nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
See here for more discussion.

Saturday, April 17, 2010

New England Journal: Citizens United Decision Will Adversely Affect Health Care

Leave it to the opinion pages of the New England Journal of Medicine (NEJM) to find a connection between political campaign funding and public health.

My most recent copy of the Journal has a piece that twists and turns to link the US Supreme Court decision to aiding those nefarious villains, scoundrels, carpetbaggers, and mountebanks who will fund efforts to undermine the health care of our precious bodily fluids.

OK, that was a piece of hyperbole, but I'm getting sick of opinions, particularly in scientific journals, that advocate political positions using the language one usually finds only in attack ads.

Citizens United was a decision that granted corporations status as entities indistinguishable from persons for the purpose of political speech.  I won't go into all the legal jargon about that.  You can argue that the Court went a step further than they were tasked to:  the original filing was against restrictions on certain types of political speech in the last 30 days of a political campaign.  Citizens United produced a film, called Hilary, the Movie, and was enjoined from airing it during this period.  The FCC used the status of the funding of the film to rule against the filmmakers. 

The NEJM authors echo the claims of other critics that the SCOTUS decision allows corporations, like health insurance companies, and unions, to "devote unlimited funds to advertisements supporting those candidates [who support their interests] and attacking their opponents." 

[Parenthetically, it's not clear that this will influence elections:  some legal authorities have pointed out that there were other ways corporations could get around this restriction, and some studies suggest that in those states where the restrictions on corporate funding didn't apply in certain elections, the lobbying efforts went about equally to both sides, and didn't seem to have a significant impact on election results.  So, in my opinion, the truth of this claim remains to be seen.]

For an interesting and informative discussion of lobbyists' (and others) impact (or not) on health care reform, see Maggie Mahar's two-part series on Health Beathere, and here.  I'm reading her 2006 book (see below in What I'm Reading), and finding it engaging and informative.  We don't share the same systemic view of the health care system, but she makes a strong case for what we should address in successful reform.  Recommended.

But, back to the NEJM opinion piece.  Like other critics of the Supreme Court decision, they are looking to stretch the Citizens decision to areas where an indirect effect may play itself out:  corporations inimical to the current reform can devote their largesse to politically undermine the law.

My sense is that this is a bridge too far.  A key strategy in politics is to rope in as many potential implications as you can to strengthen your case.  We saw this before in my post about Global Warming and dire impacts on infectious disease worldwide:  notional, but without data, and the examples of outbreaks used in that article showed only that now and in the past, weather has influenced disease and epidemics.

So, everybody take a deep breath...lets gather the data from both sides and let the science do the talking.


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