Thursday, May 7, 2015

The Cost of Closing Clinics

I will start this piece by telling you where it ends: In 2015, in Scott County, Indiana, where we have a "public health problem" (that's a euphemism for HIV outbreak) that has been tied to the closure of a Planned Parenthood clinic. According to an Indiana Business Journal article, the Scottsburg clinic was one of five that closed its doors in the state of Indiana back in 2009, the same year "the not-for-profit Indiana Family Health Council [took] over administering $2 million in grants, some of which previously went to Planned Parenthood."

Now that we know the end, let's go back to the beginning.  Why did the State of Indiana take money away from Planned Parenthood?  Technically, I don't know, in the sense that I can't find a document - a press release, an excerpt of a speech -  that spells it out.  I think it's fairly safe to guess, however, that we can sum up the decision in two words: Abortion services. 

Abortion, after all, was the target of conservative Indiana politicians, who made Indiana the first state to defund Planned Parenthood back in 2011.  When (then) Governor Mitch Daniels signed on the dotted line in May of that year, he said, "Any organization affected by this provision can resume receiving taxpayer dollars immediately by ceasing or separating its operations that perform abortions."

Wait, you're thinking.  Taxpayer dollars and abortions go together like . . . like . . . Quarter Pounders and vegans, don't they?  Because something something something Hyde Amendment?  Yup, you're right.  And if there's something routinely put in place at the federal level (you must suspect), there's probably something in place at the state level.  Hey, right again!  But!  Many politicians on the right claim that giving any taxpayer money to Planned Parenthood - even for, say, HIV testing, prenatal care, contraception counseling, or a breast exam - funds abortion, because Planned Parenthood cannot keep all the monies apart, no matter what its claims to the contrary.  As quoted in Nuvo back in 2011, Indiana State Representative Matt Ubelhor said, "If we're buying the roof over [Planned Parenthood's] head or their paper clips, we're still subsidizing abortion."

Fun side note:  The code word you hear for this in political debates is "fungible."  It's a cool word, right?  Say it in your head.  FUN-juh-bull.  They use this word to mean that all the money is interchangeabull and interchanged.  Oh, sorry, did I say bull again?  That was phonetic.

In any case, the courts ruled that the State of Indiana could not in fact cut off Medicaid dollars to Planned Parenthood, because

Although Indiana has broad authority to exclude unqualified providers from its Medicaid program, the State does not have plenary authority to exclude a class of providers for any reason—more particularly, for a reason unrelated to provider qualifications. In this context, 'qualified' means fit to provide the necessary medical services—that is, capable of performing the needed medical services in a professionally competent, safe, legal, and ethical manner. The defunding law excludes Planned Parenthood from Medicaid for a reason unrelated to its fitness to provide medical services, violating its patients' statutory right to obtain medical care from the qualified provider of their choice (emphasis mine)
After two years, Indiana gave up.  They lost in court, so they abandoned the hope of defunding Planned Parenthood, but their defeat has not stopped other states from pulling the same move.  Indeed, Texas went so far as to refuse to fund Planned Parenthood even after the Obama administration cut off their Medicaid funding for denying poor women access to the qualified provider of their choice.  And would you like to guess who Ted Cruz blamed for that?  Hint: It's Obama.  And I don't mean Michelle.

Back in 2013, Rick Santorum said, "Too many in the GOP want to ignore the millions of innocent lives that have been extinguished by this vile organization. Defunding Planned Parenthood is a winning issue. The polls prove it."  So even if you don't think Planned Parenthood is a "vile organization," this is a "winning issue" for a Republican.  Who could resist?

Well, now we come back to Scott County, Indiana, where the people presently infected with HIV might wonder exactly who is "winning" when Planned Parenthood clinics are closed down.  According to this excellent article by Leigh Cowart, the health department in Scott County didn't offer HIV testing until the problem started to draw attention.  It's also the case, as asserted by Cowart and backed up here, that "[n]o agency receiving state funds may distribute condoms." You know who did both of those things back in the day?  Planned Parenthood.  Know what else?  Scott County didn't exactly need fewer healthcare options, since their premature death rate is roughly double the Indiana average.  You can use that link to see just how much Scott County needed help and support, instead of what they got. 

Of course, I'm sure someone would be happy to point out that Hoosiers can get healthcare through the Indiana Family Health Council, which is true, even though they can't offer any help in Scott County, and even though I am mildly concerned to find "withdrawal" listed as a means of birth control on their web site.



Since pulling out constitutes birth control, however, it's a little bizarre to learn on the same site that "a girl can get pregnant even if a boy doesn’t ejaculate or 'cum' inside her."

That whole contradiction is probably not a big deal, because teenagers never go on the web to get information, right?  And even if they do, adolescent Hoosiers surely have a solid backing in sex education that will help them see the error here.  As summarized by "sex, etc."


HIV/AIDS and Other STDs Education
  • Indiana state law requires STDs and HIV/AIDS education. Local school boards decide which subjects this education must cover and the grade level in which topics are introduced.
  • Abstinence must be covered and stressed as the only completely effective protection against unplanned pregnancy, sexually transmitted infections, and HIV/AIDS when transmitted sexually.
  • Teaching about contraceptives, such as condoms, the Pill, or the Patch, is not required.

Add all of this up, and I'm pretty sure everything is just fine.

Wednesday, April 22, 2015

Gene Schaerr's Ungenial Amicus Brief: A Breakdown

On April 28, 2015, the Supreme Court will hear oral arguments on the constitutionality of state-level bans on gay marriage. There is no handy case caption for this day - no "Roe v. Wade" or "Brown v. Board of Education" - because back in January, the Court agreed to hear four separate cases, but only by consolidating them. The Court also limited their consideration to two questions:
  1. Does the Constitution require the states to let gay couples get married? (That's known as "the marriage question.")
  2. If a gay couple was legally wed in one state, does the Constitution require other states to recognize that marriage? (That's known as "the recognition question.")
To make things extra interesting, not all of the states want to be heard on both questions.  As Lyle Denniston says on the SCOTUSblog, "Kentucky is defending [i.e. seeking to uphold] both a ban on same-sex marriages and a separate ban on the official recognition of existing same-sex marriages.  Michigan is defending only a marriage ban, and Ohio and Tennessee are supporting only recognition bans."

Got all that?

For reporters and court watchers, there is a metric ton of potential reading material related to this four-for-one, including not only the briefs from the petitioners and the defending states, but also the   amicus briefs, which are filed by people or entities who are not parties to the suits but who feel they have information to share with the Court.  The Columbia Law School Sexuality and Gender Law Clinic filed such a brief, for example, as did the President of the House of Deputies of the Episcopal Church.  PFLAG filed a brief, and so did 226 mayors from across the country.  Whole entire states have weighed in, from Virginia to Hawaii.  None of these briefs, however, has generated the press coverage received by Gene Schaerr, who made the claim in his amicus brief that forcing states to permit same-sex marriages would lead to 900,000 abortions.  Yes, he counted.

On the surface, this claim seemed so wildly bizarre that I could easily dismiss the brief without reading it, but in a weird way, the bizarreness of it is exactly what made me need to read the brief in full.  And what I found there so interested me that I wanted to share it with you. 

First, for all the liberal scoffers who laugh at the idea that a same-sex marriage can hurt an opposite-sex marriage, Schaerr wants you to know you're not getting it:
Any ruling compelling states to redefine marriage in genderless terms will adversely alter the whole institution of marriage.  That is not because same-sex marriages will directly “harm” existing man-woman marriages. It is because the forced redefinition will undermine important social norms — like the value of biological connections between parents and children — that arise from the man-woman understanding. (6)
Okay, so norms.  Schaerr really likes norms.  He lists six that are valuable to society - and only applicable to heterosexual couples, obviously.  He makes a point of that.
  1. The "biological bonding norm" (kids have the right to be raised by their biological moms and dads, and for that matter, to be financed by them, which is the "maintenance norm" subset of the biological bonding norm)
  2. The "gender-diversity norm" (kids have the right to be raised by A mom and a dad, even if not their own mom and dad)
  3. The "postponement norm" (people should wait to make babies until they're in meaningful, committed relationships)
  4. The "procreation norm" (having and raising kids is socially valuable)
  5. The "exclusivity norm" (people should make babies with one partner only)
  6. The "child-centricity norm" (children first, you heathens - and that's the grandaddy norm)
All of these norms make society strong.  Damage these norms, and you damage society.

Now, you might be thinking "Wait, I'm adopted.  Are you saying I hurt society?"  Or "Wait, I'm a single mom!  Are you saying I hurt society?" Or "Wait, I'm married with no interest in having children!  Are you saying I hurt society?"  All of you can file into that line over there and wait for Schaerr to get to you.  I hope you brought a tasty snack, though.  And the Lord of the Rings trilogy.  He might not get to you for awhile.

What he'll definitely get to is the same line we've been hearing for years now about children who are not raised by both of their biological parents.  To quote the CDC:
Adverse outcomes accrue to children of divorce and children raised in single-parent families. Although not all single-parent families are the result of divorce and not all divorced mothers remain single, virtually all children of divorce spend some time in a single-parent household until the mother remarries.  Even when the mother does remarry, studies suggest that children in stepfamilies have similar risks of adverse outcomes as children in single-parent families: both groups of children do worse than children living with two biological parents in terms of academic achievement, depression, and behavior problems such as drug and alcohol abuse, premarital sexual intercourse, and being arrested.
I can't argue with the CDC.  Study after study (after study, plus more studies) find a risk of "adverse outcomes" awaiting the children of single mothers.  That said, did you miss the part where two gay parents equal one not-gay parent?  I did, too.  Even if we accept the "child-centricity norm," we can't say that the children of two heterosexual people who got divorced are the best point of comparison for the children of two gay people who got married, can we?  Because if we can, I'm not sure where to go from here.

We can't even safely or confidently say that heterosexual couples who stay married will uphold the norms that Schaerr identifies.  As he writes, "opposite-sex parents who embrace the norms of child-centricity and maintenance are also less likely to engage in behaviors - such as physical or sexual child abuse, neglect, or divorce -  that not only harm their children, but typically require state assistance or intervention" (emphasis mine).  Sure.  And accountants who brush and floss are less likely to lose their teeth.  Does that mean accountants have exceptional dental hygiene?

Schearr doesn't have time for accountants and toothbrushes.  A heterosexual marriage is a righteous marriage, and since that's so, he has this bit of logic to unfurl.  Changing the law to prohibit states from banning same-sex marriage would:
undermine those norms among heterosexual men, who generally need more encouragement to marry than women.  Such changes convey that society no longer needs men to bond to women to form well-functioning families or to raise happy, well-adjusted children.
Exactly!  Well said!

Wait, what was that again?

If gay people can marry, then . . . heterosexual men . . . will . . . think no one needs them?  And therefore . . . refuse to get married?  While sulking?  In a corner?  Sensitive group, those heterosexual men.

If you think that's absurd, by the way, Schaerr has FACTS and CHARTS to persuade you.  Just look at the marriage and divorce rates in states where gay marriage is legal!  (This is his table.)


Are you shocked and horrified by the way that gay marriage has driven down the marriage rates in those states?  I'm pretty shocked myself, except for the part where marriage rates fell for years without anyone blaming gay marriage.  Data from the CDC says the national rate in the year 2000 was 8.2.  In 2005, it was 7.6.  In 2010, 6.8.  Those were some busy stealth-gays.

Of course, the marriage rate has been holding at 6.8 for a few years now, so maybe I'm wrong.  Maybe other things used to cause it, but now gay marriage causes it.  Or maybe it's accountants who don't floss.

Because see, the problem with holding two things up next to each other is that you can't make them have a causal relationship.  Gay marriage didn't cause marriage rates to decline any more than single mothers have caused their children's grades to drop (or be at risk for dropping). 

Oh, and to circle back to that abortion issue, after the gays make the heterosexual men sulk in the corner refusing to get married because of norm damage, well, abortions.  How?
The logic is simple and intuitive: Fewer opposite-sex marriages means more unmarried women, which in turn means fewer children born, more children born to unmarried mothers, and more children aborted.
There are charts for this, too, and emphatic discussion of how Vermont, Iowa, Connecticut, and Massachusetts have some of the highest abortion rates in the country, caused, no doubt, by gay marriage.  Again.

If you're thinking by this point that you can write the Yale-educated Schaerr off as a crank or a lone gunman, I'll leave you with this.  These are the people who signed the brief along with him.



Aguirre, Dr. Maria S., Professor of Economics,

The Catholic University of America



Allen, Dr. Douglas W., Professor of Economics,

Simon Fraser University



Alvare, Helen M., Professor of Law,

George Mason University



Araujo, Dr. Robert John, University Professor Emeritus,

Loyola University Chicago



Baptist, Dr. Errol C., Clinical Professor of Pediatrics,

University of Illinois



Bateman, Dr. Michael, Assistant Professor of Pediatrics,

University of Minnesota



Bauman, Dr. Michael E., Professor of Theology and Culture,

Hillsdale College



Benton, Dr. Thomas B.B., Adjunct Faculty in Pediatrics,

University of Florida College of Medicine



Bleich, Dr. J. David, Professor of Jewish Law and Ethics,

Cardozo Law School, Yeshiva University



Boone, Dr. Mark J., Assistant Professor of Philosophy,

Forman Christian College



Bouvier, Dr. Joseph, Clinical Assistant Professor of

Child Health (Pediatrics) and Emergency Medicine,

University of Arizona College of Medicine



Bradford, Dr. Kay, Associate Professor of Family, Consumer & Human Development,

Utah State University



Bradford, Dr. Nathan F., Associate Professor of Family

Medicine, AnMed Health Oglesby Center



Brakman, Dr. Sarah-Vaughan, Associate Professor of Philsophy,

Villanova University



Busby, Dr. Dean, Professor of Family Life,

Brigham Young University



Carlson, Jr., Dr. Alfred J., Associate Faculty in Pediatrics,

University of Pennsylvania Medical School



Cavadini, Dr. John, Professor of Theology,

University of Notre Dame



Christensen, Dr. Bryce, Associate Professor of English,

Southern Utah University



Colosi, Dr. Peter J., Associate Professor of Moral Theology,

Charles Borromeo Seminary



Corral, Dr. Hernan, Professor of Private Law,

University of the Andes (Santiago, Chile)



Crosby, Dr. John F., Professor of Philosophy,

Franciscan University of Steubenville



De Jesus, Ligia M., Associate Professor of Law,

Ave Maria School of Law



Deneen, Dr. Patrick J., Associate Professor of Political Science,

University of Notre Dame



Dennis, Dr. Steven A., Professor of Human Development,

Brigham Young University-Idaho



DeWolf, David K., Professor of Law,

Gonzaga University



Duncan, Dwight, Professor of Law,

University of Massachusetts



Esolen, Dr. Anthony M., Professor of English,

Providence College



Farnsworth, Dr. Richard Y., Adjunct Associate Professor of Pediatrics,

University of Utah School of Medicine



Field, Dr. Scott, Adjunct Faculty in Pediatrics,

University of Alabama-Huntsville



Fields, Dr. Stephen M., Associate Professor of Theology,

Georgetown University



Fitzgibbons, Dr. Richard, Director,

Institute for Marital Healing



Foley, Dr. Michael P., Associate Professor of Patristics,

Baylor University



Gombosi, Dr. Russell, Adjunct Professor of Pediatrics,

Commonwealth Medical University (Scranton, PA)



Grabowski, Dr. John, Associate Professor of Moral Theology & Ethics,

The Catholic University of America



Hafen, Bruce C., Emeritus Dean and Professor of Law,

Brigham Young University



Hancock, Dr. Ralph, Professor of Political Science,

Brigham Young University



Hartle, Dr. Ann, Professor of Philosophy,

Emory University



Hawkins, Dr. Alan J., Professor of Family Life,

Brigham Young University



Healy, Dr. Nicholas J., Assistant Professor of Philosophy,

Pontifical John Paul II Institute on Marriage and Family

at The Catholic University of America



Hendershott, Dr. Anne, Professor of Psychology, Sociology & Social Work,

Franciscan University of Steubenville



Henry, Dr. Douglas, Associate Professor of Philosophy,

Baylor University



Hill, Dr. E. Jeffrey, Professor of Family Life, Brigham Young University



Hoffman, Dr. Robert P., Professor of Pediatrics,

The Ohio State University



Holland, Dr. Matthew S., University President and Professor of Political Science,

Utah Valley University



Jacob, Bradley P., Associate Professor of Law,

Regent University



Jacobs, Dr. Nathan A., Visiting Lecturer in Philosophy,

University of Kentucky



James, Dr. Spencer, Assistant Professor of Family Life,

Brigham Young University



Jeynes, Dr. William, Professor of Education,

California State University at Long Beach



Johnson, Dr. Byron R., Distinguished Professor of the Social Sciences,

Baylor University



Jones, Dr. Woodson S., Adjunct Professor of Pediatrics,

University of Texas Health Science Center



Kaleida, Dr. Phillips H., Formerly Professor of Pediatrics (Retired 2014),

University of Pittsburgh



Kampowski, Dr. Stephan, Professor of Philosophical Anthropology,

Pontifical John Paul II Institute on Marriage and Family at The

Catholic University of America



Keen, Dr. Mary, Clinical Associate Professor,

Loyola University Medical School



Keys, Dr. Mary M., Associate Professor of Political Science,

University of Notre Dame



Knapp, Dr. Stan J., Associate Professor of Sociology,

Brigham Young University



Koterski, Dr. Joseph W., Associate Professor of Philosophy,

Fordham University



Krason, Dr. Stephen, Professor of Political Science and Legal Studies,

Franciscan University of Steubenville



Kries, Dr. Douglas, Professor of Philosophy,

Gonzaga University



Lacy, Dr. Mark D., Associate Professor of Medicine,

Texas Tech University



Lafferriere, Dr. Jorge Nicolas, Professor of Civil Law,

Pontificia Universidad Catolica Argentina



Laughlin, Gregory K., Associate Professor of Law, Cumberland School of Law,

Samford University



Lindevaldsen, Rena M., Professor of Family Law,  

Liberty University School of Law



Lim, Dr. Paul, Adjunct Professor of Surgery,

University of Minnesota Medical School (Duluth)



Liu, Dr. Paul, Clinical Assistant Professor of Pediatrrics,

University of Arizona



Mansfield, Dr. Richard, Clinical Associate Professor of Pediatrics,

Georgia Health Science University; Assistant Professor of Pediatrics,

Virginia  College of Osteopathic Medicine



Marcin, Raymond B., Emeritus Professor of Law,

The Catholic University of America



Martins, Joseph J., Assistant Professor of Law,

Liberty University School of Law



Matthews, Dr. Randolph, Clinical Assistant Professor of Pediatrics,

Wake Forest School of Medicine



McCarthy, Dr. Margaret, Assistant Professor of Theological Anthropology,

Pontifical John Paul II Institute at The Catholic University of America



McGehee, Dr. Frank T., Clinical Instructor in Pediatrics, University of Texas-Arlington



Mikochik, Stephen, Visiting Professor, Ave Maria School of Law; Professor Emeritus,

Temple University School of Law



Miller, Dr. Jerry A., Clinical Professor of Pediatrics, Medical College of Georgia



Morton, Dr. Charles, Clinical Professor of Pediatrics,

University of Illinois College of Medicine at Urbana-Champaign



Nathanson, Dr. Paul, Religious Studies Faculty (retired),

McGill University



Nowicki, Dr. Michael J., Professor of Pediatrics,

University of Mississippi School of Medicine



Olson, Dr. Ross, Assistant Professor of Pediatrics (retired),

University of Minnesota



Pearson, Dr. James M., Assistant Clinical Professor,

East Tennessee State University College of Medicine



Pearson, Dr. Lewis, Assistant Professor of Philosophy,

University of St. Francis



Pecknold, Dr. C. C., Associate Professor of Theology,

The Catholic University of America



Peterson, Dr. James C., Professor of Ethics,

Roanoke College



Prudlo, Dr. Donald S., Associate Professor of Ancient & Medieval History,

Jacksonville State University



Pruss, Dr. Alexander, Professor of Philosophy,

Baylor University



Rane, Dr. Tom, Professor of Child Development,

Brigham Young University-Idaho



Schlueter, Dr. Nathan, Associate Professor of Philosophy,

Hillsdale College



Schramm, Dr. David, Associate Professor of Human Development & Family Studies,

University of Missouri



Shaw, Dr. Bill, Assistant Professor of Pediatrics,

Virginia Commonwealth University



Shelton, Dr. Jean, Associate Professor of Pediatrics,

East Virginia Medical School



Sherlock, Dr. Richard, Professor of Philosophy,

Utah State University



Silliman, Dr. Ben, Professor of Youth Development,

North Carolina State University



Smith, Dr. Christine Z., Assistant Professor of Pediatrics,

Texas Tech Paul Foster School of Medicine



Smolin, David M., Professor of Law, Cumberland Law School,

Samford University



Sodergren, Dr. Andrew, Adjunct Assistant Professor  of Psychology, Pontifical John Paul II Institute at The Catholic University of America



Somerville, Dr. Margaret, Professor of Law, Professor Faculty of Medicine,

McGill University



Storm, Dr. Joanna, Professor of Psychology,

Franciscan University of Steubenville



Tollefsen, Dr. Christopher, Professor of Philosophy,

University of South Carolina



Vitz, Dr. Paul C., Senior Scholar and Professor of Psychology,

The Institute for Psychological

Sciences; formerly Professor of Psychology,

New York University



Vizcarrondo, Dr. Felipe E., Associate Professor,

University of Miami Miller School of Medicine



Walls, Dr. Jerry, Professor of Philosophy,

Houston Baptist University



Wheless, Dr. James W., Professor and Chief of Pediatric Neurology,

University of Tennessee



Williams, Dr. Richard N., Professor of Psychology,

Brigham Young University



Wilson, Jr., Dr. Robert, Clerkship Co-Director of Pediatrics,

Florida State University College of Medicine



Yates, Dr. Ferdinand D., Professor of Clinical Pediatrics,

State University of New York at Buffalo



Yenor, Dr. Scott, Professor of Political Science,

Boise State University



Young, Dr. Katherine K., Professor Emeritus of Religious Studies,

McGill University



Zanga, Dr. Joseph, Professor of Pediatrics,

Mercer University School of Medicine;

Clinical Professor of Pediatrics, Medical College of Georgia &

Philadelphia College of Osteopathic Medicine



Zaso, Dr. John, Clinical Assistant Professor of Pediatrics,

Hofstra NS-LIJ School of Medicine