Of course, the GOP primary voters to which she and the others were throwing their red meat were highly unlikely to notice.
I don’t know what’s more terrifying: the GOP’s embrace of “look at me, look at me” Donald Trump (who is unable to answer any substantive question with even a modicum of understanding or gravitas, and who endorsed the discredited theory that vaccines cause autism) or Ben Carson (the “scientist” who doesn’t believe in evolution or climate change and hasn’t a clue what government does) or Fiorina’s obvious calculation that she can improve her prospects by being the female face of the war on women, even if that requires playing fast and loose with those pesky things called “facts.”
A couple of years ago, the website Raw Story had a troubling report about a conflict between religion and individual rights that is both accelerating and less visible than the high-profile conflicts (think Kentucky clerk) that make the news.
Why should we care? Why is this is medically problematic?
Recently a woman was traveling across the Midwest when she developed abdominal pain. She and her husband went to the nearest hospital, where she was diagnosed with a potentially fatal ectopic pregnancy. The doctors recommended immediate surgery to remove the fallopian tube containing the misplaced embryo, a procedure that would reduce by half her future chances of conceiving a child. They failed to mention that a simple injection of Methotrexate could solve the problem, leaving her fertility intact. (In fact, at a secular hospital she found on her smart phone, it subsequently did.) Why the omission?
According to Catholic teaching, an injection that destroys an ectopic embryo counts as an abortion; removing the part of a woman’s reproductive system containing the embryo is not.
The article has several other examples of situations, both in the U.S. and abroad, where theological commitments have trumped sound medical practice. In 2012, for example, a 16-year-old Dominican girl was denied cancer treatment for weeks while doctors debated whether chemotherapy would constitute an abortion. She eventually miscarried and later died.
An angry father shared his daughter’s experience:
A Catholic doctor at a Catholic hospital went against my daughter’s wishes and signed consent to have a hysterectomy because of severe endometriosis. One ovary had already exploded. My daughter had never intended or desired children nor was she in a suitable situation to have a child. She was single, in her late 20s. When she awoke from surgery she learned that the doctor had over-ridden her wishes and consent in an attempt to save her fertility. The operation was botched, leaving my daughter on permanent disability, in pain, with even more health problems than she’d had before.
When we go into a hospital, most of us expect our doctors and other healthcare providers to honor our expressed treatment directives. Many of us have Living Wills or other healthcare documents that reflect our own considered, deeply-held beliefs.
When a patient’s wishes are disregarded because they are inconsistent with someone else’s religion, that’s an unjustified denial of religious liberty–a denial that is particularly egregious because the “bargaining power” of the parties is so unequal.
In a diverse society committed to civic equality, hospitals dependent upon government funds (Medicare, Medicaid, etc.) should be required to respect the decisions of adult, competent patients.
And medical practices consistent with accepted standards of care should never take a back seat to doctrine.
America has long had a “bandwagon” approach to policy; our penchant for simple solutions leads us into all manner of fads: the New Public Management, outsourcing and privatization, untested education “reforms,” and others.
For the past couple of decades, the answer to virtually every management challenge has been “privatization.” As I’ve indicated previously, there are times/situations where contracting out (which is what our version of “privatization” really is) makes sense, but thanks to our penchant for jumping on the bandwagon, government agencies have employed this method of delivering public services without the sort of rigorous analysis–or often any analysis–that should accompany decisions to turn tax supported programs over to private vendors.
Lately, however, citizens and public officials are beginning to recognize the downside of inappropriate contracting. A newspaper in North Carolina recently editorialized on the results of that state’s privatization of mental health services:
[A]ccess to services was confusing; services became unavailable to clients, and the number of people with mental illness who ended up in emergency rooms and jails significantly increased.
According to the Orange County Register, privatization’s consequences for Costa Mesa, California, were similar.
When the Costa Mesa City Council attempted to privatize large portions of municipal operations, it did so without conducting any analysis about whether its actions would save money – or whether it would cost more, which it did….
Southern California has provided fertile ground for other failed outsourcing initiatives. In the 1990s, Seal Beach thought it was on the cutting edge of local government privatization. The beach community managed to save about $30,000 in its first year of privatized jail services, and local officials were quick to pat themselves on the back for what they thought was really smart governing.
But what privatization delivered was two decades of lawsuits, two in-custody deaths, improper responses to medical emergencies, inadequately trained staff and a steady stream of violations uncovered by state regulators and health officials. Privatization of Seal Beach’s jail has resulted in so many serious problems that the city is now spending a reported $1.2 million just to start the process of bringing jail services back in-house.
The county of Orange’s most recent information-technology debacle provides yet another cautionary tale. After the county entered into a staggering $132 million contract with Xerox to upgrade phone and computer networks, performance by Xerox was so poor that the Board of Supervisors appears to be poised to sue over the broken promises and cost increases.
The article cites other examples, and notes that enthusiasm for contracting may finally be on the wane:
Across the country, governments of all sizes are rethinking the outsourcing of services as they discover its many unwelcome consequences, including lack of transparency, cost overruns, lack of competition for contracted services, and glaring weaknesses in accountability and oversight.
It’s hard to argue with her conclusion:
Services provided by public entities should be judged by what is best for the health, well-being, civil liberty and security of the public. Inserting a profit motive is an open invitation to graft and corruption and, more often than not, results in services that cost more and serve the public less.
There are economic consequences to most policy choices. That’s just as true of so-called “social” policies as it is of decisions to build roads or wage wars.
When religion is driving policy, economic repercussions tend to get ignored. So it was interesting to read Two Sides, Same Coin–a report by the University of California at San Francisco on the economics of abortion policy. Researchers followed women who were turned away–who wanted to terminate a pregnancy but were unable to do so. As the report noted,
Access to comprehensive reproductive health care, including abortion, is essential to women’s economic security. Yet many progressive politicians and advocates often ignore this important connection. This report delineates the many links between these topics—including that family planning increases women’s economic opportunity, lack of supports for pregnant and parenting women interferes with their economic stability, and there is an unfulfilled potential for reproductive health care to help create economic security—and the need to integrate both issues into any proactive policy agenda to achieve equality for women.
For a country where politicians are rather eager to promote family values, America has few policies that make it easy to have children. On top of high health-care costs and limited employer benefits, the country has little in the way of affordable child-care. It is unsurprising, then, that three-quarters of women who choose to have an abortion say it is because they cannot afford to have a child. Some will argue that they can always put their child up for adoption. Others will add that marriage can be a fine antidote to poverty (45% of all women who seek abortion are unmarried). These are fair points. But perhaps instead of closing down abortion clinics, lawmakers might consider more ways to give these women better choices.
who concluded that legalization of abortion in the 1970s explained a substantial part of the crime decline in the 1990s. (Evidently, children born into households where they are wanted, and where the adults are financially and emotionally capable of raising them, commit fewer crimes.)
None of this is an argument for making moral choices on the basis of economic consequences. But opinions on the morality of abortion are hotly contested.
It’s interesting to note that people who believe that the moral position requires respect for personal autonomy and reproductive choice tend to give generously to organizations like Planned Parenthood. On the other hand, the lawmakers most willing to use government’s power to impose their personal moral/religious beliefs on women who may not share them have shown little interest in ensuring the well-being of children once they are born.
The economic consequences of that disinterest fall on the rest of us.
I’m sharing an unusually long quotation, also shared by Political Animal, from one Dave Roberts (a writer with whom I am unfamiliar), because it has so much explanatory power.
Roberts traces the history behind America’s current political polarization, and he’s pretty convincing:
In postwar, mid-20th-century America, there was a period of substantial bipartisanship, and it powerfully shaped the way political and economic elites think about US politics. The popular picture of how politics works — reaching across the aisle, twisting arms, building coalitions behind common-sense policy — has clung to America’s self-conception long after the underlying structural features that enabled bipartisanship fundamentally shifted.
What enabled bipartisanship was, to simplify matters, the existence of socially liberal Republicans in the Northeast and Democrats in the South who were fiscally conservative and virulently racist. Ideologically heterogeneous parties meant that transactional, cross-party coalitions were relatively easy to come by.
Over the past several decades, the parties have polarized, i.e., sorted themselves ideologically (that’s what the GOP’s “Southern strategy” was about). Racist conservative Democrats became Republicans and social liberals became Democrats. The process has now all but completed: The rightmost national Democrat is now to the left of the leftmost national Republican.
Crucially, however, the process of polarization has been asymmetrical. While almost all liberals have become Democrats and almost all conservatives have become Republicans, far more Republicans self-identify as conservative than Democrats do as liberal, and consequently the GOP has moved much further right than the Democratic Party has left.
Part of the explanation is that there has been a demographic sorting as well. The demographics that tend Democrat — minorities, single women, young people, LGBTQ folks, academics, and artists — cluster in the “urban archipelago” of America’s cities. Meanwhile, the Republican Party has increasingly become the voice of white people who live around other white people in rural and suburban areas, where they have been radicalized by burgeoning right-wing media and a network of ideologically conservative think tanks and lobbying groups.
It is not surprising that small-government ideology appeals to people who view government as a mechanism whereby special interest groups make claims on their resources, values, and privileges. Conservative whites, freaked out by hippies in the ’60s, blacks in the ’70s, communists in the ’80s, Clintons in the ’90s, Muslims in the ’00s, and Obama more recently, are now more or less permanently freaked out, gripped by a sense of “aggrieved entitlement,” convinced that they are “losing their country.” (If only someone would come along and promise to make it great again!)
As the GOP has grown more demographically and ideologically homogeneous, it has become, in the memorable words of congressional scholars Thomas Mann and Norm Ornstein, “a resurgent outlier: ideologically extreme; contemptuous of the inherited social and economic policy regime; scornful of compromise; un-persuaded by conventional understanding of facts, evidence, and science; and dismissive of the legitimacy of its political opposition.”
When I was a new lawyer, a more seasoned colleague told me “There’s actually only one legal question: what do we do?”
That question is equally applicable to politics. But for those of us who miss the previously sane and respectable Grand Old Party–and the balance it provided to the political system–the answer is far more elusive.
