MOMocrats™

Go Watch This: "Last Friday Night My Father Asked Me to Kill Him"

I lost my grandmother on Tuesday. On the way out of one meeting and already thinking ahead to the next, my cell phone rang. It was my aunt, calling from the grandmother's house to tell me she had died.

She'd just turned 83 earlier this month. Besides a little hypertension (controlled via medication), she had no serious health conditions. We're still waiting for final word on what happened -- it appears to be a stroke or heart attack -- but her death was sudden and unexpected.

Last evening I took to the sofa, exhausted from a long day of work and feeling I need a mulligan on 2010 (besides my grandmother, there have been other serious family illnesses, epic snow and cold, and frantic work schedules). I flipped channels rather aimlessly and eventually settled on MSNBC, where I could half-listen to the news.

And half-listen I did, until Keith Olbermann read his special comment and blew me away.

Visit msnbc.com for breaking news, world news, and news about the economy

One of These Things is Not Like the Other

I was looking at the list of invitees to the White House’s forthcoming summit on health care reform. Do you notice anything interesting about the list?

There is precisely one woman – Speaker Nancy Pelosi – on the list of invitees. Twenty of the 21 invitees are men, with the vast majority (everyone except Charlie Rangel and James Clyburn) being white.

I’m not a hard charger for identity politics. I’d take a Senate full of the late, great, and much-missed Paul Wellstone (D-MN) over a Senate full of Kay Bailey Hutchison (R-TX) every day and twice on Sunday.

The FY2011 Budget: Impact on Women and Families

With much fanfare and more than a little trepidation, President Obama released his FY2011 budget on Monday.

In this post, I’ll be focusing on budget items that fall under the Department of Health and Human Services. I know that moms and others care about more than just health but before you start shouting “Where's education? Where’s money for veterans and their families? What about foreign assistance?” let me remind you that budget is BIG. Like many thousands of pages big.

I know many people have been reading about a spending freeze. Obama wants to – with some exceptions – freeze FY11 spending at FY10 levels to hold down our debt. Mandatory spending programs – Medicaid, Medicare, and Social Security – would be exempt as would defense spending. When you carve out those exceptions you’re left with a relatively small fraction of federal spending, but, hey, you gotta start somewhere, right?

The explanatory document (read: actual, human English) about HHS is here. It is a nice, easy read. But it is only eight pages. Why? Well, it just an overview of the president’s outlook on HHS spending; no details. The appendix (read: wonkery on high) is here. The appendix is only about 50 pages but in teeny 8 point font and has most of the spending details on a wide variety of programs, agencies, offices and more. Finally, HHS’ own budget with lots of details about what they plan to spend their dough on is here (114 pages, and pretty readable if bone-dry).

Because the budget is so very, very large I’m just hitting a couple of highlights (and low-lights):

Go Read It: Is It 2013 (or 2014) Yet?

 "All of the competing and often compelling arguments brought to bear on these intractable social issues are steeped not in health care, medicine, epidemiology, economics, practicality, or common sense.  Rather, they are broadcast to us across treacherous philosophical, emotional and spiritual terrain that will never be amenable to political compromise.  And so, in short, the ideologues on both sides of each issue pounced; the issue was squeezed altogether from The Plan or flash-frozen in its current state of impasse (abortion being the perfect example); and what we’ve ended up with is a health care “reform” bill that re-paints all the old lines in the political pavement and promises to reform almost nothing structural or profound about health care in America."

This is an excellent, if somewhat wonky, post on health care reform. If you are concerned about rising health care costs, please do take the time to read it.

For those of us who have worked on health care reform for a long time, the "incredible shrinking health care reform bill" is a disappointment. As I tell others, this bill (be it HR 3962 or HR 3590, and it will probably more closely resemble the latter) is the beginning. There will need to be tweaks and rewrites; just as other legislation needs to be reauthorized periodically to reflect new realities -- and outlays -- so too will health care reform.

I just wish it was a more auspicious start.

Dear Nate Silver...

Nate Silver, over at FiveThirtyEight.com has 20 questions for people who are coming out against the health care reform bill currently pending before the Senate.

Over the medium term, how many other opportunities will exist to provide in excess of $100 billion per year in public subsidies to poor and sick people?

Subsides don’t make coverage affordable nor do they guarantee access. The penalty for noncompliance – that is, for not obtaining coverage – in some versions of the bill have been significantly lower than the cost to actually buying a plan. Baucus tried to get round this by including a “young invincible” plan since it is critically important for risk-spreading that young healthy people become part of large insurance pools. The “young invincible” plan morphed into the “catastrophic plan” (Section 1302(e) in the Senate bill) and would be available to those aged 30 or younger. Nevermind that this is when preventive care is most important and this plan limits it to three visits.

And furthermore: Coverage does not equal access. Opening Medicaid up to poor people someplace around 150% of the federal poverty line does not mean that they suddenly will have good health care. Will they be protected from catastrophic injury? Yes. Will they be able to find a dentist, psychiatrist or other health care provider in a timely fashion? Doubtful. Look at the story of Deamonte Driver and remember that Maryland is a population-dense state with loads of medical providers and yet a 12-year-old boy died for want of dentist.

2. Would a bill that contained $50 billion in additional subsidies for people making less than 250% of poverty be acceptable?

At this point, real health reform would be acceptable. The federal poverty measure is a joke. It hasn’t been retooled in decades and $55,125 for a family of four isn’t a lot of money, particularly when you consider that under some provisions in the bill, a family could be stuck paying 3:1 for older members, 1.5:1 for tobacco users, etc. And the subsidies would reduce the cost of insurance to 2% of income for those at 100% of the FPL but could be as much as 9.8% of income for those at 400% of the FPL.

And the deductible for small employer plans could be as much as $4000 (Sec. 1302(2) of the Senate bill). That’s almost 10% of the above family’s income.

The Season of Giving

A terrific blogger, Alias Mother, is doing a blog-link-y thing where she's writing about her favorite charities and encouraging readers to do the same.

To that end, a couple of MOMocrats will be posting about our favorites charities - ones that help women and their families - in the coming weeks.

APOPO - HeroRat
Apopo was founded in the 1990s and it works with rats. Special rats. Rats that detect land mines. Following the long civil war, many areas of Mozambique were virtually uninhabitable due to heavy mining -- children cannot play in open areas for fear they will lose a limb or worse.

The rats find the landmines (they find scent from the TNT) but aren't heavy enough to set off the mine. The mine then can be removed or detonated. And, just in case you think this sounds...odd...keep in mind that the rats passed official licensing tests according to IMAS standards under supervision of the Geneva International Centre for Humanitarian Demining (GICHD).

You can watch a great video about the rats from PBS/Frontline here

UNIJECT
PATH, a non-profit with offices in Seattle and DC/MD, is devoted to improving the lives of women worldwide. To that end, they created Uniject.

Uniject can be used my minimally-trained people to deliver vaccines (Hep B, mostly) and drugs to prevent postpartum hemorrhage. It is single use, so helps lessen the worry about proper sterilization and transmission of HIV/AIDS.

Again, a great video is here.

My husband and I are tremendously lucky that our daughter will never have to run a gauntlet of land mines to attend school. And while childbirth carries risk, the likelihood that I or any woman in the first world would die from postpartum hemorrhage is infinitesimal compared to women in the developing world. And we won't lose our daughter to neonatal tetanus, a major killer in areas without access to vaccines.

"Off With Their Heads!" (Hey, They Aren't Using Them Anyway)

I'm sure by now most MOMocrats readers have seen the video of Billionaires for Wealth serenading Bill McInturff as he speaks to America's Health Insurance Plans (AHIP). But, if you haven't yet witnessed the spectacle, please feast your eyes:

I saw the video on Rachel Maddow. "Gleeful" might be too weak a word to describe my reaction. My husband, ever the professor, reminded me that I'd be all kinds of annoyed if someone interrupted a meeting of say, Trust for America's Health or the National Partnership for Women and Families.

I thought about that all evening. You know what? He's right. I would be FURIOUS. And if that makes me a hypocrite, so be it. I'm ready to fight for health care reform. 

Wonk 101: A Camel is a Horse Designed By (Conference) Committee. Also: How the Senate Parliamentarian Might Be King.

In our last installment, we highlighted the circus – complete with large steaming piles – that is floor action. This post will cover what happens when the House and Senate actually get round to passing a bill...but the House version, for example, includes a public option for health care and the Senate version says, “Well, we don't want anyone to die in the street but it could happen.”

Before the bother of a conference committee, the 2d chamber to consider the legislation will usually send a message to the 1^st chamber (where the bill started) asking them to concur with the amendment(s). If the 1^st disagrees with the amendment(s), then they request a conference and appoint conferees. The 2d chamber can either concur with the 1^st house or insist on their amendments and also appoint conferees.

Off to conference...

Wonk 101: Ringling Bros. Ain’t Got Nothing on This Circus

In our last installment, we introduced you to the bill drafting process, and some basics on committee action. This post will cover more of the committee process and floor action, including why your congressperson pouts like a two-year-old when the words “closed rule” are thrown around.

After a bill is introduced, numbered, and assigned to committee, the process generally goes subcommittee hearing--->subcommittee markup & vote--->full committee hearing--->full committee markup & vote. This is called “normal order.” It might also be called relatively-rare-order since there are places where this process goes off the rails, both for good and for ill.

Wonk 101: Mommy, Where Do Bills Come From?

MOMocrats is hosting a short series, Wonk 101, to cover some of the intricacies of the legislative process. Why? Well, while School House Rock remains the gold-standard for entertaining and informative, it does gloss over some of the weirder happenings. In an effort to make it easier to understand why there are three versions of health reform percolating in the House and Arlen Specter kept repeating, “There is no Senate bill,” we present this series. Got a burning question about something? Please leave a comment.

I thought this first post would cover how a bill gets written, introduced, and referred to a committee. And the inevitable exceptions to those rules. The next posts will focus on the chaos wonderment that is floor action and the conference process. Given the rage over health care reform, I thought it’d be good to provide a sort of blueprint for following the process.

When Two (or a Couple Thousand) People Love Each Other An Idea... From the thousands of constituent requests, meetings with lobbyists, and handed-down party priorities, a representative might cull a couple dozen ideas in which to actually invest staff time and draft a bill. Alternatively, an outside group might draft a bill and then shop it around to members. In either case, the actual drafting can take months as people duke it out over exact wording (think “It depends on what the meaning of “is” is.)

There are questions to be asked and answered: Will it alter (amend) or repeal existing laws or regulations? Where does it fit in existing federal statutes? Does the counsel’s office think it is constitutional? Is it likely to pass? Who can we partner with? How well funded is the opposition?

What happens next?