Health Care Policy

Governor Perry signs pro-life pledge

The move to sign the Susan B. Anthony List’s pledge is completely in line with the Governor’s actions while in office here in Texas. He has advocated for parental consent, for informed consent, and for the prenatal protection law we passed in 2005.

This year, he put the “ultrasound bill” on the fast track by naming it as an emergency bill. We also moved our family planning money to hospitals and docs who provide comprehensive, continuing care rather tna limiting services to “family planning,” and ensured that local hospital and health districts that wish to receive State funds will cease performing elective abortions. (The Travis County Health Department paid for 750 elective abortions last year, but recently voted to immediately comply with the new law, surprising some.)

FOR IMMEDIATE RELEASE:August 24, 2011
Contact: Ciara Matthews, (202) 630-7067

Perry Becomes Seventh Candidate to Sign SBA List Presidential Pledge

WASHINGTON, D.C.  – The Susan B. Anthony List announced today that Republican Presidential candidate Governor Rick Perry has signed its Pro-Life Presidential Leadership Pledge, making him the seventh Republican candidate for President to do so.

“Governor Perry has been a long-time friend of, and leader for, the pro-life community,” said SBA List President Marjorie Dannenfelser. “His signature on our pledge is more than welcome and we applaud him for his commitment to continue to fight for women and unborn children.”

The Pro-Life Presidential Leadership Pledge developed by the SBA List is what has been defined as a “minimum standard” of what is expected of the next pro-life President. The Pledge contains four principles to which its signers are expected to adhere:

FIRST, to nominate to the U.S. federal bench judges who are committed to restraint and applying the original meaning of the Constitution, not legislating from the bench;

SECOND, to select only pro-life appointees for relevant Cabinet and Executive Branch positions, in particular the head of National Institutes of Health, the Department of Justice, and the Department of Health & Human Services;

THIRD, to advance pro-life legislation to permanently end all taxpayer funding of abortion in all domestic and international spending programs, and defund Planned Parenthood and all other contractors and recipients of federal funds with affiliates that perform or fund abortions;

FOURTH, advance and sign into law a Pain-Capable Unborn Child Protection Act to protect unborn children who are capable of feeling pain from abortion.

Politico.com is confused by the fact that Governor Perry endorsed Rudy Guiliani in 2008. Mayor Guiliani had promised to only nominate strict constructionist judges.

By ALEXANDER BURNS | 8/24/11 10:16 AM EDT Updated: 8/24/11 10:39 AM EDT

Read more: http://www.politico.com/news/stories/0811/61982.html#ixzz1VxxeQKTX

No Deaths Due to Gardasil

I’m still getting emails from people warning about deaths due to Gardasil and there are repetitive false reports in the “lame-stream media” and by bloggers repeating the same lies.

One email and an “alert” on one of the big forums has no link to real data, but does link to a law firm in Florida that is looking for cases to use in a suit against Merck. Unfortunately for them, the trial lawyers link to the CDC web page showing that they have no case.

In contrast, the reports given by the FDA and CDC show no connection to deaths and no connection to any serious reactions. All of the reported events happen at the same rate that they do in the general population, whether or not the people were vaccinated.

From the CDC page linked by that trial lawyer:

As of June 22, 2011 there have been a total 68 VAERS reports of death among those who have received Gardasil® . There were 54 reports among females, 3 were among males, and 11 were reports of unknown gender. Thirty two of the total death reports have been confirmed and 36 remain unconfirmed due to no identifiable patient information in the report such as a name and contact information to confirm the report. A death report is confirmed (verified) after a medical doctor reviews the report and any associated records. In the 32 reports confirmed, there was no unusual pattern or clustering to the deaths that would suggest that they were caused by the vaccine and some reports indicated a cause of death unrelated to vaccination.

From the FDA page:

Concerns have been raised about reports of deaths occurring in individuals after receiving Gardasil.  As of December 31, 2008, 32 deaths had been reported to VAERS.  There was not a common pattern to the deaths that would suggest they were caused by the vaccine.  In the majority of cases with available autopsy, death certificate and medical records, the cause of death was explained by factors other than the vaccine.

There have been about 40 Million doses given in the US, closer to 60 million in the world, since 2001. There is no connection to deaths due to the vaccine. The Vaccine Adverse Events Reports confirm a death rate less than that of the general population (around 60/100,000).

There are multiple post-marketing studies going on all over the world, since at least 2001 and yet there are no “red flags.”

I’ve covered this much more extensively elsewhere on WingRight, along with some of the examples of the non-confirmed reports and instructions as to how to look up the VAERS reports for yourself.

Rick Perry’s Pro-life Record in Texas

The various pro-life groups all over Texas have affirmed the Governor’s record of pro-life advocacy. Read the article at LifeNews.com for concrete examples and testimonies from Texas Alliance for Life, Texas Right to Life, and many more.

The long record of pro-life accomplishments will serve the Texas governor well should he decide to seek the Republican nomination. He would face off against other candidates who are equally committed to pro-life values, but his pro-life track record will give him a chance to gain positive support from voters in places like Iowa and South Carolina. Should he ultimately become the nominee, Perry, like other Republicans seeking the nomination, would present a clear pro-life versus pro-abortion contrast with Obama that would rally the majority of Americans who are pro-life to his side.

Rick Perry Becomes Latest Pro-Life Republican 2012 Hopeful | LifeNews.com

Pro-life groups around Texas all confirm the strong pro-life record of Governor Perry. Read the article for the examples of his actions in the name of protecting innocent life at all stages and ages.

The long record of pro-life accomplishments will serve the Texas governor well should he decide to seek the Republican nomination. He would face off against other candidates who are equally committed to pro-life values, but his pro-life track record will give him a chance to gain positive support from voters in places like Iowa and South Carolina. Should he ultimately become the nominee, Perry, like other Republicans seeking the nomination, would present a clear pro-life versus pro-abortion contrast with Obama that would rally the majority of Americans who are pro-life to his side.

via Rick Perry Becomes Latest Pro-Life Republican 2012 Hopeful | LifeNews.com.

Doctors wary of Perry’s stem cell treatment – The Boston Globe

Yeah, Daley destroys human embryos to harvest stem cells, even made a few designer embryos with the intention of destroying them. The International Stem Cell Research group fawned all over the faux Korean cloner.

These people to be have no business talking about ethics or “wise decisions.”

[S]ome scientists are questioning the safety and wisdom of Perry’s treatment, especially because it was not part of a clinical trial in which unproven therapies are tested in a way that helps protect patients and advances medical knowledge.

Perry “exercised poor judgment’’ to try it, said Dr. George Q. Daley of Children’s Hospital Boston and the Harvard Stem Cell Institute. “As a highly influential person of power, Perry’s actions have the unfortunate potential to push desperate patients into the clinics of quacks’’ who are selling unproven treatments “for everything from Alzheimer’s to autism.’’

Daley is past president of the International Society for Stem Cell Research, a group of 3,000 scientists and others in the field. He favors stem cell research. But of Perry’s treatment he said: “I would never in a million years accept for one of my family members to undergo this.’’

via Doctors wary of Perry’s stem cell treatment – The Boston Globe.

Wonderful news on Conscience from Arizona

Without a conscience, what is a doctor, nurse, or pharmacist except a technician willing to follow the whims of law?

(Again, this is not sound-bite material!)  I received an e-mail from the American Defense Fund concerning the lawsuit against the State of Arizona by Planned Parenthood over a law to protect those of us in medicine who have consciences.

The ruling overturned a two year old injunction that prevented quite a few limitations placed on abortion in the State, including informed consent, parental consent, and the requirement that doctors, not nurses, perform abortions as well as the conscience issue.

Over the last decade, there have been several deliberate attacks against the right of medical professionals to obey our consciences and to refuse to provide services that we do not believe are “medical care.” I’ve tried to cover them at LifeEthics.org., even though I had a hard time keeping my promise to avoid politics and religion on that blog.

The articles at LifeEthics.org include this one from the American Journal of Bioethics, this one by a lawyer writing in the New England Journal of Medicine, and this one from this year about the Obama Administration’s refusal to protect the conscience.

Here’s the update, dated August 11, 2011:

A litigation update:

The Arizona Court of Appeals issued an opinion today on conscience rights.

In a case litigated partially by the State, partially by the Speaker of the Arizona House, and partially by ADF, BDF, and CAP on behalf of a variety of pro-life medical groups (Ave Maria Pharmacy, Christian Medical and Dental Associations, Christian Pharmacists Fellowship International, American Association of Pro-Life Obstetricians and Gynecologists, and Catholic Medical Association) . . . . . . the Court upheld Arizona’s state conscience protection statute Ariz. Rev. Stat. § 36-2154, against a challenge by Planned Parenthood of Arizona. The Court also upheld the right of the aforementioned pro-life groups to intervene in the case to defend the conscience law.

Here is the opinion,http://azcourts.gov/Portals/89/opinionfiles/CV/CV090748.pdf and below I provide some highlights.

The conscience statute protects hospitals, physicians, and staff from being involved in abortion, and all of the above plus pharmacists and pharmacy employees from being involved in any abortive or anti-implantive drug or device. The Court of Appeals’ decision reverses an injunction that Planned Parenthood had obtained below in the Arizona trial court, which had enjoined not only conscience protections but a bunch of pro-life provisions of Arizona law (including laws about parental involvement in abortion, prohibiting non-doctors from performing them, and other pro-life measures).

PP threw the kitchen sink of anti-conscience arguments against this conscience statute, and the Court specifically addresses PP’s arguments on pages 32-37, saying some very helpful things against some of the popular “access” arguments we all hear against conscience rights. (The Court does unfortunately characterize the conscience statute as “refusal provisions.”)

Among the arguments the court smacked down are the following:

• The Court rejected PP’s argument that conscience protections violate a woman’s right to access abortion. The Court gave several reasons. First, in a previous case the Court had upheld an Arizona law prohibiting abortions at state university hospitals, saying “Even as plaintiff does not have an absolute right to an abortion on demand, she also does not have the right to select any public facility she chooses for an abortion.” By extension, therefore, the Court held that since “Even a state actor can refuse to facilitate an abortion,” it is even more true that private actors can refuse.
• In addition, the Court declared that the conscience law protecting private individuals and institutions can’t possibly violate a woman’s constitutional rights because “any reproductive rights that might exist under [the Arizona Constitution] can only be asserted against governmental acts, not the decisions of private individuals. . . . Therefore a woman’s right to an abortion or to contraception does not compel a private person or entity to facilitate either.”
• The Court further noted: “In its arguments below, PPAZ also contended the statutes would ‘thwart women’s ability to chart their own medical course.’ As explained above, whatever right a woman may have to ‘chart her own medical course,’ it cannot compel a health-care provider to provide her chosen care.”
• The Court rejected PP’s argument that the conscience law “allows medical professionals to abandon their patients, even in an emergency.” The Court pointed out that because the Arizona Constitution protects common law medical malpractice actions from being abrogated by statute, the conscience statute therefore does prevent a woman from suing any physician for denying her the standard of care, whatever that might be. A woman’s ability to impose malpractice liability therefore defeats the argument that the conscience statute allows abandonment in an emergency.
• The Court rejected PP’s argument that the conscience statute “justif[es] practices inconsistent with the peace and safety of the state.”
• First, “no authority suggests that permitting individuals to choose whether to facilitate abortions places the peace and safety of the state at risk.”
• Second, the Arizona Constitution says that constitutional protections for conscience do not protect violations of peace and safety, but it does not prohibit the legislature from protecting conscience even more than the constitution happens to do.
• Third, the “peace and safety” limitation is merely a limit on how far judges are supposed to interpret the constitutional protections; it does not allow private citizens to sue to contend that too much conscience is being protected.
• Notably, the Court observed that the conscience statute may well protect employees of Planned Parenthood who object to involvement in abortion, but it went on to reject PP’s above arguments anyway.

Presumably PP will appeal this case to the Arizona Supreme Court, but the Court has discretionary review so it could simply deny the petition. In any event, the case will go back down to the trial court for final proceedings (to the same judge who issued the injunction), because this was just a “preliminary” decision.

Ultrasound law due September 1

The Texas Tribune, as part of its “31 Days, 31 Ways”  series of articles has a video interview with Dr. David Spear, an Austin abortionist and director of Planned Parenthood, concerning the soon to be enforced law requiring the doctor to meet with women before an abortion, and give her the information available from her pre-abortion ultrasound.

“The law is currently being challenged in federal court. U.S. District Judge Sam Sparks has said he plans to rule on the case by September. The New York-based Center for Reproductive Rights filed the suit in June, before requesting an injunction to prevent the law from going into effect on Sept. 1. In the suit, Texas Medical Providers Performing Abortion Services v. Department of State Health Services Commissioner David Lakey, the group argues that the law violates the equal protection clause by “subjecting [women] to paternalistic ‘protections’ not imposed on men” and the First Amendment rights of doctors by “forcing physicians to deliver politically-motivated communications” to their patients.”

Dr. Spear confirms that the ultrasound is standard of care as we heard that over and over in testimony at the Lege. The woman pays for the Ultrasound, already. It is her medical information.

No responsible doctor would introduce an instrument into the uterus without an ultrasound these days. It’s common practice to do this a couple of days before the abortion, although Dr. Spears implies that it is done the same day as the procedure. If it is true that it’s done the same day, is that before or after sedation and/or is the woman given the chance to evaluate her medical information while clothed, eye to eye with the doctor, or is she in a gown, feet up in the stirrups?

No one complains about other informed consent laws. There’s already law describing the informed consent for electric shock therapy, radiation therapy, sterilization and hysterectomy. Hysterectomy was the first such law. These (and the mandatory waiting period before Medicaid will pay for sterilization) came about because of a patronizing “doctor knows best” attitude of the past.

There’s nothing either political or religions about informing women about the ultrasound. There’s certainly noting political or religious about expecting the doctor to give informed consent – can you imagine if this conversation were about the heart catheterization and the heart ultrasound (echo-cardiogram)?

Part of the law includes the requirement to give information about the father;s responsibilities and about aide that is available locally for pregnancy and after the birth. These lists have been printed by the State and paid for by licensing fees for abortion clinics since 2005.

Common State Abortion Restrictions Spark Mixed Reviews

Why would anyone want doctors to be forced to perform elective, interventional procedures that they find morally wrong?

Gallup typically finds few differences between men’s and women’s attitudes about the legality of abortion in general. Consistent with that, the new poll shows relatively minor gender differences in views about the seven specific restrictions tested.

Partisan differences are much greater, although majorities of Democrats as well as most Republicans favor informed consent, parental consent, 24-hour waiting periods, and a ban on “partial birth abortion.”

By contrast, Republicans and Democrats are on opposite sides when it comes to opt-out provisions and withholding federal funds from abortion providers.

via Common State Abortion Restrictions Spark Mixed Reviews.

Doggett layoff author opposes Perry

Big surprise: Lloyd Doggett doesn’t like Perry. I guess he’s given up on winning his primary against one of the Castro twins (I can’t tell them apart), so he’s going to spend time campaigning against the Governor who wouldn’t lie for money.

ABC.news has a blog entry explaining the details, here.

Doggett’s the creator of the Doggett layoff, causing school districts all over the Nation to layoff teachers. Doggett was the author of the amendment to part of a stimulus bill, refusing money to Texas education by setting specific, individual requirements for Texas that no other State must meet and that go against Texas’ Constitution. Doggett repeatedly claimed at the time that claiming the Governor could lie and violate the State Constitution if he wanted the money badly enough.Doggett kept repeating that the requirements weren’t “unConstitutional.”

Last year, I met with this man with a group of doctors about graduate medical education, identifying as a doctor interested in primary care, not as a Republican. He assumed he could talk freely to us and literally shook with fury when he criticized Conservatives and the Tea Party. Claims Republicans don’t think for ourselves and only listen to Fox news and Limbaugh.

And yet, here I am reading ABC.news and there he is spouting his hate for conservatives. Well, he won’t be unopposed this election – and he’ll have a great panel of Conservatives vying to run against him on the Republican ticket, too.

Rick Perry is against embryonic stem cell research, but he wants Texas to be center of stem cell advances | Texas on the Potomac | a Chron.com blog

The Governor has always opposed unethical destructive stem cell research, but Representative Hardcastle changed his mind on embryonic stem cells and cloning this year.

Hardcastle said the governor’s office didn’t ask him to carry it — as the only member of the Legislature with MS, he said, it’s been on his mind for “a long time” — but one of the governor’s staffers did advise him on it. Somewhat involved, Hardcastle said, was Jones, who has already removed some of Hardcastle’s stem cells to prepare them for re-injection.

A spokeswoman with the Health and Human Services Commission said the agency is in the very early stages of considering whether to create the stem cell bank. A few weeks ago, the agency received a letter from Houston Reps. Beverly Woolley, a Republican, and Senfronia Thompson, a Democrat, expressing their “serious concern” with the measure, for fear it might hinder the work of public and private scientists.

Meanwhile, Texas Medical Board spokeswoman Leigh Hopper said the regulatory agency held a stem cell stakeholder meeting last week — “at the governor’s behest, via Dr. Jones” — to start dialogue about adult stem cell treatments in Texas. The question? If Americans are — like Jones — increasingly flying all over the world to get promising stem cell treatments, shouldn’t Texas be a scientific and economic center for it?

via Rick Perry is against embryonic stem cell research, but he wants Texas to be center of stem cell advances | Texas on the Potomac | a Chron.com blog.

Dose of Reason: Perry and Gardasil

Bear with me, this isn’t a “sound bite” subject.

(Edit 8/23/11: The opt out is for 2 years, not 1. BBN )

The Human Papilloma Virus is an infection, and should not be a moral issue. In contrast, the vaccine against four strains of the virus, Gardasil, has become a political issue, even though the Federal Food and Drug Administration (FDA) now recommends it for all boys and girls.

Governor Rick Perry has been criticized for his February, 2007 Executive Order that made the vaccine mandatory for girls before entering the 6^th grade. Very little is said about the part of the EO that affirmed the right of and facilitated parents who wish to “opt out” of not only Gardasil, but other vaccines as well.

We expect the Governor to direct the people that he appoints, right?  The Governor is responsible for management of the Executive Branch, including the Department of State Health Services. He appoints the head of the DSHS, who supervises the people who decide which vaccines will be mandatory. Texas’ Legislature modified Chapter 38.001 of the Texas Education Code over the years to mandate certain vaccines and allow the DSHS to add other mandated vaccines without Legislative oversight.  Just before the Gardasil controversy, the Department had mandated Chicken Pox and Hepatitis A, which are both manufactured using cultures of human fetal tissue obtained at an abortion.

The Governor’s Executive Order (RP 65) that caused all the controversy also ordered the director of DSHS to make it easier for parents to opt out of vaccines. The Legislature had changed the law from “opt in” to a requirement to “opt out” once for all the school years. Next, they changed to a two year limit on the opt out, and then in 2005, the Legislature restricted the period to one year and required a new State form bearing a “seal.” Parents had to go to Austin or start early in the summer. There were bureaucrats who maintained that the only way to get the form with the seal was to go to Austin, find the right office and make the request in person.  Perry used his EO to tell the Director of DSHS to make the request (and the seal) available on-line, making it easier to “opt out.”

In fact, the reason for the Executive Order was to speed up private insurance coverage and to make it easier for parents to exercise their right to opt out.

The Federal government doesn’t have the authority to mandate vaccines in the States.  Not yet, not exactly. However, thirty days after the National Advisory Committee on Immunization Practices (ACIP) recommended the vaccine, Texas was required by Federal law to buy and distribute the vaccine in the “Vaccines for Children” program.  The program provides vaccines without cost to uninsured children up to age 21, those who are insured by Medicaid, and those whose private insurance does not pay for vaccines at all. In effect, the only families who have to pay for Gardasil – for whom the State of Texas will not pay, anyway, under Federal law – are those whose private insurance will only pay for mandated vaccines.

Gardasil is manufactured the same way that insulin for diabetics is made these days: using recombinant DNA. In this case, common bakers’ yeast makes the proteins that cause the immune response. Gardasil had been thoroughly studied even in 2007, and is not only included in the Vaccines for Children program, it is the most-requested vaccine for girls. We are even seeing cross-protection from other strains.  It has recently been recommended for boys. The recommended time to give the HPV vaccine is at 11 or 12 years old, when children are scheduled to receive other shots (tetanus and MMR boosters) and before they were likely to be infected.

The only reason that we do “Pap smears” (the papanicolaou test) is to look for changes in the cell nuclear DNA of the cervix, the opening to the uterus or womb. Over the last 15 years, we have found that 99.7% of these changes are due to HPV infections. In the US, 70% of cervical cancers are caused by HPV 16 and 18. (50% by HPV 16.) These are the two types of HPV that result in the most damage and cost, due to repeat paps and the subsequent biopsies, freezing, “LEEP,” or other treatments in which the surface of the cervix (the opening to the uterus or womb) is burned off to remove cancerous and pre-cancerous cells. These treatments lead to infertility and premature births.

Because 15% of girls begin sex before age 15 and half of girls who have sex before 20 say their first time was involuntary, the first trial of Gardasil involved 1200 girls between the ages of 9 and 15. The girls 15 and under had a better response to the vaccine than the older girls and women 16 and above. The researchers compared blood levels of antibodies. The research ethics committee ensured that no paps or pelvics were done on the young girls. (Every one of the young women under the age of 21 when I sent them for colposcopy for cancerous changes had been raped before they were 15 years old.)

The reports of deaths and injuries from Gardasil are poorly documented. The great majority of the adverse effects in the reports include pain, redness, and tingling at the injection site and fainting and headaches. People often faint and complain of headaches after seeing a needle, even without being stuck. It looks awful sometimes, like a seizure. The FDA has ruled that none of the deaths that have been confirmed were caused by the vaccine. In addition, this article from the Canadian Medical Association Journal contains a table showing the numbers of serious events and the numbers of deaths in several studies on the use of the HPV vaccine.

Remember your statistics classes. With 33 million doses, there are bound to be deaths that coincide with the timing of the vaccine use. The teen death rate from all causes is 62 per 100,000 across the US. Most of those are boys, but still: In 10 million girls, 30 deaths are not outside the rate for the age group. They are tragic, but consistent with life on this Earth.

More likely the girls who had severe reactions or death had other risk factors, due to the population presenting to clinics giving the vaccine: those who present with worries about STD’s, the newly sexually active and those entering college. The records show that many were given new scripts at the same visit for birth control pills and other vaccines and medicines, according to the analyses in the medical literature. (Also, remember the silicon, SSRI, and the general vaccine scares that have been blown out of proportion through the years and later proven to be untrue.)

The reports on the possible vaccine-related deaths are available for viewing at” the “Vaccine Adverse Event Report Site” (VAERS),(drop down to the table at the middle of the Page, option #3) using “HPV4” (This is the Merck vaccine), at Option#4, check “YES” at “life threatening” (or you could check “death”) and (top of page)”Sort by submission date.”

Here’s a few examples:

    Administered by: Unknown  Purchased by: Unknown Symptoms: Adverse reaction Write-up: It was reported from an article, published on 29-JUN-2009 that there were “hundreds” of life-threatening reactions said to be associated with GARDASIL. This is one of several reports received from the same source. Attempts are being made to obtain additional identifying information to distinguish the individual patients mentioned in this report. Additional information will be provided if available.

Another:

FINAL DX: Hodgkins lymphoma, nodular sclerosing, stage IIA. Records reveal patient was pale & had firm left clavicular lymph node. Excisional biopsy done 7/23/09 revealed diagnosis. Tx w/chemotherapy & possibly radiation tx when chemo completed.

And another:

    Write-up: Vaccine was administered, patient became dizzy 30 seconds after shot. Patient was pale, diaphoretic & nauseous. Symptoms lasted about 45 minutes. BP dropped to 90/50 & pulse to 50/min. 8/20/09 PCP note received DOS 8/4/09. After shots pt became naseated, pale, diaphoretic, dizzy and had difficulty breathing. BP dropped to 90/50 and pulse into the 50’s. Sx lasted ~45 minutes with return to baseline. Vax record states pt “passed out.”

New Right to Government Funding?

“Americans will be thrilled to know that the courts have invented a new “right” to government money.”

These are points that need to be clarified: How much control do the people of the State have when money passes from the taxpayers to the Feds, and then back through the State’s Treasury under the State Legislature and does any entity have a “right” to tax funds? In other words (borrowed from something I read somewhere from Justice Rehnquist) are the courts to decide the big issues and only allow the Legislatures to decide small, inconsequential issues?

Today’s Washington Update, an e-mail newsletter from Tony Perkins and the Family Research Council, reviews a recent legal ruling in a Kansas Court.

The Judge indulged in political speech, himself (“The purpose of the statute was to single out, punish, and exclude Planned Parenthood.”) but he may have a point that Kansas Legislators might not have legal standing to limit the use of Federal Title X (“Title Ten”) family planning funds that come out of Medicaid appropriations. This is a point that needs to be clarified: How much control do the people of the State have when money passes from the taxpayers to the Feds, and then back through the State’s Treasury under the State Legislature?

Here in Texas, there haven’t been any challenges against our new laws that will eventually limit tax payer funds that will go to PP. We worked on Texas’ family planning funds rather than Federal money. We prioritized funds going to hospitals, county health and federally qualified health clinics that provide comprehensive and continuing care for more than one body system. We also tightened up law prohibiting State tax funds from going to any organization or clinic that performs abortions.

Supreme Court: Higher First Amendment Hurdles for Public Health Regulation

From the New England Journal of Medicine:

Vermont’s statute had a fatal self-inflicted wound. By prominently announcing that the state intended to tip the balance in the “marketplace for ideas” against drug companies, the law dug itself into a constitutional hole: state interference with that marketplace was likely to provoke the ire of a majority of the Supreme Court. Writing for the Court, Justice Anthony Kennedy stated, “[t]he more benign and, many would say, beneficial speech of pharmaceutical marketing is also entitled to the protection of the First Amendment.”

Instead of dealing with this statute under existing precedent, Kennedy seized the opportunity to expand the First Amendment’s reach and power to strike down government regulation of health care information. The Court’s opinion raises serious questions for some public health rules and the regulation of drug marketing. Justice Stephen Breyer, writing in dissent, charged that the Court added an unprecedented constitutional standard that would hinder consumer-protection regulations, including Food and Drug Administration (FDA) restrictions against off-label marketing.

Although the First Amendment’s core is the protection of religious freedom and political speech, in recent decades, federal courts have expanded its application to business-related or “commercial” speech. In the 1970s, the Court used the commercial speech doctrine to reach state laws prohibiting advertising by professionals such as lawyers, accountants, pharmacists, and physicians. These professions had been self-regulating, following ethical rules that limited market competition. The Supreme Court struck down the prohibitions, using a standard of review that reserved some deference to the state legislature. By 1980, this “intermediate-scrutiny” standard was encapsulated in the Central Hudson decision, and until now, the Central Hudson test — whereby it’s considered constitutional to regulate commercial speech only if doing so “directly advances” a “substantial” government interest in a way that “is not more extensive than is necessary” — has been the operative standard.

Kennedy applied a more stringent “heightened-scrutiny” standard to the Vermont law, seeing the additional burden as justified because the law regulated specific conduct (drug marketing) and specific persons (data miners and drug companies). Under this standard, the Court didn’t carefully weigh the health care cost savings described by Vermont and gave short shrift to physicians’ confidentiality in patient-related decision making, claiming that prescriber-identifiable information was widely available in the marketplace. The majority dismissed Vermont’s concerns about data mining as “nothing more than a difference of opinion,” without considering seriously the peer-reviewed evidence on marketing’s effect on prescribing choices. Indeed, experts’ testimony to the Vermont legislature was offered as evidence of the state’s bias.

via Higher First Amendment Hurdles for Public Health Regulation | Health Policy and Reform.

Partisan disagreement over Health Care Law

Which way will those Independents vote in 2012?

Data Watch | Health Policy and Reform.