be adhered to, regardless of why it was created. We aren’t just witnessing a dispute about tax credits; this may become a battle about the nature of law itself. The outcome has yet to be seen, but this proves that the battle over the ACA is far from over.

—

Jake Ephros (@JakeEphros)

Featured image courtesy of [Joe Mabel via WikiMedia Commons, Progress Ohio via Flickr, modified by Jake Ephros]

Jake Ephros

Jake Ephros is a native of Montclair, New Jersey where he volunteered for political campaigns from a young age. He studies Political Science, Economics, and Philosophy at American University and looks forward to a career built around political activism, through journalism, organizing, or the government. Contact Jake at staff@LawStreetMedia.com.

The post Conflicting Courts: Affordable Care Act Up in the Air Again appeared first on Law Street.

All anyone seems to talk about recently is the Hobby Lobby case and women’s reproductive rights. I think this is grossly unfair. Yes, I agree that women’s health is important; but in all the hustle and bustle, we have forgotten about the other half of the population and their delicate reproductive systems. So, I’m going to bring those deprived, long-ignored men’s issues to the spotlight and finally give them the attention they deserve.

First, some background information that you just might not know:

• A man’s reproductive health is apparently directly linked to his fragile self-esteem. Take, for example, the policeman who sued rapper Meek Mill. Mill allegedly made derogatory comments in the press about the officer, which the cop claimed resulted in his boys in blue losing the heat they were formally packing. This just goes to show that men need a lot of (ego) stroking to remain functional.
• Long ago in France, women could sue for divorce if their husbands had ED. How, you ask, would they be able to prove this? Well, it turns out women didn’t have to prove anything. In a reversal on the old ‘innocent until proven guilty’ credo, it was the man’s job to prove he didn’t have a problem. In the infamous impotence trials, men might request a Trial by Congress allowing them to prove they could perform in the bedroom by, well, performing in the bedroom…in front of the court.
• In India, impotence was legally classified as mental cruelty. I think we can all agree with that. The frustration and shame that this causes is torturous (I assume), and I can understand why a court would say Mother Nature is a cruel mistress for causing it. Oh, wait…it’s mental cruelty caused by the man to his wife? Well, those poor men – it’s just never about them.

Now that you see that men all around the world and throughout time have been mistreated and hurt by their lack of reproductive support, I’m sure you will agree that women have been given way too much attention in the healthcare arena as of late.

Courtesy of Tumblr.

To help change that, I am going to tell you about a couple of lawsuits that resulted when the healthcare industry failed men and their genital health.

The Short Story

The first suit takes place across the border in Canada where a man was rushed to a Montreal hospital with a “fractured appendage.” Details of how the fracture occurred were not given, but what is known is that the injury happened while the man was performing his husbandly duties.

He went to the hospital with great faith that the experienced doctors would be able to help him. The doctors decided that surgery was needed and promptly acted to bring this man out of his misery.

Sadly for him, the procedure had some unintended effects: it left an ugly scar, it stopped him from having intimate relations with his wife, and, maybe worse than anything else, the doctors, like all my hairstylists, trimmed off more than was requested. He allegedly ended up an inch shorter, and unlike my hair, he can’t just wait two weeks for it to grow back. After all this, his unsatisfied wife left, presumably to find a man more able to meet her sizable needs.

The man is now suing the hospital for its alleged negligence and his “indescribable anguish.” The question now becomes, just how is he going to prove his claims? I hope for his sake he has before and after shots.

The Never-Ending Story

This next suit took place in Delaware where a truck driver needed some help getting his motor started: to get back to business, he jump-started his equipment with penile implant surgery.

After the surgery, the man’s ED was gone so you might think to yourself, “Success! Good for that lucky devil!” Unfortunately, the surgery left him with a new concern: he could shift into high gear but couldn’t get back to neutral.

If you have ever seen a Viagra commercial then you know that if your erection lasts more than four hours, you should probably contact a doctor. This trucker must not be a late-night television watcher, though, because he didn’t contact the hospital until a firm eight months had passed.

That’s right: he had an eight-month erection. That’s real stamina.

The doctors claimed they weren’t entirely at fault because the man should have come to them sooner, like maybe when, after the surgery, his “scrotum swelled to volleyball size.” Anyway, another surgery fixed the current problem and a third surgery fixed the initial problem, but it still left the man with bad memories and a lot of medical bills.

The angry driver did what any man who suffered from eight months of hardship would do: he began a medical malpractice suit alleging negligence on the part of the doctors.

I’m sad to say that once again our legal system failed to protect the sexual health and well-being of our male population: it took less than two hours for a jury of his peers to decide that there was no negligence.

I’m all for civil justice, but I think we cannot reach equality until we consider all people. Stand up for men’s rights today!

Courtesy of Tumblr.

—

Ashley Shaw (@Smoldering_Ashs) is an Alabama native and current New Jersey resident. A graduate of both Kennesaw State University and Thomas Goode Jones School of Law, she spends her free time reading, writing, boxing, horseback riding, trivia, flying helicopters, playing sports, and a whole lot else. So maybe she has too much spare time.

Featured image courtesy of [Hammerin Man via Flickr]

Ashley Shaw

Ashley Shaw is an Alabama native and current New Jersey resident. A graduate of both Kennesaw State University and Thomas Goode Jones School of Law, she spends her free time reading, writing, boxing, horseback riding, playing trivia, flying helicopters, playing sports, and a whole lot else. So maybe she has too much spare time. Contact Ashley at staff@LawStreetMedia.com.

The post Penile Code: The Unappreciated Plight of Men’s Reproductive Health appeared first on Law Street.

The healthcare law specialty has grown exponentially in recent years, especially with the development of the Affordable Care Act and the varied state-level initiatives for implementation. The call for qualified lawyers in the field will only grow as battles over the ACA continue. Here are Law Street’s top ten law schools that provide their students with extensive and holistic educations in Healthcare Law.

Click here for detailed ranking information for each of the Top 10 Law Schools for Healthcare Law, and click here for the methodology used.

Research and analysis done by Law Street’s Law School Rankings team: Anneliese Mahoney, Brittany Alzfan, Erika Bethmann, Matt DeWilde, and Natasha Paulmeno.

Click here for detailed ranking information for each of the Top 10 Law Schools for Healthcare Law.

Featured image courtesy of [UBC Library via Flickr]

Correction 7/9/14: The Top 10 Law Schools for Healthcare Law rankings have been updated to include new information since their release on July 7.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Top 10 Law Schools for Healthcare Law appeared first on Law Street.

Research and analysis done by Law Street’s Law School Rankings team: Anneliese Mahoney, Brittany Alzfan, Erika Bethmann, Matt DeWilde, and Natasha Paulmeno.

Click here to read more coverage on Law Street’s Law School Specialty Rankings 2014.

Click here for information on rankings methodology.

Featured image courtesy of [Amerique via Wikimedia Commons]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Top 10 Law Schools for Healthcare Law: #1 Loyola University Chicago School of Law appeared first on Law Street.

Research and analysis done by Law Street’s Law School Rankings team: Anneliese Mahoney, Brittany Alzfan, Erika Bethmann, Matt DeWilde, and Natasha Paulmeno.

Click here to read more coverage on Law Street’s Law School Specialty Rankings 2014.

Click here for information on rankings methodology.

Featured image courtesy of [thisisbossi via Flickr]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Top 10 Law Schools for Healthcare Law: #2 Georgetown University Law Center appeared first on Law Street.

Research and analysis done by Law Street’s Law School Rankings team: Anneliese Mahoney, Brittany Alzfan, Erika Bethmann, Matt DeWilde, and Natasha Paulmeno.

Click here to read more coverage on Law Street’s Law School Specialty Rankings 2014.

Click here for information on rankings methodology.

Featured image courtesy of [Frederic C. Chalfant via Wikimedia Commons]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Top 10 Law Schools for Healthcare Law: #3 University of Maryland Carey School of Law appeared first on Law Street.

Research and analysis done by Law Street’s Law School Rankings team: Anneliese Mahoney, Brittany Alzfan, Erika Bethmann, Matt DeWilde, and Natasha Paulmeno.

Click here to read more coverage on Law Street’s Law School Specialty Rankings 2014.

Click here for information on rankings methodology.

Featured image courtesy of [Denacipriano via Wikimedia Commons]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Top 10 Schools for Healthcare Law: #4 Case Western Reserve University School of Law appeared first on Law Street.

Research and analysis done by Law Street’s Law School Rankings team: Anneliese Mahoney, Brittany Alzfan, Erika Bethmann, Matt DeWilde, and Natasha Paulmeno.

Click here to read more coverage on Law Street’s Law School Specialty Rankings 2014.

Click here for information on rankings methodology.

Featured image courtesy of [Chensiyuan via Wikipedia]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Top 10 Schools for Healthcare Law: #6 Harvard Law School appeared first on Law Street.

Research and analysis done by Law Street’s Law School Rankings team: Anneliese Mahoney, Brittany Alzfan, Erika Bethmann, Matt DeWilde, and Natasha Paulmeno.

Click here to read more coverage on Law Street’s Law School Specialty Rankings 2014.

Click here for information on rankings methodology.

Featured image courtesy of [Pradipta Mitra via Wikimedia Commons]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Top 10 Schools for Healthcare Law: #7 Yale Law School appeared first on Law Street.

Research and analysis done by Law Street’s Law School Rankings team: Anneliese Mahoney, Brittany Alzfan, Erika Bethmann, Matt DeWilde, and Natasha Paulmeno.

Click here to read more coverage on Law Street’s Law School Specialty Rankings 2014.

Click here for information on rankings methodology.

Featured image courtesy of [Anne via Flickr]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Top 10 Schools for Healthcare Law: #8 Boston University School of Law appeared first on Law Street.

Research and analysis done by Law Street’s Law School Rankings team: Anneliese Mahoney, Brittany Alzfan, Erika Bethmann, Matt DeWilde, and Natasha Paulmeno.

Click here to read more coverage on Law Street’s Law School Specialty Rankings 2014.

Click here for information on rankings methodology.

Featured image courtesy of [MC Lewis via Wikipedia]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Top 10 Schools for Healthcare Law: #9 University of Houston Law Center appeared first on Law Street.

Research and analysis done by Law Street’s Law School Rankings team: Anneliese Mahoney, Brittany Alzfan, Erika Bethmann, Matt DeWilde, and Natasha Paulmeno.

Click here to read more coverage on Law Street’s Law School Specialty Rankings 2014.

Click here for information on rankings methodology.

Featured image courtesy of [Bonbar via Wikimedia Commons]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Top 10 Schools for Healthcare Law: #5 Georgia State University College of Law appeared first on Law Street.

Research and analysis done by Law Street’s Law School Rankings team: Anneliese Mahoney, Brittany Alzfan, Erika Bethmann, Matt DeWilde, and Natasha Paulmeno.

Click here to read more coverage on Law Street’s Law School Specialty Rankings 2014.

Click here for information on rankings methodology.

Featured image courtesy of [Charles Paradis via Flickr]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Top 10 Schools for Healthcare Law: #10 University of Virginia School of Law appeared first on Law Street.

She was the Hillary Clinton before Hillary Clinton. She stared gender stereotypes in the face and boldly took them on. She paved the way for women desiring to make their mark in the political world and did so with pride. Though she never once considered a career in politics growing up, Patricia Schroeder became a national icon and a representative of women and their rights during her time serving in the United States Congress. She shocked the masses time and time again, especially when she ran an unprecedented campaign for President of the United States.

Despite her monumental achievements, she is surrounded by a humble and genuine air. I felt completely comfortable approaching her at her appearance at the Library of Congress last week to request an interview. I wrote a brief article chronicling the short event, which barely whet my palate of curiosity. Luckily she quickly agreed to my request.

Patricia Schroeder, born in Oregon, comes from modest beginnings. Her father worked in the aviation industry, which often uprooted the family from one city to another. Because of her father’s career, Patricia Schroeder obtained a license to fly and developed an admiration for Amelia Earhart, along with other bold female figures. “Eleanor Roosevelt and Amelia Earhart were two women who spoke their minds and branched out and did things that women weren’t normally doing,” Schroeder explained in a pensive tone during our phone conversation.

Because her mother was a teacher, Pat Schroeder grew up with a female role model who was successful as both a mother and a working woman. “I was very lucky in that my mother was a teacher and I didn’t have as many hangups about being able to work and raise my children. I didn’t have such a severe attack of guilt about doing both. [My parents] encouraged me to do whatever I want.” Schroeder does not think that her political career had any negative impacts on her children. “They are both well adjusted, not on drugs, one went to Princeton and got a PhD, one went to Georgetown and got an MBA, and they’re both married with two kids.” Yes, it sounds like they are doing just fine.

During our interview, Schroeder recounted an amusing anecdote about the time when her son called her while he was at college. The simple reason was to thank her for not constantly asking if he was dating anyone like the mothers of his friends did. Schroeder said that the information about his friends’ romantic lives was none of their parents’ business.

After attending the University of Minnesota for her undergraduate degree, Schroeder attended Harvard Law School. When I asked how her time at Harvard changed her as a person, she pointed out that it was good preparation for entering into the male dominated Congress later on in life. “I went to the University of Minnesota first and there were 30 or 40 thousand students. It was huge and we were assumed to be adults; if you come and you pass, great, if you come and don’t pass, too bad. At Harvard it was more regimented in a way. A lot of the students had always gone to private schools or [gender] segregated schools and couldn’t get over going to schools with girls.” She told me that men constantly lectured her about taking a “man’s job.”

Despite her immense success as a player in the political arena, Schroeder never considered a career in politics before her husband’s suggestion that she run for congress to challenge the Republican incumbent in their Colorado district. James, her husband, was not only responsible for jump starting her career as a politician at age 32, but also acted as a role model for men whose wives were in similar roles. “A lot of guys didn’t know how to manage if their wife was in a prominent role,” Schroeder explained. “They thought it reflected on their masculinity.”

Being one of the few female politicians at the time was certainly challenging, but Schroeder used a variety of techniques to combat the difficulties. When I asked if she ever tried to change herself to better fit into the testosterone-dominated world of Washington politics, she quickly answered, “No. I always figured I was not an actress. If I couldn’t be myself this whole thing was not going to happen. What you saw was what you got.”

She was always well known for her quippy one-liners and sense of humor. For example, when asked how she could be a mother and a politician, she explained that she had “a uterus and a brain that both worked.” According to Schroeder, “humor is a wonderful way to keep your head. You can either get mad or find humor in it.” She partly attributes her ability to come up with her famous quotes to her gender. “Males always use sports analogies. Part of why people thought [my sense of humor] was different, was just the gender difference in what women might say. They rarely talk about ‘moving the goal posts’.”

Though in some ways women’s rights have come a long way, many issues still stand out for Schroeder as great challenges facing women today. “To me, it’s shocking that we are just a few years away from looking at having had the vote for 100 years, and yet we still aren’t in the constitution. Still? Remember Abigail Adams writing to John saying ‘remember the ladies’? Well, they still haven’t remembered the ladies.” Preventive healthcare for women is also an issue at the forefront of Schroeder’s mind, as it always was during her time in Congress. “One hundred years ago, Margaret Sanger was saying contraception was a big part of women’s preventative health issues and now the Supreme Court is looking into if it is necessary.”

Schroeder also criticizes the lack of equality between women and men in the workforce, and the measly amount of time given to women for maternity leave. “Two-thirds of the minimum wage earners are women and women college graduates will make less than men by about one million six.” Single moms have still got a really tough time, and we haven’t done anything to make childcare more accessible. In the United States, if you work for a group of more than 50 people you can get 12 weeks of unpaid leave. Women are not a minority, yet we haven’t been able to put it together and say ‘enough already.’ Somehow, it just hasn’t moved women and I guess I must be strange.”

During both of my encounters with Schroeder, she proved to be anything but “strange.” I see her as simply ahead of the curve, as she always was. Her iconic role as a political pioneer for women made it easier for them to enter into similar careers. Patricia Schroeder is a prominent advocate for taking action to make a change. “Don’t wait for somebody to ask you — men never wait to be asked. We keep pretending that we are at a dance and this is not a dance. Women are 100 percent qualified and men about 50 percent. Getting women to step forward and say ‘I can do this’ is very important, and they couldn’t mess it up any more than it already is.”

—

Marisa Mostek (@MarisaJ44) loves globetrotting and writing, so she is living the dream by writing while living abroad in Japan and working as an English teacher. Marisa received her undergraduate degree from the University of Colorado in Boulder and a certificate in journalism from UCLA. Contact Marisa at staff@LawStreetMedia.com.

Featured image courtesy of [Wikimedia]

Marisa Mostek

Marisa Mostek loves globetrotting and writing, so she is living the dream by writing while living abroad in Japan and working as an English teacher. Marisa received her undergraduate degree from the University of Colorado in Boulder and a certificate in journalism from UCLA. Contact Marisa at staff@LawStreetMedia.com.

The post Patricia Schroeder: Trailblazer for Women in Politics appeared first on Law Street.

Happy April Fool’s Day, folks! Guess what happened last night while you were sleeping?

The Affordable Care Act’s first open enrollment period ended, and the government reached its goal metrics. Signups on Healthcare.gov and 14 state-based exchanges cleared the 7 million mark — the minimum enrollment goal — and will continue to grow over the next few weeks as last-minute signups clear the system.

This is pretty exciting. Why? Because Obamacare is officially too big to easily dismantle. The Republicans, with all their blathering on about bullshit death panels and anti-Americanism, have lost this fight. Healthcare reform is a thing that happened. And it’s not un-happening anytime soon.

And that’s a huge deal. Medical care is insanely expensive in the U.S., as is quality health insurance. Those high price tags have locked tons of low-income Americans out of quality healthcare, leaving them with lower standards of living and shorter life expectancies.

Basically, the high cost of healthcare has turned a basic human need into a luxury for the rich. It’s established that some lives (ahem, rich folks) are more important than others. And that’s super fucked up.

So thanks, Obamacare, for taking a first step toward fixing that problem.

But! Let’s not get too excited. Obamacare is still full of problems. The ACA is NOT universal healthcare — not by a long shot, and it shows. Let’s investigate, shall we?

Sarah, whose name has been changed to protect her privacy, is a recent beneficiary of the Affordable Care Act. She signed up for the Empire Catastrophic Guided Access Plan back in February. Under this plan, Sarah pays nearly $200.00 a month for the most basic of health insurance — her copays and deductible are high, making her policy little more than a guarantee that she won’t go completely bankrupt if she gets cancer tomorrow. (So we hope.)

Unsurprisingly, Sarah’s not super pumped about the state of her healthcare coverage. As a 20-something-year-old with mountains of student loan debt and a low-paying, entry-level job, she’s on a tight budget. And every month, $200 of that budget goes toward her health insurance — and that’s if she doesn’t actually try to use it.

So, why, if this plan was so lackluster, did Sarah choose it? Aside from the obvious factor of affordability (this plan is about as cheap as they come), Sarah wanted to make sure she could access birth control and STI screenings through her insurance.

“I signed up for this plan because, on the Planned Parenthood website, it listed Empire as an accepted insurer,” Sarah said. “But it turns out, for my plan, they are out of network, even though when I called they said I was covered.”

“Turns out STI screenings are not covered at all, so I have to not get tested ever, and I have to try to find a gynecologist who takes my insurance. I also no longer qualify for state assisted birth control at Planned Parenthood because I have health insurance that isn’t actually health insurance. I am literally worse off than when I was uninsured.”

So, thanks to Obamacare, Sarah is essentially paying more money for less access to the healthcare she needs. And that’s really not cool.

There have been a lot of GOP horror stories about the Affordable Care Act. This video is one of them.

Largely, these tales are vague, exaggerated, or entirely untrue. They’re pure propaganda for conservaturds who want to keep the healthcare industry as privatized and profitable as possible.

But then there are real people, like Sarah, who really aren’t making out too well under Obamacare. Stories like hers aren’t to denounce the ACA as a complete failure — even she conceded that the Affordable Care Act is a step in the right direction.

But Sarah is living proof that there are a lot more steps that need to be taken in that direction. Quality healthcare still isn’t truly accessible to countless American citizens. Obamacare is not universal healthcare. And that’s really what we need.

So, now that Obamacare has reached its enrollment goals, let’s keep pushing, shall we? Let’s make healthcare a thing that we can actually use.

—

Hannah R. Winsten (@HannahRWinsten) is a freelance copywriter, marketing consultant, and blogger living in New York’s sixth borough. She hates tweeting but does it anyway. She aspires to be the next Rachel Maddow.

Featured image courtesy of [Daniel Borman via Flickr]

Hannah R. Winsten

Hannah R. Winsten is a freelance copywriter, marketing consultant, and blogger living in New York’s sixth borough. She hates tweeting but does it anyway. She aspires to be the next Rachel Maddow. Contact Hannah at staff@LawStreetMedia.com.

The post Obamacare Is Here to Stay! But It Still Kind of Sucks appeared first on Law Street.

Happy almost Friday, folks! This week is almost over. THANK GOODNESS. Coming back after a holiday is rough, am I right?

If you have a uterus and you live in Michigan, your week has been especially rough. Shit is getting REAL over there in the Mid-West. Lawmakers in the Great Lakes State are currently debating a bill that would require women to buy rape insurance.

That’s right. Rape insurance.

I tell you, this shit just gets more ridiculous every week I write about it. It’s actually insane.

Here’s how it’s going down. Lawmakers in Michigan don’t want health insurance to cover abortion. Why? They’re not fans of a woman’s right to choose, and so, while they can’t completely outlaw abortion, they can use insurance technicalities to restrict women’s options.

What happens when insurance doesn’t cover abortions? Women either have babies that they don’t want or are unable to carry, or they pay a hefty price to terminate. Obviously, not ideal. So! While Wolverine legislators were batting around this nifty little bill, the same question came up that always comes up when we start talking about restricting women’s access to abortions.

“But what about cases of rape and incest?!” Because, empathy. For like, five seconds.

The legislators of Michigan had an answer ready and waiting. Make women buy additional insurance to cover the possibility of needing an abortion in the future.

This little tidbit prompted Republican Gov. Rick Snyder to veto the bill last year when it was first introduced. He wasn’t too keen on legislation that required women to pay for abortions out of pocket, unless of course, they had paid extra for that separate insurance rider. “I don’t believe it is appropriate to tell a woman who becomes pregnant due to a rape that she needed to select elective insurance coverage,” Snyder said when he rejected the bill last winter.

Well, duh. Obviously.

That would be like telling a man who had a heart attack that he couldn’t have life-saving surgery, because he didn’t plan ahead and book an operating room beforehand. Or like telling a cancer patient that she can’t receive treatment because she hadn’t reserved a chemo supply ahead of time. Plan ahead, people, be prepared! For all of the possible things that could happen to you ever! (Because that’s possible.)

Folks, let’s get one thing straight. No one plans to get an abortion. Needing one is definitely not a desirable situation to be in. Really, abortions are a last resort. An emergency measure, taken after something has unintentionally gone wrong. Maybe she got raped. Maybe the condom broke. Maybe she forgot to take her birth control pill that day. Maybe she just discovered that the baby won’t survive the pregnancy or infanthood.

Whatever the situation, abortions are last ditch efforts to rectify a bad situation that wasn’t planned for. So asking women to plan for unplanned emergencies — and be monetarily penalized either way — makes absolutely no sense.

It’s about as logical as this guy.

But, alas, the anti-choicers think it does make sense, and they’ve got a rage-inducing argument as to why that is. One prominent advocate of the bill claimed that rape is like a car accident, and it was totally fine to make women pay for extra insurance in order to prepare for it.

This is so incredibly gross on so many levels.

First of all, we’re comparing women’s bodies to cars right now. To cars. Inanimate objects that can be damaged, fixed, or replaced. One car is much like another—it gets you from A to B. Women’s bodies are not like cars. They are not replaceable. Their value doesn’t depreciate after a traumatic event. They are not interchangeable. They are not for you to use.

Actually, women’s bodies are attached to living, breathing, human beings. They happen to have vaginas. But they also have lives, passions, emotions, and agency. And when you liken their bodies being raped to a car being crashed, you ignore the human involved in the trauma. You assume she’s an object, instead of a subject.

Stop that right now.

Second of all, expecting women to prepare themselves for rape is absurd and cruel.

Preparation assumes the inevitable. You prepare for a car accident—if we’re going to follow through with this terrible example—because being involved in one, someday, is more or less inevitable. People are stupid. Let a bunch of idiots operate heavy machinery near each other, and things are bound to go wrong eventually. Better prepare yourself for the asshole who forgot to use his blinker and caused a pileup on the freeway.

But rape? That shouldn’t be inevitable. Rape doesn’t happen because of human error. Rape isn’t something that idiots do. Rape happens when one person makes a conscious decision to violate another person. Consent isn’t given. Accidents aren’t made. This isn’t an “oops I didn’t mean to get sexually violent with you, my bad,” kind of situation.

Not at all.

When we treat rape like it is inevitable, we give rapists a free pass. We’re sending them the message that, hey, you’re only human! People make mistakes. No big deal. But it is a big deal. And it wasn’t a mistake. This isn’t like forgetting to use your blinker, or running a red light. This is violence and coercion. And there’s always another option.

So, to all the anti-choicers of Michigan, I have a question for you: If a man was shot, and he had to pay out of pocket to have the bullet removed because he hadn’t planned ahead with elective murder insurance, how would you feel about that?

Probably like this kid.

Not so good, I’m guessing. Because it’s ridiculous to ask a man to prepare himself for the possibility that one day, he might be a homicide victim. No one expects to be on the receiving end of that kind of violence.

So stop asking women to do the same. We don’t need to prepare for our impending rape. We shouldn’t be waiting expectantly, insurance policy in hand, to be the victims of sexual violence. And we sure as hell aren’t cool with legislators putting a price tag on our uteruses.

So, stop it, OK? Just stop it.

Stop restricting our access to safe abortions. Stop legislating our bodies. Stop objectifying us. And stop being so cavalier when it comes to rape.

Do you think the GOP can handle that, folks? Discuss!

—

Hannah R. Winsten (@HannahRWinsten) is a freelance copywriter, marketing consultant, and blogger living in New York’s sixth borough. She hates tweeting but does it anyway. She aspires to be the next Rachel Maddow.

Featured image courtesy of [American Life League via Flickr]

Hannah R. Winsten

Hannah R. Winsten is a freelance copywriter, marketing consultant, and blogger living in New York’s sixth borough. She hates tweeting but does it anyway. She aspires to be the next Rachel Maddow. Contact Hannah at staff@LawStreetMedia.com.

The post LADIES: Michigan Says You Need Rape Insurance appeared first on Law Street.

How was your weekend, loves? Mine was fabulous!

But Obamacare’s weekend was kind of rough.

On Sunday, The Daily Kos reported that the frustrating, glitchy, failure-face of a website that is Healthcare.gov is such a mess, in part, because of coordinated conservative hackattacks.

That’s right. You heard me correctly.

Conservatives are hacking into Healthcare.gov to prevent it from working correctly.

Specifically, hackers have been launching DDoS attacks—an acronym that stands for Distributed Denial of Service—against the site, which function to make a network unavailable to users.

Sound familiar? I think so! How many gazillions of stories have you heard about uninsured, Obamacare-enthused folks getting kicked off the site, denied access to sign up for their government-sponsored health benefits?

Probably a lot.

These cons are SERIOUSLY getting on my nerves.

And that’s not all. In addition to these hackattacks—which are being launched with a tool called “Destroy Obama Care,” no joke—conservative lawmakers are encouraging insurance companies to fraudulently screw over their customers, and blame Obamacare for the ridiculousness.

For example, in Florida, douchebag extraordinaire Governor Rick Scott required insurance companies to blame Obamacare for any canceled plans, even if their reasons for canceling those plans had NOTHING AT ALL to do with Obamacare.

Lie, he said. It will be profitable, he said.

But actually. Because let’s be real here. Insurance companies make a lot of money for doing very, very little. They make healthcare prohibitively expensive. They’ve made medicine less about saving lives, and more about making money.

I mean really. The U.S. is the only country in the world where Breaking Bad makes any goddamn sense.

So when conservative lawmakers freak out about how horrible Obamacare will be, they’re really just lamenting the oncoming fall of big business. Of insane wealth disparities. Of that line in the sand that separates the haves from the have-nots.

Because what LOGICAL reason exists to vehemently defend the existence of companies that make healthcare INACCESSIBLE to the vast majority of Americans?

Seriously. Let’s look at a hypothetical example, shall we?

Mom gets breast cancer. It’s fairly advanced, but not untreatable.

She doesn’t have health insurance, because it’s way too expensive. She made a choice between paying for her monthly groceries, and electricity, and heat, and part of her mortgage payment—OR paying for health insurance. Years ago, she chose the former.

So now, here we are. Breast cancer. It wasn’t caught earlier because Mom lives in a state where women’s health funding has been slashed. Her local women’s clinic closed down. (Thanks Republicans.) She hasn’t had a mammogram in years. Preventive care wasn’t readily available to her.

Now that she has her diagnosis, Mom faces a choice. She can get treatment for her breast cancer, but she’ll go bankrupt paying for it. Or, she can forgo treatment, continue scraping by for now, and wait for the inevitable.

This is a bullshit choice.

The reality for Americans without insurance is completely absurd. They live in a wealthy, developed nation, where there are clean hospitals, abundant medicine, and well-equipped doctors. Quality medical treatment is right here. It’s there for the taking.

But it’ll cost you your house. And your groceries. And the clothes on your back. Actually, if you take advantage of all those lifesaving facilities, you’ll likely wind up bankrupt and homeless.

So really, for these Americans—for this fictional, hypothetical working mom with breast cancer—what’s the point of being American? What’s the point of living in the United States? She might as well live in a struggling, rural nation that has very few hospitals, and very little medicine. Her access to those facilities would be roughly the same.

And that’s completely insane. It makes no sense that uninsured people in the United States must choose between two life-destroying options: forgo treatment and wait for death, or go into total financial ruin.

I really wish I was, Chelsea.

The only reason anyone should forgo medical treatment is if treatment does not exist. You can’t go to the hospital for chemotherapy if there is no hospital, if there is no chemo.

But we do have hospitals. We do have chemo. And so, people should be able to use them. While also keeping a roof over their heads and food in their mouths.

This is not a difficult argument to make. This is just common sense.

But conservatives are abandoning that logic. They’ve made it their mission to defend a system that clearly isn’t working. They’re defending a healthcare system that bankrupts people. They’re defending insurance companies that lie and swindle their customers. They’re encouraging those insurance companies to act fraudulently.

This is stupid, am I right?

So lovelies, let’s try and put an end to this madness, mmkay? Obamacare is not ideal, but it’s a step in the right direction. It’s a step toward affordable and accessible healthcare for all. So let’s get behind it.

—

Featured image courtesy of [LaDawna Howard via Flickr]

[Featured image courtesy of the LA Times]

Hannah R. Winsten

Hannah R. Winsten is a freelance copywriter, marketing consultant, and blogger living in New York’s sixth borough. She hates tweeting but does it anyway. She aspires to be the next Rachel Maddow. Contact Hannah at staff@LawStreetMedia.com.

The post Conservatives Are Deliberately Hacking Healthcare.Gov appeared first on Law Street.

Well folks, it happened. After a collective freak out from the media – and a collective yawn from the general public – the government shut down today. Not surprising.

If you’ve been keeping up with this latest political soap opera, you’ll know that House Republicans planned this ridiculousness months ago, when they refused to meet with House Democrats and Hash out their budgetary differences ahead of time.

You’ll also know that this government shutdown isn’t the end of the world. A ton of federal employees will be furloughed, possibly without pay, military troops will stop receiving paychecks, national parks will close, passport applications won’t get processed, and Social Security checks will probably be a bit delayed. Obamacare will still become law. And Ted Cruz will forever be known as the latest King of Crazytown. (I told you all that someone would replace Michele Bachmann!)

To the average American, some of these facts will be irritating, inconvenient, or downright awful. (Are you the poor soul who planned a Washington, D.C. vacation for this upcoming week? No panda for you!) And the economy will definitely take a dip. But overall, nothing too horrific.

But! Let’s not get too comfy in our government-shutdown-who-cares apathy. Even though this doesn’t mean our entire democracy will come crashing down around our shoulders, it does bring up some very interesting questions about who matters in our government.

Let’s start with Obamacare, shall we?

A few days ago, Ted Cruz filibustered Congress for 21 hours, talking about why Obamacare is an awful, terrible idea.

First of all Ted, trying to dismantle healthcare reform while engaging in a very medically irresponsible activity probably isn’t your smartest idea. Just something to think about.

Forrest knows what’s up.

Second of all, what is so awful about Obamacare? Why is Teddy over here torturing himself, and creating quite the media circus, over defunding it?

Here’s what’s so awful about it – Obamacare benefits mostly everyone, but mostly poor people and women. Who are, incidentally, often the same thing. Also people of color and queer folks. Again, many times the same thing. Who does it benefit the least? Rich people! White people! Men! Again – many times, one in the same.

Ted Cruz’s obsession with defunding Obamacare is reflective of a larger idea that’s present across both parties, but which has come to a particularly alarming head within the GOP. Poor people, women, people of color, and queer people don’t matter. They are not worth out tax dollars or our reform efforts, and bills – like Obamacare – that would benefit them are offensive. That’s a really classy concept, isn’t it?

Seriously. It’s pretty gross that House Republicans would rather the government shut down than to extend basic healthcare to folks who don’t have access to racial, gendered, or economic privilege.

Now, obviously, that’s pretty shitty. But since the whole government shutdown thing isn’t overly dire, it’s not really a big deal, right? Jerks will be jerks, can’t we call just roll our eyes and move on?

Not really. Very soon, this government shutdown won’t be our only problem. In just 17 days, Congress will have to vote to lift the United States’ debt ceiling. While this sounds like voting to allow the government to spend more and rack up more debt, that’s not at all what it means – instead, lifting the debt ceiling simply means voting to keep the American economy running.

Without lifting the debt ceiling, the U.S. won’t be able to pay any of its bills. That means indefinitely delayed Social Security checks, no more benefits for veterans, and no more paychecks for soldiers. Also, hundreds of thousands of companies that do business with the U.S. government won’t get paid, the cost of borrowing money will skyrocket, and the U.S. won’t be seen as a safe place for business or investment.

Basically the U.S.’ economy, and the global economy, would go kaput. You think 2008 was bad? Failing to lift the debt ceiling would be much, much worse. And guess what! The GOP doesn’t want to do it.

Unless of course, a whole bunch of entirely unreasonable demands are met. Halting healthcare reform, building an oil pipeline, and nixing the regulation of greenhouse gases all make the list. It reads, essentially, like Mitt Romney’s campaign platform.

But, you see, Mittens lost the 2012 election for a reason.

He wasn’t shy about his disdain for the less fortunate, for those of us who are outside of privilege. We all remember his comment about the 47 percent. And last November, we all collectively decided that his wasn’t the kind of attitude we wanted in the White House. The American people have spoken! This case should be closed.

Mitt.

But the GOP isn’t willing to let it go. Some of their other demands over the past few years have included eliminating funding for Planned Parenthood – which would leave thousands of women, mostly poor and of color, without access to necessary healthcare – slashing food stamp funding – a program that is already insufficient for making sure the poor don’t starve to death – and preserving or implementing a bunch of tax reforms that benefit the rich and screw the rest of us.

The pattern is very clear. To the GOP, political negotiation means demanding people who are outside of privilege be made as vulnerable as possible. It means crusading against women, poor folks, people of color, and the queer community. It means threatening political and economic ruin for the entire country if our lives and livelihoods aren’t seriously threatened.

So, even though this latest government shutdown isn’t the end of the world, it’s only one episode in an ongoing political drama. And in 17 days, things could get much, much worse.

Because today, the Republican Party has shown that it would rather shut down the government than support a whole bunch of disenfranchised citizens gaining access to healthcare.

What will they do on October 17th?

—

Hannah R. Winsten (@HannahRWinsten) is a freelance copywriter, marketing consultant, and blogger living in New York’s sixth borough. She hates tweeting but does it anyway. She aspires to be the next Rachel Maddow.

Featured image courtesy of [Mount Rainier National Park via Flickr]

Hannah R. Winsten

Hannah R. Winsten is a freelance copywriter, marketing consultant, and blogger living in New York’s sixth borough. She hates tweeting but does it anyway. She aspires to be the next Rachel Maddow. Contact Hannah at staff@LawStreetMedia.com.

The post Here’s Why Republicans Shut Down the Government appeared first on Law Street.

Senators Chuck Grassley (R-Iowa) and Ron Wyden (D- Ore.) have co-authored a bill that would make the Medicare claims database available to the public, allowing for unprecedented transparency in medical costs.  If this bipartisan bill becomes law, the media, advocacy groups and consumers will be able to see how much the federal government pays for healthcare procedures for those on Medicare.  Doing so would give the American public the ability to compare the costs of different treatments, procedures and even the varying prices between hospitals.

Americans spent $2.7 trillion on healthcare last year, nearly $600 billion of which was paid for by Medicare alone.  Insight into the largest purchaser of health services in America would provide the public with an unprecedented amount of information about the healthcare market, and could potentially create a check on medical costs.  However, opponents of the proposed legislation claim that releasing this data to the public would reveal too much about the practicing patterns of individual doctors, hospitals and providers.  There is certainly a trade-off, but providing new information to consumers may be in the public’s best interest.

[Politico]

—

Featured image courtesy of [Sharyn Morrow via Flickr]

Kevin Rizzo

Kevin Rizzo is the Crime in America Editor at Law Street Media. An Ohio Native, the George Washington University graduate is a founding member of the company. Contact Kevin at krizzo@LawStreetMedia.com.

The post Bipartisan Bill to Change Healthcare Market appeared first on Law Street.

Texas Governor Rick Perry signed into law Thursday a bill that  greatly restricts abortion in the state. In his remarks before signing the bill, Perry said that the new law would prevent “reckless doctors performing abortions in horrific conditions” as a part of “our continued commitment to protecting life in the state of Texas.”

The new law makes abortions in Texas illegal after 20 weeks of pregnancy. It enforces surgical center regulations that will likely shut down the majority of abortion clinics as well as severely limit the locations where an abortion can be performed.

“That is reasonable. That is (the) common sense expectation for those caring for the health and safety of the people in the state of Texas,” Perry said in reference to the higher safety requirements.

[KMBZ]

—

Featured image courtesy of [Ed Schipul via Flickr]

Davis Truslow

Davis Truslow is a founding member of Law Street Media and a graduate of The George Washington University. Contact Davis at staff@LawStreetMedia.com.

The post Texas Sets Further Limits on Abortions appeared first on Law Street.