Tapped: The Prospect Group Blog

Trump Bashes Minnesota’s Somali Immigrants

(Photo: Flickr/Lorie Shaull)

Somali-American candidate for Minnesota State Representative, Ilhan Omar speaking at a Hillary for MN event at the University of Minnesota in October. 

Less than 72 hours before Election Day, Donald Trump decided to hold an airport rally in the safely blue state of Minnesota. Why? Apparently, to bash the 70,000 Somali immigrants who have sought refuge, and put down roots, in the state.

“Here in Minnesota, you’ve seen first-hand the problems caused with faulty refugee vetting, with very large numbers of Somali refugees coming into your state without your knowledge, without your support or approval and with some of them then joining ISIS and spreading their extremist views all over our country and all over the world,” Trump said on Sunday, as he preached the need for his policy of so-called extreme vetting of refugees.

Trump was clearly trying to exploit isolated incidents within Minnesota’s Somali American community, like the arrests of nine Somali youth who were charged for intending to go to Syria to join ISIS in 2014, or the knife attack by a Somali man in central Minnesota in September.

“Everybody’s reading about the disaster taking place in Minnesota,” he declared. “You don’t even have the right to talk about it.”

Indeed, Trump was so busy trying to stoke fear and xenophobia as a voter-turnout strategy that he forgot to mention the 1,000 Somali workers who help make the Minneapolis-St. Paul airport, where he was speaking, function. Nor did he mention the nearly 3,000 mostly East African–owned businesses in the state or the estimated $800 million annual buying power of the African immigrant community in the Twin Cities alone, as ThinkProgress points out.

Perhaps most conveniently of all, he also forgot to mention that Ilhan Omar—who fled violence in Somalia, toiled in refugee camps, and was eventually accepted into the United States as a refugee—is about to become the nation’s first Somali American legislator. After beating a longtime incumbent in the Democratic-Farmer-Labor (Minnesota’s Democratic Party) primary, she is all but certain to be elected as the state representative for a Minneapolis district that includes the state’s largest Somali refugee community.

Omar blasted Trump for his bigoted rhetoric in a Facebook post:

Why Are There So Many Different Gender Wage Gap Calculations?

What is the correct figure for how much women are paid relative to men? Is it 80 cents to the dollar? Or is it 83 cents?

The answer, it turns out, is both: There are alternative methods for measuring the gender wage gap, and a Wednesday panel discussion at the Economic Policy Institute in Washington, D.C., focused on the myriad ways the gap shortchanges female workers. The event centered on a new EPI report entitled “What is the gender pay gap and is it real?”

“Different gender wage gaps are answers to different questions,” said EPI senior economist Elise Gould, a co-author of the report, during the discussion. “It doesn’t mean [the wage gap] is not real.” While 80 cents to the dollar reflects the median discrepancy for women working full-time, Gould said that EPI uses the 83 percent figure because it looks at per-hour wages and includes part-time workers.

In practical terms, that means that women’s median take-home pay amounts to $15.67 an hour, compared with $18.94 for men. Over the course of her lifetime, the gender pay gap costs the average woman worker more than $530,000 in lost wages. The lifetime wage losses are even greater for college-educated women, averaging close to $800,000. The wage gap reflects not just employers’ decisions to pay women less, the panelists stressed, but also institutional barriers and the work-life decisions that women make.

The gap tends to widen with education levels in part because of wage floors like the federal minimum wage, but also because women face penalties throughout their professional lives for having children or caring for family members. “Women can’t simply educate themselves out of the gender wage gap,” said Gould.

Nor can women simply choose different and higher-paying careers, agreed Wednesday’s panelists, who also included Sarita Gupta, the executive director of Jobs With Justice; Heidi Hartmann, president of the Institute for Women’s Policy Research; and Latifa Lyles, the director of the Women’s Bureau at the Department of Labor.

Occupational segregation still contributes to large pay discrepancies across similar fields, and subtle gender discrimination can inhibit women from crossing over—Hartmann cited the examples of a female machine operator who could make $13,000 more as a welder, and a library assistant who could make $24,000 more as an IT specialist. Gould also noted that as women enter a particular field in increasing numbers, the pay will often decrease as the work becomes devalued.

One of the most consistently devalued occupations is caregiving, a field dominated by women and people of color. Gupta, who is also the co-director of Caring Across Generations, emphasized the need for a better “care infrastructure” that would help both low-paid workers and women who are unpaid caregivers to family members.

In the absence of better paid leave policies for both women and men, said Lyles, “a lot of women are going to have some reason to leave the workforce” in their lifetimes, and that translates into “lost earnings that compound over a lifetime.”

Better paid leave policies would also alleviate a barrier faced by women in high-profile professions that demand longer hours. “I do believe that these long hours were created to reserve these jobs for men,” Hartmann said. Gould added that the willingness to work late is often “an incorrect signal” for productivity.

The EPI report also highlighted the uptick in economic inequality since 1980, which is what primarily accounts for any narrowing of the gender pay gap over those decades. “The stagnation and decline of median men’s wages has played a significant role in the decline in the unadjusted gender wage gap,” the report states. Also Wednesday, Gould unveiled the EPI’s gender pay gap calculator, which tells users how much money they would be making in the absence of a gender wage gap, and how much they would be making if wages had increased with economic growth, as they in the three decades after World War II. For example, a 30-year-old woman with a Bachelor’s degree and an annual salary of $40,000 would be making $44,785 in the absence of a pay gap, and $64,420 if inequality hadn’t increased.

But regardless of gender, the conclusion was the same: “Had workers’ wages continued to keep pace with productivity, both men and women would be earning much more today.”

The ‘Ban-the-Box’ Paradox

For the 70 million-plus Americans living with criminal records, finding a job can be a Sisyphean task. Ex-offenders return to their communities in search of work only to find that many employers are reluctant to hire anyone with a rap sheet. Because they can’t find a job, many will end up back in prison. To break this cycle and reintegrate ex-offenders into the workforce, states have passed “ban-the-box” laws, which prohibit employers from asking job candidates about criminal records until the final stages of the hiring process. Hawaii passed the first ban-the-box regulations in 1998. Today more than 150 counties and cities, 24 states, and the federal government have some type of ban-the-box measure in place.

The laws, named for the checkbox on a job employment applications requesting disclosure of criminal history, give an applicant the opportunity to explain why he or she is a good fit for a position and why his or her criminal record should not be a barrier to employment.  But a new study by Jennifer Doleac, a University of Virginia assistant professor of public policy and economics, and Benjamin Hansen, a University of Oregon associate professor of economics, suggests that banning the box comes with unintended consequences. Doleac and Hansen measured the laws’ effects and found that they exacerbated certain racial disparities in employment.

The study found that between 2002 and 2014 in states where ban-the-box reforms have been implemented, total employment for young African American and Hispanic men declined by 5.1 and 2.9 percent, respectively. The researchers hypothesized that due to popular stereotypes of young minority men as ex-offenders, some employers screen out candidates based on age, race, and ethnicity early in the hiring process if they do not have information about a person’s criminal history.

Doleac and Hansen’s conclusions about a widening racial employment gap in employment are consistent with other recent studies. The reforms have worked, but not for recently released ex-offenders who have the most difficulty in finding employment. Certain groups including college-educated black women and low-skilled, older black men did better in the job market after ban-the-box reforms were implemented.

“Ban-the-box reforms were never intended as a panacea for the severe employment barriers facing people with records, and certainly not for the entrenched employment challenges of young men of color locked out of the job market,” National Employment Law Project program director Maurice Emsellem and Ford Foundation fellow Beth Avery argued in a recent policy brief.

Discrimination based on race, ethnicity, and age is hard to detect and even harder to prosecute. However, criminal justice reform advocates continue to view ban the box as a step forward in promoting a wider range of reform strategies that include record-sealing and other “clean slate” measures.

Chicago Charter School Strike Deadline Looms

Unionized teachers and staff at UNO, a charter network comprising 16 elementary and high schools in Chicago, may go on strike Wednesday.

Many local news organizations have incorrectly claimed that a walkout by the unionized charter school teachers would be the first labor action of its kind. But as Jacobin first reported, teachers at a Philadelphia charter school staged a “sick-out” in 2011 when school administrators refused to bargain in good faith; the two sides ultimately reached a contract compromise. In 2014, the unionized teachers at the same Philadelphia charter voted to strike, but reached a contract deal with administrators before a walkout took place.

Nevertheless, a UNO strike would be significant development. UNO is one of the largest charter chains in the city, educating roughly 8,000 students. As more charter teachers opt to unionize across the country, more educators will likely begin engaging in traditional labor protests.

More than 95 percent of the 532 unionized UNO workers voted in favor of going on strike. The stickiest points of the charter union’s negotiations revolve around pension payments, class size caps, and salary increases. Their first-ever contract, negotiated in March 2014, has expired. Teachers and school administrators have been in contract talks for the past eight months.

“We aren’t going to strike just to make history,” says Erica Stewart, a fifth grade UNO teacher on the union bargaining team. “It’s just not feasible, or the right thing. If we need to walk off the job, it needs to be for the right reasons.”

While UNO administrators have said that they can’t afford to pay for all the teachers’ demands, the union members don’t believe them. Teachers point to things like UNO's central offices located in downtown Chicago, which rent for more than $30,000 per month. They argue that their employer could be making very different budget choices.

Union leaders and school administrators plan to bargain all day Tuesday. If they fail to reach an agreement by midnight, then teachers will strike. UNO has already reached out to families to warn them that all school and extracurricular activities may be cancelled beginning Wednesday.

Stewart, who has taught at UNO for six years, says that the working conditions at her school were very challenging before the charter network formed a union in 2013.

“I was constantly afraid to ask for anything, I was afraid to leave my classroom if I needed a bathroom break,” she says. “I always felt I was going to get fired, and I took the job because I’ve got three kids at home to feed and I needed the work. I love teaching, and I love my students. It was just really difficult to work in a culture of fear like that.”

When I asked how parents and students have reacted to the possibility of a strike, Stewart says they’ve tried to keep bargaining politics out of the classroom and have organized informational meetings for parents, off-campus, after school hours. “The parents have been going out of their way to talk to us,” says Stewart. “They’re also trying to get their own voices heard within UNO.”

Report: Judicial Elections Fuel Anti-LGBT Bias

The chief justice of Alabama’s highest court, who once called lesbian parents “immoral,” “detestable,” and “inherently evil,” has been suspended without pay following his February directive to the state’s probate judges to stop issuing marriage licenses to same-sex couples.

State Supreme Court Chief Justice Roy Moore’s removal from the bench last month came within a day of the release of a report by nonprofit LGBT rights group Lambda Legal that pointed to broad ideological biases by state Supreme Court judges. The report specifically singled out Moore, who had run for his seat on an anti-marriage equality platform, and whose marriage license directive violated a federal court order. Moore was suspended from the bench for the remainder of his term by a unanimous vote of the state’s nine-member judiciary court.

“When it comes to courts, win or lose, LGBT people need to know that there isn’t a thumb on the scales and that we haven’t been shut out of the process,” stated the report, dubbed Justice Out of Balance.

The report lays the blame for anti-LGBT judicial bias on the growing practice of installing state Supreme Court judges via election rather than by appointment. Today, 38 states elect their judges either via competitive or retention elections—a practice unique to America. And in recent years, the amount of spending in judicial elections has exploded; the money spent on state Supreme Court elections has more than doubled in the past decade.

“Far-right groups and powerful special interests are working to game the system by stacking state courts with judges who will rule in accordance with their agendas,” the report states. Moore himself had already been removed from the bench in 2003 for refusing to follow a federal court order to remove the display of the Ten Commandments from the state judicial building. The voters elected him again in 2012.

“The pressures of running for re-elections, courting donors, and securing endorsements often force candidates to take extreme positions,” wrote report author Eric Lesh in a blog post following the study’s release. Tellingly, appointed justices ruled in favor of the LGBT community 82 percent of the time. By contrast, elected judges ruled in favor of LGBT claims only 53 percent of the time.

In Iowa, three Supreme Court justices faced the wrath of right-wing activists when they sought re-election in 2010. Having unanimously ruled to legalize same-sex marriage in Iowa the previous year, the judges faced attacks led by Bob Vander Plaats, an influential Iowa conservative leader. All three justices lost their elections.

Judicial elections are also fueling a “stunning lack of diversity” on state Supreme Court benches, the report found. Racial minorities and women are under-represented, and only ten openly gay or lesbian justices serve on state Supreme Courts. Importantly, nine of these ten justices were appointed, and all nine appointees were installed by Democratic governors. The upshot is “a significant lack of trust in the courts among LGBT and respondents with HIV,” according to the report.

“A diverse bench increases public confidence in the court,” said Lesh in an interview. He added: “When you see the courts don’t reflect the diversity of the community that they serve, it has an impact on public confidence.”

As Hyde Amendment Turns 40, Poll Shows Support for Its Repeal

It’s been 40 years to the day since Congress first passed the so-called Hyde Amendment that bars federal funding for abortion services, and it’s also the first year that any presidential candidate—in this case, Hillary Clinton—has campaigned on a promise to repeal that amendment if elected.

It’s unclear whether Clinton’s pledge will carry much weight with voters. In an election in which women’s votes are expected to be pivotal, abortion has not surfaced as a major campaign issue. Both Clinton and GOP nominee Donald Trump have sought to appeal to female voters with proposals for paid parental leave and equal pay for women, but neither has spent much time talking about reproductive health care.

But recent polling suggests that women in key battleground states might find Clinton’s Hyde Amendment opposition compelling. Named for former Illinois Senator Henry Hyde, a Republican, the amendment prohibits abortion coverage for women enrolled in federally funded health-care plans such as Medicaid, which serves low-income families; Tri-Care, which serves military families; and the government health-care plan that covers federal employees.

The poll was conducted by Hart Research Associates for All Above All, a coalition of organizations working to end insurance coverage bans on abortion. Pollsters focused on the battleground states of Colorado, Florida, Iowa, Michigan, New Hampshire, Nevada, North Carolina, Ohio, Pennsylvania, Virginia, and Wisconsin. The poll targeted 1,155 registered voters and included larger-than-average samples of both young voters age 18 to 34, and of African Americans and Hispanics.

A full 76 percent voters agreed with the statement, “However we feel about abortion, politicians should not be allowed to deny a woman's health coverage for it just because she's poor.” The voters who agreed included 76 percent of independents, 66 percent of Republicans, and 89 percent of Democrats.

Voters also said they would support a bill that would require Medicaid to cover all pregnancy-related care, including abortion, by a margin of 53 percent to 41 percent. The support for the repeal of Hyde is even stronger with millennials, a group Clinton is making a special effort to win over. More than two-thirds of young voters said they support Medicaid coverage for all reproductive health care, including abortion.

“The battleground-state poll findings are consistent with a nationwide poll from 2015,” says Destiny Lopez, co-director of All Above All Action Fund. “Both polls found that a majority of voters support requiring that Medicaid coverage include abortion care.”

The polling data may draw notice from reproductive-rights advocacy groups that are busy registering and turning out voters in a year when Clinton, the first woman to head a major national party’s presidential ticket, has emerged as a strong women’s health advocate.

“Some of our strongest supporters are people of color and young people—a critical voting bloc,” says Lopez. “Secretary Clinton’s position on lifting Hyde [is] completely in sync with voters, and we’ll be using this to energize her base and be sure they turn out on Election Day.”

Deportations and Clinton’s Latino Outreach

Hillary Clinton has come under fire for failing to sufficiently galvanize Latinos, a bloc of voters key to Democrats in both the presidential and Senate contests. The Washington Post this week quoted critics saying Clinton had run too few Spanish-language ads, and spent too little on targeted messaging.

But there may be another reason why Clinton’s performance lags behind President Obama’s in 2012: Obama’s own deportation policies, which have drawn fire from Latinos on several fronts. These include the Obama administration’s deportations of the children who crossed the border in droves two years ago to flee violence in Central America. Overall, the administration deported 2.4 million people between fiscal 2009 and 2014. And non-criminal deportees outnumber those charged with crimes.

Deportation orders dipped when Obama signed the executive order known as Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA), which would have shielded several classes of immigrants from deportation. But a series of state lawsuits and a Supreme Court deadlock have blocked the administration from implementing that order, and Latinos remain frustrated. Some of that frustration seems to be spilling over to Clinton—despite widespread Latino antipathy to Trump.

“People are very disappointed and they don’t want to vote,” said Adriana Cazorla, a domestic worker from Washington state. “They don’t want to be guilty of putting a person in office who will do the same as [Obama].”

Cazorla made her comments Friday at a march from the Supreme Court to the White House organized by the National Alliance for Domestic Workers and several allied groups. The march brought out hundreds of immigrant women, many of them undocumented, to deliver a message to Obama: Stop the deportations.

Dubbed the Immigrant Women’s Walk Against Deportations, the event took place on the one-year anniversary of last year’s 100-mile march for immigration reform. Before the march Cazorla told The American Prospect how she had been hiding from an abusive husband when he found her and called immigration officials. She was detained for four months in a detention center.

“I was treated badly, given spoiled food, had no access to potable water or medical attention like the rest of the people did,” Cazorla says of her time in the detention center. Cazorla says she now has legal status thanks to the Violence Against Women Act—but that her children, who were without their mother for four months, suffered the most during her detention. The separation of families was a big point of contention for the marchers and their supporters.

“Many children worry about it,” Cazorla said with tears in her eyes. “They go to school with fear that they’ll go back home and their parents won’t be there.”

Marcher Patricia Rosas described how she immigrated to the United States from Mexico more than two decades ago with her children. But four years ago, her son was deported back to Mexico. “I brought him here when he was one year old,” said Rosas, “so he was basically raised here. When he got to Mexico, he didn’t know what to do or where to go.” Rosas’s son left behind a wife and a two-year-old son. “He wanted to be with his son, so he tried to come back,” explained Rosas, “but he was apprehended and was deported again.”

Rosas said she was marching in hope that DAPA would become law so, that “after 26 years, I can see my mom and my siblings again.”

Hill Hearing Spells Bad News for Veterans

Not a single veterans service organization was asked to speak last week at the House Veterans Affairs Committee’s hearing on the final recommendations of the VA Commission on Care, though such groups represent millions of former military personnel.

Also noticeably absent from the witness list was Vietnam veteran Michael Blecker, executive director of the San Francisco veterans group Swords to Plowshares, who served on the Commission on Care, and who dissented from its final report. Blecker objected that the commission’s leading recommendation—the creation of a so-called VHA Health System network of private-sector care providers—could fatally weaken veterans’ health care.

Instead, Committee Chair Jeff Miller, a Florida Republican, invited only two people to testify before the panel: Delos “Toby” Cosgrove, vice chair of the commission and CEO of the Cleveland Clinic, and Commission Chair Nancy Schlicting, who is CEO of the Henry Ford Health System. Miller happens to be a faithful supporter of Donald Trump, who has touted the VA committee’s chairman as his top pick as secretary of veterans affairs in any Trump administration.

While Schlicting has expressed support for the VHA, Cosgrove was one of the leaders of a commission faction—what some have dubbed the “Strawman” group—that favored the complete elimination of the VHA.

At the hearing, which took place on September 7, Cosgrove and Schlicting both expressed enthusiasm for creating a VHA Care System that ostensibly would create a network of private-sector providers to deliver health care to veterans while also somehow integrating them into the VHA. The report estimates that this system would eventually channel up to 60 percent of veterans into private-sector health care, and even acknowledges that the new setup would potentially weaken the VHA itself.

Alarmingly, all the Democrats on the committee—with one notable exception—voiced support for this general policy direction, albeit with less ideological fervor than Miller and his GOP colleagues. The one committee member who spoke out against the plan—fortunately for veterans—was ranking Democrat James Takano, of California, who expressed serious reservations about the proposed VHA Care System, and echoed concerns about it that have already been raised by President Barack Obama and by VA Secretary Robert MacDonald.

The other panel Democrats came across as shockingly misinformed, and offered such VHA fixes as Texas Representative Beto O’Rourke’s argument that the VHA should only concentrate on service-related mental and physical health conditions, rather than routine primary care. If treatment of veterans were limited in this fashion, many service-related conditions that experienced VHA providers now identify in primary care visits would go undetected. Such conditions would be far less likely to be diagnosed by private-sector providers, who often have little knowledge of military/veteran problems. As Blecker has pointed out, if Vietnam veterans were dependent on the private sector, PTSD and problems related to Agent Orange, which the VA itself took too long to identify, may never have been recognized and researched at all. (Having learned from its Vietnam experience, the VHA has been quick to identify and act to treat traumatic brain injuries, the signature injury of the wars in Iraq and Afghanistan.)

Also alarming was Veterans Affairs Committee members’ bipartisan embrace of the recommendations by Cosgrove and Schlicting that the VHA abandon its highly successful in-house system of electronic medical record-keeping (which it is working to improve) and replace it instead with commercial products. Lobbyists for companies that produce these systems have spent millions urging hospitals to purchase their wares—despite the fact that, as a large body of research has documented and as a recent JAMA editorial underscored, they have largely failed to fulfill their promise of creating safer and more efficient health care. 

“The systems being proposed for purchase at the VHA have been widely disparaged by medical professionals and patient safety advocates for their lack of user friendliness, failure to consider clinical workflow and [prioritization] of billing information over care,” Ross Koppel, an expert in health-care information technology at the University of Pennsylvania, told The American Prospect.

During the hearing, no member of Miller’s committee expressed concern about the estimated 300,000 veterans whose military discharges—sometimes due to service-related mental health problems—leave them barred from the VHA. The Commission on Care recommended that some veterans with other than honorable discharge receive tentative eligibility for health-care services.

All in all, it was disappointing day for vets on Capitol Hill. It was also a warning of what’s in store for veterans if Trump, who has not only floated Miller as VA secretary but has revealed his own ignorance of veterans’ health-care issues, becomes commander-in-chief on Election Day.

Studies Show Veterans Health Care Improving

When the House Veterans Affairs Committee holds a hearing on September 7 to assess the future of the Veterans Health Administration, federal lawmakers would do well to consider recent reports that challenge the continual drumbeat of negative and often unfair coverage and congressional criticism of the VHA.

One report, from the RAND Corporation, said that while there were differences in care and leadership culture across the system, researchers “did not find evidence of a system-wide crisis in access to VA care.” In fact, the report identified congressional policies as one of the main barriers to VHA improvements (despite the Veteran Affairs Committee Chairman Jeff Miller’s apparent belief that firing VHA leaders is the solution to any access problems). The report noted that “inflexibility in budgeting stem[med] from the congressional appropriation processes,” and concluded that the hastily designed and implemented Veterans Choice Program, “further complicated the situation and resulted in confusion among veterans, VA employees, and non-VA providers.”

Though it received no media attention, another positive report on the VHA came this month from the Joint Commission, the independent nonprofit that accredits U.S. hospitals and health-care organizations. After surveying the VHA between 2014 and 2015, the commission found improvements in access, timeliness, and coordination of care, as well as in leadership, safety, staffing, and competency.

Finally, the Association of VA Psychology Leaders, the Association of VA Social Workers, and unions representing VA employees issued a policy brief opposing the Commission on Care’s proposal to create a new VHA Care System, which would ultimately channel up to 60 percent of eligible veterans into private-sector health care. Two independent national groups, the American Psychological Association (APA) and the National Association of Social Workers, also signed the policy paper.

In an email, Heather O’Beirne Kelly, the APA’s lead psychologist on military and veterans policy, told The American Prospect that the APA “is opposed to the primary recommendation of the Commission on Care’s report, which we feel would in effect disassemble one of the most successful, innovative features of current VA care: the primary care/mental health integrated approach.”

Every report on the VHA over the past two years has documented that the system provides care equal to or superior to private-sector care, and have spotlighted significant improvements in problematic practices that led to two years of scandal-mongering on Capital Hill and in the national media. But instead of lauding the VHA for its progress and working to sustain the system, federal lawmakers and critics are quick to jump on any hint of a glitch and lambast the VHA for not changing more rapidly, steadfastly ignoring the fact that changing the culture of any institution, particularly that of America’s largest health-care system, must take years.

Sustained improvement will also require transformations in the congressional budgeting process and dramatic shifts in health-care policy. As The New York Times reported in 2014, shortages in the physician workforce have made lengthy waits to get an appointment “the norm in many parts of American medicine.” If Congress is serious about protecting veterans, it must immediately appropriate more money so that VHA can offer salaries competitive with those in the private sector, as even the Commission on Care recommends, and allocate more medical residency training slots to primary, geriatric, and palliative care. 

The narrative of a VHA that is broken beyond repair that the news media and some federal lawmakers insist on does not acknowledge that the VHA is a national or global leader in fields like telemedicine, mental health, primary and geriatric care, and reducing opioid use. Why would anyone want to work in a system depicted as broken beyond repair, doomed to disappear, and filled with demoralized staff? That overwrought story discourages nurse practitioners, social workers, psychologists, and other professionals from working at the VHA.

Report: Patients’ Groups With Big Pharma Ties Came Out Against Medicare Drug Plan

Earlier this year, nearly 400 patients’ groups signed onto two separate letters criticizing a recent Medicare proposal aimed at bringing down the cost of prescription drugs. Warning that there would be dire consequences for patients if the proposal moves forward, patients’ groups including the Partnership to Improve Patient Care and the Quality Cancer Care Alliance urged congressional leaders and the head of the Centers for Medicare and Medical Services to “permanently withdraw” what they viewed as “flawed policy.” In doing so, patients' groups had joined bottom-lined focused pharmaceutical companies in their opposition to the plan, a move that appeared to bolster the argument against the proposal. 

But a recent Public Citizen report “Patients’ Groups and Big Pharma” suggests that the story is more complicated. The report shows that at least three-quarters of the 147 patients’ groups who signed on to the letters received funding from the pharmaceutical industry.

Public Citizen combed through websites and documents to determine which patients’ organizations had received pharmaceutical dollars. Some groups had websites emblazoned with pharmaceutical sponsors’ logos or featured specific companies listed as benefactors in reports, while others were featured in pharmaceutical companies’ public disclosures.

“When patients’ groups side with the pharmaceutical industry against proposed policy reforms, they lend credibility and a sympathetic voice to industry lobbying efforts,” the report says, going on to note that such groups’ reliance on industry money “should complicate the view that patients’ groups’ interest in such policy battles is categorically different from the industry’s financial interest.”

The patients’ groups had warned that discouraging medical professionals from prescribing more costly drugs is a “one-size-fits-all” policy that could force them to prescribe cheaper drugs that are also less effective. Such a policy could even lead to an “abrupt halt” in treatment altogether, they argued. One group also cautioned that the measure would particularly hurt patients with disabilities, who had more diverse treatment needs.

It’s not the first time the pharmaceutical industry and patients’ groups have worked together fight this Medicare plan. Last month, USA Today reported that the Community Oncology Alliance (a patients’ group that signed onto one of the Medicare prescription drug letters) used language nearly identical to talking points disseminated by the Pharmaceutical Research and Manufacturers Association in its public comments on the proposal. The pharmaceutical association is also one of oncology alliance’s corporate members.

The Public Citizen report notes that its findings are likely understated, since they are based largely on voluntary disclosures by drug companies and the groups in question. While the Affordable Care Act mandated that drug companies disclose their payments to physicians beginning in 2013, the law did not apply to health advocacy organizations.

The ties between the pharmaceutical industry and patients’ groups are well known. After Senator Chuck Grassley, the Iowa Republican, started investigating pharmaceutical companies’ links to these organizations in 2009, The New York Times reported that the National Alliance on Mental Illness took in around 75 percent of its donations, or about $23 million, from drug manufacturers from 2006 to 2008, a sum that even the group’s executive director admitted was too much.

Patients’ groups rarely talk about high drug prices, a possible consequence of their reliance on industry money. A 2006 study of the issue noted: “Just as gifts (monetary or in kind) may induce feelings of loyalty and indebtedness in physicians which can influence medical decision-making, one may expect patient groups also to be caught between two masters.” Smaller organizations that relied heavily on industry donations to help fund their operations were particularly at risk, the study found.

Public Citizen’s report comes less than a month after the watchdog group issued a separate report on the matter, which found that members of Congress who criticized the Medicare proposal had received significant contributions from the pharmaceutical industry.