Mental Health Parity: This is a Really, Really Good Thing

Image courtesy of antpkr / FreeDigitalPhotos.net

There is a new regulation going into effect on the national level that is going to help millions upon millions of Americans: insurance companies will be required to treat mental health and substance abuse the same as general physical ailments.

This is huge. And it makes me want to tell you a story, because this is something I have personal experience in:

My first job out of college was working for a California company that provided mental health case management and claims administration as a carveout to local HMO providers for professional services. Mental health is a very nuanced field in healthcare, and at the time, most HMOs would contract with a company that specialized in that area to handle their members’ needs. The HMOs would pay either as a fee-for-service (which is to say, the carveout would receive a certain amount of money per procedure), or, they would pay a monthly capitation rate (which is a lump sum estimated on the number of lives covered). To make money on a fee-for-service, the carveout simply had to pay the provider of the service less than what they received from the HMO. To make money on capitation, the carveout had to make sure that payments to providers each month were less than what they received from the HMO each month. Of course, the providers had to be contracted with the carveout, so those rates were previously negotiated.  This is a fairly predictable thing, as the carveouts typically only handled professional fees (doctor’s/therapist’s visits), which means they were shielded from those huge-dollar, unpredictable hospital bills.

With all of the problems I saw in the company I worked for, I can honestly say that despite the obvious temptation to shortchange care for a larger profit margin, I never saw them do this. They’d cut corners in every way imaginable, but in the end if someone needed care, they got care. That said, I saw a system that was designed to fail: the Pre-Parity California System.

At that time, all mental health was considered a “specialist” benefit. You know how on the back of your insurance card, you have a lower copay for general office visits and OB/GYN visits, but a higher copay for specialists? Mental health providers fell under that specialist category. If you had schizophrenia, bipolar disorder, severe depression, or any other mental illness, you had to pay that higher copay whenever you saw your mental health providers. In these more serious instances, that meant you had to pay a copay once a month for your 15-minute medication management session with a psychiatrist, and you had to pay a copay no less than once a week for your 45 minute counseling session with your therapist. With things like severe depression or anxiety, it’s not unheard of to have a therapy session two or three times a week. Keep in mind, if you were on an HMO like our patients were, your doc had to obtain an authorization to see you, and “renew” that authorization every 6 visits (which is why so many providers hate HMOs; on the other side, it does provide a check that can ensure a provider isn’t fraudulently billing or just dicking around in their sessions).

The worst example of this process I’ve seen came from an insurance I’m going to call Acme Health. This is a huge national provider that had and has a presence in California. Their specialist visit copay in 1999 was…get ready for this…$50/visit. Fifty damn dollars. Now here’s the kicker – due to our agreement with the HMO group connected to Acme Health, we were contractually obligated to take that full copay amount from the member. Why is that worth mentioning? Because our medication management reimbursed at $45. So because the patient was using their insurance, they actually paid more out-of-pocket than what we charged for the session. Once a month, for a session that lasted up to 15 minutes, no more. If you did medication management, you almost always had to supplement it with counseling, so add $50 per week to a counseling session with a masters-level therapist, who was reimbursed at $65 per session. So in one month, you, a person who is schizophrenic or severely depressed or what have you, just spent $250 on your mental health on top of what you pay monthly for your premium. Your insurance paid $60. Do you see where this comes across as somewhat immoral and outrageous?

I was working for the company when California passed their own Parity Act. The act stated that any treatment for specific diagnoses (all severe mental illnesses, like schizophrenia or severe depression) had to be handled the way a general office visit would, meaning members only had to pay their office visit copay and not their specialist copay. Those people who were paying $50 a visit, now only had to pay $10 a visit. Rather than spending $250 a month on their care, they were now only spending $50 a month (plus that premium, of course). Think about that when you hear Big Insurance panic – and they will. They were making a fortune off of the mentally ill in California, and then they were cut off.

The Parity Act killed businesses like the one I worked for – why pay someone to manage something that you are now managing like a regular office visit? We folded in under a year due to the passage of that act. I had no problem with that. When you hear Big Insurance say they can’t stay in business because of this government interference? Just look at Acme Health – they are still in business today, and are one of the largest and most profitable insurance providers not only in California, but in the nation.

London Calling: The Religion of Nationalism

For the past week and a half, I’ve been soaking up the sights in London. This is only my second trip overseas, and once again I find myself longing to do this more often. London is an amazing city teeming with excitement, diversity and history (and pubs). As someone who loves art history, it has been a feast for the eyes. I particularly enjoyed exploring both St. Paul’s Cathedral and Westminster Abbey – these two houses of worship are very different from one another, but have a common thread which runs between them. As I walked through them, I found myself thinking about politics and religion in the U.S., and how the concept behind the Anglican Church influences us today.

My first stop was at Westminster Abbey. While it was built over multiple eras and has a variety of stylings to show for it, the Gothic signatures are the most dominant – flying buttresses, an enormous rose window, and my favorite – stunning, stretch-to-the-sky rib vaults. The nave is particularly breath-taking; I kept looking upward as I walked along it. The abbey is beautiful and at times seems to defy gravity.

Unlike the churches in America or the cathedrals I’ve seen in Italy, there is an unmistakeable secular feel once you are inside of the church. As I later joked to Chris, who couldn’t join me for the excursion, “anybody who’s anybody is buried in Westminster Abbey!” There are so many tombs here, you are practically tripping over tombs to get to more tombs. Images or statues of the crucifix are lost or forgotten when placed next to these often grand monuments to the rich and the powerful. When I think of the history and evolution of the Anglican Church, I find it interesting to see the theme of placing images of royalty in the church where one would expect to find a Biblical figure.

The Lady Chapel, housing the tomb of Elizabeth I (and is also the burial place for her half-sister Mary I) is an area of exceptional beauty, filled with natural light and elaborately carved pendants and fan vaults. According to the Abbey literature, the room is dedicated to the Virgin Mary, but the architecture and positioning of the tomb make it clear that Elizabeth I’s tomb is the main focus of the room. I would even make the argument that there was a conscious effort to equate Elizabeth I with the Virgin Mary in this space.

There is a celebration of the humanities at Westminster Abbey as well, with the famed “Poet’s Corner” as well as monuments honoring Purcell and Handel, who were both buried here. It is only when you enter the older portion of the church – the undercroft – where you feel a sense of piety and quiet spiritual reverence through its simplicity.

St. Paul’s Cathedral, its current iteration constructed in 1675-1711 after the prior cathedral burned in the Great Fire, has a different character than Westminster. It’s built in the English Baroque style, with a Romanesque approach to it’s arches and vaulting systems. Aesthetically, it’s a “heavier-looking” building than Westminster and is more of a celebration of massiveness achieved through an open, rounded horizontal design versus the celebration of the vertical displayed in Westminster. It has a far more religious feel to it than Westminster Abbey, with images on the dome telling the story of St. Paul’s life. Again, though, there is a secular feel on the main floor with the statues featured. The religious iconography is out of reach and at times difficult to see (in part because much of it is so high up on the ceiling of the massive dome), but the secular figures are large and at arm’s reach. This isn’t to say it is a primarily secular space – the high altar, chapel and quire are all very traditional in design – it is just more focused on the secular than one would see in the American churches or Italian duomos.

As I walked through St. Paul’s and Westminster Abbey, I kept thinking about using art as a way to connect leaders and religion. In these two grand spaces, you see a governing body that intertwined itself with religion to encourage people to equate their nationalism with their religiousness and vice versa. The role of St. Peter and subsequent popes are replaced with a nation’s leader and subsequent leaders, in a way that encourages people to believe their leader has the “keys to the kingdom,” that is, the direct line to God. Supporting your leaders is supporting your nation, and supporting your nation is supporting your God. In return, God will bless your nation, which blesses your leaders and by association, you. God Save the King.

When you look at American history, you see a similar trend of equating nationalism with religiousness, particularly when the nation’s ideology is challenged. Consider the phrase “In God We Trust.” It appears in the fourth verse of The Star-Spangled Banner, which was written during the War of 1812. When we were a nation divided during the Civil War, the Union added “In God We Trust” to coins as a way to indicate God was on the side of the Union. In the 50s, as a response to the anti-religious sentiment of communism at the height of the Cold War, we changed our nation’s motto from “e pluribus unum” to “In God We Trust” and added the phrase to all paper money. Finally, following the September 11 attacks, posters with the phrase “In God We Trust” filled the schools, again suggesting God is on the side of the United States. Once again, supporting your leaders is supporting your nation, supporting your nation is supporting your God. If we all are patriotic enough, God will Bless America. Whether you believe this or not is entirely up to you, but the parallels in history are fascinating (to me, at least).

There is one noticeable difference between the U.S. and the U.K.: when I look at the reverence placed on kings and queens in Westminster Abbey and the similar VIPs buried in St. Paul’s, I notice a certain secularism to the Anglican Church and to England in general that we don’t have in the U.S. The effect in England seems to give the religious areas a more secular feel, whereas in the U.S. the effect gives our secular areas a more religious feel. I’m not sure why that is, but I’m interested in reading the various theories people may have explaining it.

As I come across other notable things while in London, I’ll share them with you – most will likely they be far more fluffy and touristy than this post. I’ve seen many amazing things here and have a few suggestions to those of you who are considering a visit. Until then – cheers!

Help Me Understand

It’s easy to sit here and type out my opinions. It’s easy to let the rage and frustration I feel take over and shut myself off from the world until the latest tragedy becomes old news and we’re back to talking about Anne Hathaway’s crotch shot at a premiere or Lindsay Lohan’s legal troubles. I debated what I was going to write today. I’ve struggled with writing as of late, because I am not in a place to write funny and happy things. I’ve felt exhausted talking about issues, because there are too many people who don’t want to have a conversation.  They want to scream and plug their ears until they have their way. It’s just too much some times.

Suddenly, here we are. As I read my Twitter and Facebook feeds responding to a national tragedy, I realize that there is a way of thinking in this country I simply cannot comprehend. I need to understand this:

Help me understand why you think the real solution to preventing a tragedy is to arm kindergarten and first grade teachers.

I keep seeing this over and over. See, in my mind, I separate the right to bear arms from a mandate to bear arms. When I imagine a world where a kindergarten teacher feels they must carry a gun on them while they standing in front of a class of 5 and 6 year-olds in a suburban, sleepy Connecticut elementary school – and in this case, it would need to be a gun that could defend against a person in a bulletproof vest armed with a semi-automatic weapon – I don’t see a world of Freedom or Apple Pie or a God Blessed America with a Right to Bear Arms and a cherry on top; I see a world that is in a lawless, militant state; a state where no place is safe and every house has a panic room with steel walls that are a foot thick.

Why do I see this?

Because any world where a kindergarten teacher feels that they must arm themselves in order to go to work is a world where gun ownership is not a right, but a mandate. It is a world where a sweet 27 year-old with a winning smile and a gentle soul has to strap on a Glock in case a day of fingerpainting is disrupted by the possibility of engaging a madman in a gunfight. Wow. We really want to go there?

Since we’re all a fan of slippery slopes, answer me this question: say we allow teachers to bring guns to school. Say some of those teachers and administrators don’t believe in owning guns and choose to not carry. Say a gunman still enters the school and guns down people.  If the “fault” of the latest massacre is not allowing a person to bear arms in a school, who is at fault when an individual chooses not to carry? Before you bring up the argument of “well, derp, nice try, but someone would carry and they would Wyatt Earp that crazy mother fucker and shoot him down before anything happens,” let me remind you of something:

Several people had the right to carry a gun at the event where Jared Loughner shot and killed a number of people in Tucson. At that event, people either made the choice not to carry, or in the chaos, people forgot they were carrying or felt it would be ineffective. Keeping this in mind, can we agree that MOAR GUNZ isn’t really a solution?

While on this subject, I need your help understanding one other thing: Why is it when any challenge is brought up in regards to waiting periods, limits on arming those who are severely mentally ill, or simply disagreeing with a MOAR GUNZ philosophy, it is automatically assumed that people want to repeal the 2nd amendment?

Newsflash: Most people in this country don’t want to repeal the 2nd amendment. Check out the polls. It’s not going to happen. The problem is, we can’t even start the conversation about what we can do in a civil manner without the NRA cock-blocking the discussion with hyperbole, rhetoric and fear-mongering.  Can’t we have a civil conversation about this? Can’t we discuss why pro-gun advocates hate having a small waiting period before purchasing their guns, and why someone like me sees waiting periods as completely benign? Can’t we sit down together and attempt to come up with a solution that does not infringe upon the rights of responsible gun owners while keeping guns out of the hands of those who intend to use these guns to take away the rights of others?

Unfortunately, we all know the answers to these questions. For those who are responsible gun owners who do not want their rights infringed upon, I will tell you this: if you can come up with solutions that do not involve mandating gun ownership – be it developing a health care system that better supports the mentally ill, whatever – now is the time to share your ideas and be vocal on those solutions. Both sides want these tragedies to stop – if you can find a solution that doesn’t require me to carry a gun, I will stand by you and support your ideas and your rights.

Remember the Ladies

“I long to hear that you have declared an independancy – and by the way in the new Code of Laws which I suppose it will be necessary for you to make I desire you would Remember the Ladies, and be more generous and favourable to them than your ancestors. Do not put such unlimited power into the hands of the Husbands. Remember all Men would be tyrants if they could. If particular care and attention is not paid to the Ladies we are determined to foment a Rebellion, and will not hold ourselves bound by any Laws in which we have no voice, or Representation.”
- Abigail Adams, 1776

As I watched the election results roll in last Tuesday, I couldn’t help but think of this quote by Abigail Adams.  While Tuesday was not what Abigail Adams had in mind with that quote, the 2012 election is definitely the election that remembered the ladies.  Over the past couple of years we saw overreaching laws against women’s rights emerge at the local level and attempts by lawmakers to redefine biology, rape and take away a family’s privacy in the form of explaining/justifying contraception usage to employers.  As I’ve mentioned previously, we are witnessing Evangelical politics’ extinction burst before our very eyes, and it is wrapping its mangled claws around anything it can to stay relevant and keep women “in their place.”

Judging by the election results, I was happy, relieved, proud and hopeful to see not only a push back against these ideas, but to see an unprecedented number of women elected to federal office with a number of “firsts.” Some notables are:

  • Consumer watchdog and Daily Show favorite Elizabeth Warren replacing Scott Brown in Massachusetts. This is the first time Massachusetts elected a female senator.
  • Democrat Tammy Baldwin in Wisconsin and Republican Deb Fischer in Nebraska are also first-time female senators for their respective states. Baldwin will also be the first openly lesbian senator.
  • Democrat Tammy Duckworth from Illinois will serve as the first female member of Congress who was injured in combat.
  • The two wins in New Hampshire by Ann McLane Kuster and Carol Shea-Porter mean New Hampshire’s entire delegation is made up of women.
  • Arizona’s own Kyrsten Sinema, the first openly-bisexual member of congress, and personally one of my favorite Arizonans. Anyone who has seen Kyrsten in action knew she was going to go places. I can’t wait to see her take on Washington.

I mention these women because I hope this indicates a trend where these wins will no longer be notable, but commonplace.  We have quite a way to go but this seems like a big step in the right direction towards diversity.

Beyond electing a diverse group of women into Washington, voters sent a message to candidates who proved to be apathetic and uneducated on rape and women’s rights: The man who said women’s bodies had a way of “shutting down” a pregnancy from rape, the guy who equated rape to having a baby out of wedlock, and the guy who said a pregnancy from rape was a gift from God were all defeated.  Exit polls indicated that 61% of those who voted against Akin attributed their vote to his comments about rape.   It would appear that men and women in this country who believe in both science and the separation of church and state understand the dangers of electing those who believe in neither.

Does this mean “we’ve won”? No; this fight is far from over.  When dealing with ideas that people hold dear to their hearts it would be foolish to think that they would simply put their tail between their legs and hide in a corner.  History shows that quite the opposite occurs – the belief becomes stronger and the voices become louder.  We saw this most recently in 2008 with the fanatics who screamed, protested and accused the president of being some Kenyan-born, Muslim, Hitlerwannabe extremist, Manchurian, OrlyTaitified, Militant Christian Extremist, Witch Doctor, Angry Black Man, Middle-East Apologist, Abortion-Loving, Drug-Dealing, Intellectual, didn’t earn his admission to Harvard, unAmerican, vegetable-growing, NOBAMA, OBAMINATION, dictator freak with big ears.

Did I miss anything?  Wow, that seriously felt like I just performed a seance and was possessed by one of the superPACs recently killed in this election cycle. Shudder…

Anyway…point being, history and psychology show when someone’s belief system is challenged they don’t fold, they double-down.  What does this mean for the ladies? Expect to see more ballot measures and bills introduced on the state level limiting a woman’s right to choose or access to contraception.  Expect to find additional ballot measures and bills disguised as one thing (“protecting women’s health” is a popular red herring) but have an underlying effect of achieving these goals.  This is what is going to happen, and for those of you who “sent the message” last Tuesday, know that your work isn’t done.  Smaller off-cycle elections are coming up to try and undo some of the work of this election.  Additionally, states like Arizona and Mississippi simply do not have the votes to stand against these intrusions. What can you do? My advice? Be loud, be active, educate yourself and provide support in whatever way you can to continue the efforts you believe in.  Whether that is for reproductive rights or simply for rape education is your choice.  Whether it is donating your time or your money to causes that align with your views is also your choice. These things sneak in when we are complacent – the only way to fight successfully is to never be complacent.

Remember the ladies.

Image: FreeDigitalPhotos.net

How Patriotic Is Your Candidate? A Score Card

This time of year brings an abundance of political mailers to our doorstep.  Thanks to a major election year and Arizona’s redistricting, we could wallpaper our family room with the brochures and pamphlets we receive.

With all of these options, how does one decide who to vote for? I mean, it’s not like you want to read the newspaper or look up their existing voting records, right? Who has time for any of that hullaballoo?  No, you want to judge your candidate off of those glossy little mailers.  Don’t you know you can tell with absolute certainty how patriotic someone is just from their mailer?  In fact, by assigning point values to items on the mailer, you can easily compare the patriotism of two candidates:

For each son or daughter shown = +3
Real patriots have kids – lots of ‘em!

For each grandchild shown = +5
Even better when the kids grow up and have more kids to make for big, smiley reunion photos! Plus, older = wiser.  If you are old enough to raise this big, wonderful family, you are basically a big Oz Head filled with knowledge and solutions to all of our problems.

For each great-grandchild shown= -2
Just don’t be too old, Wizard.

For each child shown who is not the candidate’s child = -5
Passing off other people’s kids as your own is easily fact-checkable, and is quite frankly a little creepy and weird.

If the only family picture shown is of the candidate holding one grandchild = -15
Even creepier (and weirder). Maybe it’s just weird to see such an angry person smile?

Candidate has a famous political dad = +3

Candidate’s dad is Dan Quayle = -5

But candidate and his dad Dan Quayle live in Arizona = +10

But candidate was just redistricted against someone who actually has experience in politics = -10

Candidate has a golden retriever = +10
Golden Retrievers are All-American Dogs – they drool apple pie and shed stars and stripes.  They bark in a cadence remarkably similar to Reagan’s “Tear Down This Wall” speech.  And besides – their GOLDEN! Do you know how valuable gold is right now? Owning a golden dog is an investment for your future and is the equivalent of having Glenn Beck’s endorsement.  This is a fact.

Candidate has a breed of dog that weighs less than 20 pounds = -15
Little dogs aren’t American.  You know who has little dogs? Hollywood elitists.

Candidate is wearing a button-down denim shirt = +1
Because you can’t get any more blue collar than a literal blue collar!

…With the sleeves rolled up = +5
See? The candidate is ready to work! Add a hard-hat to that look and you’ve got yourself a winner.

Candidate is endorsed by the fire department or police department = +20
Because firemen and policemen are American times infinity!

Candidate is endorsed by fire or police unions = -20
Because unions are Un-American times infinity! Ignore the cognitive dissonance rattling around in your skull; moving on…

Candidate has “a million-dollar smile” = +25
We’ve all heard Joe Biden speak off-the-cuff, right? So…how?!?

Oh, yeah.  A winning smile is “a big f-ing deal.”

Candidate has “Manson Lamps” for eyes = -15
Fortunately, there is a segment of the population that finds Crazy Eyes endearing, so this could be a good thing, depending on where the candidate lives.  Dead eyes are also bad, unless they can be Photoshopped to become bedroom eyes.  It’s a fine line, really.  Then you’ve got yourself an up-and-comer with People magazine “Eligible Bachelor” potential!

The candidate is married = +10
The candidate is a single man = -5
In politics, people are far more forgiving of an adulterer than a bachelor.  So if you are single and want a career in politics? Shack up with the nearest trophy, and fall into a loveless but equitable marriage.

Candidate is a single woman = -10
When people see single women in politics, do you know what they think? The woman is either an “uppity bitch” or a lesbian.  Whereas if you’re a married woman, you’re seen as…a shrieking harpy.  Really, you’re kind of working against the current no matter how you slice it.  Them’s the breaks, ladies. Sorry and good luck, there.

Image: FreeDigitalPhotos.net

HB2036: When Republican isn’t Conservative and Pro-Life Isn’t Pro-Life

As part of evangelical politics’ extinction burst,  we are witnessing a bizarre war on women in this country.  My home state of Arizona, in an attempt to retain its Heavyweight Champion Belt in Yosemite Sam-ism, recently took the lead in this war by introducing overreaching, extremist legislation that would make Barry Goldwater turn in his grave.  I’m assuming that a few of the elected cockroaches in the state capitol building realized that their lives were still incredibly shitty after driving out all the “illegal Mexicans”, and decided to make women number two on their Shit List.  It couldn’t possibly be because they are horrible people who make horrible decisions, could it? Never! It’s got to be the Mexicans and the bitches.

While I gave Governor Jan Brewer a polite golf-clap for suggesting Debbie Lesko’s anti-birth control bill appeared to be a gross invasion of privacy, I take back any and all praise when she signed the other oppressive, anti-woman bill, HB 2036 into law.  While sites like Mother Jones have done a decent job of covering the part of the bill making abortions after 20 weeks illegal, there are a number of disturbing points within the law’s 27 pages of requirements that aren’t getting a whole lot of attention.  For example:

- A provider must provide the patient with the gestational age of the fetus and list the risks associated with abortions. Sounds simple enough if not a bit redundant, right?  The state takes it 900 steps too far by overriding actual medical science and requiring a doctor to use their definition of gestational age and disregard the true age of the fetus when it can be more accurately determined.  A provider cannot list the risks of the procedure based off of fact-based science.  No, the state tells the provider specifically what to tell the patient, because some representative read a couple of articles, and surely that gives them more knowledge than the person who spent years and years of schooling and continuing education on the matter.

- The provider must tell the patient in person that “medical assistance benefits may be available for prenatal care, child birth and neonatal care,” the father of the child is liable to assist in child support, and there are public and private agencies to help the woman if she chooses to not have an abortion.  Because discussing what the state might do for you is the responsibility of a doctor.  Oh, and these state “benefits” aren’t exactly “available.”  More on that later.

- The state requires the provider must offer to describe the state-mandated ultrasound in detail to the patient, and mandates what physical features the provider is required to describe to the patient on the ultrasound.

- The patient must have a 24-hour “reflection period” between seeing the abortion provider and going back for the abortion, because the state is assuming you horrible ladies are incapable of considering the ramifications of this procedure and need to be put in a time out. Since many abortion providers were driven out of the state on prior laws, this 24 hour period is also designed to create another hurdle for disadvantaged women in rural areas, since they’ll have to travel quite a distance for the procedure, pay for a hotel room they can’t afford, and take time off from a job they can’t lose. 

- Non-pregnant taxpayer/voter? You think you’re off the hook? No, the state is using your taxpayer dollars to maintain a website that “describes the unborn child” to the woman.  This description must show and describe fetal development, and must include all of the same items the doctor is required to tell the patient.  Despite the fact that this information is already one easy Google click or library visit away, we are putting a few people on our cash-strapped government payroll to do this.  Oh, and the web site must be “objective, nonjudgmental and designed to convey only accurate information about the unborn child at the various gestational ages.” Remember,  the doctor has to use a state-defined version of “gestational age,” not the objective, non-judgmental accurate version. Because you’re using two different definitions, doesn’t that cause a misrepresentation of fetal development by 2-3 weeks? I see what you did there, Arizona. Clever, clever…

If the provider doesn’t do everything as strictly defined in this law, he or she can lose their license and be sued by a host of people.  So let me get this straight, Arizona Republican Legislature:

- Your party’s platform is supposed to be for tort and malpractice reform, but you just wrote a law making it easier for an OB-GYN to get sued.  This causes malpractice insurance to go up in our state, and will drive specialized care out of Arizona – a state that is already desperate for specialized care in rural areas.  Good job.

- Another aspect of your party’s “limited government” platform is to not create redundant laws.  While many of the provisions of this law are being touted as protecting a women’s health, every aspect that protects the woman’s health in this bill (the quality of the clinic, informing the patient of medical risks, etc.) is already covered in other laws as well as in medical licensing standards.

- You strip taxpayer dollars from services that can actually help Arizonans (again, more on that later), but you just mandated that the state pay for some stupid web site that provides information that can be found elsewhere without costing taxpayers a dime.

- Your party claims they don’t want to legislate people’s lives, and well…here we are, yet again.

Way to be a conservative.  So let’s talk about the word “Pro-Life.”  What does that word mean to you? Because I don’t think that word means what you think it means.

As I mentioned above, the new law wants healthcare providers to talk about the services the state “may offer” to moms.  The key word in there is “may,” because here’s the colossal fail that that resides in “may”:

- In 2011 Arizona cut services for children with developmental delays and froze health insurance for the poor.  Because of these cuts, 85,000 children were on the waiting list for KidsCare.

- Thanks to our poorly funded health programs, Arizona is currently ranked 47th out of 51 in the country for children who are insured, 44th for parents who are insured, 40th for children who have had a preventative medical visit in the past year, 45th for children with preventative dental visits, dead last for children with special health care needs in need of referrals, and 40th for children who are at a moderate to high risk for developmental or behavioral delays.

So we’ve established that Arizona pretty much sucks at providing adequate health care to these babies they want to save.  How else does Arizona protect its children? Haha, good one.  Yet again, needed services were cut from the state’s budget because we’re so goshdurn conservative, and yet again, CPS remained grossly underfunded.  We expect master’s level counselors with a mountain of student loan debt to accept a nearly unlivable wage, be responsible for more kids in one month than most people will know in their lifetime, fight the red tape war every day, only to get persecuted by state politicians when a kid dies.  Sign me up! Representatives actually have the gall to go on our local news and state that they “don’t want to throw money at the problem.” You say throwing money at a problem;  I call it FUNDING A NEEDED SERVICE. To-may-to, To-mah-to, I guess? A recent report showed the fruits of our non-labor, non-money-throwing actions and the results were damning:

- CPS currently has a backlog of 8400 cases, with cases dating back to last summer that still have not been investigated

- We have 11,535 children in state custody

- There is a 20% increase in neglect reports

- There is a 10% increase in the number of kids entering foster care, yet the number of foster homes continue to decline, meaning there are children waiting longer in group homes and crisis shelters.

We’ve got kids suffering and dying thanks to the state’s lack of funding and care, yet these same people are claiming they want to save a few fetuses…for what, exactly?  So you can let these fetuses become babies and give them the chance to experience the joys of behavioral and developmental problems, or for you to kill them slowly through your profound apathy and class warfare against the poor? So you can stand behind their mother in the supermarket line – the mother you coerced into having a child – and judge her when she uses her food stamp card? So you can then cut food stamps funding to put your shaming on paper? So you can feel better about yourself in your Paradise Valley McMansion, because you showed that woman – God blessed you and damned her.  How dare she expect the state to help her after the state promised there’d be services available? How dare she take a penny from you to try and feed that child or take her baby to the doctor for a checkup.  Doesn’t she know you have valets to tip?

She should have been abstinent.  Oh that’s right, we’ve learned that doesn’t really work.  She should have just practiced safe sex.  That’s what someone said in sex ed.  Oh, that’s right, you made Arizona’s abstinence-focused sex ed optional.  You also have laws pending preventing her right to receive birth control.  She should put her child up for adoption…and let those kids in foster care, group homes and crisis shelters wait even longer for a place to go?  And for you to slut-shame her when you find out she’s *gasp* an unmarried woman?  Or *confused gasp* is married and doesn’t want to keep her child?  Well, she could just go and get an abor…

Oh.  Oops…

Portrait of a Whore Pill-Popping Godless Harlot

First of all, I am a human.

Second, I am a woman.

I love, I sympathize, and I like helping people.  I believe in the American Dream.  I really do like pina coladas and getting caught in the rain, although I do not care for that song.  At all.  I cry when I read a sad story about someone I don’t even know.  I have a feeling if you and I sat down for tea and didn’t talk a peep of politics, I’d like you.  I’d even make you some of my famous banana bread.

I am imperfect.  I occasionally act like a know-it-all, but I know I have a lot to learn.

I was a registered Republican for many years, believe it or not.  I dated and lived with a man for nearly eight years before marrying him.  Our nine year anniversary is at the end of May.  We make an odd pair, he and I, but every day is interesting.  I love him, I respect him, and I am proud of him.

I am not a Whore Pill-Popping Godless Harlot, I am you.

Okay, I’m not exactly like you: I did take the whore pills for about 15 years, so I guess that would qualify as whore pill-popping.  Allow me to give a little background on this one:

See, when I was a teenager, I got the worst kind of cramps imaginable.  It felt like someone scraped the insides of my uterus with a box cutter.  It would hurt so bad, it would somehow impact the nerves in my legs, and my thighs would throb with pain.  My skin would go ashen, and I would throw up.  By the time I hit college, it generally got better, but there were days I felt so much pain, I couldn’t leave my bed let alone my room.  It would be easy for me to say this was the sole reason I went on the Pill, and you’d probably agree that is reasonable.  If I said that, I wouldn’t be entirely truthful.

I also went on the pill because I made a choice.  I did not want to have children, and I was well aware of the statistics for children born to young mothers.  Did you know that sons of teen mothers are more likely to go to prison, and daughters are more likely to become teen mothers themselves?  Nearly 80% of teen mothers wind up on welfare.  If I did want children, I’d want them to have the best chance possible.  There are so many unavoidable obstacles in raising a child – don’t you agree we should do our best to avoid those we can?  That’s why a lot of women take the Pill for contraceptive purposes.  These aren’t just teens, or even unmarried women.  Many women on the pill are wives and already loving mothers.  They take the Pill because they understand the financial and emotional realities of being a parent, and want to provide their existing children the best opportunities possible.  The Pill helps a husband and wife plan their family for success.

When I made my decision, I realized I had to take my health, my life, and my well-being into my own hands, rather than in the hands of another person.  I made a responsible choice to take the Pill – the most effective form of birth control this side of sterilization.  When I went on it, I had been with my future husband for a while, and we had a long-term monogamous relationship.  It made sense to take this next step.  I also liked the idea of not being bedridden from pain every month.

See, what worries me about your anti-birth control agenda is you’re shaming a young woman when you should be applauding her.  She is making sensible choices and putting her needs and the needs of her potential future children first.  She knows she’s not in a position or condition to have children and as a result, she’s setting up a better life for her future children down the line, if she chooses to have any.

Here in Arizona, there is a proposed bill that explicitly singles out birth control as an acceptable thing to discriminate against on health plans.  Not only does the bill single out birth control from an unending list of things health plans provide that an employer can have a “religious or moral objection” to (such as the non-procreation-sex-promoting Viagra, or you know, blood transfusions), it exhibits remarkable ignorance on how benefit plans are designed and on the Pill itself.  It is also designed to shame the woman: she would have to not only provide her employer with proof she was taking the Pill for non-contraceptive purposes, the bill allows the employer to charge the employee for all fees incurred by her employer while they confirmed she wasn’t a Whore-Pill Popping Godless Harlot.  Oh, dads aren’t off the hook either – they can look forward to explaining to their employer that their 16 year-old dependant has crippling cramps and is not in fact, a Godless Harlot.  They can also enjoy paying the fees for the interrogation into their family life and determination of moral character.

Is this what we’ve come to?  Shaming women for being responsible about their bodies and their future? Arizona, a state with the 5th highest poverty rates in the country, 2nd highest teen pregnancy rates, and low high school completion rates, thinks it’s a good idea to create thinly veiled social legislation shaming a family for determining what is best for them?  How is this limited government again?

I really want to believe you are someone who means well but are so removed from the every day reality of hard-working young American women and their families, you are simply making ill-informed statements and decisions.  We can work together on that one, because I’d like to think you want to be educated on the reality of your constituents.  My fear is that despite your touting first amendment rights, you actually want to marry church and state as long as it is your religion that marries the two.  If that is the case, I am afraid we cannot come to an agreement.  I just request that you explicitly tell your constituents the truth behind your actions rather than cherry-pick justifications for forcing your religious beliefs on others via public office.

Now that we have come to this, I recognize you would still probably see me as a Whore Pill-Popping Godless Harlot.

But I know I’m still you, I’m just lucky to be on this side of your bubble.