Racial Disparities in Autism Services

On any issue like this you'll always get the inequality arguments. From the continuing series on autism at Los Angeles Times, "Warrior parents fare best in securing autism services":

Public spending on autistic children in California varies significantly by racial or ethnic group and socioeconomic status, according to data analyzed by the Los Angeles Times.

For autistic children 3 to 6 — a critical period for treating the disorder — the state Department of Developmental Services last year spent an average of $11,723 per child on whites, compared with $11,063 on Asians, $7,634 on Latinos and $6,593 on blacks.

Data from public schools, though limited, shows that whites are more likely to receive basic services such as occupational therapy to help with coordination and motor skills.

The divide is even starker when it comes to the most coveted service — a behavioral aide from a private company to accompany a child throughout each school day, at a cost that often reaches $60,000 a year.

In the state's largest school district, Los Angeles Unified, white elementary school students on the city's affluent Westside have such aides at more than 10 times the rate of Latinos on the Eastside.

It might be tempting to blame such disparities on prejudice, but the explanation is more complicated.

“Part of what you're seeing here is the more educated and sophisticated you are, the louder you scream and the more you ask for,” said Soryl Markowitz, an autism specialist at the Westside Regional Center, which arranges state-funded services in West Los Angeles for people with developmental disabilities.

In both the developmental system and the schools, the process for determining what services a disabled child receives is in essence a negotiation with the parents.

RTWT.

The photos themselves are intense. And some of the family vignettes are sad. But then, that's exactly what this series is about: building an agenda for more state funding for those who're underserved --- and the program's already an entitlement, spending billions annually. The problem is those with less economic resources lack the skills and time to navigate the system and secure the lion's share of support.

And while autism is pretty undefined --- and yeah, it's probably over-diagnosed, ---I know from my own's son's experiences that there are real health issues at stake for families. And again, look at those pictures.

Previously: "Unraveling Autism."

Unraveling Autism

At Los Angeles Times:

Amber Dias couldn't be sure what was wrong with her little boy.

Chase was a bright, loving 2 1/2-year-old. But he didn't talk much and rarely responded to his own name. He hated crowds and had a strange fascination with the underside of the family tractor.

Searching the Internet, Amber found stories about other children like Chase — on websites devoted to autism.

“He wasn't the kid rocking in the corner, but it was just enough to scare me,” recalled Dias, who lives with her husband and three children on a dairy farm in the Central Valley town of Kingsburg.

She took Chase to a psychologist in Los Angeles, who said the boy indeed had autism and urged the family to seek immediate treatment.

But a team at the Fresno agency that arranges state-funded services for autism said Chase didn't have the disorder. His problems, staff members said, were nothing more than common developmental delays that he would eventually outgrow.

Unconvinced, Dias imagined the worst — that Chase would never have a girlfriend, a job, a place of his own. She pressed the agency to reconsider and hinted at a lawsuit. Finally, officials relented, and her son began receiving 40 hours a week of one-on-one behaviorial therapy.

She had to hint about a lawsuit? God, that is awful.

My wife's grandparents lived in Kingsburg. For a while, we went down there from Fresno every week or two for dinner with the whole family. It's total heartland territory. It feels like the Midwest, with all the agriculture and Scandinavian culture.

Anyway, continue reading at the link.

Obama Administration Blocks FDA on 'Morning After' Pill

At New York Times, "Plan to Widen Availability of Morning-After Pill Is Rejected."

It doesn't take a rocket scientist to figure out why. The administration's out of step on these issues and is freakin' over election year repercussions. See the editors at the Los Angeles Times (via Jill Stanek).

And from pro-abort extremist Amanda Marcotte, "Who to blame for the Plan B debacle?"

Britain's National Institute of Health to Ration Viagra

This is no joke.

Viagra is available privately, but the NHS is dogging those least able to pay for it out of pocket, the same people who are supposed to be better off with nationalization. Socialism sucks that way.

At Telegraph UK, "Viagra rationing to limit patients' sex lives":

With the Christmas holidays approaching fast, hard-working middle-aged couples could be forgiven for viewing the season of mistletoe and wine as a chance to spend a few cherished moments between the sheets.

But their amorous plans may be scuppered after penny-pinching NHS managers introduced new viagra prescription guidelines which could limit thousands of couples to having sex once a fortnight.

New policy documents advise GPs in parts of the country that patients in need of Viagra or similar drugs should be limited to two pills per month, down from the normal prescription of four.

Although the policy was described as a "recommendation" by NHS authorities, local medical committees told the GPs' magazine Pulse it was being handed down to family doctors as an "edict".

Erectile dysfunction medication is already stringently limited on the NHS and can only be prescribed to patients with certain conditions such as diabetes, multiple sclerosis and prostate cancer.

According to the NHS some 2.2 million prescriptions for erectile dysfunction drugs were issued last year, with 14.5 million tablets issued at a cost of about £78 million.

NHS guidance acknowledges that there "appears to be no clinical reason to restrict the number of tablets" but it adds that, according to research, the average person has sex four times a month.
It says: "The average frequency of sexual intercourse in the 40 to 60 age range is once a week."
The new policy is aimed at economising on non-essential treatments, recommending that the minimum effective dose be prescribed "two times per month using the drug with the lowest acquisition cost."

The guidance applies to sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis).

And this is the clincher:

Richard Hoey, editor of Pulse, said: "Ask most doctors and they will say that being able to live a satisfactory sex life is a key part of health and wellbeing, but the NHS has never recognised that in its policy on treatment for erectile dysfunction.

"Limiting patients to drugs like Viagra just twice a month is to treat sex like an unnecessary luxury, and completely fails to recognise the degree of anguish it can cause some men with erectile dysfunction."

Well, yeah.

Freakin' big government health bureaucrats. What losers.

The Newtitlement State

At Wall Street Journal, "On Medicare, Mitt Romney has the bolder, better reform":

The contradictions of Mr. Gingrich's entitlement plan reveal part of his political character, which is that his policies often don't match the high-decibel, sometimes grandiose nature of his rhetoric. This can make it easier for his opponents to stigmatize his policies as more radical than they really are because Mr. Gingrich tells everyone they're radical. He might achieve more if he spoke more softly and carried a bigger stick.

RTWT at the link.

Medical Marijuana Target of U.S. Prosecutors

At New York Times, "Medical Marijuana Industry Is Unnerved by U.S. Crackdown."

UKIAH, Calif. — An intensifying federal crackdown on growers and sellers of state-authorized medical marijuana has badly shaken the billion-dollar industry, which has sprung up in California since voters approved medical use of the drug in 1996, and has highlighted the stark contradiction between federal and state policies.

Federal law classifies the possession and sale of marijuana as a serious crime and does not grant exceptions for medical use, so the programs adopted here, in 15 other states and in the District of Columbia exist in an odd legal limbo. While federal agencies have long targeted Californians who blatantly reap illegal profits in the name of medicine, or who smuggle marijuana across state lines, the Justice Department said in 2009 that it would not normally pursue groups providing marijuana to sick patients, in accordance with state laws.

But in the last several weeks, federal prosecutors have raided or threatened to seize the property of scores of growers and dispensaries in California that, in some cases, are regarded by local officials as law-abiding models. At the same time, the Internal Revenue Service has levied large, disputed tax charges against the state’s largest dispensary, threatening its ability to continue.

In a hint of the simmering federal-state tensions, Kamala D. Harris, the attorney general of California, described in pointed terms the Oct. 7 announcement by four United States attorneys of their tough new campaign against many dispensaries, which they called commercial operations that violate the intent of California law as well as federal statutes.

“It was a unilateral federal action, and it has only increased uncertainty about how Californians can legitimately comply with state law,” Ms. Harris said in an interview. Since federal authorities do not recognize that marijuana can serve medical ends, she said, “they are ill equipped to be the decision makers as to which providers are violating the law.”

Kamala Harris is a blithering idiot. The Feds know exactly what's going on, which is that medical marijuana's a scam. Some patients may benefit, but otherwise the whole agenda is about stealth legalization.

And since I'm on this, I've been meaning to post Melanie Phillips' killer essay, "Drug legalisation? We need it like a hole in the head.

Melanie Phillips provides the essential conservative argument on the legalization debate (and she devastates the case of Portugal, which is widely cited by legalization enthusiasts as the "successful model" of decriminalization). But compare to David Swindle, "Our Deceitful Marxist President’s Cruel War on Sick Medicinal Marijuana Patients." It's a winding piece, but I'm still not convinced pot smoking's not counter-cultural. Or, let's just say that the tea party folks --- who I've been protesting with for over two years --- aren't down with it. But the Occupy folks are: "Zuccotti Utopia: Portraits of The New Revolutionaries." (Also, federalization of drug policy by itself doesn't make a conservative argument on marijuana legalization, and the federal government does indeed have authority to regulate "which of the plants God set growing on this earth" --- it's called the Commerce Clause, which kicks in when drugs and drug-related inputs are bought and sold across state lines. Besides, as I always say, drugs are for losers.)

RELATED: At Los Angeles Times, "L.A. council to debate whether to outlaw medical pot stores."

Place the Super Committee Blame Where it Belongs: On the Democrats

Look, idiot progressives are in denial, but the fact is Democrats have pushed for higher taxes all year and the GOP hasn't budged. Here's GOP Conference Chairman Jeb Hensarling, at Wall Street Journal, "Why the Super Committee Failed:

Even if Republicans agreed to every tax increase desired by the president, our national debt would continue to grow uncontrollably. Controlling spending is therefore a crucial challenge. The other is economic growth and job creation, which would produce the necessary revenue to fund our priorities.

In the midst of persistent 9% unemployment, the committee could have enacted fundamental tax reform to simplify the tax code, help create jobs, and bring in over time the higher revenues that come with economic growth. Republicans put such a plan on the table—and even agreed to $250 billion in new revenue by eliminating or limiting most of the deductions, credits, loopholes and tax expenditures mainly enjoyed by higher-income Americans. We offered this to avoid the even larger tax increases already written into current law that will intensify the pain Americans are feeling during these difficult economic times.

Republicans were willing to agree to additional tax revenue, but only in the context of fundamental pro-growth tax reform that would broaden the base, lower rates, and maintain current levels of progressivity. This is the approach to tax reform used by recent bipartisan deficit reduction efforts such as the Bowles-Simpson fiscal commission and the Rivlin-Domenici plan.

The Democrats said no. They were unwilling to agree to anything less than $1 trillion in tax hikes—and unwilling to offer any structural reforms to put our health-care entitlements on a permanently sustainable basis.

Unfortunately, the committee's challenge was made more difficult by President Obama. Since the committee was formed, he has demanded more stimulus spending and issued a veto threat against any proposed committee solution to the spending problem that was not coupled with a massive tax increase.

RTWT.

Jennifer Rubin places blame directly on the president: "The consequences of presidential weakness" (via Memeorandum).

Additional thoughts at Left Coast Rebel.

Susan Seven-Sky v. Holder

The D.C. Circuit has issued a ruling upholding the constitutionality of the individual mandate of the Affordable Care Act (the federal version of Romneycare). The opinions are here. Two interesting features of the majority opinion: (1) it was authored by Judge Lawrence H. Silberman, a very conservative jurist appointed by President Reagan; and (2) it relies heavily on the precedential value of that old New-Deal chestnut, Wickard v. Filburn, 317 US 111 (1942), in which the Court ruled that the federal government could regulate, under the Commerce Clause, wheat grown by a farmer for his own consumption.

Perhaps I'm overly cynical, but I wonder whether Judge Silberman, who expressly notes in his opinion that the Supreme Court will ultimately decide on the constitutionality of the individual mandate, was merely teeing up Wickard v. Filburn, hoping that the Supreme Court might strike it down along with the individual mandate. The Roberts Court certainly has not been hesitant to overrule well-established Supreme Court precedents extending back many decades. See Citizens United.

Mitt Romney:The GOP's Pro-Science Candidate

As many news outlets are reporting (see, e.g., here), GOP presidential candidate Mitt Romney has publicly broken from Republican Party orthodoxy by proclaiming that climate science demonstrates the need to reduce anthropogenic greenhouse gas emissions. His willingness to follow the scientific data, as opposed to political expediency, is both refreshing and laudable. I cannot help wondering, however, why he would buck his party on climate change, while kowtowing to it on health care, disavowing policies that are embodied in a law he championed and signed as Governor of Massachusetts. As a matter of political strategy, I find his comparative positions on climate policy and health care reform puzzling. What's his calculus?

Obamacare and Romneycare Share a Lot in Common

The Wonk Room (here) provides this handy-dandy table comparing major provisions of the federal Affordable Care Act and the Massachusetts Health Law, which shows the challenge Mitt Romney faces in trying to distinguish "Romneycare" from "Obamacare":

Major Provisions	Affordable Care Act	Massachusetts Health Law
Individual Mandate	Yes	Yes
Employer Responsibility	Yes — but not required to provide coverage	Yes — required to provide coverage
Affordability Credits	Yes	Yes
Standard Benefit Package	Yes — w/o abortion services	Yes — w/ abortion services
Establishes Exchanges	Yes	Yes
Prohibits Insurance Company From Canceling Coverage	Yes	Yes
Bans Denying Medical Coverage For Pre-existing Conditions	Yes	Yes
Medicaid Expansion	Yes	Yes
Medicare Cuts	Yes	No Authority

"Obamacare" as Health Insurance Privatization

The Affordable Care Act is often characterized as a massive government program designed to extend health insurance to millions. It might more accurately be characterized, however, as a massive privatization mechanism designed to move millions of individuals from the existing socialist system of de facto public insurance - taxpayer-funded emergency room visits for the technically uninsured - to private insurance coverage. Why aren't conservatives embracing this market-based solution to a problem of socialism?

The Health Care Act Reduces the Deficit!

According to Ezra Klein's excellent column in today's Washington Post (here), we all need to keep repeating that fact until a majority of the American electorate, and Republicans in Congress, understand it.

Orentlicher on Virginia v. Sebelius

Today's New York Times features a series of comments on yesterday's federal district court decision in Virginia v. Sebelius, striking down the insurance mandate of the Health Care Act. I blogged about the case here yesterday. Among the esteemed panel of commentators in the Times today is my colleague David Orentlicher, who makes a strong argument on both legal and policy grounds against the court's ruling (here).

The Health Insurance Mandate in the Courts

As all the news outlets are reporting (e.g., here), a Virgina court today invalidated the Health Care Law's insurance mandate. Judge Henry E. Hudson's ruling in Virgina v. Sibelius can be read here. Importantly, the judge declined to stay implementation of the law while his decision is appealed.

I am not a constitutional commerce-clause expert, but I have previously blogged (here) about my belief that the insurance mandate is constitutional because the government, as long ago as the Second Militia Act of 1792, signed into law by President George Washington, required citizens to supply their own muskets and other equipment. Judge Hudson neglects this history.

The law blogs are all abuzz about Judge Hudson's decision. I am persuaded by a couple of negative reviews from  relatively conservative (but eminently fair-minded) commentators, including my colleague Gerard Magliocca (at writing at Concurring Opinions here) and George Washington University Law Professor Orin Kerr (writing at The Volokh Conspiracy here), each of whom finds Judge Hudson's ruling to contain important legal errors.

Today's decision was the third federal district court ruling on the constitutionality of the Health Care Act, and the first to rule against any provision of the statute. Interestingly, the first two federal judges who upheld the statute were both Clinton appointees. Judge Hudson is an appointee of George W. Bush. Do you suppose  ideology/party affiliation have anything to do with the respective outcomes?

UPDATE: According to reports (e.g., here), Judge Hudson, who ruled against the Health Care Act today, holds a stake of between $15,000 and $50,000 in a Republican consulting firm that lobbied against the Act's passage in Congress. This is reminiscent of BP oil spill case, where judges with substantial financial stakes in the gulf oil industry ruled against the Obama Administration's moratorium on deep-sea exploration and drilling (see here and here).