Viewpoints, The Houston Chronicle
802 Texas Ave.
Houston, Texas 77002
Dear Editor,
Please explain the title, "$628 million women’s health project to help break gender gap," which appeared in the May 12th issue over Jane E. Brody’s byline. From that headline one would think either that women needed some extra help to catch up to the health status of men, or that more effort had been made to study male health problems than women’s health problems. Neither of those ideas are true.
One index of the health of any segment of a population is its average life span. The health of the populations of different countries are often compared based on the average life span of the residents of the countries. Health care professionals often use low survival rates or shorter life spans as an indication that more research is needed for a particular health problem or more health services are needed by a particular segment of the population. The average life span for women is currently four to seven years longer than that of men, depending on ethnic status. At the turn of the century that difference was only one year. The increasing difference in average life span had to be disregarded when special allocations were requested and made for a Women's Health Initiative. Men die sooner, and the usual logic of public health programs would suggest that spending more money to try to improve the health of a segment of the population which is better off already, is immoral, if not a waste of funds.
The decision to spend more money to improve the health of women who are already surviving seven years longer than men was made due to articles such as Jane Brody’s which claimed that the opposite was true. As a specific example of the distortion of the facts related to the relative health status of men versus women, is the widely published notion that women's health has been under studied by those government agencies charged with preserving the health of all U.S. citizens, the National Institutes of Health. Actually the ratio of spending for gender relevant studies ( about 15% of the total budget for NIH research) is 2 to 1 in favor of women. Of the total budget 10 % is spent on women's health and 5% (or half as much) is spent on men's health (from a report of the NIH Office on Women's Health).
So the group that lives longer, women, is studied more. This ratio of spending twice as much on studies of women's health is also reflected in the number of articles published. The Index Medicus, which is an almost universal collection of medical publications shows that 23 articles on women's health topics are published for every one on men's health issues. The government policy and social concept of the disposable male is clearly embodied in these facts as distorted in articles and legislation funding health care research.
Certainly The Chronicle can’t be blamed for reprinting an article from the prestigious New York Times. And the Times relied on opinions of women such as Bernadine Healy who advocate for their own gender, to the detriment of funding for needed studies on men’s relatively shortened life span. But I would suggest more skepticism in the future about opinions and statements from advocates trying to shape funding policy for their own benefit. It was only two days before that you reprinted the story exposing Lenore J. Weitzman’s twenty year old exaggerated claims about how divorce was so financially negative for women. That study helped get numerous laws passed to shift money from husbands to wives in divorce cases. It was a lie. So is the Healy claim that women’s health studies have been slighted by the National Institutes of Health. May I suggest that you use the resources of Houston’s universities and libraries to verify any advocate’s claims of victimhood for her or his group before reprinting them?
Sincerely, Jerry W. Lester, Ph.D.
As a result of these experiments, welfare rolls are down in this country -- there are 1.3 million fewer welfare recipients today than when the President took office. And child support collections are up, up 40 percent to a record $11 billion, tracking down deadbeat dads, making sure that kids get the support they're entitled to receive. But, most importantly, there are 10 million welfare recipients, which is 75 percent of the total welfare caseload, that are participating in these experiments at the local level in 38 states as a result of the 61 waivers that the President has approved.
The most significant thing today is the fact that there was no news in this speech. Mr. Dole tried one idea without first checking to see what the President's record was. In fact, drug testing is something that not only has the President authorized through the waivers that he signed, but is, in fact, specifically authorized in the President's version of welfare reform that we submitted to Congress this year. Before he reads his speeches, he ought to read the President's bill and study the President's record with respect to welfare reform.
I've asked Bruce Reed who you know is the White House expert on welfare reform, Assistant to the President for Policy Planning, to walk through the five specific waivers that we've signed that allow drug testing at the state level, and also to take any questions that you've got on what we're doing on welfare reform.
Q Before you do that, on the substance, though, Senator Dole was pretty tough stylistically on the President. He went after him in a very personal and political way. What --MR. MCCURRY: He is out on the campaign trail, advocating his own election, incurring expenses that the Dole campaign will have to pay for and they are going to run out of money since they've only got $170,000 plus left. But you should contact Joe Lockhart over at our campaign and they'll respond.
Q What about the personal attacks on the President? He said that Bill Clinton doesn't have to give speeches anymore and can raise his hand and say "me, too," whenever Bob Dole does something.MR. MCCURRY: Bereft of any new ideas Senator Dole resorts to personal attacks. Because there is no new substance in anything he said on welfare reform today, so he resorts to personal attacks. That's all he's left with since he clearly didn't study the President's record on this subject, nor is he familiar with the bill that we have submitted to Congress.
Q Mike, just one more thing before you go. The President read -- I mean, Dole read a list of states the President -- where waivers are still pending, challenging the President to go ahead and grant those waivers while he said that wouldn't be enough, he said it would be something. Is the President prepared to do that?MR. MCCURRY: We're prepared to work with individual states to authorize the kind of welfare experiments that will be tough, have tough work requirements associated with them, make sure that welfare dependents move from welfare to work situations, but in doing so, making sure that we take care of kids because we have to protect kids who are going to be caught up in these experiments. And what we look for in each of these, as we did with the Wisconsin plan, is what are the work requirements, what are the guarantees for child care, for health care, what kind of commitment is the state going to make to make good on the promises that they develop as part of their package.
Q So that's a maybe?MR. MCCURRY: No. Look, the record on our approval of waivers is clear. We've approved three times as many waivers for welfare reform experiments as President Bush and Reagan did combined. And we've signed 61 waivers in 38 states. I suspect that by mid-summer we're going to be up to 40 states -- fair to say. You might want to ask Bruce a little bit more about it.
Q One final thing on that same chain, Mike. Now that the President has praised the Wisconsin plan, can you guarantee that he will, in fact, grant the waiver requested by Wisconsin?MR. MCCURRY: I took that question earlier today and I said based on -- we've only gotten about half of the Wisconsin waiver requests submitted so far, but we don't see any problem with them and can't imagine that there would be any problem approving them. They're going to go through some of the fine points and finalize some of the legal and technical details. But we're in the process of doing it; we're in a 30-day period now and HHS is moving expeditiously on the waiver request.
Q Can you respond to Dole's criticism that some waivers have been sitting around for 210 days and the fact that the waivers have not been given promptly?MR. MCCURRY: We've got the best expert in the White House for that right here.
MR. REED: Well, as Mike said, we've granted 61 waivers, 38 states, and a number of other waivers are in the pipeline. We'll get more done in the weeks and months to come.Waivers are sometimes withdrawn by states, sometimes there's a change of leadership in the state; there are lots of reasons why they sometimes take longer. Often they're -- waivers request things that cannot be waived, and we can only grant waivers as far as our legal authority goes.
So, in general, I think even Governor Thompson has gone out of his way on a number of occasions to point out that this President has gone further than any previous President to get waivers done for states. And, obviously, we support national legislation so we can go even further.
Q On the Wisconsin waiver, am I mistaken or wasn't Wisconsin's waiver, the one that the President spoke about Saturday, speeded up very fast from the normal process?MR. REED: Well, on Saturday the President praised the Wisconsin plan. We've only received half the waiver request and we received it about 10 days ago. The law requires a 30-day public comment period before we can actually grant the waiver.But the President has granted three waivers to Wisconsin even prior to this one, and he has been following the Wisconsin plan with great interest for some time. The reason the Wisconsin plan came about in the first place is that Democrats in the state legislature proposed that the state of Wisconsin follow the President's lead in calling for an end to welfare. Governor Thompson agreed to take them up on that. And in 1994 the state legislature voted to end welfare by a date certain and then spend the next legislative session coming up with a plan to carry that out, which passed and was signed into law in April.
So this is -- and as the President said on Saturday, it's one of the most revolutionary plans ever put forward by a state. So it is a -- it's very consistent with what the President has always supported. And it's worth noting that the Wisconsin plan does two things that the President has always advocated that the Republican congressional welfare reform bill failed to do, which is that it guarantees child care and it guarantees health care to welfare recipients.
Q The Senator challenged the President to sign the California and Florida waivers today. What's the story with California and Florida?MR. REED: Well, we've already given a number of waivers to California and Florida. So I don't want to comment on the particular ones outstanding because I think --Q You just did on Wisconsin. Why aren't you going to comment on the others?MR. REED: Well, I just don't have them all in front of me. There are several -- a number of waivers pending from a variety of states. But, as I said, we've gotten more done faster than any President in history, and we'll continue to do so.Q But this confusion over which waivers are up seems to underscore the point that Senator Dole was making and that is that it would probably would be better if you could not do this piecemeal and didn't have to have the federal government granting special dispensations to each state, but enacted some kind of a --MR. REED: Absolutely. And the President has been fighting throughout this administration to pass a national welfare reform bill that requires work, imposes time limits, includes tough child support measures, and gives states the kind of flexibility so they don't need -- so that they can make these choices on their own.Q Bruce, hello. The President didn't -- when did the President first put a bill in the hopper that he stood by on welfare reform?MR. REED: The President introduced a bill in June of 1994. He held a welfare summit at the White House in January of '95.Q And that bill now -- he's still for that bill, or he's for something else now?MR. REED: He helped -- he threatened to veto the House welfare reform bill and, in response to that, descended back down and produced a bill that was more acceptable from our standpoint. But in conference, the House prevailed.Q What about the welfare -- the work first and personal responsibility act of 1996? Now, that's not the same as what he offered in 1994 now, is it?MR. REED: No, it's a bill that is -- the President's principles on this issue have not changed. He's always been for time limits; he's always been for work requirements; he's always been for tough child support enforcement; he's always been for requiring minor mothers to live at home. The bills in the current Congress would achieve more savings than our initial bill, which was revenue-neutral, which is in part because we're working hard to come up with a seven-year balanced budget plan.But the Wisconsin plan, as I said earlier, is much closer to the President's initial pledge to end welfare as we know it than the Republican conference report that the President vetoed.
Q But it's not quite like any of the welfare bills he's offered, is it?MR. REED: Well, it's actually -- in general, it's quite similar -- it requires work, it invests in child care and health care, it has a five-year lifetime limit. So in that respect -- and I think we have a table that we can pass out that shows exactly why the Wisconsin plan is closer to the President's plan than it is to the Republican conference report that the President vetoed.Q This is a kind of technical thing. The Senator had another idea, which was instead of getting cash he would give vouchers for things that mothers need -- diapers, et cetera. Now, it's kind of specific, but what does the White House -- or is this contained in any of the waivers that you've had and what is the White House position on something like that? In other words, keeping cash from being used for drugs.MR. REED: Well, we've been very supportive of the notion of states being able to provide in-kind assistance as an alternative to cash for people who hit the time limit or families with additional children born on welfare. Vouchers are often used -- are often proposed as a way to do that. The administration has also fought hard to take welfare benefits out of the equation for drug addicts. The administration supported and the President signed changes to the -- what's called the DA&A Program -- Drug Assistance and Alcoholism Program, which until our changes were signed into law allowed drug addiction to be considered a disability and qualified people for SSI benefits. We've changed that. It will move tens of thousands of drug addicts off the rolls.While I'm at it, if I could just walk you through -- since Senator Dole made it a point to highlight the issue of drug testing, this is something that, with help from the Clinton administration, a number of states are already doing. We've granted five waivers to states to do drug testing and drug treatment -- most recently in South Carolina. We also have a tough program in place in Texas. And you can look through -- we have plans in Ohio, Oregon and Connecticut as well.
And the other important point to note is that what Senator Dole proposed today, that states should be able to do this, is already allowed under the President's bill. So that's not a new idea at all. The President's bill allows states to require recipients to sign personal responsibility contracts. States can make drug abstinence one of the conditions if they choose to. So there's nothing new.
Senator Dole had kind words to say about other proposals that the President has put forward, including he made a -- he spoke favorably of the tougher child support enforcement and mentioned a number of proposals that the administration put forward in 1994 which, under pressure from the administration, the Republican Congress agreed to in 1995, and both Houses of Congress have included in all the welfare reform bills that have been taken up in this Congress.
Q You mentioned a statistic earlier that the President has approved more waivers than Reagan and Bush put together. I'm assuming the President obviously would not accept waivers unless requested and that's a fairly new phenomenon. What other statistics for the Bush and Reagan administrations? And are you asserting that they turned down waivers that were requested?MR. REED: I don't have the batting average on every administration. But I can tell you this, that "the quiet revolution", as The New York Times called it, that is going on in the states right now is in large measure due to the fact that the President, as a candidate, called for an end to welfare as we know it. It's no coincidence that we've seen a tremendous surge in the number of welfare reform initiatives in the states.Every state is -- virtually every state is taking the President up on his call, and that is why we've been flooded with waiver requests. That's why there's been a tremendous amount of interest, though, unfortunately, little action at the congressional level to do national welfare reform. And it's also important to note that even though we've heard a lot of talk about welfare reform from a lot of previous Republican administrations, that there was no major reform proposed by the Bush administration, not nearly the kind of activity in terms of waivers for child support enforcement as we've had in this administration.
As Mike said, welfare rolls are down 1.3 million since we took office. Food stamp rolls are down by 1 million. Child support enforcement is up 40 percent and the President has taken repeated actions, which Mike mentioned -- executive order to require all federal employees to pay their child support, executive action to require all minor mothers to stay in school as a condition of benefits, regulatory change so that no longer will food stamp benefits go up when a recipient is sanctioned for refusing to work; and then, of course, the 38 states and 61 waivers.
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