Evidence based care in Medicaid

We want to do evidence based care.  We want to do things that work and avoid things that don’t work.  This sounds simple.  Let’s look at two very good natural experiments on unintended pregnancy rates:

Colorado:

    Since 2008, Colorado has successfully increased access to family planning services throughout the state, particularly for the most effective contraceptive methods, such as intrauterine devices (IUDs) and implants.

  • The Colorado Family Planning Initiative has increased health care provider education and training and reduced costs for more expensive contraceptive options, enabling more than 30,000 women in the state to choose long-acting reversible contraception….
  • When contraception, particularly the long-acting methods, became more readily available in Colorado between 2009 and 2013, the abortion rate fell 42 percent among all women ages 15 to 19 and 18 percent among women ages 20 to 24.
  • Colorado is a national leader in the use of long-acting reversible contraception, and reducing teen pregnancy and repeat pregnancies.

    • Teen birth rates in our state have declined more rapidly than in any other state or the nation as a whole.
  • The birth rate for Medicaid-eligible women ages 15 to 24 dropped sharply from 2010 to 2012, resulting in an estimated $49 million to $111 million avoided expenses in Medicaid birth-related costs alone.

More reliable and effective contraception was made available to Colorado women who had the choice to elect Long Acting Reverisble Contraception (LARC) or do something else.  A significant number of women elected to use LARC and the increased autonomy and reliability produced amazingly good results.

Texas

 

Reducing contraceptive availability led to higher abortion rates and higher unplanned pregnancies. Earlier live births have massively negative multi-generational repercussions for both the parents and kids.

The evidence strong suggests that significant improvements in quality of life can be made and significant expenditures reduced if contraception is made readily available.

And guess what Congress will consider to be a high priority:

House Speaker Paul Ryan announced Thursday that Republicans will move to strip all federal funding for Planned Parenthood as part of the process they are using early this year to dismantle Obamacare.

Wahoo… the evidence will strongly support the hypothesis that this policy will lead to more unintended pregnancies, more abortions and far worse outcomes for far more Americans.

Evidence based policy making — Hoo Yaa



Floriduh Woman: Personal Grooming Edition

Don’t do this!

Internet punsters are celebrating Megan Barnes as Florida’s “Pubic Enemy,” others are chattering about her “razor sharp focus.”

The 37-year-old Barnes catapulted to instant fame for an alleged multi-tasking mash-up that earned the bottle-blonde’s mug shot a spot on hundreds of Web sites.

According to a startled Florida Highway Patrol trooper, Barnes was shaving her bikini area while driving south on the famed Overseas Highway when she crashed into the rear of an SUV March 2.

In the police report obtained by ABC News, the trim job was apparently essential because the arresting officer, trooper Gary Dunick, said the Indiana native told him she was heading to Key West visit her boyfriend.

“She said she was meeting her boyfriend in Key West and wanted to be ready for the visit,” Dunick told the Key West Citizen.

It gets weirder. In order to pay full attention to her sensitive regions, police say Barnes enlisted her ex-husband, Charles Judy, who was riding shotgun, to hold the wheel.

Yes, her ex-husband.

Much more information at the link.



Thursday Morning Open Thread: Rallying Against the New Not-Normal

The Washington Post reports:

Teresa Shook never considered herself much of an activist, or someone particularly versed in feminist theory. But when the results of the presidential election became clear, the retired attorney in Hawaii turned to Facebook and asked: What if women marched on Washington around Inauguration Day en masse?

She asked her online friends how to create an event page, and then started one for the march she was hoping would happen…

Now, more than 100,000 people have registered their plans to attend the Women’s March on Washington in what is expected to be the largest demonstration linked to Donald Trump’s inauguration and a focal point for activists on the left who have been energized in opposing his agenda…

Organizers say plans are on track, after securing a permit from D.C. police to gather 200,000 people near the Capitol at Independence Avenue and Third Street SW on the morning after Inauguration Day. Exactly how big the march will be has yet to be determined, with organizers scrambling to pull together the rest of the necessary permits and raise the $1 million to $2 million necessary to pull off a march triggered by Shook’s Facebook venting…

“We plan to make a bold and clear statement to this country on the national and local level that we will not be silent and we will not let anyone roll back the rights we have fought and struggled to get,” said Tamika Mallory, a veteran organizer and gun-control advocate who is one of the march’s main organizers.

More than 150,000 women and men have responded on the march’s Facebook page that they plan on attending. At least 1,000 buses are headed to Washington for the march through Rally, a website that organizes buses to protests. Dozens of groups, including Planned Parenthood and the antiwar CodePink, have signed on as partners.

Organizers insist the march is not anti-Trump, even as many of the groups that have latched on to it fiercely oppose his agenda…

They’re not anti-Trump; they’re just pro-everything Trump and his followers hate / fear / despise.

***********
What’s on the agenda for the day, as we prepare to keep on fighting?


(via)



Late Night Open Thread: “If You Can’t Get Rid of the Family Skeletons, Make Them Dance”

#ConfessMyUnpopularOpinions: I loathed Singin’ in the Rain so intensely it put me off movie musicals for life, so I never paid much attention to Debbie Reynolds. But after watching Carrie Fisher’s Wishful Drinking (highly recommended! — with due trigger warnings), I suspect her mother, if she had to die at all, would’ve loved the theatricality of dropping in her tracks while planning her daughter’s funeral.

NYMag:

While many paid tribute to Carrie Fisher’s legacy on Tuesday by sharing their favorite scenes from Star Wars or When Harry Met Sally, some fans chose to remember the actress for her work destigmatizing mental illness… Soon the hashtag #InHonorOfCarrie had over 180,000 unique visitors on Twitter with many revealing their mental-health issues…

Julie DiCaro, a Chicago journalist who also tweeted on Tuesday, told the Times that Fisher made it easier to not feel so alone in her illness: “It’s comforting that Carrie, or Princess Leia — who’s cooler than Princess Leia? — was comfortable speaking publicly about her struggles. It made me feel comfortable.” Which seems like the message Fisher would have wanted, especially as she chose to present only her true self, war wounds and all, in her later years.


Read more



Florida Woman! (Not BettyC!)

Florida Woman strikes again:

Police have arrested a 24-year-old Waldo woman who they believe called in a bomb threat to the University of Florida last week.

Jessica Ward was charged with making a false report concerning planting a bomb, which is a felony, according to a news release today from UF police.

The threat was made against the university’s engineering building, and Ward worked in the building’s Java Hut Coffee Kiosk, the release says.

Students were evacuated from the building Wednesday after a note was found on the first floor of the building in a restroom, and classes in the building were canceled for the rest of the day.

Later, during an interview with police, Ward said she wrote the threat. She told them she wanted to leave work at the threat’s indicated time so she could have “me time,” according to the release.

Ward was arrested this morning and remained at the Alachua County jail on a $15,000 bond.

Open Thread!



Late Night Open Thread: “Don’t Be Stupid, Don’t Be Dumb… “


[NSFW, obviously]
.

The indefatigible Pussy Riot electioneers in favor of… woman power, shall we say. I enjoyed it!

(via Dan Savage)



America’s Rage Puppet

trumppuppet

I remember clearly when Donald Trump’s birther crusade stopped being funny. There was never anything truly comical about it, of course; it was always an outrageous racist lie concocted to delegitimize the first black president. But living in a nation of 320M people, a not-negligible percentage of whom are raving idiots, we learn to laugh. Baratunde Thurston taught me to stop laughing and see the tragedy of it.

When President Obama produced his “long-form” birth certificate in 2011, I perceived it as a president hilariously smacking down an absurd, malignant, preening blowhard. Thurston saw it as an affirmation that the president — and by extension Thurston himself, and all other black people — were still less than full citizens. Even with a black man in the Oval Office.

Five years later, we’ve come full circle. That very same absurd, malignant, preening blowhard — whose birther antics should have banished him from the company of serious people forever — has instead been elevated to head one of our two major political parties. And this time, he’s telling Hillary Clinton, and by extension all women, that their aspirations are illegitimate and that they are less than full citizens.

Trump’s vile misogyny and painfully obvious lack of basic human decency — and more importantly, its echoes from tens of millions of our fellow Americans — have tarnished what should have been a joyous celebration of a historical milestone. We see them. We understand the implications.

wheel-of-fortune

Trump had help from nearly the entire GOP establishment, the Beltway media, his abhorrent family, his pack of ghastly political operatives, the Putin-reanimated remnants of the KGB and a self-important wanker with a grudge residing in the Ecuadorean Embassy in London as a fugitive from justice.

But that’s only the latest cast of characters. The hit has been out for Hillary Clinton ever since she emerged from Arkansas as a woman with a national profile and an agenda of her own.

During the recent debate, Clinton called Trump Putin’s puppet, and good for her. It’s about goddamned time someone said as much while the country was listening.

But Trump is not just Putin’s puppet. He’s America’s rage puppet, dancing in a fury because change is coming — no, it is here. And there are so many hands on the strings. That’s the tragedy of it.