Fun with Trans-vaginal Probes….

It was only a momentary diversion, but yesterday the Indiana Senate debated a proposed amendment to the offensive bill requiring (among other things) that poor women wanting prescriptions for abortifacants undergo two trans-vaginal probes.

Here’s the relevant language:

“Before giving, selling, dispensing, administering, prescribing, or otherwise providing an erectile dysfunction drug to a man showing symptoms of erectile dysfunction, a physician licensed under IC 25-22.5 shall do the following:

(1) Examine in person the man showing symptoms of erectile dysfunction.

 (2) Conduct a prostate examination or oversee a prostate examination by an individual who is licensed or certified in Indiana and whose scope of practice includes the conducting of a prostate examination.

 (3) Document the following information on the patient’s medical records:

(A) The size of the patient’s prostate.

(B) Whether the patient is showing symptoms of benign prostate problems.

 (C) Whether a benign prostate problem could be contributing to the patient’s erectile dysfunction.

(4) Provide the following information to the man diagnosed with erectile dysfunction:

(A) A copy of the final printed drug label.

(B) The name and telephone number for the physician who prescribed the erectile dysfunction medication and information for follow-up care in the event of an adverse event described in section 2 of this chapter.

(c) A physician licensed under IC 25-22.5 who gives, sells, dispenses, administers, prescribes, or otherwise provides an erectile dysfunction drug to a man shall schedule a follow-up appointment with the man at approximately fourteen (14) days after prescribing the erectile dysfunction drug to:

 (1) conduct a physical exam, including an electrocardiogram, to ensure that the man is healthy enough for continued sexual activity; and assess the degree to which the erectile dysfunction drug has aided in temporarily relieving the symptoms of erectile dysfunction.

(d) The physician described in subsection (c) shall make a reasonable effort to ensure that the patient returns for the follow-up appointment described in subsection (c), including recording in the patient’s medical records:

(1) the date and time of the follow-up appointment;

(2) a brief description of the efforts the physician and the physician’s staff took to ensure the patient’s return; and the name of the individual who performed the efforts.

There’s more, but you get the idea.

Gee–I wonder why this eminently reasonable amendment, motivated solely by concern for the health of the male patient, was voted down.

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Perverse Incentives

I know this chart has probably been floating around the Internet for a while, but I recently came across it, and it really made me think.

The chart lists 30 major corporations, their profits for 2011, the amount of taxes each paid that year, and the amounts they paid lobbyists. A majority of those listed  paid zero taxes on massive profits, thanks to various provisions of the tax code. Many of them actually got money back, again, courtesy of those same arcane provisions. Virtually all of them spent millions of dollars lobbying the federal government; in every case, the amounts spent to influence policy far exceeded the amounts paid in taxes.

What’s wrong with this picture?

There are often sound reasons for using the tax code to encourage behaviors that benefit the greater society. If we want more energy, for example, and we recognize that the costs of exploration and the risk of coming up dry are high, it makes sense to provide a tax incentive to ameliorate that risk. If we want businesses to modernize, to invest in equipment that will make them more productive, offering them the ability to write off those investments over the useful life of the equipment is reasonable. There are many other examples.

The problem comes when the incentives bear no reasonable relationship to the behaviors they are intended to encourage–when those well-compensated lobbyists manage to persuade lawmakers to favor their clients by inserting special provisions in the law or special treatment in the tax code. In the case of oil and gas, for example, companies have not only benefitted from obscenely favorable tax provisions, but have negotiated leases of public lands on terms that have been widely criticized as giveaways.  Here in Indiana, Leucadia–a politically well-connected energy company–will benefit from a 30-year agreement with the state that effectively shields the company’s new coal gasification plant from unfavorable market conditions. 

Leucadia is hardly an isolated example. There’s a reason someone coined the term “crony capitalism.”

The well-connected and powerful have always been able to influence policy. To a certain extent, it’s an unavoidable aspect of human society. But in 21st Century America, we are dangerously close to corrupting the system, eviscerating checks and balances, and institutionalizing a caste system. Recent studies have documented America’s depressing loss of social mobility. Headlines routinely report the self-dealing of Wall Street bankers and financiers, along with the outrageous salaries and bonuses that bear no relationship to their performance. Jack Abramov, the disgraced lobbyist whose name has become synonymous with K-Street and Washington deal-making, is trying to rehabilitate his reputation in interviews sharing “chapter and verse” of influence-peddling in the nation’s capital, and the picture he paints is not pretty.

Local business-people, shop-owners, mom-and-pop enterprises and other middle-class Americans go to work every day, follow the rules, and pay their taxes when due. They don’t have agents working the halls of the legislature to get them special deals. They don’t have hundreds of thousands of dollars to contribute to Super-Pacs, and Citizens United didn’t free them to donate megabucks to buy a Congressman or two.

Shouldn’t the major corporations that are profiting so handsomely also be paying taxes to the country that makes those profits possible? Those companies depend upon workers educated in our public schools. They rely on our courts to enforce their contracts. Their trucks drive on roads paved by American taxpayers. Tax-supported police and fire-fighters protect their warehouses. Why do they prefer to pay millions to lobby for special advantage rather than simply using that money to pay their fair share of the costs to maintain our physical and social infrastructure?

What are the incentives that lead those who are already rich and privileged to seek even more by gaming the system?

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Deficits

I remain convinced that America has two deficits–one fiscal, and one informational. The economic deficit is important, but the deficit in basic understanding of the world we inhabit is arguably the bigger problem.

Case in point, as Steve Benen reports at Maddowblog: debates about the deficit.

As it happens, the budget deficit is getting smaller. In fiscal year 2010, which was President Obama’s first full fiscal year in office, the budget deficit was $1.3 trillion. In fiscal year 2013, the Congressional Budget Office projects the deficit will be $845 billion. That’s a 35 percent decrease in terms of dollars, and it’s even bigger—41 percent—if you are computing the deficit as a share of the GDP. The percentage drop is even bigger—roughly 50 percent—if you start from fiscal year 2009, which overlapped the final year of the Bush presidency and the first year of Obama’s.

The fact that the deficit is declining is not reason to ignore it, of course, but its size and trajectory are important factors–or should be–in any economic analysis, including proposals about appropriate measures to address it.

The problem is, when Bloomberg News commissioned a survey asking Americans whether they believed the budget deficit was growing or shrinking, just six percent answered the question correctly. Ninety-four percent had no clue. (Of the clueless, 62 percent actually thought the deficit was growing.)

So far as I know, Bloomberg didn’t ask a related question, of equal importance. It would be interesting to determine the percentage of Americans who could explain the difference between the deficit and the national debt.

For that matter, it would be interesting to know what percentage of our elected officials could correctly answer either of those questions.

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Words Fail….

A Facebook friend notes that Indiana Sen. Travis Holdman–author of the bill to require insertion of a transvaginal probe into a woman’s womb in order to take a video both before and after she obtains medication causing abortion–is also the author of a bill making it a crime to take a video of a farm or industrial operation.

After all, what happens on your farm or in your factory is private. Your uterus, evidently, is more like a high-school locker–yours to use as long as you follow the rules established by the relevant authorities, but subject to search when those authorities deem necessary.

Furthermore, as “pro-life” lobbyist Sue Swayze pointed out, if you’re pregnant it’s because you previously allowed something else to enter your vagina. And once you’ve allowed something to enter, you have obviously waived any right to decide what else you will admit into those lady-parts. Using her “logic,” once you’ve had sex, you lose the right to pick and choose who or what else visits those regions. You are fair game to be raped.

Aren’t we all proud to be Hoosiers?

Stop whining, women! It’s not like someone is taking pictures of your farm!

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Live and Let Live in a Connected World

Watching the Indiana legislature is sort of like driving past a big wreck….hard not to slow down and stare, even when you know you should look away. The debate over a measure intended to close down “clinics” (aka Planned Parenthood) by requiring them to build mini-hospitals and force patients to undergo two trans-vaginal ultrasounds got me thinking more generally about the nature of law in our contemporary society.

I often tell students that the underlying premise of the Bill of Rights is “live and let live.” There was a libertarian philosophy that heavily influenced our approach to government, a respect for the individual right to personal autonomy, best summed up as: people have a right to live their lives as they see fit, so long as they don’t harm the person or property of a non-consenting other, and so long as they are willing to extend an equal right to self-determination to others.

The seeming simplicity of that construct belies the difficulty Americans have had in applying it. The confounding issue is the nature of harm (and sometimes, as in the so-called “abortion wars,” the definition of “person”).

Smoking is a good example. If you are an adult, the government has no business interfering with your choice to engage in a bad habit. When it became known that passive smoke is harmful, however, the government was justified in stepping in with regulations intended to protect non-smokers from the effects of your bad habit. Seat belts are a more dicey proposition; there is an argument that drivers who fail to buckle up sustain more injuries in accidents, thus driving up the insurance premiums for everyone else, but that’s a pretty speculative harm on which to base a fairly substantial intrusion.

The problem is, as a society, we are becoming more and more connected. Increasingly, the actions of one person affect many others, and if those actions threaten some sort of harm, we look to government to intervene. Worse, the Puritans who have always been a part of American culture remain with us, insistent scolds who want government-as-moral-nanny-state, government that both protects us from ourselves and prevents us from sinning (as they define sin).

We may never agree on where to draw the line. Government surely has the right to tell us we can’t rob the local liquor store, and it just as surely has no right to insist that we eat our broccoli, but between those poles lies great conflict.

We need to become much more thoughtful about the nature of the harms that justify government interventions in our lives. I understand the ongoing debates about abortion–those debates spring from very different beliefs about “personhood.” Seat belts, not so much.

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