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The GOP view towards womens health is a bit confusing.

The Senate bill, Better Care Reconciliation Act cuts funding to Planned Parenthood.

Eighty percent of Planned Parenthoods work is preventing pregnancy. The bill further eliminates protections of essential health benefits which would ensure access to preventive health services including well woman care and contraception as well as maternity care.

Every single medical group agrees that TrumpCare is a disastrous plan. Rep. Pete Olson (R-Texas) laughed about prenatal care coverage because he cannot have a baby, therefore he does not understand why it should be covered.

We already know that Republicans would like to end all access to abortion. Now it seems they would like to end all access to pregnancy prevention. Worse, it seems they would like to end safe pregnancy care and care for the children that will result from lack of access to pregnancy prevention.

Lack of access to contraception and prenatal care will mean more special needs children. That is a fact. So they are creating a system that will ensure children that will need expensive specialty care and they are taking away coverage for it.

That is quite special.

As far as I can tell every single person alive today got here through a mother for that reason alone we should cover maternity care. It is called a social contract.

We went through these arguments before passage of the Affordable Care Act how quickly the 13 white men who designed the BCRA forgot. If women have access to affordable maternity care, and contraception without cost sharing, it is good for all.

Mr. Olson What if I do not want to pay for your earlier heart attacks, nor your Viagra, nor your prostate disease?The whole idea of insurance is a risk pool. Im sorry I have to explain that to you.

After seven years of hand wringing over Obamacare, to come back with a bill that deconstructs Medicaid and aims its arrows at women lays clear that the war on women never stopped.

Supercharged by a president who hurls insults over Twitter, the Republican party has discarded an allegiance to right to privacy and small government where women are concerned. For us, apparently the decisions over our bodies cannot be a private one between a woman and her physician the one with the training instead it apparently belongs to politicians.

The peril of this path awaits. BCRA will do harm. It is a bill that will kill. Instead we could look to solutions.

The answer to rising premiums and deductibles and out-of-reach prescription drug costs, is not to rip away coverage to the most vulnerable in our society.

For all its faults, ObamaCare was based on RomneyCare the plan in place in Massachusetts at the time.

TrumpCare has no model to base itself after.

This is not American exceptionalism unless it is a race to the bottom.

We could look around the world and see that covering all citizens and reining in costs is achieved by single payer or some sort of government control.

That is achievable.

For many, particularly on the right, a single payer system in not palatable. So what if we were to form a hybrid system?

We know from all the data we have that preventive services save money. That seems like something we want everyone to have access to. It certainly seems appropriate that true emergencies and traumas be covered (since many in Congress seem to think that is how everyone has access to care anyway).

What if we expand Medicare to cover those services for everyone?

That would not raise the Medicare tax dramatically.

For the rest of care insurers could develop existing Medicare A advantage plans, which already sell across state lines. These could be tailored to different levels of need, much as Congress has been pulling their hair over.

There would need to be stipulations to allow insurance to remain affordable as it is in the rest of the world. It would have to go back to being not-for-profit. No more shareholders.

Caps on executive salaries and strict controls over what can be charged. While this may seem a difficult sell, it is better than eliminating care to our most vulnerable or the alternative destroying an entire industry what the two extremes far right and far left propose.

We would need to allow Medicare to negotiate prescription drug prices just as governments do in the rest of the world.

If pharmaceutical companies balk tell them to stop spending money on direct to consumer advertising. Why that is allowed is an anathema to me. The myth of high prices to pay for research has been exposed. They have had decades of record profits.

Lastly look at reimbursement appropriately be consistent in imaging costs and ensure that primary care can stay viable given that it is the most cost effective. Stop the unfunded mandates and the plethora of prior authorizations for everything even generic medications.

Given the amount of training involved, why not trust physicians instead of burning them out?

We need consistency in pricing for high end technology and procedures. Families should not fear bankruptcy due to a medical condition.

Allowing Medicare to set a pricing standard will ensure this to occur.

It is time to remember that we can learn from others and yes we can make America great again.

Dr. Cathleen London is physician based in Maine who developed a cost-effective alternative to the standard EpiPen in response to skyrocketing prices. London has been an on-air contributor on Fox News and local television stations around the nation. Her healthcare innovations have been featured in the New York Times.

The views expressed by contributors are their own and are not the views of The Hill.

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The Republican healthcare plan bad medicine for women and the poor - The Hill (blog)

The basics of Republican health legislation, which havent changed much in different iterations of Trumpcare, are easy to describe: Take health insurance away from tens of millions, make it much worse and far more expensive for millions more, and use the money thus saved to cut taxes on the wealthy.

Donald Trump may not get this reporting by The Times and others, combined with his own tweets, suggests that he has no idea whats in his partys legislation. But everyone in Congress understands what its all about.

The puzzle and it is a puzzle, even for those who have long since concluded that something is terribly wrong with the modern GOP is why the party is pushing this harsh, morally indefensible agenda.

Think about it. Losing health coverage is a nightmare, especially if youre older, have health problems and/or lack the financial resources to cope if illness strikes. And since Americans with those characteristics are precisely the people this legislation effectively targets, tens of millions would soon find themselves living this nightmare.

Meanwhile, taxes that fall mainly on a tiny, wealthy minority would be reduced or eliminated. These cuts would be big in dollar terms, but because the rich are already so rich, the savings would make very little difference to their lives. More than 40 percent of the Senate bills tax cuts would go to people with annual incomes of more than $1 million but even these lucky few would see their after-tax income rise only by a barely noticeable 2 percent.

So its vast suffering including, according to the best estimates, around 200,000 preventable deaths imposed on many of our fellow citizens in order to give a handful of wealthy people what amounts to some extra pocket change. And the public hates the idea: Polling shows overwhelming popular opposition, even though many voters dont realize just how cruel the bill really is. For example, only a minority of voters are aware of the plan to make savage cuts to Medicaid.

In fact, my guess is that the bill has low approval even among those who would get a significant tax cut. Warren Buffett has denounced the Senate bill as the Relief for the Rich Act, and hes surely not the only billionaire who feels that way.

Which brings me back to my question: Why would anyone want to do this?

I wont pretend to have a full answer, but I think there are two big drivers actually, two big lies behind Republican cruelty on health care and beyond.

First, the evils of the GOP plan are the flip side of the virtues of Obamacare. Because Republicans spent almost the entire Obama administration railing against the imaginary horrors of the Affordable Care Act death panels! repealing Obamacare was bound to be their first priority.

Once the prospect of repeal became real, however, Republicans had to face the fact that Obamacare, far from being the failure they portrayed, has done what it was supposed to do: It used higher taxes on the rich to pay for a vast expansion of health coverage. Correspondingly, trying to reverse the ACA means taking away health care from people who desperately need it in order to cut taxes on the rich.

So one way to understand this ugly health plan is that Republicans, through their political opportunism and dishonesty, boxed themselves into a position that makes them seem cruel and immoral because they are.

Yet thats surely not the whole story, because Obamacare isnt the only social insurance program that does great good yet faces incessant rightwing attack. Food stamps, unemployment insurance, disability benefits all get the same treatment. Why?

As with Obamacare, this story began with a politically convenient lie the pretense, going all the way back to Ronald Reagan, that social safety net programs just reward lazy people who dont want to work. And we all know which people in particular were supposed to be on the take.

Now, this was never true, and in an era of rising inequality and declining traditional industries, some of the biggest beneficiaries of these safety net programs are members of the Trump-supporting white working class. But the modern GOP basically consists of career apparatchiks who live in an intellectual bubble, and those Reaganera stereotypes still dominate their picture of struggling Americans.

Or to put it another way, Republicans start from a sort of baseline of cruelty toward the less fortunate, of hostility toward anything that protects families against catastrophe.

In this sense theres nothing new about their health plan. What it does punish the poor and working class, cut taxes on the rich is what every major GOP policy proposal does. The only difference is that this time its all out in the open.

So what will happen to this monstrous bill? I have no idea. Whether it passes or not, however, remember this moment. For this is what modern Republicans do; this is who they are.

Paul Krugman is a columnist for The New York Times.

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Understanding Republican cruelty - Rutland Herald

Democrat Kanew seeks to challenge Republican Rep. Blackburn Kansas City Star A film writer and producer says he is seeking the Democratic nomination to challenge Republican U.S. Rep. Marsha Blackburn of Tennessee next year. The Tennessean reports that Justin Kanew says he was inspired to run for the heavily Republican 7th ... and more »

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Democrat Kanew seeks to challenge Republican Rep. Blackburn - Kansas City Star

RESIDENTS OF ESSEX know that the fried clam was invented in 1916 at Woodmans, a much-loved clam shack that hugs the Essex River in its last approach to the sea. But few remember that one of our most essential words emerged around the corner. Just down Route 133, a weather-beaten sign on the First Congregational Church recalls John Wise, the minister who helped serve this small seaside community when it was known as Chebacco. In a small book published 300 years ago, in 1717, Wise gave a new urgency to a term that had never been acceptable in polite society, and which still gives us trouble. Democracy the word is so basic to our lives that we barely pause to hear it.

The story of democracy resembles an immigrants tale, though we rarely think about it that way. Like many newcomers, the word was first received with hostility, and took decades to assimilate. But now, its so much a part of our heritage that we cant envision ourselves without it. And its as New England as those fried clams.

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From high school civics classes to presidential speeches, democracy is simply everywhere, part of a soundtrack that always plays faintly in the background. Even North Korea, the least democratic country on earth, calls itself The Democratic Peoples Republic of Korea. As Leonard Cohen wrote in his song Democracy, the term is so prevalent that its coming through a hole in the air. But a close study reveals that the word, like the thing itself, is more fragile than we might think. Or as Leonard Cohen would say, its real, but it aint exactly there.

That sounds right for 2017, when democracy is something of an endangered species. Abroad, it is not in vogue, as authoritarians crack down in Turkey, Egypt, and the Philippines, and Europe reels from one crisis to the next. At home, President Trump uses the catchphrases of democracy less often than his predecessors.

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To some extent, that represents the obvious Democrats tend to like democracy more than Republicans. In Andrew Jacksons day, the Democratic party called itself The Democracy; Bill Clinton and Barack Obama both gave frequent seminars about how a healthy democracy functions, including the value of opposition parties, the rule of law, a thriving free press. It is difficult to imagine President Trump going there.

A century after a hard-fought confirmation battle, the story of the first Jewish Supreme Court justice holds a lesson for Merrick Garland.

But some impressive Republicans have embraced democracy notably, Ronald Reagan, and George W. Bush, who found democracy and freedom useful terms for what he was trying to build in Iraq. A new book by Condoleezza Rice, Bushs close adviser, manages to get both words into its title. Democracy: Stories from the Long Road to Freedom argues that the United States should not abandon the hard work of democracy abroad.

In fact, democracy has been contested for centuries, and New England furnished an early battleground. We love to quote John Winthrop in a way that makes him seem like a 20th century American; building a city upon a hill for all to see, a kind of theme park into which we can fit so much of what came later. But democracy was a term of reproach to the earliest Bostonians. John Cotton, spiritual leader to the first generation, wrote, Democracy, I do not conceive that ever God did ordain as a fit government either for church or commonwealth. Instead, responsible leaders were expected to emerge from a tightly-controlled network of ministers and magistrates, working in concert to suppress any unhealthy outbursts of popular feeling.

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But with time the old hierarchies gave way. In 1717, John Wise of Essex began to chip away at the authority of inherited ideas. Wise was not born into the Puritan elite the families, like the Mathers, that had dominated for decades. He was the son of an indentured servant who later became a butcher and a brewer Imbibe Wisely would have been a natural slogan for his product, if the Puritans had permitted advertising. When he went to Harvard, his father paid some of his tuition in malt.

But Wise did not feel especially inferior to the Mathers, or to anyone, and that helped him to argue in a new, more American language. He was a natural writer, with surprising wit for a Puritan. He was also commanding in person; of towering height, of great muscular power, stately and graceful in shape and movement; in his advancing years of an aspect most venerable. He grew up here, and when English officials began to impose new taxes and suppress dissent in the 1680s, he led a resistance. He was fined, jailed, and briefly stripped of his pulpit.

Such a figure was not likely to accept local intimidation either. In his rustic seat by the Essex River, he had grown steadily implacable, and when the Mathers tried a power grab, he was ready with a volley of verbal grapeshot. In 1717, he published A Vindication of the Government of New England Churches. On the surface, the book was about the way New England churches governed themselves, not electoral politics. But underneath, it was deeply political. Democracy is the theme of the book from start to finish; he uses the word often, like a cudgel, to club his opponents, and to argue that a church government that springs up from the people is better than one in which their betters make all the big decisions.

If Wises vocabulary was new; so was his reasoning, which drew not only from the Bible, but from the Light of Nature, and the Light of Reason phrases that were not so distant from the Enlightenment to come. To him, a human being was not quite as lost as the earliest Puritans had believed; but at the upper-end of Nature, a Creature of a very Noble Character, and therefore capable of self-government. In accents we would associate more with the end of the 18th century, he wrote, the end of all good government is to cultivate humanity, and promote the happiness of all, and the good of every man is all his Rights, his Life, Liberty, Estate, Honor, & without injury or abuse done to any. To this country parson, it was as plain as daylight that there was no Species of Government like a Democracy to attain this end.

Of course, 1717 was decades before independence, and Wise was not there yet. But when his book was republished in 1772, one of the subscribers was the future commander of the minutemen at Concord. It was republished again in 1860, at another moment when democracy seemed to be up for grabs. By that point, not many people remembered John Wise. But his distant voice, 300 years ago, helps explain one of the more remarkable transformations in our history the story of how Massachusetts steadily forged a new language of self-reliance. A single word, democracy, was the pivot.

Condoleezza Rice ends her book with a reflection on Winston Churchills witty line: democracy is the worst form of Government, except for all those other forms that have been tried from time to time. He made that remark in a parliamentary debate in 1947. In the same debate, Churchill cited Americas example, working out democracy over many generations, fine-tuning, self-correcting, oiling the works. Way back in our history, the son of an indentured servant spoke the word so loudly that it can still be heard, three centuries later, over the din of the diners ordering their fried clams.

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Democracy's immigrant story - The Boston Globe

China wouldnt have to make major structural changes to practice indirect democracy.

By Xiaochen Su for The Diplomat

July 04, 2017

During Chinese President Xi Jinpingfirst visit to Hong Kong, the political conflict surrounding democracy and sovereignty in the city has been highlighted time and time again. Followingwhat many Western media called the broken promise of direct democracy, the citys pan-democrats have grown more disillusioned with the slow pace of political reform. Seeing the central government in Beijing as a fundamental obstacle to the reforms, a growing number has come to the conclusion that the citys political independence is the only way forward for establishment of true democracy.

Yet it is rather simplified argument to say that democracy in Hong Kong is not movingforward because of Beijings opposition. The Communist Party of China (CPC)emphasizes the importance of democracy in various documents and does have institutions set up within the existing political structure that allow for direct popular elections. It is, then, important to reexamine why the brand of democracy espoused by the CPC falls short of Hong Kongs (and indeed, any Western) definition of the same political concept, and how the differing definitions can be better aligned.

Section 5 of the Constitution of the Peoples Republic of China stipulates a system of indirect democracy. Members of governing council (Peoples Congress) at the lowest level of political jurisdictions (including villages, towns, and counties, and urban districts) are to be directly elected by the general population. In turn, the members of the local Peoples Congress vote for municipal ones, who in turn vote for regional/provincial ones, who in turn select members for the national Peoples Congress that conveys in Beijing. Just as the National Peoples Congress holds power to confirm appointments of the executive leadership of the Politburo through all-member votes, the local and regional Congresses can do the same for selection of local mayors and governors.

What, in the eyes of Westerners, violates democratic principles, is the vetting of candidates before they are votedon by the common people.Chen An notes in his 1998 book on Chinese political reforms that candidates running for seats in the local Congresses must be nominated and receive explicit support before they can stand for elections. Given the outsized role played by the CPC in the Chinese party-state polity, it is unsurprising then that any potential candidate with views and ideologies different from the prevailing CPC ones will be filtered out at this stage. The vetting process, in essence, cements the CPCs monopoly over the countrys political establishment, reinforced through an existing democratic process.

Interestingly, the concept of vetting candidates before elections is exactly the same condition the central government proposed in 2014to Hong Kong as a condition for implementing universal suffrage. The pan-democrats rejection of this vetting sank perhaps the only possibility ofa smooth, Beijing-approved transition to universal suffrage and underscored the inherent difference between how the pan-democrats and Beijing understood democracy. Given the political reality of mainland China, the pan-democrats worry that vetted candidates will only include those from the pro-Beijing camp is highly reasonable and justified.

Thus, it can be said that the vetting of candidates is the primary point of contention separating China from Western-style democracy. It is commonly argued that Beijing insists on the vetting (in mainland China and Hong Kong alike) for the purpose of monopolizing power within the CPC and those politically friendly to the CPC. Not vetting candidates would quickly lead to erosion of CPCs political power as those from outside (and indeed, opposing) the party would become Congress members.

However, it is questionable whether suddenly stopping the vetting of candidates for local Congresses would rapidly alter the political balance in a manner unfavorable for the CPC. As the sole organized political institution in China for the past six decades, the CPC has acquired unwavering allegiance among millions who depend upon it, if only to get ahead in their own careers. Even if new political parties, unfettered by the CPC, were to form immediately tomorrow, it would take decades for them to match the organizational, financial, and communication powers the CPC presently has. The long time it would take for these political parties to maturewould provide more than enough time for the CPC to craft, adopt, and implement strategies that cement its dominant position in a more competitive political environment.

Furthermore, the fact that elections occur in a hierarchical, indirect manner in the current electoral institutions favors the incumbent party.Local elections focus on local issues of livelihood, which incumbent parties generally have much more political capital to resolve quickly and effectively. Even if the opposition wereto gain a majority in some local elections, their advantages in certain localities would quickly be eroded in regional and national elections if the majority of localities still favor the incumbent.

Without changes in the current political structure, even unvetted, popularly elected political leaders would be hamstrung by the CPC. The countrys dual party-state governance structure means political positions (such as governors) are subordinate to party positions (such as the regional party secretary). No matter how democratic the state governance structure becomes, it can face constraints in the face of an undemocratic party one. But given the credibility of state officials elected through a popular vote, it would be increasingly difficult for party officials to assert views opposite to those of state officials. Implementing indirect democracy without candidate vetting has the positive side effect of weakening the role of the party in the party-state structure over time, even without the need for significant structural changes.

Indeed, the primary benefit of implementing indirect democracy in China is how little political disruption it would cause in the process. All political institutions, with the exception of candidate nominations, would remain largely the same.

The result would be a true democracy that is beneficial for many reasons. The reform would be acceptable for the CPC, as its political dominance would not be immediately jeopardized inan indirect democracy. The ability to quickly execute long-term policy changes and grand projects, a benefit of the existing political structure that scholars like Tony Saich argueis at least partially responsible for Chinas recent economic rise, would largely remain intact. The indirect election of national leaders will alleviate the fear of a rise of nationalistic populism a la Donald Trump in the United States. Plus, the Western criticism is that China is not democratic can be better parried and refuted.

Those who have sought political changes in China, including scholars in the West and the Tiananmen leaders, have been too focused on overhauling the entire system in a top-down fashion. Understandably, such proposals draw the ire of the CPC and skepticism of a stability-minded Chinese populace. If the focus of reforms is instead bottom-up, starting with the abolishing of candidate vetting at local Congress elections, there is possibility of real changes that fit with the interests of all sides. Democratic-minded China-watchers in Hong Kong, mainland China, and elsewhere, should shift their strategies to demand more realistic, incremental reforms at the most grassroots level.

Xiaochen Su currently resides in Iringa, Tanzania, working for a NGO that helps smallholder farmers to increase productivity through provision of high-quality agricultural inputs and microcredit. Su previously studied International Political Economy at the London School of Economics.

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A Path to 'True' Indirect Democracy in China - The Diplomat