Jonathan P. Baird

It is utterly backward that birth control has reemerged as a controversial issue. For the last 50 years, there was no controversy about it. Cost has been a factor but its need was not widely questioned. 86% of Americans support policies that make it easier, not harder, to get birth control.

So how can it be that the Trump Administration proposes rules that will make it harder for many women, especially the low income, to access birth control?

It is a slap in the face of modernity, as well as women.

In early October, the Trump Administration released new rules that allow employers more exemptions from Obamacare’s contraception mandate. Employers can now opt out of the requirement to provide contraception if they have “religious” or “moral” reasons.

Under the Affordable Care Act, company health care plans had to cover contraception at no cost to the insured. Obamacare required that health insurance plans fully cover preventive health benefits for women.

The Trump Administration rule change will adversely affect hundreds of thousands of women. The National Women’s Law Center has stated that as of September 2017, 62.4 million women had insurance that covered contraception without having to pay out-of-pocket. There will be plenty of women, given economic realities, who will not be able to afford birth control, whether birth control pills, IUDs’ or other methods.

One study found that the Obamacare contraception mandate saved women $1.4 billion in 2013 in the cost of birth control. I think that gives a ballpark figure for the yearly economic value of the contraception mandate.The Kaiser Family Foundation found that under the mandate the percentage of privately insured women who paid out-of-pocket for contraception dropped from 20% to 4%.

Blowing a hole in the contraception mandate by allowing more exemptions effectively guarantees less access to birth control and more unplanned pregnancies. Contrary to Trump Administration assertions, there will be a widespread impact.

In May, Trump had opened the door to an attack on birth control when he signed an executive order directing his administration “to address conscience-based objections” to covering birth control. This came in the aftermath of the U.S. Supreme Court decision in Hobby Lobby which granted corporations with a “closely held” ownership structure the ability to opt out of the contraception mandate.

The new Trump rules do not define the basis for moral objections to contraception. The vagueness will allow all kinds of entities – public and private – to assert their personal objection to birth control. These entities could be employers, insurance plans, universities, or individuals. Under the Trump rules, these entities would have no obligation to notify the government if they stopped providing contraception coverage. They would only have to notify their employees.

This is much different from the Obamacare rules where companies with a religious objection had to notify the government as part of the accommodation.

The Trump rules use religious liberty as a license to discriminate against women. The employer’s religious beliefs are granted a higher value than their employee’s right to preventive health care service. The rules are shockingly anti-worker. They also raise constitutional questions about separation of church and state.

It is easy to take the benefits of birth control for granted. Just to be able to plan when to have children is immensely important. Family planning goes hand in hand with school, work and career planning. There is also the human benefit of having a sexual life without the constant fear of pregnancy when that is not desired.

In this context, it must be mentioned that there are an estimated one million women who use contraception for medical reasons. For example, the pill is used to prevent and treat endometriosis, polycystic ovarian syndrome as well as treatment for painful periods, a condition called dysmenorrhea. The Trump rules do not account for women who have been prescribed birth control for non-contraceptive medical reasons.

One question that jumps out: why is the Trump Administration on its anti-birth control kick? I do not think it is a mystery. It ties in to the political marriage of strange bedfellows. You have The Donald who is a graduate of the Roger Ailes-Bill O’Reilly-Harvey Weinstein School of Sexual Predation and you have the far, far right that includes fierce anti-birth control zealots who are inspired by A Handmaid’s Tale. These folks see birth control access as encouraging risky sex and promiscuity.

Talk about an unholy alliance!

Trump made the calculation that he needs the anti-birth control reactionaries. They are part of his base and with the new rules, he is throwing them some red meat. As crazy as it may seem, the anti-birth control fringe has embedded itself in the Trump Administration, especially Health and Human Services.

Trump has systematically filled critical Administration positions with individuals who have had long track records opposing women’s health and supporting junk science. He hired Katy Talento as Domestic Policy Counsel to the White House. Talento believes birth control causes miscarriages and abortions. Trump made Teresa Manning the Title X National Family Planning Overseer. Manning, a former lobbyist for the National Right to Life Committee claimed in an interview with WBUR that “contraception doesn’t work” and she stated on C-SPAN that she does not believe the federal government should run family planning programs. The top Spokesperson for Health and Human Services, Charmaine Yoest, who spent years as an anti-abortion extremist, has supported phony claims that abortion causes breast cancer. Valerie Huber, Chief of Staff for Don Wright, the Acting Secretary of Health and Human Services, is an anti-sex education activist. She was CEO of Ascend, formerly known as the National Abstinence Education Association.

Since so many of the Trump appointees come out of the hardcore anti-abortion movement, you might think that anti-choicers would support contraception. After all, contraception is the best tool against conception and abortion. However, you would be wrong if you drew that conclusion. For these flat earthers, contraception is the devil’s workshop. There is a fringe in the anti-abortion movement that is simply anti-sex.

The president of the American Congress of Obstetricians and Gynecologists, Dr. Haywood Brown, nailed it when he said the Trump Administration was “focused on turning back the clock on women’s health”.

The ACLU, the National Women’s Law Center, California, Washington, Pennsylvania and Massachusetts have all filed suit against the Trump birth control rules. Opponents to the rule have strong substantive and procedural grounds to object. Hopefully, the courts will stop this.

in 2017, it seems unbelievable to me that we still have to fight for birth control – but we do.

October 2, the birthday of Mahatma Gandhi, was the International Day of Non-Violence. On that day, at the United Nations, the Indian delegation sponsored an event entitled “Significance of Non-Violence in Today’s World.”

The event did not receive any public attention in the United States. It got zero publicity. While it is not surprising, no one from the United States UN delegation, from Ambassador Nikki Haley on down, even bothered to attend.

It is sad and it speaks volumes that no one from the United States UN delegation was there. We are the country with the non-violent tradition of Dr. Martin Luther King Jr., a shining example of successful struggle. But at the same time, we are a country drenched in violence from our endless wars to our Las Vegas massacre to our everyday domestic violence.

We have become numbed and too accepting of the extraordinary violence around us.

I would not have known about the UN event if not for an old friend, Doug Allen. Allen, a philosophy professor at the University of Maine in Orono and a distinguished Gandhi scholar, was asked to speak at the UN event. Among a panel of experts, he spoke on the significance of Gandhi today.

In watching the event (it is available on the UN website), I was struck by the need for a renewal of the tradition of non-violent struggle in the United States. You do not hear much about non-violence as a political strategy. I think it is typically dismissed by cynics as the realm of hopeless idealism.

Professor Allen would dispute that perspective. The Gandhi he presented was a realistic activist. Gandhi waited on no political party to tell him what to do. Through decades of struggle working toward India’s independence. Gandhi maintained a concern about ethical questions. How do you live a moral life? How do you demonstrate care about human suffering? How do you lead a life of selfless service?

Gandhi was a moralist. He did not believe the ends justified the means. Gandhi did not want to lower his ethical standards.

At the same time, Gandhi, who was a lawyer by training, was realistic, cunning, and down-to-earth. He had been arrested and went to jail 13 times. He was very self-critical and considered himself a failure. He got depressed. As Professor Allen has remarked, he was not some Hallmark greeting card stereotype. He constantly reevaluated the best way to advance his non-violent movement. He was nuanced.

For those desiring social change and a genuine attack on income inequality in the United States, Gandhi’s history holds positive lessons. As activists here, we should not lower our ethical standards. I think of the examples of both King and Nelson Mandela. It was their moral power that drew people to their respective movements. No political party, while they have a role, can show us the way. We need movements outside our political parties.

The womens’ marches after Trump’s election are the most recent example of organizing that show how non-violence can power a massive movement. That potential needs to be harnassed. The horror that is the Trump presidency is also a powerful motivator.

I think identification with non-violence both sets a tone and prevents detractors from tarring social justice movements as “violent”.

Part of the job of a non-violent movement is raising consciousness about the violence around us. I believe we are too passive and accepting of what passes for normal violence. No shortage of items demonstrate this point.

We are in the 16th year of the war on terror. It is the 14th year since the start of the Iraq war. To quote the historian Andrew Bacevich: “On matters related to war. American citizens have opted out”. We do not pay that much attention. We have learned not to care. The wars are the equivalent of background music. As long as not too many Americans die, it is not a problem. Nobody seems to tabulate the astronomical cost.

The lack of rationale for these wars seem not to bother either political party. If we really cared about the troops, maybe we would oppose wars that lack any persuasive rationale.

The excessive bellicosity of our President also must be mentioned. While you could dismiss much of his verbiage as shtick, talk about destroying North Korea is unacceptable. Millions could potentially die in a nuclear war with North Korea. Trump’s talk about “the calm before the storm” is not reassuring.

NBC reported that Trump said during a meeting in July that he wanted a tenfold increase in the nation’s nuclear stockpile. This was the context where Secretary of State Rex Tillerson reportedly said Trump was a “moron”. Trump later denied NBC’s report, calling it “fake news”.

Gandhi would have put emphasis on challenging systemic power and not just the individual president but still Trump’s cavalier attitude toward war and violence is worrisome.

In discussing violence, it is impossible not to mention the Las Vegas Massacre. Our collective impotence in the face of this tragedy is remarkable. We are absolutely stumped about how to respond.

I think a renewal of the non-violent tradition in America is one appropriate response to Las Vegas and the broader violence. History shows that the moral power of non-violent movements can sometimes overcome opponents who are armed to the teeth.

In remembering Gandhi, I certainly did not want to say he was beyond criticism. I put him on no pedestal. However, he was a founder of the modern non-violent movement. For that alone, he deserves acknowledgment.

It has been a long time since I have featured any favorite poet of mine. I wanted to highlight Kenneth Rexroth.

I cannot remember exactly how I discovered him. I found Kenneth Patchen at the same time – the two Kenneths. Somehow I had gotten the New Directions paperback of Rexroth’s collected shorter poems. All I can still say is “wow”! The range and versatility of his poetry is impressive. I was drawn especially to his love poems and his political poems.

The West Coast anarchist tradition is very reflected in his work as is his love of jazz, his interest in Japanese and Chinese writers, and his engagement with Buddhism. I see him as a precursor to Gary Snyder and Lawrence Ferlinghetti.

For those unfamiliar with his work (he died in 1982), I wanted to offer a few of his poems.

On a military graveyard

Stranger, when you come to Washington
Tell them that we lie here
Obedient to their orders.

After Simonides

Andree Rexroth

Now once more gray mottled buckeye branches
Explode their emerald stars,
And alders smoulder in a rosy smoke
Of innumerable buds.
I know that spring again is splendid
As ever, the hidden thrush
As sweetly tongued, the sun as vital —
But these are the forest trails we walked together,
These paths, ten years together.
We thought the years would last forever,
They are all gone now, the days
We thought would not come for us are here.
Bright trout poised in the current —
The raccoon’s track at the water’s edge —
A bittern booming in the distance —
Your ashes scattered on this mountain —
Moving seaward on this stream.

Climbing Milestone Mountain, August 22, 1937

For a month now, wandering over the Sierras,
A poem had been gathering in my mind,
Details of significance and rhythm,
The way poems do, but still lacking a focus.
Last night I remembered the date and it all
Began to grow together and take on purpose.
We sat up late while Deneb moved over the zenith
And I told Marie all about Boston, how it looked
That last terrible week, how hundreds stood weeping
Impotent in the streets that last midnight.
I told her how those hours changed the lives of thousands,
How America was forever a different place
Afterwards for many.
In the morning
We swam in the cold transparent lake, the blue
Damsel flies on all the reeds like millions
Of narrow metallic flowers, and I thought
Of you behind the grille in Dedham, Vanzetti,
Saying, “Who would ever have thought we would make this
history”?
Crossing the brilliant mile-square meadow
Illuminated with asters and cyclamen,
The pollen of the lodgepole pines drifting
With the shifting wind over it and the blue
And sulphur butterflies drifting with the wind,
I saw you in the sour prison light, saying,
“Goodbye comrade.”
In the basin under the crest
Where the pines end and the Sierra primrose begins,
A party of lawyers was shooting at a whiskey bottle.
The bottle stayed on its rock, nobody could hit it.
Looking back over the peaks and canyons from the last lake,
The pattern of human beings seemed simpler
Than the diagonals of water and stone.
Climbing the chute, up the melting snow and broken rock,
I remembered what you said about Sacco,
How it slipped your mind and you demanded it be read
into the record.
Traversing below the rugged arete,
One cheek pressed against the rock
The wind slapping the other,
I saw you both marching in an army
You with the red and black flag, Sacco with the rattlesnake
banner.
I kicked steps up the last snow bank and came
To the indescribably blue and fragrant
Polemonium and the dead sky and the sterile
Crystalline granite and final monolith of the summit.
These are the things that will last a long time, Vanzetti,
I am glad that once on your day I have stood among them.
“When these days are but a dim remembering of the time
When man was wolf to man.”
I think men will be remembering you a long time
Standing on the mountains
Many men, a long time, comrade.

With the latest Republican attempt to repeal and replace Obamacare going down in flames, health care policy is at a crossroads. We can either act to improve Obamacare and move in the direction of universal coverage or we can backslide into an abyss where we leave millions more without access to any health care.

I believe Bernie Sanders showed the way forward when he recently proposed his Medicare-for-All bill. Sanders had sixteen Senate co-sponsors including such perceived 2020 presidential contenders as Kamala Harris of California, Elizabeth Warren of Massachusetts, and Cory Booker of New Jersey. This was drastically different from the experience Sanders had in 2011 when he introduced a similar bill. Then he had no Senate co-sponsors.

Not surprisingly, even as the bill was released, Republican and some Democratic naysayers popped up. It is entirely predictable that something genuinely progressive would draw heavy fire. Any plan of consequence would automatically be subjected to intense scrutiny and criticism.

The idea that Democrats would propose a visionary, bold plan is actually novel. For so long the Democrats have been the timid party, unwilling to stake out more than minimalist, incremental change.

Say what you will about the Republicans but they cannot be accused of timidity. They, without hesitation, try to move forward a maximalist, extreme right wing agenda, no matter how humanly destructive that agenda is.

Sanders’ bill proposes extending Medicare to all Americans, regardless of their age. It would be phased in over a four year period. Initially, in the first year, everyone under 18 and over 55 would be covered. Medicare now covers those over age 65. In the second year, it would expand to cover those over age 45. In the third year, it would cover those over age 35 and in the fourth year, it would cover everyone else.

The Medicare-for-All plan would also be far more comprehensive than current Medicare. It would include dental, vision, and hearing care.

Dental care in America is an unspoken scandal and as an issue it deserves far more attention than it has received. The fact that an estimated 130 million Americans have no coverage for dental care is a national disgrace. Nearly 50 million Americans live in places where it is difficult to access dental care. With this record, you might think we were some backwater Third World country instead of the great nation we are.

One-quarter of U.S. adults age 65 or older have lost all of their teeth. About 17 million low-income children do not see a dentist each year. Only 45% of Americans age 2 and older saw a dental provider in the past 12 months.

Untreated dental problems can have very serious health consequences. Medicare-for-All would be a revolution in dental care, greatly improving access. Sad to say but there are many people living with rotting teeth and dental pain who cannot afford any care.

Medicare-for-All would put an end to co-pays, deductibles, and the need to fight with insurance companies when they fail to pay for charges. In this plan, health care would be a right, not a for-profit business, and it would be guaranteed to all Americans.

Medicare-for-All would build on the success of the Affordable Care Act. Under the Affordable Care Act, more than 17 million Americans have gained health insurance. This has cut the number of uninsured to an all-time low. Among other things, through the Affordable Care Act, millions of low-income Americans in 31 states gained coverage through expanded Medicaid. Young people up until age 26 can stay on their families’ health plans. The Affordable Care Act also protected against exclusions for pre-existing conditions and life-time limits. All these gains are essential.

At the same time, there are still an estimated 29 million Americans who lack any health insurance. Many are underinsured or have to pay exceedingly high co-payments and deductibles charged by private insurers. It does not disparage the Affordable Care Act to acknowledge both its strengths and weaknesses. It was a step but health care for all requires new steps.

There is no contradiction in fighting to maintain existing gains and advancing progressive reforms while struggling toward Medicare-for-All. Those who say it will not pass now are correct but they fail to see that Sanders’ bill opens the conversation. It may be years before Medicare-for-All can be enacted but Sanders’ bill puts it on the national agenda and starts a critical dialogue. When there is a Democratic president and a Democratic Congress, the bill could pass.

The fact that there will be no instant results is hardly a reason to avoid this fight as this fight is worth it.

Certainly, the biggest question about Medicare-for-All is how it will be funded. There is no exact plan yet although Sanders released some proposals: a 7.5% payroll tax on employers, a 4% individual income tax and an assortment of taxes on wealthier Americans and corporations. At this stage, I think it is okay that no funding formula is nailed down. There is a need for more creative discussion about funding formulas.

Those predisposed to oppose the idea will focus on the funding and it is impossible to deny that the issues are real. The challenge is immense. Still, there is much evidence that a single payer system can ultimately get runaway spending under control.

Medicare could set fees and pay health providers in much the same way it does now. Billing could be much simpler. There could be a single billing form and a single fee schedule. The administrative costs of Medicare are at 2% while the administrative costs of U.S. private insurers averages 17%. This would save much waste and excessive administrative cost.

I know there are some who will see Medicare-for-All as some extreme socialist plot. Honestly that is such a parochial view. Nearly every industrialized country besides the United States guarantees universal access to health care. Think Canada, England, France or Germany. They all spend less on health care and have far better outcomes than we do. Medicare-for-All would lead to less out-of-pocket cost for the average family.

To quote Bernie Sanders:

“We remain the only major country on earth that allows chief executives and stockholders in the health care industry to get incredibly rich, while millions of people suffer because they can’t get the health care they need. This is not what the United States should be about.”

Polls show that support for single payer began increasing around the start of the 2016 campaign. More people now believe that health care is a government responsibility. A June 2017 poll from the Kaiser Family Foundation found 53% support for the idea of single payer health care.

I see Medicare-for-All offering the Democrats both an attainable long-term goal and an energizing vision that can garner huge grassroots support and unite disparate factions. For a party lacking coherent identity, that is no small positive. The effort will likely take years but it certainly can happen.