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Written by Jennifer Rogers for RHRealityCheck.org – News, commentary and community for reproductive health and justice.
America’s bicentennial year, 1976, was one of phenomenal events and inventions: Apple Inc was founded; West Point began to admit women; my husband was born; and the Toxic Substances Control Act (TSCA), our primary chemical safety law, was enacted. In the ensuing 34 years, much has changed. The boxy desktop computer bears almost no resemblance to the recently launched iPad; women are serving valiantly in both Iraq and Afghanistan; and my husband has gone from a pudgy baby to a gray-haired professor.
Unfortunately, despite the introduction of thousands of new chemicals into the products we use every day, TSCA has undergone no revisions. Scientists, health care providers, reproductive and environmental health advocates agree: TSCA has not kept up with the times.
When TSCA was passed in 1976, it was considered a huge step forward in the government’s ability to regulate toxic chemicals. To some degree, however, TSCA was already outdated before it was signed into law. Many dangerous chemicals were “grandfathered in” under the new law and remain in use today. Many new chemicals remain unregulated because the legislation was limited in scope.
As a result, one of the primary deficiencies of TSCA is that the chemicals we encounter in our daily lives—in our water and baby bottles, food containers, children’s toys, household cleaners, and personal care products—are not tested for safety and these chemicals are harming the reproductive health and fertility of women, men and children. Lower-income and communities of color are disproportionately and adversely affected by chemicals in consumer products whether through workplace exposure, specific marketing of niche products, or through products sold in and to their communities. For example, dollar stores, typically located in lower-income communities, are often the last stop for consumer products that can not or will not be sold in other stores. These products, including house wares, toys, jewelry, and food and drink containers, often have been recalled or discontinued. However, these products end up in dollar stores with little regulation or oversight. Likewise, environmental and reproductive justice organizations have long been concerned with the toxic chemicals found in skin lighteners and hair relaxers, products marketed specifically to women of color.
Pregnant women and children are another group among the most vulnerable to toxic chemicals. We know that the short- and long-term effects of early exposure to even low levels of toxic chemicals have been linked to a host of health problems including childhood cancer, early puberty, reduced fertility, and learning and developmental disabilities, including autism and ADHD. Phthalates, for example, a common product found in vinyl, cosmetics, fragrance, and medical devices, has been linked to early puberty, infertility and endometriosis. Although some phthalates have been banned from children’s products, they remain poorly regulated under TSCA.
Toxic chemicals can accumulate or build up in our bodies, negatively impacting our health and our future pregnancies long after exposure. Hormone disruptors (also known as endocrine disrupting chemicals) are one class of chemicals of particular concern because they alter the essential hormone balance required for overall health including the function and regulation of our reproductive health system. Bisphenol A (or BPA) is a widely known hormone disruptor commonly used in plastics products such as water and baby bottles as well as in the lining of canned food, beverages, and infant formula. In 2008, BPA became a household word when news emerged that the popular bottle maker, Nalgene, decided to stop using plastic made with BPA due to growing concern about the negative health impacts of this chemical.
Experience has shown that TSCA does not provide EPA with the regulatory mechanisms necessary to protect public health. The decision by Nalgene, for example, was made voluntarily due to consumer and media pressure. The federal government has not issued any regulations regarding BPA. In addition to phthalates and BPA, there are currently more than 80,000 different chemicals produced and used in the US. In 34 years, EPA has been able to require testing on just 200 of these chemicals and only 5 have been restricted. In fact, EPA tried to use TSCA to restrict asbestos 18 years ago and failed; they haven’t tried since. And why would they? Despite spending tens of millions of dollars and amassing thousands of pages of evidence, the EPA was unable to prove that asbestos presented an “unreasonable risk.” In other words, TSCA’s burden of proof is so high that under this legislation not even the worst of the worst chemicals, like asbestos, can be taken off the market.
Even as I write this, I begin to feel nervous, angry, and overwhelmed. How can this be true? For years, I’ve used products that may have caused me and my family harm. I have come to realize that as much as anyone can try to do research and keep up with the science, we can’t all be PhDs in chemistry. And we can’t shop our way out of the problem. I shouldn’t have to figure out what’s safe and what’s not. This is why we have government. We need a new, modern law that protects us all. Having just witnessed passage of historic healthcare legislation now is the time for Congress, especially the Democratic Party, to get serious about issues that are adversely affecting reproductive health, family health, and the general health of lower-income populations.
I believe the reproductive health movement must be a key player in achieving chemical policy reform. Our movement has a legitimate, unique, and necessary role to play in educating the American public about the dangers of toxic chemicals and in mobilizing for policy change. Not only do we have considerable resources and infrastructure to contribute to these efforts, but according to recent opinion research, three of the four most effective messages in support of chemical policy reform involve reproductive health concerns.
And now is the opportune time for reproductive health and justice organizations to get involved. The impact of toxic chemicals on human health has recently captured the imaginations of the media, public, and policymakers. In fact, 12 states and the District of Columbia have already introduced legislation to ban BPA. Nicholas Kristof of the New York Times has written on the links between toxic chemicals and diseases such as cancer and autism.
Perhaps most notably, champions of environmental health in the US Senate currently stand poised to introduce legislation to reform TSCA. Sponsored by Frank Lautenberg (D-NJ), the Safe Chemicals Act of 2010 would empower the EPA to require testing of chemicals and to regulate chemicals we know harm health. It should come to no surprise that our main opposition for reform is the chemical industry. However, the leading chemical industry association, the American Chemistry Council, finally endorsed reform of TSCA in 2009, reversing its long-standing opposition. But reforming TSCA is not about an updated marketing ploy—instead, we need to ensure this legislation includes a few key principles:
- Basic Safety Information for All Chemicals: All chemicals should have basic health and safety information as a condition for entering or remaining on the market — something other laws already require for drugs and pesticides.
- Expedited Action on the Most Dangerous Chemicals: Ensurethat the EPA moves quickly to reduce the impact of those chemicals already known to be dangerous.
- Real-World Analysis Using the Best Science: Currently, chemicals are assessed (when assessed at all) as if a person is exposed to individual chemicals in isolation. Instead, we need to follow the National Academies of Sciences recommendations that cumulative exposure to chemicals, such as they are experienced in the real world, should be considered when the EPA reviews chemicals for safety.
And while toxic chemical reform many not be as sexy as the newest gadget from Apple or as visually symbolic as women at West Point, the impact these chemicals are having on our nations collective reproductive health is dangerous and pervasive. If we want to give birth to and raise the next generation of innovative thinkers or brave service members, we need to start at the beginning: the health of their mothers. Thousand of people have added their voices to this growing movement– will you?
by Rick Bendinger, MD
I am a rural health provider in Abbeville, Alabama and have been here almost 30 years. I originally went to school on a public health scholarship and took the private practice option. This was a program that existed in the 1980s that paid for tuition and a stipend with the obligation to go either to a prison, rural area, or Indian reservation.
Sadly the program no longer exists. Both myself and my partner went to school on this program. The thought was that once you paid off a 4 year obligation working in a rural area you would stay and for me it worked.
Currently we provide care to the county and surrounding counties but with the 21% Medicare cuts, rising costs and requirements it is going to make our job even more difficult. I have reassured my patients that in spite of the current cuts I will still be here for them but I really worry about affording to continue to care for them and what will happen when I retire.
Most primary care providers in Alabama are in their mid-fifties and we are getting little help from new students who, owing $250,000-$300,000, opt for more lucrative specialties. Many will retire with the advent of this bill and make things more difficult. Furthermore, poor counties provide poor schools and not many young professionals with children want to practice in rural areas of this state.
We treat the poor and indigent each and every day but have a hard time with their care when we want to refer for specialty care as many of the internists and specialists in the nearby “big town” are not taking new Medicare patients and won’t take indigent care. Not because they are greedy but because they are not paid enough to operate a business.
I practice in a different environment than the big city doctors. Patients are friends and like family. I have coached their children in baseball and basketball helped them with some of their homework, and been a part of the community. I see them in the grocery store and at ballgames they are friends. I have stitched them up on my kitchen table, made house calls and cried with them when they have lost a loved one. They are like family in a small town practice and that is a big difference between what I do and a big city doctor.
With that said, the new health care bill gives patients a shiny new card that is supposed to keep them out of the ER, but in reality, if they have no provider to go to that is where they will end up. You can’t just dump another 30 million folks into this system without more doctors. The requirements for their care built in this bill will require us to do more work and outcomes data without paying for the cost of doing this. Frankly, it is an impossible task.
I really noticed the uptick in non-productive work with the advent of the Medicare Part D program. Although I still fully don’t understand the rationality of things like the doughnut hole provision, we spent many visits trying to explain to patients what the program was about and many hours on the phone with their pharmacy benefit managers trying to get their medicine they had been on for years approved.
This was the tip of the iceberg because many private insurers followed suit with the prior authorizations for drugs and MRIs as well. I have one employee who does nothing but these issues. This is an example of what drives up our overhead. Medicare has not raised our rates in 10 years. Medicare monies are taken out of one big finite pot. So if we get a raise, another provider gets a cut. Promises of higher primary care payments have been empty.
Will I retire because of health reform? No, I can’t afford to leave patients without a stable provider. But this new bill will make my work even harder. My hope is that there is an effort to train and increase primary care providers. It addresses student loans, restaurant calorie counts and numerous other superfluous things that won’t bring new rural doctors.
I would like to see a Manhattan-type program, like what the government did with the bomb, that would train primary care doctors and pay them on a better scale. Medical students who come out with $300,000 in student loans can’t go into primary care for $170,000 per year. Surely, within the trillions that are being proposed for health care there could be an effort to incentivize some of the best and brightest students to go into primary care.
Nurse practitioners and physician assistants are being hired by many of the specialists to work for them — they too are often shunning primary care. We need to capture some of them, but they need to be paid as well. Currently, private insurers only pay them 80% of what they pay me to do the same thing.
Hopefully this gives some insight into what I do and how rural medicine will be affected by health care reform.
Richard Bendinger is a family physician.
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Carl Armstrong
April 18, 2010 at 5:58 pm
Oh and Chris, there are pictures of CHeney and Rumsfeld shaking the hand of Saddam Hussein and his cronies.
Have fun choking because that rather shoots down any sense of superiority you get claiming making up stupid claims about Obama and Chavez.
April 18, 2010 at 5:57 pm
Chris wrote:
Bush was a humble person, a faithful husband, a dignified person in general.
He was arrogant and egotistical.
And as for “faithful husband” that has what to do with being President? No matter what you say he was one of our worst Presidents of all time.
Bush authorized a fools war in Iraq that did no small part in nearly bankrupting this country. He attacked Iraq despite them having nothing to do with 9-11. He let Osama bin Laden get away and he did little to deal with Al Qaeda. He authorized torture. He sacrificed much of our moral standing with the rest of the world. And domestically he continously screwed over the middle class and the poor while kissing the asses of the rich.
And you want to claim that Kennedy’s alleged affairs makes him a worse person then Bush? My..you do have a messed up sense of morality. Let me know when you want to bother to have an actual sense of morality. Because thinking that a person who cheated on his wife is worse morally then a person who ordered torture is just this side of being morally depraved.
April 18, 2010 at 3:02 pm
Historians are just liberal elitist pricks who look back at history and form an opinion on it. They don’t look at history any more objectively than they look at the present day. “Historian” is just a title given to someone with a hobby in reading history books. And those historians are just using W. as a scapegoat; there was that one American president (I forget his name) who lasted one month in the presidency. He got nothing done in that one month, needless to say, so you would think any objective “historian” would call him the worst. But the “historians” obviously based their conclusion on Bush being the worse simply because they didn’t like him.
“A loophole or gap in a law is common, and not a sign of incompetence.” Oh, okay. I’d have to argue that incompetence is common, then. (Well, that goes without saying when it’s in regard to Congress.)
“If insurance companies deprive coverage,…there will be litigation.” They wouldn’t be breaking any laws by denying coverage to anyone, because the law doesn’t say they can’t. I’m not saying they should deny coverage, of course, but looking at it objectively, they have that right. But I see you’ve jumped on the insurance-companies-are-evil bandwagon, even though they make only 3% profit.
“Unless Sauron is more effective in mustering Republicans against an amendment than he was the first time around. It would be a heckuva fight, with pro-life Republicans publicly repudiating their stands in order to force children to suffer and die.” It wasn’t just Republicans who were against the health-care takeover; Republicans were, Democrats were, and Independents were. And come on, guy, that’s a tad dramatic, “The Republicans want to force children to suffer and die!” Oh, okay.
“…The provision Sen. Feinstein had proposed to fix the problem was stopped by Republican.” Republicans against have not once tried to stop reform, and the Democrats who supported the health-care takeover have not once tried to initiate reform. The new bill does nothing to reform anything. It doesn’t increase competition because it still prevents you from purchasing insurance across state lines. There’s no malpractice-suit reform in there. Republicans offered numerous solutions while the Democrats literally locked themselves up behind closed doors to prevent the Republicans from having any part of the legislation. So, yes, the Republicans should be proud that they tried to prevent socialism and offered up true reform.
“It will be interesting to see how recalcitrant industries fight improved health care. The important first step in reining in costs was to expand coverage.” Coverage was expanded to some 10 or 15 million people at the expense of freedom and at the expense of reducing the quality of the health care to everybody else. Yay.
“Occasional wins by evil is not evidence that the war has been lost.” Good, this gives me some hope.
April 18, 2010 at 2:50 pm
You’ve never met Bush, and you don’t know much about him, do you.
April 18, 2010 at 2:47 pm
Good friends with Chavez? They’ve met once. Obama said Venezuela needs to get with the program, stand up for rule of law in the Americas. Chavez gave Obama a book.
You imagine a lot that didn’t happen and isn’t realistic. Obama’s no closer to Chavez than Dick Cheney is, just wiser in handling the nut.
Who cares what Castro says in an interview? Castro didn’t claim Obama’s anything other than a U.S. flag-waving patriot. I can’t find anything that suggests Castro approves of Obama’s policies, especially since Obama turned up the diplomatic heat on Chavez. What are you talking about?
April 18, 2010 at 2:21 pm
And apparently I suck at HTML.
April 18, 2010 at 2:18 pm
Nick Kelsier:
Yes, because W. cheated on his wife with countless women and thought he could do whatever he wanted just because he was the president. Bush was a humble person, a faithful husband, a dignified person in general.
Yes, because Saddam Hussein wasn’t a brutal dictator who killed hundreds and hundreds of thousands of his own people. The world is safer because that madman is dead. Because BUSH got rid of him. Hussein DID have WMDs (he used them against his own people, duh). The only thing Bush made a mistake at was warning Iraq that we were coming (the UN approved of the invasion, by the way, as did Congress). Because we warned Hussein (Saddam, not Obama), he was able to get the WMD over the border to Syria. We should have just gone in there with no warning. And we need to do the same to Iran, but Obama’s a weak rookie who likes to appease and pal around with dictators (he’s good friends with Chavez, and even Castro–former communist dictator of Cuba–approves of the way Obama is running America. Communists don’t approve of democracy, yet this communist approves of Obama’s job. Interesting, no?
Yeah, poor terrorists, being “tortured,” boo-hoo. We made blood-thirsty psychopaths THINK they were drowning, oh man, so harsh, so, so evil! Poor terrorists!
Now, I can’t WAIT for you to tell me how Bush “crashed the economy.” I can’t wait. Please tell me, seriously. Don’t hold back. Tell me what you think.
You:
You mean like Obama is doing now? On both counts? Kinda like that? Why are liberals so anti-rich? People get rich because they earned it. They get rich because of hard work and ambition, most of the time. Other times they inherit it, sure, but the majority of the time, they earned it. Jealous? Then try harder like they did. Don’t steal from them to pay for your unambitious, whiny self.
April 18, 2010 at 11:24 am
Ed writes:
It would be a heckuva fight, with pro-life Republicans publicly repudiating their stands in order to force children to suffer and die.
Really think they’re going to have much of a problem doing that, Ed? It’s not like they’ve shown much concern for the health and life of children after they’ve been born so far….
Claiming the Republicans are “pro-life” is like claiming that David Duke is pro-black.
April 18, 2010 at 10:13 am
Health care legislation as Waterloo – Oliphant (and Benson …
April 18, 2010 at 1:24 am
Not liberals based on polls who said Bush was worst ever: Historians, based on their comparison with every other president. (It’s a Rolling Stone story, and their website is down this weekend for dramatic revisions.)
A loophole or gap in a law is common, and not a sign of incompetence. It’s quite inventive of the insurance companies to claim to have found a way to deprive sick and injured children of coverage. I’m sure you read the article carefully. If insurance companies deprive coverage, contrary to the language of the conference report, there will be litigation. If by some fluke the insurance companies win that litigation, proving that Congress’s intent was not carried out in the language they passed, there will be amendments, unless Sauron is more effective in mustering Republicans against an amendment than he was the first time around. It would be a heckuva fight, with pro-life Republicans publicly repudiating their stands in order to force children to suffer and die.
The new law has protections of consumers built in, to resolve and head off some of the problems you fear, according to the NYT article (by my old friend Robert Pear, who is among the best in covering these issues):
Will insurance premiums rise? We were sure of it before, at about a 15% per year clip. Does the LA Times article say they will rise faster than that? It notes that the provision Sen. Feinstein had proposed to fix the problem was stopped by Republican’s obstreperousness (“Congressional rules” is what the article said). Republicans won’t be proud to trumpet this one, either, I’ll wager. We needed a good gross of Righty-Be-Gone to fix that problem (Why didn’t you note that it was the right that cause this problem? Are you ashamed of it, too?)
It will be interesting to see how recalcitrant industries fight improved health care. The important first step in reining in costs was to expand coverage. A public option to compete with insurance companies might have provided a good, market mechanism to fight undue increases, but since the Republicans have not allowed that yet, we’ll probably have to go the regulatory route.
Ironic that Republicans are driving increased regulation of private industry, no? Unprincipaled, unholy opposition to good government will create such problems, and every Republican should hang his or her head in shame.
My God is not incompetent. Evil is not benign, though, and must be fought at every turn, at every moment. Occasional wins by evil is not evidence that the war has been lost.
WordPress and HTML: Yeah, HTML is accepted at almost all WordPress powered blogs, and all WordPress hosted blogs that I have found. Good luck with your blog.
April 18, 2010 at 12:23 am
Anything Kennedy did as far as being a “disgusting human being” pales to W, Chris.
Least Kennedy didnt start a fools war in a country that did nothing to deserve invaded. At least Kennedy didn’t authorize torture. And at least Kennedy didn’t crash the economy, screw the middle class and suck the dicks of the rich.
April 17, 2010 at 10:42 pm
I agree with you about Truman. He’s just about the only Democrat I like. He made unpopular decisions that saved millions of lives (and not only the lives of Americans). And aside from being a disgusting human being, Kennedy was not too bad a president. Remember when you liberals pointed to Bush’s approval ratings (and still do) and said, “See? He’s the worst president in history”? Yeah.
Now, I’m glad you brought up this “no pre-existing conditions” thing. It was reported in the New York Times, one of Obama’s many personal fluffers, that while ObamaCare DOES prevent children from being DROPPED from coverage because of a discovered pre-existing condition, it does NOT prevent insurance companies from DENYING coverage to children with pre-existing conditions. That’s what happens when, in a mad rush to advance pure Marxism, you push through legislation before even taking time to proofread it, let alone read it at all. Remember what Pelosi said? “We have to pass the bill so you can see what’s in it.”
And just for kicks, from the LA Times, one of the most liberal, in-the-can-for-Obama publications around, we find this:
“Public outrage over double-digit rate hikes for health insurance may have helped push President Obama’s healthcare overhaul across the finish line, but the new law does NOT give regulators the power to block similar increases in the future.
“And now, with some major companies already moving to boost premiums and others poised to follow suit, millions of Americans may feel an unexpected jolt in the pocketbook.
“Although Democrats promised greater consumer protection, the overhaul does NOT give the federal government broad regulatory power to prevent increases.
“‘It is a very big loophole in health reform,’ Sen. Dianne Feinstein (D-Calif.) said. Feinstein and Rep. Jan Schakowsky (D-Ill.) are pushing legislation to expand federal and state authority to prevent insurance companies from boosting rates excessively.”
Your gods are completely incompetent.
Also, from one decent human being to another, I just made my WordPress blog last night and am still unsure of a bunch of things, one of which is whether or not I can use basic HTML in comments like this. Do you happen to know? I didn’t want to try it and then have my comment end up looking like crap because HTML is NOT accepted. There’s no preview button, so I figured I shouldn’t risk it.
April 17, 2010 at 10:07 pm
Like Truman, sometimes you pay a public poll price for doing the right thing. Still have to do the right thing.
Wait until the Republicans start campaigning on repeal of the “no pre-existing condition” clause. I can hardly wait.
April 17, 2010 at 9:37 pm
Meanwhile, his poll numbers keep falling….