“Birthing Person” and the Debauching of the English Language

I’d like to say I’ve seen everything now, but I’d only be fooling myself—UNLESS those of us who love the English language put a stop to radical progressives destroying and politicizing the English language to their own narcissistic advantage. The latest example is Rep. Cori Bush’s use of the moniker “birthing person” for “mother.” Senator Lankford of Oklahoma recently confronted HHS Secretary Xavier Becerra about the use of that nom de guerre (and yes, it made me go “grr”) for “mother” in new HHS regulations and budgets. The radical progressive despots have become so enamored with their newfound terminology that they don’t see how they’ve castrated their own long-held convictions about the gender formerly and patriarchally known by some as the fairer sex. (You Prince fans see what I did there on several levels, right?)

The obvious problem with “birthing person” is that it reduces the biological woman to her biological function. I thought feminism (can we even use THAT term anymore?) was all about breaking the stereotype of “barefoot and pregnant in the kitchen,” but I guess the progressives want to go back 70 years and restore that role for women, seeing them only as vessels to perpetuate the human race. I would think women would be furious, and it appears that many are. It also strips the woman of all that goes into being a mother, because I think most women agree that there is much more to being a mother than just giving birth.

The term is also at its core transphobic as well. A male who has transitioned to a eunuchoid (regardless of gender identity or nonidentity) can never be a real “birthing person,” so this gives the biological woman a decided advantage over the eunuchoid. Where’s the equity in that, eh progressives? They get all the attention for bringing that cute little baby, um, I mean birthed person, into the world. Eunuchoids will never know the joys of sensing the life of a soon-to-be-birthed person growing and developing in their bodies and the ecstasy that comes when the baby is finally birthed into the world.

I would think the term “birthing person” would also be offensive to those women who have never given birth, but have been foster and adopting mothers to millions of children. Again, where’s the equity? If they are caring for children in a family unit the same way a “birthing person” would, why should they have a different title? (By the way, that would go against Federal Plain Language guidelines, which state that you can’t use different terms for the same function or type of person in Federal regulations.) I can imagine the regulatory nightmare of trying to sort out perinatal language if a birthing mother gives up her child for adoption at birth.

And let’s not deny that the men who father the babies have an emotional attachment as well. I shared in the (creation and) birth of all three of my children. And I’ll be spitting nails if someone tries to call me an “birthing observer.” I supported my kids’ mother through all three pregnancies, and that contribution was priceless to me and appreciated by her.

If all these reasons aren’t enough to stop the slippery slope into the debauching of the English language, I’m almost certain this final reason will. If we’re going to reduce mothers, or women, to their primary biological function in perpetuating the human race in our terminology, then it’s only fair we do the same for men. So, if the regulators want to insist on “birthing person,” then they need to reduce the father to his biological role in the procreation process as well: change “father” to “impregnator.”

[Mic drop.]

Scott Stocking

My thoughts and opinions are my own. And in case some of you have trouble recognizing sarcasm or a tongue-in-cheek comment, that’s what the last paragraph is.

Are Bezos and Buffet Calling the Shots at CMS? (#SustainableAmerica)

The effort to help keep drug prices down took an interesting turn last month with the CMS proposed rule to eliminate “safe harbors” for rebates to pharmacy benefit managers (PBMs) and insurers and transfer that safe harbor to the point of sale. For several years now, PBMs have served as the go-between for insurers and the pharmaceutical industry to manage the prescription drug benefits for plans on all lines of health insurance—commercial, Health Insurance Marketplace plans, and government health care programs.

Power of the PBM

PBMs use their purchasing power, by virtue of representing several plans with millions of customers, to negotiate rebates and discounts with pharmaceutical manufacturers. Rebates are passed on to the insurer, in whole or in part, ostensibly to reduce premiums. Discounts serve to reduce the cost of the drug. However, it’s not always easy to discern how much the price of any one drug is reduced by these factors, and therein lies the beef with the system.

However, PBMs do much more than just negotiate drug price reductions. Often they serve as the check and balance between the provider and patient, examining and enforcing clinical guidelines to ensure that patients are not only getting the best priced drugs, but also to get the right drugs in the dosage quantities they need. They also look at other guidelines such as prior authorization and step therapy to ensure that other, less costly treatments are tried; that prescribed drugs don’t negatively interact with other drugs; and that less expensive but equally effective drugs are tried first before more expensive drugs are prescribed. This can also serve as a check against doctors who may have questionable or illegal agreements with pharmaceutical companies to prescribe their drugs.

PBMs also perform many customer and pharmacy services as part of their agreement with the insurers they represent. If a pharmacy is having trouble processing a claim, the PBM can assist with any technical or coding issues with the claim. Pharmacies can also contact the PBM if in reviewing a patient’s drug regimen they discover a drug interaction concern or other utilization issue through a State’s prescription drug monitoring program. The new proposed rule seems to downplay these important roles of the PBM, and could potentially impact the quality of care a patient receives.

Plundering the Pharmaceutical Market

This is where Bezos’s, Buffet’s, and Dimon’s venture into the prescription drug market is somewhat concerning, not so much because they claim they want to lower drug prices, but in that their description of how they want to do it seems to line up with CMS’ latest proposed rule. They want to eliminate the middlemen from the process as much as possible, which could have serious consequences for quality of care on the one hand, and could position the richest men in the world  (richer than some pharmaceutical companies in most cases) to be the real “middlemen” (and profit takers) in the drug supply chain.

The article cited in the previous paragraph gets a key fact wrong about PBMs. Not all of them enrich themselves on the rebates. As such, making out PBMs (or the insurance companies, for that matter) as the bad guys is not really accurate. It is dangerous at best to eliminate checks and balances that PBMs and insurance companies offer. As I said above, they can help ensure that patients can get the best drugs at the best price and keep an eye out for potentially life threatening drug interactions.

And, we’re fooling ourselves if we think Bezos and Buffet haven’t found some way to cash in on this. How would they function any differently than a PBM, except there’s nothing to indicate in the article cited that they have any intention of maintaining any kind of integrity in the system. If they really think they can go direct from pharmaceutical to consumer, they have a ton of logistical challenges to overcome. They claim to have the technology in place to offer these point of sale rebates. Is it much of a leap, then, to assume that they’ve helped CMS write this new proposed rule to fit their model? (As an aside, when I worked for a government contractor, we usually knew that certain high-dollar bids were written in such a way so that only CMS “favorites” would qualify, so it’s not too much of a stretch for me to assume Buffet et al. have helped write this rule to favor themselves.)

Pilfering Providers

Whatever they’re planning will most likely not lead to reduced costs, but only change who pockets the “savings.” And the proposed rule ignores an equally concerning threat to the Medicare trust fund and the solvency of State Medicaid programs: improper payments. Last year, improper payments for Medicare (all parts) and Medicaid were nearly $85 billion, with only a fraction of that coming from Part D prescription drug plans (1.66% for Part D, compared to 8.1% for Medicare FFS & Part C and 9.8% for Medicaid). Part D plans and their PBMs are the most efficient at holding down improper payment rates. (By the way, the Medicare/Medicaid improper payment amounts surpass the improper payments of all other agencies combined!) Some of those improper payments are recovered eventually, but the breakdowns reveal that no more than half that amount is recovered.

Conclusion

Ultimately, the problem with pricing has little to do with PBMs, insurers, and other middlemen. The pharmaceutical companies alone determine their pricing and in turn whatever volume discounts or rebates they choose to negotiate with the middlemen. In a free market economy, it would be dangerous indeed to start putting price controls on any business, let alone pharmaceutical companies. And it would be even more dangerous to let the swamp dwellers in Washington do a complete takeover of health care, because the improper payments numbers prove they’re not capable of efficiently managing what they do control.

Scott Stocking has worked the last 8 years in the area of Medicare and Medicaid integrity education and now as a Sr. Regulatory Analyst in the commercial and government health insurance industry. His opinions in this article are his own and are not intended to represent those of any employer past or present.

 

 

 

 

The Myth of “Born That Way”: Vote NO on LB167 (#SustainableAmerica)

People should have the freedom to do what they want with their lives. That’s the American dream. If you’ve read my blog posts, you know I love God and love America. But just because I love God doesn’t mean I want to impose my beliefs or values on someone who doesn’t believe as I do. In fact, I’m a bit Libertarian when it comes to that. Although I believe God looks with disfavor on homosexuality, I am not a fan of making laws against or persecuting those who choose that lifestyle (yes, I said “choose”). That’s ultimately between the individual and God, or just up to the individual if they make the free-will choice to deny his existence.

Let me also say that the extreme expressions of so-called Conversion Therapy that Nebraska State Senator Megan Hunt has been “promoting” are truly horrifying as well. I find no value in those extremes, and any licensed professional who uses such methods without medical warrant should have their practice reviewed according to due process and suspended as appropriate. What I’m about to say here should not be taken as an endorsement of the macabre extremes.

Challenging the False Narratives

What I am challenging, though, is the notion that homosexuals, transgenders, and individuals with various manifestations of gender dysphoria cannot change because they’re “born that way.” When you really think about the progressive- and media-driven narrative that ALL homosexuals have that preference because of some innate biological disposition, it’s easy to pick out the flaws. I know of no other behavior for which any scientist can say 100 percent of the cases are attributable to one and only one factor, biological or otherwise. Most studies that try to suggest biology is the sole factor have serious methodological flaws. And yet the Left wants to persist with the false, misleading, and dare I say abusive narrative. That belief in a false narrative is what is driving Senator Hunt’s misguided LB167 to criminalize not just all forms of so-called Conversion Therapy, but to ban any professional from even suggesting that a person struggling with sexual identity issues might consider being restored to the Creator’s original design (see Genesis 1:27 and its reaffirmation in Romans 1:22–32).

A person’s expression of gender and sexual preference cannot and should not be reduced to biological factors only. If gender is a “social construct,” as those on the Left are fond of saying, then it certainly has strong psychosocial and even behavioral etiological influences. Can we really say that a young girl who witnessed her father beating her mother was not impacted toward an aversion to the love of a man because of that? Or that a young boy who was abused by his father turns to seek love and affirmation from another man when he’s older? I can hear my detractors screaming at their computers even as I suggest these possibilities. Of course, these possibilities are merely a couple examples of the complex influences on a person’s gender identity and sexual preference, so don’t get so upset.

Change IS Possible

The sheer number of testimonies from numerous sources reveal that people can and do reject the homosexual or transgender lifestyle and go on to live in healthy heterosexual relationships. So why would Senator Hunt want to deny young people the chance to get some counseling if they’re truly conflicted about the sexual identity issues they’re experiencing? It’s easy to answer that question: she doesn’t care about the truth of the situation and wants to use these kids to push her own social agenda as people on the left are prone to do. The hypocrisy should be obvious to everyone: a political figure who believes a woman has the right to do what she wants with her body when it comes to having a baby doesn’t want to give a young woman the right to explore the biblical concept of womanhood, especially if abusive socialization has led to sexual identity issues.

Vote NO!

LB167 is poorly written, poorly documented, and an assault on the freedom of the individual. Many States have laws that allow minors to seek out therapy on their own when it comes to sexual abuse or mental health issues, and those same States typically protect their right to privacy unless the life of the minor is in danger from influences outside of the family (it’s part of my day job to research and study these laws; typically, the provider they seek out is the one who makes and documents the decision whether to inform the parents). Sen. Hunt’s bill counters that growing trend in children’s mental and behavioral health care.

I could understand and support her if she wanted to ban certain extreme so-called therapeutic practices, especially for young people. But LB167 goes way to far and threatens not only the parents’ right to seek appropriate help for a child struggling with gender identity or sexual preference issues, but also denying the very rights of the children themselves. I urge Nebraska legislators to vote NO on LB167.

Scott Stocking

@ScottSox

My opinions are my own.

Hollywood Shows Its Ignorance and Irrelevance (#SustainableAmerica)

I don’t often watch the Hollywood award shows. If there’s any group of people that consider themselves more self-important than Democrat politicians, it’s the privileged Hollywood elite. But the family wanted to watch the Golden Globe awards last night, so I suffered through it. Jimmy Fallon made it at least tolerable, and Steve Carell’s & Kristin Wiig’s bit, reminiscent of the Michael Scott character, was probably the best lead-in of all the presenters.

But when Meryl Streep got up to accept her lifetime achievement award, or whatever it was, you just knew what was coming. In a room full of elite, embarrassingly wealthy admirers, she had the gall to say the privileged Hollywood elite were among the most despised classes of Americans, along with the press and (Democratic) politicians. I’m not sure why they’re surprised about that. The left has been fostering hatred against the business rich for decades. Now they’re finally getting a taste of their own medicine.

The Over- and Underregulated

But I think I’ve figured out why the silver-spoon rich on the left are so mad about the business rich being rich, and President-Elect Trump knows first hand why. And he made that a central part of his campaign: overregulation. Let’s take a look, generally, at what Trump and other small and large business owners have to do to get rich. Trump is a real estate mogul. When Trump builds a skyscraper or casino, or when a local contractor builds a house, they have hundreds of regulations and specific building codes for which they have to spend thousands of dollars to follow, and inspections galore along the way to boot. Some of these regulations are ridiculous and overly burdensome to the business man, big or small. It would seem their primary purpose is to eat into the profits of the business and put money in the coffers of the government, as if the outlandish taxation on businesses wasn’t enough. Yet the business rich still find a way to make a profit, in spite of government’s efforts to keep them from doing so.

These regulations pervade almost every industry and affect hundreds of professions. Farmers and others who make their living off the land and sea have to abide by hundreds of environmental regulations. Some fishing boat operators now have to pay for Federal inspectors to be on board their privately owned fishing vessels every time they go out to sea! Talk about government overreach! Truckers have regulations about how much they can drive, weight limits of loads, and various nuances on licensing their vehicles. Bankers have hundreds of regulations. Medical professionals who want to help the poor and the elderly have a pile of regulations almost as prolific as the IRS tax code.

But if you look at the latest complete edition of the Code of Federal Regulations (CFR), guess who doesn’t have any regulations to live by in their profession? That’s right, actors and actresses, journalists (their employers, however, have dozens of FCC regulations to abide by for their broadcasts), and politicians. The latter exempted themselves from Obamacare, for crying out loud! Actors and journalists have been writing blank checks for themselves for years, expecting to get a pass because of “freedom of press” and “freedom of speech.” But let a pastor preach a sermon that gives the biblical perspective on adultery, homosexuality, or gambling, and Oh, the Intolerance! Let a baker who doesn’t want to endorse a homosexual wedding refuse to bake a cake, and Oh, the Discrimination! The Hatred! And the Press and the Left vilify and financially ruin the baker or the pastor or their clientele while they rake in their opulent salaries and live their privileged lives.

Actor Birthers?

As if that part of her rant wasn’t enough, she then moved into a list of foreign-born Hollywood types and made some ridiculous comment about why the Right wasn’t asking those folks for their birth certificates while hounding Obama for his. Hello, Meryl, anyone home? Actors and other Hollywood types don’t have constitutionally imposed age and birthplace restrictions like POTUS does. How is it Streep doesn’t know that? Oh, wait, I’m guessing she does, she just thinks the Trump voters are too stupid to figure out her rant is completely irrelevant, off-topic, and downright deceptive.

If Streep and the rest of Hollywood want to know why the average, frustrated American voted for Trump and despises the Hollywood elite, they need to look no farther than themselves. They have no restrictions on what they say or do and rake in the big bucks, while hard-working business professionals have to navigate the minefield of regulations imposed by the politicians and political correctness imposed by the press to build their wealth.