To my Republican Christian friend who posted the following right wing Christian link denouncing the 2012 electorate

To my Republican Christian friend who posted the following link:

Inspiring Faithful Stewards

The Real Battle Begins

Posted on November 11, 2012 by Chuck Bentley

The 2012 election reveals a sea change in the long-term direction of this nation. We are no longer guided by our historic values, but steaming full speed into darkness without concern for the rocks ahead...

Chuck Bentley, the blogger you cite here is long on speculation and short on actual facts (and in some cases a good editor).  He implies that anyone who voted Democratic must have done so because of "sour grapes" or emotion.  As someone who voted against my economic interests but on core values, I know I am not alone.  You may not agree with us, but pretending to read the minds of half of Americans who cast votes (and many more who didn't) smacks of sore losing.  

He claims that voters "endorsed the right of women to publicly funded birth-control and abortion."  This is incorrect on two counts.  Publicly-funded birth control (no hyphen needed) has always been available.  The ACA mandate the bishops council created such a public row about involved PRIVATE plans and whether they should be compelled to waive copayments on contraception (what is forgotten in all this breathless "war on religion" talk is that as it turns out, no, they don't).  No public funds support abortion (per the Hyde Amendment).  

He claims that President Obama is "running up the largest national deficit in our history."  This is incorrect.  President Obama's deficit is uncomfortably high, as was his predecessor's, but it has come down, not up.  It is not unprecedented.  Bentley maybe confusing debt and deficit (a common mistake); in nominal dollars, the debt is unprecedented, but in terms of GDP it is not, and is entirely accounted for by a decade of Bush tax cuts and two wars.  All three will be ended soon.  At any rate, Congress, not the president, controls the purse strings.  Last time I checked, the House was in Republican hands.

He claims that "Americans who are financially successful should be demonized and that their wealth be redistributed, turning the sin of envy into public policy."  Well, if this was a sin, Jesus was guilty of it too.  What he proposed was redistribution; what President Obama proposed was raising top marginal tax rates 3% to levels below where they were under Clinton.  It is bearing false witness to claim this is redistribution.  No one is demonizing people for being rich, but those who are rich, materialistic, and unwilling to pay their fair share of taxes should be called out.   Their behavior most certainly is not Christian.  

He falsely claims that the electorate has accepted "massive increases in government welfare as a form of compassion and care for the poor" and that the Bible teaches that "compassion and generosity are a personal responsibility that cannot be shunted off on the government."  I would be very curious to see that passage but it sounds like rationalization to me.  If "personal responsibility" sufficed, then there would be no hungry, poor, or homeless - no one is preventing Christians or people of any faith from sharing all that they have with them as Jesus commanded, but it does not seem any are doing that.  And why should they when their house needs a 22 car garage?

In the area of healthcare, one area I have direct extensive experience, he is as wrong as he could be when he claims that we are "virtually guaranteed" to destroy ... the finest health care system in the world."  First, our health care system is not globally ranked #1, not by a long shot, except in one category:  spending.  We spend about 15.6% of GDP on healthcare, more than any other country in the world but fail (so far) to cover all of our citizens.  Tens of thousands of Americans die for want of health insurance.   The United States is the only developed country where bankruptcy - losing everything you own - is the price you pay simply because you got sick.  I have seen it happen so many times that it really burns me up when someone such as Bentley talks about a reality that does not exist, ruined by a proposal no one made.  The ACA is an all-private deal except for some badly needed expansion of Medicaid.  And by the way, Medicare, with its 1.8% administrative overhead,is far more efficient than private plans, which often have overheads as high as 15-25%, much of it due to advertising and executive compensation.  And if the ACA were ruining healthcare, why are private insurers up so much since the law was passed?

And before condemning the Affordable Care Act as some dastardly Democratic plot to ruin America, let's not forget that it was essentially a Republican invention, later disowned when championed by an African American president.  Republicans years ago proposed such an idea in retort to Clinton's attempted healthcare reform, and - irony of ironies! - the man President Obama just defeated successfully implemented a state pilot of the program in Massachusetts (which now enjoys the lowest rate of uninsured citizens in the country).

He blames the president apparently for the votes of millions of Americans in support of marriage equality. (He incorrectly states that only two states did so - I believe the number was four.)

He bemoans the decriminalization of marijuana, claiming that cannabis takes a "tremendous toll" on "those poor souls who struggle to be free from its addictive power." As a psychiatrist, I think most people would be better off not seeking to alter themselves with recreational drugs, but alcohol and nicotine have a far higher death toll and are far more addictive than cannabis. This is not to say it's a good idea to welcome another legal drug into the mix, but countries that have de facto or de jure decriminalized marijuana have not seen increases in their overall rate of substance abuse or crime. If Bentley believes that no Americans use marijuana because it is illegal, I have news for him. The question is whether police have better things to do than hunt down nonviolent citizens whose only crime is possessing small quantities of a substance he does not like. I think they do.

On concrete, disprovable facts, the blogger continues to get it wrong. He claims that "13 million fewer Americans voted in the 2012 Presidential race than turned out in 2008." Actually,120,871,984 voted in 2012. 129,391,711 voted in 2008. The difference is currently 8,519,727, not 13 million. His figure is 152% the actual number!

But it should encourage him to note that more evangelical Christians voted in 2012 than in 2004; they were just swamped by everyone else, most of whom disagreed with them. That's democracy. And if everyone voted, he would be even more unhappy.

He claims that those who showed up to vote were "interest groups rallied by their self-interest." Fascinating. I voted against my self-interest and represent no interest group.

He compares debt reduction, immigration reform, a fairer tax code, and poverty reduction to "bread and circuses" repeating the discredited elderly- and veteran-bashing 47% remarks of Mitt Romney: "About half of America does not pay taxes, yet can vote to take more from others." First of all, all Americans pay some form of taxes, many of which are embedded in every product we buy. The majority of those in the 47% either paid income taxes and social security over their working lives, or are paying at least social security now. Calling disabled veterans or the working poor moochers because they do not pay federal income taxes today is rather callous. And isolating out a very particular tax and calling it "taxes" is disingenuous.

He states that "politicians are elected promising to take from those who do not support them to give more to those who do." This is callous and cynical (and ignores the fact that in 2008 Wall Street gave more to President Obama than to McCain). There simply are not enough Americans who are recipients of entitlement programs other than Social Security or Veterans benefits (the former of which was paid into by today's recipients when they were working) to make a decisive voting block. The vast majority of those who voted for President Obama work, many at 2 or 3 jobs to make ends meet. To say they are looking for a handout is insulting and frankly unchristian.

"We either see man as fallen and sinful in need of laws to enforce standards of moral conduct, justice and freedom or we see man as good and capable of self-governance without standards that restrain or restrict individual sinful desires," he states. So why then does he oppose efforts to enforce standards of moral conduct such as paying one's fair share of taxes, not cheating on one's tax return, not stealing the productivity surges of one's workers by paying them no more than when they were far less productive, or protecting miners from greedy mine owners who tamper with carbon monoxide detectors? Why does he believe "self-governance" will be any more successful with charitable giving, regulation of Wall Street (greed, last time I checked, was a sin), or carbon emissions than in other spheres?

He claims most Americans have "vastly differing worldviews" than he does, but is this really the case? Do we really disagree about the moral imperative to work hard, feed our children, fund our government, and be kind and compassionate to each other? I doubt the blogger has ever taken estrogen-progesterone or been confronted with an unintended pregnancy or (I am assuming from his homophobic slant) wanted to have to right to visit a dying life partner who happens to be of the same sex, so these are - for him - marginal issues that do not personally affect him. The ones that do, we mostly agree on. As to whether you believe in god or capitalize his pronouns or call him Jesus or Yahweh or Zeus, those are not world views but metaphysical views, speculations beyond the here and now that demands action from us.

He seems confused about the difference between losing an election and losing a war. We have a long and hallowed tradition of peaceful transfer of power in this country. His call to "battle" and his condemnation of "peace" as a "sin" (an idea I would imagine the pacifist Jesus would condemn) is upsetting. I hope he is only being metaphorical, but these sorts of violent metaphors may encourage others to engage in horrific acts of violence.

He writes that "Government in a democracy is merely a reflection of the desires of the people and their choices for leadership." Fair enough. So the people desire something and have chosen someone different from what he would choose. He is welcome to attempt to exhort people to agree with him but at present they don't. It's not his job to tell the rest of us what sort of culture or leadership we should choose. He claims that "the real solution to America’s problems is the return of the common denominator that once united a diverse people." Given the rich diversity of religious and political opinions that shaped this country, I don't think such a unity ever existed. I hope it never does because at that point we will become a theocracy. America's richness is that it doesn't much care what you think or believe, but it very much welcomes what you can do.

The idea of a "culture with common values and biblical principles" is oxymoronic since the bible is not shared by all Americans as an authoritative text and as John Adams and George Washington once wrote, the United States is "in no way a Christian nation." We are a secular republic but everyone is free to believe or not in god as they choose.

"We must work to rebuild our country as one nation under God" perhaps unaware that that phrase (under god) was inserted during the McCarthy era. For most of our history we were not "under god" and stumbled along OK. The Greatest Generation did not say "under god" when they said the pledge of allegiance each morning (if they did at all) but somehow that didn't stop them from storming beaches at Normandy and Iwo Jima.

"The GOP lost the election, but GOD did not," he says, but GOD was not on the ballot I cast.

He talks about "The Lion of Judah" which "has been about redeeming people from worldly philosophies since they chose to eat from the Tree of the Knowledge of Good and Evil." He is mixing up some biblical allegories here; I don't think Adam and Eve were doing all that much philosophizing (but perhaps they should have). And why is his "worldly philosophy" so superior to all the other competing Axial Ages philosophies or the much older traditions of Buddhism and Judaism that preceded Christianity?  Simply claiming that a philosophy purports to represent all truth, god, etc., does not make it so.

"Let us arm ourselves with the ultimate weapons of love and truth and let’s go forth and boldly engage in the battle for hearts and minds." Fair enough, but it seems that whole "love and truth" part is a necessary component. You do not express "love" for an electorate you dismiss as sinful and self-serving and beholden to (or part of) an interest group. You do not show a dedication to "truth" if you get so many disprovable facts wrong (from what the ACA mandates to how many people voted).

Interestingly, after condemning self-serving interest groups, he asks for money. "Crown," he says, needs "your financial support" among other things. There is nothing wrong with this per se - all worldly philosophies, even those claiming to have a monopoly on extraterrestrial reality, need to pay the bills - but it seems to contradict everything he said about "the biblical admonishment to work as unto God for your resources, if physically able." Is he physically able? Than according to his worldview he should not ask for other people's money.

Twelve Things the Republican Party might learn from this election.

Twelve Things the Republican Party might learn from this election



To my Republican friends:  I know what you are feeling right now.  We went through it in 2004.  We survived and you will too.
But here's the thing.   Buried in that campaign are some nuggets of true wisdom.  As Ben Franklin once said, That which hurts instructs.  Perhaps this isn't the best teaching moment and I really do not write this in a spirit of gloating (it was a close, painfully expensive election after all). I simply hope that we can stop the food fight, grow up, roll up our sleeves and work together as adults.
In that spirit, I offer you twelve things Republicans might learn from this election.

Don't lie.  It worked with Iraq, it worked (to a certain extent) with the intelligence failures leading to 9-11, but I really do think the American people have a learning curve.   Don't talk about Jeep moving jobs to China when the CEOs of those companies have internet connections and are bound to hear those whoppers sooner or later.   Don't say the economy is going in the wrong direction when you know damn well that a.) it was in freefall when President Obama took office and b.) it may not be moving as FAST as you like, but the DIRECTION has been UP since it bottomed in 2009.  Don't talk about a War on Religion (see below) that does not exist.

Don't tell the truth.  I know this sounds contradictory, but if you are going to run on a platform by the 1% for the 1% don't ever actually say that out loud, especially if someone might be recording you.  If you do lie, lie consistently, otherwise the times you do tell the truth, we will discover not just the fact that you were lying all along but the complete disdain you have for most Americans, including soldiers, veterans, retirees, the poor and disabled.  In an age of tiny cameras and YouTube there are no closed doors anymore.  To solve this problem, how about writing a platform and running a candidate that honestly represents all Americans?  It would end up being a lot easier since you don't have to keep track of what version of Romney you are supposed to be today.

Don't make up goofy stuff about the president.  If you don't like his policies, his values, or even the color of his skin (I'm looking at you, Glenn), just say so.  People might even forgive you for saying that you are harboring a little racism even in 2012, but it just sounds weird to have Donald Trump out there fronting your latest conspiracy about his birth certificate or college transcripts or a black power transformative agenda rooted in Kenyan anticolonialism (Newt).  Just say it:  he does not look like your image of a president which is closer to George W. Bush on a circling aircraft carrier in a custom made flight suit in front of a Mission Accomplished banner.  That sort of thing.

Stop attacking women.  They make up half the electorate and they vote.  Perhaps your staff didn't tell you that, but most women, even those who might agree that abortion rights should be restricted a bit here and there, do not like the idea of having men in government coming up with all sorts of nutty ideas about how they are going to force rape victims to get a vaginal ultrasound probe that doctors say they don't need and women say they don't want.  And for god's sake drop the whole contraception thing.  It's weird.  That was settled law a century ago and the science hasn't changed all that much.

Don't misrepresent science.  If you don't think oil companies and coal companies who contribute mightily to your campaigns would be as profitable if they were regulated a bit more or had to compete with a thriving solar or wind power industry, just say so.   Some Americans might forgive you.  But don't make jokes about not intending to do anything about rising sea levels because those rising sea levels might rise in a major, election-changing way days before the election.  American education might not be as strong as it should be in this area, but most Americans trust NASA, the National Institute of Health, the CDC, and scientists in general far more than they trust lawyers in suits writing laws saying that climate change doesn't exist (or that abortion causes breast cancer or never is needed to save the life of the mother).

Don't talk about rape except to say how you would prevent it.  Rape is not funny and there is no way to put it in a cute little evangelical package and use it as a vehicle to sell your anti-abortion stance to the American people.  Most (but not all) rape victims are women and you are not going to get any mileage with them parading men in front of the cameras telling them how their bodies have way to "shut that whole thing down" (if it's "legitimate" of course) or how it's a gift from god (yes, you were referring to the baby, not the rape, but no rape, no baby).  It's your weakest argument against abortion and take my advice - just don't go there.  Ever.

Vet your candidate.  If you demand to see all of his tax returns before he runs, guess what - the American people are going to want to also.  Maybe his tax returns are as boring as his anecdotes about his wife falling on her rump on a stage once (true story), but the more they are withheld and the more Mrs. Romney said she had told "you people" all we needed to know, the more our imaginations went to work.  It's like an obscenity.  Just say the word.  Bleeping it out only makes our mind fill in the blanks with all sorts of dastardly things that might not even be there.  And if they are... well, perhaps the GOP should run another candidate with less dirt.

Stop talking about a war on religion.   Wars involve killing people.  Wars on religion often involve rounding people up, putting them in ghettos or camps, then killing them.   Asking religiously-affiliated universities and hospitals (that receive massive amount of federal funds) to play by the same level, federally-mandated playing field as everyone else is not the same as the Holocaust or the Crusades.  No one is forcing bishops to use contraception, but if they offer their employees healthcare, that plan has to include copayment-free access to them.

If you are running on a platform that is essentially that of President Bush, at least have the decency to invite him to campaign and to the Convention.   It's hard to sell another package of tax cuts and a more muscular foreign policy (does this mean another war?) to the American people without explaining why this would be less disastrous than the first time we tried that.  And who better to explain the nuances of how a Romney first term would really be a Bush third term, than W himself?  Admittedly he is not the most articulate of spokesmen, and probably has an awful lot of brush to clear on his ranch, but he, like Romney before the first debate, can be coached.  Not having him even attend, much less speak at a Convention that highlights and amplifies all of his policies is just plain weird.  His silence on the campaign trail was palpable.

Don't try to buy an election - it's a waste of money.  You guys spent billions (and so did the Democrats admittedly) raising limitless corporate donations, but even Karl Rove and the Koch brothers were slapped down this cycle.  It doesn't mean you can't dust yourself off and figure out a way to come roaring back in 2 or 4 years, but you need more than money.  You also need honesty, a commitment to reality as the rest of us know it (facts and stuff), and a plan that is different than the one that got us in the mess you criticize President Obama for not having fixed fast enough.  It still comes down to one citizen, one vote, and more of us are voting than ever before.  And most of us don't watch Fox.

Don't exploit a terrorist attack for political gain.  All right, admittedly it worked for you in 2004 when you almost literally ran on the legacy of 9-11 (a masterful twist since this happened on your watch).  But don't try to create a conspiracy over the tragic deaths of 4 Americans abroad when you guys ran an election on your failure to prevent the deaths of almost 3,000 Americans.   You can't have it both ways, as much as you would like to.  And when Americans die abroad, please have the decency to keep your "unraveling" theories to yourself.  It's mean-spirited and at least one of the victim's relatives asked you to stop.

Finally:  Leave Big Bird out of this.  He may have a funny voice but he is like ten feet tall and is a hell of a lot more popular than your candidate.



And before you get out your tea bags and assault rifles and orthographically-challenged signs demanding your country back (again), please consider how that turned out the first time.  We got healthcare done anyway, the Supreme Court upheld it, and - what do you know? - President Obama is still your Commander-in-Chief.  The American people chose him not once but twice.

Be adults.  Let's work together on real problems.  God knows we have enough to solve.

Contraception Access Could Prevent a Million Abortions in the US a Year
Thursday, February 23, 2012

You can oppose abortion.  You can oppose contraception.  But you cannot logically oppose both.

You don't have to be a gynecologist to understand that abortion's final common pathway is unintended pregnancy.  Preventing an unintended pregnancy makes abortion impossible.

Using 2008 data from the Guttmacher Institute, I came up with this admittedly speculative extrapolation.  Using retrospective data is always risky, but if I worked in an emergency room and noticed that the most severely injured car accident victims were not wearing their seat belts or intoxicated (or both), it would not be difficult to extrapolate what would happen if seat belt usage were universal and stricter drunk driving laws were followed.   In fact, the public health campaigns addressing these two issues were launched based on exactly those sorts of observations.  

In the same way, data about who gets an abortion can allow us to estimate what might happen if access to and use of contraception were improved.

Opponents of contraception are fond of pointing out that over half of those who seek an abortion were using contraception at the time of the conception.  Since contraception does not work perfectly, it must not work at all, right?  

Wrong.  54% of women who had an abortion used a contraceptive method the month prior to their unintended pregnancy.  The most common type of contraception was the condom or the pill.  But of these women, 76% of pill users and 49% of condom users admitted to not using the method consistently.  In fact, only 13% of pill users and 14% of condom users reported correct use.  

Since people have a tendency to over-report things that make them look good in the eyes of the surveyor, it's likely that this 13-14% "correct use" number is higher than reality.  

Besides, there are many ways someone deprived of rigorous education on contraception use might inadvertently misuse them.  A condom might be worn properly, for example, but how many people check the expiration date prior to use or avoid exposing a condom to excess pressure (as in a wallet in a back pocket) or heat (as in a car left in the sun)?   Did the condom also have a spermicidal lubricant or was it used in conjunction with spermicidal foam?  Did someone who was on an oral contraceptive forget to take it one day, then doubled the next, or simply dropped that pill from the cycle?  Studies of parents of children taking a 10-day course of antibiotics indicate 30% fail to give at least one dose by day 3, and that almost three-fourths fail to complete the full 10-day course, so the probability of a woman missing a dose of a regimen running over a much longer period is even higher.  

The bottom line is that the vast majority of those who have abortions were either not using contraception at all or using it inconsistently.  So what would happen if we improved these numbers (something the bishops are fighting fiercely to prevent)?   

Let's imagine a group of 100 women seeking abortions in 2008.  On average, 46 did not use any contraception whatsoever.   This is the low-lying fruit:  the biggest improvement would be to encourage all women who are sexually active but not ready to get pregnant to use contraception as religiously as they wear a seat belt.  Such a change in behavior would mean 46 more women would use contraception.

Admittedly, that would not prevent 46 abortions because - as the 13-14% of women obtaining an abortion who reported using contraception consistently reminds us - some unintended pregnancies can occur even with proper use.  

Note:  the fact that 13% of those taking who were on oral contraceptives and who got abortions in 2008 reported regular use does NOT indicate that the pill's failure rate is as high as 13%.  According to the CDC, oral contraceptives are 92-99% effective, meaning their "failure rate" is between 1-8% (probably closer to 1% if used properly and combined with other methods).  This is a classic Bayesian probability problem - the fact that you know the rate of exposure to proper use of oral contraceptives given an unintended pregnancy tells you nothing about the rate of unintended pregnancy given proper use of oral contraceptives.  

But let's assume for sake of argument that of the 46 additional women who now use contraception, 13% get pregnant anyway.  That still means 87% do not get pregnant, so even in this dismally unlucky scenario, contraception use has prevented 40 abortions (87% x 46).

Let's return to the other 54 women who already use contraception.  Of these, only 6 (about 13%) used it consistently and correctly.  That means 48 women in the contraception group are not using it consistently or correctly.  If we could - through an outreach and education campaign perhaps, or by eliminating financial barriers to filling their prescriptions or buying condoms - get that number up to 100%, even if we used the ridiculously high 13% failure rate, proper contraception use would prevent another 42 abortions (87% x 48).  

Adding the 40 abortions prevented by getting those who used no contraception to use it to the 42 abortions prevented by getting those who used contraception irregularly to use it regularly, even with the artificially high 13% failure rate of properly-used contraception, 82 total abortions of the original 100 would be prevented.  

Bottom line:  universal access to contraception, used properly, would reduce the abortion rate by 82%.  Extrapolated to national data, 82% of 1.21 million abortions in 2008 translates into 980,000 prevented abortions!  

So when Rick Santorum or Newt Gingrich say they are "pro-life", ask them why they are attacking policies that - in combination with other efforts, such as poverty reduction and universal access to healthcare - could easily prevent a million abortions a year.   If they really wanted to prevent the intentional loss of embryonic life why wouldn't they do whatever it took?  

            Yes, some who oppose contraception on theological grounds might sincerely believe that Jesus would prohibit the use of estrogen-progesterone pills or latex condoms, but since Jesus never said any such thing they cannot be sure.  Some rudimentary contraception existed in his time, but if it bothered Jesus, he never spoke against it, just as he never said a word about that other sexual litmus test of modern Christianity - homosexuality.   

What Jesus did teach was a variation of Rabbi Hillel's Golden Rule.  It's hard to imagine that when he said we should do unto others as we want them to do unto us that he would support preventing poor women in a wealthy nation from accessing technology that might break their cycle of poverty  compounded by unintended pregnancies leading to children born into a society that is appallingly indifferent to their post-natal existence.   It's hard to see how the man who saved a woman from being stoned to death for adultery would have wanted women today to be barred from an entire class of medicine because men they never met fear other women might use them to control the timing and number of her children.  

At any rate, it's unfair to claim to speak for Jesus or Yahweh or any entities, real or imagined, or are unable to speak for themselves, particularly when the 34,000 denominations of Christianity who all claim to be channeling the same spirit of Jesus disagree about what he actually meant.   Why not do as the Good Samaritan did, and not let the obtuse, abstract, legalistic religious ritual prevent us from doing the obvious good right in front of us.  If a man is bleeding to death in the road, help him.  If you have the means of preventing a million abortions a year, then for god's sake use it!.  

Shouldn't Women Demand Men Filling Viagra Prescriptions Be Screened if Not Barred?

 Why not mandate a 24 hour waiting period, followed by a thorough prostate exam for anyone wanting to fill a prescription for medications such as Viagra?  If a man is either not married or married to a woman who is postmenopausal then clearly this is the kind of sex that many religiously-minded people who believe that all sex must have a chance at causing pregnancy would find objectionable. Is it not a violation of their religious freedom to have to fill a prescription for a man who is clearly past his reproductive prime, especially if he is most likely to be filling the prescription, as Newt was in the 90s, so he could go have sex with his mistress? Since some man somewhere might theoretically be having sex for the sheer pleasure of it, isn't it safer to allow pharmacists and healthcare administrators to refuse to fill this entire class of medications for every man all the time? Also, if you believe that the timing and number of children should be left to chance and that any use of technology to intervene artificially is morally offensive, why would this not apply to erectile dysfunction agents? After all, if you really believed that no blade of grass falls without god having willed it, why would divine intervention be any less present in a wilting erection? In this view of reality, isn't impotence simply god's way of saying your breeding days are over? If so, then isn't it flouting god's will to do anything to upset that divine plan, which leads always and everywhere to the best of all possible worlds? Unfortunately the bible is as useless in answering this question as it is with so many other matters (go ahead and search for Viagra, erectile dysfunction, or estrogen in any online bible - you won't get any hits) but do we really think that god wants Newt Gingrich to be able to pleasure Mistress #4 more than he wants a poor woman in Alabama to be able to access a condom that will protect her from contracting HIV from her philandering husband?

Let Doctors and Patients, Not Bishops, Make Healthcare Decisions

Let Doctors and Patients, Not Bishops, Make Healthcare Decisions

If the all-male executives of an international corporation, none with medical expertise, denied treatment access to women employees of all faiths, based on the executive order of a former CEO, we would be outraged. So why do we politely defer to this demand simply because the corporation is religious? Pope Paul VI's 1968 Humanae Vitae is perhaps the most-ignored "teaching" of the papacy; if 98% of Catholic women don't follow it, why should women of all faiths employed by Catholic-affiliated universities and hospitals be compelled to? No religion has the right to discriminate based on gender. Lost in the bishops' misinformation campaign is this simple truth: opposition to contraception is wrong, morally and medically. President Obama, however much the Catholic hierarchy dislikes him (although over 51% of the laity voted for him) did not make the recently-reversed decision to compel all hospitals and universities to obey the law; the Institute of Medicine, after exhaustive review, agreed with the CDC, WHO, AMA, and every non-sectarian medical society that contraceptives are preventive medications with demonstrable health benefits, so should be covered without copayment. President Obama chose not to override this overwhelming medical and scientific consensus. The religious right seems intent on personalizing this, seizing on it to "prove" that a president they never really liked whose faith they never accepted is hostile to religion. Nonsense. This is not a war on religion as much as a war on women and science.


Some historical background: 

Humane Vitae History from Papal Sins (2000) by Garry Wills (emphasis added):

Humanae Vitae (1968)
The Pontifical Commission met five times, first in 1963.
The second was in 1964 attended by 13 men.
No one had recommended altering the church's teachings on contraception by the third meeting.
The rhythm method made people obsessed with sex and anxious about its failure rate.  "Sex is for procreating, yes - but all the time, and each and every act?  
Eating is for subsistence.  But any food or drink beyond that necessary for sheer subsistence is not considered mortally sinful.  In fact, to reduce eating to that animal compulsion would deny symbolic and spiritual meetings in shared meals -- the birthday party, a champagne victory dinner, the Eucharist itself…  the more they saw the questionable roots from which it grew -- the fear and hatred of sex, the feeling that pleasure in it is a biological bribe to guarantee the races perpetuation, and any use of pleasure beyond that purpose is shameful.  This was not a view derived from Scripture or from Christ, but from Seneca and Augustine. " 
When the 19 theologians on the commission, convened for a separate vote, were asked whether church teaching could change on contraception, 12 said yes, 7 no.
     - page 91

Pope Paul VI ignored the vote and instead seized on the minority report.  Humanae Vitae was issued "The church, calling man back to the observance of the natural law, as interpreted by its constant doctrine, teaches at each and every marriage act must remain open to the transmission of life."  
    Catholics responded with an unparalleled refusal to submit.  Polls registered an instant noncompliance with the encyclical.  A simultaneous poll among German Catholics at large founded 68 percent of them thought the Pope was wrong on contraception. [page 95]
The Pope was stunned.  He would spend the remaining 10 years of his pontificate as if sleepwalking, unable to understand what happened to him, why such open dissent was entertained at the very top of the episcopate. [page 97] 
Humanae Vitae condemned in vitro fertilization.  [page 97] 

In the War on Women's Health and Contraception, as in any war, the first casualty is the truth...

The Seven Biggest Lies in the War Against Women's Health Equality and Contraception 
February 9, 2012  

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It seems that the GOP is intent on trying to use contraception in the same way they used gay marriage in 2004:  as a wedge issue that distracts from more glaring Republican failures while beating up on a minority (in this case, poor women) who tend not to vote GOP anyway.  What is shocking in both cases is the misinformation and outright lies, especially by people who pride themselves on being pillars of righteousness and virtue (such as the Catholic Bishops and their anti-contraception lobby).    
People tend to lie when they know that telling the truth would result in their losing an argument and by extension, an election.  Dishonesty is a sign of weakness, an admission that the truth is not on your side.  Otherwise, why take the risk of lying and being caught? 
Republicans lied about the existence of weapons of mass destruction in Iraq and links between Saddam Hussein and al Qaeda because they knew that the case for something as radical and immoral as an unprovoked invasion of another country that would not and could not attack us would be thoroughly rejected by the American people. 
They lied about lower taxes for the wealthiest Americans because it's hard to rally 99.9% of Americans to vote for something that disproportionately favors the top 0.1%, particularly if the majority must suffer draconian cuts to social services to finance those tax cuts.  But claiming past tax cuts "always pay for themselves" (they don't) or "create jobs" (ditto), Republicans managed to put lipstick on a corpse, taking a dead-on-arrival gift to a tiny wealthy elite and twisting it into a populist issue that would somehow, magically and counter-intuitively, benefit us all.  They even appealed to people's selfishness, greed, and lack of understanding of probability theory to make a lottery argument:  someone has to win.  Who knows?  Maybe your heirs could pay the estate tax one day?   The misinformation campaign worked:  Americans polled guessed that 40% of us pay the estate tax (the actual number is less than 1%).
They lied about healthcare reform because most people support protecting consumers and patients from gouging insurance companies and forcing everyone to pay their fair share (not to free ride a system they will access at least in an emergency).  But fabricated "death panels" or "government takeovers of healthcare" - none of which are in the law - do not.
Republicans of course lie about President Obama, a milquetoast, right-of-center moderate, portraying him as everything from a "black nationalist" with an "intense hatred of white people" (Glenn Beck), an anti-colonial activist (Newt) who has launched a "war on religion" (Newt, Santorum, the entire Fox News staff), or someone whose economic policies have been enacted into law (they haven't; the Tea Party made sure of that) or who has raised taxes (tax rates and collection by any measure are LOWER under Obama than Bush, whose tax cuts he extended (most Republican voters believe Obama raised taxes)).  To run against a reasonable man man proposing reasonable things only works if your policy is convincingly superior.  But running against a foreign-born monster with a sinister agenda that threatens our freedom, prosperity, and right to worship is much, much easier.  
Romney, whose successful and popular Massachusetts healthcare reform was identical to the Affordable Care Act he now says threatens life as we know it in America, chose to create a fictional Obama to run against since the real one is so hard to dislike (or distinguish from Romney 1.0 - the pre-campaign Romney).
So now the latest target of GOP misinformation is women's health, or more specifically poor women's health (since the wealthy will always find the means to get the healthcare they need even if public agencies tasked with providing healthcare services are defunded).  But there is something even uglier that seems at work here, a backlash against the very recent notion that women should be in charge of their bodies, their sexuality, and the number and timing of their children.   Conservatives rarely say it out loud, but the idea of a woman not yielding to her husband's sexual and reproductive demands (or of even having a sexual partner who is not her husband) is one they fundamentally reject.  When they do slip their anti-woman strategy becomes too obvious, as I believe happened last week, they face a firestorm of criticism from the 50% of the electorate that fought hard for the once-radical rights to own property, testify in court, vote, hold public office, and access healthcare including contraception.  So to avoid future firestorms, they must not  directly assault women's sexual and reproductive freedom, just undermine it, linking it with other issues that both distract and divide, issues over which there is not universal consensus.  They even borrow icons and buzz phrases from the women's liberation movement, naming an anti-abortion group after a prominent suffragette whose name has become synonymous with a woman's right to vote, or making the rather strange claim that unless a woman is forced to have a child she does not want, is not ready for, or endangers her life or health, she is not really free, and that unless this choice is overridden by government bureaucrats (mostly men), she is somehow being exploited just as badly as women in countries where governments make the opposite decision for them, forcing them to abort.   
Contraception is as close to noncontroversial as any issue in our country, but there is a vocal minority that apparently still believes the idea of not leaving a conception to chance is immoral, that every sexual encounter, even rape, must have the potential to lead to a pregnancy and that doing anything proactively to prevent any pregnancy at any time is wrong.  Within this group is a smaller group that feels so strongly about the importance of rolling the biological dice with every roll in the hay that they want to impose this belief system on the vast majority of women of all faiths (and theirs) who disagree with them.   They would like all American women, regardless of religious affiliation if any, to be be denied access to certain technology, even if that technology is also used to treat painful or even potentially fatal medical conditions.
Most people, including the vast majority of Catholics, politely hear this shrill minority (politely because we have all been trained never to criticize absurd or dangerous beliefs if cloaked in religious garb) but ignore them (virtually all sexually active Catholic women have used birth control).  So a frontal assault advancing this peculiar minority view on the majority of Americans who strongly reject it would never work. Instead, the GOP and the religious right are desperately trying to blur the line between contraception and abortion, an issue over which intelligent people do tend to disagree, some quite violently.  
Although the majority of Americans (and the vast majority of Americans involved in the direct delivery of healthcare to women) support a woman's right to choose to terminate a pregnancy, the minority is vocal enough and able to make life very painful for those who do not appease them that associating something with abortion is a great strategy for making something non-controversial controversial. 
Planned Parenthood was a victim of this strategy.  An organization that in many counties in America is the only provider of women's health services from breast and cervical cancer screening to contraception, an organization that disproportionately serves the poor, would be impossible to attack head-on.  But transform it into some kind of sinister organization with a diabolic plot to abort black babies (yes, there are posters to this affect in many predominantly African American cities put up by mostly white men angry that abortion is legal and Santorum has said there is no moral difference between a woman who aborts her child and a slave-owner who beats a slave to death), collude with child prostitution rings (or at least not report child sexual abuse as required), or expand their network of "abortion mills" (never mind that only 3% of their activities involve pregnancy termination) and suddenly yanking funding for cancer screening of the least among seems not just acceptable but even moral in some twisted way.  Until last week, when this strategy backfired, it seemed to be wildly successful, but like all the right wing smear campaigns, it was clear that an honestly made argument would be too weak to be believed, so needed distortion, misinformation, and outright lies (most American voters seem unaware that federal law prohibits any tax dollars given to Planned Parenthood being spent on abortion).
And today, we have an even stranger and more blatant misinformation campaign, this one led by a group of celibate, allegedly asexual men intent on denying the full range of healthcare services to female (and only female) employees of all faiths who may work for a university, hospital, or other large corporation otherwise affiliated with a nominally religious organization.  The idea of men with no personal or professional experience or training in gynecology making unilateral healthcare decisions for their female employees is so outrageous in a country that is not a theocracy and does not even have an official state religion that it would be political suicide to advocate it honestly and directly.   Particularly when the law does not address abortion, but the noncontroversial issue of contraception, or more properly, medications that may be used for many purposes including contraception.
Enter the Great Lie.  Several of them actually.  (Is it any accident that the same organization lobbying for the right to discriminate invented the word "propaganda"?  The word comes from the Congregatio de propaganda fide a 1718 Catholic Congregation to try to expand shrinking market share of what had been an enormously lucrative religious market.) 

Lie #1:  Churches must provide services they find immoral.   As Romney put it, taking a jab at Obama in the process, 

This same administration said that in churches… that they have to provide for their employees, free of charge, contraceptives, morning-after pills — in other words abortive pills…

Actually, churches are exempt from the requirement that has so angered the Vatican and the GOP.  Only corporations that have a religious affiliation (which theoretically could include Harvard, Princeton, and Yale, all of which were founded by religious orders) and who hire people of a diversity of faiths must comply with this law. 

Lie #2: The "morning-after" pill is an "abortive" pill.   It isn't.  Levonorgestrel does NOT induce abortion.  Rather, if used 72 hours after intercourse, it can prevent conception.  If conception has already occurred, it does NOT interfere with it or cause congenital malformations.   You would think the anti-abortion lobby would be all over this intervention, since it is credited with preventing over 50,000 abortions in the United States in the year 2000 alone.  Rather than deal with that inconvenient reality - that those who oppose access to emergency contraception will make abortions more likely - why not just call the pill loudly and repeatedly something it isn't, an "abortifacent" as the Catholic Bishops lobbying group puts it?  Although the Bishops themselves are neither medical nor scientific experts, clearly they have raised enough money to afford to one who could explain to them in language they can understand (Latin perhaps) what this word means and why it does not apply to levonorgestrel.  John Boehner may claim the law forces coverage of "abortion-inducing drugs and devices" but he is simply not telling the truth.

Lie #3:  Birth control pills are only used for contraception.     They aren't.  In fact, up to 58% of women who take them use them to treat conditions even the Bishops would unlikely want to go untreated, from ovarian cysts to acne to luteal phase disorder (a more polite term for premenstrual syndrome) and endometriosis.   It's possible (but I hope unlikely) that the Bishops would want women to suffer from these conditions (some of which can threaten future fertility), but I think it's more likely that if they make this a black-and-white issue, they can get away with treating women in their health plans as second class citizens (something acceptable in the Vatican but not in the United States). 

Lie #4:  The Affordable Care Act is a violation of religious freedom.   This is true only if your religion mandates that you discriminate against others.  It does not prevent a single priest from saying Mass, a single imam from calling the faithful to Friday prayers.  It does not even require that religious people DO anything, only that they NOT do something, that is treat women of all faiths who happen to work for large organizations affiliated with their religion differently than men (who face no such restrictions) or women who happen to work for employers who are not affiliated with or funded by religious corporations.  In fact, no one is forcing anyone to provide healthcare coverage for their employees, but they are saying that if you do, you must play by the rules.   Insurance has always been a heavily-regulated industry; the Bishops' claims to be shocked by this discovery does not seem credible, and far too convenient coming at a time when so many (including many Catholics) seem intent on embarrassing President Obama at all costs, even if by doing so, they help abort healthcare reform for everyone.  
If the University of Notre Dame is so incensed that it cannot charge a Jewish librarian or an agnostic administrator a copay for the estrogen-progesterone mix used to treat their endometriosis that it drops coverage for all employees in protest, then that is their choice.  An absurdly disproportionate and amoral one, but if they really feel that preventing a conception is the same as disrupting one and terminating a pregnancy is the same as murder, it's time for them to put up or shut up.   I would love them to try to justify that act of passive-aggressive nastiness.  Perhaps instead of religious organizations worrying so much about having to follow a law they don't like, the affiliated institutions might instead re-think the liability of linking themselves to an organization that does not reflect the values of a diverse, pluralistic society of laws, one that defers private medical decisions to a woman and her doctor, not to a committee of men in Rome. 

Lie #5:  President Obama is hostile to people of faith.   This recent claim by Santorum is not just untrue, but like so much the man says, insulting.  It implies that President Obama is not himself a "man of faith."  Of course he is.  We all are, even if our faith leads us to believe that there is one god, many, or none at all (and the president's stated faith is Christian).   Most people of faith, including Catholics, simply disagree about the immorality of using contraception or the morality of forcing women to pay for it, knowing that many at the margin will face hardship or might have to interrupt treatment.   Some will suffer terribly or face an unintended pregnancy, half of which end up being terminated.  
This is not an issue of faith but of healthcare policy.  Santorum and others have no right to speak for all Catholics or all women who work for any Catholic-affiliated organization.  They simply do not agree with this very personal area of reproductive health, an area the Vatican had no fixed position on until 1968.    It's hard to make the case that opposition to contraception is a hallowed tradition when for 98% of the church's history it didn't see this issue as important enough to comment on, much less prohibit.  Yes, it's possible that they were wrong to remain silent and right now, but this would undermine the idea of papal infallibility declared formally by Pope Pius IX in 1870.  Assuming he intended this doctrine to apply to himself, was he fallible because he did not forbid contraception himself or even foresee the need to?   And once the idea of fallibility is introduced and accepted, is it not equally plausible that the church is wrong now and was right then?   At any rate, making a rule that is almost universally ignored by American and European Catholics changes no external reality but does threaten the credibility of the institution making that rule.


Lie #6:  Providing the option of coverage of a treatment is the moral equivalent of being forced to dispense or provide that treatment yourself.    If the Bishops are to be believed, you might have a mental image of them being forced to dispense oral contraceptives to women before, during, or after Mass.   You might think that dastardly Obama administration was putting a gun to their head, forcing them to scrub in on a first trimester D&C for a woman with severe congestive heart failure who was told that carrying her pregnancy to term could kill her.   
Nothing could be farther from the truth.  Nothing in the lives of the religious or their flock would change.  All that would change is that women employees of all faith would not be forced to drop or change medical treatment for financial reasons because a religious institution to which they do not belong and whose top administrators they never met decided for her what treatment options she should have available.   Insurance companies, who are often for profit third parties with no religious affiliation themselves (except the religion of profit) would set premiums, collect premiums, and review and pay claims.  The Bishops would never need to get personally involved.  In fact, by law and tradition, employees do not waive their right to medical privacy simply because their employer arranges and pays for part of the insurance coverage, a benefit in lieu of cash compensation.  An employer should never get involved with employee health decisions.
If it bothers the Bishops that women make different decisions than they believe they themselves would if they were sexually active and had a uterus, then perhaps they should question why they are operating in a free country, and move all of their operations overseas to places where governments accede more easily to their demands.   
At any rate, nothing in the current law or the new one prevents a woman from obtaining legal treatment options, including abortion and contraception, using her own funds (from a tax cut, let's say).  Not paying for something or slapping a copayment on preventive services in violation of the letter and spirit of healthcare reform will not prevent most women from getting it - it will simply punish them with financial hardship for doing so, a hardship women working for nonreligious employers or men working for anyone do not have to face.  Wealthy women will always find a way to get the treatment they need; the poor and those living paycheck-to-paycheck with hardly a dollar of discretionary income will be the ones who will find unfinanced treatments off limits.  So once again, we have to ask what religious teaching supports or condones the cutting off of poor women's access to healthcare options medical experts consider essential and basic? 


Lie #7:  Being forced to pay for something you find morally objectionable is a violation of religious freedom.   This is a broadening of the idea in Lie #4 but merits a separate listing.  We all pay for things we find morally objectionable.  The Vatican opposes the death penalty yet all Americans, Catholic or not, must pay taxes, some of which go to finance executions and the extraordinarily expensive legal proceedings entailed.   Pope John Paul condemned the United States invasion of Iraq as "immoral", a "defeat for humanity" and a "crime against peace" that was neither legally nor morally justified, yet a trillion dollars of tax revenue, many of those dollars from Catholics of good faith, supported the invasion and occupation.  Orthodox Jews and devout Muslims are probably offended that some of their tax dollars subsidize the pork industry or a food lunch program that largely ignores their religious laws and teachings.   The Bishops are either disingenuous or have not thought the matter through when they paint a picture of the Obama administration as forcing them for the first time ever to do something they find morally objectionable.    (Yet the law does not even force them to do anything - see Lie #6.)
Compromise is part of living in a democracy that creates laws that not everyone will agree with but everyone must follow.  If we don't like a law, we can vote for people who will attempt - through the democratic process - to support laws more to our liking, but in the interim, we do have to obey them.  I cannot withhold the portion of my taxes that goes to war or executions and pay the rest.  We don't have the right to take a cafeteria-style approach to the duties inherent in living in a civil society.   The Golden Rule that Jesus and Rabbi Hillel emphasized in their teachings can guide us here:  I obey even unreasonable laws because I would want others to obey laws I consider important but they view as obnoxious or offensive.   I don't flout some laws and obey the others anymore than I would like a mother to ignore laws mandating that she restrain her child in the car or fasten her own seat belt.
In the mind of the fundamentalist, compromise is a dirty word, which is why the more I hear the absolutist, over-the-top rhetoric of the religious right, the more I wonder whether their institutions, vestiges of the authoritarian Roman empire, are compatible with ours without serious reform.  
I will end with an excerpt from a mailing I received from Cecile Richards, President of Planned Parenthood Action Fund, who inspired this post:

Here's the truth. Nearly every sexually active woman — including 98 percent of Catholics — will rely on birth control at some point. It's basic preventive care — not just as a contraceptive, but for women who use the birth control pill to manage ovarian cysts, endometriosis, and other conditions. The health care reform law requires employers to provide coverage for preventive care with no co-pays. While churches, mosques, and other religious institutions do no have to abide by this requirement, the Obama administration has decided that religiously affiliated hospitals and universities with large numbers of employees of different faiths can't impose their ideology on those employees. It's simple: your boss can't decide whether you have access to birth control with no co-pays.

So when Mitt Romney says the rule forces anyone to provide "abortive pills," he's not telling the truth. This is about birth control. When Newt Gingrich says that the rule applies to every Catholic institution, he's not telling the truth. When John Boehner claims it includes "abortion-inducing drugs and devices," he's not telling the truth. This is about hospitals, colleges, and other non-church employers who serve and hire people of all beliefs. When anyone says this rule is about imposing on the conscience of employers, they're not telling the truth. This is about protecting women's access to basic health care.

Tell them to stop misleading the public in order to undermine women's health.

The amazing outpouring of support we saw last week when the Susan G. Komen for the Cure Foundation was pressured to defund Planned Parenthood health centers' breast cancer prevention programs proved something important: Women's health is not a political game. It is long past time for anti-choice activists and the lawmakers who pander to them to stop twisting the truth and attacking women's access to care.

This is basic health care. It shouldn't be attacked. It shouldn't be politicized. And it shouldn't be lied about. If you agree, click here to speak out.

I know that together we are strong enough to protect women's access to care. Thank you, as always, for your ongoing support of Planned Parenthood and the women, men, and teens who rely on us.