The politics of health care (5x8 - 3/5/13)
Posted at 7:04 AM on March 5, 2013
by Bob Collins
(12 Comments)
Filed under: Five by 8
Abortion fight takes center stage, if teachers taught in hip hop, computer gamers unravel mysteries of the brain, can workers be trusted when to work, and poverty in black and white.
1) ABORTION FIGHT TAKES CENTER STAGE
Just when people were mostly ignoring the Minnesota health exchange issue, it jumps ahead of almost every other issue generating buzz at the Capitol. Overnight, the Minnesota House of Representatives passed the bill but added an abortion provision that is making Minnesota politics stop in its tracks and pay attention. The abortion issue in Minnesota usually does.
First, a definition: A health insurance exchange is a state-run marketplace that allows consumers without health coverage to shop for the best deal. People pay their own money for it (although some will be using federal subsidies to pay for it). Minnesota politicians are debating setting up a state system and if it doesn't work, the feds will set up a one-size-fits-all-market. The Minnesota website is already open.
Legislators lined up yesterday with over 100 amendments to the bill in the Minnesota House, but the one that's got all the attention is one that passed, banning coverage for any abortion procedure.
Here's the exact amendment:
"Subd. 3. Abortion coverage prohibited. (a) No abortion coverage may be provided by a qualified health benefit plan offered through the Minnesota Insurance Marketplace created pursuant to the Affordable Care Act, Public Law 111-148.
(b) This limitation shall not apply to an abortion:
(1) performed to prevent the death of the mother;
(2) when the pregnancy is the result of criminal sexual conduct as defined in section 609.342, clauses (c), (d), (e), item (i), and (f), and the incident is reported within 48 hours after the incident occurs to a valid law enforcement agency for investigation, unless the victim is physically unable to report the criminal sexual conduct, in which case the report shall be made within 48 hours after the victim becomes physically able to report the criminal sexual conduct; or
(3) when the pregnancy is the result of incest, but only if the incident and relative are reported to a valid law enforcement agency for investigation prior to the abortion."
Up until now, just about everything about the new health care law has involved whether it's the government getting involved in the private health care decisions of people. So there's a little irony that anti-abortion foes used the bill to get involved in the private health care decisions of individuals.
Or is it? The press release from Minnesota Concerned Citizens for Life makes clear they were ready for the accusation.
"Abortion is not health care and it should not be among the procedures covered in the state exchange's insurance plans," the executive director Andrea Rau said.
The inevitable court challenge to the amendment will be a fascinating clash. In the 1995 Doe v. Gomez decision (available here), the Minnesota Supreme Court required the state to provide public funds for abortion services for poor women. Significantly, perhaps, the ban on public funds that was struck down in that case, had nearly identical exemptions as the amendment that was attached yesterday.
Since individuals (mostly) pay their own money to buy private insurance under the state exchange concept, the ban would mean individuals spending their own money on insurance could not obtain abortion coverage, but people spending the state's could.
Minnesota is not alone in adding the abortion restrictions. At least 20 other states have done so. But most of those states don't have Doe v. Gomez.
Related: U.S. women dying younger. No one is quite sure why.
Wisconsin women's mortality rate worsens in central, northern parts of state (Milwaukee Journal Sentinel)
2) IF TEACHERS TAUGHT IN HIP HOP
What if teachers taught in a language urban kids speak?
If researchers ever conquer the final frontier -- the human brain -- maybe they'll have a computer game player or two to thank. Scientists at MIT, for example, are trying to map the neuron connections to the eye and they know just the people to help.
"Anyone sitting in their living room can just fire up a web browser and look at images of neurons, and help us figure out how they're connected," Sebastian Seung tells NPR today.
Increasingly, Joe Palca says, scientists are taking data, putting it in the form of games, and asking gamers to help explore it and figure it out.
More science: The human body -- in Google Map form. (Time.com)
4) CAN WORKERS BE TRUSTED TO WORK?
This would be a good day to log on and get some work done from home instead of sitting in a snowbound commute. It's too bad, perhaps, that that's so 1990s. More and more companies, apparently, want their minions in their cubicles and aren't shy about saying so, now that Yahoo's CEO has issued the order to end the days of telecommuting.
Writing in the Kansas City Star, Barbara Shelly says it's the right call, despite the howls of nerdy protest.
Some of us rarely pause for conversation, much less lunch. A while ago, a senior partner in a law firm told me he had to order his associates to go to lunch with clients and each other, just to get away from their desks and get some perspective. I hear this from many people in the workplace. The yield is abundant, but the harvest is bland and uninspired.
Perhaps a shake-up is called for. Bring the telecommuters into the office so they can get to know their co-workers by something other than an email address. And send the office workers home for a nap, which research indicates will boost both productivity and performance.
Either way, the workplace and the people served by it would be better off if more companies -- and workaholic employees, too -- could bring themselves to trade a bit of productivity for innovation.
But the Pioneer Press' Julio Ojeda-Zapata reports a Minnesota ad agency disagrees.
Adopting a middle ground, Fast Horse in Minneapolis has invested a great deal of effort and expense to create an appealing office but gives its employees the leeway to work elsewhere.
"Wherever and whenever they feel they can be the most productive is up to them," said Jorg Pierach, the agency founder. "They're responsible for meeting their obligations, and they can do this on their own terms."
@ojezap It's not a telecommuting problem. It's an employee trust problem. That doesn't get fixed by ordering people into the office.
— Peter Shankman (@petershankman) March 5, 2013
In 1968, famed photographer Gordon Parks, an adoptive Minnesotan, shot a photo essay for Life Magazine. "A Harlem Family," became the faces of urban poverty for millions of Americans. Whatever happened to the Fontenelle family? The New York Times' Lens blog provides the answer today. Of the eight children, only one lived past 30. He became a friend of Parks, but died three days before a current exhibit of Mr. Parks' essay opened.
It's an incredible story:
Those images jolted Life's readers, whose response to "A Harlem Family" was immediate and overwhelming. Hundreds of letters poured into the magazine's offices expressing sympathy and pledging money. Encouraged by the response, Mr. Parks urged Life to contribute enough additional money to buy and furnish a new home in Springfield Gardens, Queens, for the Fontenelles.
"Most important," Mr. Parks wrote in "A Hungry Heart," another memoir, "the magazine helped Norman get a job."
But the Fontenelles' new beginning came to a sudden end. A little over a year after the story was published, Life ran an editor's note under the headline, "Tragedy in a House that Friends Built." Late one night, the house had gone up in flames. Norman and his son Kenneth died in the fire; Bessie and the other children survived. The house and everything in it was destroyed. The family had only lived in the home for three months.
Related: Life and death in Harlem (Mail Online)
Bonus I: Because of a University of Cambridge professor, people anywhere in the world can "explore, compare and combine elements from the composer's music, comment on it as they go, and ultimately construct their own version of the Chopin work to an extent that has never before been possible."
Bonus II: Does the Air Force really need a band anyway?
TODAY'S QUESTION
During a key scene in the play "Venus in Fur'' the lead actress lights up a Marlboro from her purse and takes a drag, tilting her head backward while exhaling a long stream of smoke. Those stage moments could become harder to pull off in Minnesota if lawmakers amend the state's smoking ban. Today's Question: Should performance art continue to be exempted from the smoking ban?
WHAT WE'RE DOING
Daily Circuit (9-12 p.m.) - First hour: Minnesota's Senate Leaders join The Daily Circuit to give their take on the recent budget forecast and how that changes the tax discussion at the capitol, and discuss other issues making their way through the Legislature.
Second hour: The debate over workplace flexibility.
Third hour: How things have changed - and stayed the same - for women today.
MPR News Presents (12-1 pm): Supreme Court Justice Sonia Sotomayor, speaking at the Commonwealth Club of California about her life and her memoir, "My Beloved World."
Talk of the Nation (1-2 p.m.) - Pro sports and sexual orientation.
All Things Considered (3-6:30 p.m.) - TBD
Comments (12)
4) CAN WORKERS BE TRUSTED TO WORK?
By the number of comments I make here in a day? No.
:)
@#1) Its nice to see some exceptions at least in the amendment... Though it is still kind of silly to say just because you are operating with in our market you can't offer these services... But that's the government...
Maybe some day we can leave health care up to those who are, you know, health professionals... people like doctors, and nurses, maybe even patients, instead of elected officials who have only the faintest grasp of these concepts.
@#4) Hard to dis agree with BJ.
// people like doctors, and nurses, maybe even patients, instead of elected officials who have only the faintest grasp of these concepts.
That's really the other fascinating part of this, isn't it? We're not really talking about health CARE as much as we are health PAYMENT. At least in this case. And these are private companies who are putting packages together to be listed on the website for potential customers to choose.
// not really talking about health CARE as much as we are health PAYMENT
I wonder what Health Management Organizations have abortion as a standard option to begin with?
If it is standard, how many/percent use HMO to pay for it (vs cash).
The healthcare exchange is NOT a marketplace.
MPR should interview Twila Brase of Citizens Council for Health Freedom. www.cchfreedom.org to provide a balanced story.
I've been able to work from home for the past three years, for two different companies. My current company has a policy simliar to Fast Horse. Everyone can work from home if that's where they are productive. Yet nearly everyone comes into the office, minus days like today.
I think it's a culture thing as much as a trust thing. Work from home when it makes sense, but coming into the office and getting to know your co-workers while discussing problems(both work related and nnot) over morning coffee is productive in a different way.
lars, I've read the website you link to and still don't understand how it is not a marketplace. The only real "it is not a marketplace" argument I see is that there are government regulations. But every marketplace I go to has government regulations, from "no shoes no shirt no service" to licensing requirements to requiring sales tax.
Of course women are dying at a younger age. The US's maternal mortality rate has DOUBLED since 1987...yet nobody seems to care. Thankfully, that might be changing.
//provide a balanced story
Balanced with a fringe thinker?
JIM SPENCER, Star Tribune
May 24, 2010 said "That puts her at odds with many of the most popular concepts in modern health care: evidence based medicine, electronic medical records, DNA data banks, doctor quality ratings."
So the bill doesn't say what you think they are building, and so that's what it does? Either it is poorly written and I am missing something or its some circular logic that only fringe people will believe.
You can dislike it because it is something you don't like, but a place where you buy something can be called a market.
Also, if you read BJ's link above, it is a confusing, out of date diagram and huge jumps, that aren't all true, made in the text. It is written by someone who clearly doesn't understand the technology or what is actually happening when someone goes to the exchange.
So, to clear up some confusion, if you go to the exchange, and you are interested in purchasing insurance and not getting a subsidy, it will be very similar to travelocity.
Only when you are looking for the government money will the state then need to verify certain things about you to see if you are eligible. And that's how it works, if you want money from the government, the tax payers want us to make sure you actually are eligible for that money. If we didn't do that, these same fringe groups would be going crazy about us giving money to "illegals" and "welfare queens wearing fur coats."
The amendment will never see a court challenge because it will never become law. The Senate will never allow it to go on its bill. On the miracle chance that it would, it would still not survive conference committee because Governor Dayton would never sign it.
That the amendment passed the House shouldn't surprise anyone. The House has always been a pro-life body, even at the height of recent DFL majorities votes on pro-life issues were extremely close (with one even going down on a tie, IIRC). This is due mostly to the fact that a DFL majority usually entails a large portion of rural DFLers who skew towards being pro-life. A little quirk of legislative politics.
I worked from home for a couple years. I was absolutely more productive working remotely. And, because my company had what I'd call a culture of supplication, it allowed me to avoid some of the less enjoyable elements of working for a company that does not trust (nor arguably value) its employees.
The enjoyable thing has been watching them try to roll-out a knowledge management employee networking system, while maintaining a culture of silos and exclusion. The result, instead of aencouraging employees to find utility in the system, we got email blasts about an enterprise 2.0 scavenger hunt. It'll be interesting to see what survives, the prevailing culture or the networking system, I don't expect it to be both.
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