Sunday, August 21, 2016

Last Call For Not-So Pro-Life

Texas's Republican rule has been deadly for women and babies, as the state GOP's Taliban-like fanaticism to end abortion has led to Texas having the highest mortality rate among childbirth in the developed world.

The rate of Texas women who died from complications related to pregnancy doubled from 2010 to 2014, a new study has found, for an estimated maternal mortality rate that is unmatched in any other state and the rest of the developed world.

The finding comes from a report, appearing in the September issue of the journal Obstetrics and Gynecology, that the maternal mortality rate in the United States increased between 2000 and 2014, even while the rest of the world succeeded in reducing its rate. Excluding California, where maternal mortality declined, and Texas, where it surged, the estimated number of maternal deaths per 100,000 births rose to 23.8 in 2014 from 18.8 in 2000 – or about 27%.

But the report singled out Texas for special concern, saying the doubling of mortality rates in a two-year period was hard to explain “in the absence of war, natural disaster, or severe economic upheaval”.

From 2000 to the end of 2010, Texas’s estimated maternal mortality rate hovered between 17.7 and 18.6 per 100,000 births. But after 2010, that rate had leaped to 33 deaths per 100,000, and in 2014 it was 35.8. Between 2010 and 2014, more than 600 women died for reasons related to their pregnancies.

No other state saw a comparable increase.

And you can 100% lay this at the feet of the Texas GOP.

In the wake of the report, reproductive health advocates are blaming the increase on Republican-led budget cuts that decimated the ranks of Texas’s reproductive healthcare clinics. In 2011, just as the spike began, the Texas state legislature cut $73.6m from the state’s family planning budget of $111.5m. The two-thirds cut forced more than 80 family planning clinics to shut down across the state. The remaining clinics managed to provide services – such as low-cost or free birth control, cancer screenings and well-woman exams – to only half as many women as before.

At the same time, Texas eliminated all Planned Parenthood clinics – whether or not they provided abortion services – from the state program that provides poor women with preventive healthcare. Previously, Planned Parenthood clinics in Texas offered cancer screenings and contraception to more than 130,000 women.

In 2013, Texas restored funding for the family planning budget to original levels. But the healthcare providers who survived the initial cuts reported struggles to restore services to their original levels.

When your laws cut the number of women who get health care during pregnancy in half, the number of women who die from childbirth complications doubles. 

Now understand that Texas is the second most-likely state besides Florida to have a major Zika virus outbreak this year, and you have a recipe for disaster.

Pro-life my ass.

The Right To Discriminate

As LA Times business columnist Michael Hiltzik reminds us, this week the most dire predictions of Justice Ginsburg's blistering dissent in the 2014 Hobby Lobby decision have come to pass as a federal judge has used the decision to rule that a funeral home has the right to discriminate against a transgender employee based solely on "sincerely held religious beliefs."

"The court, I fear, has ventured into a minefield.”

That’s how Supreme Court Justice Ruth Bader Ginsburg concluded her dissent to the 2014 Hobby Lobby decision. That’s the case in which the court ruled that businesses have a right to their own religious beliefs, and could use them to flout otherwise generally applicable federal laws — in this particular, the Affordable Care Act’s mandate that businesses provide contraceptive coverage as part of their employees’ health insurance.

The minefield Ginsburg warned about has now detonated. On Thursday, U.S. District Judge Sean F. Cox of Detroit ruled that a local funeral home was well within its rights to fire a transgender employee because its owner had a religious belief that gender transition violated biblical teachings.

Cox’s ruling puts the lie to Justice Samuel Alito’s denial, in his majority opinion in Hobby Lobby, that the ruling would provide a shield for a wide range of discriminatory practices by allowing them to masquerade as religious scruples. “Our decision today provides no such shield,” Alito wrote.

Ginsburg, who was on the short end of a 5-4 decision, knew better. She said there could be “little doubt” that religious claims would proliferate, because the court’s expansion of religious freedom to corporations “invites for-profit entities to seek religion-based exemptions from regulations they deem offensive to their faith.” She asked, “where is the stopping point?… Suppose an employer’s sincerely held religious belief is offended by health coverage of vaccines, or paying the minimum wage … or according women equal pay for substantially similar work?”

She further cited court precedents holding that “accommodations to religious beliefs or observances … must not significantly impinge on the interests of third parties.”

As it happens, the case before Cox involves all those points. At issue was the firing of Aimee Stephens by R.G. & G.R. Harris Funeral Homes, which she had joined as a funeral director and embalmer under the name Anthony Stephens in 2007. In July 2013, she informed her employer that she would transition to her female identity starting in 2013, living and working as a woman for a year before undergoing sex-reassignment surgery. Within two weeks, she was fired. A year later, the federal Equal Employment Opportunity Commission sued the funeral homes on her behalf.

And this decision is just the tip of the iceberg.  I'm hoping the EEOC appeals the decision all the way up the the Supreme Court, but that won't be a very fun time if Donald Trump gets to name a ninth justice, will it?

Sunday Long Read: Flair Apparent

The long-running joke behind restaurant chain T.G.I.Friday's is of course, the flair (and if you've ever seen the excellent 1999 comedy Office Space, you know exactly what I mean.)  But what happens to all the little doodads and collectible items that crowd the walls of your favorite casual dining watering hole when the chain finally decides to go twenty-teens minimalist?



Tall windows flood the vast dining room with natural light, illuminating a minimalist mix of rectangular and round tables—each ringed by tasteful, Modernist chairs—beneath a grid of industrial light fixtures and exposed wooden beams. Is this the city’s hottest new restaurant that everyone’s been talking about, the one with the locally sourced ingredients served on artfully presented plates? No, it’s the new T.G.I. Friday’s.



That’s right, Friday’s, the once-popular singles bars and burger joints found in the parking lots of many a suburban mall. In March 2016, the famously clutter-filled chain introduced the first prototype for its spartan new design concept in Corpus Christi, Texas. The most startling aspect of this otherwise inoffensive space is the complete lack of Friday’s characteristic kitsch. No tin signs or pedal cars adorn the walls; there’s no dark wood or Tiffany-style lamps; there are no chipper red-and-white stripes to be found anywhere.

If you live or work in San Francisco, as I do, this bare, open look has become as cliché and unremarkable as Teslas and luxury condos. The new Millennial-approved restaurant aesthetic, which Friday’s is attempting to replicate in Corpus Christi, has become the beige-linen wall covering of choice, papering over the scruffier textures of the city’s quirky saloons, galleries, bookstores, and mom-and-pop shops. Suddenly, everything is “nice,” and the steep prices, which well-paid techies can easily afford, are guaranteed to keep the riffraff out.

For the past 40-plus years, casual-dining chain restaurants have dominated the suburban landscape. Friday’s and its ilk have served as cozy sanctums for Baby Boomer collectors and other nostalgia junkies, filled to the brim with mostly authentic antiques, which ranged from low-value, easy-to-find items to rare, high-dollar picks. Now that the sterile, clutter-free look has infected T.G.I. Friday’s—it will soon spread to each of its 900 restaurants around the globe—2010s urban Modernism is about to go suburban. FourTaco Bell prototypes in Southern California suggest that the upscale minimalist look is spiraling rapidly down-market.

Truth told, restaurant kitsch has been dying a slow death for the last decade. There are exceptions, of course—the Cracker Barrel Old Country Store brand depends on folksy nostalgia to appeal to its long-standing customer base. But less-rural restaurants felt the sting when 1999 movie “Office Space” mocked the typical chipper casual-dining atmosphere and its myriad “pieces of flair.” In 2005, Friday’s went through the first of a series of make-unders, removing the fake Tiffany lamps and reducing the number of vintage tchotchkes on its walls. In 2007, Friday’s competitor Ruby Tuesday jettisoned its Tiffany-style lamps and flea-market mementos for a more sophisticated look while offering more expensive fare. Five years later, Chili’s Bar and Grill debuted its remodeled prototype in Mesquite, Texas, replacing its jumble of Southwest kitsch with Modernist furniture in natural woods and a few well-appointed antiques like framed sepia-toned photographs.

The new Corpus Christi Friday’s, however, is the first time the restaurant has completely severed itself from its original retro, candy-striped image. Jeff Walsh, president of Hospitality Solutions Design, spent decades adorning casual-dining spots with memorabilia. After starting his career as an antiques picker 35 years ago, Walsh launched his Beverly, Massachusetts-based interior design group, which has worked with Friday’s, Chili’s, Applebee’s, Bennigan’s, and Chevy’s, among others. Today, he says, restaurant owners are asking for a completely different style.

As something of a signage history junkie (Cincinnati is home to the American Sign Museum, a absolute must-visit if you come to town) this is a pretty fascinating story here at Collector's Weekly, detailing the history of how the kitschy restaurant got started and where all that stuff comes from. Enjoy.

And as always, tip your server.

Aetna Tu, Brute? Con't

With Aetna pitching a fit and bailing on Obamacare exchanges after the Justice Department decided to fight the insurer's planned anti-competitive merger, one heath care think tank estimates as many as a third of Obamacare plan recipients will have only one provider available.

With the departure of Aetna and other major insurers from a significant swath of Obamacare exchanges, health care industry analysts anticipate a dramatic increase in regions where competition in the Affordable Care Act marketplaces is low come the 2017 plan year. According to a report released Friday by the health care consulting firm Avalere, consumers in seven states are currently expected to have only one carrier option in their ACA marketplaces.

The report additionally compared the level of marketplace competition by geographical regions within each state.

"Avalere experts predict that one-third of the country will have no exchange plan competition in 2017, leaving consumers with few options for coverage," a press release unveiling the report said.

Avalere's predictions are based on insurers' public announcements so far about their intentions for 2017. Those plans could still shift ahead of the Nov. 1 open enrollment period.

The Avalare report breaks down expected insurer competition level by exchange market rating regions, the geographic areas used to set insurance premiums. Thirty-six percent of exchange market rating regions may have only one or no carriers in 2017. Another 19 percent of market rating regions are currently expected to have two insurers, meaning less than half the market rating regions -- 45 percent -- will offer insurers three or more plans. That number could grow, however, if insurers announce plans to expand.

Competition's already a problem, but remember if these planned mergers had gone through, far more people would have only one provider choice.  We'll see who picks up the slack, if anyone, but the real issue is that the Obamacare model and the for-profit insurance model aren't co-existing well at all.

One of them is going to have to go eventually.