Dear John, Does Banning Abortion Trump Job Growth?

With millions of Americans out of work, House Republicans are focusing in on real priorities: decimating private abortion coverage and crippling public funding for abortion, as Jessica Arons reports in RH Reality Check.

In AlterNet, Amanda Marcotte notes that the No Taxpayer Funding for Abortion Act, or H.R. 3, also redefines rape as “forcible rape” in order to determine whether a patient is eligible for a Medicaid-funded abortion. Under the Hyde Amendment, government-funded insurance programs can only cover abortions in cases of rape and incest, or to save the life of the mother. Note that the term “forcible rape” is legally meaningless. Supporters of the bill just want to go on the record as saying that a poor 13-year-old girl pregnant by a 30-year-old should be forced to give birth.

Feminist blogger Sady Doyle has launched a twitter campaign against the bill under the hashtag #dearjohn, a reference to Speaker John Boehner (R-OH). Tweet to let him know how you feel about a bill that discriminates against 70% of rape victims because their rapes weren’t violent enough for @johnboehner, append the hashtag #dearjohn.

Everybody Chill Out

A federal judge in Florida ruled the entire Affordable Care Act unconstitutional on Monday. However, as political scientist and court watcher Scott Lemieux explains at TAPPED, the ruling is not necessarily a death blow to health care reform:

[T]his ruling is less important than the controversy it will generate might suggest. Many cornerstone programs of the New Deal were held unconstitutional by lower courts before being upheld by the Supreme Court. This ruling tells us nothing we didn’t already know: There is a faction of conservative judges who believe the individual mandate is unconstitutional. Unless this view has the support of five members of the Supreme Court — which I still consider very unlikely — it won’t matter; Vinson’s reasoning would have a much greater impact if adopted by the Court, but for this reason it is even less likely to be adopted by higher courts.

In a follow-up post, Lemieux explains the shaky legal reasoning behind Judge Robert Vinson’s decision. The judge asserts bizarrely that being uninsured has no effect on interstate commerce. That premise is objectively false. Health insurers operate across state lines and the size and composition of their risk pools directly affects their business.

Given the glaring factual inaccuracies, Judge Vinson’s decision may be overturned by a higher court before it gets to the Supreme Court.

Scamming Medicare

Terry J. Allen of In These Times win’s the headline of the week award for an article entitled “Urology’s Golden Revenue Stream.” She reports that increasing numbers of urologists are investing millions on machines to irradiate prostate cancer in the office. The doctors can bill Medicare up to $40,000 per treatment, but they have to use the machines a lot to recoup the initial investment. So what does this mean for patients? Allen explains:

Rather than accessing centralized equipment and sharing costs, physicians are concentrating their own profits by buying expensive in-practice technologies that pay off only if regularly used. One result is overtreatment, which is driving up health care costs, exposing patients to unnecessary radiation and surgeries, and is frequently no better than cheaper approaches.

One third of Medicare patients with prostate cancer undergo the expensive IMRT therapy, as the procedure is known. In 2008, Medicare shelled out over a billion dollars on a treatment that has not shown to be any better for patients than less expensive therapies.

Obstetric Fistula in the Developing World

Reproductive Health Reality Check is running a special series on the human rights implications of obstetric fistula. Fistula is a devastating complication of unrelieved obstructed labor in which the baby’s head gets stuck in the birth canal and presses against the soft tissues of the pelvis. If labor goes on long enough, the pressure will starve the pelvic tissues of blood, and they will die, creating a hole between the vagina and the bladder, and/or between the vagina and the rectum. Fistula patients face lifelong incontinence, chronic pain, and social ostracism.

The condition is virtually unknown in the developed world, where women with obstructed labor have access to cesarean delivery. However, an estimated 2 million women, primarily in sub-Saharan Africa and Asia, have untreated fistulas with an estimated 50,000 to 100,000 new cases occurring each year. Without reconstructive surgery, these women will be incontinent for life.

Sarah Omega, a fistula survivor from Kenya, tells her story. Omega sustained a fistula when she delivered her first child at the age of 19. She suffered for 12 years before she finally obtained the surgery she needed. As Agnes Odhiambo explains in another installment in the series, fistula is a symptom of a dysfunctional health care system. Women suffer needlessly because they can’t get access to quality health care.

The most likely victims of fistula are the most vulnerable members of their respective communities. Early childbearing increases a woman’s risk of fistula. Pregnant rape victims may face even greater barriers to a safe delivery, thanks to the social stigma that accrues to victims of sexual violence in many societies. (Not to mention any names, House Republicans…)

Preventing and repairing obstetric fistula is a major human rights issue. The U.S. should make this effort a high priority for foreign aid.

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