Chasing Those ‘Elitists” Away

Even policies that are adopted after extensive research and thoughtful debate often generate unanticipated consequences, so it shouldn’t be a surprise that a policy based on rejection of relevant evidence and refusal to engage in debate is rapidly degrading access to medical care in Red states.

I’m referring, obviously, to the abortion bans that were enacted (or triggered) immediately after the Dobbs decision overturned Roe v. Wade.

In November, Timothy Noah reported that warnings of an eventual “brain drain” caused by those bans had the timing wrong: it wasn’t “eventual”–it was already occurring. Red state culture wars aren’t only creating medical care “deserts,” they’re driving other college-educated workers— teachers, professors, and more—out as well.

Noah began his article by telling the story of a married same-sex couple, both Ob-Gyns practicing in Oklahoma. They now live in Washington, D.C.–a move that doubled their housing costs and reduced their pay. (It turns out that Red states, which have fewer Ob-Gyns, pay doctors significantly higher wages than states where there are ample practitioners.)

Kate Arnold and Caroline Flint are two bright, energetic, professionally trained, and public-spirited women whom Washington is happy to welcome—they both quickly found jobs—even though it doesn’t particularly need them. The places that need Kate and Caroline are Oklahoma and Mississippi and Idaho and various other conservative states where similar stories are playing out daily. These two fortyish doctors have joined an out-migration of young professionals—accelerated by the culture wars of recent years and pushed to warp speed by Dobbs—that’s known as the Red State Brain Drain.

Abortion restrictions have turbocharged that brain drain, but state laws restricting “everything from academic tenure to transgender health care to the teaching of ‘divisive concepts’ about race” are making these states uncongenial to other knowledge workers.

The number of applications for OB-GYN residencies is down more than 10 percent in states that have banned abortion since Dobbs. Forty-eight teachers in Hernando County, Florida, fed up with “Don’t Say Gay” and other new laws restricting what they can teach, resigned or retired at the end of the last school year. A North Carolina law confining transgender people to bathrooms in accordance with what it said on their birth certificate was projected, before it was repealed, to cost that state $3.76 billion in business investment, including the loss of a planned global operations center for PayPal in Charlotte. A survey of college faculty in four red states (Texas, Florida, Georgia, and North Carolina) about political interference in higher education found a falloff in the number of job candidates for faculty positions, and 67 percent of the respondents said they would not recommend their state to colleagues as a place to work. Indeed, nearly one-third said they were actively considering employment elsewhere.

Here in Indiana, school corporations are experiencing dramatically higher teacher vacancies, and like other Red states, Hoosier rural residents struggle to find medical care–and not just prenatal care. It seems it isn’t just Ob-Gyn practitioners who are abandoning Red states.

Family doctors are also “reassessing” their options–and training availability.

Researchers from the Person-Centered Reproductive Health Program at the University of California San Francisco have found there is reason to be concerned about training for family physicians in ban states as well.

A study published in the November-December issue of the Annals of Family Medicine found that 29% or 201 of 693 accredited family medicine residency programs in the U.S., are in states with abortion bans or significant restrictions on abortion access. The study used publicly available data from the American Medical Association to conduct the analysis, and found 3,930 residents out of 13,541 were in states where abortion is banned or heavily restricted.

For practitioners who remain in those states, the training they are now able to receive deprives them of the skills they need to deal with miscarriages and various problems in pregnancy. Residents in those states no longer have access to comprehensive reproductive health training because they’re not experiencing it within their state context. As the lead researcher explains, “they cannot see abortions, cannot perform them, cannot learn how to care for patients after abortions in the same way they would be able to if they were working in a state where abortion was unrestricted.” As she points out, early pregnancy loss is very common, and the skill set for caring for that and first trimester abortion are very similar.

It bears repeating that the exodus of educated citizens isn’t limited to medical professionals. (MAGA Republicans are actually applauding the exit of the teachers and professors they distrust.) Ironically, the rural folks these MAGA lawmakers disproportionately represent are the ones first experiencing the “unintended consequences” of their misogyny–the absence of teachers and doctors.

It will only get worse…..

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What’s Different This Time? A Lot.

Back in the 60s, Bob Dylan told us that “the times, they are a-changing.” They still are.

I’ve been thinking about about the Supreme Court’s efforts to reverse social change, and the extent to which their targets have become too firmly embedded in the culture to be reversed.

Roe v. Wade was decided in 1973–almost exactly 50 years ago–and we sometimes forget how much American life  has changed since then. I’ve been thinking about what those changes may mean for the radical Court decision to overrule the constitutional right of a woman to control her own reproduction.

Consider just a few…

  •  Roe was argued in a void of sorts.Tthere was virtually no public discussion of women’s experiences with abortion, because it had been illegal in many if not most states, and coming forward to publicly explain and provide context to a decision to terminate a pregnancy would have labeled the woman a criminal. As Dobbs made its way through the judicial system, however, women faced no such restraint, and their stories have illustrated the multiplicity of situations women face, and the intensely personal impacts of their decisions.
  • Columnist Jennifer Rubin has written about one outcome of that public discussion–widespread recognition of the cruelty of forced birth. How do you defend GOP insistence that a 10-year-old girl impregnated by her rapist carry that pregnancy to term? Yet in that very real case, at least two Republican gubernatorial candidates have affirmed their belief that this child should be required to give birth. As Rubin noted, those utterances by GOP candidates weren’t anomalous: Mississippi House Speaker Philip Gunn said that, in his view, a 12-year-old impregnated by incest should be forced to complete her pregnancy. Herschel Walker, the Georgia Republican Senate nominee, insists he wants no exceptions, even to save the woman’s life. Ohio state Rep. Jean Schmidt has called forcing a 13-year-old rape victim to give birth an “opportunity.” Even people with qualms about abortion are likely repulsed by this sick lack of concern for the lives and health of living women.
  • Poll after poll shows that most people who want to restrict abortion don’t want to ban the procedure entirely. Yet–as The New York Times reports– “There are no allowances for victims of rape or incest in Alabama, Arkansas, Florida, Kentucky, Louisiana, Missouri, Oklahoma, Ohio, South Dakota, Tennessee or Texas.” In Idaho, a woman would have to file a police report to obtain an abortion, something virtually impossible for incest victims and others who live in fear of their attackers.”
  • As legal observers have noted–and survey research has confirmed--the U.S. Supreme Court is in the midst of a full-fledged legitimacy crisis, worsened by a steady stream of extreme decisions handed down by the conservative supermajority. Opinions about the Court are far more negative than they were in 1973.
  • The decision in Dobbs, as I’ve previously explained, rests on an analysis that threatens other rights–rights that weren’t recognized fifty years ago (and thus were not “deeply rooted” in Justice Alito’s version of American history) such as same-sex marriage (2015), contraception (1965) and interracial marriage (1967). That threat is widely understood, and it significantly expands the number of Americans who (accurately) view Dobbs as a personal threat.
  • The media environment today is dramatically different from that of 1973. Whatever their negatives–and I routinely post about those negatives–the ubiquity of the Internet and social media means that very few Americans are unaware of either the Court’s decision or its likely impacts. Digital communication has also made it much, much easier to organize political movements and raise dollars–and we are already seeing a strong political response online to what is being described–again, I believe accurately–as a theocratic and profoundly anti-liberty decision.
  • Over the past fifty years women have become considerably more empowered.
  • The percentage of Americans following the dictates of organized religion is at an all-time low.

I’m old, and I remember 1973.

In 1973, my mother–who was considered pretty liberated for her time– was still saying things like “Men won’t buy the cow if they can get the milk for free.” Women who had sex outside of marriage were considered sluts. Women who dared to have both children and careers were  “obviously” bad mothers. Women who weren’t married were pitied and called “old maids.” Women who earned more than their husbands were “castrating.” Women who played sports were unfeminine–and the very few women who wanted to report on sports were barred from male players’ locker rooms…It was 1974 before we could even get our own credit cards.

In short, a lot has changed since 1973. As a recent car commercial puts it, “this isn’t your father’s Oldsmobile.”  

 In 1971, Helen Reddy wrote our anthem..

In 2022, I think women really are going to roar.

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One More Time…

Can you stand one more post about the Supreme Court’s attack on our fundamental freedoms?

To begin with, when he was asked to comment on Alito’s draft decision, “Mayor Pete” knocked it out of the park. You need to watch this.

Then, in a Facebook Post, my lawyer friend David Honig pointed to Alito’s deeply dishonest “history.”

May I take a moment to comment on one aspect of the shocking dishonesty of Alito’s draft abortion opinion? It’s just one, but it highlights the rest.

Alito and his ilk claim to be “originalists,” wise jurists who look to the meaning of words at the time the Constitution was written, in 1789, to glean their meaning.
One fact first. The 9th Amendment says, “The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.” That means there are rights that aren’t written down, rights that people retain. That would include all the rights, according to an “originalist,” that they held in 1789.

So Alito, in his draft decision, spent paragraphs on the sudden explosion of anti-abortion laws in the mid 19th Century, many decades after the writing of the Constitution, to support his position that abortion wasn’t an existing right to be preserved.

Why would he do that? Why would an “originalist” look, not to the time of the writing of the Constitution, but to a century later, for the very core of the originalist argument?

Because he’s a damned liar.

During Colonial times abortion was quite common. The usual method was actually drinking oil of peppermint, or perhpas black root or cedar root, carefully measured to be enough to cause spontaneous abortion, while not threatening the life of the mother. In English colonies, contrary to Alito’s blatant lie that abortion was illegal from the beginning of Common Law, it was legal until “quickening,” when the fetus could be felt moving.

So my point here isn’t to dive headlong into the abortion debate.

My point is to start the discussion with a fact – the opinion coming down is a lie premised on a lie based on lies.

Whatever you think of abortion, this must color what you think of the Court. The United States Supreme Court has been an actor for good and for ill in our nation over time. The same entity that gave us Plessy vs. Ferguson gave us Brown vs. Board of Education.

But today, that Court is giving us lies in favor of a political, and to some extent religious,* opinion, and doing so boldly and without apology. The end justifies the means, even if it means the United States Supreme Court is a filthy den of liars with as much credibility as the three card monty player on a dingy street corner.

As a man who has spent nearly 40 years working for and believing in the rule of law, while recognizing it is imperfect, the indisputable fact that it is now, from its highest temple, not merely imperfect, but dishonest, is crushing.

Finally, in a footnote, David warns us not to underestimate the degree to which the opinion codifies a conservative version of Christianity as our nation’s one true religion and source of law; as he notes, other religions do not hold the same tenets about abortion that Alito privileges in his dishonest diatribe. Jewish law, for example, considers abortion permissible, as do several Christian  denominations. This Court prides itself on what it calls “religious liberty,” but–as David points out–it is really protecting and elevating one version of Christianity, while ignoring the liberties of those who hold different religious, beliefs.

It’s America’s version of Sharia law.

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About That Ciivil War..

Jennifer Rubin’s column on the leak of Alito’s “slash and burn” opinion pretty much summed up where we are: she pointed out that

unelected justices — in some cases appointed by presidents who lacked a popular-vote majority and confirmed by senators who did not represent a majority of the country — would bring to head a battle between a fading racial, religious and political minority and an increasingly diverse, secular country.

Rubin is not the only pundit pointing to the implications of the leaked analysis: this isn’t simply an attack on Roe, or on the right to abortion. This is the culmination of a 50-year effort to reverse the jurisprudence of substantive due process.

As I used to explain to my students, in American law, there are two kinds of due process: procedural and substantive. Procedural due process is–as the name implies–concerned with the fundamental fairness of the legal process. Did an accused person get a fair trial? If the matter was civil, rather than criminal, was the government procedure properly respectful of the individual’s liberty interests and property rights?

Substantive due process, as the name implies, is concern for the substance of a proposed law or government action. Is this an area where government regulation or action is appropriate, or is this a matter that must be left up to the individual to determine?

In other words, in this particular instance, who gets to decide? Government or the individual involved?  The question is not: what should the decision be? The question is: who gets to make the decision?

Ever since the Supreme Court ruled in Griswold v. Connecticut that the legislature had no business deciding whether married couples could use birth control, the doctrine of substantive due process has been applied to limit state intrusion into what the Court has called “intimate decisions.” Those “intimate decisions” include whether and when to have children, who to marry, whether to have consensual sexual relations, and many other choices that contemporary citizens believe are simply none of government’s business.

Alito’s sneering draft sweeps away that distinction. He hands over to state legislatures the authority to invade the most personal and private areas of individual lives, and to decree how those “intimate” lives should be led.

Make no mistake: eviscerating the doctrine of substantive due process, which is what this decision would begin to do, would return the U.S. to a pre-modern version of state authority–to a time when government had the right to impose the religious beliefs of those in power on citizens who do not share those beliefs.

If the leaked draft represents the Court’s ultimate, official decision, it will generate a civil war between the minority of Americans who want to turn back the clock to a time when church and state were joined in authority over citizens’ most personal decisions, and the rest of us.

Why do I characterize what’s coming as “civil war”?

Over the past 50 years, Americans (and for that matter, citizens of other Western democracies) have become accustomed to a legal system that draws a line between permissible and impermissible government actions. We have become accustomed to a culture in which we are entitled to a degree of personal autonomy, to control of the most meaningful, personal aspects of our own lives. In the U.S., polling repeatedly shows that large majorities believe that a woman should be able to control her own body and make her own reproductive decisions, that people of the same sex or different races should have the right to marry, that decisions to use or forgo contraception is none of government’s business.

A minority of paternalistic religious critics have worked  tirelessly to turn back the clock– to return to a time when these decisions were made by the White Christian Males in charge, those Rubin properly characterized as a “fading racial, religious and political minority.” Alito’s draft represents a massive victory for that minority. If it is seen accurately for what it promises–a steady stream of decisions depriving citizens of hard-won rights to live their “intimate” lives as they see fit– I believe furious Americans will launch a civil revolution of massive proportions.

It will be war.

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After Roe

Happy Sunday! I will be delivering the following “sermon” (via Zoom) at the Danville Unitarian-Universalist Church this morning.

_________________

Thank you for asking me back! I’m gratified.

As you all know by this time, my academic background is law—and more specifically, Constitutional law and the Bill of Rights.

The Bill of Rights, the approach to individual liberty that animates it, and the jurisprudence interpreting it  tell us when government must respect declarations of “my body, my choice.” We’ve been hearing that slogan a lot from the people who are refusing to be vaccinated—and ironically, they’re often the very same people who label themselves “pro life” and vigorously oppose a woman’s right to control her own body.

I’m here to tell you that the anti-vaxxers throwing that slogan around have it exactly backwards.

The Founders who crafted our Constitution and Bill of Rights were influenced by the philosophy of the Enlightenment and by what we call the “libertarian construct”—the belief that we humans have an inborn right  to “do our own thing”—to pursue our own interests, form our own beliefs, and make our own life choices and moral judgments, free of government interference– until and unless we are harming the person or property of someone else, and so long as we are willing to grant an equal right to others.

That approach to human rights requires government to refrain from interfering with citizens’ political or religious beliefs, but it also imposes a governmental duty to protect citizens from harm. Philosophers like Hobbes believed that was a major purpose of government—to keep the strong from taking advantage of the weak, to protect citizens from threats both foreign and domestic. We can certainly quibble over the nature and degree of the harms that justify government action, but if government can protect us from drunk drivers and the dangers of passive smoke, then a dangerous and frequently fatal pandemic is clearly a sufficient basis for government rule-making.

A pregnant woman’s decision to terminate her pregnancy, on the other hand, poses no threat of harm to her neighbors.

Despite the rhetoric—the legal issue is not whether abortion is right or wrong, good or bad. The issue is who gets to make that decision, the individuals involved or the government? In our Constitutional system, decisions about the religion you will follow, the books you will read, the political philosophy you’ll embrace, and many others—are all supposed to be left to the individual. What the courts call “intimate” decisions, like those about who you will marry and whether you will procreate, are to be left up to individual citizens, because they are none of  government’s business.

I agree with the people who point out that the so-called “pro-life” movement is really pro-birth. Most of the legislators who identify themselves with the pro-life label are clearly unconcerned about women’s lives, or about feeding, housing and educating babies once they are born. But I wasn’t asked to speak to the considerable dishonesties of the anti-choice position; I was asked to focus on what will happen if—as most of us anticipate—the Supreme Court eviscerates or overrules Roe v. Wade.

Before that, however, we need to look at the actual origins of the anti-abortion movement.

Noted religion scholar Randall Balmer has documented those origins. It wasn’t until 1979—a full six years after the Court decided Roe v, Wade—that evangelical leaders, goaded by Paul Weyrich, seized on abortion as “a rallying-cry to deny President Jimmy Carter a second term.”

Objecting to abortion was seen as “more palatable” than what was actually motivating them, which was protection of the segregated schools they had established following the decision in Brown v. Board of Education. 

According to Balmer (this is a quote),

Both before and for several years after Roe, evangelicals were overwhelmingly indifferent to the subject, which they considered a “Catholic issue.” In 1968, for instance, a symposium sponsored by the Christian Medical Society and Christianity Today, the flagship magazine of evangelicalism, refused to characterize abortion as sinful, citing “individual health, family welfare, and social responsibility” as justifications for ending a pregnancy. In 1971, delegates to the Southern Baptist Convention in St. Louis, Missouri, passed a resolution encouraging “Southern Baptists to work for legislation that will allow the possibility of abortion under such conditions as rape, incest, clear evidence of severe fetal deformity, and carefully ascertained evidence of the likelihood of damage to the emotional, mental, and physical health of the mother.” The convention, hardly a redoubt of liberal values, reaffirmed that position in 1974, one year after Roe, and again in 1976.

End quote.

Let me emphasize that. It was rightwing anger about civil rights laws that actually motivated the “Right to life” movement. The Rightwing was savvy enough to recognize that organizing grassroots evangelicals to defend racial discrimination wouldn’t cut it—that they would need a different issue if they wanted to mobilize evangelical voters on a large scale.

The bottom line is that what motivated the Christian Right’s political activism, including but not limited to its opposition to abortion, was racism and defense of racial segregation.

Let’s give credit where credit is due: that tactic has been incredibly successful. Christian Nationalists now own one of America’s two political parties—and I say that as someone who worked hard for the Republican Party for 35 years. Mitch McConnell has achieved the GOP’s fever dream of taking over the Supreme Court, and much as it pains me to say this, with the imminent demise of Roe, we are looking at what is probably the first of many times this Court will roll back individual liberties.

So what now?

If Roe is overruled—or more likely, effectively neutered– there will certainly be some horrendous consequences. But there may also be some unanticipated positives.
We have all come up against the intransigence of the “one issue” anti-choice voters, the people who disagree with Republicans about virtually everything else, but vote Republican because they are “pro life.” Without Roe, I think many of them will abandon the GOP.
Losing Roe will also make it much more difficult to energize a national movement against birth control, which is actually a target of the most rabid anti-choice activists—a significant number of whom are men who want women barefoot, pregnant and back in the kitchen. Bottom line: anti-choice voters have been a mainstay of the GOP–and at the federal level, at least, they will arguably be considerably less motivated.

If Roe is no longer the law of the land, the issue will revert to the states, and a number of states will opt to protect reproductive choice. Those of us who care about women’s autonomy will need to do some serious fundraising to make it possible for poor women in Red states to travel to places where abortion is legal, and that’s a pain. But even now, with abortion theoretically legal, there are many places in the U.S. where clinics are few and far between; women have to travel long distances, put up with bogus, medically-inaccurate “counseling,” and deal with other barriers to the exercise of what is currently a constitutional right to terminate a pregnancy.

What the de-nationalization of Roe might do–should do–is redirect liberal and pro-choice energies from national to state-level political action. And while there are no guarantees, that could be a huge game-changer.

The current agenda of the Republican Party doesn’t reflect the desires of the American majority–far from it. GOP numbers have been shrinking steadily; some 24% of voters self-identify as Republican. Their electoral success has been due primarily to the 2011 gerrymander, and that was made possible because they controlled a large number of state governments when redistricting took place. More recent GOP vote suppression tactics that have depressed Democratic turnout and disenfranchised Democratic voters have also been facilitated by state-level control. In many states—possibly even Indiana—redirecting voters’ attention to state-level politics could change that.

Without Roe, it is reasonable to predict that the single-issue anti-choice voters that have been a mainstay of the GOP will be less motivated to vote. Pro-choice voters, however, will be newly energized, and polling suggests they significantly outnumber “pro-life” activists. A recent Pew survey has found that 61% of Americans say abortion should be legal in all or most cases, with 27% saying in all cases and another 34% saying in most cases. Only twelve percent of the public says abortion should be illegal in all cases, and only 26% would outlaw it most cases.

In anticipation of the loss of Roe, some states have already seen efforts to protect reproductive rights. A ballot drive has been launched in Michigan. Reproductive Freedom for All’s petition would affirm the right to make pregnancy-related decisions without interference, including about abortion and other reproductive services such as birth control. The groups leading the effort are Planned Parenthood Advocates of Michigan, the Michigan ACLU and an organization called Michigan Voices.

New Jersey has already enshrined abortion rights in state law. Lawmakers in that state bolstered protections for reproductive rights in anticipation of the upcoming U.S. Supreme Court decision, and Gov. Phil Murphy has signed a bill codifying abortion rights into state law. He also signed a second bill that expands insurance coverage for birth control.

Meanwhile, in states like Florida and South Dakota, lawmakers are rushing to impose new restrictions on abortion, anticipating the Court’s acquiescence with much more restrictive rules.

Knowing our Hoosier legislators, I anticipate some pretty dreadful legislation being introduced here. It will require organization and activism in Indiana to derail what the ridiculous pro-gun, anti-vaccine legislators who call themselves “pro life” will try to do.
Indiana will need an enormous uprising—of women, of men who support women, and especially of liberal churches—if we are going to escape replicating the Handmaid’s Tale here in Hoosierland.

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