Archive for July, 2022

An Indiana Power Grab Shows Politics At Its Worst

Thursday, July 21st, 2022

Fifty-two-year-old Theodore Edward Rokita, known as Todd, not Ted, is Indiana’s 44th Attorney General.

A dedicated far-right Republican, his political life is a thirsty search for one powerful political office after another. Elected Indiana’s Secretary of State at age 32 in 2002, he was the youngest Secretary of State in America at the time. He went on to capture Indiana’s 4th Congressional District seat in 2011 and served in the U.S. House until 2019.

In 2015, during his time in the House, Indiana created the Healthy Indiana Plan and expanded its Medicaid Program to take advantage of the Affordable Care Act. Rokita’s reaction to this was to say the ACA was “one of the most insidious laws ever created by man.”

He ran against Eric Holcomb for Governor in 2016 to replace Mike Pence, who had resigned to become Donald Trump’s running mate. Holcomb won convincingly, and, as I hope to prove below, Rokita never forgave him for the drubbing.

In 2017, Rokita resigned his House seat and sought the Republican nomination for U.S. Senator. He failed again.

But in 2020, in a political comeback of sorts, Todd, not Ted, Rokita defeated incumbent Curtis Hill for the Republican nomination for Indiana Attorney General, and in November 2020, he won the general election.

If that were all we ever learned of Todd Rokita, we could chalk him up as just another political hack of the Republican persuasion.

But the story doesn’t end there. It begins there. And it begins with a 10-year-old girl from Ohio.

In May 2022, a man from Columbus, Ohio, Gerson Fuentes, 27, allegedly raped that 10-year-old girl not once, but twice, and she became pregnant by him. On 27 June, a child abuse doctor treated her, but could not refer her for an abortion in Ohio, because, following the Supreme Court’s Roe reversal earlier in June, Ohio’s trigger law fired and outlawed abortions after six weeks of insemination. He determined the girl was six weeks and three days pregnant. So, he called a colleague in neighboring Indiana, where abortions were still legal in the first 22 weeks. Dr. Caitlin Bernard, an obstetrician-gynecologist, agreed to help, and the 10-year-old was quickly on her way to Indiana.

On 30 June, Dr. Bernard performed the abortion. The 10-year-old, who will bear the horrid psychological scars of this for the rest of her life, was spared the further horror of giving birth to her rapist’s child.

Among all the bureaucratic red tape government can create, Indiana has created what are called Termination of Pregnancy Reports, TPRs, and these must be completed by physicians who terminate pregnancies in the state. In the case of a pre-teen abortion, the law calls for TPR completion within three days of the abortion. Dr. Bernard completed and submitted her TPR for the 10-year-old within two days, on 2 July, thereby complying with the law.

On the first of July, one day after the abortion and one day before Dr. Bernard submitted her TPR, the Indianapolis Star ran a story about pregnant women from Ohio and Kentucky who were heading to Indiana for abortions because of the restrictive laws in their states. The story began:

On Monday, three days after the Supreme Court issued its groundbreaking decision to overturn Roe v. Wade, Dr. Caitlin Bernard, an Indianapolis obstetrician-gynecologist, took a call from a colleague, a child abuse doctor in Ohio.

Hours after the Supreme Court action, the Buckeye state had outlawed any abortion after six weeks. Now this doctor had a 10-year-old patient in the office who was six weeks and three days pregnant.

Could Bernard help?

The story later said Dr. Bernard had agreed to help. It did not say she had performed the abortion, just that she had agreed to help.

This story caught the nation’s attention, mostly for the wrong reasons. It was ridiculed. The Wall Street Journal called it “fanciful.” Republican Ohio Attorney General Dave Yost was among those who questioned the validity of the story.  Ohio Republican Representative Jim Jordan called the story “another lie” in a now-deleted tweet. Some of Fox’s most high-profile hosts — Tucker Carlson, Jesse Watters, Laura Ingraham — suggested the account of the 10-year-old rape victim was a “hoax” and “politically timed disinformation,” and claimed that the Biden administration was “lying” about the case after the Supreme Court overturned Roe v. Wade.

All this happened between the Indy Star’s story and the arrest—and confession—of Mr. Fuentes, which is when the backtracking happened. Jordan deleted his tweet, the WSJ issued a “correction,” Fox News actually took credit for “justice being served,” and Indiana Attorney General Todd Rokita, with all the empathy of an empty paper cup, saw an opportunity and took the stage.

Was he devastated that a 10-year-old had suffered such a horrific experience? If he was, he never said. What he did say, during a press conference he hurriedly called on the subject, complete with TV, Radio and Print media, was that he would be investigating Dr. Bernard for failing to provide the Termination of Pregnancy Report within the time required by law (She had).

On 13 July, twelve days after the abortion, he wrote a letter to Governor Holcomb, the same Eric Holcomb who had trounced him in the race for Governor, advising, “If  Doctor Bernard has failed to file the required reports on time, she has committed an offense, the consequences of which could include criminal prosecution and licensure repercussions.” Rokita went on to say “key” people on his staff had been trying to get the Indiana Department of Health to forward the TPR for two days, without success. Two days.

Rokita’s letter lectures the Governor, saying, “As state officeholders, we bear an important responsibility to get to the bottom of this matter immediately….” He admonishes the man who beat him in the election of 2016 by saying Holcomb should “direct the state agencies under your purview to produce immediately to my office the requested TPRs…so we can confirm Dr. Bernard’s compliance with the law.”*

Not one drop of the Balm of Gilead does Todd, not Ted, Rokita offer the 10-year-old whose life has been so tragically scarred. Nope. He can’t be bothered. He has other things on his mind. He is 100% focused on scoring whatever rancid political points he can.

No wonder people hate politicians.

 

*On 14 July, one day after Rokita’s letter to the Governor, Indianapolis TV station Fox 59 published the TPR, submitted by Dr. Bernard within two days of the procedure, which it had secured by a Freedom of Information request. Maybe Todd should have tried that.

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Gavin Newsome And Insulin: An Example Of What Leadership Looks Like

Monday, July 11th, 2022

Having just returned from a wonderful and pretty much off the grid trip to America’s southwest, I discover some pennies have dropped.

Roe is now in Wooly Mammoth land; New Yorkers, and soon many others, will now find it easier to pack a bit of heat; the EPA (and, presumably a lot of other governmental agencies) is no longer going to be able to regulate what its been regulating for the last 50 years; the January 6 Select Committee continues to unearth the sewer-living sludge of the Trump Big Lie; another mass shooting happened, the 309th of 2022, at a July 4th parade no less (only in America); the charlatan Boris Johnson is officially on the way out; and, this past Friday morning, a 41-year-old Shinzo Abe hater, assassinated the former prime minister of Japan at a campaign stop.  Abe’s killer made the gun himself, because it’s nearly impossible to procure a gun in Japan—Japan, the country with the lowest rate of handgun violence in the developed world.

With all of that, I’m thinking Chicken Little was right, and the sky is about to fall any minute now and land on my bucolic, Berkshire back deck.

Nonetheless, today’s Letter is not about any of that sky is falling stuff. We’ll get to all of it later. No, today’s Letter is about a momentous, and non-COVID, medical development that happened while I was gone, when California’s Governor Gavin Newsome announced the state would commit $100 million to making its own insulin for California’s diabetics.

Diabetes kills one American every three minutes. It affects children and adults, both genders, every race and ethnic group and leaves a vicious imprint on those who suffer from it and on those who love them. It is a leading cause of blindness, heart disease, stroke, kidney failure and non-traumatic amputations.

According to a nationwide survey by the Juvenile Diabetes Foundation International, 75 percent of Americans do not know how deadly the disease is, and 38 percent believe that either insulin cures diabetes, makes it harmless, or they don’t know what effect it has.

In 2017, the nation’s total direct medical cost due to diabetes was $237 billion. Average medical expenses for diabetics were 2.3 times higher than for non-diabetics.

Based on information found on death certificates, diabetes was the 7th leading cause of death in the United States in 2015, with 79,535 death certificates listing it as the underlying cause of death, and 252,806 listing diabetes as an underlying or contributing cause of death. However, diabetes is underreported as a cause of death; studies have found that only about 35% to 40% of people with diabetes who died had diabetes listed anywhere on their death certificates and only 10% to 15% had it listed as the underlying cause of death. An example of best practice would be, “Death caused by infection contracted from hemodialysis due to kidney failure, a complication of the patient’s diabetes.”

At 10.2%, California ranks 31st among US states in the percent of adults with diabetes*. There are more than 3.2 million of them in California, the great preponderance being Type 2 diabetics.

There are close to 35 million Type 2 diabetics in the nation. T2Ds still make some insulin, just not enough. For most, lifestyle changes will improve their health, sometimes to the point where they will no longer have to inject insulin. Some will become insulin dependent, and without it, those people will face life-changing complications.

There is a rarer, but much worse, kind of diabetes. That would be Type 1, also known as Juvenile Diabetes. There are 1.6 million T1Ds in the country. According to the CDC, of all the states, California has the lowest rate of juvenile, Type 1 diabetes. T1Ds make no insulin and will die quickly if they don’t get it. Type 1 diabetes can happen at any time in life, but is vastly more prevalent in young people. My daughter came down with Type 1 diabetes at 21 years of age; my late wife Marilyn, at 12. You wouldn’t be wrong to think I’m invested in this topic.

I have argued strenuously in the past (here and here) that the country should guarantee insulin to T1Ds, regardless of their ability to pay for it. It is quite literally a matter of life and death. I can think of no other disease in which, if a patient is deprived of their medicine, death will result within a couple of weeks. But that’s the world T1Ds inhabit.

Government has been kicking the diabetes can down the road for generations. It’s been playing patty-cake with it since then Speaker of the House Newt Gingrich made it a core cause of his 25 years ago, in 1997. This has resulted in two things: government investing more money in looking for a cure—unsuccessfully, and skyrocketing insulin costs for patients. As President Biden noted correctly in his State of the Union address, insulin costs its manufacturers less than $10 per vial to make. Yet, depending on their circumstances, patients are paying anywhere from $300 to $800 for that same vial.  Reprehensible doesn’t begin to describe this situation.

While it is true that most of the ~50% of Americans who have employer sponsored insurance (ESI) only pay co-pays of $30 to $50 for a month’s supply of insulin, nearly all of them pay the full, painful cost until they meet their pharmacy deductible requirements. And one thing more to keep in mind: before Congress Passed the Affordable Care Act in 2010, the 1.9 million diabetics without ESI found their diabetes treated as a pre-existing condition. They paid full freight every time. Fast forwarding to now, some T1Ds are dying, because they either ration, or even go without, their insulin. Why? Because they can’t afford the price.

In my 2018 series on this topic, What Price Life?, I concluded:

So, here’s a question: Should anyone in the United States who requires a daily drug just to stay alive be forced to come up with the money to pay for it? Or, should that be a government-sponsored, health care right, as in the Declaration Of Independence’s “self-evident…unalienable right…to life.”

Gavin Newsome has answered that question. He has had enough. In taking matters into his own hands, he is extending a lifeline to California’s diabetics who struggle with the cost of staying alive. His move will both help those diabetics and provide good paying jobs to the people hired to build the manufacturing process and supply chain. He promises to provide California’s insulin to its diabetic citizens at “a little above cost.”

I don’t know what you think of Gavin Newsome. He certainly has his critics. But on this critical, life and death issue, he is showing a brand of leadership seldom, if ever, seen in that bought-and-paid-for vacuum of mediocrity we call the United States Senate.

_______________________

*It may not surprise you to learn the states with the highest incidence of diabetes, primarily Type 2, are the states whose citizens have the worst health care problems in the country. They are Red states, and are led by Senator Joe Manchin’s West Virginia at 15.7%, followed by Louisiana, Mississippi and Alabama. Mississippi. Always Mississippi. Pounded so low it has to look up to tie its shoes.

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