Upcoming Event: 11/01/12 Obamacare on Trial – Book talk and panel discussion with Einer Elhauge

Obamacare on Trial

Book talk and panel discussion by Einer Elhauge, Carroll and Milton Petrie Professor of Law, Harvard Law School (and founding director of the Petrie-Flom Center)

Panelists:

November 1, 2012, 6:00 pm

Wasserstein Hall, Milstein East A

Harvard Law School

1585 Mass Ave, Cambridge, MA

Sponsored by the Harvard Law School Library

Florida’s Constitutional Amendment on Healthcare: Why It Still Matters after the Supreme Court’s Healthcare Decision

By Katie Booth

This November, Floridians will vote on whether to amend the Florida constitution “to prohibit laws or rules from compelling any person or employer to purchase, obtain, or otherwise provide for health care coverage.” Similar constitutional amendments are on the ballot in Alabama and Wyoming and have already been adopted in Arizona, Oklahoma, and Ohio. While Florida’s proposed amendment has not received much attention after the Supreme Court’s decision to uphold the individual mandate requirement of the Affordable Care Act (“ACA”), these state constitutional amendments should not be written off entirely.

The Florida amendment could have some effect on the upcoming presidential election. Since the amendment is included on the ballot, it could help win votes for Romney and other Republican candidates by reminding undecided swing voters about the ACA as they are filling in the ballot. If the amendment passes—which requires sixty percent of the popular vote—it will almost certainly be seen as a referendum on the ACA that will give ammunition to Republicans in future elections.

The existence of these state amendments and other similar legislation also raises the stakes of future Supreme Court litigation over the ACA. While the Supreme Court may be loath to revisit the ACA anytime soon, opponents are likely to continue challenging different aspects of the ACA that have not yet been litigated. Some of these cases could eventually end up in the Supreme Court, especially if there is ambiguity around whether the ACA preempts certain aspects of state constitutional amendments.

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Reality Check, Please!

by Suzanne M. Rivera, Ph.D.

By now, many people have seen a still photo or video footage of Rep. Paul Broun (R-Georgia), standing in front of a wall full of deer heads, proclaiming that evolution, embryology, and the Big Bang theory are “lies straight from the pit of hell.”  According to the Congressman, “it’s lies to try to keep me and all the folks who were taught that from understanding that they need a savior.”

Readers might shrug these statements off as merely absurd.  But Rep. Broun is a member of the U.S. House Committee on Science, Space, and Technology, and he’s running unopposed for re-election.

Broun is just one of the members of the House Committee on Science, Space, and Technology whose unusual views should give voters pause.  His colleagues on the Committee include Todd “Legitimate Rape” Akin (R-MO), and Randy Neugebauer (R-Texas), whose congressional record is most notable for introducing a resolution that “people in the United states should join together in prayer to humbly seek fair weather conditions.” Read More

JAMA Forum: Reproductive Freedom and the 2012 Presidential Election

Glenn Cohen and his co-author, Eli Adashi, have a new blog post out at the JAMA Forum on reproductive freedom and the presidential election:

It is commonly assumed that the economy will constitute the key, if not sole, battleground of the 2012 presidential election. That may well be the case. In the past several months, however, both parties have paid ever-growing attention to the possibility that the candidates’ positions on issues involving reproductive freedom could affect the leanings of women voters and thereby the final outcome. In conducting intense monitoring—not to mention targeted messaging—in this area, both presidential campaigns have acknowledged that for many women, especially women of reproductive age, reproductive health is as much an economic issue as it is a health care issue.

In a departure from past campaigns, the 2012 presidential election ventures beyond the confines of the abortion issue to incorporate a tapestry of competing ideologies on related questions. Given the interest in these issues, the positions articulated by President Obama and Governor Romney in the domain of reproductive freedom may well be a factor in the 2012 election, because an analysis reveals 2 very different points of view.

Read more…

What Is a (Big) Bird in the Hand Worth?

by Suzanne M. Rivera, Ph.D.

The Presidential debate on Wednesday was fascinating theater.  Much of the post-debate commentary in social media has focused on Mitt Romney’s threat to cut federal funding to PBS as a way of reducing the deficit (save Big Bird!) and President Obama’s unexpected restraint (including this piece of NSFW satire from The Onion).

I love Big Bird as much as the next child of the Sesame Street generation, but I’m even more concerned about something else.

Very little attention has been paid to the fact that neither candidate said much about science.  Because I was listening closely for any reference to research or innovation in medicine and healthcare, I can tell you this: the closest either candidate came to making a claim in this area was President Obama who (I think) intended to say something like, ‘Cuts to basic science and research would be a mistake.’ Read More

FDA’s New Dance with Big Pharma: Are Patients the Band?

Efthimios Parasidis

One week prior to the Supreme Court’s landmark ruling in the health care cases, Democrats and Republicans overwhelmingly voted in favor of health-related legislation (387-5 House; 96-1 Senate).  Industry and HHS were quick to congratulate our elected officials on a triumphant bipartisan achievement, while the FDA enthusiastically welcomed its latest collaboration with Big Pharma.  Lobby groups boasted of their ability to “craft” legislation with FDA and praised the “unprecedented level of public input” into the new law.

We should all be concerned.

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Taking Liberties (and Libertarians) Seriously

By Abby Moncrieff

First, an uncontroversial statement: Despite academics’ resistance, libertarian arguments played a huge role in the Supreme Court’s Obamacare decision. That seems obvious. Chief Justice Roberts and the four dissenters based their Commerce Clause analyses largely on notions of individual freedom, asserting that the federal government should not be allowed to force individuals to purchase private products.

But to heath scholars, that line of analysis is incredibly irksome and even a bit dissonant. Health insurance isn’t like ordinary private products, we cry; it is intimately connected to health care regulation, and forcing people to have health insurance, unlike forcing them to buy (or even eat) broccoli, will make them healthier! Congress made this point explicitly, finding that “[t]he economy loses up to $207[ billion] a year because of the poorer health and shorter lifespan of the uninsured”! Failing to eat broccoli doesn’t make you unhealthy the same way that failing to carry insurance does, especially if you’re substituting broccoli with green beans instead of donuts. And eating broccoli doesn’t make you healthy the same way that carrying insurance does, especially if you’re also eating steaks (or eating more than 2000 calories a day of pure broccoli). So, Supreme Court, you just got it wrong. The individual mandate isn’t a crass attempt to get people to buy something. It is, like countless other uncontroversial provisions of the U.S. Code, an attempt to improve the health and longevity of the American people. If you don’t think Medicare (or a Certificate of Need law) infringes liberty, you shouldn’t think the individual mandate does.

Here’s the problem: The Solicitor General didn’t make that argument.

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Obama v. Romney on Health Care

Ok, so we’ll have a NEJM-heavy day today! But you’ve got to check out one more thing, statements from the presidential candidates on the future of American health care.  This was the topic of a hugely successful Petrie-Flom Center event earlier this week, which was – sadly – off the record.  We heard from the candidates’ representatives, but here it is directly from the source(s):

NEJM: Cutting Family Planning in Texas (and more)

Our friends over at the New England Journal of Medicine just alerted us to a new perspectives piece addressing the impact of cutting family planning funds in Texas (the piece was also picked up by Politico).  The authors interviewed 56 leaders of organizations throughout the state that provided reproductive health services using public funding before cuts went into effect, and what they found was disturbing:

  • Most clinics have restricted access to the most effective contraceptive methods because of their higher up-front costs (choosing pills over IUDs or subdermal implants).
  • Clinics have started to turn away those who canot pay, when previously their visits would have been covered by public funds, and women who can pay the newly instated fees are choosing less effective methods and fewer tests to save money.
  • A number of clinics have lost their exemption from Texas’ law requiring parental consent for teens under 18 who seek contraceptives.

Overall, the authors conclude that laws intended to defund Planned Parenthood in an attempt to limit access to abortion (even though federal and state funding cannot be used for abortion anyway) have resulted in policies limiting women’s access to range of preventative reproductive health services and screenings.

Alta Charo weighs in via a NEJM podcast, discussing the future of reproductive health care for women in the US, particularly in light of upcoming elections (as well as the article we discussed last week on conscientious action, and other general issues in reproductive health policy).  Take a listen!

And one more NEJM plug for now: our Bill of Health blogger Kevin Outterson also has a podcast online discussing the record-breaking settlements of pharmaceutical fraud cases and the need for further regulation.

Upcoming Event at the JFK Jr. Forum: Health Care in 2013: Why the Race for the Presidency Matters

This Monday, October 1, 2012 @ 6PM, our friends at the John F. Kennedy Jr. Forum at the Harvard Kennedy School are hosting a panel on Health Care in 2013: Why the Race for the Presidency Matters. The event will feature:

  • Robert Blendon, Menschel Professor; Senior Associate Dean, Harvard School of Public Health
  • Vivek Murthy, President, Doctors for America
  • Thomas Scully, Administrator, Centers for Medicare and Medicaid Services (2001-2003)
  • Sheila Burke, Adjunct Lecturer in Public Policy; Faculty Research Fellow, Malcolm Wiener Center for Social Policy (moderator)

Location: John F. Kennedy Jr. Forum at the John F. Kennedy School/Harvard
79 JFK Street
Cambridge, MA
(corner of JFK and Eliot Streets)

Can’t make it? Watch the event live.