Biden Thread

[Crandar]

We just got our new US ambassador, Mr. Tsounis. Not exactly the American Talleyrand, but he pays well:

A lawyer, developer and philanthropist, Tsunis has donated to both Democrats and Republicans, including more than $1.3m to Obama in 2012.

[Montmorency]

Crandar, if you wanted more about the internal dealings of the court, here is some. And on Chief Justice Roberts, who as I said prefers to make politics with finesse and subtlety compared to his copartisans, is as I suggested being shut out by the Radical Right majority.

Of those rulings, the Obamacare one ruffled the most feathers because Roberts reportedly reversed his position days before the decision was announced, ultimately voting to find the law constitutional.

“There is a price to be paid for what he did. Everybody remembers it,” said an attorney close to several conservative justices, who was granted anonymity due to the sensitive nature of the court’s arguments.

Context: A decade ago Roberts was going to overrule Obamacare/ACA in its entirety, but was persuaded that doing so would damage the court's legitimacy, so he negotiated with the liberals and satisfied himself with a pound (or two) of flesh from the program.

In 2019 it was reported that Roberts had originally voted to invalidate the individual mandate and uphold the Medicaid expansion requirement. He believed that the Constitution's commerce clause never was intended to cover inactivity, such as the refusal to buy insurance. But he was uneasy with the political division in the vote tally and also did not want to invalidate the entire law because he thought the individual mandate was only inseverable from "community rating" and "guarantee issue" provisions of the law. Due to this impasse he explored the argument that the individual mandate could be upheld as a tax and invalidating the Medicaid expansion. Breyer and Kagan had previously voted to uphold the Medicaid expansion, but decided to switch and join Roberts's opinion on that section.[64]

The Supreme Court as a concept has always been abstractly indefensible in its traditional form, but moreover it's been one of the single most important factors in the totalitarian radicalization of the American Right, since those who control the courts control the laws, and those who control the laws control the future, so you might as well try to seize all power in the name of the movement.


Meanwhile, Spain's government, which previously made it illegal to harass or intimidate women in interference with their right to abortion, is increasing access to abortion in public healthcare, increasing the rights of teenagers to abortion, increasing access to feminine hygiene products (such as in schools), and mandating up to three days' leave for menstrual pains - per month.

America goddam.

[Montmorency]

my father was a prominent anti abortion activist. clarence thomas was a close family friend growing up. i literally cannot tell you how many times i EXPLICITLY heard from these people, EXPLICITLY, smug glee over the idea of women dying from unsafe abortions. they see it as appropriate punishment and they say so, outright. i was told as a child, over and over again, that women who sought abortions deserved to die. you can't appeal to the morality of these people because they have none.

At first I misread the tweet as "my father was a prominent abortionst. Clarence Thomas was a close family friend" and was confused. Anyway, yes, I'm surprised if any veterans of 2000s Internet discussion boards could be unaware of this theme. But the naivety of the general population of passive liberals or apoliticals no longer surprises me, since 2016.

[Montmorency]

Here with Alabama, not to be confused for Mississippi. So it's already as bad there as it was in Ireland for the Duration, and abortion isn't even technically banned. What's horrific to me is that even if criminal(ized) syndicates can supply a steady stream of chemical abortifacients to red-state women (these already account for perhaps a majority of typical abortions), and none of these DIY procedures become medically complicated, all healthcare for women will come to suffer in quality and responsiveness.

If you want to understand the future of medical care for pregnant women in a post-Roe world, look no further than what is happening in Alabama. As others have pointed out for Slate, the leaked draft majority opinion in Dobbs v. Jackson Women’s Health Organization paves the way for criminalizing many aspects of pregnancy. While Texas’ abortion ban, S.B. 8, has essentially halted all abortions in the state, Alabama offers a glimpse of a troubling future in which the provision of medical care for pregnant people is deeply intertwined with the cultural attitudes that seek to criminalize “undesirable” pregnancy outcomes.

In the summer of 2020, I got a firsthand experience of these attitudes in action. Three weeks after starting to practice at West Alabama Women’s Center, my application for a medical license was denied and my temporary medical license revoked for what we can’t help but question may have been political reasons. Although I had been hired to offer general gynecological care, the Women’s Center has historically been known as an abortion clinic, and I am open on social media about my views that abortion should be on demand. Because of the eight-month-long process to reverse and reinstate my license, I did not begin to understand how dire health care access was in Alabama until I was able to practice medicine in March 2021.

I was astounded by how often patients were turned away from emergency rooms and their doctor’s offices in the middle of their miscarriages. No wonder Alabama has the third-highest maternal mortality rate in the nation, I initially thought. People are denied urgent medical attention outright, which left me wondering at first if health care providers were simply negligent and not keeping up with their medical education. Or was this lack of care a reflection of discrimination? Eventually, I landed on discrimination as the cause.

But I was wrong. The reality is much worse. Instead, these medical professionals seem to know what they are supposed to do, but choose not to.

I came to this realization when I saw a patient in active miscarriage (bleeding, passing clots, cramping) who had just had an office visit with her primary physician. She was forced to wait more than 48 hours in order to get the results of her bloodwork. Doctors will sometimes check a patient’s levels of HCG, or human chorionic gonadotropin, to help distinguish miscarriages from ongoing pregnancies or ectopic pregnancies. I could not understand why someone with all of the clinical signs of a miscarriage in progress was required to wait for much-needed intervention, all the while bleeding and cramping and suffering.

I was angry that the patient’s doctor did not just provide the standard medical treatment for a miscarriage: surgically removing the contents of her uterus, which would stop her pain and bleeding. Then I saw a different patient who was actively miscarrying, and a lightbulb clicked on: The doctors were afraid of being attacked by the state of Alabama.

Medical providers who treat pregnancy-related issues in red states exist in a constant state of fear of performing any procedure that can be classified as an abortion—even while the procedures remain legal. We know that we face the risk of being prosecuted, having our licenses revoked, or even being thrown in jail if we fail to precisely follow every regulation, no matter how arcane or medically unnecessary it is. (We can be cited if the clinic’s janitor’s closet isn’t the size deemed appropriate by the state, for example.)

As an OB-GYN, I work in active fear of being arrested for providing evidence-based health care in this state. I am certain that I am not alone. Intervening in an ongoing pregnancy would be examined as an “abortion” by the medical board and subject to the same scrutiny as any procedure I perform in my clinic. Doctors know that if you perform anything that could even be suspected of an abortion, you had better have all of your regulations followed to the letter. No wonder, even though we are directed under federal law to provide appropriate medical care to any pregnant person who shows up in the ER with a medical emergency, few in Alabama are willing to risk their careers and liberty to provide that care.

Too often, I see and hear about examples of this stigma and fear at work when women come to me after being refused treatment in the local ER. For example, one patient started bleeding heavily at home. When she got out of bed in the morning, she said blood and clots ran down her legs and onto the floor. She rushed to the ER, where she told the nurse practitioner that she had taken mifepristone and misoprostol for a medication abortion 10 days earlier. The nurse practitioner knew the patient was experiencing an incomplete abortion, which happens when the body is not able to completely pass the pregnancy on its own. (Miscarriage and abortion are often indistinguishable clinically, and that’s a huge problem because people miscarrying will be denied care because of abortion suspicion.)

As is protocol, the nurse practitioner called the OB-GYN on call. He said he would not see the patient. No further explanation was given. The nurse practitioner then tried involving the ER physician; however, he was “in a meeting” and unavailable. Ultimately, she was told by hospital administrators to send the patient more than 2.5 hours away for care, back to the clinic that gave her the medication to end her pregnancy.

Desperate for help, the nurse practitioner called me. I, of course, said that if the patient was safe to drive (ride with a friend) all that way, I would certainly provide the needed care. Sarah had an aspiration procedure with me that took less than seven minutes from start to finish. It was uncomplicated and safe. She later told me that she slept in the car during the 2.5-hour ride back home. Seven minutes could not be spared by the doctors at her local emergency room where she was bleeding on their floor. Instead, she was told to go away.

Many of the medical professionals in Alabama who refuse to treat women who are miscarrying are not incompetent or hateful—they are scared.

[Montmorency]

The Talibangelicals in Georgia this week bombed and destroyed a non-Christian monument (associated with right-wing conspiracism) known as Georgia's Guidestones after radical Republican politicians declaimed the site as a font of Satanic influence which needed to be smote.

God is God all by Himself. He can do ANYTHING He wants to do. That includes striking down Satanic Guidestones.

It is the culmination of a grassroots Evangelical campaign designating the site as Satanic since it was first established over 40 years ago.


ICYMI a few weeks ago the Supreme Court declared almost all gun control facially unconstitutional.

On the other hand, California has implemented its latest budget, including provisions for state-sponsored manufacturing of insulin.


During the public hearings of the January 6 Commission into Trump and stuff, the Republican Speaker of the Arizona House, Rusty Bowers, testified that he refused encouragement from Trump and Giuliani to overturn the result of the election in Arizona, and reaffirmed that the Bie Lie of the stolen election is indeed a lie.

You are asking me to do something that is counter to my oath when I swore to the Constitution to uphold it, and I also swore to the Constitution and the laws of the state of Arizona. It is a tenet of my faith that the Constitution is divinely inspired, of my most basic foundational beliefs. And so, for me to do that because somebody just asked me to is foreign to my very being. I—I will not do it.

Strong words!

If he is the nominee, if he was up against Biden, I’d vote for him again. Simply because what he did the first time, before COVID, was so good for the country. In my view it was great.

A great display of principled fortitude against attempts to morally compel him to vote for people who intend to do things he believes to be wrong and bad. One must certainly respect the man's commitment to his ethos!

[Montmorency]

Still can't believe the entire center-to-right spectrum united for a week in lying about the non-reality of the easily-provable account of a 9-year-old who was raped pregnant and struggled to secure an abortion following the termination of constitutional privacy rights. Hundreds of pubescent children receive clinical abortions every year! It's not even rare.

But more important than even this are the millions of women who will now (already are) be withheld routine or acute medical care because of the actuarial fear that any tangential medical intervention upon females or their reproductive systems could potentially be considered abortion by zealous state prosecutors. Even the Taliban would be confused.

Such a great evil stalks this country. In every facet of our lives fascists and theocrats seek to impose slavery and death on our people.

[Montmorency]

@rory_20_uk

Arguably not even the worst five stories I've seen yet about denial of medical care to ambulatory uteri.

Six days after the Supreme Court struck down the right to abortion, lupus patient Becky Schwarz got an unexpected message from her rheumatologist.

“This is a notice to let you know that we are pausing all prescriptions and subsequent refills of methotrexate,” the message read. “This decision has been made in response to the reversal of Roe vs. Wade.”

Schwarz was stunned. Methotrexate is a cheap, common drug prescribed to millions of Americans. Like her, many have rheumatic illnesses. Others take it to treat inflammatory bowel disease, psoriasis or cancer.

Yet few are aware that it is used off-label to end ectopic pregnancies, or that it could be restricted by doctors or pharmacists even in states like Virginia that do not ban abortion.

The reasons are numerous, and muddy.

In Texas, dispensing methotrexate to someone who uses it to induce a miscarriage after 49 days of gestation is a felony; that makes pharmacists hesitant to fill such prescriptions for almost anyone with a uterus. A new total ban on abortion in Tennessee will effectively criminalize any medication that could disrupt pregnancy past the point of fertilization, with strict exceptions for a patient who will otherwise die. And in Virginia, confusion over rules about who is permitted to prescribe drugs “qualified as abortifacients” may be blocking access to the medication.

“That’s what was shocking to me,” said Schwarz, a 27-year-old who lives in Tysons Corner, Va. “In a state where I thought I was relatively protected regardless of what the Supreme Court decided, I found out I wasn’t.”

Methotrexate was originally developed as a chemotherapy agent more than 60 years ago. But in low doses, it has proved to be one of the safest, least expensive and most effective treatments for roughly a dozen autoimmune conditions, from juvenile idiopathic arthritis to Crohn’s disease.

“It’s one of the most common medications that I prescribe,” said Dr. Grant Schulert, a pediatric rheumatology specialist at Cincinnati Children’s Hospital. “It’s really a mainstay of our practice.”

Indeed, methotrexate was first approved to treat rheumatic illnesses in 1959, before Schulert was born and almost 15 years before Roe vs. Wade was decided.

Since its reversal, many patients have been delayed or denied this “gold-standard” treatment for conditions that have nothing to do with pregnancy.

“I have gotten some reports where children have been denied methotrexate for their juvenile arthritis until they’ve proven they’re not pregnant,” said Dr. Cuoghi Edens, an assistant professor of internal medicine and pediatrics at University of Chicago Medicine and a rheumatology expert who treats adults and children.

In one case, a pharmacist initially refused to dispense methotrexate to an 8-year-old girl in Texas. In a note the child’s doctor shared with Edens, the pharmacist wrote, “Females of possible child bearing potential have to have diagnosis on hard copy with state abortion laws.”

Methotrexate is a folate antagonist, which can cause miscarriage at high doses. Although it is not used in medication abortion, it is the preferred treatment for ectopic pregnancy, a rapidly fatal complication that affects about 100,000 patients per year in the U.S.

In an ectopic pregnancy, the fertilized egg never reaches the uterus and instead implants, for example, in the fallopian tube. Such pregnancies are always fatal for the fetus and can also kill the mother.

Those patients represent about 2% of the 5 million Americans who take methotrexate. Yet this uncommon, off-label use is the basis for tight new restrictions on a medication that is disproportionately prescribed to women and girls of reproductive age.

“The majority of rheumatic diseases affect females at substantially higher rates than males,” Edens explained. “The prevalence of rheumatoid arthritis in women to men is 3 to 1. For lupus it’s 10 to 1. And so rheumatology is a very female-predominate patient population.”

Such patients take a far lower dose of methotrexate than is used to treat ectopic pregnancy or breast cancer. Most are counseled to use contraceptives, and to switch to alternative treatments if they seek to get pregnant.

Nevertheless, some doctors have already stopped prescribing methotrexate rather than risk falling afoul of antiabortion laws.

Many pharmacists have likewise refused to fill methotrexate prescriptions, or have demanded additional proof before dispensing the medication to patients they believe could get pregnant.

Experts say it’s not clear yet how many patients will lose access to their medication in the wake of the Supreme Court decision, or even which states might try to limit it.

That’s led to panic for many patients who rely on the drug.

“The biggest thing that right now I’m hearing is just a lot of fear of what is going to happen next,” said Schulert. “Even in patients who are doing well who stop a medication, about half will flare their disease in six to 12 months.”

Without methotrexate, many of Schulert’s juvenile idiopathic arthritis patients could no longer hold a pencil or type on a computer. Others face irreversible damage to organs and joints.

“Patients are saying, ‘I’ve been on this medication for years, I’m finally feeling like myself again, I don’t want to have to switch,’” said Zoe Rothblatt, a community outreach manager at the Global Healthy Living Foundation, a patient advocacy organization. “It’s the gold standard, and we need to get the word out so people aren’t scared and they’re able to get their medication.”

Early-onset puberty in females is now considered to be earlier than age 8. Substandard medical care across the spectrum is probably a greater ongoing public health hazard to women and girls in America than Covid at its height.