Living through 2014 has given many of us the sensation that after years of record warm years this could be an exception. Of course even if this was the case, one year would not change the overall trend, and certainly add no credence to the phony conservative claim of a hiatus in global warming. We can be mislead because having a generally cooler year in some areas does not mean the same is true globally. I was a bit surprised to find that the past August was the hottest on record and 2014 is still turning out to be one of the warmer years on record according to NASA’s data. The Hill reports:
The globe just experienced its hottest recorded August, according to new data released by NASA on Monday.
While last month is ranked the No. 1 August by temperature, the difference among the top five is fewer than .03 degrees Celsius, NASA said in an email to The Hill.
All together, summer 2014 ranked fourth out of the warmest summers on record.
The small difference between the top five Augusts, however, reveals that long-term trends are more significant when it comes to tracking global warming, according to NASA.
“August 2014 was a very warm month globally, and the 2014 is shaping up to be a very warm year,” said Gavin Schmidt, director of NASA’s Goddard Institute for Space Studies.
“In the broader context, these continuing high ranked months and seasons confirm and add to the long-term trend in temperatures that have been seen in recent decades,” Schmidt said.
The electoral college has been shifting in a Democratic direction since the Bush years when the country was split more evenly and a single state would determine the winner. This trend was seen both times Obama was on the ballot leading to the assumption that the Democratic candidate in 2016 has a strong edge. Tom Holbrook at Politics by the Numbers took a closer look at the electoral college. Here is a condensed version for those who want the predictions without going through all the data. The conclusion in the final paragraph is that the Democrats don’t have a “lock” on the Electoral College but do have a strong advantage:
In very gross terms, there is a an important trend in favor of Democratic presidential candidates. Looking just at the direction of movement (ignoring magnitude), there are 29 states that have seen Democratic gains, and 21 states where Republicans have gained strength. In terms of electoral votes, the states where Democrats have made inroads control 366 electoral votes, while the states with Republican gains control just 169 electoral votes. This is a substantively large and meaningful difference. However, it may overstate the case somewhat, since some states in which the parties gained strength were already in the Democratic or Republican column and only became more strongly partisan; and in a few states where a party gained strength (e.g., Mississippi and Georgia for the Democrats, and Minnesota and Wisconsin for the Republicans), their position is improved but they are still at a distinct disadvantage. And there are a handful of states where movement was very slight, though on balance in one party’s favor…
From this perspective, there has been clear and important movement in the direction of the Democratic party. The number of states that have moved through this zone in the Democratic direction (and the number of electoral votes associated with them) improves the Democratic position substantially over the past forty years. A couple of caveats. First, this is only one way to cut the data and the designation of the competitive zone is admittedly arbitrary (as most such designations would be). Second, this discussion places a premium on a certain type of change and ignores cases in which parties increased their grip on already friendly states. To be sure, there are a number of Republican and Democratic states where this has happened, and the Republican party has a slight edge in this category…
In the current period, Democratic candidates have a distinct advantage in close national contests. If the average state-level vote is 50%, the expected Democratic Electoral Vote count is 319. If the average Democratic state vote drops to 48%, Republicans would be expected to pick up Colorado, Florida, Nevada, and Ohio, but Democrats would still have a fighting chance, with an expected Electoral Vote count of 257. And, of course, if Democrats carry 52% on average across the states, they win a comfortable Electoral Vote margin. What is most impressive here is not just the Democratic advantage, but how that advantage has shifted since the 1970s, where the Democratic Electoral Vote was much more proportional to the national popular vote.
It is important to remember that the change in the Democratic advantage is not affected just by changes in patterns of party support across the states but also by changes in the Electoral Votes awarded to the states. In fact, changes in the distributions of electoral votes have muted the shift in Democratic advantage slightly. For instance, at a 50% average state vote the expected Electoral Vote of Democrats in the 2010s would be 333 if there had been no change in the Electoral College since the 1970s.
There is still no evidence of a Democratic “lock” on the Electoral College, but the data presented here do make a clearer case that Republican presidential candidates face an uphill battle, and that their position has deteriorated over time. The political landscape has changed appreciably in the last forty years and that change is politically consequential. Of course, all of this raises interesting questions about the causes of the changes in party support, questions I will take up in my next post (soon, I hope).
The causes have been widely discussed and it will be interesting to see if Holbrook comes to the same conclusions based upon the data as most political observers have. The most obvious trend has been for the Republicans to increasingly to have their support concentrated in the south and portions of the west, while losing support in most other states. Demographic changes such as younger voters, more educated voters, and racial changes have all favored the Democrats, leading to some red states turning blue, with others possibly flipping in the future. Holbrook does not see Texas flipping as others have predicted it might in the future.
Democratic advantages among the young and minorities are discussed more often, but the effect of education is also quite significant. In looking at the effects of education on voting trends, it is worth repeating an interesting statistic which I quoted yesterday from Electoral-Vote.com:
In 1980, when Ronald Reagan was first elected, white voters without college degrees made up 65% of the electorate. In 2012, that number was 36%. Ever since Richard Nixon began his Southern strategy, Republicans have been basing their campaigns on getting older white men without college degrees to back them. They still do, but there aren’t enough of them any more and it is beginning to be a real problem, hence the action in many states to limit who can vote (voter ID requirements) and when they can vote (shortening early voting periods).
Various forecasts for who will control the Senate are now tilting in the direction of the Democrats, with most still agreeing the race is very close, continuing a trend I noted at the beginning of the month. Some of the predictions more favorable to Democrats have been those which concentrate more on polls as opposed to historical trends and other factors. Nate Silver had previously discounted many of the polls, noting both the low number and often poor quality of polls available. Silver is now reconsidering his prediction, decreasing chances for Republicans to take control of the Senate from 65 percent two weeks ago to 55 percent.
Two things may be keeping Republican strategists up at night: money and the Democratic ground game. Perhaps the biggest untold story of this election is how so many Republican and conservative donors, at least those whose last name isn’t Koch, have kept their checkbooks relatively closed. In many cases, GOP candidates are not enjoying nearly the same financial largesse that existed in 2012, and in some races, they are well behind Democrats. While Republican candidates, national party committees, and super PACs are hardly starving, their Senate and House campaign committees have not been able to keep pace in fundraising with their Democratic counterparts. Their super PACs do not have nearly the funding that they had in 2012 (even allowing for the absence of a presidential race this year). And, in a number of key races, Democratic candidates, party committees, and their allied groups have been on the air significantly more than Republicans. GOP strategists have privately said that if it were not for spending by organizations affiliated with the Koch brothers, they might well be in really bad shape.
Many Republican and conservative donors appear to be somewhat demoralized after 2012. They feel that they were misled about the GOP’s chances in both the presidential and senatorial races that year, and/or their money was not well spent. In short, they are giving less if at all, and it has put Republican candidates in a bind in a number of places.
Another reason things might not turn out for Republicans is if the highly touted Democratic Senate ground game comes together. Clearly the Obama campaign and Democratic allies had a superior voter-identification and get-out-the-vote operation two years ago. Earlier this year, Senate Democrats announced the Bannock Street Project, a $60 million program with the goal of putting in place 4,000 paid workers to use techniques perfected and put to work in 2010 by DSCC Chairman Michael Bennet in his race, and again two years ago by the Obama campaign. While some Republicans have scoffed at the likelihood of Democrats being able to mount such an effort, they concede that the Democratic ground game was superior two years ago. In midterm elections, if Democrats can crank up the turnout among young, female, and minority voters, then their chances of success this year increase.
The GOP might be paying for its divorce from reality when Republicans were predicting victory in 2012 despite all the polling data showing that they were delusional.
Electoral-Vote.com also looks at how Democrats are spending their money more effectively, along with factors such as the culture war issues now favoring the Democrats and the Republicans big demographic problem–a considerable decrease in the low-information, non-college-educated white males who provide such a large percentage of Republican votes (emphasis mine):
Republicans used to use cultural issues like same-sex marriage and abortion to rev up their supporters and get them to vote. Now the shoe is on the other foot. It is the Democrats who are talking about cultural issues and scaring the voters with them. Not only has same-sex marriage gained enormous popularity in the past five or ten years, but Republican support for limiting birth control (such as in the Hobby Lobby case) is scaring women and driving them to the Democrats. Much of the Republicans’ problem has to do with shifting demographics. In 1980, when Ronald Reagan was first elected, white voters without college degrees made up 65% of the electorate. In 2012, that number was 36%. Ever since Richard Nixon began his Southern strategy, Republicans have been basing their campaigns on getting older white men without college degrees to back them. They still do, but there aren’t enough of them any more and it is beginning to be a real problem, hence the action in many states to limit who can vote (voter ID requirements) and when they can vote (shortening early voting periods). This year in states as diverse as Colorado and North Carolina, Democratic candidates are claiming that the Republicans are out of the mainstream. Such an approach was unthinkable 10 years ago, when it was the Republicans making these claims about the Democrats.
What Democrats in red states are also desperately trying to do is make the race between them and their actual opponent, not between President Obama and their opponent. In a new ad the Democratic candidate for the Senate in Kentucky, Alison Lundergan Grimes, literally says “I’m not Barack Obama” while shooting a gun. Then she shows a photo of her opponent, Sen. Mitch McConnell (R-KY), waving a gun with her saying he doesn’t know how to hold it. The Republicans, in contrast, are running against Obama everywhere. Obama himself is not sitting idly by. In October he will begin serious campaigning, although he may be limited to states where he is relatively popular, such as Colorado, Iowa, and Michigan. And of course he can show up in New York and California any time he wants to in order to raise money for the DSCC.
First Read points to how the gender gap continues to help Democrats.The Washington Examiner looked at how Democratic super PACs have been more effective in their use of advertising money.
The Republican playing field has also been narrowing, with states such as Michigan, and now North Carolina moving firmly in the direction of the Democrats. Having Kansas be unexpectedly in play also makes a huge difference. An election which initially looked highly favorable for Republicans now looks to be even.
Hillary Clinton appears to have unofficially begun her campaign in Iowa over the past weekend, and the response from the right is loud and clear: “Benghazi, Benghazi, Benghazi.” The right wing Heritage Foundation put out an old, meaningless story by Sharyl Attkisson which made it to the top of Memeorandum thanks to all the right wing blogs repeating it.
Even Glenn Beck’s web site, The Blaze, did a better job of giving the other side of the story:
The State Department on Monday rejected a report saying that senior officials purposely withheld sensitive documents from the group that was investigating the 2012 attack against the U.S. consulate in Benghazi.
Earlier in the day, the Heritage Foundation’s Daily Signal reported that senior officials worked to identify and withhold potentially damaging documents from the Accountability Review Board, which was investigating the incident. That story said former Deputy Assistance Secretary Ray Maxwell watched State Department officials and even some top aides to then-Secretary of State Hillary Clinton sift through documents.
But when asked about that report, State Department Spokeswoman Marie Harf rejected the entire story, and said the ARB had open access to all documents.
“The ARB had full and direct access to State Department employees and documents,” she told reporters. “Any accounts to the contrary, like that one you mentioned, are completely without merit, completely ill-informed.”
“These reports show a complete lack of understanding of how the ARB functioned,” she added.
Harf said the ARB had the authority to collect documents directly from “anybody in the department,” and said everyone in the department was told to provide documents to the body directly.
“That’s what happened,” she said, adding that ARB’s own cochairmen have said they had “unfettered access to all the information they needed, period.”
Otherwise reporting fell along ideological grounds as expected. Fox reported this as being news, and Media Matters debunked the story:
…Attkisson’s report has several flaws. It is based solely on conjecture from Maxwell, who does not claim and cannot prove that any documents were withheld from the ARB in its investigation, but rather only speculates about the fate of the documents that were reviewed.
The State Department has already denied Maxwell’s speculation in a statement to Attkisson — State Department spokesman Alec Gerlach called “the implication that documents were withheld ‘totally without merit,'” emphasizing that the “range of sources that the ARB’s investigation drew on would have made it impossible for anyone outside of the ARB to control its access to information.” Other allegations that the ARB investigation was biased have been repeatedly disproven.
Maxwell himself is a dubious source. He was placed on administrative leave after the Accountability Review Board’s investigation found a “lack of proactive leadership” and pointed specifically to Maxwell’s department, saying some officials in the Bureau of Near Eastern Affairs “showed a lack of ownership of Benghazi’s security issues.” A House Oversight Committee report released findings from the classified version of the ARB report, which revealed that the ARB’s board members “were troubled by the NEA DAS for Maghreb Affairs’ lack of leadership and engagement on staffing and security issues in Benghazi.”
Disgruntled over being “the only official in the Bureau of Near Eastern Affairs (NEA), which had responsibility for Libya, to lose his job,” Maxwell spoke to The Daily Beast in May 2013 in an attempt to “restore” his “honor.” Maxwell, who had filed official grievances regarding his treatment, expressed anger that Mills — the same staff member Maxwell speculated was involved in hiding potentially damaging documents — “reneged” on a deal to eventually bring Maxwell back to the NEA after his leave.
Attkisson, too, has been roundly discredited and is well known for her shoddy reporting, both during her time at CBS News and after leaving the network. Attkisson supported CBS’ disastrous Benghazi reporting, for which the network ultimately had to apologize and retract. And CBS executives reportedly saw her as “wading dangerously close to advocacy on the issue.”
Fox’s adoption of this story as a major new development is not surprising given the network’s history of relying on discredited Benghazihoaxsters and using “bombshell” to describe everything but new developments in the story.
There are plenty of real reasons to criticize Clinton, but the right wing is hardly going to criticize her for being overly hawkish, conservative on civil liberties, or for being too cozy with Wall Street. Instead they have to resort to continuing to raise the disproven Benghazi attacks.
Listen was an ambitious episode of Doctor Who, even if it does fall short of Blink, which it has been compared to. The episode deals with the character and origin of the Doctor, the further importance of the impossible girl in the development of the Doctor, along with Danny Pink’s (and presumably Clara’s) family tree. The episode begins with the Doctor writing on his chalk board (chalk boards are cool) and seeming to be talking directly to the audience about an idea he has come up with:
Listen! Question, why do we talk out loud when we know we’re alone? Conjecture: because we know we’re not. Evolution perfects survival skills. There are perfect hunters There is perfect defense. Question, why is there no such thing as perfect hiding? Answer: how would you know? Logically, if evolution were to perfect a creature whose primary skill were to hide from view, how would you know it existed? It could be with us every second and we would never know. How would you detect it? Even sense it? Except in those moments when for no clear reason, you choose to speak aloud. What would such a creature want? What would it do? Well? What would you do?
In many ways this is a repeat of previous Moffat ideas. The Weeping Angels, introduced in Blink, are a terror which can be hidden in plain site, only moving when you aren’t looking at them. The Silence took this further, with people losing all memory of seeing them. Now the Doctor postulates a creature which cannot be detected at all. However, while we learned about the nature of the Weeping Angels and the Silence, at the end of the episode it is not clear whether these beings even exist.
If the exist, they could mean that a common nightmare is really about something which has actually occurred:
I think everybody at some point in their lives has the exact same nightmare. You wake up, or you think you do, and there’s someone in the dark, someone close. Or you think there might be. So you sit up, turn on the light, and the room looks different at night. It ticks, creaks, and breathes. And you tell yourself there’s nobody there. Nobody watching, nobody listening, nobody there, naturally. And you very nearly believe it. You really, really try.
For the Doctor it was real, but instead of being a creature whose existence was unknown, it turned out to be Clara, back in time to the Doctor’s childhood on Gallifrey. Seeing the Doctor’s childhood in the barn does provide a connection to The Day of the Doctor, providing a reason as to why the War Doctor chose this place to decide whether to detonate the Moment. The scene also provides background to the Doctor’s antipathy towards soldiers (at this season, ignoring his past work with UNIT) and reused a line from 1963: “Fear makes companions of us all.”
It is questionable whether Clara could really control the TARDIS at all (even putting aside Sexy’s dislike of Clara, as revealed in The Doctor’s Wife), and even more questionable whether she it could have gone to Gallifrey, which was time locked, but whose status is no longer clear after the events of The Time of The Doctor. However these minor questions of continuity are outweighed by the manner in which Moffat ties in the entire history of the Doctor and the show.
Besides Gallifrey, the TARDIS traveled along Danny Pink’s timeline, presumably due to the importance to Clara’s. This included a visit to him as a young child, then called Rupert, to literally the end of the universe where a time-traveling descendant was stranded. If the implications are correct that Orson Pink is a descendant of both Danny and Clara, it looks like time travel is the Pink/Oswald family business on Doctor Who just as it is for Alec’s family on Continuum. Clara also has both influenced Danny’s decision to be a soldier and has made Dan the Soldier Man not only an important part of Danny’s life, but a family heirloom. Clearly, “A soldier so brave, he doesn’t need a gun” also refers to the Doctor.
Listen isn’t limited to other times ranging from the Doctor’s childhood on Gallifrey to the end of the universe. Moffat also took advantage of his experience from Coupling to present Clara and Danny’s first date. Things did not work out very well, but Clara ultimately figured out that she had to make it right.
One of the scenes of the date included an astronaut walking through the restaurant to get Clara. Using the astronaut suit made no sense, but this, along with the minor questions of continuity, can easily be overlooked. A more serious problem with the episode is that the initial question as to whether the creature which the Doctor speculated about does exist is never answered. Learning that Clara was the creature under the Doctor’s bed suggested that there was no need for such a complicated explanation for the nightmare. The noises in Orson’s ship could have been these creatures, or perhaps just noises from the ship. It is harder to explain what wrote on the Doctor’s chalkboard, and what was under Rupert’s sheets.
ICHABOD AND ABBIE TRY TO GET A “HEAD” OF THE COMPETITION ON AN ALL-NEW “SLEEPY HOLLOW” MONDAY, SEPTEMBER 29, ON FOX
Ichabod Crane and Lt. Abbie Mills concoct a daring plan to try to rescue Ichabod’s wife, Katrina, from the Headless Horseman by resurrecting a Frankenstein-like monster created by Benjamin Franklin. Meanwhile, Frank Irving faces new trouble after revealing the true details of his encounter with a demon, and Jenny Mills finds herself at odds with the new sheriff in town in the all-new “The Kindred” episode of SLEEPY HOLLOW airing Monday, Sept. 29 (9:00-10:00 PM ET/PT) on FOX. (SLH-202) (TV-14 L, V)
While sometimes Outlander seems to move too slowly, The Garrison Commander does advance the plot considerably. It seems to be a safe prediction that Jack Randall does not just forget about Claire following her marriage. The Hollywood Reporter interviewed Tobias Menzies, who plays both Jack Randall and, back in the 20th century, Clarie’s husband Frank. The interview does have some major spoilers as to future events from the novels:
Because Outlander is primarily Claire’s story, we don’t get to see Frank’s internal monologue while she’s in 1743 Scotland. Have you filled in the blanks in terms of Frank’s state of mind and what he’s dealing with back in England?
We see Frank still struggling to come to terms with what happened, and be at loggerheads with the authorities and the police. Basically, they tell him to go home and that his wife has eloped with someone else. He won’t believe it. Through the episodes, we see him coming to accept the version of events that people are saying to him. I suppose he does know Claire better than the others, and in a way, he’s right. She isn’t a woman who would run off with someone else, and he’s forced to give up. I think it’s a good episode.
At the end of the episode, Dougal proposes that Claire marry Jamie. How do you think Frank would react to that?
I think he would be pretty understanding. My understanding is that Claire, later on in the novels, reappears and is taken back by Frank, even though she’s pregnant and she tells this story of time travel. And for whatever reason, he chooses to accept it and raise a child together, which I think is a pretty big gesture on his part. What’s interesting about Frank is that he’s thoughtful. It’s not the great, most ostentatious of loves. In that respect, he’s overshadowed by Jamie and Claire. But I think [Frank and Claire’s relationship is] deep and meaningful and speaks volumes.
This was a big episode for Black Jack and Claire. Let’s talk about the interrogation scene.
It’s only a page and half in the book. It was a great decision on the part of the writers to explode that moment. In the book, there’s a lot of Jack being referred to and not a lot of him being there. You need him onscreen. I’m really happy with where it ended up. It gave us the time to go back and understand where the backstory with Jamie and Jack began and also to understand the emotions that are driving Jack, so he isn’t just a two-dimensional thug. Compared to the rest of the season, it’s a change of gear. It’d be interesting to see how people find it.
Here are some great examples of what Star Trek, the original show, could have looked if filmed in wide screen. Here is creator Nick Acosta’s description of this project:
Forty eight years ago this week Star Trek debuted its first episode on NBC. The show, like all other shows at the time, was broadcast in the old style 4×3 aspect ratio. Using HD screen caps from my friends at Trekcore.com, I created this project of what the show would have looked like in Cinerama widescreen. As a kid the show always felt bigger and more epic than it appears to me as an adult. I was able to create these shots by waiting for the camera to pan and then I stitched the separate shots together. The result is pretty epic. It reminds me of the classic science fiction movies of the 50’s and 60’s. Suddenly the show has a “Forbidden Planet” vibe. Other shots remind me of how director Robert Wise would use a camera technique to keep the foreground and background elements in focus.
Major television events of the upcoming week include the season finale of the best new sit-com to come around in a long time, You’re The Worst. Gretchen and Jimmy might be “the worst” but that is what makes them so fun to watch. If the season is a ten episode version of a warped romantic comedy movie, the eighth episode was the required portion in which the couple temporarily break up based upon a misunderstanding. Last week was somewhat of an origin episode with flash backs to before they met, as shown in the pilot. Hopefully this Thursday will end the season with the two back together, and ready for many seasons to come. The other summer sit-com from FX, Married, also ends this week. If it returns I will probably watch it, but it is You’re The Worst which I will really miss if it does not return.
You’re the Worst would also be a great show to binge watch if you haven’t seen it, with only ten episodes for the season and all highly entertaining. Another show to binge watch if you missed it (as I did until binging over the past week) is An Hounorable Woman. Certainly there are unrealistic aspects, but watching it for eight hours was like reading a highly entertaining novel, and the portions which might not be realistic in the real world can easily be ignored while following the events surrounding Nessa Stein and her family.
Binge watchers are also getting excited to hear that the full seven seasons of The Gilmore Girls will be available on Netflix starting October 1. In 2006 I posted some of the political lines from the show. USA Today has listed five top episodes to watch once they are available.
If you want to stick with science fiction, Vulture has listed the best science fiction movies on Netflix.
Nurse Jackie is to end after the upcoming seventh season. It is probably the right decision. We can’t keep going through cycles of Jackie getting off drugs and then relapsing year after year.
Community, on the other hand, deserves at least one more year and a movie–preferably far more. I am glad to hear that Dan Harmon is denying the rumors that Alison Brie is not returning.
Hayley Atwell, star of the upcoming series Agent Carter, will appear on the second season premiere of Agents of SHIELD. I don’t know if this will be a flash-back or Agent Carter at an older age. In other Marvel news, there is talk that the Hulk might return both for a television series and movie. New DC projects being considered include Supergirl and Teen Titans.
While the show has had its ups and downs, The Leftovers did end with a satisfying season finale (far more than I can say for True Blood). While the show will probably never really explain what happened, at least we have the view of some characters as for the reason only some disappeared, along with finally learning what The Guilty Remnant was up to. The show has now caught up with the end of the novel, making next season even more of an unknown.
Martin O’Malley’s incipient presidential campaign already has 11 staffers on the ground in Iowa, working to elect Democrats and build valuable connections for 2016.
Several sources have told The Daily Beast that the Maryland governor, a War of 1812 aficionado, has placed staffers through the Iowa Democratic Party’s coordinated campaign, the umbrella organization that runs field efforts for all the Democratic candidates. That’s in addition to the campaigns of the Democratic nominee for governor, Jack Hatch, and Democratic nominee for secretary of state, Brad Anderson, as previously reported by the Des Moines Register. The staffers are focused on either field efforts or political outreach.
O’Malley, who was the first Democratic presidential hopeful to appear in the Hawkeye State is the only Democrat with staff on the ground in Iowa. He also has sent staffers through his political action committee, the O’Say Can You See PAC, to New Hampshire and South Carolina. In Iowa, O’Malley is mirroring former Indiana senator Evan Bayh, who in 2006 sent a number of paid staff to help Hawkeye State Democrats before eventually deciding not to run for president.
The staffers O’Malley has placed will give him a head start if he chooses to run for president. They will be able to identify potential supporters far in advance, as well as build lists of volunteers key to the grassroots organizing necessary in the Iowa caucuses. And deploying staffers allows O’Malley to earn chits with Iowa Democrats and build a reservoir of goodwill that he can use in the future.
“He’s committed to electing Democrats in 2014, and this commitment of staff in Iowa is part of that strategy,” said Lis Smith, a spokesman for O’Malley.
Hillary Clinton will be appearing in Iowa on Saturday, with The New York Times reporting that she is looking like she is planning to run.
While Republicans have generally been trying to restrict access to contraception, recently some Republicans have been promoting making oral contraceptives available over the counter without prescription. Many people quickly saw through this. It gives the Republicans a way to claim they are removing a barrier to receiving contraception and avoid situations like the Lobby Hobby case. It also does something else–make contraception less accessible for many women. While the Affordable Car Act requires that contraception be covered without out-of-pocket expense to the woman, many insurance plans do not cover over the counter medications. This is also an incomplete response to the issue as there are many other types of birth control, including forms which many Republicans are attempting to restrict.
Birth Control Pills Should Be Available Over the Counter, But That’s No Substitute for Contraceptive Coverage
September 11, 2014
By Adam Sonfield and Sneha Barot, Guttmacher Institute
In recent weeks, some opponents of the Affordable Care Act’s (ACA) contraceptive coverage guarantee have promoted the idea that oral contraceptive pills should be available to adult women without a prescription. Sens. Kelly Ayotte (R-NH) and Mitch McConnell (R-KY), for example, recently introduced the so-called Preserving Religious Freedom and a Woman’s Access to Contraception Act, a bill that would urge the Food and Drug Administration (FDA) to study whether to make contraceptives over the counter (OTC)—though for adults only.
Making birth control pills available over the counter, if done right, would meaningfully improve access for some groups of women. However, such a change is no substitute for public and private insurance coverage of contraceptives—let alone justification for rolling back coverage of all contraceptive methods and related services for the millions of women who currently have it.
The Policy Behind Over-The Counter Contraception
Making birth control pills available OTC has merit, and the Guttmacher Institute is part of a coalition that has been working toward this goal for years. Leading medical groups have also endorsed such a move, including the American Medical Association and the American Congress of Obstetricians and Gynecologists. By removing the need to obtain a prescription, OTC status would eliminate this potential barrier to contraceptive use and thereby increase access.
This is especially true for uninsured women and those who don’t have time for a doctor’s visit or otherwise can’t readily reach a health care provider. However, if the goal is to truly expand access to contraceptive care—and not just provide cover for undercutting insurance coverage for contraceptives—the case to move birth control pills to OTC status should proceed alongside several other important policies and goals:
Protect contraceptive coverage and full method choice: The ACA requires most private health plans to cover the full range of women’s contraceptive methods and services, without out-of-pocket costs for the patient. This policy eliminates cost as a barrier to women’s ability to choose the method that is best for them at any given point in their lives, an approach that has been proven to make a substantial difference in facilitating access to and use of contraceptive services.
Contrary to what some policymakers and commenters have claimed, giving the pill OTC status would not be an effective substitute for the ACA policy. First, it would do nothing to help women access any contraceptive method other than the pill. This matters, since most women use four or more different contraceptive methods over their lifetime to meet their changing needs. If only the pill were available OTC and contraceptives were no longer covered by insurance, women would face significant new barriers in choosing the method that best suited their needs. Cost is a particularly steep barrier for highly effective methods like the IUD or implant that not only have high upfront expenses, but also require a trained provider for insertion and therefore are not candidates for OTC status.
Even for the pill itself, there is no convincing evidence to suggest that moving it to OTC status would substantially lower out-of-pocket costs to patients, let alone come close to the $0 out-of-pocket cost guaranteed under the ACA policy. Rather, making the pill available OTC, if done at the expense of insurance coverage, would replace one barrier (ease of access) with another (cost). Likewise, greater reliance on Health Savings Accounts or Flexible Spending Accounts, as some opponents of insurance coverage have proposed, would also merely replace full insurance coverage with patient out-of-pocket costs—leaving most privately insured women, particularly low-income women, worse off. Uninsured women on average pay $370 for a full year’s supply of the pill, the equivalent of 51 hours of work at the federal minimum wage of $7.25.
Millions of women already benefit from the ACA’s contraceptive coverage guarantee and these hard-won gains must be protected. Rather than substituting for contraceptive coverage of all methods and related services, OTC status for birth control pills should complement and enhance such coverage.
Strengthen coverage for over-the-counter methods: While the ACA’s preventive care provision specifically requires private health plans to cover certain products with over-the-counter status (including the emergency contraceptive Plan B, folic acid, aspirin to prevent heart disease and tobacco use cessation products), a prescription is needed for these items to be covered—essentially negating the benefits of OTC status. This prescription requirement should be eliminated for any current and future over-the counter contraceptives. Coverage of over-the-counter products without a prescription is already the norm in some state Medicaid programs and in the U.S. military’s Tricare insurance program. Further, ensuring full coverage for over-the-counter contraceptives would prevent “free-riding” by insurance companies that benefit from not having to cover pregnancies that were averted through patient out-of-pocket expenditures.
Ensure equal access for young women: Adolescents and young women, who face greater risk of unintended pregnancy and more barriers to accessing contraception than older women, have among the most to gain from a switch to OTC status. However, recent calls to give birth control pills OTC status as a substitute for contraceptive coverage have specifically excluded minors. That would require women 17 and younger to obtain a prescription, without providing any medical evidence to justify such restrictions. This approach would be harmful to adolescent women and would be counterproductive to helping them avoid unplanned pregnancies and the negative health, social and economic consequences that often follow.
In addition, excluding minors would likely not result in a true over-the-counter status, but instead could put contraceptive pills behind the counter, much as happened when the emergency contraceptive Plan B was first approved for OTC sales. To comply with an age restriction, stores would have to require proof of age via a valid picture ID from any woman who looks young enough to potentially be barred from purchasing birth control pills without a prescription. This would be an added hurdle for millions of women, and it ignores the reality that many young women do not have government-issued forms of photo ID.
Keep politics out of FDA decision making: To switch any drug to OTC status, the typical process involves the drug’s manufacturer submitting an application to the Food and Drug Administration (FDA), which—based on several criteria, including the safety and efficacy profile of the medication—decides whether to grant the request. The evidence is quite strong that providing birth control pills OTC would be safe and effective, including for minors. The FDA process should be driven by the evidence and free from political interference by the administration, Congress and others.
It is troubling but not at all surprising that Senator Ayotte and others who purport to be interested in contraceptive access would preempt the FDA with unfounded calls to bar minors from benefiting from any future OTC status for birth control pills. This echoes the longtime political and legal wrangling over minors’ access to OTC emergency contraceptive pills, despite clear evidence that minors could safely use these products without a prescription.
It is also noteworthy that there are dozens of brands and formulations of birth control pills, most of which would likely have to undergo the lengthy and expensive FDA process to gain OTC status separately. Because formulations of the pill are not medically interchangeable, with some women tolerating specific pills better than others, making one or several versions of the birth control pill available OTC would not benefit all current pill users.
Not A One-Size-Fits-All Policy Solution
Just as birth control methods are not “one size fits all” at any point in a woman’s life, let alone for all of her reproductive years, neither is there a one-size-fits-all policy solution to enhance access to the full range of methods, information and services for women of all ages and income levels, regardless of where they obtain their care. A wide range of approaches is necessary to meaningfully respond to women’s family planning needs in a comprehensive way.
One such approach includes making birth control pills available over-the-counter, if done so without additional costs or barriers to women. Doing so can complement and enhance current efforts to help more women become effective contraceptive users, including the ACA’s significant gains for comprehensive private and public insurance coverage for contraceptive counseling, services and supplies.
If anything, contraceptive coverage should be broadened to cover more women and strengthened to eliminate the prescription requirement for OTC methods that are covered. Other urgent priorities include expanded access to Medicaid, public support for safety-net family planning centers and the Title X national family planning program, comprehensive sex education and the development of new contraceptive technologies.
Truly increasing access to contraceptive care requires a multifaceted approach to meet the needs of all women throughout their reproductive lives. Political talking points will not do it.
This article was originally published on Health Affairs Blog at this link.
Click here for a recent statement from the American Congress of Obstetricians and Gynecologists (ACOG) supporting over-the-counter access to birth control pills as part of a broader dialogue about improving women’s health care as opposed to a political tool.
Bill Maher provides an example of why I think it would be a mistake for Democrats to nominate Hillary Clinton. The Hill reports:
“Rand Paul is an interesting candidate to me. Rand Paul could possibly get my vote,” the 58-year-old comedy veteran said of the Kentucky senator.
Maher commented on the son of former Rep. Ron Paul (R-Texas): “As I always used to say about his father, I love half of him. I love the half of him that has the guts to say we should end the American empire, pull the troops home, stop getting involved in every foreign entanglement… He’s way less of a hawk than Hillary, and that appeals to me a lot because I’m not crazy about how warlike she is.”When ITK asked if Maher, who donated $1 million to an Obama super PAC in 2012, would be doing the same for a Hillary Clinton PAC, he quickly answered, “No, I don’t think so. First of all, I’m not as big a fan of Hillary as I am of Obama. So we’ll see who’s running. I’m not even committing to being for Hillary.”
When pressed on whether he was leaning towards the Republican lawmaker in a potential Clinton/Paul matchup (neither has announced any 2016 plans), Maher said, “I wouldn’t say leaning, but I would say for the first time in a long time I’d be considering the Republican product. I might choose their toothpaste when I’m in the aisle.”
Supporting the Pauls on libertarian grounds is a mistake. I’ve looked at Ron Paul’s positions which would lead to less freedom in greater length in the past. However the question is not whether voting for Rand Paul makes sense but whether people will. It is not that I really think that Rand Paul could win a general election, and even his chances at the Republican nomination are questionable. It is also easy to dismiss Bill Maher here because he is often more libertarian than traditional progressive Democrat. This would be a mistake.
What must be considered is the future of Democratic voters. The old New Deal coalition is dead. Today’s Democratic voters include many who primarily support the Democratic Party because of objections to Republican big government–from the Iraq War to intrusions on the private lives of individuals. Millennial voters quite commonly fall into this group. They certainly are not as easy targets for a Rand Paul as some believe, opposing his views on the destruction of the safety net. When Democrats nominate a candidate such as Barack Obama, both Bill Maher and millennials are on board.
Hillary Clinton changes the calculus. Regardless of whether she runs against Paul, a conservative Democratic nominee like Clinton, who is weak on both foreign policy and civil liberties issues, gives little reason for either Bill Maher or millennials to get excited. She will probably still win (although that is far from guaranteed) but many voters will see far less reason to stick with the Democrats long term if they see it as the party of Hillary Clinton. The next presidential election could give Democrats the voters to solidify the support of young voters for years to come, but not under Clinton’s leadership.
There was certainly a lot of ridiculous hype today. Apple had their big announcement that their phone and watch can now do what Android devices could do for months, if not years, as long as you don’t want the freedom to configure things the way you want them to work, as opposed to how Apple thinks your devices should work. They were even doing their own live tweeting of the event, showing what control freaks they are.
There might have been a time when Apple was on the leading edge. Now they are just charging more for old tech which has an Apple logo on it. The Apple watch will start at $349–well more than the cost of my Sony Smartwatch II, even with the more expensive metal wrist band. The only real surprise was that the watch will be called the Apple Watch and not iWatch.
When I first responded to the event on Facebook and Twitter as the news came in, I did get a comment questioning the value of a smartwatch. I’ve been using a smartwatch for over two years and do find it to be of value, but I suspect that the majority of people do have little real need for one.
For me, the smartwatch essentially replaces my beeper. I receive many messages a day on my phone, including Facebook notifications, personal text messages, news bulletins, along with messages from the hospital or answering service which previously went over a pager. I need to both make sure I don’t miss any important messages, and know when an incoming message is important enough to respond to immediately versus letting it sit on the phone.
The smartwatch allows me to very quickly see whether an incoming message is urgent, and is far more discreet to check than pulling out a phone every time it vibrates. In some situations this is especially important, such as in a dark movie theater where it would be awkward to turn on the phone every time a message comes in. It also comes in handy if at the pool. I can put my phone safely in a nearby bag, and pick up messages on my waterproof smartwatch. In the event anyone does see me checking messages, people tend to think it is cool to see a message come in over a watch due to the novelty factor, while it often looks tacky to look at a phone when with other people.
Under some situations I just want to use the watch to monitor for important messages. At other times I can read more. This includes text messages, email, RSS feeds, and any notifications which a smartphone app can make.
Plus my smartwatch has an advantage which the Apple Watch does not–it is connected by blue tooth to an Android phone.
Of course there are many other things it can do. Some try to respond to tweets on their smart watch, but personally I think that if you are actually following an ongoing discussion, and especially if you want to type responses, at that point it makes more sense to just use your watch. (I also prefer to use a blue tooth keyboard if doing very much typing). Fitness apps are popular on Android smartwatches and I’m sure that many will use them on the Apple Watch. Some use their watch for fitness apps which track their foot steps every day but I found a limitation to this. I sometimes take the phone out of my pocket to charge during the day, preventing a complete count. While my LG G3 will generally last all day, I hear bigger fears that the iPhones will not do so, and changing the battery during the day is not an option as on many Android phones.
While certainly not essential, my smartwatch will also tell me the weather and remotely control my phone. I haven’t yet used the apps to remotely see the view screen of the camera or take pictures, but I can see situations where this might come in handy. I do use it to remotely control music sent from my phone to a blue tooth speaker. I have impressed friends over for football games when, after a score, I tap my watch and a speaker across the room starts playing Hail to the Victors. Sadly, for the first time since 1984, there was no opportunity to do this last Saturday.
Update: Reading more about the Apple Phone, it does look like some of the fitness/health capabilities are beyond what is currently available for Android. Of course, by the time the Apple Watch makes it to market, there are likely to be even more advanced Android apps. Plus, trusting your private health information with Apple sounds as sensible as sharing your nude selfies with them. Just ask Jennifer Lawrence.