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He previously produced \u003ca href=\"http://www.kqed.org/lowdown\">The Lowdown\u003c/a>, KQED’s multimedia news education blog. Matthew's written for numerous Bay Area publications, including the Oakland Tribune and San Francisco Chronicle. He also taught journalism classes at Fremont High School in East Oakland.\r\n\r\nEmail: mgreen@kqed.org; Twitter: @MGreenKQED","avatar":"https://secure.gravatar.com/avatar/3bf498d1267ca02c8494f33d8cfc575e?s=600&d=mm&r=g","twitter":"MGreenKQED","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["administrator"]},{"site":"lowdown","roles":["administrator"]},{"site":"stateofhealth","roles":["author"]},{"site":"science","roles":["administrator"]},{"site":"education","roles":["editor"]},{"site":"quest","roles":["editor"]},{"site":"forum","roles":["administrator"]},{"site":"elections","roles":["editor"]},{"site":"liveblog","roles":["editor"]}],"headData":{"title":"Matthew Green | KQED","description":"KQED Contributor","ogImgSrc":"https://secure.gravatar.com/avatar/3bf498d1267ca02c8494f33d8cfc575e?s=600&d=mm&r=g","twImgSrc":"https://secure.gravatar.com/avatar/3bf498d1267ca02c8494f33d8cfc575e?s=600&d=mm&r=g"},"isLoading":false,"link":"/author/matthewgreen"},"lewislehe":{"type":"authors","id":"7527","meta":{"index":"authors_1716337520","id":"7527","found":true},"name":"Lewis Lehe","firstName":"Lewis","lastName":"Lehe","slug":"lewislehe","email":"lewis500@berkeley.edu","display_author_email":false,"staff_mastheads":[],"title":null,"bio":"Lewis Lehe is a PhD student in Civil Engineering at the UC Berkeley, where he researches electronic road tolling and runs the \u003ca href=\"http://vudlab.com\"> VUDlab \u003c/a>(Visualizing Urban Data Idealab). He also creates data visualizations under the brand “Setosa” at \u003ca href=\"http://setosa.io\"> setosa.io\u003c/a>.","avatar":"https://secure.gravatar.com/avatar/2a29abb9aab370fd65426407746f10c5?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"lowdown","roles":["contributor"]}],"headData":{"title":"Lewis Lehe | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/2a29abb9aab370fd65426407746f10c5?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/2a29abb9aab370fd65426407746f10c5?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lewislehe"},"jessengebretson":{"type":"authors","id":"8628","meta":{"index":"authors_1716337520","id":"8628","found":true},"name":"Jess Engebretson","firstName":"Jess","lastName":"Engebretson","slug":"jessengebretson","email":"jess.engebretson@gmail.com","display_author_email":false,"staff_mastheads":[],"title":null,"bio":"Jess Engebretson is a radio producer from Virginia.","avatar":"https://secure.gravatar.com/avatar/82da81d5865f1a046c91ee925e616266?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"lowdown","roles":["contributor"]}],"headData":{"title":"Jess Engebretson | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/82da81d5865f1a046c91ee925e616266?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/82da81d5865f1a046c91ee925e616266?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/jessengebretson"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"lowdown_27438":{"type":"posts","id":"lowdown_27438","meta":{"index":"posts_1716263798","site":"lowdown","id":"27438","score":null,"sort":[1498264985000]},"parent":0,"labelTerm":{"site":"lowdown"},"blocks":[],"publishDate":1498264985,"format":"aside","disqusTitle":"How We Got Here: Why Americans Can't Seem to Ever Agree on A Good Health Care Fix","title":"How We Got Here: Why Americans Can't Seem to Ever Agree on A Good Health Care Fix","headTitle":"The Lowdown | KQED News","content":"\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>https://youtu.be/qV0hFyXnq5k\u003c/p>\n\u003cp>Republicans on Thursday got one step closer in their epic quest to repeal and replace the Affordable Care Act, aka \"Obamacare.\"\u003c/p>\n\u003cp>Controversially drafted behind closed doors by Senate Majority Leader Mitch McConnell (R-KY) and a small group of his Republican colleagues, the Senate bill is, despite earlier pledges, broadly similar to legislation narrowly passed by House Republicans in May. \u003ca href=\"http://www.npr.org/sections/health-shots/2017/06/22/533942041/who-wins-who-loses-with-senate-health-care-bill\" target=\"_blank\" rel=\"noopener noreferrer\">This NPR chart\u003c/a> has a good side-by-side comparison of the House and Senate bills and how they measure up against Obamacare.\u003c/p>\n\u003cp>Like the House version, the Senate bill would gut many of Obamacare's key provisions, including the \"individual mandate,\" which now requires everyone to purchase insurance or pay a penalty.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The new bill would also repeal most of the taxes used to pay for the ACA. Additionally, it would eliminate federal funding for Planned Parenthood and slash funding for Medicaid, a sweeping program that subsidizes health care for \u003ca href=\"http://kff.org/medicaremedicaid50/\" target=\"_blank\" rel=\"noopener noreferrer\">nearly 70 million people\u003c/a>. And while the legislation proposes creating a new system of tax credits to help people buy insurance, the health overhaul would likely result in millions of lower-income Americans losing their coverage.\u003c/p>\n\u003cp>A vote is expected next week, although \u003ca href=\"http://www.politico.com/story/2017/06/23/dean-heller-oppose-health-care-bill-239907\" target=\"_blank\" rel=\"noopener noreferrer\">five Republican senators\u003c/a> have already announced their opposition the bill in its current form, a move that would all but doom the effort.\u003c/p>\n\u003cp>Democrats, who universally oppose the legislation, were quick to express their disdain: \"This is a bill designed to strip away heath care benefits and protections from Americans who need it most, in order to give a tax break to the folks who need it least,\" said Senate Minority Leader Chuck Schumer (D-NY).\u003c/p>\n\u003cp>This is just the latest chapter in the Republicans' tireless endeavor to destroy the ACA. Since it became law almost seven years ago, President Obama's signature health care reform has managed to survive countless attacks, two Supreme Court challenges and dozens of legislative assassination attempts.\u003c/p>\n\u003cp>But after the 2016 election gave Republicans control of both the White House and Congress, the ACA finally seemed doomed.\u003c/p>\n\u003cp>As a candidate, President Trump repeatedly pledged to dismantle it promising an alternative plan that would offer \"\u003ca href=\"http://www.cbsnews.com/news/donald-trump-promises-health-insurance-for-everybody/\">insurance for everybody\u003c/a>” while dramatically cutting costs (although he stopped short of providing any firm details).\u003c/p>\n\u003cp>Things got a good deal messier after that. Repealing the ACA without a reasonable replacement would cause millions of Americans to lose their health coverage, a prospect that sparked the ire of constituents in Republican districts across the country.\u003c/p>\n\u003cp>In fact, despite the Democrats' sweeping defeat in 2016, support for the ACA is oddly now at \u003ca href=\"http://kff.org/interactive/kaiser-health-tracking-poll-the-publics-views-on-the-aca/#?response=Favorable--Unfavorable&aRange=all\">the highest level it's been in years\u003c/a>.\u003c/p>\n\u003cp>https://youtu.be/09RvU9_m30Q\u003c/p>\n\u003ch4>America, the outlier\u003c/h4>\n\u003cp>It’s safe to assume that just about everyone wants affordable health care. Why then is it so hard for Americans to come up with a decent health care fix that most of us can all at least marginally agree on?\u003c/p>\n\u003cp>Most of the world's other wealthy countries seem to have navigated this issue a lot more smoothly and effectively. Just about every other high-income nation spends significantly less than the U.S. does, yet delivers a higher quality health care available to all their residents, mostly through single-payer government systems.\u003c/p>\n\u003cfigure id=\"attachment_27458\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM.png\">\u003cimg class=\"size-large wp-image-27458\" src=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-1020x408.png\" alt=\"\" width=\"640\" height=\"256\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-1020x408.png 1020w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-160x64.png 160w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-800x320.png 800w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-768x308.png 768w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-1180x473.png 1180w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-960x384.png 960w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-240x96.png 240w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-375x150.png 375w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-520x208.png 520w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM.png 1271w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Peterson-Kaiser Health System Tracker: analysis of \u003ca href=\"http://dx.doi.org/10.1787/health-data-en\" target=\"_blank\" rel=\"noopener noreferrer\"> data from OECD (2017)\u003c/a>, \"OECD Health Data: Health expenditure and financing: Health expenditure indicators\", OECD Health Statistics.\u003c/figcaption>\u003c/figure>\n\u003cp>In a \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30818-8/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">recent study\u003c/a> published in The Lancet medical journal, researchers at the University of Washington created a global health care quality index by looking at 32 causes of death in 195 countries between 1990 to 2015. The U.S., the wealthiest, most powerful nation on earth, is ranked a dismal 80th, on par with Montenegro and Estonia.\u003c/p>\n\u003cp>Among citizens of the industrialized world, Americans have long been uniquely wary of too much government involvement in most aspects of life, but particularly health care. It's a skepticism rooted in the nation's longstanding emphasis on individualism, self-sufficiency and free markets, and America's distinct national aversion to anything resembling socialism.\u003c/p>\n\u003ch4>Truman's big push\u003c/h4>\n\u003cp>To begin to understand why the U.S. is such an outlier on the health care front, we need to go back to November 1945. That’s when President Harry Truman \u003ca href=\"https://www.trumanlibrary.org/publicpapers/index.php?pid=483&st=&st1=\" target=\"_blank\" rel=\"noopener noreferrer\">proposed \u003c/a>a new health insurance program that would cover all Americans. His plan would have made the government centrally involved in providing health care. The plan was actually a far more radical approach than the ACA, which largely just expands access to private insurance.\u003c/p>\n\u003cfigure id=\"attachment_26342\" class=\"wp-caption alignright\" style=\"max-width: 450px\">\u003ca href=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px.jpg\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cimg class=\"wp-image-26342 size-full\" src=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px.jpg\" alt=\"Truman_HealthInsurancePlan_450px\" width=\"450\" height=\"336\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px.jpg 450w, https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px-160x119.jpg 160w, https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px-240x179.jpg 240w, https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px-375x280.jpg 375w\" sizes=\"(max-width: 450px) 100vw, 450px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In the late 1940s, President Harry S. Truman tried to pass a robust health care reform bill. Here, he's speaking to the 1949 Convention of the American Federation of Labor. (Courtesy of Free Speech Radio News Archive)\u003c/figcaption>\u003c/figure>\n\u003cp>Most Americans were initially receptive to Truman’s proposal; nearly 60 percent supported it, according to a Gallup Poll conducted after the president introduced it.\u003c/p>\n\u003cp>The immediate enthusiasm, though, worried the American Medical Association, which represented the business interests of doctors and was then one of the country's richest and most influential lobbies. A nationwide plan to make health care more affordable for patients, the AMA reasoned, would also make it less profitable for many private-practice physicians.\u003c/p>\n\u003ch4>\"Socialized medicine\"\u003c/h4>\n\u003cp>And so the group quickly got to work on an ingenious ad campaign centered on two powerful words: \"socialized medicine.\"\u003c/p>\n\u003cp>Over the next few years, as Congress worked to craft a universal health care bill, the AMA invested in what was then the largest ad campaign in U.S. history, explicitly aimed at convincing Americans to reject Truman's plan.\u003c/p>\n\u003cp>\"Would socialized medicine lead to socialization of other phases of American life?\" one pamphlet posited. \"Lenin thought so. He declared, 'Socialized medicine is the keystone to the arch of the socialist state.' \"\u003c/p>\n\u003cp>(The quote was completely made up, but took hold nonetheless.)\u003c/p>\n\u003cp>When the plan was introduced in Congress, Sen. Robert Taft, a conservative Republican from Ohio, interrupted his Democratic colleague, stating that the bill was \"the most socialistic measure this Congress has ever had before it.\"\u003c/p>\n\u003cp>National health insurance, Taft suggested, came directly from the Soviet constitution. He announced that Republicans would boycott the hearings, and then promptly marched out of the Senate chamber.\u003c/p>\n\u003cp>The AMA continued to push the \"socialized medicine\" angle. In one editorial, the group warned that national health insurance would turn doctors into \"slaves.\" In one Tallahassee, hospital, doctors slipped political ads onto patients' breakfast trays.\u003c/p>\n\u003cp>Ahead of the 1950 midterm elections, the AMA spent more than $1 million on radio and TV ads -- far more than the government could spend to defend it. As one Truman ally ruefully noted, countering the AMA's ads was like \"trying to put out a forest fire with a sprinkling can.\"\u003c/p>\n\u003cp>When the election results rolled in, Democrats lost nearly 30 seats in the House and five in the Senate. Public support for the proposal had plummeted, dropping from 60 to 24 percent approval in just five years.\u003c/p>\n\u003cp>And so the prospect of national health insurance was dead, for the time being at least. Over the following decades, the AMA would go on to fight additional government health-related reform proposals. This included a campaign against Medicare – a battle it did not win, even with the star power of then-actor Ronald Reagan as its spokesman. Reagan took to the airwaves to scare people into opposing the program, warning that if it went forward, \"you and I are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free.\"\u003c/p>\n\u003cp>https://youtu.be/Bejdhs3jGyw\u003c/p>\n\u003cp>The 1961 recording of Reagan was part of Operation Coffee Cup, an elaborate AMA effort to prevent the government from diverting any existing public funding towards paying for health insurance for the elderly and the poor.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/lowdown/2015/08/03/50-years-ago-medicare-had-its-haters-too-and-we-never-did-awake-to-socialism/\" target=\"_blank\" rel=\"noopener noreferrer\">Related: Back in the Day Medicare Had Its Haters Too\u003c/a>\u003c/p>\n\u003cp>The effort, of course, ultimately failed. In 1965, President Lyndon Johnson signed the bill that created the Medicare and Medicaid federal health insurance programs for Americans ages 65 and up (regardless of income) and low-income residents. To this day, Medicare — that harbinger of “socialism” and destroyer of freedom that Reagan warned about— remains one of the most popular federal programs, approved by an overwhelming majority of Democrats \u003cem>and\u003c/em> Republicans.\u003c/p>\n\u003ch4>A change of heart\u003c/h4>\n\u003cp>In 2010, the AMA changed its tune and moved to support federal health reform -- thanks in part to some major \u003ca href=\"https://www.nationalreview.com/nrd/articles/312377/who-gave-us-obamacare\">behind-the-scenes horse-trading\u003c/a>. Today, the AMA's \u003ca href=\"https://www.ama-assn.org/content/understanding-affordable-care-act\">website\u003c/a> refers to Obamacare as \"a tremendous step forward on the path toward meaningful health system reform.\" The group has since implored Republicans not to repeal the ACA without offering an adequate replacement plan, and has opposed previous Republican alternative proposals.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The AMA, though, couldn't put the \"socialized medicine\" genie back in the bottle, and today the term retains the powerful pariah status in American political discourse that the lobbying group helped establish more than half a century ago in its battle against national health care reform.\u003c/p>\n\n","disqusIdentifier":"27438 https://ww2.kqed.org/lowdown/?p=27438","disqusUrl":"https://ww2.kqed.org/lowdown/2017/06/23/why-cant-americans-ever-agree-on-a-good-health-care-fix/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":1529,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":36},"modified":1498504907,"excerpt":null,"headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"","title":"How We Got Here: Why Americans Can't Seem to Ever Agree on A Good Health Care Fix | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"How We Got Here: Why Americans Can't Seem to Ever Agree on A Good Health Care Fix","datePublished":"2017-06-23T17:43:05-07:00","dateModified":"2017-06-26T12:21:47-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"why-cant-americans-ever-agree-on-a-good-health-care-fix","status":"publish","path":"/lowdown/27438/why-cant-americans-ever-agree-on-a-good-health-care-fix","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!--more-->\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/qV0hFyXnq5k'\n title='//www.youtube.com/embed/qV0hFyXnq5k'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Republicans on Thursday got one step closer in their epic quest to repeal and replace the Affordable Care Act, aka \"Obamacare.\"\u003c/p>\n\u003cp>Controversially drafted behind closed doors by Senate Majority Leader Mitch McConnell (R-KY) and a small group of his Republican colleagues, the Senate bill is, despite earlier pledges, broadly similar to legislation narrowly passed by House Republicans in May. \u003ca href=\"http://www.npr.org/sections/health-shots/2017/06/22/533942041/who-wins-who-loses-with-senate-health-care-bill\" target=\"_blank\" rel=\"noopener noreferrer\">This NPR chart\u003c/a> has a good side-by-side comparison of the House and Senate bills and how they measure up against Obamacare.\u003c/p>\n\u003cp>Like the House version, the Senate bill would gut many of Obamacare's key provisions, including the \"individual mandate,\" which now requires everyone to purchase insurance or pay a penalty.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new bill would also repeal most of the taxes used to pay for the ACA. Additionally, it would eliminate federal funding for Planned Parenthood and slash funding for Medicaid, a sweeping program that subsidizes health care for \u003ca href=\"http://kff.org/medicaremedicaid50/\" target=\"_blank\" rel=\"noopener noreferrer\">nearly 70 million people\u003c/a>. And while the legislation proposes creating a new system of tax credits to help people buy insurance, the health overhaul would likely result in millions of lower-income Americans losing their coverage.\u003c/p>\n\u003cp>A vote is expected next week, although \u003ca href=\"http://www.politico.com/story/2017/06/23/dean-heller-oppose-health-care-bill-239907\" target=\"_blank\" rel=\"noopener noreferrer\">five Republican senators\u003c/a> have already announced their opposition the bill in its current form, a move that would all but doom the effort.\u003c/p>\n\u003cp>Democrats, who universally oppose the legislation, were quick to express their disdain: \"This is a bill designed to strip away heath care benefits and protections from Americans who need it most, in order to give a tax break to the folks who need it least,\" said Senate Minority Leader Chuck Schumer (D-NY).\u003c/p>\n\u003cp>This is just the latest chapter in the Republicans' tireless endeavor to destroy the ACA. Since it became law almost seven years ago, President Obama's signature health care reform has managed to survive countless attacks, two Supreme Court challenges and dozens of legislative assassination attempts.\u003c/p>\n\u003cp>But after the 2016 election gave Republicans control of both the White House and Congress, the ACA finally seemed doomed.\u003c/p>\n\u003cp>As a candidate, President Trump repeatedly pledged to dismantle it promising an alternative plan that would offer \"\u003ca href=\"http://www.cbsnews.com/news/donald-trump-promises-health-insurance-for-everybody/\">insurance for everybody\u003c/a>” while dramatically cutting costs (although he stopped short of providing any firm details).\u003c/p>\n\u003cp>Things got a good deal messier after that. Repealing the ACA without a reasonable replacement would cause millions of Americans to lose their health coverage, a prospect that sparked the ire of constituents in Republican districts across the country.\u003c/p>\n\u003cp>In fact, despite the Democrats' sweeping defeat in 2016, support for the ACA is oddly now at \u003ca href=\"http://kff.org/interactive/kaiser-health-tracking-poll-the-publics-views-on-the-aca/#?response=Favorable--Unfavorable&aRange=all\">the highest level it's been in years\u003c/a>.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/09RvU9_m30Q'\n title='//www.youtube.com/embed/09RvU9_m30Q'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003ch4>America, the outlier\u003c/h4>\n\u003cp>It’s safe to assume that just about everyone wants affordable health care. Why then is it so hard for Americans to come up with a decent health care fix that most of us can all at least marginally agree on?\u003c/p>\n\u003cp>Most of the world's other wealthy countries seem to have navigated this issue a lot more smoothly and effectively. Just about every other high-income nation spends significantly less than the U.S. does, yet delivers a higher quality health care available to all their residents, mostly through single-payer government systems.\u003c/p>\n\u003cfigure id=\"attachment_27458\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM.png\">\u003cimg class=\"size-large wp-image-27458\" src=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-1020x408.png\" alt=\"\" width=\"640\" height=\"256\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-1020x408.png 1020w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-160x64.png 160w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-800x320.png 800w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-768x308.png 768w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-1180x473.png 1180w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-960x384.png 960w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-240x96.png 240w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-375x150.png 375w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM-520x208.png 520w, https://ww2.kqed.org/app/uploads/sites/26/2017/06/Screen-Shot-2017-06-23-at-3.33.59-PM.png 1271w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Peterson-Kaiser Health System Tracker: analysis of \u003ca href=\"http://dx.doi.org/10.1787/health-data-en\" target=\"_blank\" rel=\"noopener noreferrer\"> data from OECD (2017)\u003c/a>, \"OECD Health Data: Health expenditure and financing: Health expenditure indicators\", OECD Health Statistics.\u003c/figcaption>\u003c/figure>\n\u003cp>In a \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30818-8/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">recent study\u003c/a> published in The Lancet medical journal, researchers at the University of Washington created a global health care quality index by looking at 32 causes of death in 195 countries between 1990 to 2015. The U.S., the wealthiest, most powerful nation on earth, is ranked a dismal 80th, on par with Montenegro and Estonia.\u003c/p>\n\u003cp>Among citizens of the industrialized world, Americans have long been uniquely wary of too much government involvement in most aspects of life, but particularly health care. It's a skepticism rooted in the nation's longstanding emphasis on individualism, self-sufficiency and free markets, and America's distinct national aversion to anything resembling socialism.\u003c/p>\n\u003ch4>Truman's big push\u003c/h4>\n\u003cp>To begin to understand why the U.S. is such an outlier on the health care front, we need to go back to November 1945. That’s when President Harry Truman \u003ca href=\"https://www.trumanlibrary.org/publicpapers/index.php?pid=483&st=&st1=\" target=\"_blank\" rel=\"noopener noreferrer\">proposed \u003c/a>a new health insurance program that would cover all Americans. His plan would have made the government centrally involved in providing health care. The plan was actually a far more radical approach than the ACA, which largely just expands access to private insurance.\u003c/p>\n\u003cfigure id=\"attachment_26342\" class=\"wp-caption alignright\" style=\"max-width: 450px\">\u003ca href=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px.jpg\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cimg class=\"wp-image-26342 size-full\" src=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px.jpg\" alt=\"Truman_HealthInsurancePlan_450px\" width=\"450\" height=\"336\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px.jpg 450w, https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px-160x119.jpg 160w, https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px-240x179.jpg 240w, https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px-375x280.jpg 375w\" sizes=\"(max-width: 450px) 100vw, 450px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In the late 1940s, President Harry S. Truman tried to pass a robust health care reform bill. Here, he's speaking to the 1949 Convention of the American Federation of Labor. (Courtesy of Free Speech Radio News Archive)\u003c/figcaption>\u003c/figure>\n\u003cp>Most Americans were initially receptive to Truman’s proposal; nearly 60 percent supported it, according to a Gallup Poll conducted after the president introduced it.\u003c/p>\n\u003cp>The immediate enthusiasm, though, worried the American Medical Association, which represented the business interests of doctors and was then one of the country's richest and most influential lobbies. A nationwide plan to make health care more affordable for patients, the AMA reasoned, would also make it less profitable for many private-practice physicians.\u003c/p>\n\u003ch4>\"Socialized medicine\"\u003c/h4>\n\u003cp>And so the group quickly got to work on an ingenious ad campaign centered on two powerful words: \"socialized medicine.\"\u003c/p>\n\u003cp>Over the next few years, as Congress worked to craft a universal health care bill, the AMA invested in what was then the largest ad campaign in U.S. history, explicitly aimed at convincing Americans to reject Truman's plan.\u003c/p>\n\u003cp>\"Would socialized medicine lead to socialization of other phases of American life?\" one pamphlet posited. \"Lenin thought so. He declared, 'Socialized medicine is the keystone to the arch of the socialist state.' \"\u003c/p>\n\u003cp>(The quote was completely made up, but took hold nonetheless.)\u003c/p>\n\u003cp>When the plan was introduced in Congress, Sen. Robert Taft, a conservative Republican from Ohio, interrupted his Democratic colleague, stating that the bill was \"the most socialistic measure this Congress has ever had before it.\"\u003c/p>\n\u003cp>National health insurance, Taft suggested, came directly from the Soviet constitution. He announced that Republicans would boycott the hearings, and then promptly marched out of the Senate chamber.\u003c/p>\n\u003cp>The AMA continued to push the \"socialized medicine\" angle. In one editorial, the group warned that national health insurance would turn doctors into \"slaves.\" In one Tallahassee, hospital, doctors slipped political ads onto patients' breakfast trays.\u003c/p>\n\u003cp>Ahead of the 1950 midterm elections, the AMA spent more than $1 million on radio and TV ads -- far more than the government could spend to defend it. As one Truman ally ruefully noted, countering the AMA's ads was like \"trying to put out a forest fire with a sprinkling can.\"\u003c/p>\n\u003cp>When the election results rolled in, Democrats lost nearly 30 seats in the House and five in the Senate. Public support for the proposal had plummeted, dropping from 60 to 24 percent approval in just five years.\u003c/p>\n\u003cp>And so the prospect of national health insurance was dead, for the time being at least. Over the following decades, the AMA would go on to fight additional government health-related reform proposals. This included a campaign against Medicare – a battle it did not win, even with the star power of then-actor Ronald Reagan as its spokesman. Reagan took to the airwaves to scare people into opposing the program, warning that if it went forward, \"you and I are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free.\"\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/Bejdhs3jGyw'\n title='//www.youtube.com/embed/Bejdhs3jGyw'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>The 1961 recording of Reagan was part of Operation Coffee Cup, an elaborate AMA effort to prevent the government from diverting any existing public funding towards paying for health insurance for the elderly and the poor.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/lowdown/2015/08/03/50-years-ago-medicare-had-its-haters-too-and-we-never-did-awake-to-socialism/\" target=\"_blank\" rel=\"noopener noreferrer\">Related: Back in the Day Medicare Had Its Haters Too\u003c/a>\u003c/p>\n\u003cp>The effort, of course, ultimately failed. In 1965, President Lyndon Johnson signed the bill that created the Medicare and Medicaid federal health insurance programs for Americans ages 65 and up (regardless of income) and low-income residents. To this day, Medicare — that harbinger of “socialism” and destroyer of freedom that Reagan warned about— remains one of the most popular federal programs, approved by an overwhelming majority of Democrats \u003cem>and\u003c/em> Republicans.\u003c/p>\n\u003ch4>A change of heart\u003c/h4>\n\u003cp>In 2010, the AMA changed its tune and moved to support federal health reform -- thanks in part to some major \u003ca href=\"https://www.nationalreview.com/nrd/articles/312377/who-gave-us-obamacare\">behind-the-scenes horse-trading\u003c/a>. Today, the AMA's \u003ca href=\"https://www.ama-assn.org/content/understanding-affordable-care-act\">website\u003c/a> refers to Obamacare as \"a tremendous step forward on the path toward meaningful health system reform.\" The group has since implored Republicans not to repeal the ACA without offering an adequate replacement plan, and has opposed previous Republican alternative proposals.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The AMA, though, couldn't put the \"socialized medicine\" genie back in the bottle, and today the term retains the powerful pariah status in American political discourse that the lobbying group helped establish more than half a century ago in its battle against national health care reform.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/lowdown/27438/why-cant-americans-ever-agree-on-a-good-health-care-fix","authors":["8628","1263"],"categories":["lowdown_2409","lowdown_1","lowdown_2593"],"tags":["lowdown_145","lowdown_2337","lowdown_144","lowdown_142"],"featImg":"lowdown_19242","label":"lowdown"},"lowdown_26324":{"type":"posts","id":"lowdown_26324","meta":{"index":"posts_1716263798","site":"lowdown","id":"26324","score":null,"sort":[1490336548000]},"parent":0,"labelTerm":{"site":"lowdown"},"blocks":[],"publishDate":1490336548,"format":"aside","disqusTitle":"Why Do Americans Have Such A Hard Time Agreeing on Health Care Reform?","title":"Why Do Americans Have Such A Hard Time Agreeing on Health Care Reform?","headTitle":"The Lowdown | KQED News","content":"\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>https://youtu.be/aa0XPCHksFk\u003c/p>\n\u003cp>Despite seven years or relentless attacks, two Supreme Court challenges and dozens of congressional efforts to kill it, the Affordable Care Act -- aka Obamacare -- has again lived to see another day.\u003c/p>\n\u003cp>After the 2016 election with Republicans in control of both the White House and Congress, President Obama's signature health care reform seemed all but doomed.\u003c/p>\n\u003cp>As a candidate, President Trump repeatedly pledged to dismantle the law, promising an alternative plan that would offer \"\u003ca href=\"http://www.cbsnews.com/news/donald-trump-promises-health-insurance-for-everybody/\">insurance for everybody\u003c/a>” all while dramatically cutting costs (although he stopped short of providing any firm details).\u003c/p>\n\u003ch4>Messy business\u003c/h4>\n\u003cp>Things got a good deal messier after that. Repealing the ACA without a reasonable replacement would cause millions of Americans to lose their health coverage, a prospect that, as it turns out, a lot of people aren't too thrilled about. That was made abundantly clear when scores of irate constituents recently packed into Republican congressional town hall meetings across the country to air their grievances.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In fact, despite the ongoing, high profile barrage of attacks against the ACA, and the striking number of former Obama backers who voted for Trump -- a candidate who vowed to dismantle it -- support for the law is actually at \u003ca href=\"http://kff.org/interactive/kaiser-health-tracking-poll-the-publics-views-on-the-aca/#?response=Favorable--Unfavorable&aRange=all\">the highest level it's been in years\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, Republicans have struggled mightily to figure out what an overhaul would actually look like. It’s a tall order, after all: guaranteeing health coverage for everyone doesn't exactly jive with the party's agenda to slash federal spending and dramatically reduce government’s role in managing the health care market.\u003c/p>\n\u003cp>The result, the American Health Care Act, introduced by Republicans earlier this month, would have gotten rid of the individual mandate and replaced federal insurance subsidies with tax credits and block grants to states, among other major changes. In its \u003ca href=\"https://www.cbo.gov/publication/52486\">analysis of the bill\u003c/a>, the Congressional Budget Office projected that while the proposal would indeed save billions of federal dollars, it would also result in 24 million more Americans without health insurance over the next decade.\u003c/p>\n\u003cp>Even after big changes to the legislation, and a major push by President Trump and House Speaker Paul Ryan, the bill still failed to get enough Republican support in Congress to guarantee its passage (it was uniformly opposed by Democrats). Some moderates remained concerned it would cause too many of their constituents to lose health coverage, while a group of hardline conservatives opposed to big government argued that the bill was still too much like Obamacare.\u003c/p>\n\u003cp>A House vote scheduled for Thursday -- on the ACA's seven year anniversary -- was postponed at the last minute. And by Friday, just before the vote was finally set to happen, Republican leaders \u003ca href=\"https://www.washingtonpost.com/powerpost/house-leaders-prepare-to-vote-friday-on-health-care-reform/2017/03/24/736f1cd6-1081-11e7-9d5a-a83e627dc120_story.html?hpid=hp_hp-top-table-main_desktop-tab-ledeblurb%3Ahomepage%2Fstory\" target=\"_blank\" rel=\"noopener noreferrer\">scrapped the whole deal\u003c/a>, a major defeat for Trump and Ryan.\u003c/p>\n\u003cp>“Obamacare is the law of the land,” Ryan conceded. “We’re going to be living with Obamacare for the foreseeable future.\"\u003c/p>\n\u003cp>He added: \"Doing big things is hard.\"\u003c/p>\n\u003ch4>Uphill battle\u003c/h4>\n\u003cp>But why so hard? Why can't Americans agree on a good national health care fix?\u003c/p>\n\u003cp>It’s safe to assume that just about everyone wants affordable health care. Yet, finding consensus on a plan we can all live always seems out of reach.\u003c/p>\n\u003cp>Nearly every other high-income nation in the world has figured out a way to spend a lot less money than the U.S. does on health care, yet deliver high quality universal health care to their citizens. Countries can do this in a lot of different ways. In some systems, the government provides for all health care; others include a mix of government funding and private insurance.\u003c/p>\n\u003cp>In 2000, when the World Health Organization \u003ca href=\"http://www.who.int/whr/2000/media_centre/press_release/en/\" target=\"_blank\" rel=\"noopener noreferrer\">ranked different countries' health care systems\u003c/a>, the U.S. landed in dismal 31\u003csup>st\u003c/sup> place -- despite spending more per capita than any country. \u003ca href=\"https://www.bloomberg.com/news/articles/2016-09-29/u-s-health-care-system-ranks-as-one-of-the-least-efficient\">Other\u003c/a> \u003ca href=\"http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective\">studies\u003c/a> paint a similar picture of inefficiency.\u003c/p>\n\u003cp>https://youtu.be/09RvU9_m30Q\u003c/p>\n\u003cp>But in the U.S., citizens have long been wary of government involvement in health care. Some of the skepticism is cultural, related to the American emphasis on individualism and self-sufficiency.\u003c/p>\n\u003cp>Some of it has to do with support for organized labor, which has historically been much stronger in Europe than in the U.S., and health care is typically a key perk of union membership. Some of it is also a remnant of the Cold War, when many Americans began to worry that government involvement in health care was a big step toward socialism.\u003c/p>\n\u003ch4>Truman's big push\u003c/h4>\n\u003cp>To begin to understand why the U.S. is such an outlier on the health care front, we need to go back to November 1945. That’s when President Harry Truman \u003ca href=\"https://www.trumanlibrary.org/publicpapers/index.php?pid=483&st=&st1=\" target=\"_blank\" rel=\"noopener noreferrer\">proposed \u003c/a>a new health insurance program that would cover all Americans. His plan would have made the government centrally involved in the provision of health care – a far more radical approach than that of the ACA, which for the most part just expands access to private insurance.\u003c/p>\n\u003cfigure id=\"attachment_26342\" class=\"wp-caption alignright\" style=\"max-width: 450px\">\u003ca href=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px.jpg\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cimg class=\"wp-image-26342 size-full\" src=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px.jpg\" alt=\"Truman_HealthInsurancePlan_450px\" width=\"450\" height=\"336\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px.jpg 450w, https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px-160x119.jpg 160w, https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px-240x179.jpg 240w, https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px-375x280.jpg 375w\" sizes=\"(max-width: 450px) 100vw, 450px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In the late 1940s, President Harry S. Truman tried to pass a robust health care reform bill. Here, he's speaking to the 1949 Convention of the American Federation of Labor. (Courtesy of Free Speech Radio News Archive)\u003c/figcaption>\u003c/figure>\n\u003cp>Most Americans were initially receptive to Truman’s proposal, with nearly 60 percent in support, according to a Gallup Poll conducted after the president's address.\u003c/p>\n\u003cp>The immediate enthusiasm, though, worried the American Medical Association, which was then one of the country's richest and most influential lobbies, representing the business interests of doctors. A nationwide plan to make health care more affordable for patients would also make it less profitable for many private-practice doctors.\u003c/p>\n\u003ch4>\"Socialized medicine\"\u003c/h4>\n\u003cp>And so the group quickly got to work on an ingenious ad campaign centered on two magic words: \"socialized medicine.\"\u003c/p>\n\u003cp>Over the next few years, as Congress worked to craft a universal health care bill, the AMA invested in what was then the largest ad campaign in U.S. history, all aimed at convincing Americans to reject Truman's plan.\u003c/p>\n\u003cp>\"Would socialized medicine lead to socialization of other phases of American life?\" one pamphlet posited. \"Lenin thought so.He declared, 'Socialized medicine is the keystone to the arch of the socialist state.' \"\u003c/p>\n\u003cp>(The quote, by the way, was completely made up, but it stuck nonetheless.)\u003c/p>\n\u003cp>When the plan was introduced in Congress, Sen. Robert Taft, a conservative Republican from Ohio, interrupted his Democratic colleague, stating that the bill was \"the most socialistic measure this Congress has ever had before it.\" National health insurance, Taft suggested, came directly from the Soviet constitution. He then announced that Republicans would boycott the hearings, and promptly marched out of the Senate chamber.\u003c/p>\n\u003cp>The AMA continued to push the \"socialized medicine\" angle. In one editorial, the group warned that national health insurance would turn doctors into \"slaves.\" In a Tallahassee, Florida, hospital, doctors slipped political ads onto patients' breakfast trays.\u003c/p>\n\u003cp>Ahead of the 1950 midterm elections, the AMA spent more than $1 million on radio and TV ads -- far more than the government could spend to defend it. As one Truman ally ruefully noted, countering the AMA's ads was like \"trying to put out a forest fire with a sprinkling can.\" When the election results rolled in, Democrats lost nearly 30 seats in the House and five in the Senate. Public support for the proposal had also plummeted, dropping from 60 to 24 percent in just five years.\u003c/p>\n\u003cp>And so the prospect of national health insurance was dead, for the time being at least. Over the following decades, the AMA would go on to fight many more nationwide government health-related reform proposals, including Medicare – a battle it did not win, even with the star power of Ronald Reagan as its main spokesman.\u003c/p>\n\u003cp>https://youtu.be/Bejdhs3jGyw\u003c/p>\n\u003cp>The 1961 recording of then-actor Ronald Reagan was part of Operation Coffee Cup, part of an elaborate AMA effort to prevent Social Security funding going to health insurance for the elderly and the poor.\u003c/p>\n\u003cp>The effort, of course, ultimately failed. In 1965, President Lyndon Johnson signed into law the bill that created the Medicare and Medicaid federal health insurance programs for Americans ages 65 and up, regardless of income (and later expanded to include younger people with permanent disabilities) and low-income Americans. To this day, Medicare — that harbinger of “socialism” and destroyer of freedom that Reagan warned about— remains one of the most popular federal programs, approved by an overwhelming majority of Democrats \u003cem>and\u003c/em> Republicans..\u003c/p>\n\u003cp>But in 2010, the AMA did an about-face and decided to support federal health reform -- thanks in part to a lot of \u003ca href=\"https://www.nationalreview.com/nrd/articles/312377/who-gave-us-obamacare\">behind-the-scenes horse-trading\u003c/a>. Today, the AMA's \u003ca href=\"https://www.ama-assn.org/content/understanding-affordable-care-act\">website\u003c/a> refers to Obamacare as \"a tremendous step forward on the path toward meaningful health system reform.\" The group has implored Republicans not to repeal the ACA without offering an adequate replacement plan, and has come out against the Republicans' bill.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The AMA, though, couldn't put the \"socialized medicine\" genie back in the bottle. The majority of Americans today might not know how the phrase originated, but many automatically consider anything linked to it \u003ca href=\"http://thefederalist.com/2016/07/15/obama-obamacare-didnt-work-so-lets-completely-socialize-medicine/\" target=\"_blank\" rel=\"noopener noreferrer\">an infringement of their rights.\u003c/a>\u003c/p>\n\n","disqusIdentifier":"26324 https://ww2.kqed.org/lowdown/?p=26324","disqusUrl":"https://ww2.kqed.org/lowdown/2017/03/23/why-is-american-health-care-reform-so-dang-controversial/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":1541,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":35},"modified":1498093679,"excerpt":null,"headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"","title":"Why Do Americans Have Such A Hard Time Agreeing on Health Care Reform? | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Why Do Americans Have Such A Hard Time Agreeing on Health Care Reform?","datePublished":"2017-03-23T23:22:28-07:00","dateModified":"2017-06-21T18:07:59-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"why-is-american-health-care-reform-so-dang-controversial","status":"publish","path":"/lowdown/26324/why-is-american-health-care-reform-so-dang-controversial","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!--more-->\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/aa0XPCHksFk'\n title='//www.youtube.com/embed/aa0XPCHksFk'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Despite seven years or relentless attacks, two Supreme Court challenges and dozens of congressional efforts to kill it, the Affordable Care Act -- aka Obamacare -- has again lived to see another day.\u003c/p>\n\u003cp>After the 2016 election with Republicans in control of both the White House and Congress, President Obama's signature health care reform seemed all but doomed.\u003c/p>\n\u003cp>As a candidate, President Trump repeatedly pledged to dismantle the law, promising an alternative plan that would offer \"\u003ca href=\"http://www.cbsnews.com/news/donald-trump-promises-health-insurance-for-everybody/\">insurance for everybody\u003c/a>” all while dramatically cutting costs (although he stopped short of providing any firm details).\u003c/p>\n\u003ch4>Messy business\u003c/h4>\n\u003cp>Things got a good deal messier after that. Repealing the ACA without a reasonable replacement would cause millions of Americans to lose their health coverage, a prospect that, as it turns out, a lot of people aren't too thrilled about. That was made abundantly clear when scores of irate constituents recently packed into Republican congressional town hall meetings across the country to air their grievances.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In fact, despite the ongoing, high profile barrage of attacks against the ACA, and the striking number of former Obama backers who voted for Trump -- a candidate who vowed to dismantle it -- support for the law is actually at \u003ca href=\"http://kff.org/interactive/kaiser-health-tracking-poll-the-publics-views-on-the-aca/#?response=Favorable--Unfavorable&aRange=all\">the highest level it's been in years\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, Republicans have struggled mightily to figure out what an overhaul would actually look like. It’s a tall order, after all: guaranteeing health coverage for everyone doesn't exactly jive with the party's agenda to slash federal spending and dramatically reduce government’s role in managing the health care market.\u003c/p>\n\u003cp>The result, the American Health Care Act, introduced by Republicans earlier this month, would have gotten rid of the individual mandate and replaced federal insurance subsidies with tax credits and block grants to states, among other major changes. In its \u003ca href=\"https://www.cbo.gov/publication/52486\">analysis of the bill\u003c/a>, the Congressional Budget Office projected that while the proposal would indeed save billions of federal dollars, it would also result in 24 million more Americans without health insurance over the next decade.\u003c/p>\n\u003cp>Even after big changes to the legislation, and a major push by President Trump and House Speaker Paul Ryan, the bill still failed to get enough Republican support in Congress to guarantee its passage (it was uniformly opposed by Democrats). Some moderates remained concerned it would cause too many of their constituents to lose health coverage, while a group of hardline conservatives opposed to big government argued that the bill was still too much like Obamacare.\u003c/p>\n\u003cp>A House vote scheduled for Thursday -- on the ACA's seven year anniversary -- was postponed at the last minute. And by Friday, just before the vote was finally set to happen, Republican leaders \u003ca href=\"https://www.washingtonpost.com/powerpost/house-leaders-prepare-to-vote-friday-on-health-care-reform/2017/03/24/736f1cd6-1081-11e7-9d5a-a83e627dc120_story.html?hpid=hp_hp-top-table-main_desktop-tab-ledeblurb%3Ahomepage%2Fstory\" target=\"_blank\" rel=\"noopener noreferrer\">scrapped the whole deal\u003c/a>, a major defeat for Trump and Ryan.\u003c/p>\n\u003cp>“Obamacare is the law of the land,” Ryan conceded. “We’re going to be living with Obamacare for the foreseeable future.\"\u003c/p>\n\u003cp>He added: \"Doing big things is hard.\"\u003c/p>\n\u003ch4>Uphill battle\u003c/h4>\n\u003cp>But why so hard? Why can't Americans agree on a good national health care fix?\u003c/p>\n\u003cp>It’s safe to assume that just about everyone wants affordable health care. Yet, finding consensus on a plan we can all live always seems out of reach.\u003c/p>\n\u003cp>Nearly every other high-income nation in the world has figured out a way to spend a lot less money than the U.S. does on health care, yet deliver high quality universal health care to their citizens. Countries can do this in a lot of different ways. In some systems, the government provides for all health care; others include a mix of government funding and private insurance.\u003c/p>\n\u003cp>In 2000, when the World Health Organization \u003ca href=\"http://www.who.int/whr/2000/media_centre/press_release/en/\" target=\"_blank\" rel=\"noopener noreferrer\">ranked different countries' health care systems\u003c/a>, the U.S. landed in dismal 31\u003csup>st\u003c/sup> place -- despite spending more per capita than any country. \u003ca href=\"https://www.bloomberg.com/news/articles/2016-09-29/u-s-health-care-system-ranks-as-one-of-the-least-efficient\">Other\u003c/a> \u003ca href=\"http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective\">studies\u003c/a> paint a similar picture of inefficiency.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/09RvU9_m30Q'\n title='//www.youtube.com/embed/09RvU9_m30Q'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>But in the U.S., citizens have long been wary of government involvement in health care. Some of the skepticism is cultural, related to the American emphasis on individualism and self-sufficiency.\u003c/p>\n\u003cp>Some of it has to do with support for organized labor, which has historically been much stronger in Europe than in the U.S., and health care is typically a key perk of union membership. Some of it is also a remnant of the Cold War, when many Americans began to worry that government involvement in health care was a big step toward socialism.\u003c/p>\n\u003ch4>Truman's big push\u003c/h4>\n\u003cp>To begin to understand why the U.S. is such an outlier on the health care front, we need to go back to November 1945. That’s when President Harry Truman \u003ca href=\"https://www.trumanlibrary.org/publicpapers/index.php?pid=483&st=&st1=\" target=\"_blank\" rel=\"noopener noreferrer\">proposed \u003c/a>a new health insurance program that would cover all Americans. His plan would have made the government centrally involved in the provision of health care – a far more radical approach than that of the ACA, which for the most part just expands access to private insurance.\u003c/p>\n\u003cfigure id=\"attachment_26342\" class=\"wp-caption alignright\" style=\"max-width: 450px\">\u003ca href=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px.jpg\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cimg class=\"wp-image-26342 size-full\" src=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px.jpg\" alt=\"Truman_HealthInsurancePlan_450px\" width=\"450\" height=\"336\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px.jpg 450w, https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px-160x119.jpg 160w, https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px-240x179.jpg 240w, https://ww2.kqed.org/app/uploads/sites/26/2017/03/Truman_HealthInsurancePlan_450px-375x280.jpg 375w\" sizes=\"(max-width: 450px) 100vw, 450px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In the late 1940s, President Harry S. Truman tried to pass a robust health care reform bill. Here, he's speaking to the 1949 Convention of the American Federation of Labor. (Courtesy of Free Speech Radio News Archive)\u003c/figcaption>\u003c/figure>\n\u003cp>Most Americans were initially receptive to Truman’s proposal, with nearly 60 percent in support, according to a Gallup Poll conducted after the president's address.\u003c/p>\n\u003cp>The immediate enthusiasm, though, worried the American Medical Association, which was then one of the country's richest and most influential lobbies, representing the business interests of doctors. A nationwide plan to make health care more affordable for patients would also make it less profitable for many private-practice doctors.\u003c/p>\n\u003ch4>\"Socialized medicine\"\u003c/h4>\n\u003cp>And so the group quickly got to work on an ingenious ad campaign centered on two magic words: \"socialized medicine.\"\u003c/p>\n\u003cp>Over the next few years, as Congress worked to craft a universal health care bill, the AMA invested in what was then the largest ad campaign in U.S. history, all aimed at convincing Americans to reject Truman's plan.\u003c/p>\n\u003cp>\"Would socialized medicine lead to socialization of other phases of American life?\" one pamphlet posited. \"Lenin thought so.He declared, 'Socialized medicine is the keystone to the arch of the socialist state.' \"\u003c/p>\n\u003cp>(The quote, by the way, was completely made up, but it stuck nonetheless.)\u003c/p>\n\u003cp>When the plan was introduced in Congress, Sen. Robert Taft, a conservative Republican from Ohio, interrupted his Democratic colleague, stating that the bill was \"the most socialistic measure this Congress has ever had before it.\" National health insurance, Taft suggested, came directly from the Soviet constitution. He then announced that Republicans would boycott the hearings, and promptly marched out of the Senate chamber.\u003c/p>\n\u003cp>The AMA continued to push the \"socialized medicine\" angle. In one editorial, the group warned that national health insurance would turn doctors into \"slaves.\" In a Tallahassee, Florida, hospital, doctors slipped political ads onto patients' breakfast trays.\u003c/p>\n\u003cp>Ahead of the 1950 midterm elections, the AMA spent more than $1 million on radio and TV ads -- far more than the government could spend to defend it. As one Truman ally ruefully noted, countering the AMA's ads was like \"trying to put out a forest fire with a sprinkling can.\" When the election results rolled in, Democrats lost nearly 30 seats in the House and five in the Senate. Public support for the proposal had also plummeted, dropping from 60 to 24 percent in just five years.\u003c/p>\n\u003cp>And so the prospect of national health insurance was dead, for the time being at least. Over the following decades, the AMA would go on to fight many more nationwide government health-related reform proposals, including Medicare – a battle it did not win, even with the star power of Ronald Reagan as its main spokesman.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/Bejdhs3jGyw'\n title='//www.youtube.com/embed/Bejdhs3jGyw'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>The 1961 recording of then-actor Ronald Reagan was part of Operation Coffee Cup, part of an elaborate AMA effort to prevent Social Security funding going to health insurance for the elderly and the poor.\u003c/p>\n\u003cp>The effort, of course, ultimately failed. In 1965, President Lyndon Johnson signed into law the bill that created the Medicare and Medicaid federal health insurance programs for Americans ages 65 and up, regardless of income (and later expanded to include younger people with permanent disabilities) and low-income Americans. To this day, Medicare — that harbinger of “socialism” and destroyer of freedom that Reagan warned about— remains one of the most popular federal programs, approved by an overwhelming majority of Democrats \u003cem>and\u003c/em> Republicans..\u003c/p>\n\u003cp>But in 2010, the AMA did an about-face and decided to support federal health reform -- thanks in part to a lot of \u003ca href=\"https://www.nationalreview.com/nrd/articles/312377/who-gave-us-obamacare\">behind-the-scenes horse-trading\u003c/a>. Today, the AMA's \u003ca href=\"https://www.ama-assn.org/content/understanding-affordable-care-act\">website\u003c/a> refers to Obamacare as \"a tremendous step forward on the path toward meaningful health system reform.\" The group has implored Republicans not to repeal the ACA without offering an adequate replacement plan, and has come out against the Republicans' bill.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The AMA, though, couldn't put the \"socialized medicine\" genie back in the bottle. The majority of Americans today might not know how the phrase originated, but many automatically consider anything linked to it \u003ca href=\"http://thefederalist.com/2016/07/15/obama-obamacare-didnt-work-so-lets-completely-socialize-medicine/\" target=\"_blank\" rel=\"noopener noreferrer\">an infringement of their rights.\u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/lowdown/26324/why-is-american-health-care-reform-so-dang-controversial","authors":["8628","1263"],"categories":["lowdown_2409","lowdown_1","lowdown_2593"],"tags":["lowdown_145","lowdown_2337","lowdown_144","lowdown_142"],"featImg":"lowdown_19242","label":"lowdown"},"lowdown_24332":{"type":"posts","id":"lowdown_24332","meta":{"index":"posts_1716263798","site":"lowdown","id":"24332","score":null,"sort":[1477965965000]},"parent":0,"labelTerm":{"site":"lowdown"},"blocks":[],"publishDate":1477965965,"format":"standard","disqusTitle":"Should California Raise Tobacco Taxes? (Includes Lesson Plan)","title":"Should California Raise Tobacco Taxes? (Includes Lesson Plan)","headTitle":"The Lowdown | KQED News","content":"\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Depending on what voters decide next week, smoking in California could soon become a much pricier habit.\u003c/p>\n\u003cdiv>\n\u003caside class=\"alignright\">\u003cb>\u003cspan style=\"font-size: x-large;\">\u003cspan style=\"color: #993300;\">Teach with the Lowdown\u003c/span>\u003c/span>\u003c/b>\u003cbr>\n\u003cimg class=\"alignnone wp-image-22868\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2016/07/hands-e1469568663680-400x143.jpg\" width=\"340\" height=\"122\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2016/07/hands-e1469568663680-400x143.jpg 400w, https://ww2.kqed.org/app/uploads/sites/26/2016/07/hands-e1469568663680-800x286.jpg 800w, https://ww2.kqed.org/app/uploads/sites/26/2016/07/hands-e1469568663680-768x274.jpg 768w, https://ww2.kqed.org/app/uploads/sites/26/2016/07/hands-e1469568663680.jpg 957w\" sizes=\"(max-width: 340px) 100vw, 340px\">\n\u003cp>Suggestions for nonfiction analysis, writing/discussion prompts and multimedia projects. Browse our lesson plan collection \u003ca href=\"https://ww2.kqed.org/lowdown/category/lesson-plans-and-guides/\" target=\"_blank\">here\u003c/a>.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2016/10/Tobacco-Tax-Lesson-Plan.pdf\" target=\"_blank\">Lesson Plan: Tobacco Taxes (PDF)\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003c/div>\n\u003cp>\u003ca href=\"http://elections.kqed.org/measure/2019/info/proposition-56\" target=\"_blank\">Proposition 56\u003c/a>, one of 17 statewide measures on the ballot this November, would increase the state's tobacco tax by $2 per pack, a huge leap from the current rate of 87 cents. The new $2.87 tax would also be levied on other tobacco products, including e-cigarettes (which now are taxed at a much lower rate than regular cigarettes).\u003c/p>\n\u003cp>If Proposition 56 succeeds, the new tax would take effect April 1, 2017. It's expected to generate $1.2 billion to $1.6 billion in its first year, according to analysis by the \u003ca href=\"http://www.lao.ca.gov/BallotAnalysis/Proposition?number=56&year=2016\" target=\"_blank\">Legislative Analyst's Office\u003c/a>. While some of this new revenue is earmarked for smoking prevention and cessation programs, the majority of it will go to Medi-Cal, the state's health insurance program for low-income residents, which covers roughly one in three Californians.\u003c/p>\n\u003cp>\u003ca href=\"https://ballotpedia.org/California_Proposition_56,_Tobacco_Tax_Increase_%282016%29#Opposition\">The No on 56\u003c/a> campaign has out-raised supporters by roughly 2-1, with most of the $71 million war chest funded by two of the nation's largest cigarette manufactures: \u003ca title=\"Philip Morris USA\" href=\"https://ballotpedia.org/Philip_Morris_USA\">Philip Morris USA\u003c/a>, \u003ca title=\"R.J. Reynolds Tobacco Company\" href=\"https://ballotpedia.org/R.J._Reynolds_Tobacco_Company\">R.J. Reynolds Tobacco Co\u003c/a>., and their affiliates . The biggest donor to \u003ca href=\"http://www.yeson56.org/\" target=\"_blank\">Yes on 56\u003c/a> is billionaire \u003ca class=\"mw-redirect\" title=\"Tom Steyer\" href=\"https://ballotpedia.org/Tom_Steyer\">Tom Steyer\u003c/a>, who has contributed more than $11 million. The latest \u003ca href=\"https://ballotpedia.org/California_Proposition_56,_Tobacco_Tax_Increase_%282016%29#Polls\">polls\u003c/a> show support for Proposition 56 at around 60 percent, with \u003ca class=\"mw-redirect\" title=\"California Democratic Party\" href=\"https://ballotpedia.org/California_Democratic_Party\">California's Democratic Party\u003c/a> backing it and the state's\u003ca class=\"mw-redirect\" title=\"California Republican Party\" href=\"https://ballotpedia.org/California_Republican_Party\"> Republican Party\u003c/a> opposing it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Supporters of Proposition 56 say the higher tax will raise millions of dollars for crucial state smoking prevention programs and health care services, while helping to potentially encourage smokers to quit and actively discouraging young people from taking up smoking in the first place.\u003c/p>\n\u003cp>Opponents claim that the hike would be regressive -- disproportionately hurting low-income smokers. They also argue that the measure is a tax grab by health insurance companies, labor unions and hospitals, with just a fraction of the revenue going to actual smoking prevention programs.\u003c/p>\n\u003ch4>How does California's tobacco tax compare to other states?\u003c/h4>\n\u003cp>California's current cigarette excise tax (a tax levied on specific commodities) is pretty low compared to most other states - 35 out of 50, to be precise. The average state tobacco tax is $1.65.\u003c/p>\n\u003cdiv align=\"center\">\u003ciframe src=\"https://mgreen.carto.com/viz/ea712400-a15f-11e6-9fa1-0e233c30368f/embed_map\" width=\"100%\" height=\"750\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">\u003c/iframe>\u003c/div>\n\u003cp>In fact, California's tobacco tax hasn't been raised since 1998; a [contextly_sidebar id=\"XxmEDmEESVj09Uc8HJCgVWAA56J7A2Sk\"]2012 proposition to increase it by $1 per pack failed by less than 1 percent of the vote. Opponents of the measure put up close to $47 million to defeat it, nearly four times what supporters spent. The current proposed increase would make California's tobacco tax among the highest in the nation (although still far short of New York's, which stands alone at $4.35 per pack).\u003c/p>\n\u003cp>Smokers in the U.S. also pay a federal excise tax of about $1 a pack on top of state taxes.\u003c/p>\n\u003cp>In May 2016, the California legislature \u003ca href=\"http://www.latimes.com/politics/la-pol-sac-jerry-brown-smoking-bills-20160504-story.html\" target=\"_blank\">voted to raise\u003c/a> the state's smoking age from 18 to 21, the second state in the nation to do so (after Hawaii). The new rules went into effect in June. The legislature also moved to restrict the use of electronic cigarettes in certain public places, including school grounds and hospitals and restaurants.\u003c/p>\n\u003ch4>How does California's smoking rate measure up?\u003c/h4>\n\u003cp>Despite its low taxes, California actually has the second-lowest smoking rate in the country: just north of 12 percent of adults. Compare that to the national rate of nearly 20 percent or one in five (the smoking rate among California's youth is slightly higher than it is among adults, but still far below the national average). The state's adult smoking rate has declined consistently over the last two decades, sparing more than 1 million lives and $86 billion, according to state health officials.\u003c/p>\n\u003cp>In 2010, California's smoking rate reached a record low of 11.9 percent (it has risen slightly since then), down from almost 26 percent in 1984. The most significant decrease occurred among adults ages 25 to 44. But while California's current smoking rate is significantly lower than in many other parts of the country, there still are roughly 4.5 million adult smokers statewide.\u003c/p>\n\u003ch4>Why is California's smoking rate so comparatively low?\u003c/h4>\n\u003cp style=\"text-align: left;\">There's obviously no single answer, but a number of policy measures have received a lot of credit. California has long been a trendsetter in local and state government smoking reduction efforts. In 1995 it placed a statewide ban on smoking in restaurants and workplaces, the first state to do so. Three years later, the ban was extended to bars. California has also spearheaded significant smoking prevention and education efforts, particularly geared toward youth. A 25-cent cigarette tax in 1998 created the \u003ca href=\"http://www.cdph.ca.gov/programs/tobacco/pages/default.aspx\" target=\"_blank\">California Tobacco Control Program\u003c/a>\u003cstrong>, \u003c/strong>the first of its kind in the nation, charged with leading aggressive anti-smoking campaigns.\u003c/p>\n\u003ch4>What's the history of tobacco taxes in California?\u003c/h4>\n\u003cul>\n\u003cli>1959: The state's first tobacco tax was passed by the Legislature. It added 10 cents to the cost of a pack of cigarettes. The revenue went straight into the general fund.\u003c/li>\n\u003cli>1988: Voters approved Proposition 99, which added an additional 25-cent tax to fund tobacco prevention, education and research programs.\u003c/li>\n\u003cli>1993: A 2-cent tax enacted by the Legislature created a fund for breast cancer research.\u003c/li>\n\u003cli>1998: Voters approved Proposition 10, adding a 50-cent tax to fund early child development programs.\u003c/li>\n\u003c/ul>\n\u003cp>Last year, total state revenues from taxes on tobacco products were just over $900 million.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2016/10/SmokingRateChartAdults20101.png\">\u003cimg class=\"alignnone size-full wp-image-24372\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2016/10/SmokingRateChartAdults20101.png\" alt=\"smokingratechartadults20101\" width=\"1449\" height=\"788\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101.png 1449w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-160x87.png 160w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-800x435.png 800w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-768x418.png 768w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-1020x555.png 1020w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-1180x642.png 1180w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-960x522.png 960w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-240x131.png 240w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-375x204.png 375w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-520x283.png 520w\" sizes=\"(max-width: 1449px) 100vw, 1449px\">\u003c/a>\u003c/p>\n\u003ch4>Does raising taxes on tobacco products actually reduce smoking?\u003c/h4>\n\u003cfigure id=\"attachment_2227\" class=\"wp-caption alignright\" style=\"max-width: 364px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2012/05/youthsmoking.png\">\u003cimg class=\"wp-image-2227 size-full\" title=\"youthsmoking\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2012/05/youthsmoking.png\" width=\"364\" height=\"237\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2012/05/youthsmoking.png 364w, https://ww2.kqed.org/app/uploads/sites/26/2012/05/youthsmoking-320x208.png 320w\" sizes=\"(max-width: 364px) 100vw, 364px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: California Department of Public Health\u003c/figcaption>\u003c/figure>\n\u003cp>Yes, according to the \u003ca href=\"http://www.cdc.gov/media/mmwrnews/2012/0329.html#1\" target=\"_blank\">Centers for Disease Control and Prevention\u003c/a>. \"Increasing the price of cigarettes is one of the most reliable and effective ways to reduce smoking and prevent youth initiation,\" the agency reported in it Morbidity and Mortality Weekly Report on March 29, 2012. The report added: \"The evidence indicates that further increases in cigarette excise taxes would continue to reduce the demand for cigarettes, thereby preventing youth initiation, reducing cigarette consumption, and decreasing the prevalence of smoking, particularly among youth and young adults. States can reduce cigarette use even further by investing excise tax revenue in tobacco prevention and control.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Some economists, however, argue that high cigarette taxes can do more harm than good, drawing smokers to buy cigarettes in nearby states with significantly lower taxes and resulting in lost tax revenue for California. High costs, it's been noted, could also encourage a black market in cigarette sales, as has become common practice in \u003ca href=\"http://observer.com/2011/11/22/the-war-on-cigarette-taxation-and-why-the-city-is-losing/\" target=\"_blank\">New York City\u003c/a>.\u003c/p>\n\n","disqusIdentifier":"24332 http://ww2.kqed.org/lowdown/?p=24332","disqusUrl":"https://ww2.kqed.org/lowdown/2016/10/31/is-it-time-for-california-to-raise-its-tobacco-tax-includes-lesson-plan/","stats":{"hasVideo":false,"hasChartOrMap":true,"hasAudio":false,"hasPolis":false,"wordCount":1133,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":["https://mgreen.carto.com/viz/ea712400-a15f-11e6-9fa1-0e233c30368f/embed_map"],"paragraphCount":20},"modified":1478291867,"excerpt":null,"headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"","title":"Should California Raise Tobacco Taxes? (Includes Lesson Plan) | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Should California Raise Tobacco Taxes? (Includes Lesson Plan)","datePublished":"2016-10-31T19:06:05-07:00","dateModified":"2016-11-04T13:37:47-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"is-it-time-for-california-to-raise-its-tobacco-tax-includes-lesson-plan","status":"publish","customPermalink":"2016/10/31/prop-29-should-smoking-in-california-be-more-expensive-2/","path":"/lowdown/24332/is-it-time-for-california-to-raise-its-tobacco-tax-includes-lesson-plan","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Depending on what voters decide next week, smoking in California could soon become a much pricier habit.\u003c/p>\n\u003cdiv>\n\u003caside class=\"alignright\">\u003cb>\u003cspan style=\"font-size: x-large;\">\u003cspan style=\"color: #993300;\">Teach with the Lowdown\u003c/span>\u003c/span>\u003c/b>\u003cbr>\n\u003cimg class=\"alignnone wp-image-22868\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2016/07/hands-e1469568663680-400x143.jpg\" width=\"340\" height=\"122\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2016/07/hands-e1469568663680-400x143.jpg 400w, https://ww2.kqed.org/app/uploads/sites/26/2016/07/hands-e1469568663680-800x286.jpg 800w, https://ww2.kqed.org/app/uploads/sites/26/2016/07/hands-e1469568663680-768x274.jpg 768w, https://ww2.kqed.org/app/uploads/sites/26/2016/07/hands-e1469568663680.jpg 957w\" sizes=\"(max-width: 340px) 100vw, 340px\">\n\u003cp>Suggestions for nonfiction analysis, writing/discussion prompts and multimedia projects. Browse our lesson plan collection \u003ca href=\"https://ww2.kqed.org/lowdown/category/lesson-plans-and-guides/\" target=\"_blank\">here\u003c/a>.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2016/10/Tobacco-Tax-Lesson-Plan.pdf\" target=\"_blank\">Lesson Plan: Tobacco Taxes (PDF)\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003c/div>\n\u003cp>\u003ca href=\"http://elections.kqed.org/measure/2019/info/proposition-56\" target=\"_blank\">Proposition 56\u003c/a>, one of 17 statewide measures on the ballot this November, would increase the state's tobacco tax by $2 per pack, a huge leap from the current rate of 87 cents. The new $2.87 tax would also be levied on other tobacco products, including e-cigarettes (which now are taxed at a much lower rate than regular cigarettes).\u003c/p>\n\u003cp>If Proposition 56 succeeds, the new tax would take effect April 1, 2017. It's expected to generate $1.2 billion to $1.6 billion in its first year, according to analysis by the \u003ca href=\"http://www.lao.ca.gov/BallotAnalysis/Proposition?number=56&year=2016\" target=\"_blank\">Legislative Analyst's Office\u003c/a>. While some of this new revenue is earmarked for smoking prevention and cessation programs, the majority of it will go to Medi-Cal, the state's health insurance program for low-income residents, which covers roughly one in three Californians.\u003c/p>\n\u003cp>\u003ca href=\"https://ballotpedia.org/California_Proposition_56,_Tobacco_Tax_Increase_%282016%29#Opposition\">The No on 56\u003c/a> campaign has out-raised supporters by roughly 2-1, with most of the $71 million war chest funded by two of the nation's largest cigarette manufactures: \u003ca title=\"Philip Morris USA\" href=\"https://ballotpedia.org/Philip_Morris_USA\">Philip Morris USA\u003c/a>, \u003ca title=\"R.J. Reynolds Tobacco Company\" href=\"https://ballotpedia.org/R.J._Reynolds_Tobacco_Company\">R.J. Reynolds Tobacco Co\u003c/a>., and their affiliates . The biggest donor to \u003ca href=\"http://www.yeson56.org/\" target=\"_blank\">Yes on 56\u003c/a> is billionaire \u003ca class=\"mw-redirect\" title=\"Tom Steyer\" href=\"https://ballotpedia.org/Tom_Steyer\">Tom Steyer\u003c/a>, who has contributed more than $11 million. The latest \u003ca href=\"https://ballotpedia.org/California_Proposition_56,_Tobacco_Tax_Increase_%282016%29#Polls\">polls\u003c/a> show support for Proposition 56 at around 60 percent, with \u003ca class=\"mw-redirect\" title=\"California Democratic Party\" href=\"https://ballotpedia.org/California_Democratic_Party\">California's Democratic Party\u003c/a> backing it and the state's\u003ca class=\"mw-redirect\" title=\"California Republican Party\" href=\"https://ballotpedia.org/California_Republican_Party\"> Republican Party\u003c/a> opposing it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Supporters of Proposition 56 say the higher tax will raise millions of dollars for crucial state smoking prevention programs and health care services, while helping to potentially encourage smokers to quit and actively discouraging young people from taking up smoking in the first place.\u003c/p>\n\u003cp>Opponents claim that the hike would be regressive -- disproportionately hurting low-income smokers. They also argue that the measure is a tax grab by health insurance companies, labor unions and hospitals, with just a fraction of the revenue going to actual smoking prevention programs.\u003c/p>\n\u003ch4>How does California's tobacco tax compare to other states?\u003c/h4>\n\u003cp>California's current cigarette excise tax (a tax levied on specific commodities) is pretty low compared to most other states - 35 out of 50, to be precise. The average state tobacco tax is $1.65.\u003c/p>\n\u003cdiv align=\"center\">\u003ciframe src=\"https://mgreen.carto.com/viz/ea712400-a15f-11e6-9fa1-0e233c30368f/embed_map\" width=\"100%\" height=\"750\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">\u003c/iframe>\u003c/div>\n\u003cp>In fact, California's tobacco tax hasn't been raised since 1998; a \u003c/p>\u003cp>\u003c/p>\u003cp>2012 proposition to increase it by $1 per pack failed by less than 1 percent of the vote. Opponents of the measure put up close to $47 million to defeat it, nearly four times what supporters spent. The current proposed increase would make California's tobacco tax among the highest in the nation (although still far short of New York's, which stands alone at $4.35 per pack).\u003c/p>\n\u003cp>Smokers in the U.S. also pay a federal excise tax of about $1 a pack on top of state taxes.\u003c/p>\n\u003cp>In May 2016, the California legislature \u003ca href=\"http://www.latimes.com/politics/la-pol-sac-jerry-brown-smoking-bills-20160504-story.html\" target=\"_blank\">voted to raise\u003c/a> the state's smoking age from 18 to 21, the second state in the nation to do so (after Hawaii). The new rules went into effect in June. The legislature also moved to restrict the use of electronic cigarettes in certain public places, including school grounds and hospitals and restaurants.\u003c/p>\n\u003ch4>How does California's smoking rate measure up?\u003c/h4>\n\u003cp>Despite its low taxes, California actually has the second-lowest smoking rate in the country: just north of 12 percent of adults. Compare that to the national rate of nearly 20 percent or one in five (the smoking rate among California's youth is slightly higher than it is among adults, but still far below the national average). The state's adult smoking rate has declined consistently over the last two decades, sparing more than 1 million lives and $86 billion, according to state health officials.\u003c/p>\n\u003cp>In 2010, California's smoking rate reached a record low of 11.9 percent (it has risen slightly since then), down from almost 26 percent in 1984. The most significant decrease occurred among adults ages 25 to 44. But while California's current smoking rate is significantly lower than in many other parts of the country, there still are roughly 4.5 million adult smokers statewide.\u003c/p>\n\u003ch4>Why is California's smoking rate so comparatively low?\u003c/h4>\n\u003cp style=\"text-align: left;\">There's obviously no single answer, but a number of policy measures have received a lot of credit. California has long been a trendsetter in local and state government smoking reduction efforts. In 1995 it placed a statewide ban on smoking in restaurants and workplaces, the first state to do so. Three years later, the ban was extended to bars. California has also spearheaded significant smoking prevention and education efforts, particularly geared toward youth. A 25-cent cigarette tax in 1998 created the \u003ca href=\"http://www.cdph.ca.gov/programs/tobacco/pages/default.aspx\" target=\"_blank\">California Tobacco Control Program\u003c/a>\u003cstrong>, \u003c/strong>the first of its kind in the nation, charged with leading aggressive anti-smoking campaigns.\u003c/p>\n\u003ch4>What's the history of tobacco taxes in California?\u003c/h4>\n\u003cul>\n\u003cli>1959: The state's first tobacco tax was passed by the Legislature. It added 10 cents to the cost of a pack of cigarettes. The revenue went straight into the general fund.\u003c/li>\n\u003cli>1988: Voters approved Proposition 99, which added an additional 25-cent tax to fund tobacco prevention, education and research programs.\u003c/li>\n\u003cli>1993: A 2-cent tax enacted by the Legislature created a fund for breast cancer research.\u003c/li>\n\u003cli>1998: Voters approved Proposition 10, adding a 50-cent tax to fund early child development programs.\u003c/li>\n\u003c/ul>\n\u003cp>Last year, total state revenues from taxes on tobacco products were just over $900 million.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2016/10/SmokingRateChartAdults20101.png\">\u003cimg class=\"alignnone size-full wp-image-24372\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2016/10/SmokingRateChartAdults20101.png\" alt=\"smokingratechartadults20101\" width=\"1449\" height=\"788\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101.png 1449w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-160x87.png 160w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-800x435.png 800w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-768x418.png 768w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-1020x555.png 1020w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-1180x642.png 1180w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-960x522.png 960w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-240x131.png 240w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-375x204.png 375w, https://ww2.kqed.org/app/uploads/sites/26/2016/10/SmokingRateChartAdults20101-520x283.png 520w\" sizes=\"(max-width: 1449px) 100vw, 1449px\">\u003c/a>\u003c/p>\n\u003ch4>Does raising taxes on tobacco products actually reduce smoking?\u003c/h4>\n\u003cfigure id=\"attachment_2227\" class=\"wp-caption alignright\" style=\"max-width: 364px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2012/05/youthsmoking.png\">\u003cimg class=\"wp-image-2227 size-full\" title=\"youthsmoking\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2012/05/youthsmoking.png\" width=\"364\" height=\"237\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2012/05/youthsmoking.png 364w, https://ww2.kqed.org/app/uploads/sites/26/2012/05/youthsmoking-320x208.png 320w\" sizes=\"(max-width: 364px) 100vw, 364px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: California Department of Public Health\u003c/figcaption>\u003c/figure>\n\u003cp>Yes, according to the \u003ca href=\"http://www.cdc.gov/media/mmwrnews/2012/0329.html#1\" target=\"_blank\">Centers for Disease Control and Prevention\u003c/a>. \"Increasing the price of cigarettes is one of the most reliable and effective ways to reduce smoking and prevent youth initiation,\" the agency reported in it Morbidity and Mortality Weekly Report on March 29, 2012. The report added: \"The evidence indicates that further increases in cigarette excise taxes would continue to reduce the demand for cigarettes, thereby preventing youth initiation, reducing cigarette consumption, and decreasing the prevalence of smoking, particularly among youth and young adults. States can reduce cigarette use even further by investing excise tax revenue in tobacco prevention and control.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some economists, however, argue that high cigarette taxes can do more harm than good, drawing smokers to buy cigarettes in nearby states with significantly lower taxes and resulting in lost tax revenue for California. High costs, it's been noted, could also encourage a black market in cigarette sales, as has become common practice in \u003ca href=\"http://observer.com/2011/11/22/the-war-on-cigarette-taxation-and-why-the-city-is-losing/\" target=\"_blank\">New York City\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/lowdown/24332/is-it-time-for-california-to-raise-its-tobacco-tax-includes-lesson-plan","authors":["1263"],"categories":["lowdown_2498","lowdown_2409","lowdown_2399","lowdown_2391"],"tags":["lowdown_2337","lowdown_2571","lowdown_121","lowdown_120"],"featImg":"lowdown_24350","label":"lowdown"},"lowdown_19800":{"type":"posts","id":"lowdown_19800","meta":{"index":"posts_1716263798","site":"lowdown","id":"19800","score":null,"sort":[1444159766000]},"parent":0,"labelTerm":{"site":"lowdown"},"blocks":[],"publishDate":1444159766,"format":"aside","disqusTitle":"MAP: Physician-Assisted Suicide Laws by State","title":"MAP: Physician-Assisted Suicide Laws by State","headTitle":"The Lowdown | KQED News","content":"\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"100%\" height=\"700\" frameborder=\"0\" src=\"https://mgreen.cartodb.com/viz/65970b2e-6c4e-11e5-b372-0e5db1731f59/embed_map\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Following months of emotionally-charged debate, Gov. Jerry Brown on Monday signed \u003ca href=\"http://ww2.kqed.org/news/2015/10/05/governor-brown-signs-physician-assisted-suicide-bill-into-law\" target=\"_blank\">landmark legislation\u003c/a> allowing terminally-ill patients to obtain lethal medication. When the measures goes into effect in 2016, California will become the fifth state to legalize physician-assisted suicide.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>[For a comprehensive list of current state laws and a curated set of arguments for and against the practice, check out \u003ca href=\"http://ww2.kqed.org/lowdown/2015/10/06/california-becomes-fifth-state-to-legalize-physician-assisted-suicide-interactive-map/\" target=\"_blank\">ProCon.org\u003c/a>.] \u003c/strong>\u003c/p>\n\u003cp>The \"End of Life Option Act\" requires two different doctors to first determine that a patient has six months or less to live before prescribing lethal drugs. Patients must be physically able to swallow the pill-form medication themselves and have the mental capacity to make medical decisions.\u003c/p>\n\u003cp>“In the end, I was left to reflect on what I would want in the face of my own death,” Brown, who struggled with the decision, wrote in his signing message. “I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>His signature at least temporarily halts a hotly-contested, 10-month debate that drew emotional testimony from lawmakers and cancer patients as well as disability advocates and members of the religious community.\u003c/p>\n\u003cp>The long-standing issue over physician-assisted suicide in California was reignited late last year amidst widespread media coverage of Brittany Maynard, a 29-year-old terminally-ill California resident, moved to Oregon to end her life legally, allowed under that state's Death With Dignity law.\u003c/p>\n\u003cp>Physician-assisted suicide is notably different from euthanasia. In the former, patients with a terminal diagnosis formally request a prescription from a doctor for a fatal dose of a drug (generally in pill form) which they can administer themselves privately when they wish, according to the end-of-life resource site \u003ca href=\"http://www.comfortcarechoices.com/index.php?option=com_content&view=article&id=89:whats-the-difference-between-physician-assisted-suicide-pas-and-euthanasia&catid=37:faqs&Itemid=72\" target=\"_blank\">Comfort Care Choices\u003c/a>.\u003c/p>\n\u003cp>Euthanasia, on the other hand, involves a physician or other healthcare provider deliberately administering treatment -- such as a lethal injection -- to end a patient's life, with or without the patient's consent. Although not allowed anywhere in the U.S., the practice is legal in several northern European nations, including Belgium and the Netherlands.\u003c/p>\n\u003cp>Supporters of physician-assisted suicide argue that these laws allow terminally ill patients to avoid unbearable suffering and die on their own terms in a humane and dignified way. It also allows greater accountability and state oversight of the process, they contend, without taking away other end-of-life care options, giving patients more autonomy to make their own end-of-life decisions.\u003c/p>\n\u003cp>Those against the law include the Catholic Church and a number of other religious institutions who argue that life is a gift from God and should not be prematurely shortened under any circumstance. Other opponents fear that the law could result in caregivers pressuring patients to end their lives as a way of saving money or easing the burden of care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>There is also strong concern that because physician-assisted suicide is often cheaper than end-of-life care, it may influence decisions made by patients, doctors and insurance companies. And, some opponents argue, it can be very difficult for doctors to accurately predict how much time certain patients have left live and how much influence intensive care can have in prolonging their lives.\u003c/p>\n\n","disqusIdentifier":"19800 http://ww2.kqed.org/lowdown/?p=19800","disqusUrl":"https://ww2.kqed.org/lowdown/2015/10/06/california-becomes-fifth-state-to-legalize-physician-assisted-suicide-interactive-map/","stats":{"hasVideo":false,"hasChartOrMap":true,"hasAudio":false,"hasPolis":false,"wordCount":573,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":["https://mgreen.cartodb.com/viz/65970b2e-6c4e-11e5-b372-0e5db1731f59/embed_map"],"paragraphCount":14},"modified":1465489796,"excerpt":null,"headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"Following months of emotionally-charged debate, Gov. Jerry Brown on Monday signed landmark legislation allowing terminally-ill patients to obtain lethal medication. When the measures goes into effect in 2016, California will become the fifth state to legalize physician-assisted suicide.","title":"MAP: Physician-Assisted Suicide Laws by State | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"MAP: Physician-Assisted Suicide Laws by State","datePublished":"2015-10-06T12:29:26-07:00","dateModified":"2016-06-09T09:29:56-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"california-becomes-fifth-state-to-legalize-physician-assisted-suicide-interactive-map","status":"publish","path":"/lowdown/19800/california-becomes-fifth-state-to-legalize-physician-assisted-suicide-interactive-map","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"100%\" height=\"700\" frameborder=\"0\" src=\"https://mgreen.cartodb.com/viz/65970b2e-6c4e-11e5-b372-0e5db1731f59/embed_map\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Following months of emotionally-charged debate, Gov. Jerry Brown on Monday signed \u003ca href=\"http://ww2.kqed.org/news/2015/10/05/governor-brown-signs-physician-assisted-suicide-bill-into-law\" target=\"_blank\">landmark legislation\u003c/a> allowing terminally-ill patients to obtain lethal medication. When the measures goes into effect in 2016, California will become the fifth state to legalize physician-assisted suicide.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>[For a comprehensive list of current state laws and a curated set of arguments for and against the practice, check out \u003ca href=\"http://ww2.kqed.org/lowdown/2015/10/06/california-becomes-fifth-state-to-legalize-physician-assisted-suicide-interactive-map/\" target=\"_blank\">ProCon.org\u003c/a>.] \u003c/strong>\u003c/p>\n\u003cp>The \"End of Life Option Act\" requires two different doctors to first determine that a patient has six months or less to live before prescribing lethal drugs. Patients must be physically able to swallow the pill-form medication themselves and have the mental capacity to make medical decisions.\u003c/p>\n\u003cp>“In the end, I was left to reflect on what I would want in the face of my own death,” Brown, who struggled with the decision, wrote in his signing message. “I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>His signature at least temporarily halts a hotly-contested, 10-month debate that drew emotional testimony from lawmakers and cancer patients as well as disability advocates and members of the religious community.\u003c/p>\n\u003cp>The long-standing issue over physician-assisted suicide in California was reignited late last year amidst widespread media coverage of Brittany Maynard, a 29-year-old terminally-ill California resident, moved to Oregon to end her life legally, allowed under that state's Death With Dignity law.\u003c/p>\n\u003cp>Physician-assisted suicide is notably different from euthanasia. In the former, patients with a terminal diagnosis formally request a prescription from a doctor for a fatal dose of a drug (generally in pill form) which they can administer themselves privately when they wish, according to the end-of-life resource site \u003ca href=\"http://www.comfortcarechoices.com/index.php?option=com_content&view=article&id=89:whats-the-difference-between-physician-assisted-suicide-pas-and-euthanasia&catid=37:faqs&Itemid=72\" target=\"_blank\">Comfort Care Choices\u003c/a>.\u003c/p>\n\u003cp>Euthanasia, on the other hand, involves a physician or other healthcare provider deliberately administering treatment -- such as a lethal injection -- to end a patient's life, with or without the patient's consent. Although not allowed anywhere in the U.S., the practice is legal in several northern European nations, including Belgium and the Netherlands.\u003c/p>\n\u003cp>Supporters of physician-assisted suicide argue that these laws allow terminally ill patients to avoid unbearable suffering and die on their own terms in a humane and dignified way. It also allows greater accountability and state oversight of the process, they contend, without taking away other end-of-life care options, giving patients more autonomy to make their own end-of-life decisions.\u003c/p>\n\u003cp>Those against the law include the Catholic Church and a number of other religious institutions who argue that life is a gift from God and should not be prematurely shortened under any circumstance. Other opponents fear that the law could result in caregivers pressuring patients to end their lives as a way of saving money or easing the burden of care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>There is also strong concern that because physician-assisted suicide is often cheaper than end-of-life care, it may influence decisions made by patients, doctors and insurance companies. And, some opponents argue, it can be very difficult for doctors to accurately predict how much time certain patients have left live and how much influence intensive care can have in prolonging their lives.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/lowdown/19800/california-becomes-fifth-state-to-legalize-physician-assisted-suicide-interactive-map","authors":["1263"],"categories":["lowdown_2409","lowdown_242","lowdown_1"],"tags":["lowdown_2482","lowdown_2481","lowdown_2337","lowdown_2480"],"featImg":"lowdown_19816","label":"lowdown"},"lowdown_16104":{"type":"posts","id":"lowdown_16104","meta":{"index":"posts_1716263798","site":"lowdown","id":"16104","score":null,"sort":[1431612042000]},"parent":0,"labelTerm":{"site":"lowdown"},"blocks":[],"publishDate":1431612042,"format":"video","disqusTitle":"The Feverish Roots of Today's Anti-Vaccine Movement","title":"The Feverish Roots of Today's Anti-Vaccine Movement","headTitle":"The Lowdown | KQED News","content":"\u003cfigure id=\"attachment_16178\" class=\"wp-caption alignnone\" style=\"max-width: 1276px\">\u003ca href=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/The_cow_pock.jpg\">\u003cimg class=\"size-full wp-image-16178\" src=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/The_cow_pock.jpg\" alt=\"\" width=\"1276\" height=\"908\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2015/02/The_cow_pock.jpg 1276w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/The_cow_pock-400x285.jpg 400w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/The_cow_pock-800x569.jpg 800w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/The_cow_pock-1180x840.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/The_cow_pock-768x547.jpg 768w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/The_cow_pock-320x228.jpg 320w\" sizes=\"(max-width: 1276px) 100vw, 1276px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A cartoon from 1802 illustrating the hysteria that came with the \"cowpock\" vaccine. \u003ccite>(\u003ca href=\"https://commons.wikimedia.org/wiki/File:The_cow_pock.jpg\">Wikimedia Commons\u003c/a>)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On May 14, 1796 a rural British physician by the name of Edward Jenner inoculated a healthy 8-year-old boy with pus extracted from the cowpox lesions of a dairymaid.\u003c/p>\n\u003cp>The boy subsequently developed mild fever but quickly recovered. Several months later, Jenner again inoculated the boy, but this time with matter from a fresh smallpox lesion. The boy did not contract the disease, leading Jenner to conclude that his patient had built up immunity.\u003c/p>\n\u003cp>Fast forward 219 years. Today, nearly 170 measles cases have been reported in 20 states since the start of 2015. Most of these cases stem from a December 2014 outbreak at Disneyland in Southern California, according to the \u003ca href=\"http://www.cdc.gov/measles/cases-outbreaks.html\" target=\"_blank\" rel=\"noopener\">Centers for Disease Control and Prevention\u003c/a>.\u003c/p>\n\u003cp>The outbreak has come with no shortage of angry finger-pointing at the small but growing contingent of Americans who choose not to vaccinate their children against the highly contagious, yet preventable disease.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/state-measles-cases.png\">\u003cimg class=\"alignnone size-full wp-image-17586\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/state-measles-cases.png\" alt=\"state-measles-cases\" width=\"700\" height=\"476\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2015/02/state-measles-cases.png 700w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/state-measles-cases-400x272.png 400w\" sizes=\"(max-width: 700px) 100vw, 700px\">\u003c/a>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As recently as 20 years ago, measles was listed by the World Health Organization as one of the five leading causes of death in the world. But by 2000, the disease\u003ca href=\"http://www.cdc.gov/measles/about/faqs.html\"> \u003c/a>was \u003ca href=\"http://www.cdc.gov/measles/about/faqs.html\" target=\"_blank\" rel=\"noopener\">declared “eliminated” in the U.S.\u003c/a>, largely credited to the success of statewide public health campaigns to make the MMR (measles, mumps, rubella) vaccine mandatory for children enrolling in public schools.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/measles-cases-616px.gif\">\u003cimg class=\"alignright wp-image-16234 size-medium\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/measles-cases-616px-e1423972922856-300x177.gif\" alt=\"\" width=\"300\" height=\"177\">\u003c/a>Since then, however, the number of parents requesting religious or philosophical exemptions to state rules has gone up, as have reported measles cases. In 2014, the CDC reported the highest number of cases in over a decade: 644 in 27 states, including one outbreak in an Amish community in rural Ohio infecting more than 300 people.\u003c/p>\n\u003cp>Not surprisingly, rates have increased fastest in states with the most lenient vaccination exemption rules. All but two states (Mississippi and West Virginia) allow for religious exemptions, and 19 states — California included — permit parents to opt out of vaccinating their children on personal or philosophical grounds. Many parents who do so, say they doubt the effectiveness of the vaccine or have concerns that it may cause autism or other major health problems, even as no medical evidence actually supports these theories.\u003c/p>\n\u003cp>So why this recent outbreak in anti-vaccination sentiment?\u003c/p>\n\u003cp>It's actually nothing new: anti-vaccination movements have a robust, storied history. Intermittent backlashes against compulsory government vaccination campaigns have arisen ever since the first series of inoculations were given more than 200 years ago.\u003c/p>\n\u003cp>Perhaps most interesting is the striking cultural similarities and motives of today's prototypical \"anti-vaxxers\" and their 19th Century forebears: both have been typically portrayed as affluent, well-educated and politically progressive, driven by strong distrust in the safety of vaccines and intensely protective of civil liberties and personal choice.\u003c/p>\n\u003ch3>The First Vaccine Revolution\u003c/h3>\n\u003cp>If you know little or care less about smallpox, Edward Jenner's the man to thank for that.\u003c/p>\n\u003cp>Among the most gruesome and deadly diseases in human history, smallpox terrorized the world for centuries, ravaging entire societies during its sporadic outbreaks and claiming millions of lives, particularly those of young children. Highly infectious, smallpox typically covers the skin in large oozing, pus-filled bumps.\u003c/p>\n\u003cp>In 1796, Jenner, a rural British physician, tested a locally shared theory that milkmaids who contracted cowpox were immune from smallpox. Similar to smallpox but far less severe, cowpox is generally found in animals, and can be transmitted to human handlers. Jenner extracted pus from a cowpox scab and inserted it into an incision on the arm of an eight-year-old boy. Although the child contracted a mild virus, he recovered quickly, developing antibodies that built up his immunity to both cowpox and smallpox.\u003c/p>\n\u003cpre>\u003cstrong>[Source: \u003ca href=\"http://www.ndm.ox.ac.uk/edward-jenner-museum\" target=\"_blank\" rel=\"noopener\">Nuffield Dept. of Medicine, University of Oxford\u003c/a>]\u003c/strong>\u003c/pre>\n\u003cp>Jenner subsequently coined the term \"vaccine,\" from \"vacca,\" Latin for cow.\u003c/p>\n\u003cp>Although initially rejected by the British medical establishment, Jenner's findings were eventually published after subsequent successful trials, and the field of modern immunology was born. The discovery paved the way for vaccine breakthroughs over the next two centuries, including inoculations for polio, tetanus, influenza, rabies, diphtheria and, yes, measles.\u003c/p>\n\u003cp>The smallpox vaccine and its later iterations proved so successful that the World Health Organization in 1980 declared smallpox the first disease to be eradicated as a result of global vaccination efforts. To date, there is no cure or treatment for the disease; vaccination is the only means of prevention.\u003c/p>\n\u003cpre>\u003cstrong>[Source: \u003ca href=\"//www.who.int/features/2010/smallpox/en/\" target=\"_blank\" rel=\"noopener\">World Health Organization\u003c/a>]\u003c/strong>\u003c/pre>\n\u003ch3>Birth of the Anti-Vaccination Movement\u003c/h3>\n\u003cp>Protection from one of the most feared, miserable ailments in human history: who wouldn't raise a (sterilized) glass to that?\u003c/p>\n\u003cfigure id=\"attachment_16227\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/wolr5328.f1.jpg\">\u003cimg class=\"size-medium wp-image-16227\" title=\"\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/wolr5328.f1-300x228.jpg\" alt=' 1887 illustration from an anti-vaccination flier. Included in the text: \"This monster has been named vaccination; and his progressive havoc among the human race, has been dreadful and most alarming.\" ' width=\"300\" height=\"228\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An illustration from an 1807 anti-vaccination flier. Included in the text: \"This monster has been named vaccination; and his progressive havoc among the human race, has been dreadful and most alarming.\" (Courtesy of National Institutes of Health)\u003c/figcaption>\u003c/figure>\n\u003cp>Turns out, lots of folks. As word of the procedure spread, Jenner was ridiculed by a host of angry critics, particularly members of the clergy, who charged that the idea of inoculating someone with pus from a diseased animal was not only revolting but blasphemous. Rumors abounded of vaccinated patients contracting bovine diseases and suffering grotesque reactions. Enough evidence, however, demonstrated the obvious advantages of the vaccination, and the procedure soon became widespread.\u003c/p>\n\u003cp>By the mid-1800s, in the wake of several smallpox outbreaks, the United Kingdom enacted a set of laws making vaccinations compulsory, initially for infants, but eventually for all children up to 14 years old. Cumulative penalties were imposed on violators.\u003c/p>\n\u003cp>The measures were met with staunch resistance and incited a series of riots. The unrest prompted the creation of the Anti-Compulsory Vaccination League in 1867, whose founders were primarily concerned with what they considered a blatant infringement of personal choice and liberty.\u003c/p>\n\u003cfigure id=\"attachment_16260\" class=\"wp-caption alignright\" style=\"max-width: 215px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/OldAnti-VaccinePoster.jpg\">\u003cimg class=\" wp-image-16260\" title=\"\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/OldAnti-VaccinePoster.jpg\" alt=\"Notice of a demonstration at Andover Town Hall (England) in support of an anti-vaxxer on her release from imprisonment for refusing to allow her children to be vaccinated (date unknown). (Courtesy of MicroBiology Today).\" width=\"215\" height=\"277\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Notice of a demonstration at Andover Town Hall (England); date unknown. (Courtesy of MicroBiology Today).\u003c/figcaption>\u003c/figure>\n\u003cp>The group's seven-point mission statement, printed on the masthead of its newsletter, included the following pronouncement:\u003c/p>\n\u003cp>\u003cem>\"As parliament, instead of guarding the liberty of the subject, has invaded this liberty by rendering good health a crime, punishable by fine or imprisonment, inflicted on dutiful parents, parliament is deserving of public condemnation.\"\u003c/em>\u003c/p>\n\u003cp>By the 1870s and 1880s, even as smallpox vaccination techniques were rapidly advancing and helping to contain the disease's spread, anti-vaccination campaigns gained increased momentum in the U.K. and beyond. As propaganda literature proliferated and leaders of the movement adeptly tapped into the public's understandable anxieties about the still nascent procedure. some efforts were successful in temporarily lowering vaccination rates.\u003c/p>\n\u003cp>One of the largest demonstrations, in Leicester, England in 1885, drew upwards of 100,000 people, with props including a child's coffin and an effigy of Jenner.\u003c/p>\n\u003cfigure id=\"attachment_16261\" class=\"wp-caption alignright\" style=\"max-width: 261px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/Leicester-Demonstration.jpg\">\u003cimg class=\"wp-image-16261\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/Leicester-Demonstration.jpg\" alt=\"\" width=\"261\" height=\"199\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2015/02/Leicester-Demonstration.jpg 400w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/Leicester-Demonstration-320x243.jpg 320w\" sizes=\"(max-width: 261px) 100vw, 261px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An artist's depiction of the 1885 anti-vaccine demonstration in Leicester. (Courtesy of Immunize USA).\u003c/figcaption>\u003c/figure>\n\u003cp>The rally prompted a government commission to investigate the protesters' grievances, which eventually concluded that the vaccine was safe and effective but, in a political move to pacify detractors, also recommended the abolition of penalties for violators. In 1898, the passage of a new national vaccination act removed penalties and included a \"conscientious objector\" clause, which allowed parents concerned with the safety of vaccinations to apply for an exemption certificate.\u003c/p>\n\u003cpre>\u003cstrong>[Source: \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123944/#B2\" target=\"_blank\" rel=\"noopener\">National Institutes of Health\u003c/a>]\u003c/strong>\u003c/pre>\n\u003ch3>Anti-vaccination fever spreads to the U.S.\u003c/h3>\n\u003cp>In the late 1800s, a series of smallpox outbreaks in the U.S. prompted local government vaccine campaigns and subsequent anti-vaccine advocacy, including a visit from prominent British anti-vaccinationist William Tebb. By 1879, the Anti-Vaccination Society of America was established, followed by the emergence of several local leagues, including the New England Anti Compulsory Vaccination League and the Anti-Vaccination League of New York City. A second national league was formed in the early 1900s. Activists waged court battles to repeal vaccination laws in a number of states, including California, Illinois and Wisconsin.\u003c/p>\n\u003cblockquote>\u003cp>\"Vaccination is the putting of an impure thing into the blood - a virus or poison -- often resulting in serious evil effects. In vogue for more than one hundred years, it has been received by most persons without question. Yet the time is passing when people will accept a medical dogma on blind faith.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003cspan style=\"font-size: small\">-- From \"\u003ca href=\"http://www.whale.to/vaccines/pitcairn.html\" target=\"_blank\" rel=\"noopener\">The Fallacy of Vaccination\u003c/a>,\" a 1911 essay by John Pitcairn, Jr., prominent Pennsylvania industrialist and president of the Anti-Vaccination League of America.\u003c/span>\u003c/p>\n\u003cp>Inflaming tensions and helping to further cast vaccination campaigns as an affront to civil liberties, public health officials commonly resorted to heavy-handed, uneven enforcement tactics, often vaccinating immigrants and minorities against their will during outbreaks, notes \u003ca href=\"University%20of%20Georgia%20history%20professor%20Stephen%20Mihm\" target=\"_blank\" rel=\"noopener\">University of Georgia history professor Stephen Mihm\u003c/a>.\u003c/p>\n\u003cp>Fears were also legitimately stoked by the lack of oversight of vaccine production, which was primarily controlled by private industry and at times resulted in questionable product. In one of the worst incidents, nine children in Camden, New Jersey died after being inoculated with a batch of tetanus-contaminated smallpox vaccine. News of the tragedy prompted Congress to pass the Biologics Control Act of 1902, which required increased government oversight of the manufacturing process.\u003c/p>\n\u003cp>Following a smallpox outbreak in 1902, the city of Cambridge, Mass. mandated vaccinations for all residents. After one man refused to comply on the grounds that the law violated his right to care for himself, the city filed criminal charges against him. The case -- \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449224/\" target=\"_blank\" rel=\"noopener\">Jacobson v. Massachusetts\u003c/a> - made its way in 1905 to the U.S. Supreme Court, which sided with the state. In its decision, the court ruled it within the power of the state to enact mandatory vaccine laws in order to protect the public in the event of a communicable disease. The decision marked the first Supreme Court case weighing in on state power in enacting public health law.\u003c/p>\n\u003cpre>\u003cstrong>[Source: \u003ca href=\"http://www.historyofvaccines.org/content/articles/history-anti-vaccination-movements\" target=\"_blank\" rel=\"noopener\">History of Vaccines, College of Physicians of Philadelphia\u003c/a>]\u003c/strong>\u003c/pre>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"http://www.youtube.com/embed/GzvfpyyZO9o\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\" width=\"100%\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\n","disqusIdentifier":"16104 http://blogs.kqed.org/lowdown/?p=16104","disqusUrl":"https://ww2.kqed.org/lowdown/2015/05/14/the-feverish-roots-of-todays-anti-vaccine-movement/","stats":{"hasVideo":true,"hasChartOrMap":true,"hasAudio":false,"hasPolis":false,"wordCount":1662,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":["http://www.youtube.com/embed/GzvfpyyZO9o"],"paragraphCount":35},"modified":1556576875,"excerpt":"How the history of inoculation gave birth to the anti-vaccine movement.","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"How the history of inoculation gave birth to the anti-vaccine movement.","title":"The Feverish Roots of Today's Anti-Vaccine Movement | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"The Feverish Roots of Today's Anti-Vaccine Movement","datePublished":"2015-05-14T07:00:42-07:00","dateModified":"2019-04-29T15:27:55-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"the-feverish-roots-of-todays-anti-vaccine-movement","status":"publish","path":"/lowdown/16104/the-feverish-roots-of-todays-anti-vaccine-movement","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16178\" class=\"wp-caption alignnone\" style=\"max-width: 1276px\">\u003ca href=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/The_cow_pock.jpg\">\u003cimg class=\"size-full wp-image-16178\" src=\"https://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/The_cow_pock.jpg\" alt=\"\" width=\"1276\" height=\"908\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2015/02/The_cow_pock.jpg 1276w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/The_cow_pock-400x285.jpg 400w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/The_cow_pock-800x569.jpg 800w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/The_cow_pock-1180x840.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/The_cow_pock-768x547.jpg 768w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/The_cow_pock-320x228.jpg 320w\" sizes=\"(max-width: 1276px) 100vw, 1276px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A cartoon from 1802 illustrating the hysteria that came with the \"cowpock\" vaccine. \u003ccite>(\u003ca href=\"https://commons.wikimedia.org/wiki/File:The_cow_pock.jpg\">Wikimedia Commons\u003c/a>)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On May 14, 1796 a rural British physician by the name of Edward Jenner inoculated a healthy 8-year-old boy with pus extracted from the cowpox lesions of a dairymaid.\u003c/p>\n\u003cp>The boy subsequently developed mild fever but quickly recovered. Several months later, Jenner again inoculated the boy, but this time with matter from a fresh smallpox lesion. The boy did not contract the disease, leading Jenner to conclude that his patient had built up immunity.\u003c/p>\n\u003cp>Fast forward 219 years. Today, nearly 170 measles cases have been reported in 20 states since the start of 2015. Most of these cases stem from a December 2014 outbreak at Disneyland in Southern California, according to the \u003ca href=\"http://www.cdc.gov/measles/cases-outbreaks.html\" target=\"_blank\" rel=\"noopener\">Centers for Disease Control and Prevention\u003c/a>.\u003c/p>\n\u003cp>The outbreak has come with no shortage of angry finger-pointing at the small but growing contingent of Americans who choose not to vaccinate their children against the highly contagious, yet preventable disease.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/state-measles-cases.png\">\u003cimg class=\"alignnone size-full wp-image-17586\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/state-measles-cases.png\" alt=\"state-measles-cases\" width=\"700\" height=\"476\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2015/02/state-measles-cases.png 700w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/state-measles-cases-400x272.png 400w\" sizes=\"(max-width: 700px) 100vw, 700px\">\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As recently as 20 years ago, measles was listed by the World Health Organization as one of the five leading causes of death in the world. But by 2000, the disease\u003ca href=\"http://www.cdc.gov/measles/about/faqs.html\"> \u003c/a>was \u003ca href=\"http://www.cdc.gov/measles/about/faqs.html\" target=\"_blank\" rel=\"noopener\">declared “eliminated” in the U.S.\u003c/a>, largely credited to the success of statewide public health campaigns to make the MMR (measles, mumps, rubella) vaccine mandatory for children enrolling in public schools.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/measles-cases-616px.gif\">\u003cimg class=\"alignright wp-image-16234 size-medium\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/measles-cases-616px-e1423972922856-300x177.gif\" alt=\"\" width=\"300\" height=\"177\">\u003c/a>Since then, however, the number of parents requesting religious or philosophical exemptions to state rules has gone up, as have reported measles cases. In 2014, the CDC reported the highest number of cases in over a decade: 644 in 27 states, including one outbreak in an Amish community in rural Ohio infecting more than 300 people.\u003c/p>\n\u003cp>Not surprisingly, rates have increased fastest in states with the most lenient vaccination exemption rules. All but two states (Mississippi and West Virginia) allow for religious exemptions, and 19 states — California included — permit parents to opt out of vaccinating their children on personal or philosophical grounds. Many parents who do so, say they doubt the effectiveness of the vaccine or have concerns that it may cause autism or other major health problems, even as no medical evidence actually supports these theories.\u003c/p>\n\u003cp>So why this recent outbreak in anti-vaccination sentiment?\u003c/p>\n\u003cp>It's actually nothing new: anti-vaccination movements have a robust, storied history. Intermittent backlashes against compulsory government vaccination campaigns have arisen ever since the first series of inoculations were given more than 200 years ago.\u003c/p>\n\u003cp>Perhaps most interesting is the striking cultural similarities and motives of today's prototypical \"anti-vaxxers\" and their 19th Century forebears: both have been typically portrayed as affluent, well-educated and politically progressive, driven by strong distrust in the safety of vaccines and intensely protective of civil liberties and personal choice.\u003c/p>\n\u003ch3>The First Vaccine Revolution\u003c/h3>\n\u003cp>If you know little or care less about smallpox, Edward Jenner's the man to thank for that.\u003c/p>\n\u003cp>Among the most gruesome and deadly diseases in human history, smallpox terrorized the world for centuries, ravaging entire societies during its sporadic outbreaks and claiming millions of lives, particularly those of young children. Highly infectious, smallpox typically covers the skin in large oozing, pus-filled bumps.\u003c/p>\n\u003cp>In 1796, Jenner, a rural British physician, tested a locally shared theory that milkmaids who contracted cowpox were immune from smallpox. Similar to smallpox but far less severe, cowpox is generally found in animals, and can be transmitted to human handlers. Jenner extracted pus from a cowpox scab and inserted it into an incision on the arm of an eight-year-old boy. Although the child contracted a mild virus, he recovered quickly, developing antibodies that built up his immunity to both cowpox and smallpox.\u003c/p>\n\u003cpre>\u003cstrong>[Source: \u003ca href=\"http://www.ndm.ox.ac.uk/edward-jenner-museum\" target=\"_blank\" rel=\"noopener\">Nuffield Dept. of Medicine, University of Oxford\u003c/a>]\u003c/strong>\u003c/pre>\n\u003cp>Jenner subsequently coined the term \"vaccine,\" from \"vacca,\" Latin for cow.\u003c/p>\n\u003cp>Although initially rejected by the British medical establishment, Jenner's findings were eventually published after subsequent successful trials, and the field of modern immunology was born. The discovery paved the way for vaccine breakthroughs over the next two centuries, including inoculations for polio, tetanus, influenza, rabies, diphtheria and, yes, measles.\u003c/p>\n\u003cp>The smallpox vaccine and its later iterations proved so successful that the World Health Organization in 1980 declared smallpox the first disease to be eradicated as a result of global vaccination efforts. To date, there is no cure or treatment for the disease; vaccination is the only means of prevention.\u003c/p>\n\u003cpre>\u003cstrong>[Source: \u003ca href=\"//www.who.int/features/2010/smallpox/en/\" target=\"_blank\" rel=\"noopener\">World Health Organization\u003c/a>]\u003c/strong>\u003c/pre>\n\u003ch3>Birth of the Anti-Vaccination Movement\u003c/h3>\n\u003cp>Protection from one of the most feared, miserable ailments in human history: who wouldn't raise a (sterilized) glass to that?\u003c/p>\n\u003cfigure id=\"attachment_16227\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/wolr5328.f1.jpg\">\u003cimg class=\"size-medium wp-image-16227\" title=\"\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/wolr5328.f1-300x228.jpg\" alt=' 1887 illustration from an anti-vaccination flier. Included in the text: \"This monster has been named vaccination; and his progressive havoc among the human race, has been dreadful and most alarming.\" ' width=\"300\" height=\"228\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An illustration from an 1807 anti-vaccination flier. Included in the text: \"This monster has been named vaccination; and his progressive havoc among the human race, has been dreadful and most alarming.\" (Courtesy of National Institutes of Health)\u003c/figcaption>\u003c/figure>\n\u003cp>Turns out, lots of folks. As word of the procedure spread, Jenner was ridiculed by a host of angry critics, particularly members of the clergy, who charged that the idea of inoculating someone with pus from a diseased animal was not only revolting but blasphemous. Rumors abounded of vaccinated patients contracting bovine diseases and suffering grotesque reactions. Enough evidence, however, demonstrated the obvious advantages of the vaccination, and the procedure soon became widespread.\u003c/p>\n\u003cp>By the mid-1800s, in the wake of several smallpox outbreaks, the United Kingdom enacted a set of laws making vaccinations compulsory, initially for infants, but eventually for all children up to 14 years old. Cumulative penalties were imposed on violators.\u003c/p>\n\u003cp>The measures were met with staunch resistance and incited a series of riots. The unrest prompted the creation of the Anti-Compulsory Vaccination League in 1867, whose founders were primarily concerned with what they considered a blatant infringement of personal choice and liberty.\u003c/p>\n\u003cfigure id=\"attachment_16260\" class=\"wp-caption alignright\" style=\"max-width: 215px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/OldAnti-VaccinePoster.jpg\">\u003cimg class=\" wp-image-16260\" title=\"\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/OldAnti-VaccinePoster.jpg\" alt=\"Notice of a demonstration at Andover Town Hall (England) in support of an anti-vaxxer on her release from imprisonment for refusing to allow her children to be vaccinated (date unknown). (Courtesy of MicroBiology Today).\" width=\"215\" height=\"277\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Notice of a demonstration at Andover Town Hall (England); date unknown. (Courtesy of MicroBiology Today).\u003c/figcaption>\u003c/figure>\n\u003cp>The group's seven-point mission statement, printed on the masthead of its newsletter, included the following pronouncement:\u003c/p>\n\u003cp>\u003cem>\"As parliament, instead of guarding the liberty of the subject, has invaded this liberty by rendering good health a crime, punishable by fine or imprisonment, inflicted on dutiful parents, parliament is deserving of public condemnation.\"\u003c/em>\u003c/p>\n\u003cp>By the 1870s and 1880s, even as smallpox vaccination techniques were rapidly advancing and helping to contain the disease's spread, anti-vaccination campaigns gained increased momentum in the U.K. and beyond. As propaganda literature proliferated and leaders of the movement adeptly tapped into the public's understandable anxieties about the still nascent procedure. some efforts were successful in temporarily lowering vaccination rates.\u003c/p>\n\u003cp>One of the largest demonstrations, in Leicester, England in 1885, drew upwards of 100,000 people, with props including a child's coffin and an effigy of Jenner.\u003c/p>\n\u003cfigure id=\"attachment_16261\" class=\"wp-caption alignright\" style=\"max-width: 261px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/Leicester-Demonstration.jpg\">\u003cimg class=\"wp-image-16261\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/Leicester-Demonstration.jpg\" alt=\"\" width=\"261\" height=\"199\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2015/02/Leicester-Demonstration.jpg 400w, https://ww2.kqed.org/app/uploads/sites/26/2015/02/Leicester-Demonstration-320x243.jpg 320w\" sizes=\"(max-width: 261px) 100vw, 261px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An artist's depiction of the 1885 anti-vaccine demonstration in Leicester. (Courtesy of Immunize USA).\u003c/figcaption>\u003c/figure>\n\u003cp>The rally prompted a government commission to investigate the protesters' grievances, which eventually concluded that the vaccine was safe and effective but, in a political move to pacify detractors, also recommended the abolition of penalties for violators. In 1898, the passage of a new national vaccination act removed penalties and included a \"conscientious objector\" clause, which allowed parents concerned with the safety of vaccinations to apply for an exemption certificate.\u003c/p>\n\u003cpre>\u003cstrong>[Source: \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123944/#B2\" target=\"_blank\" rel=\"noopener\">National Institutes of Health\u003c/a>]\u003c/strong>\u003c/pre>\n\u003ch3>Anti-vaccination fever spreads to the U.S.\u003c/h3>\n\u003cp>In the late 1800s, a series of smallpox outbreaks in the U.S. prompted local government vaccine campaigns and subsequent anti-vaccine advocacy, including a visit from prominent British anti-vaccinationist William Tebb. By 1879, the Anti-Vaccination Society of America was established, followed by the emergence of several local leagues, including the New England Anti Compulsory Vaccination League and the Anti-Vaccination League of New York City. A second national league was formed in the early 1900s. Activists waged court battles to repeal vaccination laws in a number of states, including California, Illinois and Wisconsin.\u003c/p>\n\u003cblockquote>\u003cp>\"Vaccination is the putting of an impure thing into the blood - a virus or poison -- often resulting in serious evil effects. In vogue for more than one hundred years, it has been received by most persons without question. Yet the time is passing when people will accept a medical dogma on blind faith.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003cspan style=\"font-size: small\">-- From \"\u003ca href=\"http://www.whale.to/vaccines/pitcairn.html\" target=\"_blank\" rel=\"noopener\">The Fallacy of Vaccination\u003c/a>,\" a 1911 essay by John Pitcairn, Jr., prominent Pennsylvania industrialist and president of the Anti-Vaccination League of America.\u003c/span>\u003c/p>\n\u003cp>Inflaming tensions and helping to further cast vaccination campaigns as an affront to civil liberties, public health officials commonly resorted to heavy-handed, uneven enforcement tactics, often vaccinating immigrants and minorities against their will during outbreaks, notes \u003ca href=\"University%20of%20Georgia%20history%20professor%20Stephen%20Mihm\" target=\"_blank\" rel=\"noopener\">University of Georgia history professor Stephen Mihm\u003c/a>.\u003c/p>\n\u003cp>Fears were also legitimately stoked by the lack of oversight of vaccine production, which was primarily controlled by private industry and at times resulted in questionable product. In one of the worst incidents, nine children in Camden, New Jersey died after being inoculated with a batch of tetanus-contaminated smallpox vaccine. News of the tragedy prompted Congress to pass the Biologics Control Act of 1902, which required increased government oversight of the manufacturing process.\u003c/p>\n\u003cp>Following a smallpox outbreak in 1902, the city of Cambridge, Mass. mandated vaccinations for all residents. After one man refused to comply on the grounds that the law violated his right to care for himself, the city filed criminal charges against him. The case -- \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449224/\" target=\"_blank\" rel=\"noopener\">Jacobson v. Massachusetts\u003c/a> - made its way in 1905 to the U.S. Supreme Court, which sided with the state. In its decision, the court ruled it within the power of the state to enact mandatory vaccine laws in order to protect the public in the event of a communicable disease. The decision marked the first Supreme Court case weighing in on state power in enacting public health law.\u003c/p>\n\u003cpre>\u003cstrong>[Source: \u003ca href=\"http://www.historyofvaccines.org/content/articles/history-anti-vaccination-movements\" target=\"_blank\" rel=\"noopener\">History of Vaccines, College of Physicians of Philadelphia\u003c/a>]\u003c/strong>\u003c/pre>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"http://www.youtube.com/embed/GzvfpyyZO9o\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\" width=\"100%\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/lowdown/16104/the-feverish-roots-of-todays-anti-vaccine-movement","authors":["1263"],"categories":["lowdown_2409","lowdown_2365"],"tags":["lowdown_582","lowdown_2337","lowdown_581","lowdown_583"],"featImg":"lowdown_16178","label":"lowdown"},"lowdown_12229":{"type":"posts","id":"lowdown_12229","meta":{"index":"posts_1716263798","site":"lowdown","id":"12229","score":null,"sort":[1422063004000]},"parent":0,"labelTerm":{"site":"lowdown"},"blocks":[],"publishDate":1422063004,"format":"aside","disqusTitle":"America's Confusing Patchwork of Abortion Laws: A Map of State Rules","title":"America's Confusing Patchwork of Abortion Laws: A Map of State Rules","headTitle":"The Lowdown | KQED News","content":"\u003cp>On Thursday, the 42nd anniversary of the Supreme Court's landmark \u003ca href=\"http://www.law.cornell.edu/supremecourt/text/410/113\" target=\"_blank\">Roe vs. Wade\u003c/a> decision to legalize abortion nationwide, House Republicans had intended to vote on a proposal banning abortions at the 20-week post-conception period. But rather than approving the so-called “fetal pain” measure, the House swapped it for a watered down bill that would weaken insurance coverage for the procedure. It was a last minute switch was made after a small group of mostly female Republican lawmakers came out strongly opposing the more restrictive measure.\u003c/p>\n\u003cp>All of which begs the question: what are current abortion laws?\u003c!--more-->\u003c/p>\n\u003cp>Easier asked than answered.\u003c/p>\n\u003cp>Although Roe v. Wade, the 1973 landmark Supreme Court decision, established a woman's constitutional right to an abortion, it did little to prevent individual states from enacting their own laws tightening restrictions on the procedure. So while all 50 states must permit some form of abortion, per the court's ruling, many conservative states have enacted restrictions to making the procedure far more difficult.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/01/last-four-years-231-restrictions.png\">\u003cimg class=\"alignright size-medium wp-image-15882\" title=\"\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/01/last-four-years-231-restrictions-300x318.png\" alt=\"\" width=\"283\" height=\"300\">\u003c/a>In recent years, anti-abortion campaigns have increasingly geared their efforts towards passing restrictive abortion laws in individual states, rather than at the federal level. In 2013 alone, state legislatures enacted 70 laws restricting abortion access, ranging from bans on abortions at 20 weeks post-conception to limitations on insurance coverage for the procedure, according to the \u003ca href=\"http://www.guttmacher.org/\" target=\"_blank\">Guttmacher Institute\u003c/a>, a pro-choice advocacy group that tracks state laws. In fact, more abortions restrictions were enacted from 2011 to 2013 than in the entire previous decade.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The map below, created by designer Lewis Lehe, shows abortion rates by state as well as the dizzying patchwork of various state abortion restrictions (note that these are just some of the many state restrictions in place). Like the lattice-work of laws, the map is a bit complicated. Select a category tab on the right, and then mouse over each state to see its specific restrictions .The graph below the map shows te number of abortions in each state per 1,000 women (aged 15 - 44), To compare different states, click on one state and then mouse over (but don't click) another. Hit the \"Compare US Total\" button to show the selected state against the national rate.\u003c/p>\n\u003cp>Note that the map was last updated in 2014. The 'viability' of a fetus is generally considered to start at 24 weeks. Normal pregnancies run about 40 weeks. Additionally, while some states have both parental notification and parental consent laws, the map shows only the strictest law.\u003c/p>\n\u003cp>\u003cem>(article continues below visualization)\u003c/em>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://lewis500.github.io/abortionstats/\" width=\"800\" height=\"830\" frameborder=\"0\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Public opinion on the issue remains sharply divided. In a 2013\u003ca href=\"http://firstread.nbcnews.com/_news/2013/01/21/16626932-nbcwsj-poll-majority-for-first-time-want-abortion-to-be-legal?lite\" target=\"_blank\"> Wall Street Journal/NBC News poll\u003c/a>, 70 percent of respondents said they would not want the Supreme Court to completely overturn Roe v. Wade, as opposed to 24 percent who did. But 58 percent of respondents favored imposing some limits on abortion procedures.\u003c/p>\n\u003cp>Despite the controversy surrounding the procedure, abortion is still a relatively common experience for a significant number of American women, although the rate has decreased fairly steadily since its peak in 1980, when there were more than 29 abortions per 1,000 women aged 15 to 44. In 2011, there were fewer than \u003cspan>17 abortions for every 1,000 women, according to a \u003ca href=\"http://www.guttmacher.org/media/nr/2014/02/03/index.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Guttmacher+(New+from+the+Guttmacher+Institute)\" target=\"_blank\">recent Guttmacher study\u003c/a>. That's the lowest it's been since 1973, when the Supreme Court legalized the procedure in all 50 states. \u003c/span>\u003c/p>\n\u003cp>\u003ca href=\"http://blogs.kqed.org/education/2014/03/28/abortion/\" target=\"_blank\">\u003cimg class=\" wp-image-12266 alignright\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2014/03/DoNowAbortionImage-2-150x150.jpg\" alt=\"DoNowAbortionImage (2)\" width=\"112\" height=\"112\">\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While the study doesn't specifically investigate reasons for the decline, its authors note that the trend predates the recent wave in new state abortion restrictions. They largely attribute the drop to an uptick in the use of new, long-acting contraceptive methods that have significantly reduced the frequency of unwanted pregnancies.\u003c/p>\n\n","disqusIdentifier":"12229 http://blogs.kqed.org/lowdown/?p=12229","disqusUrl":"https://ww2.kqed.org/lowdown/2015/01/23/visualization-what-are-the-abortion-restrictions-in-your-state/","stats":{"hasVideo":false,"hasChartOrMap":true,"hasAudio":false,"hasPolis":false,"wordCount":634,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":["https://lewis500.github.io/abortionstats/"],"paragraphCount":15},"modified":1524244378,"excerpt":null,"headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"On Thursday, the 42nd anniversary of the Supreme Court's landmark Roe vs. Wade decision to legalize abortion nationwide, House Republicans had intended to vote on a proposal banning abortions at the 20-week post-conception period. But rather than approving the so-called “fetal pain” measure, the House swapped it for a watered down bill that would weaken insurance coverage","title":"America's Confusing Patchwork of Abortion Laws: A Map of State Rules | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"America's Confusing Patchwork of Abortion Laws: A Map of State Rules","datePublished":"2015-01-23T17:30:04-08:00","dateModified":"2018-04-20T10:12:58-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"visualization-what-are-the-abortion-restrictions-in-your-state","status":"publish","customPermalink":"2014/03/27/abortion/","path":"/lowdown/12229/visualization-what-are-the-abortion-restrictions-in-your-state","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>On Thursday, the 42nd anniversary of the Supreme Court's landmark \u003ca href=\"http://www.law.cornell.edu/supremecourt/text/410/113\" target=\"_blank\">Roe vs. Wade\u003c/a> decision to legalize abortion nationwide, House Republicans had intended to vote on a proposal banning abortions at the 20-week post-conception period. But rather than approving the so-called “fetal pain” measure, the House swapped it for a watered down bill that would weaken insurance coverage for the procedure. It was a last minute switch was made after a small group of mostly female Republican lawmakers came out strongly opposing the more restrictive measure.\u003c/p>\n\u003cp>All of which begs the question: what are current abortion laws?\u003c!--more-->\u003c/p>\n\u003cp>Easier asked than answered.\u003c/p>\n\u003cp>Although Roe v. Wade, the 1973 landmark Supreme Court decision, established a woman's constitutional right to an abortion, it did little to prevent individual states from enacting their own laws tightening restrictions on the procedure. So while all 50 states must permit some form of abortion, per the court's ruling, many conservative states have enacted restrictions to making the procedure far more difficult.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/01/last-four-years-231-restrictions.png\">\u003cimg class=\"alignright size-medium wp-image-15882\" title=\"\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/01/last-four-years-231-restrictions-300x318.png\" alt=\"\" width=\"283\" height=\"300\">\u003c/a>In recent years, anti-abortion campaigns have increasingly geared their efforts towards passing restrictive abortion laws in individual states, rather than at the federal level. In 2013 alone, state legislatures enacted 70 laws restricting abortion access, ranging from bans on abortions at 20 weeks post-conception to limitations on insurance coverage for the procedure, according to the \u003ca href=\"http://www.guttmacher.org/\" target=\"_blank\">Guttmacher Institute\u003c/a>, a pro-choice advocacy group that tracks state laws. In fact, more abortions restrictions were enacted from 2011 to 2013 than in the entire previous decade.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The map below, created by designer Lewis Lehe, shows abortion rates by state as well as the dizzying patchwork of various state abortion restrictions (note that these are just some of the many state restrictions in place). Like the lattice-work of laws, the map is a bit complicated. Select a category tab on the right, and then mouse over each state to see its specific restrictions .The graph below the map shows te number of abortions in each state per 1,000 women (aged 15 - 44), To compare different states, click on one state and then mouse over (but don't click) another. Hit the \"Compare US Total\" button to show the selected state against the national rate.\u003c/p>\n\u003cp>Note that the map was last updated in 2014. The 'viability' of a fetus is generally considered to start at 24 weeks. Normal pregnancies run about 40 weeks. Additionally, while some states have both parental notification and parental consent laws, the map shows only the strictest law.\u003c/p>\n\u003cp>\u003cem>(article continues below visualization)\u003c/em>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://lewis500.github.io/abortionstats/\" width=\"800\" height=\"830\" frameborder=\"0\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Public opinion on the issue remains sharply divided. In a 2013\u003ca href=\"http://firstread.nbcnews.com/_news/2013/01/21/16626932-nbcwsj-poll-majority-for-first-time-want-abortion-to-be-legal?lite\" target=\"_blank\"> Wall Street Journal/NBC News poll\u003c/a>, 70 percent of respondents said they would not want the Supreme Court to completely overturn Roe v. Wade, as opposed to 24 percent who did. But 58 percent of respondents favored imposing some limits on abortion procedures.\u003c/p>\n\u003cp>Despite the controversy surrounding the procedure, abortion is still a relatively common experience for a significant number of American women, although the rate has decreased fairly steadily since its peak in 1980, when there were more than 29 abortions per 1,000 women aged 15 to 44. In 2011, there were fewer than \u003cspan>17 abortions for every 1,000 women, according to a \u003ca href=\"http://www.guttmacher.org/media/nr/2014/02/03/index.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Guttmacher+(New+from+the+Guttmacher+Institute)\" target=\"_blank\">recent Guttmacher study\u003c/a>. That's the lowest it's been since 1973, when the Supreme Court legalized the procedure in all 50 states. \u003c/span>\u003c/p>\n\u003cp>\u003ca href=\"http://blogs.kqed.org/education/2014/03/28/abortion/\" target=\"_blank\">\u003cimg class=\" wp-image-12266 alignright\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2014/03/DoNowAbortionImage-2-150x150.jpg\" alt=\"DoNowAbortionImage (2)\" width=\"112\" height=\"112\">\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While the study doesn't specifically investigate reasons for the decline, its authors note that the trend predates the recent wave in new state abortion restrictions. They largely attribute the drop to an uptick in the use of new, long-acting contraceptive methods that have significantly reduced the frequency of unwanted pregnancies.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/lowdown/12229/visualization-what-are-the-abortion-restrictions-in-your-state","authors":["7527","1263"],"categories":["lowdown_391","lowdown_256","lowdown_2409","lowdown_242","lowdown_457","lowdown_243"],"tags":["lowdown_482","lowdown_577"],"featImg":"lowdown_12250","label":"lowdown"},"lowdown_10531":{"type":"posts","id":"lowdown_10531","meta":{"index":"posts_1716263798","site":"lowdown","id":"10531","score":null,"sort":[1384617624000]},"parent":0,"labelTerm":{"site":"lowdown","term":2380},"blocks":[],"publishDate":1384617624,"format":"aside","disqusTitle":"These Disunited States: Two Geographic Visions of America's Deep Divides","title":"These Disunited States: Two Geographic Visions of America's Deep Divides","headTitle":"Geography | The Lowdown | KQED News","content":"\u003cfigure id=\"attachment_10570\" class=\"wp-caption alignnone\" style=\"max-width: 600px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2013/11/upinarms-map.jpg\">\u003cimg class=\"size-full wp-image-10570\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2013/11/upinarms-map.jpg\" alt=\"Courtesy of Tufts Magazine\" width=\"600\" height=\"410\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2013/11/upinarms-map.jpg 600w, https://ww2.kqed.org/app/uploads/sites/26/2013/11/upinarms-map-400x273.jpg 400w, https://ww2.kqed.org/app/uploads/sites/26/2013/11/upinarms-map-320x219.jpg 320w\" sizes=\"(max-width: 600px) 100vw, 600px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Courtesy of Tufts Magazine\u003c/figcaption>\u003c/figure>\n\u003cp>\"There’s never been an America, but rather several Americas—each a distinct nation. There are eleven nations today. Each looks at violence, as well as everything else, in its own way.\"\u003c!--more-->\u003c/p>\n\u003cp>That's according to author and Portland Press Herald reporter Colin Woodward. In a recent \u003ca href=\"http://www.tufts.edu/alumni/magazine/fall2013/features/up-in-arms.html\" target=\"_blank\">Tufts Magazine article\u003c/a> -- and in greater detail in his book \u003cem style=\"font-size: 14px\">American Nations -- \u003c/em>Woodard argues that much of North America can be neatly divided into 11 separate nation-states -- from Yankeedom and the Far West, to the Left Coast and the Deep South -- each shaped heavily by its unique geography and dominant ethnicities, Shaped since the early days of settlement, the distinct cultures of these regions, he notes, are determinate factors in a wide range of social and political positions, from voting patterns to attitudes on government and violence. \u003c!--more--> \"To understand violence or practically any other divisive issue, you need to understand historical settlement patterns and the lasting cultural fissures they established,\" Woodard writes. The \u003ca href=\"http://www.tufts.edu/alumni/magazine/fall2013/features/up-in-arms.html\" target=\"_blank\">article\u003c/a> includes a complete description of all 11 of Woodard's constructed \"nations.\"\u003c/p>\n\u003ch4>America as 15 divided \"counties\"\u003c/h4>\n\u003cp>In another take on America's divides, journalist Dante Chinni divides the country into 15 types of counties, from Big Cities to Aging Farmlands. A project of the \u003ca href=\"http://americancommunities.org/\" target=\"_blank\">American Communities Project\u003c/a>, the analysis uses a set of 36 different indicators – from population density to numbers military service members. The \u003ca href=\"http://americancommunities.org/\" target=\"_blank\">site \u003c/a>includes a detailed description of each county and the methodology used to delineate them. The map below was created by \u003ca href=\"http://www.wnyc.org/\" target=\"_blank\">WNYC \u003c/a>in collaboration with ACP. It shows the distribution of these \"counties\" throughout the country. Mouse over and zoom in for greater detail.\u003c/p>\n\u003cdiv>\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"http://project.wnyc.org/acp/#4/38.34/-94.66\" frameborder=\"0\" scrolling=\"no\" width=\"100%\" height=\"785\" class=\"iframe-class\">\u003c/iframe>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n","disqusIdentifier":"10531 http://blogs.kqed.org/lowdown/?p=10531","disqusUrl":"https://ww2.kqed.org/lowdown/2013/11/16/these-disunited-states-two-geographic-visions-of-americas-divisions/","stats":{"hasVideo":false,"hasChartOrMap":true,"hasAudio":false,"hasPolis":false,"wordCount":288,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":["http://project.wnyc.org/acp/#4/38.34/-94.66"],"paragraphCount":5},"modified":1432227871,"excerpt":null,"headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":""There’s never been an America, but rather several Americas—each a distinct nation. There are eleven nations today. Each looks at violence, as well as everything else, in its own way."","title":"These Disunited States: Two Geographic Visions of America's Deep Divides | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"These Disunited States: Two Geographic Visions of America's Deep Divides","datePublished":"2013-11-16T08:00:24-08:00","dateModified":"2015-05-21T10:04:31-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"these-disunited-states-two-geographic-visions-of-americas-divisions","status":"publish","customPermalink":"2013/11/13/americas-divides/","path":"/lowdown/10531/these-disunited-states-two-geographic-visions-of-americas-divisions","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_10570\" class=\"wp-caption alignnone\" style=\"max-width: 600px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2013/11/upinarms-map.jpg\">\u003cimg class=\"size-full wp-image-10570\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2013/11/upinarms-map.jpg\" alt=\"Courtesy of Tufts Magazine\" width=\"600\" height=\"410\" srcset=\"https://ww2.kqed.org/app/uploads/sites/26/2013/11/upinarms-map.jpg 600w, https://ww2.kqed.org/app/uploads/sites/26/2013/11/upinarms-map-400x273.jpg 400w, https://ww2.kqed.org/app/uploads/sites/26/2013/11/upinarms-map-320x219.jpg 320w\" sizes=\"(max-width: 600px) 100vw, 600px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Courtesy of Tufts Magazine\u003c/figcaption>\u003c/figure>\n\u003cp>\"There’s never been an America, but rather several Americas—each a distinct nation. There are eleven nations today. Each looks at violence, as well as everything else, in its own way.\"\u003c!--more-->\u003c/p>\n\u003cp>That's according to author and Portland Press Herald reporter Colin Woodward. In a recent \u003ca href=\"http://www.tufts.edu/alumni/magazine/fall2013/features/up-in-arms.html\" target=\"_blank\">Tufts Magazine article\u003c/a> -- and in greater detail in his book \u003cem style=\"font-size: 14px\">American Nations -- \u003c/em>Woodard argues that much of North America can be neatly divided into 11 separate nation-states -- from Yankeedom and the Far West, to the Left Coast and the Deep South -- each shaped heavily by its unique geography and dominant ethnicities, Shaped since the early days of settlement, the distinct cultures of these regions, he notes, are determinate factors in a wide range of social and political positions, from voting patterns to attitudes on government and violence. \u003c!--more--> \"To understand violence or practically any other divisive issue, you need to understand historical settlement patterns and the lasting cultural fissures they established,\" Woodard writes. The \u003ca href=\"http://www.tufts.edu/alumni/magazine/fall2013/features/up-in-arms.html\" target=\"_blank\">article\u003c/a> includes a complete description of all 11 of Woodard's constructed \"nations.\"\u003c/p>\n\u003ch4>America as 15 divided \"counties\"\u003c/h4>\n\u003cp>In another take on America's divides, journalist Dante Chinni divides the country into 15 types of counties, from Big Cities to Aging Farmlands. A project of the \u003ca href=\"http://americancommunities.org/\" target=\"_blank\">American Communities Project\u003c/a>, the analysis uses a set of 36 different indicators – from population density to numbers military service members. The \u003ca href=\"http://americancommunities.org/\" target=\"_blank\">site \u003c/a>includes a detailed description of each county and the methodology used to delineate them. The map below was created by \u003ca href=\"http://www.wnyc.org/\" target=\"_blank\">WNYC \u003c/a>in collaboration with ACP. It shows the distribution of these \"counties\" throughout the country. Mouse over and zoom in for greater detail.\u003c/p>\n\u003cdiv>\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"http://project.wnyc.org/acp/#4/38.34/-94.66\" frameborder=\"0\" scrolling=\"no\" width=\"100%\" height=\"785\" class=\"iframe-class\">\u003c/iframe>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/lowdown/10531/these-disunited-states-two-geographic-visions-of-americas-divisions","authors":["1263"],"series":["lowdown_2380"],"categories":["lowdown_2409","lowdown_242","lowdown_457"],"tags":["lowdown_425"],"featImg":"lowdown_10570","label":"lowdown_2380"},"lowdown_8603":{"type":"posts","id":"lowdown_8603","meta":{"index":"posts_1716263798","site":"lowdown","id":"8603","score":null,"sort":[1374843617000]},"parent":0,"labelTerm":{"site":"lowdown"},"blocks":[],"publishDate":1374843617,"format":"aside","disqusTitle":"Hey America, Where You Live Might Determine How Long You Live","title":"Hey America, Where You Live Might Determine How Long You Live","headTitle":"The Lowdown | KQED News","content":"\u003cp>Location, location, location.\u003c/p>\n\u003cp>It can be a matter of life and death, according to a recent \u003ca href=\"http://www.healthmetricsandevaluation.org/news-events/news-release/obesity-continues-rise-nearly-all-counties-americans-becoming\" target=\"_blank\" rel=\"noopener noreferrer\">report\u003c/a> published by the University of Washington's Institute for Health Metrics. Presenting a snapshot of America's overall wellness, researchers crunched data from every county in the country (see interactive map below), and found that although Americans are exercising more and living longer, we still lag behind the world's other high-income nation. The U.S ranks 51st in life expectancy, a dubious standing that's largely due to poor diet and over eating.\u003c/p>\n\u003cp>Even with the boost in physical activity, obesity rates continue to increase in almost every county in the nation. Heart disease has remained the \u003ca href=\"http://www.cdc.gov/nchs/fastats/lcod.htm\" target=\"_blank\" rel=\"noopener noreferrer\">leading cause of death\u003c/a>. Average life expectancy for American men is now 76, up from 67 four decades ago. And for women, it's now 81, up from 76.\u003c/p>\n\u003cp>These rates, though, vary dramatically by county, and socioeconomic status remains one of the key determinants.\u003c/p>\n\u003cp>At 81 years, men in Fairfax, VA have the highest male life expectancy in the country. But head just 350 miles to McDowell County, WV and it drops to just 64 years for men, on par with the African nation of Gambia. Meanwhile, women in Marin County live to 85 on average, the country's highest female life expectancy. Compare that to Perry County, KY, where the average female life span is 72.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In fact, the Bay Area made out quite well in the report, with San Francisco having the fewest obese men in the country.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Mouse over IHM's incredibly detailed map to see how life expectancy rates and various health conditions in counties throughout the country have changed over the last three decades. Note that what you'll see first is the health map from 1985. To see 2014 rates, use the time slider at the bottom of the graphic.\u003c/p>\n\u003cdiv>\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://vizhub.healthdata.org/subnational/usa\" width=\"100%\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\n\u003c/div>\n\n","disqusIdentifier":"8603 http://blogs.kqed.org/lowdown/?p=8603","disqusUrl":"https://ww2.kqed.org/lowdown/2013/07/26/whats-the-average-life-expectancy-where-you-live/","stats":{"hasVideo":false,"hasChartOrMap":true,"hasAudio":false,"hasPolis":false,"wordCount":318,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":["https://vizhub.healthdata.org/subnational/usa"],"paragraphCount":9},"modified":1620234574,"excerpt":null,"headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"Location, location, location. It can be a matter of life and death, according to a recent report published by the University of Washington’s Institute for Health Metrics. Presenting a snapshot of America’s overall wellness, researchers crunched data from every county in the country (see interactive map below), and found that although Americans are exercising more","title":"Hey America, Where You Live Might Determine How Long You Live - The Lowdown","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Hey America, Where You Live Might Determine How Long You Live","datePublished":"2013-07-26T06:00:17-07:00","dateModified":"2021-05-05T10:09:34-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"whats-the-average-life-expectancy-where-you-live","status":"publish","path":"/lowdown/8603/whats-the-average-life-expectancy-where-you-live","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Location, location, location.\u003c/p>\n\u003cp>It can be a matter of life and death, according to a recent \u003ca href=\"http://www.healthmetricsandevaluation.org/news-events/news-release/obesity-continues-rise-nearly-all-counties-americans-becoming\" target=\"_blank\" rel=\"noopener noreferrer\">report\u003c/a> published by the University of Washington's Institute for Health Metrics. Presenting a snapshot of America's overall wellness, researchers crunched data from every county in the country (see interactive map below), and found that although Americans are exercising more and living longer, we still lag behind the world's other high-income nation. The U.S ranks 51st in life expectancy, a dubious standing that's largely due to poor diet and over eating.\u003c/p>\n\u003cp>Even with the boost in physical activity, obesity rates continue to increase in almost every county in the nation. Heart disease has remained the \u003ca href=\"http://www.cdc.gov/nchs/fastats/lcod.htm\" target=\"_blank\" rel=\"noopener noreferrer\">leading cause of death\u003c/a>. Average life expectancy for American men is now 76, up from 67 four decades ago. And for women, it's now 81, up from 76.\u003c/p>\n\u003cp>These rates, though, vary dramatically by county, and socioeconomic status remains one of the key determinants.\u003c/p>\n\u003cp>At 81 years, men in Fairfax, VA have the highest male life expectancy in the country. But head just 350 miles to McDowell County, WV and it drops to just 64 years for men, on par with the African nation of Gambia. Meanwhile, women in Marin County live to 85 on average, the country's highest female life expectancy. Compare that to Perry County, KY, where the average female life span is 72.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In fact, the Bay Area made out quite well in the report, with San Francisco having the fewest obese men in the country.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Mouse over IHM's incredibly detailed map to see how life expectancy rates and various health conditions in counties throughout the country have changed over the last three decades. Note that what you'll see first is the health map from 1985. To see 2014 rates, use the time slider at the bottom of the graphic.\u003c/p>\n\u003cdiv>\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://vizhub.healthdata.org/subnational/usa\" width=\"100%\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\n\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/lowdown/8603/whats-the-average-life-expectancy-where-you-live","authors":["1263"],"categories":["lowdown_391","lowdown_2409","lowdown_242"],"tags":["lowdown_381"],"label":"lowdown"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You ask the questions. You decide what Bay Curious investigates. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg","imageAlt":"On Our Watch from NPR and KQED","officialWebsiteLink":"/podcasts/onourwatch","meta":{"site":"news","source":"kqed","order":"1"},"link":"/podcasts/onourwatch","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1567098962","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw","npr":"https://rpb3r.app.goo.gl/onourwatch","spotify":"https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x","tuneIn":"https://tunein.com/radio/On-Our-Watch-p1436229/","stitcher":"https://www.stitcher.com/show/on-our-watch","rss":"https://feeds.npr.org/510360/podcast.xml"}},"on-the-media":{"id":"on-the-media","title":"On The Media","info":"Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. 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