State Funded Org Joins Pharma on Public Option

It was no suprise to see a full page advertisement in the News&Observer this morning advocating Big Pharma’s position on Health Care Reform.  It was suprising to see state-funded North Carolina Biotechnology Center as one of the sponsors along with GlaxoSmithKline, Bayer HealthCare, Wyeth, Merck, NC Bio, the NC Chamber and PhRMA, (the Pharmaceutical Research and Manufacturers of America). NC BioTech has an annual budget of about $15 million, virtually all of which comes from NC General Appropriations.

The ad is a warning shot to the NC Congressional Delegation about Big Pharma jobs in NC. The superficially supportive but ambiguous message had enough code words surgically implanted in the body of the text to send a clear signal to Capitol Hill and the White House that these players oppose single payer and the public option.

What’s best for patients is what drives our business. That’s why we strongly support health care reform that provides access to affordable coverage for every American and keeps medical decisions in the hands of doctors and patients.
Policies that provide incentives for innovation are essential for continued investment and job creation.

Not readily apparent from the ad is that it is part of a national astroturf effort. A fine print reference to provides a clue.  Archstone Consulting coordinates a national campaign called “We Work for Health” (WWFH), funded by PhRMA, the Pharmaceutical Research and Manufacturers of America.  This group has targeted 10 places with major biotech and pharma interests: Colorado, Connecticut, Delaware, District of Columbia ,Illinois, Indiana, Maryland, New Jersey, North Carolina, Pennsylvania, Washington.

We Work For Health, NC Coalition Partners are listed as:
* Jeff Brennan – VP Targacept
* Sue Cole – Former President of NC Chamber/ Former Chair of BioTech Center
* Jim Fain – Immediate past Secretary of Department of Commerce
* Bob Ingram – Former Chair/CEO GSK
* Allen Joines – Winston-Salem Mayor/Governor’s Economic Development Board
* Martin Lancaster – Immediate Past President NC Community College System
* Ken Lee – Hatteras Venture Partners
* Harold Martin – Senior VP for Academic Affairs, University of North Carolina
* Charles Sanders – Former Chairman, GSK
* Christy Shaeffer- Inspire Pharmaceuticals
* Sam Taylor – NC Bio
* Norris Tolson- BioTech Center

The WWFH campaign has been running nationwide quietly for several months.  The WWFH NC group’s kick-off was held April at GlaxoSmith Kline RTP headquarters.  The keynote speaker was Richard Burr who claimed that healthcare reform was bad for the drug industry and that effective cost-control by Medicare and Medicaid was to blame for escalating private healthcare costs.

Sophisticated online efforts are being coordinated by 720 Strategies, formerly known as E-Advocates, self-described as “an award-winning, grassroots advocacy and political persuasion firm, specializing in integrated communications campaigns”.  The Company manages about 400 domain names for various integrated online campaigns.  Michael Cornfield of 720 Strategies presents a set of 14 online webinar videos for “grassroots” training in influence of Congress specifically for the WWFH campaign which is also on Twitter.

WWFH Videos include Town Hall: Mastering Town Hall Meetings, Sculpting Facts: How to Carve Argument-Winning Points Out of Data, and most recent, The Time Has Come: Communicating With Congress During the Summer of Health Care Reform.

All of which makes one wonder about the involvement of the NC Biotechnology Center.  At a time when budget cuts are increasing the rolls of underinsured and uninsured people why would a state-funded organization be legitimately advocating against proposals to provide these people with a safety net?

Builders Make Great Case For Transfer Tax

BubbleIt is generally accepted that the housing bubble precipitated the current recession. Easy access to money and low interest rates fueled housing inflation that made housing speculation profitable without growth in the underlying economy. In 2007 the Chief Executive of the National Association of Homebuilders acknowledged that overbuilding during the boom years was a factor in the housing meltdown.

That same year NC Realtors and Homebuilders fought tooth and nail at the Legislature to prevent counties from having a transfer tax option to pay for the infrastructure demanded by housing growth. Although unsuccessful at the Legislature in 2007 they have since spent millions to defeat transfer tax proposals at the polls in local referendums.

Proponents of the transfer tax argue that it relieves some of the burden of property tax by deferring it until a sale when cash flow is available, especially for existing homeowners on fixed incomes with over-inflated home values. Realtors and Homebuilders argued against it saying “Fight the Home Tax – It’s a Bad Idea”. Now faced with unsold inventories of speculatively built houses NC Homebuilders have turned to the Legislature for relief from “some of the burden of property tax by deferring it until a sale when cash flow is available.”

House Bill 852, “Defer Tax on Builders’ Inventory“, has sailed quietly through the House, 106 votes to 8, and through committees, and is calendered for a Senate vote Wednesday July 8th, with little opposition expected. In fiscal years 2010-11 and 2011-12 combined this bill is projected to have a negative effect on county and municipal revenues of $40-$45 million.

“A builder may defer the portion of tax imposed on real property that represents the increase in value of the property attributable solely to improvements resulting from the construction by the builder of a residence on the property.”

Homeowners will find no such relief and local governments will have to cut services or raise revenues to make up the $40-$45 million shortfall. Realtors and Homebuilders have argued that taxing the equity in homes is a bad idea but now they argue that “It’s a Good Idea” when it comes to builders who overbuilt in the boom years straining infrastructure and local revenue streams. The NC Homebuilders make a great case for the transfer tax.

Bullying Anti-Bullying

North Carolina Conservatives are lying about sexual orientation and gender identity to bully the anti-bullying bill into submission. To defeat SB 526, the School Violence Prevention Act, Republican House Minority Leader Paul Stam and the Christian Action League have been claiming the existence of 30 sexual orientations as listed in the DSM-IV, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) of the American Psychiatric Association. No such list exists. It is a fabrication of conservative Christians used to defeat any legislation that can be presumed to protect the human rights of gay people.

Whether through ignorance, invective or indifference, Stam and the Christian Action League have been falsely equating sexual orientation and gender identity with sexual disorders or deviations and have perpetuated a myth originated by the American Family Association that incorrectly references and misquotes the DSM-IV-TR. The American Psychiatric Association would describe this as “irrational discrimination based on gender or sexual orientation.” The Christian Action League compounds the error by variously attributing the bogus “list” to the American Psychological Association and to the American Psychiatric Association, two separate professional organizations.

The DSM-IV-TR (DSM-IV Text Revision) describes sexual orientation as sexual attraction to males, sexual attraction to females, sexual attraction to both or, sexual attraction to neither. It does not describe sexual orientation as a mental disorder.

According to the DSM-IV-TR gender identity refers to an individual’s self perception as male or female. “The term gender identity … should be distinguished from the term sexual orientation.” The DSM-IV-TR does not describe gender identity as a mental disorder.

The School Violence Prevention Act, SB 526, would require local school administrative units in North Carolina to adopt policies prohibiting bullying or harassing behavior.

“Bullying or harassing behavior includes, but is not limited to, acts reasonably perceived as being motivated by any actual or perceived differentiating characteristic, such as race, color, religion, ancestry, national origin, gender, socioeconomic status, academic status, gender identity, physical appearance, sexual orientation, or mental, physical, developmental, or sensory disability, or by association with a person who has or is perceived to have one or more of these characteristics.”

The sexual orientation and gender identity of a heterosexual male, with a self perception as male and sexually attracted to females, would be protected under this Act. Nobody would accuse Skip Stam of bestiality or necrophilia, except perhaps while flogging the dead horse that is, or should be, demonization, dehumanization and “irrational discrimination based on gender or sexual orientation.”

According to the American Psychological Association:

“Prejudice and discrimination against lesbian, gay, and bisexual people are reflected in the everyday stereotypes of members of these groups. These stereotypes persist even though they are not supported by evidence, and they are often used to excuse unequal treatment of lesbian, gay, and bisexual people.”

The American Family Association, has claimed the existence of “30 different sexual orientations” attributed to the American Psychiatric Association. This is patently false. An examination of the DSM-IV finds that there is no such enumeration of 30 sexual orientations and no description of sexual orientation per se as a mental disorder.

“The Hate Crime law, S.909 (and HR1913), will make 30 sexual orientations federally-protected. The American Psychiatric Association (APA) has published 30 such sexual orientations that, because of Congress’s refusal to define “sexual orientation,” will be protected under this legislation.
These 30 orientations are listed in the APA’s “Diagnostic and Statistical Manual of Mental Disorders,” Fourth Edition, Text Revision (Washington: American Psychiatric Association, 2000), pp. 566-582 (DSM-IV), which is used by physicians, psychologists, social workers, nurses, and psychiatrists throughout the U.S. It is considered the dictionary of mental disorders.”

This false statement has been echoed by the Traditional Values Coalition an anti-gay organization with past connections to Jack Abramoff.

· Protecting 30 Bizarre “Sexual Orientations” And “Gender Identity” — Ever-Expanding Definitions
· Traditional Values Coalition on Sexual Orientation & DSM

· San Francisco Chronicle: ‘Lucky Louie’ throws the dice
· Washington Post on Jack Abramoff and Louis P. Sheldon of Traditional Values Coalition

These are the sources of the lies being perpetuated by Rep Paul Stam and the Christian Action League which have been debunked by in the context of the Federal Hate Crimes Bill.

The American Psychological Association position is that

“Sexual orientation is an enduring emotional, romantic, sexual, or affectional attraction toward others. … Sexual orientation exists along a continuum that ranges from exclusive heterosexuality to exclusive homosexuality and includes various forms of bisexuality.”

· Sexual Orientation and Homosexuality
· Better Understanding of Sexual Orientation & Homosexuality

What Stam and the Christian Action League refer to are nowhere described in the DSM-IV-TR as “sexual orientations”. Rather they are “paraphilias” or sexual disorders or deviations that are independent of sexual orientation or gender identity. Notwithstanding the fact that these references are inapplicable, the DSM-IV-TR clearly states in introductory pages under a cautionary statement that the diagnostic criteria are offered as guidelines to enhance agreement among clinicians and investigators and that the inclusion of diagnostic criteria does not imply that a condition meets legal or other non-medical criteria and may not be wholly relevant to legal judgements.

The following is a chronology of documented references to the bogus multiple “sexual orientations” claims. Stam repeated the claims in a news conference May 26th and in committee.

Christian Action League:
Bill included categories of “sexual orientation,” “gender identification,” and “gender expression.”
Carrboro Housing Discrimination Bill Amended
posted on Friday, April 24th, 2009 at 10:32 pm
Rep. Paul Stam (R-Wake) liberally passed out a handout provided by the Christian Action League to Committee members that explained that the American Psychiatric Association names no less than thirty different “sexual orientations,” some of which are considered criminal activity.

Bullying Bill to be heard in House Education Committee on Thursday
posted on Tuesday, May 26th, 2009 at 10:44 pm
Senate Bill 526 would create a new protected class under North Carolina law for homosexuals, cross-dressers, and 29 other “sexual orientations” (as listed by the American Psychological Association) ranging from bestiality to heterosexuality to pedophilia. Many of these behaviors are illegal, yet the bill does not differentiate between these “sexual orientations.” Outlawing bullying motivated by illegal behaviors of the victim, tends to give those illegal behaviors legal sanction or approval.

House Committee Passes Anti-Bullying Bill Masquerading Advancement of Gay Rights through NC Schools
posted on Friday, May 29th, 2009 at 8:22 pm
Senate Bill 526 would create for the first time under North Carolina law specially protected classes for persons identifying as homosexuals, bisexuals, transgender, and 28 other “sexual orientations” ranging from pedophilia to bestiality. Even though many of the 30 “sexual orientations” identified by the American Psychological Association are illegal, Senate Bill 526 protects them all without any differentiation.

Download the Christian Action League’s insert for your church bulletin by clicking HERE Use this bulletin insert to get as many people as possible from your church to contact their NC House Representative.
posted on Friday, May 29th, 2009 at 8:22 pm
Senate Bill 526 would create a new protected class under North Carolina law for homosexuals, cross-dressers, and 29 other “sexual orientations” (as listed by the American Psychological Association) ranging from bestiality to heterosexuality to pedophilia. Many of these behaviors are illegal, yet the bill does not differentiate between these “sexual orientations.” Outlawing bullying motivated by illegal behaviors of the victim, tends to give those illegal behaviors legal sanction or approval.

Anti-Bullying Bill Continues to Pose Urgent Threat
posted on Friday, June 5th, 2009 at 6:29 pm
Senate Bill 526 poses as a policy that would protect school children from being bullied, but in fact is a means by which “sexual orientation” (which includes homosexuals, bisexuals, and 28 other “sexual orientations” ranging from pedophilia to bestiality) and “gender identity” (transsexuals) will become protected classes under North Carolina law.

Bullying Bill to Be Voted on Tuesday and Wednesday
posted on Monday, June 15th, 2009 at 9:24 pm
Sponsors of the Anti-bullying bill have staked the entire future of the anti-bullying bill on the inclusion of a clause enumerating special classes of victims of bullying, including “sexual orientation” and “gender identity.” These two terms define homosexuality, cross-dressing, and 29 other variations of “sexual orientations.”

Most recently the conservative Christian organization Called2Action issued this alert, linking back to the Christian Action League:
NC House trying to pass radical “Anti-Bullying” bill!
Called2Action alert:
Posing as a bill to end bullying, the Anti-Bullying bill would actually normalize homosexuality and cross-dressing in public schools
This “anti-bullying” bill is really about promoting sexual anarchy in our public schools and the normalization, if not outright promotion, of deviant sexual behavior. Don’t be fooled by the “Anti-Bullying” language – it is a Trojan Horse! “sexual orientation” and “gender identity.” These two terms define homosexuality, cross-dressing, and 29 other variations of “sexual orientations.”

Please take action against bullying and homophobia:

EqualityNC Action Alert:
NC House to Vote Monday on Anti-Bullying Bill

The NC House will debate and vote on SB 526, the School Violence Prevention Act during their session Monday night at 7:00 PM. The vote Monday night will make or break our effort to pass effective and inclusive anti-bullying protections, and it will be the toughest yet. Equality NC calls on our supporters to take action to shore up support for the bill.

More Links:
Prevent School Violence NC
Equality NC Blog

Kabuki House Theater

Stam, Tillis, Budget press conference
NC House Republicans Thursday morning performed another act of the Kabuki theater that is the State Budget process. Standing behind a pile of budget reports at a press conference Rep Skip Stam called out for transparency, without any trace of irony. Stam was trying to make a point that Republicans were shut out of the process. He claimed to have been personally turned away from a closed meeting in committee room 612, next door to his own office, but on questioning could not remember by whom and he did not describe the nature of the meeting.

Rep Thom Tillis called for a show of hands from Republican Appropriations Sub-Committee members (seen in the photo). Tillis said that committee meetings were being held elsewhere in the building at the same time. He said that the reason these committee members could be present at the press conference was because they were “not engaged in the process”, again, without any trace of irony.

Rep Pearl Burris-Floyd claimed proposed “draconion” cuts to Health & Human Services were “intended to incite individuals who are the least of us” and that “we believe this is a time for government to do those things for people who cannot do those things for themselves”. When asked “Would you vote for tax increases?” she replied “Absolutely not”, again, without any trace of irony.

Curiously, for someone who chooses and disects words carefully, Stam made a couple of references to opposition to “tax rate increases” but did not broach the subject of increasing revenues by broadening the tax base and lowering tax rates.

Stam claimed, with all the bluster he could muster, that “the Democratic leadership is just not involving Republicans at all” and that it “is time for the Governor to step up to the plate and lead” and that “the crisis is too great for her to remain on the sidelines”. Stam is one of the smarter Republicans and a skilled parliamentarian, or he wouldn’t be House Minority Leader, but this kind of hyperbole is a Hail Mary pass from Monday morning quarterbacks at best.

Stam and Tillis did have valid observations about the House Rules that constrain Committee actions but the ritualistic drama of party politics obscured those points and the absence of specific proposals ensured that the Kabuki House Theater would move on to the next predictable act.

The general consensus at the General Assembly is that following wrap up by committees a budget will be introduced early next week with House votes Wednesday, Thursday and possibly Friday before sending the bill to the Senate. The noise about severe cuts is expected to pave the way for some revenue increases. It is not yet known if these will be in the House budget or left to the conference committee. Also expected are further pay cuts disguised as furloughs for State employees. The word is that the 0.5% cut (AKA 10 hour furlough) produced minimal savings relative to the effort to set it up in the payroll system. Now that the system is in place and employees have gotten used to the idea, deeper cuts and longer furloughs are expected.

Cross posted at

Blowing Smoke About BMI

There’s an interesting report from actuarial consultants Milliman that pours some cold water on the heated debate over State Health Plan costs associated with smokers and people with a high Body Mass Index (BMI). The report, Impact of Height, Weight, and Smoking on Medical Claims Costs, released in April, was an update of Milliman’s Medical Underwriting Guidelines.

Controlling for age and gender, the study found that smokers cost about 9% more than non-smokers. However, when people’s medical histories are known the cost difference is only 5%. The costs associated with BMI are less clear.

The report finds that BMI is not the best way to predict added healthcare costs, even when medical history is known. BMI roughly uses weight divided by height squared and the report finds that weight divided by height cubed (known as Rohrer’s Index) is a better indicator.

Using BMI as a predictor, actual costs are greater for severely underweight and severely overweight people and, for taller people (within a given range of BMI). BMI is also generally criticized because professional athletes can be classified as obese using the measure.

The State Health Plan should be cautious in the use of smoking and BMI criteria for setting premium rates.