What Dems Need to Hear During Tonight's Brooklyn Debate

Tonight's debate at the Brooklyn Navy Yard falls five days before the next primary on April 19; as the eleventh hour approaches Dems have yet to really witness a true debate between Sanders and Clinton. Rather, both candidates offer up a host of canned and rehearsed compliments, making sure that the comparison is made between the low-brow style of the Republicans and the high ideal, high-minded approach of the Democrats. After this there is usually a brief segue-way, with not so veiled references to Trump, into a moment or two of general opposition to bigotry, misogyny, etcetera. The standard stock issues are then mentioned; with Clinton calling into question Sanders' Senatorial record on gun control while he constructs the Goldman-Sachs conundrum, insisting Hillary is a thrall to Wall Street. And the answers are always the same; no one expects to hear a mea culpa from Bernie about his previous support of the Protection of Lawful Commerce in Arms Act nor does one anticipate a complete and total denouncement of worldly possessions by Hillary. The beat goes on and we, the voters, become progressively less interested in the primary delegate calculus.
According to a recent Associated Press-Gfk poll, a majority of Americans believe that none of the remaining candidates, Republican or Democrat, represent their opinions and/or concerns on major issues. Furthermore, among all registered voters more than 63 percent state that they would be disappointed if Clinton and Trump become the candidates for the general election.
Voter interest is definitely waning. How could anyone be surprised? In Arizona, voters are made to wait 5 hours just to gain access to polling stations and Colorado voters are locked out of the primary system entirely--without benefit of caucus or an opportunity to cast a ballot. Let's be clear, tuning into a town hall or debate simply to be entertained by a billionaire's penchant for policy pugilism is not equivalent to being engaged in the political process. Similarly, the Dems have done a great deal to disengage their voters--the very idea of a superdelegate is anathema to and stands in stark contrast to a representative democracy. Consequently, Clinton and Sanders must work to reverse the out-going tide of electorate engagement and offer-up a traditional debate in the style and tradition of Lincoln-Douglas.
What would this new approach sound like? For starters, the voters deserve complete answers on the issues of fracking, the minimum wage and student debt reform. Both Bernie and Hillary need to recognize any previous waffling and/or miscalculations--own them and move on. From this debate forward deflection onto one's opponent to obscure one's true opinion or position is not acceptable. Please answer the question that is asked before invoking something your opponent said or did a decade ago.  Furthermore, many among us would like to witness Senator Sanders quiz Secretary Clinton on her views regarding nation-building and attempt to harvest her reaction to what President Obama cited as his single biggest mistake while in office. Why is this important? According to an interview recently conducted with the President by Fox News, the inability of his administration to anticipate the fallout from US intervention in Libya and the fall of Gadhafi was the worst mistake of his entire presidency. That is a profound statement as regards the position and responsibility of the Secretary of State-- during the episode cited US Secretary of State was Hillary Clinton; it brings into question Hillary's views on nation building and regime change. Is she a hawk? Is she a dove? Does she have the ability to forecast the near as well as the far consequences of a move on the international stage? We deserve to know. And more importantly, we deserve to hear it from her. We deserve to hear the candidates' views on public health issues, i.e. prescription drug costs(particularly cancer drugs), soil and water safety, chemical contamination of our ground water. Do they have a policy paper on women's health issues? And if not--why not? Many of us would like to hear Senator Sanders ask Secretary Clinton about gender-based pay inequity among her own staff. Democrats need to hear from their candidates the simple truth of their agenda as well as their vision for the country. Clinton needs to clearly disavow the influence of Big Pharma and Big Business in politics once and for all. Don't take their money, it's just that simple. Fracking? Yes or no. It can be that clear. It needs to be that clear. Because the message from voters is progressively less opaque: engage in the national conversation of our everyday or risk losing not only our interest but also our vote.

Please reference: ap-gfkpoll.com, abcnews.com, foxnews.com, cnn.com

Who is still Voting for Kasich? And Why? OR Kasich, the Contradictions and the Campaign Continue

John Kasich, current Republican Governor of Ohio, is still campaigning for the Presidency. He has somehow convinced himself and those in his immediate circle of staffers that there remains a plausible as well as possible way to the White House. Reliance on the remote possibility of a brokered convention is not a political strategy of any merit or substance. In fact, the argument can be made that such poorly spun strategy disenfranchises or at least marginalizes those who fall victim to this unique form of folie a deux, so often seen between conservatives and their candidate. The campaign continues more for the hubris of said candidate than to effect change or influence the national conversation. Kasich's campaign calculus is rooted in fiction much more than it is in fact. This scenario then begs the question--Who is still voting for him? And why is anyone, irrespective of party affiliation, supporting his campaign?
Kasich is against paid maternity leave; opposes the Family and Medical Leave Act (FMLA); opposes equal pay for equal work; and is governor of a state which has yet to pass into law any legislation against female genital mutilation (FGM). And arguably the most nonsensical, contradictory part of this candidate's composite is that he is father to twin daughters.
Recent studies show that less than one-third of working women in the United States are employed by companies that offer paid maternity leave. In addition, 40 percent of the Nation's labor force remains ineligible for the paid leave mandated by the Family and Medical Leave Act. Consequently, women who are either the sole or primary wage earners for their family have a vastly reduced or completely evaporated income should they become pregnant and take leave to deliver. When Kasich was in Congress, he voted against the FMLA not once but twice. Apparently, Governor and Candidate Kasich is either too arrogant or too inept or a combination thereof to ever imagine either of his daughters being single mothers or working mothers or mothers. Because if he did, the following series of sentences would never have been spoken in response to a reporter's question regarding paid maternity leave: The one thing we need to do for working women is to give them the flexibility to be able to work at home online...The reason why that's important is when women take maternity leave or time to be with children, then what happens is they fall behind on the experience level, which means that the pay becomes a differential. Besides the fact that his response is barely coherent and makes absolutely no sense either economically or sociologically, somebody keeps voting for this man and electing him to office. And even more frightening is the fact that in the US, Kasich is considered an educated man. An educated man votes against legislation that could only benefit his daughters, their future children, their future families? An educated man believes that his daughters deserve to earn less than a man for the same work? An educated man does not see female genital mutilation as a human rights violation?
Again, Governor Kasich does not support equal pay for equal work, nor does he support the Lilly Ledbetter Fair Pay Act. This is demonstrated by the gender-based disparity in pay among those employed by his campaign. For example, the average salary for a woman employed by the Kasich presidential campaign is $55,300, with a  median salary of $44,900; while the average pay for a man employed by his campaign is $60,700 with a median salary of $60,000. Of the ten highest paid Kasich campaign employees, nine are men.
Only 23 states in the US have specific laws against female genital mutilation, despite the remote and recent passage of Federal legislation proscribing the practice. Ohio, the state to which Kasich is governor, does not have legislation prohibiting FGM practices nor does it have legislation prohibiting parents, grandparents, legal guardians, from taking girls out of the country for the purposes of female genital mutilation. The World Health Organization recognizes four types of FGM: Clitoridectomy, total or partial removal of the clitoris or prepuce; Infibulation, the most radical form of FGM in which there is removal of all external genitalia and the vulva is stitched closed; Excision, partial or complete removal of the clitoris and the labia minora, with or without concurrent removal of the labia majora; Other, all other procedures, practices done to female genitalia for a nonmedical purpose.
FGM is performed for several reasons: to control a woman's sexuality, i.e. maintain virginity before marriage and fidelity during; to increase a girl's eligibility/attractiveness for a marriage match and ultimately make her more accepted within her ethnic/religious community; and as a traditional rite of passage. According to a January 2016 survey conducted by the US Department of Health and Human Services, more than half a million women in the US have either been subject to FGM or are at risk for an FGM procedure. Internationally, female genital mutilation is recognized as a form of torture and extreme violence against women and girls, and is a human rights violation. It is performed without benefit of anesthesia, anesthetic or analgesia; it can and often does cause sepsis, infection, incontinence, miscarriage, hemorrhage, as well as birth and pregnancy complications. It is also a cause of neonatal and maternal death.
Maybe, Governor/Candidate Kasich doesn't believe that Republican girls have these parts and could never be caught in a scenario where they or their daughters could fall victim to FGM. As a physician, I feel compelled to inform Mr. Kasich that Republican girls, in fact all biological and some not so biological girls, are endowed with this anatomy and can be subject to FGM if not granted legislative protection. In Ohio, according to the Population Reference Bureau, 24,320 women and girls are at risk for FGM; 12,079 are under the age of 18 years, while 12,241 are older than the age of 18 years.
In fact, women are vulnerable to all sorts of equal rights violations and indignities when legislation is not put into place to offer protection and deterrence. By choosing to exclude women from such considerations as equal pay, paid maternity leave and protection from female genital mutilation Kasich squarely disqualifies himself from consideration for President of the United States, as he does not feel an obligation to advocate for more than 52 percent of the population, women--a special interest group to which three members of his immediate family belong.

Please reference: law.cornell.edu, equalitynow.org, theslot.jezebel.com, dispatch.com. npr.org, prb.org

What Donald Trump Needs to do to Win-Over Women and their Vote

Donald Trump's appeal as a candidate does not, apparently, transcend gender. According to a recent NBC/Wall Street Journal Poll, more than 70 percent of the Nation's women and approximately 39 percent of Republican women have a negative opinion of Mr. Trump. The reason for this gender disconnect is simple: nowhere in Trump's platform or policy papers is there a single serious reference to women's issues and/or women's health issues.
There is more than a week before the next big primary contest within the GOP--this is adequate time for candidate Trump to refine his message so as to better appeal to women voters, irrespective of party affiliation. Women's health issues should enjoy a 'politics-protected' position within the conversation of any election cycle--meaning that such issues should be approached as objective public health concerns rather than subjective abortion-based polemics distorted to cast dispersions on an opponent's morality. In addition, women's health is inextricably linked to children's health,  i.e. a woman who lives in poverty has children who also live in poverty; a woman who is food insecure has children who suffer nutritional deficits; a woman who has no income and no health insurance has children with truncated opportunities; a woman who is marginalized by society because of gender or race, has children who are equally invisible and supremely vulnerable.
Should Mr. Trump and his campaign advisors decide to formally and seriously court women during this election cycle, the following issues must be added to the public health agenda of a Trump campaign and ultimately, a Trump administration: paid maternity leave; full passage of the Lilly Ledbetter Fair Pay Act; and renewed funding for free clinics with continued support for Planned Parenthood. Before going any further, it is important to note that pursuant to the Hyde Amendment of 1977, Federal funds cannot be used to fund abortions or abortion-related services--consequently, the topic of abortion as it concerns Planned Parenthood is not a part of any relevant and dedicated discussion about women's health on the 2016 campaign trail. The discussion of women's health as public health must finally evolve beyond the tired debate of pro-choice versus no-choice; women deserve a more carefully and compassionately crafted agenda that no longer hides behind this long-favored GOP feint.
Please consider the following: More than 1.4 million women, between the ages of 15 and 50 years of age, who gave birth in the past year, were unmarried; and 9.9 million single mothers are living with children. Why is this important? Juxtapose the aforementioned figures against the Nation's present employment and benefits packages available to working women.
More than 66 percent of unmarried mothers work outside of the family home and only about half of these women are employed full-time, while nearly one-fourth are unemployed. Among unmarried mothers currently looking for work, only 22 percent receive any form of unemployment benefit. If these women do find work, they must contend with an incredible disparity in pay; white women, for example, earn 79 cents for every dollar a man earns in a comparable job, while African American women earn 64 cents on the dollar with Hispanic women and Latinas earning a mere 54 cents on the dollar. (As another interesting aside, single mothers who have occupations such as physician or surgeon earn roughly 62 cents for every dollar earned by their male counterpart.)
This becomes an issue much greater than equal pay for equal work when one realizes that among families headed by single mothers, nearly 40 percent live in poverty; 52 percent live in extreme poverty. Extreme poverty translates into an annual income of $9900/year for a family of three or a weekly budget of $200. Implicit in the term family is children; we, as a country, place apparently no priority on removing income disparity for women, consequently, the health and well-being of our children does not get addressed nor has it been addressed during this election cycle. If single mothers are unable to earn enough money to care for their children as a national trend nay a national standard, how will the United States be able to maintain its international identity? If we do not nurture and nourish the very future of this country, what result do we hope to reap? Such a lack of investment will adversely affect our national security, our scientific and research community, our educational community and ultimately our ability to compete on the world stage. How can the US claim it is competitive when 55 percent of children with single mothers do not receive food stamps, not because their mother earns too much but because they do not have access to the necessary social services that can educate, inform and direct them towards available resources; and nearly 35 percent of single mother households qualify as food insecure. Food insecurity, simply stated, is a household-level economic and/or social condition in which there is limited or uncertain access to adequate food.
The women and children who live in poverty within the US have myriad health needs and little to no resources with which to negotiate access or payment; nearly one-fourth of single mother families have no health insurance coverage. Despite the Affordable Care Act's intent, too many women and children continue to fall into the abyss of no coverage simply because they live in a state which declined to expand its Medicaid programs; this declination then truncates a woman's ability to purchase health care for herself and her family in the ACA marketplace. It is not surprising, therefore, to learn that according to a recent Women's Health Policy Report, the United States has earned a "D+" in reproductive rights and access to quality health care for women. This low mark is due, in large part, to the steady closing of women's community care clinics across the country; since 2011, nearly 31 clinics permanently close their doors every year. In states like Missouri, this has left only a single clinic open to serve the entire state. For pregnant women this creates what can only be called a dangerous situation; low-income women deserve access to prenatal care--it is a fundamental right--which is being steadily denied by those in government who deem it prudent to stop funding and close clinics that previously saw to the care and education of this at-risk population. Although so many politicians and pundits claim to care so much about the health and well-being of the unborn, they deny access to quality healthcare to mothers and pregnant women. Say this aloud--if it weren't so pathetic it would be almost laughable.
Similarly, too many women in the US are forced to take unpaid maternity leave or "pregnancy disability leave" at the conclusion of their pregnancy. If so many women are single and soon-to-be single mothers, shouldn't we have employment legislation that mandates paid maternity leave? How can a woman prepare and care for a neonate when her income has essentially been stopped for 6 to 12 weeks? Again, it is the same politicians, on both sides of the aisle, who call for regulations and revisions regarding access to quality, means-tested or free women's health care while fervently advocating for the unborn; with absolutely no consideration for the woman and child once they leave the hospital. How does one provide for a infant when on unpaid maternity leave, if there is no wealthy family/boyfriend/girlfriend/support system in place?
Investing in our Nation's children is not only the right thing to do, it is our best defense policy, our best national security policy, our best education policy--in short, it is a winning policy. And only by investing in women's and children's health will America be able to restart its heretofore interrupted legacy of winning.

Please reference: infoplease.com, abcnews.com, singlemotherguide.com, ers.usda.gov, womenhealthpolicyreport.org, todayshospitalist.com

If You Didn't Vote for Bernie Sanders because You Think He's a Socialist--Think Again, You are Too

One of the most poignant lessons of the 2016 campaign season thus far, is the profound deficiency within the electorate regarding basic knowledge of civics and government. This dearth of information and/or knowledge is best illustrated each time the former candidate Marco Rubio and current candidate Ted Cruz identify Bernie Sanders as a socialist. If these Ivy League educated Americans truly believe that socialism is one of those -isms unique to Russia, the FSR's and China, then they must have absolutely zero understanding of Social Security, Medicare and Medicaid.
Democratic socialism, one of the layers within the bedrock upon which the foundation of this country was built, posits that both the economy and society should be structured so as to meet the needs of the public and not just benefit the wealthiest one percent. In the United States, civic texts commonly used this term, democratic socialism, to describe the services provided by state and federal governments--services supported by taxes collected from the public.
One would be hard pressed to find an American politician from either side of the aisle daring enough to speak against the long-protected sacred cows of Social Security, Medicare and Medicaid. Conversely, turn on any talk radio station in the Midwest and callers as well as program hosts regularly provide exhaustive soliloquies in which communists and socialists are blamed for the death of the steel industry, the diminishment of the auto industry and the steady deliquescence of the American dream. Those same individuals who indict socialism are the same individuals who benefit from the socialist safety net put in place by the federal government as far back as FDR's administration, if not earlier.
Please consider the following: On August 14, 1935, President Roosevelt signed into law the Social Security Act. This legislation created a social insurance program designed to pay retired workers a continued wage after retirement. The funds for this program, to this day, are extracted from the paycheck of every worker in this country. More specifically, Social Security benefits are funded by a dedicated payroll tax which is paid by workers, employers and taxes paid by those who are self-employed.
President Johnson signed the Medicare Bill (Title XVIII of the Social Security Act), July 30, 1965. This legislation created a National Health Insurance program funded by the Social Security Administration--in other words, the taxpayer. It serves, primarily, retired Americans and some disabled individuals. Medicare is an entitlement program rather than a needs based program like Medicaid; thus the poor, rich and the middle class may receive Medicare benefits provided they meet eligibility requirements. Similarly, Medicaid was established in 1965 as part of the Social Security Act. This program provides health care and medical services to low-income families. Since 1982 Medicaid has been available in all fifty states. Eligible pregnant women were granted coverage in 1985; and undocumented/illegal immigrants were given coverage for certain emergent health situations the following year. Under this program, the Breast and Cervical Cancer Treatment Act of 2000 was also added, which allows any uninsured woman diagnosed with either breast or cervical cancer to receive coverage, even if she does not meet eligibility income standards.
The benefits of the aforementioned programs could be explored in greater depth, but the point has been illustrated--the tenets of socialism underwrite a large part of this country's programs. It is hypocritical to deny this obvious state of affairs while cashing a Social Security check or  presenting a Medicare/Medicaid card at the physician's office or pharmacy. It is equally myopic to dismiss a candidate based on an -ism to which each of us, as Americans subscribe to and heartily underwrite--if you need further evidence of this, have a look at your latest pay stub.
Having programs like Social Security, Medicare, Medicaid is an irrefutable benefit to so many in our country; however, it is not possible to support the theoretical basis of such programs while indicting the political theory upon which they rest. Democratic socialism is not the political equivalent of communism nor is it the political equivalent of soviet socialism. The differences are many and varied; and it is the unique responsibility of the voter to understand and know these differences. Talk radio generalities and Republican debate night misstatements, rooted more in self-interest than in the greater good, are not acceptable substitutes for an educated electorate.

Please reference: medicare.uslegal.com, socialsecurityadminstration.org, trumanlibrary.org, gomedicare.com

Female Physicians Earn Less than Male Physicians

In a profession as seemingly as objective as medicine, gender-based discrimination is alive and well. Any physician, irrespective of specialty or gender can testify to the significant sacrifices required to be accepted to, navigate and finally graduate from medical school. The debt is nothing short of overwhelming. And if the newly minted physician had any graduate degrees prior to his/her admission to medical school, that debt remains and invariably complicates post-graduate financial existence.
This next statement may sound incredible but please persevere--Male and female medical students are charged the exact same amount/rate of tuition per year of medical school education. One's cost of tuition is, to my knowledge, not based on the presence or absence of certain gender-specific organs. That being said, why then has it become accepted throughout the world of physicians to pay women less than their male counterparts? Even after residency, loan repayment schedules are not based upon projected earnings for each gender. Financial expectations, as regards loan obligations, tuition obligations, etcetera, are constant across the board. There exists no uterus-friendly clause that offers a reduced rate of interest to female med school grads and residents.
However, before we all rush to implicate motherhood, two-income households, and this mysterious desire for part-time employment so many partially informed critics have assigned to us, as female physicians, let's examine the numbers.
The existence of gender-based pay-disparity is not a new or novel economic phenomenon. For more than a few decades, American society has compensated female employees at a rate of about 79 cents for every one dollar earned by a man. For female physicians and surgeons this disparity is closer to 62 cents for every one dollar earned by a male colleague. Recent surveys and several well-crafted studies have found that female physicians, irrespective of specialty, make on average $168,000/year; for male physicians, that figure is much closer to $200,000/year. When distilled further, mid-career female physicians, again irrespective of specialty, earn between $12,500 and $15,000/year less than their male counterparts; when these figures are extrapolated over a projected 30-year career--women, as physicians, earn $350,000 less than male physicians. This very significant gap does not account for all of the financial potential and opportunities lost which are irrefutably contained in a figure as formidable as $350,000.
At first blush, the aforementioned salaries for both male and female physicians may appear substantial enough to afford a certain immunity to internecine criticism; in that, the very weightiness of a physician's income, when compared to the yearly salary of the primary school teacher or factory worker neutralizes any call for equity among the genders. Many men and non-physician women have been overheard more than once to comment, "How much money does she need?" "She's a doctor, she'll always make enough money." "Her husband is probably a doctor too." The best and most simple response to this variety of commentary is by way of extant legislation, i.e. the Equal Pay Act of 1963, Title VII of the Civil Rights Act of 1964 and the Lilly Ledbetter Fair Pay Act of 2009. Equal pay for equal work is not a complicated issue--two workers that perform comparable job duties with comparable responsibility, having completed all requisite training, certification and licensure are to be paid the same hourly wage, receive the same percentage of reimbursement with comparable benefits and insurances.
This disparity will only be brought to an end within the field of medicine when female physicians-- academics and clinicians alike--find the strength and necessary courage to challenge and ultimately silence pay discrimination. I truly believe if we needed to accomplish something this seemingly Sisyphean for our patients, it would've happened years ago.

Please reference: eeoc.gov, mobile.nytimes.com, todayshospitalist.com

The More I Know the Less I Understand

It seems as though everyday one can find an article on the internet or some news service web site that speaks con brio about the advances in medicine against cancer, chronic disease, etcetera. Popular media regularly extols physicians and the country's health care network as conquering heroes, rivaled only by the likes of Charlemagne and Julius Caesar. In truth, the coverage afforded to the world of health and medicine is often very vague and generalized--neatly packaged for consumption by the average American who wants to be wooed by success and who desperately wants to believe that irrespective of lifestyle choices, treatment options will always be there. Doc can fix it. There's probably a drug for that. Very rarely are the contradictions explored. Even more infrequently, are those contradictions examined, questioned and ultimately addressed.
Please consider this contradiction: the United States is the only developed nation in which the maternal death rate is steadily increasing. (Maternal death rate is defined as the number of registered maternal deaths due to birth or pregnancy-related complications per 100,000 registered live births.) In fact, the Nation's maternal death rate has doubled in the past 25 years. American women are still dying (and at higher rates than the previous generation) of hemorrhage and amniotic fluid emboli. In 2013, the US maternal death rate was 28 deaths for every 100,000 live births. Many readers may feel unimpressed or fail to grasp the sense of urgency this rate conveys. Without any context, admittedly, the numbers may fail to impress.
Now please allow for some context: the US and Uzbekistan share the same maternal mortality rate, 28 deaths for every 100,000 live births. Romania and Albania fare slightly better at 27 deaths for every 100,000 live births. Our neighbors to the north, Canada, are able to boast of only 12 maternal deaths for every 100,000 live births. The UK also has a rate of 12 deaths/100,000 live births. Norway and Germany can both claim rates as low as 7 deaths/100,000; while Belarus and Italy each have roughly 4 maternal deaths for every 100,000 live births. These numbers are not put forth to ridicule, demean or diminish any country; rather these figures are submitted to draw a stark and frightening contrast.
Uzbekistan, Albania and Romania three countries with very similar maternal mortality rates to the US, spend $306, $506 and $982 per capita, respectively, on health care. The United States spends $8,845 per capita on health care. Now superimpose this comparison onto the country's current election cycle and the Republican promise to systematically defund Planned Parenthood.

Where are the physicians? Where is the American Medical Association (AMA)? Where is the American Osteopathic Association (AOA)? The women represented by the numbers provided above are their patients.
With all of this country's wealth, why are we unable to put the pieces together in a way that makes sense?

(please reference: worldbank.org, the Henry J Kaiser Family Foundation, cdc.gov, odh.ohio.gov, medicinenet.com)

A Kasich Victory in Ohio! What were they thinking!?

This evening's projected Kasich victory in Ohio is more than unbelievable; it stands as a testament to the continued disintegration of what was once a Jeffersonian democracy.
Irrespective of one's party affiliation--whether one is Democrat or Republican--it is near impossible to ignore the systemic damage a Kasich Governorship has wreaked upon the state of Ohio. Consequently, logic stands defied when Ohio voters use their collective electoral support to further the political ambitions of a Republican who boldly stands against the very cornerstone of a free society--a free and public education. The state's public school system has been left for dead in the wake of Republican corporate interests and their related business affiliations such as Imagine Schools--one of the country's largest for-profit charter school management and over-sight companies. As Governor of Ohio, Kasich lifted the cap on the number of charter schools allowed to operate within the state, opening the door to corporate entities like Imagine Schools; corporate entities which were then placed in a position to usurp public school funding, leaving inner city school systems (i.e. Youngstown, OH) to be taken over by the state. This brand of private corporate encroachment upon public schools assigns CEO's in place of School superintendents and defaults curriculum decisions to what is essentially a corporate boardroom.
Consider the following: In Ohio the public school system educates more than 90 percent of school-age children; under the Kasich administration, more than $515 million in state funding has been removed from the budget of Ohio public schools. Charter school funding, under Kasich, has grown by more than 27 percent--in fact, more funds are spent on charter schools than on the entire public school system in Ohio. Which is curious when one realizes that nearly 25 percent of charter school funding goes to underperforming or poorly-rated charter schools operated by David Brennan and William Lager. Brennan and Lager, collectively have contributed in excess of $5.4million to Republican political candidates and Republican causes. (please reference innovationOhio.org as well as cnn.com, breitbart.com, washingtonpost.com and Mother Jones.)
In addition, John Kasich counts the likes of George Soros' Soros Fund Management as a major campaign contributor. (again, please reference cnn.com, breitbart.com, washingtonpost.com) Kasich, similar to Soros, espouses an open border policy for the US in addition to blanket amnesty for all illegal and/or undocumented individuals. No vetting. No follow-up. No close looks. No second looks. Simple universally applied amnesty with an open border. Kasich does a fantastic job of couching or even insinuating his true agenda amongst Golden Rule-type references while fondly repeating such phrases as ,"I will not take the low road in pursuit of the highest office in the land". Such sentiment is often employed by creatures of the body politic to distract and assuage any anxiety amongst the voting public. It's not unlike broadcasting the Super Bowl during a nuclear missile strike--the pollsters, pundits, advertisers and politicians are masters at manipulating priorities within the public conversation. They know in which direction they want us to look. And tonight in Ohio it happened again. Many hopeful, well-intentioned voters were caught admiring the pretty light show and all the corporate cut-outs while the American dream sat in the corner of the auditorium, silently weeping.

Women's Health in the 2016 Election Cycle

On the eve of Super Tuesday many voters (including this one) are left wondering "What happened to public health issues?" "What about women's health?" "When are Dems going to set the agenda for the national conversation, rather than just react to the Conservative front runners?"
This election cycle public health issues, particularly those directly related to women's health, have been comfortably relegated to the purview of Democrats. And when left to the Dems, the focus on public health sharpened momentarily with citations of Planned Parenthood defunding and lead in the drinking water, but that was a transient interest, at best. Soon after a cursory mention in debate or town hall meeting the focus became fuzzy again, and the issue of public health was essentially deprioritized. The Dems continue to allow the Republican presidential candidates to inject inaccuracies into the national conversation with little if any contradiction or counterpoint. For example, Planned Parenthood and its network of clinics across the Nation have been consistently and vehemently demonized by Conservatives--the sole focus of such comments is abortion. Irrespective of one's view on abortion, Planned Parenthood clinics offer low-cost, affordable health care to women and their families; such services include vaccinations for both flu and tetanus, anemia screening, diabetes screening, cholesterol screening, employment and sports physicals, smoking cessation services, hypertension screening, thyroid screening--all of this in addition to well woman exams, health exams for men, HIV testing, STD/STI testing, and distribution of birth control. Does it make a lot of sense to defund or restrict funding to such an organization that provides so many fundamental, basic medical services when so many areas of the country are in the throes of a primary care shortage, i.e. inner city and rural towns? Furthermore, Planned Parenthood has an income-based fee schedule and does accept Medicaid. Too many primary care providers are limiting the number of Medicaid patients that their practices will see, if they are willing to see any at all. Why or better yet how has it become acceptable to remove from at-risk communities, the one provider who will see and treat everyone? It would be a wonderful thing to have the Democratic nominee pose such questions to the nominated Republican during the general election debates. Who amongst us, however, believes it will happen?
 Going still further--the realignment of states' WIC reimbursements hasn't made the list of election issues, neither has the need to fully revamp food sources that supply the National School Lunch Program. In addition, neither side of the aisle is addressing ground water contamination with atrazine and glyphosate--two lawn chemicals and known human carcinogens which are readily available in any home improvement store.
As the election cycle progresses the bipartisan marginalization of public health and women's health issues must stop; these areas of concern deserve advancement to the fore of our national conversation.