Miscellany Blue Says a "lawmaker seeks to defund Planned Parenthood for ‘cutting children into small pieces.’

Abortion, New Hampshire, Miscellany Blue,

Funding for Planned Parenthood has become a divisive issue in New Hampshire over the past few years. Republicans have repeatedly tried to redirect taxpayer money away from family planning services because the funds go to organizations that also perform abortions. The group at the center of these debates is Planned Parenthood of Northern New England, which bills itself as the largest reproductive health care provider in the region. And this year is no different. A recent headline in a liberal blog caught our eye: "Lawmaker seeks to defund Planned Parenthood for ‘cutting children into small pieces.’" It appeared on the liberal Miscellany Blue website. We’re not checking whether it’s accurate for Groen to say abortions are equivalent to "cutting children into small pieces," in this fact check. Instead we’ll look at the history of the bill and whether any state legislators uttered those words. The article points to State Rep. Warren Groen, a Rochester Republican, as both the sponsor of a bill to defund Planned Parenthood and the source of the quote. At the time the blog post was written, author William Tucker says, Groen was identified as the sole sponsor on a legislative services request. The full bill has since been written and posted online as HB 677. It’s now co-sponsored with Republican Rep. Richard Gordon of East Kingston. Neither current bill -- titled "an act prohibiting the use of public funds for abortion services" -- nor an earlier version introduced in 2011 target a specific, named group. Instead, they would affect all health care providers that also offer abortion services. The bill suggests that taxpayer dollars going to these groups indirectly subsidize abortions by paying for "administrative costs, overhead, employee salaries, rent, utilities, and various other expenses," and seeks to ban such funding. Of the affected providers, Planned Parenthood is by far the biggest. For 2014-15, it received $737,586 from state contracts, while the Concord Feminist Health Center received $73,218 and the Joan G. Lovering Health Center in Greenland received $89,214. It’s important to note that the state already bars direct public funding for abortions through Medicaid except in case of rape, incest or danger to the life of the mother. Groen’s bill specifically targets funding for other health services provided by Planned Parenthood and similar agencies. The blog headline is close to accurate, but it oversimplifies somewhat. The measure targets all abortion providers in the state, not just Planned Parenthood. And what about the "cutting children into small pieces" quote? It comes from a Feb. 9, 2011, Concord Monitor article about a legislative hearing on the earlier version of Groen’s bill. In the article, Groen is quoted as saying: "I'm amazed the only way we can find to deliver social services is by spending money on an organization whose specialty is cutting children into small pieces." Tucker says he highlighted that four-year-old quote because it referenced Planned Parenthood specifically, and because it was made in the context of a formal hearing. Groen’s latest bill hasn’t yet come up in the House. Groen is a longtime abortion opponent, and he’s been outspoken in his views. He has made similar statements recently, too. In the Dec. 20, 2014, Concord Monitor, for example, he’s quoted as saying: "Imagine how poverty-stricken the state has to be, when in order for women to get health care they have to reach out to an organization that kills babies for a living?" Reached by phone, Groen said the quote that ran in the Monitor in 2011 sounded "pretty accurate to me," and the quote that ran in the paper in 2014 was not exact but "reasonably accurate." He also criticized the news media’s focus on Planned Parenthood in the debate. Groen, referring to Planned Parenthood, said "they have all the money," suggesting the group was trying to turn his bill into an attack on them. "Every reporter wants to talk about Planned Parenthood," he said. "That’s very interesting.". We’ll note that abortions account for a small fraction of the of the overall health care services provided by Planned Parenthood of Northern New England. According to the group, its New Hampshire clinics were visited 22,283 times in 2013. Medical personnel at the clinics performed 1,573 abortions that year, accounting for about 7 percent of all visits. For reference, the clinics did 2,979 breast exams and 1,859 cervical cancer tests over the same timespan. Planned Parenthood of Northern New England only performs first- and early-second-trimester abortions. None would be considered late-term abortions, a type often highlighted by critics of the procedure, according to spokeswoman Jennifer Frizzell. State-level numbers for the number and type of abortions performed in New Hampshire aren’t available from the federal government, as the state does not report them. The Guttmacher Institute, a nonprofit spun off from Planned Parenthood, reports that 3,200 abortions were performed in the state in 2011. Our ruling A headline in the liberal blog Miscellany Blue declared, "Lawmaker seeks to defund Planned Parenthood for ‘cutting children into small pieces.’ " Groen’s proposal doesn’t mention Planned Parenthood, but the effect of the bill would be to strip it, and other similar groups, of state funding. Meanwhile, Groen did make the statement about the group "cutting children into small pieces" four years ago, and he’s made similar declarations recently. We aren’t rating the substance of Groen’s accusations, but the headline summarizing what Groen said and what he’s proposing in the bill are generally accurate.


Dry needling offers alternative to cortisone injection for hip pain

Explanation: This news release from an orthopedics journal relates a study finding that dry needling, which uses filament needles to stimulate trigger points in the muscles, is just as effective as cortisone injections when it comes to reducing pain and swelling caused by greater trochanteric pain syndrome (GTPS), a common hip condition. We applaud its restrained tone but would have liked to get a sense of how much symptom improvement patients experienced during the six-week trial as well as a discussion of costs and availability of these two treatment options. This release says the effectiveness of steroid injections “is increasingly being questioned. An equally effective treatment with fewer adverse side effects would be beneficial.” To conclude that dry needling is “not inferior” to a treatment that isn’t very effective doesn’t say much. There is no slam-dunk treatment for chronic hip pain. But if it comes with low risk and a modest cost, dry needling might be an alternative to steroids for combating chronic pain. Also, dry needling might offer an option for patients who haven’t felt relief from steroids or are precluded from taking them due to medication interactions. As the release states, GTPS is very common and at times very painful. A safe, successful treatment that rapidly resolves pain (beyond normal natural healing) would benefit many individuals. A specific risk profile of a single cortisone injection in the soft tissues has not been determined but most researchers and practicing physicians would consider it to be minimal.

dry needling,Journal of Orthopaedic & Sports Physical Therapy (JOBST)

There’s no discussion of costs for either steroid injections or dry needling. According to costhelper.com, the cost of a steroid injection runs $100 to $300, not including the cost of a doctor’s office visit. Dry needling is considerably less expensive but typically requires more frequent treatments. We found one Kansas physical therapy practice that charges $25 for the first treatment and $20 for additional visits. Both may be covered by insurance. The news release states the results “showed that cortisone injection did not provide better outcomes than dry needling for either pain or function in patients with GTPS. Both groups experienced a decrease in pain and an improved ability to move and complete daily activities.” But there’s no information on how big the benefits were. For example, average pain scores for patients who underwent dry needling dropped from 5.4 to 2.8 on a 10-point scale, while those who received a cortisone injections saw their pain scores go from an average of 6.1 to 3.9. Weighted averages for functionality increased from 3.9 to 7.3 for those who received dry needling versus an increase from 3.4 to 6.1 for patients who had a cortisone injection. The true benefit of either treatment is difficult to determine. This study lacked a placebo group so it’s hard to gauge how it compares with normal healing without being treated. While no harms were reported in the study, the news release still should have mentioned typical side effects of dry needling such as temporary pain, bruising and post-treatment soreness. The release does mention the “potentially harmful effects of steroids” but doesn’t say what they are. The concern over potential complications from steroid injection seems to be magnified while any potential harms from dry needling is ignored. The news release describes the study’s methodology, number of patients, randomized assignment of treatment, length of treatment and other details that give readers a decent grasp of how the results were obtained. It also cautions that “while this study uses a larger sample than most, further studies are warranted. In particular, participants were only followed for six weeks; additional studies over longer time periods will be important.” The release would have been better if it mentioned additional study limitations such as a lack of blinding and the possibility that both treatment groups experienced a placebo effect, as well as the study’s’ recommendation that dry needling be studied in conjunction with rehabilitative physical therapy over a prolonged period. The release doesn’t engage in disease mongering. Hip dysfunction is very common, and the news release doesn’t appear to overstate that. It says GTPS “is estimated to affect 10% to 25% of the general population. This kind of hip pain has been reported to be more common in women and in patients with coexisting low back pain, osteoarthritis, Iliotibial band tenderness, and obesity.” The news release doesn’t mention any conflicts of interest, and none were reported in the study. The release also echoes the study’s statement that funding came from Baylor Scott & White Health, which is a Dallas-based healthcare system. The news release adequately compares dry needling with steroid injections. Still, it could have mentioned other strategies for managing chronic hip pain such as physical therapy. There’s no discussion of what’s involved with dry needling. While steroid injections take about five minutes and are usually done in a physician’s office once every six weeks or more, dry needling is usually performed by a physical therapist and requires more frequent treatments of about 20 minutes apiece. During this six-week study, the dry needling group received an average of 5.4 treatments while those who received cortisone injections had one shot. Dry needling might be more convenient than steroid injections if it’s part of treatment strategy that also involves physical therapy. The news release says this is “the first to directly compare these two treatments for the syndrome.” We found no other studies of a similar nature after a quick online search. The language is this news release is restrained.


Aveo Oncology to end breast cancer study due to low enrollment.

Explanation: Aveo Oncology said it would end a mid-stage trial testing its lead drug as a treatment for breast cancer, as the company did not have enough patients enrolled in the study.

Aveo, which was developing the drug with Japan’s Astellas Pharma Inc, said enrollment in the study had been slower than expected and did not improve despite efforts to recruit more patients. The company, which cut 62 percent of its workforce last year to focus on developing the drug as a treatment for breast and colon cancers, said in December that it was not likely to succeed in a mid-stage colon cancer study. The U.S. Food and Drug Administration rejected the drug, tivozanib, as a treatment for kidney cancer in June, saying that study results were inconsistent. The breast cancer study, which began in December 2012, was testing the efficacy of tivozanib in combination with another cancer drug on patients with locally recurrent or metastatic triple negative breast cancer. Aveo’s shares, which fell 78 percent in 2013, closed at $1.77 on the Nasdaq on Wednesday.


Hillary Clinton Says she "called for addressing risks of derivatives, cracking down on subprime mortgages and improving financial oversight" early on in the financial crisis.

National, Candidate Biography, Economy, Financial Regulation, Hillary Clinton,

Hillary Clinton has a reputation for being cozy with Wall Street -- but in her 2016 campaign, she’s been striking populist tones. Clinton introduced her plan for a variety of economic issues in a speech at the New School in Manhattan on July 14, 2015. As president, she said, she would go "beyond Dodd-Frank" -- the regulations on financial institutions that took hold in 2010, following the economic crisis of 2007-08. She said she had been calling for financial regulations since the very early stages of the crisis. "As we all know, in the years before the crash, financial firms piled risk upon risk, and regulators in Washington either couldn’t or wouldn’t keep up," she said. "I was alarmed by this gathering storm and called for addressing risks of derivatives, cracking down on subprime mortgages and improving financial oversight." Clinton used to be the senator from New York, the home of Wall Street. She has a history of campaign backing from the finance industry and of delivering high-priced speeches to finance firms, such as Goldman Sachs. And her husband, former President Bill Clinton, signed the repeal of a bank break-up bill, the Glass-Steagall Act -- a deregulation that some critics believe contributed to the financial crisis. So we questioned Hillary Clinton’s record of addressing financial regulations. Did she address derivatives, subprime mortgages and financial oversight so early in the crisis? The 2008 primary campaign While the financial crisis came to a head in summer 2008, problems with housing started to bubble up in 2007 during Clinton’s ill-fated presidential primary campaign. On the trail, Clinton addressed these nascent issues -- particularly the mortgage crisis -- as early as March of that year. Clinton, still a senator at the time, delivered a speech on the volatility of the subprime mortgage market on March 15, 2007. She said too many people were ignoring warning signs. "The subprime problems are now creating massive issues on Wall Street," Clinton said. "It's a serious problem affecting our housing market and millions of hard-working families." She gave specific proposals for addressing subprime mortgages, including expanding the role of the Federal Housing Administration, more borrowing options for underprivileged and first-time homebuyers, more safeguards against predatory lending practices and policies intended to prevent foreclosures. In August that year, she delivered a similar speech about dealing with problems from subprime mortgages. There, she reiterated earlier proposals, and also suggested laws establishing national standards and registration for loan brokers, as well as regulations on lenders. "I think the subprime market was sort of like the canary in the mine," she said. "You know, it was telling us loudly and clearly, ‘There are problems here.’ " It didn’t become law, but Clinton sponsored a bill to implement these policies in September 2007. The first time she mentioned derivatives was in a November 2007 speech in Iowa. (A derivative is a financial product that allows investors to hedge against price fluctuations in an underlying asset.) "We need to start addressing the risks posed by derivatives and other complex financial products," she said. "You can't let Wall Street send the bill to your street with the bright ideas that just don't work out. Derivatives and products like them are posing real risks to families, as Wall Street writes down tens of billions of dollars in investments. Companies are taking the loss of a billion here and a billion there simply because the securities they own are worth less than they thought." In the same speech, she spoke again of the risky lending that led to the subprime mortgage crisis, adding that she called on then-President George W. Bush to convene a conference to find a solution. And she also pushed for more oversight of financial markets: "So as president, I will move to establish the 21st-century oversight we need in a 21st-century global marketplace. I will call for an immediate review of these new investment products and for plans to make them more transparent." This November speech angered some of Clinton’s Wall Street donors, according to the New York Times. At the tail-end of her campaign, in March 2008 -- still before the financial crisis hit a peak later that summer -- Clinton released a six-point plan to increase financial regulation. The plan included, in part, more oversight of derivatives and other new financial products, establishment of mortgage standards and strengthened some consumer protections. After becoming secretary of state in 2009, Clinton made noticeably fewer comments on domestic policy and financial regulation. But the record shows that establishing policies to address the then-nascent financial crisis was a key point of her campaign platform in 2007 and 2008. Our ruling Clinton said she "called for addressing risks of derivatives, cracking down on subprime mortgages and improving financial oversight" early on in the financial crisis. The crisis hit a peak in summer 2008, though it started to gain traction in 2007. Clinton began addressing the subprime mortgage issue in her appearances in March 2007. Later that year, she took on derivatives. She also proposed specific plans for solving these problems and increasing oversight of financial institutions. Her statement is accurate.


North Carolina fair bans mist fans as health measure.

Explanation: A North Carolina fair is banning the use of hand-held mist fans to guard against an outbreak of Legionnaires’ disease like the one that happened at another fair last month.

Health, Winston-Salem, General News, North Carolina, State fairs

A spokeswoman for the Dixie Classic Fair in Winston-Salem also says the fair’s lone water ride will be disinfected daily, and drinking fountains will be available inside a building adjacent to the fairgrounds. Spokeswoman Siobhan Olson says the fair is following guidelines established by the N.C. Department of Agriculture for the fair opening Friday. State health officials say more than 120 people have been diagnosed with Legionnaires’ disease after attending last month’s Mountain State Fair in Fletcher. Health officials said an investigation suggests the outbreak could have been spread by a hot tub display at the fair.


For a full-body workout, drumming is the novelty to beat.

Explanation: Drumsticks, pounded on gym floors, clinked overhead and bounced on exercise balls, are among the latest workout tools to tap into the group fitness scene, according to fitness experts.

Drumming classes do more than conjure dreams of rock glory. They provide effective workouts for all sorts of different drummers, from grandmothers to fitness fanatics. Marc Santa Maria of Crunch, the national chain of fitness centers, admits to living out his own rock fantasy as he instructs a drumming Crunch fitness class called Pound. The sticks, he said, are the means to an end. “You’re using the sticks as a mechanism to keep moving, and there’s constant movement,” said Santa Maria, who is Crunch’s New York regional director. “Your core has to be used for all the basic movements.”  Pound is the brainchild of Kirsten Potenza and Cristina Peerenboom, California-based former drummers who set out to fuse conditioning moves and cardio interval training with the distracting fun of drumming. “You’d never think two drummers will come up with a workout,” said Santa Maria. “They’re also inspired by Pilates.”  The Pound workout is featured on Potenza and Peerenboom’s website www.poundfit.com. There is a network of instructors and classes in the United States and they plan to have an at-home version of Pound available on DVD next year. “After the warmup, around the third track, there are three-minute intervals when you’re doing intensive cardio. Then there’s ab work,” said Santa Maria, referring to the abdominal muscles. People in the 45-minute class spend about 40 percent of the time standing, 40 percent seated, and 10 percent on their backs, he added. Dr. J. Timothy Lightfoot, who has played music semi-professionally for a decade, said it’s about time someone tapped into the fitness potential of drumming. “I’m pleasantly surprised to see this is happening,” said Lightfoot, a base player who is fascinated by the movement of drummers. “It’s always been my observation that drummers are incredibly fit, even though they don’t work at it.”  Lightfoot, who is director of the Sydney and JL Huffines Institute for Sports Medicine and Human Performance at Texas A&M University, said it makes perfect sense to the physiologist to use drumming as conditioning. “It’s very physiologically taxing,” he said. “Runners are primarily using their legs, swimmers are using their upper body most, but drummers are one of the few ‘athletes,’ and I’ll call them that, to have all extremities going at once.”  Lightfoot guesses that a drumming workout class with aerobic and dance elements could burn about 400 calories. Dancer and rhythm aerobics instructor Carrie Ekins originated Drums Alive, a workout which marries aerobic dance and drumming, while recuperating from a hip injury. She found that drumming on boxes helped her mentally as well as aerobically. Drums Alive workouts, which are done in the United States as well as Canada, Europe, Asia, Israel and the Middle East, are popular in senior centers, not just gyms. “The program started when I was sitting in a wheelchair.” said Ekins, who is based in Augsburg, Germany. “Drums Alive aims to reach multiple markets whether one is healthy, ill, young or old.”  Drums Alive has a sitting program for people who can’t train while standing, as well as one specifically designed for kindergartens and schools. She said the choice of music, as well as drumsticks, varies depending on the teacher and the students in the class. Among the benefits of the drumming workout is its accessibility age groups and fitness levels, according to Santa Maria. “There’s a learning curve, but in a few months you can get stronger and more flexible,” he said. “Messing up is not a big deal. Anyone can hold a stick and hit the floor.”  Unlike other classes that require a certain level of fitness or experience, anyone can pound drumsticks. “We many times see performers and we don’t think about their physical exertion,” he said. “Maybe we should think about that.”


A daily regimen of ingesting gin-soaked raisins will help relieve arthritis symptoms.

Explanation: Gin has been featured in non-raisin arthritis cures, including one that made the news in Baltimore in 1956. In that incident, an elderly Chinese man was bitten by one of the seven rattlesnakes he’d purchased for the purpose of creating an arthritis cure that involved pickling the serpents in gin for a year.

Arthritis is an auto-immune disease that causes those afflicted with it to suffer loss of mobility and copious amounts of pain. While drug therapies are available to help alleviate some of the suffering and inflammation brought on by arthritis, those drugs don’t work equally well for everyone who takes them, and at this time there is no cure for the disease. Because medical science does not supply an effective treatment for arthritis, numerous people have turned to folk medicine for relief. Some of them swear by daily dosings of cider vinegar or honey, or the wearing of copper or magnetic bracelets. The list of arthritis curatives and remedies people have tried is lengthy, and it seems that no matter how far-flung the notion, at least one person has attempted it and come to swear by it. Which brings us to the ingestion of gin-soaked raisins, a treatment that, although it has never been properly studied, has nevertheless gained adherents over the years. According to the lore of folk medicine, the dried fruit involved must be of the golden variety (also known as white raisins) rather than the more common black (or red) raisins. The number of gin-marinated raisins to be consumed daily varies: some say it’s seven, others nine. The duration of the soak varies, too; we’ve so far heard “one week,” “two weeks,” “until the raisins plump up,” and “when the gin has completely evaporated.”  As to why gin-soaked raisins are supposed to work, we’ve heard various explanations, among them that juniper berries have anti-inflammatory properties and that grapes contain compounds called proanthocyanidins, which are thought to help fight infection and reduce inflammation, and resveratrol, a powerful antioxidant. However, while gin is flavored with the extract of the juniper berry, the amount of that fruit’s essence that is actually present in the potable is minuscule. Moreover, there doesn’t appear to be any support for claims made about the juniper berry’s anti-inflammatory properties. Regarding the levels of proanthocyanidins in raisins, the U.S. Department of Agriculture says those are “undetectable.” Also, raisins are a poor source of resveratrol, which usually is destroyed when grapes are dried (and which is found only in the skin of red grapes, rather than the species of grapes that result in the white or golden raisins typically specified in the folk remedy). Those who’ve been asked to render a medical opinion on the potential for harm for the gin-soaked raisin regimen at least see little that could go amiss. Said physician columnist Dr. Donohue, “There would not be enough alcohol retained in the seven raisins to cause harm.”  In 1994, radio personality and columnist Paul Harvey said of the practice that it had been around for 20 years, but it could well date farther back than the mid-1970s. Print sightings we’ve located so far take it back to at least 1981. Paul Harvey’s 1994 mention of the drunken raisins treatment during one of his broadcasts and subsequent reporting of his audience’s experiences with the soggy little fruits spurred interest in the regimen. Numerous listeners and readers who tried the treatment and noted positive effects wrote to tell him of their experiences. Our favorite was this letter:  Dear Paul Harvey News I couldn’t remember whether you said drink seven pints of gin and nine raisins or nine pints of gin and seven raisins, so I did both. Now I can’t find the raisins … BUT NO PAIN! We found a similar note in a 1981 newspaper:  I am trying white raisins soaked in gin for my arthritis. So far, I can’t see any improvement, but I suppose if I take enough it will either cure or I won’t care. -Mrs. H.B.


The GOP health bill "would once again allow being a rape or domestic violence victim to be a pre-existing condition.

Explanation: Various bloggers, and some members of Congress, wrote that under the House Republican health plan, sexual assault and domestic violence is a pre-existing condition. Several websites have since softened their headlines to be more careful, going from "would" to "could." The bill does not change what is or is not a pre-existing condition; the health insurance companies write those definitions for themselves. The House bill also does not single out sexual assault or any other medical issue as a pre-existing condition. Prior to the Affordable Care Act, some victims of sexual assault said they had trouble getting health insurance because they sought medical services that the insurance companies viewed as evidence of a pre-existing condition, such as for sexually transmitted illness or mental health. The Republican bill might make it harder for people who have pre-existing conditions to get affordable health care coverage. Victims of sexual assault would face the same challenge as others with pre-existing conditions. But we don’t know for sure given the bill’s current form. The statement contains some element of truth but ignores critical facts that would give a different impression. UPDATE: This fact check has been updated with a response from Rep. Chu, who issued a statement on May 10, 2017, which reads in full: "As it stands today, anybody with a preexisting condition is protected thanks to the Affordable Care Act. This includes women, who were previously charged more for a range of care that is, today, considered ‘essential’. The AHCA makes it easier for insurers to earn waivers to charge more for preexisting conditions and leaves the question of what should be covered up to others. In my statement, I said that this bill ‘would once again allow a rape or domestic violence victim to be a pre-existing condition.’ While the many fact checks have pointed out that a number of conditions would have to be met first, like state waivers, the fact is that what is currently prohibited has once again become possible thanks to the AHCA. We should not even be discussing how women can be charged more for their care, even if it requires 2, 3, or 4 extra steps. This bill represents a step backwards for Americans’ health in a number of ways." Click here for more on the six PolitiFact ratings and how we select facts to check.

Congress, Health Care, Legal Issues, Crime, Public Health, Public Safety, Women, California, Judy Chu,

Democratic Congresswoman Judy Chu of Los Angeles County repeated a deceptive claim about the GOP health care bill last week after it narrowly passed the U.S. House. Chu said the legislation "would once again allow being a rape or domestic violence victim to be a pre-existing condition," in a press release on May 4, 2017. Chu and all other Democrats in the House opposed the bill, which has an uncertain future in the U.S. Senate. The national PolitiFact team fact-checked similar claims in the headlines of several blogs and rated them . It called the statements "bombastic" and "misleading." The Washington Post Fact Checker also rejected this claim, giving it four pinnochios. PolitiFact noted that some blogs have changed their headlines or issued corrections. In a written statement on May 10, 2017, Chu said she stands by her claim: "While the many fact checks have pointed out that a number of conditions would have to be met first, like state waivers, the fact is that what is currently prohibited has once again become possible thanks to the (American Health Care Act)," she said. Summary of PolitiFact’s findings PolitiFact Wisconsin also looked at the national PolitiFact’s analysis and summarized it’s findings this way: The GOP bill does not single out any specific medical event or diagnosis as a pre-existing condition. Conditions stemming from a sexual assault or domestic violence, such as post-traumatic stress disorder or certain sexually transmitted diseases, could be judged to be a pre-existing condition. States would have the option to allow insurers to charge higher prices to people with an existing condition, possibly making coverage unaffordable. Here’s what’s wrong with the claim Under the Affordable Care Act, insurance companies cannot deny coverage or charge higher premiums because a person has a pre-existing medical condition. Republicans’ Affordable Care Act replacement — the American Health Care Act, which the House passed May 4 — weakens those protections. These blog posts get at a real problem with the Republican bill if it were to become law. Victims of sexual assault could, conceivably, find themselves in a situation where they can’t afford insurance because of medical issues that stem from their assault. But the headlines that say the GOP bill makes sexual assault a pre-existing condition are hyperbolic based on the what the bill actually says. They stoke fears that the bill singles out victims of sexual assault, limiting their access to health care specifically. But the Republican bill doesn’t pinpoint any specific medical event or diagnosis as a pre-existing condition; that’s something the insurance companies or individual states would decide. As it stands, anyone with a pre-existing condition could face problems. Problems prior to the Affordable Care Act The blogs discuss anecdotal stories of women who, prior to the Affordable Care Act, were sexually assaulted and then sought treatment stemming from that assault. Later, when these women tried to purchase health insurance, they were denied coverage. These women weren’t necessarily denied coverage because of the sexual assault; rather, it was because of residual treatment they sought afterward, such as taking HIV-preventative medication or seeing a therapist. None of the several health insurance experts we consulted were aware of insurance companies with policies that specify "sexual assault" or "rape" as a condition to consider when evaluating someone’s eligibility. But insurance resources did regularly list mental health issues or sexually-transmitted illnesses as pre-existing conditions. For example, if a person were pricked with a used needle or had consensual sex with someone they later discovered had HIV, that person might also take HIV preventatives. And because they took that medication, they, like some sexual assault victims, might have trouble buying health insurance on the open market. If a sexual assault victim chose not to seek medical treatment, he or she wouldn’t necessarily face the same challenge in getting insurance. "This is not something specific about sexual assault," said Urban Institute senior fellow Linda Blumberg. "But to the extent victims of sexual assault are needing to take this (HIV) medication, they’re very vulnerable in terms of getting insurance coverage in the future." What repealing the Affordable Care Act could mean The Kaiser Family Foundation, an independent authority on health policy, recently wrote policy papers about pre-existing conditions prior to the Affordable Care Actand how repealing the law would affect women. Neither of those two articles say sexual assault victims would face a particular challenge. The Republicans’ bill doesn’t change what is or is not a pre-existing condition. What it does is allow more consideration of pre-existing conditions than is permitted under the Affordable Care Act. "The bill just leaves it to the imagination at this point," Blumberg said, referring to what insurance companies might consider as a pre-existing condition. To be clear, the bill doesn’t allow insurance providers to deny coverage to someone based on pre-existing conditions outright. But with a waiver, states can allow providers to set premium costs based on an individual’s "health status." Even though the bill puts in some protections, health economists say this could make insurance unaffordable for those with pre-existing conditions. Before the Affordable Care Act, health insurance companies were not transparent about what counts as a pre-existing condition, and the House Republican replacement doesn’t change that, said Kathryn Votava, president of health care consulting company Goodcare. This allows for the real possibility that sexual assault victims who seek medical treatment could face challenges in getting health insurance if the Republican bill becomes law, she said. "Could" is the key word. What ultimately happens depends on whether the bill is changed in the Senate and how states and insurance companies respond. The lack of transparency, as well as the potential for different policies from state to state, would put a significant burden on consumers trying to figure out whether they can obtain insurance given their health status, said Claire Brindis, director of the Institute for Health Policy Studies at the University of California San Francisco. For victims of sexual assault in particular, the bill could have a chilling effect, she added. Women might choose not to seek medical treatment after an assault because they are concerned it might affect their ability to get health insurance down the line. Sexual assault "is the tip of the iceberg," Brindis said. "There are many many other examples of unexpected events that occur in day to day life, that you can’t plan for, can’t avoid." Our ruling Various bloggers, and some members of Congress, wrote that under the House Republican health plan, sexual assault and domestic violence is a pre-existing condition. Several websites have since softened their headlines to be more careful, going from "would" to "could." The bill does not change what is or is not a pre-existing condition; the health insurance companies write those definitions for themselves. The House bill also does not single out sexual assault or any other medical issue as a pre-existing condition. Prior to the Affordable Care Act, some victims of sexual assault said they had trouble getting health insurance because they sought medical services that the insurance companies viewed as evidence of a pre-existing condition, such as for sexually transmitted illness or mental health. The Republican bill might make it harder for people who have pre-existing conditions to get affordable health care coverage. Victims of sexual assault would face the same challenge as others with pre-existing conditions. But we don’t know for sure given the bill’s current form. PolitiFact National rated this claim . Following the same analysis, PolitiFact California rates Chu’s claim . – The statement contains some element of truth but ignores critical facts that would give a different impression. UPDATE: This fact check has been updated with a response from Rep. Chu, who issued a statement on May 10, 2017, which reads in full: "As it stands today, anybody with a preexisting condition is protected thanks to the Affordable Care Act. This includes women, who were previously charged more for a range of care that is, today, considered ‘essential’. The AHCA makes it easier for insurers to earn waivers to charge more for preexisting conditions and leaves the question of what should be covered up to others. In my statement, I said that this bill ‘would once again allow a rape or domestic violence victim to be a pre-existing condition.’ While the many fact checks have pointed out that a number of conditions would have to be met first, like state waivers, the fact is that what is currently prohibited has once again become possible thanks to the AHCA. We should not even be discussing how women can be charged more for their care, even if it requires 2, 3, or 4 extra steps. This bill represents a step backwards for Americans’ health in a number of ways." Click here for more on the six PolitiFact ratings and how we select facts to check.


Within the three miles surrounding the University Circle area, infant mortality exceeds some Third World countries.

Explanation: Expert says infant mortality rate near University Circle exceeds that of some Third World countries

Ohio, Health Care, Public Health, Michele Walsh,

Public health experts consider the infant mortality rate an important indicator of a community's well-being. It is one of the factors that helped land Cuyahoga County in the bottom third of Ohio counties in overall health in a national study released last month by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. Cuyahoga, with its major health centers, performed well again on access to primary care in the annual study. But major health centers can't compensate for poverty and the other, often related stressors that contribute to the high infant mortality of Northeast Ohio. Ohio's rate of infant mortality -- 7.7 deaths per 1,000 live births in the first year of life -- is 11th-worst in the nation, said a public radio report on the subject on WCPN's "Sound of Ideas." The most recent rate reported for Cuyahoga County was a dismal 9.1 deaths, according to the Ohio Department of Health, and the average from 2006 to 2010 was 9.7. Among the experts who discussed the subject on WCPN was Dr. Michele Walsh, division chief of neonatology at Rainbow Babies & Children’s Hospital. "Within the three miles surrounding the University Circle area, infant mortality exceeds some Third World countries," she said, "and that is an embarrassment and cannot be allowed to continue." PolitiFact Ohio agreed that the rate would be alarming. We wanted to know more. We called Dr. Walsh, who said her statement about the city reflects data from a study conducted by researchers at Case Western Reserve University Mandel School of Applied Social Sciences. Its extensive research database is called NEO CANDO, for Northeast Ohio Community and Neighborhood Data for Organizing. It draws from a wide variety of sources that include the U.S. Census and the Ohio Department of Health, and it can break down information by neighborhood. For worldwide rates of infant mortality, we checked the authoritative CIA "World Factbook." The term "Third World," which once designated countries not aligned politically with the West or the Communist bloc East, generally refers to underdeveloped and developing countries of Asia, Africa and Latin America. Many poorer nations use the term to describe themselves. For our fact-check, we used the listings of Third World countries, as measured by poverty and low human development, from the Nations Online independent reference portal. To stay within three miles of University Circle, we looked at data for neighborhoods on Cleveland's East Side. We found that two neighborhoods, Hough and Mount Pleasant, had infant mortality rates above 27 per 1,000 -- worse than in North Korea, Uzbekistan, Vietnam, Samoa, Maldives or the Gaza Strip. Two other neighborhoods -- Kinsman (with an infant mortality rate of 31 per 1,000) and South Collinwood (29) -- had infant mortality worse than was reported in Zimbabwe. Infant mortality in the University Circle neighborhood, according to the NEO CANDO database, was slightly above 69 deaths per 1,000 live births. That exceeds the rate in countries that include, among others, Bangladesh, Haiti, Burma, Cameroon, Djibouti, Sudan, Kenya, Nepal, Pakistan, Rwanda and Uganda. That number struck us as both anomalous and staggering. We looked for an explanation and got one from researcher Richard Stacklin of the Cuyahoga County Board of Health. The rate for University Circle, he said, reflected the neighborhood’s small statistical base in 2009 of 43 births and 3 infant deaths. He said its most recent three-year average -- a preferable statistic for the neighborhood because it better accounts for fluctuations -- is 18.6 deaths, a figure he noted is still unacceptable and almost double the countywide rate. The average rate worldwide, according to the "World Factbook," is 39.4 per 1,000. The book estimates infant mortality in the United States in 2012 as 6 deaths per 1,000 births -- worse than the average for nations of the European Union and worse than countries including Australia, South Korea and Cuba. Its figures show that some Third World nations have infant mortality rates that are exceeded by those for some neighborhoods within three miles of University Circle. Walsh’s statement rates as .


“The flu killed 80,000 people in the U.S. last year”

Explanation: The CDC’s estimate for seasonal flu deaths for the 2017-18 season was about 61,000. The CDC’s preliminary estimate for seasonal flu deaths for the 2018-19 season is about 34,200, but that’s not the final number.

Facebook Fact-checks, Coronavirus, Facebook posts,

With a climbing death toll from COVID-19 grabbing daily headlines, some social media users have noted that the seasonal flu kills tens of thousands per year, too. But an April 18 Facebook post exaggerates seasonal flu fatalities: "Flu killed 80k people in the U.S. last year. None of you were afraid because the media didn’t tell you to be!" This post was flagged as part of Facebook’s efforts to combat false news and misinformation. (Read more about our partnership with Facebook.) The post appears to rely on a number used as a preliminary estimate for the 2017-18 flu season. The final figure for that year was lower than 80,000. And while the number of people who died from flu during the 2018-19 season is still preliminary, it is estimated to be less than half of what the Facebook post claims as well. The U.S. Centers for Disease Control and Prevention uses a mathematical model to retroactively estimate the numbers of influenza illnesses, medical visits, hospitalizations, and deaths in the United States each year. The CDC first looks at in-hospital deaths and then uses death certificate data since not all flu deaths are in the hospital. That 80,000 figure stems from a preliminary estimate provided by the U.S. Centers for Disease Control and Prevention in September 2018. At that time, the CDC said early estimates indicated that "more than 80,000 people died from flu last season" — a reference to the 2017-18 flu season. The CDC later updated its estimate for 2017-18 to about 61,000 (though the CDC notes that the true range could be as low as 46,404 and as high as 94,987). The estimate for flu deaths for the following year, 2018-19, is 34,157 deaths, but that number is preliminary and will be updated at a later date when data on contemporary testing practices become available, a CDC spokesman told PolitiFact. The Atlantic explained that seasonal flu deaths are hard to tally. "Flu deaths are estimated through a model that looks at hospitalizations and death certificates, and accounts for the possibility that many deaths are due to flu but aren’t coded as such," The Atlantic wrote. "If flu deaths were counted like COVID-19 deaths, the number would be substantially lower. This doesn’t mean we’re overestimating the flu. It does mean we are probably underestimating COVID-19." Flu deaths are hard to tally. But we know that in September 2018, the CDC announced a preliminary estimate that flu deaths totaled 80,000. Later, the CDC updated its estimate to a lower number: 61,099 deaths. The Facebook post said "last year" which we think would refer to the 2018-19 season. The CDC’s preliminary estimate is about 34,157 deaths.


Therapy animals are everywhere. Proof that they help is not.

Explanation: The story focuses on the lack of evidence supporting the fundamental concept of “therapy animals” — that interacting with animals can reduce stress or distress in humans. The story includes input from an array of expert sources and offers a broad (if vague) overview of the research literature regarding therapy animals. There are some shortcomings here — for example, not much was said about the costs of pet therapy. However, in sum, the story effectively conveys the lack of scientific consensus regarding how effective therapy animals are at reducing stress. Tackling the efficacy of therapy animals is a challenging subject, given that the story evaluates an absence of conclusive evidence. However, it’s an important subject. For example, therapy dogs can be expensive, which means a family may spend a great deal of money on a therapy animal — with little idea of whether the animal will provide meaningful benefits for a patient. Limited resources are available to help patients dealing with mental health issues, and it is important to ensure that those resources are used to achieve the maximum possible benefit. Resources that are being spent on unproven interventions are, obviously, not being used on interventions that have proven clinical benefits. This is the sort of thoughtful reporting we are always happy to see.

Cost is not discussed, but this is an important factor to consider when evaluating any intervention–and especially one that can be expensive. For example, Autism Service Dogs of America (a group that promotes the use of service dogs for patients with autism) estimates that “the full cost to breed, raise and train an ASDA service dog is over $20,000.” Another organization that trains dogs to work with autism patients estimates the cost at $30,000 (though it does not charge the client — the expense is paid through fundraising initiatives). We don’t claim that these are costs that individual patients would necessarily be responsible for, but they do offer some insight into the potential expenses associated with the care, training and upkeep of therapy animals. It’s not negligible, and it’s worth mentioning. This is a tricky one, given that the focus of the story is on the dearth of quantifiable benefits associated with therapy animals. So, what do we look for? Well, in this case, we looked for some meaningful, big-picture discussion of benefits. For example, the story notes that the body of evidence regarding therapy animals “sometimes has shown positive short-term effects, often found no effect and occasionally identified higher rates of distress.” Is that quantifiable? No. Does it offer meaningful insight into the nature of benefits found in a wide variety of studies on the subject? Yes. Given the thrust of the story, and the in-depth discussion of benefits (or lack thereof), we think this qualifies for a Satisfactory rating. This was a tough call for us: Harms are discussed, but briefly and anecdotally. The brief portion comes in the same quote mentioned above, noting that the body of evidence regarding therapy animals “sometimes has shown positive short-term effects, often found no effect and occasionally identified higher rates of distress” (emphasis added). A little more information there would be welcome. There’s also the issue of immunosuppressed patients coming into contact with therapy animals, and possible harm to the animals, who could be over-worked or subjected to aggressive or harmful treatment from even well-meaning people. Still, some harms are at least acknowledged. The story is focused on a field of research, rather than on any specific study. However, the story provides good background on the shortcomings of much of the relevant literature. For example, the story notes: “Most studies had small sample sizes…and an ‘alarming number’ did not control for other possible reasons for a changed stress level, such as interaction with the animal’s human handler.” It also discussed how media headlines often misstate correlation and causation, a problem we’ve discussed many times. Given the nature of the story, and the scope and complexity of the field being discussed, this earns a Satisfactory rating. We also like that the story includes multiple links to additional material regarding the existing body of research. No disease mongering here. This was a strong point of the story. It cites multiple sources, clearly identifies the affiliation of all sources, and places those affiliations in a context that readers can understand. For example, the story includes input from a source at the Human-Animal Bond Research Initiative (HABRI) — and explains that HABRI is a pet-industry backed organization that funds research on the topic of therapy animals. It’s not clear what the direct alternatives would be here, so we’ll rate this as not applicable. However, the story could have talked first-line treatments such as medications and traditional talk therapy. Therapy animals are meant to extend those mainstream treatments, not replace them. The story makes clear that therapy animals are in widespread use, and offers numerous related examples. However, people may wonder how to get one, and whether their insurance would pay. The story talks about prior research and even gives a Freud anecdote about the impact of a pet on psychotherapy, in an attempt to make clear this is not novel. The story does not appear to be based on a news release.


In the aftermath of two mass shootings, President Donald Trump attacked a political opponent and bragged about crowd sizes during remarks about the incidents, whereas past presidents offered words of comfort and solidarity.

Explanation: What's true: The quotations in an Occupy Democrats meme were authentic and presented with a high degree of accuracy. What's false: The remarks attributed to former Presidents Obama, Bush and Clinton came from prepared speeches, while those attributed to Trump were cherry-picked from an off-the-cuff moment and failed to reflect the full extent of his remarks on two shooting massacres in August 2019, which included a speech that did contain sentiments of comfort and solidarity for victims.

In the aftermath of a spate of mass shootings in August 2019, attention turned to U.S. President Donald Trump’s tone in discussing the killings, and the wider issue of gun violence in the United States, as well as his comportment in visiting two of the cities affected, El Paso, Texas, and Dayton, Ohio. Trump was criticized for smiling and offering a thumbs-up gesture while visiting an infant whose parents had been shot to death in a massacre in El Paso, and allegations that the president was using the tragedies as an opportunity to gain political capital extended to unfounded rumors that his administration had hired “fake” medical staff to pose with him at a hospital in Dayton. On Aug. 9, the left-leaning Facebook page Occupy Democrats posted a meme that purported to highlight a stark difference in tone and decorum between Trump — who supposedly used a visit to El Paso to brag about crowd sizes and snipe at Democratic presidential candidate and former Congressman Beto O’Rourke — and his predecessors in the Oval Office — who purportedly offered words of comfort and solidarity in the aftermath of previous mass shootings. We received multiple inquires from readers about the accuracy of the meme, which read as follows: “Littleton, I can only say tonight that the prayers of the American people are with you.” — Bill Clinton, after Columbine. “This is a day of mourning for the Virginia Tech community — and it is a day of sadness for our entire nation.” — George H.W. [sic] Bush. “Here in Newtown, I come to offer the love and prayers of a nation. You are not alone.” — Barack Obama. “Crazy Beto only had like 400 people in a parking lot, they said his crowd was wonderful.” — Deplorable Trump, in El Paso. The caption of the meme read: “SERIOUSLY, what is WRONG with Trump?!?! He REALLY said this to the El Paso victims.”   The Occupy Democrats meme was a largely accurate recounting of four post-shooting statements made by the four most recent occupants of the White House. (Strictly speaking, Trump was addressing medical staff who had treated victims of the El Paso shooting, rather than the victims themselves, and the second quotation was, apparently in error, attributed to George H.W. Bush, rather than George W. Bush.) Despite the authenticity of the quotations, the meme presented an incomplete and rather misleading picture of Trump’s overall comportment in visiting El Paso after the August 2019 massacre there. While the president did indulge in side-sniping about a political opponent who had been fiercely critical of him (something his predecessors markedly did not do in similar circumstances), Trump did also offer words of solidarity and comfort to the victims of the August 2019 massacres, their families, and the wider communities affected by the shootings. Clinton The first quotation in the meme was taken from remarks Bill Clinton delivered in a White House press conference on April 20, 1999, the day of the Columbine High School massacre in Littleton, Colorado. His speech can be read in full here, and viewed in full in the video below. In the most relevant section, Clinton said: “To the families who have lost their loved ones, to the parents who have lost their beloved children, to the wounded children and their families, to the people of the community of Littleton, I can only say tonight that the prayers of the American people are with you.”   Bush The second quotation in the meme came from a speech that George W. Bush gave on April 17, 2007, during a convocation at Virginia Tech in Blacksburg, Virginia, the day after a student shot to death 32 people on that campus. The full text of his speech is available here, and it can be watched in full below. In the section quoted by Occupy Democrats, Bush said: “Laura and I have come to Blacksburg today with hearts full of sorrow. This is a day of mourning for the Virginia Tech community, and it is a day of sadness for our entire nation. We’ve come to express our sympathy. In this time of anguish, I hope you know that people all over this country are thinking about you and asking God to provide comfort for all who have been affected.”    Obama The third quotation in the meme was taken from a speech Barack Obama gave during an interfaith vigil at Newtown High School on Dec. 16, 2012 — two days after a shooting massacre at nearby Sandy Hook Elementary School in Connecticut. The speech can be read in full here, and watched in full in the video below. During the relevant section, Obama said: “Here in Newtown, I come to offer the love and prayers of a nation. I am very mindful that mere words cannot match the depths of your sorrow, nor can they heal your wounded hearts. I can only hope it helps for you to know that you’re not alone in your grief. That our world, too, has been torn apart. That all across this land of ours, we have wept with you, and we’ve pulled our children tight. And you must know that whatever measure of comfort we can provide, we will provide. Whatever portion of sadness that we can share with you, to ease this heavy load, we will gladly bear it. Newtown, you are not alone.”     Trump The fourth and final quotation in the meme consisted of remarks Trump made while talking to hospital staff during a visit to University Medical Center in El Paso on Aug. 7, 2019, four days after a mass shooting at a Walmart store in that city. Police in El Paso have linked the suspected shooter, Patrick Crusius, to a white nationalist manifesto posted online shortly before the massacre began. The author of the manifesto decried what he characterized as a “Hispanic invasion of Texas” and espoused the discredited “white genocide” theory. Although the manifesto’s author, thought by El Paso police to be the suspected Walmart shooter, stipulated that his anti-immigrant sentiment predated the elevation of Trump to the presidency, some observers have pointed out areas of overlap between how the president talks about immigration and immigrants, and how the manifesto addressed them. Others, including Democratic politicians and long-standing critics of the president, went further in connecting Trump to the manifesto and the El Paso shooting. U.S. Rep. Joaquin Castro (D-Texas) said the manifesto was so similar to Trump’s rhetoric that it “could have been written by the people that write Trump’s speeches.” O’Rourke described the massacre as “an act of terror inspired by [Trump’s] racism.” Conventional news media were not permitted to accompany the president and first lady Melania Trump on their visits with shooting victims, families and medical staff in Dayton and El Paso on Aug. 7, but amateur footage emerged later that showed Trump addressing medical professionals at University Medical Center in El Paso. In the short clip, the president commended the work done by hospital staff in caring for the victims of the shooting, saying “the job you’ve done is incredible,” and “it’s an honor to be with you.” Without any obvious reason or prompt, Trump then shifted to talking about a rally he had held in El Paso in February 2019 (although he mentioned “three months ago,” Trump’s most recent rally in the city was in February, six months earlier): “I was here three months ago and we made a speech and we had a — what was the name of the arena? — that place was packed … That was some crowd, and we had twice the number outside. And then you had this crazy Beto — Beto had like 400 people in a parking lot, they said, ‘His crowd was wonderful!’ …” This is viewer video of President @realDonaldTrump and @FLOTUS at @umcelpaso meeting with victims and medical staff. Send us any photos/videos of president Trump’s visit to #ElPaso and we may show it on TV. Upload here: https://t.co/UHa4MdGOH4 pic.twitter.com/DD5otJtYEg — CBS4Local (@CBS4Local) August 8, 2019  Trump was referring in those remarks to a counter-protest held in response to his Feb. 11 rally at the El Paso County Coliseum. The counter-protest was led by O’Rourke and was estimated to have had between 7,000 and 15,000 attendees — considerably more than the “400 people in a parking lot” claimed by Trump. During his rally, Trump thanked the El Paso fire department for allowing 10,000 of his supporters to enter the arena, despite the venue’s having a capacity of 6,500. In response, a spokesperson for the fire department corrected the president, insisting that no special permission had been given, and the number of attendees inside the arena was no greater than its capacity. At other times, Trump claimed that as many as 35,000 supporters had come to the rally, taking into account those outside the arena. For an unknown reason, Trump decided to re-open that six-month-old dispute and grievance over crowd sizes and news coverage, while meeting and praising hospital staff who had treated and cared for the victims of a mass shooting. That struck some observers as grossly inappropriate, and we found no record of former Presidents Obama, Clinton or Bush having engaged in similar behavior while meeting the victims of past shootings or the medical professionals who had treated them. However, Trump’s “crazy Beto” aside was not the extent of his remarks on the massacres in Dayton and El Paso, and the Occupy Democrats meme misled readers by cherry-picking that unscripted moment and comparing it with remarks made by previous presidents from behind a podium, during prepared speeches. In a White House address on Aug. 5, Trump offered sentiments of solidarity and comfort to the victims of the Dayton and El Paso shootings and their families: “The First Lady and I join all Americans in praying and grieving for the victims, their families, and the survivors. We will stand by their side forever. We will never forget. These barbaric slaughters are an assault upon our communities, an attack upon our nation, and a crime against all of humanity. We are outraged and sickened by this monstrous evil — the cruelty, the hatred, the malice, the bloodshed, the terror. Our hearts are shattered for every family whose parents, children, husbands and wives were ripped from their arms and their lives. America weeps for the fallen. “We are a loving nation, and our children are entitled to grow up in a just, peaceful and loving society. Together, we lock arms to shoulder the grief. We ask God in heaven to ease the anguish of those who suffer, and we vow to act with urgent resolve.”   The salient difference between Trump and his three most recent predecessors was not that they gave “presidential” speeches after mass shootings, because Trump, too, gave a relatively dignified speech from the White House. The key difference, in the context of the Occupy Democrats meme, was in Trump’s comportment and behavior when he stepped away from the podium. We therefore rate the truth of this meme as “Mixture.”


Explanation: Obama claims Medicare benefits will not be cut under the health care bill

National, Health Care, Medicare, Barack Obama,

"I just want to assure [you] we're not talking about cutting Medicare benefits." Those were President Barack Obama's words to a town hall audience in Portsmouth, N.H; they were meant to ease fears that health care reform will slash Medicare benefits and deprive seniors of the treatments and procedures they need. A "myth that we've been hearing about is this notion that somehow we're going to be cutting your Medicare benefits," Obama said on Aug. 11, 2009. "We are not. AARP would not be endorsing a bill if it was undermining Medicare, okay? So I just want seniors to be clear about this, because if you look at the polling, it turns out seniors are the ones who are most worried about health care reform. And that's understandable, because they use a lot of care, they've got Medicare, and it's already hard for a lot of people even on Medicare because of the supplements and all the other costs out of pocket that they're still paying." "So I just want to assure we're not talking about cutting Medicare benefits," Obama said. Listening to Obama, you'd think that Medicare will remain intact. Yet, others claim Medicare spending will be trimmed quite a bit. AARP  has said  about $231.4 billion could come out of Medicare's budget, while the 60Plus Association, a group that opposes the bill,  says  cuts could top out at $500 billion. Confused? We were, too. There are three versions of health care reform floating around the House, and each dedicates hundreds of pages to Medicare. For this Truth-O-Meter item, we're going to be focusing on the biggest changes to the program. (So far, the Senate Finance Committee, which holds the purse strings to all things health care, hasn't put any ideas on paper.) Before delving into the bill and Obama's claim, a little Medicare 101: There are two basic ways most people get Medicare coverage. They enroll in traditional Medicare and a prescription drug plan through the government and maybe buy a supplemental policy to cover most out-of-pocket costs. Or they enroll in Medicare Advantage programs (they include drug plan), which are run by private insurers. They typically have more generous benefits such as dental and vision coverage. Some plans even pay the patient’s monthly Medicare premium, which can amount to about $100. We found some disagreement about whether Obama is correct that Medicare benefits would not be cut. The House bill will not cut any benefits, said Tricia Neuman, vice president and director of the Medicare Policy Project at the Kaiser Family Foundation. "What it will do is cut growth in Medicare spending," Neuman said. Indeed, some of the biggest savings in the bill — about $196 billion — would come from a permanent reduction in the annual payment adjustments for some Medicare services, including inpatient hospital services and ambulatory care, according to the Congressional Budget Office. That doesn't mean health care providers will stop being paid for taking care of the elderly; rather, they won't see pay increases in the future. Obama also wants to save money on the Medicare Advantage program, which covers about one-fifth of all Medicare patients. "We do think that systems like Medicare are very inefficient right now, but it has nothing to do at the moment with issues of benefits," Obama said in his speech in New Hampshire. "The inefficiencies all come from things like paying $177 billion to insurance companies in subsidies for something called Medicare Advantage that is not competitively bid, so insurance companies basically get a $177 billion of taxpayer money to provide services that Medicare already provides. And it's no better — it doesn't result in better health care for seniors. It is a giveaway of $177 billion." Indeed, a June 2009 MedPAC analysis said that the Advantage plan costs taxpayers on average of 14 percent more than the traditional Medicare plan. The House bills propose to change the benchmarks that set the payments, making them equal to what the government pays for traditional Medicare services. According to the Congressional Budget Office, those changes would translate to a savings of $156 billion over 10 years. We asked experts from both sides of the debate whether all these changes constituted a cut, and most had the same answer: yes and no. On one hand, they might not be considered cuts because nowhere in the bill are benefits actually eliminated, they said. And other parts of the bill expand coverage for seniors and ultimately make some components of Medicare less expensive for patients. For instance, the bill would require the pharmaceutical industry to help pay for prescription drugs. That savings will ultimately help the government cover more drug benefits for more patients. But experts told us the cuts in the Advantage program could lead to some changes. The basic benefits that mirror regular Medicare will stay the same, but the extra benefits that people receive under Advantage could be changed. "The core benefits of Medicare won't change," said Marc Steinberg, deputy director of health policy for Families USA, an advocate for health care consumers. "Most [Medicare Advantage] plans are solid and resemble traditional Medicare." However, some insurance plans have entered the program "to make a quick buck. They may have to reconsider their budget, which could mean some patients will see changes in the services provided above and beyond traditional Medicare." Stuart Guterman, assistant vice president for the Commonwealth Fund’s program on payment system reform, had a similar view. "People enrolled in (Medicare Advantage) get services that people in traditional care do not get under Medicare," he said. "Insurance companies can afford to cover these services because taxpayer money is subsidizing them. Plans will most likely not offer those extra services, but in no case will [patients] get less Medicare benefits than people in the rest of the program." Another example involving regular Medicare coverage: The House bill proposes a $20 billion cut in hospital readmission subsidies. This has to do with patients who re-enter the hospital to be retreated or have procedures fixed. Gail Wilensky, who ran the Medicare program under President George H.W. Bush in the early 1990s, said this is just one example of how cuts to Medicare payments could ultimately trickle down to patients. "Most of the ways to get money with any certainty is to have it happen quickly, which you do by either raising taxes or whacking prices," said Wilensky, now an economist and senior fellow with Project Hope, a health care advocacy group. "In this case they're whacking prices. ... Are these patients in jeopardy? You can't guarantee they're not." That leaves us with Obama's claim that, under the health care reform proposal, Medicare benefits will not be cut. He's right that the bill does not directly trim Medicare benefits; instead, the government is proposing ways to slow or eliminate some Medicare spending to beef up other aspects of the plan. But experts told us it's conceivable or even likely that those financial changes could lead to reduced benefits, particularly for people in the Advantage program. From that perspective, it's a stretch for Obama say that Medicare patients won't see changes in their plans as a result. We give Obama a .


Trio wins chemistry Nobel for work on antibody drugs, smart enzymes.

Explanation: Two Americans and a Briton won the 2018 Nobel Prize for Chemistry on Wednesday for harnessing the power of evolution to generate novel proteins used in everything from environmentally friendly detergents to cancer drugs.

The fruits of this work include the world’s top-selling prescription medicine — the antibody injection Humira sold by AbbVie for treating rheumatoid arthritis and other autoimmune diseases. Frances Arnold of the California Institute of Technology, George Smith from the University of Missouri and Gregory Winter of Britain’s MRC Laboratory of Molecular Biology were awarded the prize for pioneering science in enzymes and antibodies. Arnold, only the fifth woman to win a chemistry Nobel, was awarded half of the nine million Swedish crown ($1 million) prize while Smith and Winter shared the other half. “Some people breed cats and dogs. I breed molecules,” Arnold told Reuters after learning of the award, which she said had come as a complete surprise. The Royal Swedish Academy of Sciences said Arnold had transformed science by using the principles of evolution — genetic change and selection — and to evolve new types of proteins very fast. Arnold is the second woman to win a Nobel prize this year after Canada’s Donna Strickland shared the physics award on Tuesday. Her research on enzymes — proteins that catalyze chemical reactions — laid the bedrock for the development of better industrial chemicals and pharmaceuticals. “There are enzymes now in detergents that we use in our dishwasher and have been evolved by this process. There are also enzymes that can create new types of biofuels or that catalyze the formation of building blocks for new medicines,” said chairman of the Nobel chemistry committee Claes Gustafsson. “All this you can do with enzymes that Frances Arnold has developed.”  Smith developed a method using a virus that infects bacteria to produce new proteins while Winter used the same phage display technique to engineer the evolution of antibodies, with the aim of producing more effective medicines. Humira, or adalimumab, was the first drug based on Winter’s work to win regulatory approval in 2002. It has since gone on to become a blockbuster, with sales last year of $18 billion. “With this medicine, far fewer people with rheumatoid arthritis are forced to use a wheelchair,” said immunologist Dan Davies of the University of Manchester. Other antibody drugs at the cutting edge of medicine use the same technology, including a number of treatments that have proved highly effective against cancer. Winter said he was surprised by the huge commercial success of antibody drugs, which he put down in large part to the high prices that drug companies have managed to charge for them. “I had no idea they would be so commercially successful ... it was a complete paradigm shift,” he told reporters in a conference call. “Antibodies as a pharmaceutical product are still growing great guns.”  The prizes for achievements in science, literature and peace were created and funded in the will of Swedish dynamite inventor and businessman Alfred Nobel and have been awarded since 1901. For the first time in decades, the Nobel line-up did not feature a literature award after a rift within the Swedish Academy over a rape scandal involving the husband of a board member left it unable to select a winner. The science and peace prizes are selected by other bodies. Chemistry is the third of this year’s Nobel Prizes after the winners of the medicine and physics awards were announced earlier this week. (Nobel laureates graphic tmsnrt.rs/2y6ATVW)


UCB urges stronger warning on cough medicine.

Explanation: Belgian pharmaceutical group UCB SA  has proposed a stronger warning for its prescription cough  medicine Tussionex following reports that five young children  died, a company spokesman said on Friday.

Five deaths have been reported among children under 6 who  took the medicine since its approval in 1987, UCB spokesman  Eric Miller said. The drug, known as Tussionex Pennkinetic  Extended-Release Suspension, is approved only for adults and  children age six and older. The prescribing information for doctors specifically says  it should not be used in children younger than 6. Miller said  the company felt that information should be strengthened and  proposed new language to the U.S. Food and Drug Administration. “We recently proactively reached out to the FDA to update  the Tussionex label,” Miller said. The drug is “safe and effective when used as directed,” he  added. Tussionex is one of eight prescription cough medicines that  contain the narcotic pain reliever hydrocodone, Miller said. The Wall Street Journal reported on Friday that the FDA  planned to issue an alert about Tussionex after numerous  reports of adverse events including some deaths. The Journal  said the FDA had received reports of patients taking higher  doses or more frequent doses than recommended. FDA spokeswoman Susan Cruzan said the agency officials were  “aware of these safety concerns and are working to address  them.”    “We plan to communicate our recommendations to the public  as soon as possible,” she said.


Oregon Health Authority Says that in 2007, "Oregon ranked 25th -- or 7th from the bottom -- in percentage of children with untreated decay compared to 32 other states with similar data.

Explanation: Did Oregon rank No. 25 of 32 states in untreated decay in 2007?

Oregon, Children, Public Health, Oregon Health Authority,

Last week, PolitiFact Oregon heard an earful from fluoride opponents upset with our ruling on their claim that Multnomah County has the 15th lowest cavity rate in the country, as the county hovered at roughly the same percentage as the state of New York. We ruled the statement  because county data is not comparable to state data. Plus, we found that New York didn’t really rank 15th lowest because the cavity numbers posted on the website of the Centers for Disease Control and Prevention were from varying years and, consequently,  can’t be ranked. Accurate dental health statistics are critical because Portland residents will vote May 21, 2013, on whether to add fluoride to the city’s drinking water. For that fact check, we spoke with Shanie Mason, oral health program manager for the state agency that published the "Smile Survey" in 2002 and in 2007. Her office released a draft of the 2012 version last week at the request of The Oregonian. At the time, she cautioned against such comparisons and said, "We have only compared ourselves against neighboring states with a similar methodology." So imagine our surprise when we read this statement in the 2012 draft report: "In 2007, Oregon scored worse in every major measure of oral health for children compared to 2002. At that time, Oregon ranked 25th – or 7th from the bottom – in percentage of children with untreated decay compared to 32 other states with similar data." It’s accurate to say that Oregon measured worse in 2007 when compared to itself in 2002. However, the "ranked" numbers looked very much like the numbers erroneously relied on by anti-fluoride campaign Clean Water Portland -- which Mason cautioned against comparing -- when it made its claim about New York and Multnomah County. The CDC posts the percentage of third-graders with "untreated decay." But a spokeswoman for the CDC says the statistics are not meant to be "ranked" because they cover different time periods, with some as dated as 1999. The states have different response rates and vary in the percentage of children who qualify for free and reduced-price meals, she said. "There are many caveats in looking at these data across states," wrote Linda S. Orgain in yet another email to PolitiFact Oregon. "These issues make ranking the states on these children's indicators less meaningful and probably not accurate. We would not recommend doing that." We returned to the Oregon Health Authority for a response. Bruce Gutelius, who is presenting the 2012 survey, said in a reply email they wanted to provide context for Oregon’s numbers. He said they had other options -- for example, sticking with 2002 and 2007 Oregon figures, or measuring Oregon against a national figure from 1999-2004 -- but decided that a ranking "was the most meaningful to provide the needed context." We do not see how declaring Oregon No. 25 based on a list of percentages from other states and other years provides meaningful or accurate context. The percentage of third-graders in Oregon who showed evidence of untreated decay in 2006-07 was 35.4. Vermont was at 16.2 percent in 2002-03 and Arkansas was at 42.1 percent in 2001-02. The Smile Survey released last week contains numbers for children ages 6 to 9 -- so we’re talking largely kids in first, second and third grades. This is slightly different from the numbers reflected on the CDC website. In 2011-12, the percentage of children in this group who showed evidence of untreated tooth decay was 20 percent. In 2007 it was 36 percent. That’s a sizable decrease. This week, the Oregon Health Authority also shared statistics for 43 states, including numbers not yet posted to the CDC website. More than 21 percent of third-graders in Oregon and in Alabama have untreated decay for 2011-13. Oregon is in the middle of the pack if you look just at the percentages for the 43 states -- but again, we don’t know how some of the older numbers have shifted since then. We want the state to make recommendations on public health, even if controversial. The Oregon Health Authority has no official position on the city water measure, although public health officials there clearly favor fluoridating water. But we don’t think this was the most responsible way to put perspective on Oregon’s untreated decay percentages. The agency could have run in its 2007 report all the percentages for the 32 states, clearly citing the years and without designating a ranking. In its 2012 report, writers should have deleted the phrase: "Oregon ranked 25th – or 7th from the bottom." The statement is .


Alissa Keny-Guyer Says "in Oregon only 41 percent of adults have ever been tested" for HIV.

Explanation: Have only 41% of Oregon adults ever been tested for HIV?

Oregon, Public Health, Alissa Keny-Guyer,

The Oregon House recently took up a bill that would change the way in which health care providers get consent to test patients for HIV. Rep. Alissa Keny-Guyer, the House’s newest member, was one of the carriers of the legislation. She gave a moving floor speech, invoking the memory of her father who passed away from complications due to AIDS in the 1980s. "Much has changed in the past 24 years," she said. "Treatment has reduced transmission." Indeed, she noted, a study last year found that those who were being treated for HIV were 96 percent less likely to pass the infection on to their partners. "The problem is that too many people still go undiagnosed," Keny-Guyer said. Testing rates remain stagnant. But, she said, these new guidelines could boost the numbers of those getting tested in Oregon. "Nationally, 21 percent (of those with HIV) are undiagnosed," she told colleagues. "And in Oregon, only 41 percent of adults have ever been tested." We thought the second figure was a little surprising, especially given that the Centers for Disease Control recommends routine screening for all patients between the ages of 13 and 64 and annual screening (at least) for "high risk" individuals. According to the CDC website, high risk patients include "injection-drug users and their sex partners, persons who exchange sex for money or drugs, sex partners of HIV-infected persons, and MSM (men who have sex with men) or heterosexual persons who themselves or whose sex partners have had more than one sex partner since their most recent HIV test." Pregnant women are also encouraged to get screened as part of their routine prenatal tests. The CDC doesn’t keep track of testing rates, but its website does link to Kaiser State Health Facts, a huge database supported by the Kaiser Family Foundation. According to that website, the testing figures for Oregon are slightly lower than what Keny-Guyer reported. Less than 37 percent of Oregonians between the ages of 18 and 64 have been tested for HIV. The national average is 40 percent. If you’re talking in the last year, the figures are even lower -- 18 percent in Oregon, 21.5 percent nationwide. The numbers were off slightly from what Keny-Guyer reported on the House floor, so we talked to an aide in her office to see if there was another source we weren’t considering. The aide told us that the representative used numbers from the previous year (2009 rather than 2010) and forwarded us the latest statistics -- the ones we’d already found. We wanted to do our due diligence, so we called up two additional organizations. Michael Kaplan, the executive director of Cascade AIDS project, said Kaiser’s site was the best he could come up with. "I couldn’t give you a better statistic than they have there," he said. Karynn Fish, a spokeswoman for the Oregon Health Authority, told us the same thing. Anything the state had, she said, would be older and less accurate. With that, we turn to our ruling. While speaking about a bill that seeks to raise the rate of HIV testing in Oregon, Keny-Guyer told colleagues that "only 41 percent of adults have ever been tested." The most recent statewide number is actually a bit lower -- 37 percent. But Keny-Guyer used a correct statistic, it was just a year old. We don't consider that significant enough to downgrade our ruling.


Receiving a clot-buster drug before reaching the hospital may reduce stroke disability

Explanation: Mobile stroke unit, University of Tennessee College of Medicine Photo: Business Wire Clot busting drugs are an established part of the tool kit in reducing damage related to strokes. Understanding exactly when to administer them is key to making sure they are used in the most effective way possible. This release describes a study of one mobile stroke unit’s experience administering clot-busting drugs — or tissue plasminogen activator (tPA). These study findings have not been peer reviewed for publication in a journal and appear to have major caveats around them. We won’t know all the details until the full study is published, and so we were pleased to see some caution expressed in the news release. A few more additions, like cost information and a better explanation of the benefits, would have helped make this release even better. [Editor’s note: A reference to clot-busting drugs “saving lives” was removed from the review. As noted in the comments section, the scope of benefits offered by tPA is controversial and the American Heart Association withdrew “life-saving” claims about tPA as discussed in these BMJ and Mother Jones stories.] The recent deployment of a handful of mobile stroke units across the country staffed with specialists and CT scanners makes this a timely release, particularly amidst the backdrop of unsustainable health care costs. The cost of outfitting all US cities with these types of units would be very great, and most of the new mobile units have been funded by private donors. Mobile stroke units could be most useful in remote areas where there is a long transport time from the scene to a hospital that could give thrombolytic therapy, but those areas are the least likely to have enough volume of patients to sustain the expertise of the mobile stroke unit’s staff.

American Stroke Association,clot buster drugs,mobile stroke units

The release briefly mentions the issue of costs with this statement: “Its better outcomes could offset the increased costs of a mobile stroke unit.” We thought the release would have been better if it had noted the nominal cost of clot busting drugs as well as the cost of a CT scanner and additional personnel essential to mobile stroke units, which would be considerable. The release does describe the benefits using numbers, but it does so in such a way that readers could be misled. The entire study only included 658 stroke patients. Half received a clot-busting drug at the hospital and half received it in the ambulance. And yet when presenting the benefits, the release presents them as a rate, saying that “three months after stroke, 182 out of every 1,000 patients treated before arriving at hospital were less disabled, including 58 patients who had zero disability, compared to people who received treatment after reaching the hospital.” How a rate like this based on just 329 patients (half of the total cohort) was derived is never explained, and the description makes it sound like there were thousands of patients in the study. The release does raise risks in a meaningful way. It says: “But tPA is not indicated and could hurt a patient’s chances if they are having a hemorrhagic stroke, in which a blood vessel ruptures. That is why patients need a CT scan to confirm the type of stroke before receiving tPA.” However, that statement could have gone further and noted that some patients with a negative CT scan may have a hemorrhage after getting tPA. The news release does a reasonable job explaining the basics of the study, though this description falls below some earlier language that has the potential to mislead. It says: Researchers analyzed results from 658 stroke patients who were treated with tPA — a drug that dissolves blood clots. About half of the participants received the clot-busting drug at the hospital, and half received it while still in the ambulance. It also notes that the findings were “presented at the American Stroke Association’s International Stroke Conference 2017.” What’s missing from this is the fact that the findings likely only received limited peer review, since they were not published in a journal. Very low in the release — but at least it was included — it says that the findings did not quite achieve statistical significance. At least that’s how we’re interpreting it. The statement itself is a bit vague, saying, “The findings bordered on statistical significance, suggesting that future clinical trials with a greater number of patients are needed to show similar benefits.” The lack of statistical significance, even with caveats, merits a Not Satisfactory for evidence. Moreover, the release doesn’t tell us why in this apparent re-analysis of the results, only about two-thirds of the patients from the original study were included. There is no disease mongering in the release. The release explains the funding source and points to the abstract, which notes that one of the authors received a modest grant from a pharmaceutical company for a clinical trial for a clot-busting drug. The release does an OK job discussing how the approach being studied compares with the standard of care. It says: “Every second counts, in the current standard of care, patients who experience stroke-like symptoms and call 9-1-1 arriving to the hospital by ambulance are assessed by clinical examination and imaging (CT or MRI scan) in the Emergency Department. This takes a certain amount of time from the patient’s symptom onset which prompted the 9-1-1 call.” Availability is not addressed beyond UCLA’s Mobile Stroke Rescue Program, which collected the data for the study. It would have been good to mention that specialist-staffed mobile stroke units have been popping up in different parts of the country over the last 3-4 years. They are mainly affiliated with larger medical centers and funded by private donations. The release does not adequately establish the novelty of the study or the findings. It does briefly allude to previous research: “Past research showed the sooner that a clot-busting tPA drug is given after an ischemic stroke – one in which a clot is blocking blood flow – the better patients fare.” There have been around a dozen trials on mobile stroke units in recent years, appearing primarily in neurology journals. Some examples: The language is generally cautious enough in the release. The errors are mostly of omission.


Utah home-birth rate is double the US average, report says.

Explanation: Utah women are choosing home birth at a rate double the national average, and mothers who do so tend to be older and have more education than women who decide to give birth in hospitals, according to a state health department report released this month.

Health, Salt Lake City, Utah, Birth rates

Planned home births made up 2.12 percent of all births in Utah in 2013, according to the report from the Utah Department of Health. The U.S. national rate is less than 1 percent. Utah has one of the highest overall birth rates in the country, influenced by a Mormon culture that tends toward larger families. Women who had a planned home birth in Utah were more likely to be 35 or older, have education beyond high school, be married and have other children, study author Shaheen Hossain, the health department’s data resources program manager, said Tuesday. Interest in home birth has been growing since the 1970s, but has picked up in recent years with movies like “The Business of Being Born” and people posting about home birth on Facebook and Instagram, said Salt Lake City midwife Eve German. German is a licensed midwife who carries a birthing room full of high-tech medical equipment in duffel bags in her car and quickly transfers women to a hospital if something goes awry. “There are plans and protocols and training and mechanisms to keep people safe without having to count on things going well and being normal,” she said. Still, she says home birth is not typically a good option for women with more complicated or higher risk pregnancies, like twins or babies in a breach position. “Midwives are specialists in low-risk births,” German said. Salt Lake City mother Summer Curry, 36, says she had a home birth because she wanted to have her baby without pain medication or medical interventions. Curry had her second daughter in an inflatable birthing tub on Saturday. She said she liked not having to rush to the hospital, and gave birth while her 4-year-old daughter played with her grandmother in the living room. “It was just seamless, and I was comfortable,” she said. The report found that in low-risk pregnancies, the health of babies born at home compared generally well to babies born in hospitals, Hossain said, though home-birth babies tended to score somewhat lower on health exams given five minutes after birth, she said. Exactly what that means in the long run, though, is unclear, and points to the need for more study, especially given the relatively high rate of home births in Utah, Hossain said. Women who labored at home were less likely to have medical procedures like medicine to jump-start labor or epidurals, though they also tended to have more prolonged labor and water that broke before active labor began. The report based on birth-certificate data analyzed from 205,486 births among Utah mothers between 2010 and 2013, of which 3,701 were home births. It did not look at birthing centers or babies accidently born at home.


California rejects unique intersex surgery ban for some kids.

Explanation: California lawmakers have rejected what would have been a first-of-its-kind ban on medically unnecessary treatment for infants born with ambiguous or conflicting genitalia.

U.S. News, San Francisco, Scott Wiener, Health, General News, Gender identity, California, Bills

The measure would have banned all procedures on intersex children 6 and under unless the Medical Board of California deemed them medically necessary. State Sen. Scott Wiener, a Democrat from San Francisco who wrote the measure, called it a civil rights issue and said the bill would “ensure that people who are born intersex are able to make their own choices about their health and their gender identity instead of having other people make those irreversible surgical choices for them.” But a majority of state lawmakers on a key legislative committee thought the bill’s definition of “intersex” was too broad, especially after hearing testimony from a pediatric urologist who said it would limit doctors’ ability to treat patients with complex medical issues. Three Democrats and one Republican on the Senate Business, Professions and Economic Development Committee voted to reject the bill after a lengthy public hearing that included testimony from people born with intersex traits — some who supported the bill and others who did not. State Sen. Jerry Hill, a Democrat from San Mateo, said he had an issue with limiting the surgeries until a child was 6. “I look at my granddaughter who is 5, almost 6 — I don’t know if that’s something that she could make that decision on,” he said. Wiener repeatedly told lawmakers that parents would still have the final decision, but he believed delaying the procedures until a child could talk would help parents make it. He said the vote likely means the proposal will not become law this year but vowed to keep trying to pass it in the future. “These are kids who are told from a young age that there is something wrong with them,” Wiener said. “There is nothing wrong with them, there is nothing to be fixed about them, and they deserve the basic human dignity of being able to make decisions about their own bodies.” Intersex people are born with genitalia, chromosomes or reproductive organs that don’t fit typical definitions for males or females. Examples include people born with both ovaries and male genitals or incompletely formed genitals that can be ambiguous. Between 1% and 2% of the population are born with intersex traits, Wiener said. Bria Brown-King was born with congenital adrenal hyperplasia, a condition that naturally produces higher levels of testosterone and leads to “secondary male characteristics.” Brown-King said they had surgery when they were 13 after a doctor told them it would make their genitals “appear more normal.” “I don’t know why he assumed to know about how I would or would not want to use my vagina,” Brown-King told lawmakers. Hillary Copp, a pediatric urologist at the University of California, San Francisco, said she opposed the bill because it would remove “all flexibility for trained medical professionals and their loved ones to do what is in the best interest of the patient.” She said many times doctors will advise parents not to operate, noting “we’re not trying to perform sex assignment surgery.” “In fact, we don’t even assign genders. We talk about the baby,” she said. “This is such a complex issue. Of course we want to get it right.” The measure was opposed by several medical groups, including the California Medical Association, which represents doctors. Records show the group donated $50,000 last week to a committee working to reelect Sen. Steve Glazer, a Democrat and chairman of the panel that rejected the bill. The committee that received the donation has no official ties to Glazer’s campaign. Glazer, through a spokesman, declined to comment on the donation. He voiced his concerns about the bill during the committee hearing but did not cast a vote. ___ This story has been corrected to show a quote attributed to state Sen. Bill Dodd should have been attributed to Sen. Jerry Hill.