Change.org's Blog Network

Sensory Integration and Implications on Understanding Speech

Dora Raymaker — 2009-07-04T12:07:00-07:00

Many of us on the spectrum report a lot of difficulty making out what people are saying. Some of us have been additionally diagnosed with auditory processing disorder (sorry about the "in children" insistence in that article--it's otherwise a good article and the info is true of adults as well). Difficulty separating foreground from background noise is commonly reported. Earlier this year I posted on mono-sensing and understanding speech and questioned whether difficulty integrating vision and hearing might contribute to auditory processing issues.

Now it seems like there's some science backing up our experiences from City College of New York's Dr. John J. Foxe,

"Sensory integration dysfunction has long been speculated to be a core component of autism spectrum disorder (ASD) but there has been precious little hard empirical evidence to support this notion. Viewing a speaker's articulatory movements can greatly improve a listener's ability to understand spoken words, and this is especially the case under noisy environmental conditions.

"These results are the first of their kind to verify that children with autism have substantial difficulties in these situations..."

Foxe goes on to describe the implications this has for classrooms--that smaller, quieter classrooms that are more accommodating of auditory processing difficulties are a good idea.

"Being able to detect speech in noise plays a vital role in how we communicate with each other because our listening environments are almost never quiet. Even the hum of air conditioners or fans that we can easily ignore may adversely impact these children's ability to understand speech in the classroom."

Again, children children children, but these issues are definitely not limited to children! The science doesn't generalize, but the concepts likely do (at least they do in my experience as an N of 1). Environmental system hums, lighting hums, the shuffling of papers and clattering of pens and shifting in seats--all things that as a graduate student I fight through in order to make out what the instructor is saying. And background noise is always there--it does not "turn off." This makes listening to speech something that is exhausting, fades in and out, and is deeply unreliable.

Autism may be less "mysterious" when our experience of the world, such as our experience of others' speech, is better understood. This can pave the way to more accommodating environments which may lead to more opportunities and a higher quality of life.

image is a spectrogram of a man saying "19th century," source wikipedia

Fear, Sex, and Pandemic - Part One

Carol Dunn — 2009-07-04T10:28:00-07:00

(photo credit: kyz)

July 2009, mid pandemic, waiting to see if the novel H1N1 virus will mutate to become even more dangerous than the killer it is. You wouldn't be able to tell by looking at the actions and attitudes of the general public though.

After an initial period of hyper awareness, the world's population calmed down to a point where we see none of the changes needed in behaviors and policies to reduce the impact of a mutation.

There is a direct connection between the initial over reaction, and the current under reaction. Too many individuals feel as if they were duped, having once vested emotions, they don't plan on being duped again. That initial response, however, as counter productive as it was, it was entirely predictable and will happen again the next time unless Pandemic risk communicators change the way they talk about pandemics. Pandemic risk Communicators don't seem to get human nature.

Psychology, meets cognitive neuroscience, meets biology. Risk communicators work to influence human behavior through information and education. The only way to do this is through understanding what it is that makes us tick. In the past few years, great strides have been made in explaining the source of some consistent human behaviors. The NYT's Nicholas Kristof has an editorial summarizing the tendency of our brains to irrationally prioritize threats, For the most part, we stop everything to focus on a threat that feels like it may be imminent, but we are heavily inclined to ignore thoughts of risk, this despite the fact that most risks are easily avoiding when objectively analyzed.

America and the Belief in Things Better

Nathaniel Whittemore — 2009-07-04T10:11:00-07:00

There is no part of the American mythology so important as the idea that individuals and communities have the power and obligation to close the gap between the world as it is and the world as it should be. Indeed, there is no element of our conception of democracy so essential as the notion that people are not just the objects of change, but instead have the power to be the agents of personal and societal transformation.

July 4th is a time for connection to our larger narrative. "America" means different things to different people; our experiences and the experiences of those around us inexorably shape what we think and feel about this land.

Few would argue that it is a perfect place. The issues that cover the pages of Change.org are, in many ways, the stories of America's warts, maladies, and imperfections. The stain of homeless veterans; the farce of indefinite incarceration; the individual and collective financial ruin that our heaving health care system can bring; the horror of modern day slavery which still runs rampant in the shadows of our proudest buildings and grandest ideals.

Yet Change.org is also a part of the profound legacy of American civil society and progressive reform. The very first people to advocate in formal ways against slavery were Quakers in the 17th century Pennsylvania colonies. The abolitionists who took their mantle built momentum in the mid 18th century for freedom for those in chains. The progressive reformers around the turn of the century saw the scourge of unchecked urbanization and advanced legislation with fundamental protections against our most unjust practices. Throughout the 20th century, the Civil Rights movement, Women's movement and more have combined with the ground-up work of community organizers to provide a platform for change. And in the last half-century particularly, nonprofits and civil society organizations have exploded to respond to our myriad social challenges.

What's important to remember is that these things are not counter to the popular narrative of America, they are the counter-narrative of what is America. The beliefs animating these activists almost always drew their power from the words and ideals, if not always the actions, of those who came before them and from the very fabric of the idea of America itself.

The freedom of religious expression promised by William Penn's colony allowed the Quakers to advocate against slavery without fear of state reprisal. The protection of free speech enshrined in our constitution allowed Jacob Riis and other muckrakers to expose the exploitation of labor and horror of unjust living conditions during the Gilded Age. The imploring that All Men Are Created Equal has been the constant and inexorable nag for those who would exploit and enslave, and the beacon of hope for those who would liberate.

Democracy is an essential context for our understanding of how to approach social change. For while philanthropy has the potential to promote the "unconscious division of the world into the philanthropists and those to be helped," as Jane Addams put it, Democracy is, at it's core, about the fundamental equality of those who participate in a society. One idea implores us to give back in recognition of our success, the other fundamentally entwines our destiny with the health and well-being of others.

Today is a day for celebrating where we came from, the glory of accomplishments past and the strength of our ideals, it would not be America if it was not also about how we look forward to improving ourselves, our country, and the wider world around us.

I'm proud to be from this place, warts and all, and I believe in our immense potential as a collective force for good. One of the most astute observers of American democracy Alexis de Tocqueville wrote:

The greatness of America lies not in being more enlightened than any other nation, but rather in her ability to repair her faults.

Happy Fourth of July.

Photocredit: Respres

What to a Slave is the Fourth of July?

Amanda Kloer — 2009-07-04T09:00:00-07:00

The Potomac River is a time machine. The city of Washington which surrounds it is a modern city, dripping with Starbucks cold, tall buildings, but the Potomac belongs to an earlier era. When you sit on its banks and watch the water ripple, it's impossible not to feel nostalgic patriotism. Close your eyes and you can see the boats carrying goods to trade and hear the musket fire of a distant revolution and feel connected to those people who died to make the country possible. The Potomac reminds me why I love America.

Yet every 4^th of July, I am also reminded of what I don't love about America and what I'd like to change: that over 150 years after it was officially abolished, we still have slaves in America. In 1852, Fredrick Douglas issued his famous (if slightly depressing and anti-American at times) speech What To a Slave is the 4^th of July. The following is an excerpt:

What, to the American slave, is your 4th of July? I answer: a day that reveals to him, more than all other days in the year, the gross injustice and cruelly to which he is the constant victim. To him, your celebration is a sham; your boasted liberty, an unholy license; your national greatness, swelling vanity; your sounds of rejoicing are empty and heartless; your denunciations of tyrants, brass fronted impudence; your shouts of liberty and equality, hollow mockery; your prayers and hymns, your sermons and thanksgivings, with all your religious parade, and solemnity, are, to him, mere bombast, fraud, deception, impiety, and hypocrisy - a thin veil to cover up crimes which would disgrace a nation of savages. There is not a nation on the earth guilty of practices, more shocking and bloody, than are the people of these United States, at this very hour.

Go where you may, search where you will, roam through all the monarchies and despotisms of the old world, travel through South America, search out every abuse, and when you have found the last, lay your facts by the side of the everyday practices of this nation, and you will say with me, that, for revolting barbarity and shameless hypocrisy, America reigns without a rival.

Perhaps today, one could argue, America is rivaled and surpassed in cruelty, in slavery, and in oppression. But the fact remains that America is better than slavery. It has been and will continue to be. But we must be the ones who make slavery history.

This 4^th of July, you may be celebrating. Great. Have fun and be safe. But also consider taking a few moments to take action in the name of freedom and to help us achieve Mr. Douglas' dream and the dream of so many others: an America untainted by slavery.

This 4^th of July, shouldn't we all be free?

Happy 4th: On Class, Ethnicity & Immigration

Leigh Graham — 2009-07-04T09:00:00-07:00

My fiance and I are dog-sitting for my mom this weekend. Hopefully we're walking them along the beach in her CT town, enjoying the sun, whose warmth I've forgotten in the cloudiest June in Massachusetts in over 100 years.

Here's some interesting links for that downtime between the BBQs and naps I hope you're enjoying today:

MySpace is the ghetto, trailer park, or barrio of the internet. Discuss.

The Obama Administration is halting Bush's Nothin' But Raids approach to immigration and going after employers who hire undocumented workers. It's most high-profile case is against American Apparel, which raises questions about the effectiveness of this approach. It's definitely more humane. But will a fine of $150,000 make a remote bit of difference?

Police Chiefs from Miami, Austin, and Sacramento come together to call for immigrant legalization and a separation of duties between local police forces and immigration enforcement. Money quote: “When you remove the emotion from the debate,” [Austin] Chief Acevedo said, "no one can argue that it is in the best interest of public safety to keep these people living in the shadows.”

Finally, Richard Trumka is on track to move from Secretary-Treasurer to President of the AFL-CIO. Perhaps most famous for his moving speech on racism in the labor movement during Obama's candidacy last year (video above), Trumka "a former coal miner and fierce critic of corporate America...would bring a more combative style to running the federation at a time when organized labor seems to be growing weaker in the nation’s workplaces but stronger in Washington."

This fighting style is right up my alley, of course. Others worry he'll be too polarizing. There's a hilarious-in-its-irony quote from an exec at the US Chamber of Commerce, fretting about Trumka's aggressiveness and potential bad publicity for the "employer community." As we document here at Poverty in America, I think Corporate America's already doing a bang-up job there! Good luck to Trumka and the labor movement. Don't forget: Support EFCA!

Marvin Gaye sings the national anthem, 1979

Emily Gertz — 2009-07-04T08:11:00-07:00

Mental health break for the holiday: Marvin Gaye singing the national anthem at the Caesars Palace Larry Holmes-Earnie Shavers match in 1979 (complete with a little Howard Cosell action).

The Anti-LGBT Moments of the Sarah Palin Tornado

Michael A. Jones — 2009-07-04T06:53:00-07:00

Sarah Palin's announcement yesterday that "I'm a celebrity, get me off this oil field," have sent a handful of shockwaves through the political chattering class. Was it a good move? Was it a bad move? Did she mean to say "I'm taking a vacation," but accidentally said "resigning," and now it's too late? Has she decided to run for the Evangelical Christian GOP nomination for President in 2012? Or is she just really looking for a change of scenery (one can only look at Russia from your house for so long...).

Well, whatever the case, it's clear that all of the papers that Sarah Palin reads will certainly be covering her abrupt resignation, and what it means for the future of a politician who thinks that the commitment between and a man and a woman is sacred above anything, but the commitment between a governor and a state's population is disposable.

Whether this turns out to be a political funeral or the beginnings of a political surge, we've got some of the more infamous moments of the tornado that is Sarah Palin's political career, when it comes to LGBT rights. For what it's worth, Alaska is not only losing their governor, but they're also losing one of the more anti-LGBT leaders in the country.

National Coming Out Day Stay in the Closet Day: Despite being urged by civil rights groups like Alaskans Together to officially recognize National Coming Out Day, Governor Sarah Palin refused to acknowledge a day that fosters acceptance of LGBT people. Sure, during her time as Governor she made official proclamations to recognize "Alaska Taiwan Friendship Week," "Christian Heritage Week," and "Biomedical Technician Week," but giving the gays one day where tolerance and understanding are the norm was a bit too much for the Alaska Governor.

Support of Ex-Gay Ministries?: Sarah Palin's hometown church in Wasilla actively promoted the ex-gay ministry "Love Won Out" by posting their ads in weekly church bulletins. These ex-gay therapy groups have been roundly criticized by science, religious leaders and politicians of all stripes, but nonetheless, Palin's own church seemed to preach that homosexuality could be overcome.

Alaska and Traditional Marriage: Though she was just a few years removed from the Bachelor's Degree that took her seven years and four colleges to get, Sarah Palin was a strong proponent of Alaska's 1998 statewide constitutional amendment which banned same-sex marriage. Additionally, Palin told the Anchorage News in 2005 that she supported repealing many domestic partner benefits given to same-sex couples in Alaska, because DP benefits were anti-family.

The Three Amigos - Sarah Palin, Michelle Bachmann, and Phyllis Schlafly: They're three of the most anti-LGBT people in the country, and the connection? Michelle Bachmann (who has called global warming a "hoax" and "voodoo," and said that God is blessing the Iraq War) stepped in for Sarah Palin during a anti-choice award ceremony at the Republican National Convention this year. Phyllis Schlafly, the denmother of radical conservatives 'round the country, said that McCain's selection of Palin as a running mate was "terribly smart," at the time. Hmm...wonder what she was saying on November 5, 2008?

Let's Define Marriage Federally: In a break with her running mate John McCain, Palin told the Christian Broadcasting Network in October 2008 that she wished the federal government would follow the lead of states like Alaska and work to ban same-sex marriage. Because fighting two wars and solving an economic crisis deserves to be side-stepped by knocking down marriage equality.....

A "Perversion and Degenerates" Ally: In March of this year, Sarah Palin had the task of choosing an Attorney General for Alaska. Her preferred candidate? Wayne Anthony Ross, a radical right-wing lawyer who has referred to LGBT people as "perverts," "degenerates," and "immoral." Ross also had a resume filled with other star attributes, like defending a KKK art project, and representing nutjobs that harass anti-war protestors.

Sheesh! We could go on and on here about the Governor. But for now her time in the political spotlight is up. Now the question becomes whether this rash decision to leave office bolsters her credentials among the radical right in this country, or shows to even the most diehard conservatives that this is not a stable politician. And the jury is still out on that one.

Self-Evident? "All Men and Women Are Created Equal"

Jen Nedeau — 2009-07-04T06:49:00-07:00

We all know that Independence Day, commonly known as the Fourth of July, is a federal holiday commemorating the adoption of the Declaration of Independence on July 4, 1776, declaring independence from Great Britain. While Independence Day is commonly associated with fireworks, parades, barbecues, concerts, baseball games, political speeches and ceremonies - I am going to pose a more provocative question for the readers of Change.org:

What does Independence Day mean for women? Historically and then in the present?

It's no secret that the Declaration of Independence was written and signed by men. And while the document has been translated to apply to both women and men and has become a statement of motivation for all marginalized groups - the original language seems to imply gender bias:

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.

I challenge those who celebrate the 4th of July today to really think about our "founding fathers" and how they built a nation where women have been struggling to find their sense of independence ever since the Declaration of Independence was signed.

Personally, I wish we nationally celebrated the 20th of July of 1848 when Elizabeth Cady Stanton created The Declaration of Sentiments, a document signed by 68 women and 32 men, 100 out of some 300 attendees at the first women's rights convention, in Seneca Falls, New York.

Now take a read at this language, it suits me a little better:

We hold these truths to be self-evident: that all men and women are created equal; that they are endowed by their Creator with certain inalienable rights; that among these are life, liberty, and the pursuit of happiness; that to secure these rights governments are instituted, deriving their just powers from the consent of the governed. Whenever any form of government becomes destructive of these ends, it is the right of those who suffer from it to refuse allegiance to it, and to insist upon the institution of a new government, laying its foundation on such principles, and organizing its powers in such form, as to them shall seem most likely to effect their safety and happiness.

Prudence, indeed, will dictate that governments long established should not be changed for light and transient causes; and, accordingly, all experience hath shown that mankind are more disposed to suffer, while evils are suffer able, than to right themselves by abolishing the forms to which they were accustomed. But when a long train of abuses and usurpations, pursuing invariably the same object, evinces a design despotism, it is their duty to throw off such government, and to provide new guards for their future security. Such has been the patient sufferance of the women under this government, and such is now the necessity which constrains them to demand the equal station to which they are entitled.

The history of mankind is a history of repeated injuries and usurpations on the part of man toward woman, having in direct object the establishment of an absolute tyranny over her. To prove this, let facts be submitted to a candid world.

I would hope that as we praise those who brought the United States to Independence from Britain today, we also think about those who brought women into independence from the patriarchy as well.

Any good feminist knows that it is important to maintain a critical eye toward tradition. Often those traditions carried misogynistic sentiments in the beginning when women were left out. Just as Betty Friedan asked all women to re-assess the alleged joys of housewifery because "The feminine mystique has succeeded in burying millions of American women alive" - I am asking those who are celebrating their own patriotism today to re-assess the role of the patriarchy in United States. It's important, in the quest for true independence - both as a country and a society - to make sure that all men and women are allowed to be independent human beings, not buried by the false expectations of what freedom is supposed to mean.

This post is dedicated to the female veterans. For more information on the plight of women in the military go see: http://www.graceafterfire.org/

Waking Up to a Failed Drug War

Matt Kelley — 2009-07-04T06:06:00-07:00

As the U.S. celebrates its 233rd independence day today, there's a feeling in the air that we're nearing the end of one of the most devastating failures in the history of our democracy - the war on drugs.

The media and the public have raised the level of drug policy discussion in recent months, perhaps sparked by a perceived opportunity for progress under the Obama administration. The summer issues of both Mother Jones and the American Prospect feature the war on drugs on their covers - and both take the positions we'd expect from these publications: fighting drugs by building prisons has been a failure, and the time has come to shape the policy of the next three decades. The political obstacles to drug policy progress are great and it will be extremely hard to forge a humane drug policy that prioritizes treatment over incarceration. I think we're up to the challenge, and now is the time.

Eli Sanders writes in the American Prospect, under the headline "The Last Drug Czar," that "one gets the distinct impression that (current drug czar Gil) Kerlikowske is positioning himself as a caretaker who can put an old model out to pasture while a new discussion is initiated."

It's a new day in the drug war. But can we end it?

Kevin Drum writes in Mother Jones (the issue is on newstands now and articles will be online soon) about the logistics of legalization. Drum, who has never inhaled, writes that he didn't much care about marijuana legalization when he began writing the piece. And then that changed:

Going into this assignment, I didn't care much personally about cannabis legalization. I just had a vague sense that if other people wanted to do it, why not let them? But the evidence suggests pretty clearly that we ought to significantly soften our laws on marijuana. Too many lives have been ruined and too much money spent for a social benefit that, if not zero, certainly isn't very high.

So is serious drug policy reform possible? Former Seattle Police Chief Norm Stamper wrote in the Huffington Post this week that expanded coverage in progressive magazines and the blogosphere is important, but it will take a big step by Democrats in Washington to embrace this change and make something of it.

While many of our elected representatives privately support serious changes to our failed drug laws, they believe they are alone. They think if they stick their necks out they'll be handed their heads come election time.

Which is why we must rise up and let our elected officials know they are safe to support drug law reform. And in considerable political danger if they do not.

Entertainment with a Conscious

Shannon Moriarty — 2009-07-04T04:20:00-07:00

Virgin is going where few have gone before: combining goodwill and entertainment. In other words, volunteer 13 hours to help the homeless and you might be a 'Free I.P.' at Freefest 2009 (August 30, 2009 in Columbia, Maryland).

Great idea, right? The concert line-up is solid and it looks like a fun day. More importantly, it's awesome to see Virgin continue their work to raise awareness about youth homelessness with such a refreshing new approach.

Check out the Freefest site for more information.

Friday Food on a Saturday: A Sweet, Savory, and Cruelty-Free Fourth

Stephanie Ernst — 2009-07-04T01:00:00-07:00

Are you ready for this? Are you sure? Because the sheer awesomeness of these recipes, divided into sweet and savory sections this time, may be more than you can handle. Everything here would be an excellent addition to quiet meals at home or gatherings with friends this weekend or any weekend. (Please read through to the end of this post for a serious note on why you should try out these and other animal-free recipes this weekend.)

First, an abundance of desserts and fruity goodness (and a reminder: those who avoid or limit intake of soy for allergy or other reasons shouldn't disregard these lovely vegan dessert recipes, even the ice creams; coconut milk and other non-soy, non-dairy milks are great substitutes, and indeed, many of these recipes don't call for soy in the first place):

Apricot Crumble Bar from Raw Epicurean (beautifully pictured courtesy Raw Epicurean at end of this section)

Sweet Tea Ice Cream from Madcap Cupcake and Wheeler's Frozen Desserts (check this post out not only for this special recipe but also for the official Madcap Cupcake review of the new Vegan Scoop cookbook)

Strawberry-Blueberry Tapioca Parfaits from FatFree Vegan Kitchen (pictured above courtesy FFVK)

Blueberries & Cream Ice Cream from the Innocent Primate Vegan Blog

-You will continue after the jump if you know what's good for you-

Slow Rise Pancakes from VeganYumYum (I know this isn't a dessert, but I think it fits in the "sweet" category, don't you?)

Raspberry-Ginger Parfait from BitterSweet (and you can find another Vegan Scoop review on this blog too)

Fresh Fruit "Cake" from Vegan Planet

And now the more savory than sweet but equally delicious:

Squash Pancakes from the Innocent Primate Vegan Blog (also check out the Innocent Primate Stars and Stripes Menu, rounding up lots of yummy recipes that have been featured on that blog)

Focaccia Bread from Hello Veggie

Tofu Fish Fillet with Papaya Salsa from Happy Herbivore

Lentil Burgers from the Reluctant Vegetarian

Roasted Garlic Tapenade from BitterSweet

Udon Noodles with Sesame-Crusted Tofu from Vegan Dad (pictured courtesy Vegan Dad below)

I wrote earlier this week about the irony in the way zoos are encouraging people to celebrate Independence Day by coming to stare at imprisoned zoo animals. But though the irony isn't as immediately obvious as in the case of the zoo animals, it's just as sad that so many people celebrate "independence" and "freedom" by grilling the body parts of our fellow animals, whom we treat as owned property and strip of all the most important freedoms, before ultimately killing them in their youth.

If you're still eating animals and animal products, do your conscience, your body, and the animals a favor by trying out some of the recipes above this weekend instead of the pieces of dead animals and what came from them. As the saying goes, no one is free while others are oppressed.

No Fireworks For Our 4th

Kristina Chew — 2009-07-04T00:39:00-07:00

Lately my son Charlie has been overwhelmed by sounds. This is still a fairly new development: When he was younger, while other autistic children were putting their hands over their ears and crying at barking dogs, Charlie would be unrattled. It's been in the past year that Charlie has clearly become highly, and painfully, attuned to sounds. Certain sounds---those barks, a metal object hitting the floor, someone's loud voice---has evoked a more extreme response, leading us to think, something literally hurts when Charlie hears those sounds.

Jim and I have been listening very closely to the sounds around us and, with Charlie, cringing at every Harley that passes the black car on the Garden State Parkway and tuning in carefully to the volume and pitch of our own voices. Seeing Charlie bow his head and cover his ears when no one is talking, we've realized that he's hearing everything in the background: Fluorescent lights, air-conditioners and fans, the pool filtering system. Charlie sometimes puts on his iPod and noise-canceling headphones, but sometimes just listening to even preferred sounds seems too much. I've been shopping around for noise-canceling headphones of all types (like the kind you use to mow the lawn with) and stuff like a summer-weight hoodie (Charlie always liked having a heavier fleece one in winter). (Suggestions for dealing with this are quite welcome.)

At home, we can keep things quiet, but none of us (Charlie in particular) could hardly stand just to stay in here: Out we must go, seeking to put a little control on the situation with pictures and schedules, explanations and stories. Still, we can't control every single sound. Ambulances will go screeching by and motorcycles, especially because it's summer, it's gotten hot after a rainy June, and, here in the US, it's the Fourth of July weekend.

Which brings me to the subject of fireworks. The Fourth of July falls on a Saturday this year so it's become the reason for a long weekend, with celebrating starting yesterday (and I heard fireworks even on Thursday night). We won't be seeking out any fireworks displays tonight, but some thunderous noises from the sky are going to be inevitable. Charlie's been curious to see the bright displays in the past, but I'm suspecting he'll have his head down and hands over his ears this year.

As in everything with Charlie, we've been trying to figure out the proper balance between changing and accommodating, and gently seeking to desensitize him to some of the sounds out there. A balancing act it is and one also requiring us to (like any parents) measure out how much to protect Charlie from what irks him, and to coax him into learning to live with it.

But I'm still glad fireworks are pretty much a one-time-a-year thing. It's a noisy enough place out there already.

Who Will Get Locked Out of the Health Exchange?

Tim Foley — 2009-07-03T21:12:00-07:00

Another question from emails I’ve received: Everyone knows the mantra of those proposing these health care reform bills is, “If you have insurance and you like it, you can keep it.” But there’s a flip-side question – what happens if you don’t like the insurance you have through an employer? Can you ditch it for the friendly ground of the National Health Exchange (House version) or the Health Gateways at the state level (Senate Health, Education, Labor and Pensions Committee version) and maybe even get yourself a piece of that ultra-competitive public plan everyone keeps talking about? Unfortunately, the answer is “it depends.” Depending on what makes it into the final bill, many of us could get locked out.

Remember that part of the reason the Senate HELP bill came in at the bargain rate of $611 billion over 10 years is because the Congressional Budget Office estimated only around 20-30 million people would use the Gateways. That's not a lot of people! Take a look at the HELP bill and follow along. It defines employer eligibility for the Gateways on pg. 111 – these are the standards for small businesses who would want to provide benefits for their employers through the Gateways, paying a percentage of the premiums and allowing the employees to each choose their own plan, public or private. However, the number of businesses who could do so is very limited. After saying the Secretary of HHS will make a determination as to the maximum number of employees the business can have, the bill specifies that the default number will be 10, unless the Secretary says otherwise. That means only tiny microbusinesses will get to escape the rough and tumble small business private insurance markets (although some of the new regulation on those markets will blunt the more capricious business practices that small business owners currently endure.)

Individuals without coverage get to participate in the Gateway, but not anyone who has coverage through Medicare, Medicaid or something like the VA. Also, those who are currently “eligible for coverage under… employer-sponsored coverage” (pg. 115) are likewise excluded unless the Secretary of HHS makes a determination that their employer-coverage is either not comprehensive or not affordable. If it’s merely “sucky,” sorry, you’re stuck with it.

The House bill is a different story. The National Health Exchange it establishes would have increasing eligibility that phases in over three years (pg 46). In Year 1, it’s individuals who don’t have coverage, and microbusinesses (10 employees or fewer). In Year 2, it’s individuals and small businesses under 20 employees. But by Year 3, it’s individuals and any other employer (although if we’re talking Microsoft, the Commissioner of the Exchange may have the hugest businesses phase in over time).

Which individuals are also different story in the House bill. If an individual “does not have coverage,” they’re in. That’s a different consideration than merely being “eligible” for coverage – you could be eligible under a new job, but reject that new plan and wait until the Health Exchange is available, with its subsidies and public plan as an option. Moreover, the House has a clause on “continued eligibility” (pg. 51) – if I’m working as a temp without benefits when the Exchange is set up, and I sign myself up for a good, affordable plan, but then get a permanent job month later at which I’d be eligible for benefits, I’m not forced out of the Exchange automatically. I can keep the plan I’m comfortable with. There’s no such provision in the Senate bill.

All of this is prologue to answering the real question – once the public health insurance option is up and running, can I drop my employer-based coverage, sign up for the Exchange and lock myself into my own little piece of Medicare-like coverage? In the Senate bill, the answer looks to be no – I’d still be “eligible” for my employer’s plan, and so ineligible for the Gateway. This is what Ezra Klein calls “a so-called ‘firewall’”, keeping out large businesses and individuals who could have coverage through their employer. If the House bill is what we get, I have more options. After all, the contract we sign with our employers and their insurer usually has different options for opting out. Some allow for “open enrollment” periods once or twice a year, most allow for “qualifying events” like marriage or divorce to add or remove dependents. A few are even more open-ended. And in many you could sign up for other benefits (401(k), life insurance, etc.) but pass on health coverage.

The success of these Exchanges and the public health insurance option (which would only be offered within these Exchanges) depends largely on how many people can participate. How much choice we’d really have in the new health care system depends on whether the House or the Senate prevail in the fight to come.

(Photo credit: dagbo on Flickr.)

Friday Femme Fatale: Sarah Palin, VAWA & Health Reform

Jen Nedeau — 2009-07-03T16:58:00-07:00

I hope everyone has a lovely 4th of July! Here are the top stories of the week in the fem-o-sphere:

Stonewall's unfinished legacy (The Guardian)

Vice President Biden Announces Appointment of White House Advisor on Violence Against Women (White House Press Room)

Study: Women Are "Emotional," Men Are "Having A Bad Day" (Jezebel)

Important Steps Towards Financial Self-Sufficiency (Mexican Legal Defense and Educational Fund)

63 women out of 176 invitees (that's 36%) (America Blog)

Clinton, Truman, Obama and Gays in the Military (The Atlantic)

Promoting Equal Pay: Lilly Ledbetter States Her Case (The New York Times)

State Law Restricts Administration of Abortion Drug to FDA-Approved Gestational Limit, Delivery Protocol (Ohio Judiciary)

What 60 Democratic Senate Votes Really Means: Welcome to the Age of Ben Nelson (Huffington Post)

Don't let millions lose reproductive-health coverage (NARAL)

Palin to Resign as Alaska Governor by End of Month (Washington Post)

Friday Tweets: Gambling, Lobbyists and a Foiled Sandwich Plot

Matt Kelley — 2009-07-03T16:47:00-07:00

Happy July 4th weekend to readers of the CJ blog in the US of A. For those of you outside of the U.S., happy July 4th weekend to you as well. (You don't need a holiday to have a happy weekend, right?)

Thanks for your emails and for joining in some great conversations on the blog this week. You can find me on twitter @mattjkelley and always feel free to email me at matt [at] change.org. Here's a quick roundup of some crime and punishment stories you may have missed during another busy news week:

States cut $1.5 billion from mental health care spending in 2009 and will cut $3 billion more in 2010. Georgia has found that a 24-hour hotline helps address problems before they get serious.

An investigation by Texas Watchdog found that lobbyists for private prison giant GEO Group are quite cozy with the state's leading lawmakers.

A post and podcast from Feministing explains the details of sexual assault exams and points to the need for every college in the country to have a sexual assault response team.

A woman was arrested in Chile for bringing a sandwich into a prison on visiting day stuffed with marijuana. (Article in Spanish)

Obama heads to Russia next week. Human Rights Watch is urging him to address the Russian government's lack of response to a spike in neo-Nazi violence. Join the call here.

Meanwhile, also in Russia, gambling suddenly became illegal at midnight on Wednesday - casinos are now quarantined in four distant corners of the country. Moving it underground?

Retweets of the week:

@brookpete Cornell Capa: Concerned About Prisons. http://bit.ly/12pC9g [that's a Capa photo above, from Nicaragua]

@maliheh_ IRAN: Ten days of anguish, abuse inside Tehran's prison archipelago. http://bit.ly/ZVSPI

@shawmurai thinks the sentence for madoff is excessive despite the suffering caused and will be halved on appeal

@insightnews Juvenile Detention Alternatives Initiative (JDAI) achieves goal http://tinyurl.com/lybguv

@accesstojustice: AG Holder Outlines DOJ's 5 Steps for Improving Indigent Defense in Address (US) http://bit.ly/1DPlf

AS Emerging Film Maker

Dora Raymaker — 2009-07-03T16:00:00-07:00

Little Theatre's Emerging Filmmakers program in Rochester (NY) is featuring a film called Aging Trees of Knowledge: Part Five: My Legacy (Gittel Jaskulski). Here is local news of it. The film maker is Adrian Esposito.

The New York Office of MR & DD has a profile of Esposito, who found his expression through the medium of film. Esposito has been actively engaged in film making since the age of 12, and he currently has his own film company Espocinema. An interest he is hoping to turn into a career.

Here's the trailer for an AS-related film he made at 16. (not captioned, sorry)

Esposito's focus seems to be on history and human rights issues. A new film is planned "We Can Shine - From Institutions to Independence, will focus on the positive changes that have occurred in the treatment of people with disabilities and on self determination in their lives." The documentary is intended to focus on Willowbrook. Sounds like a project that is needed. Much looking forward to Esposito's work in the future!

The meaning of America to a suvivor of the Holocaust

Martha Heinemann Bixby — 2009-07-03T15:27:00-07:00

Peter A. Zuckerman, a Holocaust survivor with a wonderful personal website, tells this story of his arrival in America:

After receiving my immigration papers I boarded the Marine Marlin, one of the 900 passengers that had a chance to start a new life in America.

Like millions of other immigrants to America, I experienced the elation of seeing the Statue of Liberty looming up at the entrance of New York Harbor. After the stormy crossing of the Atlantic the skies cleared as if by magic. The ship floated over the smooth surface of a suddenly tranquil sea. It seemed as if the elements themselves became subdued by the torch lifted high, promising freedom to the oppressed masses of humanity.

For me and my fellow survivors the words of Emma Lazarus -- carved on the pedestal of the Statue of Liberty -- were especially appropriate. Our ship indeed carried the "huddled masses yearning to breathe free." I experienced the exultation and emotions of joy as we disembarked in Ellis Island, the gateway for millions of immigrants to America. My sufferings came to an end. The promise of the New World, at one time unattainably distant, now became a reality. I even received a brief recognition, as the New York Herald Tribune reported our arrival (January 25, 1947).

As Americans celebrate our independence this weekend it's interesting to reflect on the many meanings of our country to survivors of genocide - those we have fought for, those we have advocated for, and those we have forgotten.

The AMA Neither Supports Nor Opposes the Public Plan

Tim Foley — 2009-07-03T15:10:00-07:00

I didn’t really want to write about the American Medical Association at all after the president’s speech a few weeks ago. As Harold Pollack notes in a recent blog post, “I’m struck by extent that the AMA seems stuck in a narrow interest-group model that represents a shrinking segment of the medical profession.” But I’ve received so many emails about a recent CNN report on new AMA president Dr. J. James Rohack, that I’m writing this one post just to clarify what happened.

It’s fair to say that the AMA is in support of health care reform in a very general way. It is not accurate to say they support a public health insurance option. CNN got it wrong.

The official AMA position, as reported by the Daily Dose and others, was voted on at their convention in Chicago. It supports a broad definition of “health system reform” but explicitly leaves out any mention of a public plan. The Daily Dose article provides some fascinating context as to the parliamentary maneuvering that went on during June 17. After the controversy of the previous two months, where the AMA seemed increasingly against a public plan and then softened that position to say they were against a public plan that forced Medicare providers to participate, the shock of the day was that they passed a resolution in support of the public plan! But then-president Dr. Nancy Neilsen essentially took the podium to say, “Not so fast, bub!” She made an appeal to not peg their support of reform to one policy, and as a result they soon they passed an amendment to that resolution to punt on the question of a public plan.

This was basically a vote of “We want reform – but we’re not going to tell you what kind.”

Fast forward to the CNN interview with Dr. Rohack from July 1. Most of his comments were strongly pro-reform, but vague on details. The only thing he seemed die-hard against was, “expanding Medicare coverage for senior citizens into a broader general public plan” – not a shock, since the AMA has been the sworn enemy of single-payer since the days of FDR. (For colorful commentary on the AMA’s intransigent past, check out this column by Nicholas Kristof.) But how could they then be for a public plan similar to Medicare if they're dead-set on Medicare for All? The confusing quote in the article which prompted the misleading headline says that the AMA supports “an ‘American model’ that includes both ‘a private system and a public system, working together.’” But that’s not a public plan – that’s the National Health Exchange as envisioned by the House bill or the state-level Gateways envisioned by the Senate Health, Education Labor Pensions Committee. The “private system” is the current insurance marketplace. The “public system” is the Exchange. Dr. Rohack makes it clear he’s looking at the Federal Employee Health Benefit Program and wonders why Congress doesn’t just expand that. The FEHBP is the model of a transparent marketplace, but it’s all private insurance. The public plan, if it makes it through the process, would be one option among many private options. But the marketplace itself is not the same as the public plan.

So it was either the reporter or the editor who missed the boat on this one. The AMA still seems to be living by the mantra of “We don’t want to get pinned down” or as Dr. Nielsen put it, “The AMA did not close doors. The AMA said we will evaluate all alternatives in keeping with our principles.” (What they’re saying in private is anyone’s guess.)

So pro-health reform in a fuzzy, hard to define way? Sure. Pro- an expansion of public coverage either through single-payer or a public health insurance option? Nope. Pro- a “level playing field” flavor of the public plan, like the one suggested by Sen. Schumer and the HELP committee? Remains to be seen, but actions speak louder than words. I wouldn’t be singing the AMA’s praises just yet.

(Photo credit: this lovely piece of the AMA's history with health care reform is by exakta on Flickr.)

West Virginia Legislation to Establish Trust Funds

Kristina Chew — 2009-07-03T14:20:00-07:00

Yesterday in West Virginia, Governor Joe Manchin signed into law new legislation that is designed to encourage the creation of trust funds for the future support of children on the autism spectrum. As reported in Metro News, under the new legislation, families with autistic children will be given a tax credit of up to $2,000 a year for contributions made to trust funds which are to be used when the children become adults; this new legislation is the "first of its kind in the country." Says Barbara Becker-Cottrill, Executive Director of the Autism Training Center which is located at Marshall University in Huntington:

"When you have a child with autism, you've got, really, constant worry about what's going to happen to your child when they become an adult......It's 24/7 concern and, then, the true worry is what will happen to them if you're not there to care for them and love them?"
....
"This bill will provide, not just the tax credit for families in the here and now, but I really think it's going to give our families a sense of security, a sense that the future is a little brighter for their child when they become adults."

That's the kind of forward-thinking legislation one hopes to see more of, for the times when children become adults, when everything isn't shiny anymore.

Fatalistic Friday: Warmer Winters Shrinking Scottish Sheep

Emily Gertz — 2009-07-03T13:00:00-07:00

Are We Not Sheep? We Are Devo(lving) Scientists solve mystery of Scotland's shrinking sheep: Shorter, milder winters caused by global warming to blame for steady decrease in size of St Kilda sheep. (The Guardian)

Rainy Days and Thursdays Always Get Me Down: Millions of euro worth of damage was caused yesterday after Dublin was swamped by a record two weeks' worth of rain in one hour. "This is the second time within the space of 12 months that Dublin experienced this type of flooding and it is clear that this is as a direct consequence of climate change," Lord Mayor Councillor Emer Costello said. (The Irish Independent)

Never Can Say Goodbye: ExxonMobil continues to sink hundreds of thousands of dollars into climate change sceptic groups National Center for Policy Analysis, the Heritage Foundation, and the American Enterprise Institute for Public Policy Research. This is despite promising more than once to stop its efforts to cultivate fear, uncertainty and doubt about global warming; Between 1998 to 2005, ExxonMobil gave almost $16 million to 43 lobby groups that worked to confuse Americans about the reality of global warming. (Wonk Room)

I Want You Back: New research reconstructing the extent of ice in the sea between Greenland and Svalbard from the 13th century to the present indicates that there has never been so little sea ice as there is now. Even though the 13th century was a notably warm time, there has never been so little sea ice as in the 20th century. (ScienceCentric)

Sludge, Drain O'er Me: EPA has posted a list of 44 “High Hazard Potential” coal ash waste dumps. They're near 26 communities in 10 different states, and similar to the impoundment that buried over 300 acres in Tennessee in toxic mud late last year. (Associated Press)

And highlights of the rest of the week's bad news about global warming:

Global warming may halve Bangladesh rice yields (SciDev.net)

NZ scientist warns of Antarctic ice melt, sea rise (China Central Television)

Permafrost melting a growing climate threat (Reuters)

Ocean acidification may push many fish to the brink (Christian Science Monitor)

Oyster Die-off in Pacific May Be Due to Ocean Acidification (e360 - Yale)

Global Sunscreen Won’t Save Corals (Carnegie Institution for Science)

India Will Reject Curbs On Its CO2 Emissions (CleanTechies)

Consumer culture keeps carbon emissions high(American Chemical Society)

World failing to halt biodiversity decline (Associated Press)

Amazon squatter law fuels deforestation worries (ScienceCentric)

Mangrove-dependent animals globally threatened (ScienceCentric)

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Image: Soay sheep on St. Kilda, Scotland. Via CommonorGarden/flickr