Monthly Archives: July 2017

Trump’s Troubled Mental State

Psychiatrists warn of president’s alarming behavior

Association sacks Goldwater Gag Rule preventing analysis of POTUS

by SHARON BEGLEY @sxbegle

A leading psychiatry group has told its members they should not feel bound by a longstanding rule against commenting publicly on the mental state of public figures — even the president.

The statement, an email this month from the executive committee of the American Psychoanalytic Association to its 3,500 members, represents the first significant crack in the profession’s decades-old united front aimed at preventing experts from discussing the psychiatric aspects of politicians’ behavior. It will likely make many of its members feel more comfortable speaking openly about President Trump’s mental health.

The impetus for the email was “belief in the value of psychoanalytic knowledge in explaining human behavior,” said psychoanalytic association past president Dr. Prudence Gourguechon, a psychiatrist in Chicago. “We don’t want to prohibit our members from using their knowledge responsibly.”

That responsibility is especially great today, she told STAT, “since Trump’s behavior is so different from anything we’ve seen before” in a commander in chief.

An increasing number of psychologists and psychiatrists have denounced the restriction as a “gag rule” and flouted it, with some arguing they have a “duty to warn” the public about what they see as Trump’s narcissism, impulsivity, poor attention span, paranoia, and other traits that, they believe, impair his ability to lead.

Reporters, pundits, and government officials “have been stumbling around trying to explain Trump’s unusual behavior,” from his seemingly compulsive tweeting to his grandiosity, said Dr. Leonard Glass, a psychiatrist at Harvard Medical School. The rule against psychiatrists offering their analysis of the emotions, thought patterns, and beliefs underlying such behaviors, Glass said, robs the public “of our professional judgment and prevents us from communicating our understanding” of the president’s mental state.

Last week, in an essay in Psychiatric Times, Glass called the prohibition on such communication “an unacceptable infringement on my right and duty” to discuss issues “where the perspective of psychiatrists could be very relevant and enlightening.” He ended the essay by announcing his resignation from the American Psychiatric Association, which adopted the rule in 1973. He had been a member for 41 years.

Called the “Goldwater rule,” the prohibition on offering opinions about the mental state of public figures was adopted after some psychiatrists answered a 1964 survey on whether Sen. Barry Goldwater, the Republican presidential candidate that year, was mentally fit for the Oval Office. The rule states that it is unethical to offer a professional opinion about a public figure’s mental health, including the presence or absence of a disorder, without that person’s consent and without doing a standard examination. In March, the psychiatric association reaffirmed the rule.

The group acted despite growing criticism that the Goldwater rule is outdated and even unethical for preventing psychiatrists from pointing out behaviors that raise questions about a government official’s mental state. No other medical specialty has such a rule; cardiologists are not prohibited from offering their views of an official’s fainting spell, for instance, as long as they make clear that they have not examined the person.

Although opposition to the Goldwater rule has existed for years, it intensified with Trump’s candidacy and then election. In October, a book titled “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President” will be published.

“When the book comes out, there will be renewed furor about the Goldwater rule, since it is precisely about what is wrong with him,” said psychiatrist Dr. Lance Dodes, a retired professor at Harvard Medical School who is now in private practice in Los Angeles.

A number of psychologists have spoken to reporters about what Trump’s statements and actions might reveal about his emotional and cognitive state. Although the American Psychological Association “prefers” that its members not offer opinions on the psychology of someone they have not examined, it does not have a Goldwater rule and is not considering implementing one, an official told STAT.

The psychoanalytic association went further. In its July 6 email, it explicitly stated for the first time that the organization does not subscribe to the rule. That position had been implicit for years, but the association’s “leadership has been extremely reluctant to make a statement and publicly challenge the American Psychiatric Association,” said one psychoanalytic association member who asked not to be publicly identified criticizing the other group.

One stated rationale for the Goldwater rule is that psychiatrists need to examine patients in order to properly evaluate them. In fact, for decades the State Department and other federal agencies have asked psychiatrists to offer their views on the psychological state of foreign leaders, Glass pointed out, evidence that government officials believe it is possible to make informed inferences about mental states based on public behavior and speech.

“In the case of Donald Trump, there is an extraordinary abundance of speech and behavior on which one could form a judgment,” Glass said. “It’s not definitive, it’s an informed hypothesis, and one we should be able to offer rather than the stunning silence demanded by the Goldwater rule.”

The Goldwater rule has long been odd in that violating it carries no penalties. In principle the psychiatric association could file a complaint with a member’s state medical board. That has apparently never happened. Nor has the association ejected a member for violating the Goldwater rule. That is something it, as a private association, would be legally permitted to do.

A state agency, however, is subject to the U.S. Constitution, civil liberties experts say, and penalizing psychiatrists for speaking out would likely be a violation of their First Amendment rights. §

Sharon Begley, senior science writer, covers genetics, cancer, neuroscience, and other fields of basic biomedical research. This article is posted with the permission of STAT, where it originally appeared.

Winning at all costs

Americans of all stripes applaud nefarious political acts

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When offered intelligence from a foreign government, Donald Trump Jr. said ‘I love it.’
AP Photo/Carolyn Kaster

 

by Daniel M. Shea, Colby College

To many, the revelation that Donald Trump Jr. was anxious to get dirt on Hillary Clinton from the Russians will not come as a surprise. It is but the latest example of the take-no-prisoners, anything-goes politics of our day. Sure, soliciting help from a hostile foreign power is exceptional, and it is certainly true that the Trumps have taken “unconventional” politics to new heights. But how we do politics in the United States, the boundaries of acceptable behavior, has been shifting for two decades.

The real surprise – the part of the story that we should be gravely concerned about – is that this disclosure will not matter to a great many American voters. After thinking and writing about politics for two decades, I have come to the conclusion that the real issue we face is not the conduct of public officials or their surrogates, but how nefarious acts are now sanctioned, and even applauded, by so many on both sides of the partisan fence.

So what’s changed in our politics?

Fear and loathing

For one, the nature of partisanship is different. Until about a decade ago, one’s attachment to a party was centered around policy disputes or cues from groups and associations. But today’s version is grounded in the fear and loathing of the other side. Trunkloads of data, much of it from the Pew Research Center, suggest each side sees the other party as crazy and certainly dangerous. So it does not matter what your side does so long as it keeps the nut jobs on the other side at bay.

A new volume by political scientists Christopher Achen and Larry Bartels further helps to fine-tune our understanding how people vote and which party they identify with. Their book, “Democracy for Realists: Why Elections Do Not Produce Responsive Government,” suggests “issue congruence [between voters and parties], in so far as it exists, is mostly a byproduct of other connections, most of them lacking policy content.” In other words, we don’t think through issues, policies and candidate characteristics, but instead see elections as “us versus them.” These scholars argue voters tie themselves with racial, ethnic, occupational, religious, recreational and other groups, with partisanship as the byproduct. Our group identity, not policy concerns or ideology, determines vote choice. That is to say, we gather comfortably with our tribe and tune out other points of view.

A central force propelling hostility toward the “other” party is the partisan media. Many such outlets have figured out a sustainable business model. Smaller audiences can be profitable, so long as they remain loyal. Loyalty springs from “crisis” and, of course, “menace.” This leads to treating every issue as a true threat to our existence or a usurpation of fundamental “rights.” The other party is always the villain, and your side can do no wrong – so long as it is for the grand struggle.

And then there is the online world. Voters rarely explore new ideas and perspectives, but share, like and retweet concordant ones. We fence in and we fence out. As recently noted by journalist and author Megan McArdle, “Social media, of course, makes this problem worse. Even if we are not deliberately blocking people who disagree with us, Facebook curates our feeds so that we get more of the stuff we ‘like.’ What do we ‘like’? People and posts that agree with us.”

Sorting and filtering

Is the filtering of information really a new development? It is not at all clear that voters have ever absorbed a broad range of information or shifted though competing evidence. It is likely party bosses, elected officials, candidates and even media elites have always been able to manipulate mass opinion to a degree. Cognitive time-saving cues, especially party identification, have always been used to sort and filter.

But something very different is happening today. In the recent past, news was more widely viewed as objective, leading to a high degree of accepted facts and authority. When the news media unraveled the story of Watergate, for example, citizens of all partisan stripes accepted it as fact. What scholars dubbed “short-term influences” could override partisan leanings.

Which leads us to “alternative facts,” the aggressive spinning of policies and arguments regardless of contrary verifiable information. This may be a game-changer in our politics. The barrier for evidence has, it seems, evaporated, and emotion-rich information is used to draw more viewers, readers and listeners. If we add the continual drive for fresh “news” and the high costs of creating traditional journalism, we are left with little consensus or authority. New York Times blogger Farhad Manjoo put it this way: “We are roiled by preconceptions and biases, and we usually do what feels easiest – we gorge on information that confirms our ideas, and we shun what does not.”

Finally, popular culture has also probably contributed to our growing indifference to nefarious acts. We pick our reality show contestant and applaud every backhanded, despicable move that gets him across the finish line. There can’t be two winners or a collective good, only a sole survivor. Or shall we say that only one apprentice can get the job? And the best part of the show – the segment that really gets the producers juiced – is when things get truly ugly.

Democratic accountability

The latest Trump team revelation is a shocker, but even more stunning is the meager impact it will likely have on his supporters. As noted in a recent USA Today story, in Trump country the Russia disclosure is no big deal.

As voters, citizens are called to judge those in power. But there must be an objective standard for the assessment, which is why the framers of the Constitution put so much stock in a free press. The governed in a democracy must be willing and able to fairly judge the acts of the governors. But today “your side” has always done a good job and the “other” party has always failed. Any contrary revelation can be explained away as fake news.

The ConversationThe key ingredient in the democratic accountability process – objectivity – is disappearing, and the foundation of our limited government has been shaken. In Federalist #51 and elsewhere, James Madison wrote, “A dependence upon the people is, no doubt, the primary control on the government…” Many are starting to wonder if Americans are up to the job – and whether the fate of the grand experiment is at risk.

Daniel M. Shea, Professor of Government, Colby College. This article was originally published on The Conversation.

The GOP’s moral rot is the problem, not Trump & Co.

VIEW FROM THE RIGHT

by Jennifer Rubin

WASHINGTON – The key insight from a week of gobsmacking revelations is not that the Russia scandal may finally have an underlying crime but that, as The New York Times’ David Brooks suggests, “over the past few generations the Trump family built an enveloping culture that is beyond good and evil.” (Remember when the media collectively oohed and ahhed that, “Say what you will about Donald Trump, but his kids are great!” Add that to the heap of inane media narratives that helped normalize Trump to the voters.)

We now see that, sure enough, the Trump legal team (the fastest-growing segment of the economy) has trouble restraining its clients, explaining away initial, false explanations and preventing self-incriminating statements. (The biggest trouble, of course, is that the president lied that this is all “fake news” and arguably committed obstruction of justice to hide his campaign team’s misdeeds.)

We have always had in our political culture narcissists, ideologues and flimflammers, but it took the 21st-century GOP to put one in the White House.

Let me suggest the real problem is not the Trump family, but the GOP.

To paraphrase Brooks, “It takes generations to hammer ethical considerations out of a [party’s] mind and to replace them entirely with the ruthless logic of winning and losing.” Again, to borrow from Brooks, beyond partisanship the GOP evidences “no attachment to any external moral truth or ethical code.”

Let’s dispense with the “Democrats are just as bad” defense.

First, I don’t much care; we collectively face a party in charge of virtually the entire federal government and the vast majority of statehouses and governorships. It’s that party’s inner moral rot that must concern us for now.

Second, it’s simply not true, and saying so reveals the origin of the problem — a “woe is me” sense of victimhood that grossly exaggerates the opposition’s ills and in turn justifies its own egregious political judgments and rhetoric. If the GOP had not become unhinged about the Clintons, would it have rationalized Trump as the lesser of two evils? Only in the crazed bubble of right-wing hysteria does an ethically challenged, moderate Democrat become a threat to Western civilization and Trump the salvation of America.

Indeed, for decades now, demonization — of gays, immigrants, Democrats, the media, feminists, etc. — has been the animating spirit behind much of the right.

Only in the crazed bubble of right-wing hysteria does an ethically challenged, moderate Democrat become a threat to Western civilization and Trump the salvation of America.

It has distorted its assessment of reality, giving us anti-immigrant hysteria, promulgating disrespect for the law (how many “respectable” conservatives suggested disregarding the Supreme Court’s decision on gay marriage?), elevating Fox News hosts’ blatantly false propaganda as the counterweight to liberal media bias and preventing serious policy debate.

For seven years, the party vilified Obamacare without an accurate assessment of its faults and feasible alternative plans. “Obama bad” or “Clinton bad” became the only credo — leaving the party, as Brooks said of the Trump clan, with “no attachment to any external moral truth or ethical code” — and no coherent policies for governing.

We have always had in our political culture narcissists, ideologues and flimflammers, but it took the 21st-century GOP to put one in the White House.

It took elected leaders such as House Speaker Paul Ryan, R-Wis., and the Republican National Committee (not to mention its donors and activists) to wave off Trump’s racists attacks on a federal judge, blatant lies about everything from 9/11 to his own involvement in birtherism, replete evidence of disloyalty to America (i.e. Trump’s “Russia first” policies), misogyny, Islamophobia, ongoing potential violations of the Constitution’s emoluments clause (along with a mass of conflicts of interests), firing of an FBI director, and now, evidence that the campaign was willing to enlist a foreign power to defeat Clinton in the presidential election.

Out of its collective sense of victimhood came the GOP’s disdain for not just intellectuals but also intellectualism, science, Economics 101, history and constitutional fidelity.

If the Trump children became slaves to money and to their father’s unbridled ego, then the GOP became slaves to its own demons and false narratives.

A party that has to deny climate change and insist “illegal” immigrants are creating a crime wave — because that is what “conservatives” must believe, since liberals do not — is a party that will deny Trump’s complicity in gross misconduct.

It’s a party as unfit to govern as Trump is unfit to occupy the White House. It’s not by accident that Trump chose to inhabit the party that has defined itself in opposition to reality and to any “external moral truth or ethical code.” §

Jennifer Rubin is a Washington Post columnist, writing from a conservative perspective. Follow NJ.com Opinion on Twitter@NJ_Opinion. Find NJ.com Opinion on Facebook. This article is displayed with permission from NJ.com

Ethics & deregulation under Trump

 

Hires with deep industry ties lead secretive teams to ease regulations

by Robert Faturechi, ProPublica, and Danielle Ivory, The New York Times

President Trump entered office pledging to cut red tape, and within weeks, he ordered his administration to assemble teams to aggressively scale back government regulations.

But the effort — a signature theme in Trump’s populist campaign for the White House — is being conducted in large part out of public view and often by political appointees with deep industry ties and potential conflicts.

Most government agencies have declined to disclose information about their deregulation teams. But ProPublica and The New York Times identified 71 appointees, including 28 with potential conflicts, through interviews, public records and documents obtained under the Freedom of Information Act.

Some appointees are reviewing rules their previous employers sought to weaken or kill, and at least two may be positioned to profit if certain regulations are undone.

The appointees include lawyers who have represented businesses in cases against government regulators, staff members of political dark money groups, employees of industry-funded organizations opposed to environmental rules and at least three people who were registered to lobby the agencies they now work for.

At the Education Department alone, two members of the deregulation team were most recently employed by pro-charter advocacy groups or operators, and one appointee was an executive handling regulatory issues at a for-profit college operator.

So far, the process has been scattershot. Some agencies have been soliciting public feedback, while others refuse even to disclose who is in charge of the review. In many cases, responses to public records requests have been denied, delayed or severely redacted.

The Interior Department has not disclosed the correspondence and calendars for its team. But a review of more than 1,300 pages of handwritten sign-in sheets for guests visiting the agency’s headquarters in Washington found that appointees had met regularly with industry representatives.

Over a four-month period, from February through May, at least 58 representatives of the oil and gas industry signed their names on the agency’s visitor logs before meeting with appointees.

The EPA also rejected requests to release the appointment calendar of the official leading its team — a former top executive for an industry-funded political group — even as she met privately with industry representatives.

And the Defense Department and the Department of Homeland Security provided the titles for most appointees to their review teams, but not names.

In February, President Trump ordered federal agencies to form task forces charged with finding regulations to weaken or eliminate. While the names of appointees to executive-agency task forces are typically made public, some agencies are refusing to reveal who is on their panels. See who we know about and who we don’t.

When asked for comment about the activities of the deregulation teams, the White House referred reporters to the Office of Management and Budget.

Meghan Burris, a spokeswoman there, said: “As previous administrations have recognized, it’s good government to periodically reassess existing regulations. Past regulatory review efforts, however, have not taken a consistent enough look at regulations on the books.”

With billions of dollars at stake in the push to deregulate, corporations and other industry groups are hiring lawyers, lobbyists and economists to help navigate this new avenue for influence. Getting to the front of the line is crucial, as it can take years to effect regulatory changes.

“Competition will be fierce,” the law firm Clark Hill, which represents businesses pitching the Environmental Protection Agency, said in a marketing memo. “In all likelihood, interested parties will need to develop a multi-pronged strategy to expand support and win pre-eminence over competing regulatory rollback candidates.”

Jane Luxton, a lawyer at the firm, said she advised clients to pay for economic and legal analyses that government agencies, short on staff, could use to expedite changes. She declined to identify the clients.

“You may say this is an agency’s job, but the agencies are totally overloaded,” Luxton said.

“We have begun a historic program to reduce the regulations that are crushing our economy — crushing,” Trump said. “We’re going to put the regulations industry out of work and out of business.”

***

On a cloudy, humid day in March, Laura Peterson, a top lobbyist for Syngenta, arrived at the headquarters for the Interior Department. She looped the letter “L” across the agency’s sign-in sheet.

Her company, a top pesticide maker based in Switzerland, had spent eight years and millions of dollars lobbying the Obama administration on environmental rules, with limited success.

But Peterson had an in with the new administration.

Scott Cameron, newly installed at the Interior Department and a member of its deregulation team, had just left a nonprofit he had founded. He had advocated getting pesticides approved and out to market faster. His group counted Syngenta as a financial partner.

The meeting with Peterson was one of the first Cameron took as a new government official.

Neither side would reveal what was discussed. “I’m not sure that’s reporting information I have to give you,” Peterson said.

But lobbying records offered clues.

Syngenta has been one of several pesticide manufacturers pushing for changes to the Endangered Species Act. When federal agencies take actions that may jeopardize endangered animals or plants, they are generally supposed to consult with the Interior Department, which could raise objections.

For decades, the EPA largely ignored this provision when approving new pesticides. But recently, a legal challenge from environmental groups forced its hand — a change that affected Syngenta.

Pesticide lobbyists have been working behind the scenes at agencies and on Capitol Hill to change the provision. Companies have argued that they should be exempt from consulting with the Interior Department because they already undergo EPA approval.

Along with spending millions of dollars on lobbying, they have funded advocacy groups aligned with their cause. Cameron’s nonprofit, the Reduce Risks From Invasive Species Coalition, was one such group for Syngenta.

The organization says on its website that its goals include reducing “the regulatory burden of the Endangered Species Act on American society by addressing invasive species.” One way to do that is to use pesticides. The nonprofit’s mission includes creating “business opportunities for commercial products and services used to control invasive species.”

Because donations are not publicly reported, it is unclear how much Syngenta has contributed to Cameron’s organization, but his group has called the pesticide company one of its “ generous sponsors.”

Cameron also served on a committee of experts and stakeholders, including Syngenta, that advised the federal government on decisions related to invasive species. At a committee event last July, he said that one of his priorities was “getting biocontrol agents to market faster,” according to meeting minutes.

Paul Minehart, a Syngenta spokesman, said: “Employees regularly engage with those in government that relate to agriculture and our business. Our purpose is to balance serving the public health and environment with enabling farmers’ access to innovation.”

A spokeswoman for the Interior Department did not respond to questions about how Cameron’s relationship with Syngenta might influence his review of regulations.

Under the law, members of the Trump administration can seek ethics waivers to work on issues that overlap with their past business careers. They can also formally recuse themselves when potential conflicts arise.

***

Under the law, members of the Trump administration can seek ethics waivers to work on issues that overlap with their past business careers. They can also formally recuse themselves when potential conflicts arise.

In many cases, the administration has refused to say whether appointees to Trump’s deregulation teams have done either.

One such appointee is Samantha Dravis, the chairwoman of the deregulation team at the EPA, who was a top official at the Republican Attorneys General Association. Dravis was also president of the Rule of Law Defense Fund, which brought together energy companies and Republican attorneys general to file lawsuits against the federal government over Obama-era environmental regulations.

The Republican association’s work has been criticized as a vehicle for corporate donors to gain the credibility and expertise of state attorneys general in fighting federal regulations. Donors include the American Petroleum Institute, the energy company ConocoPhillips and the coal giant Alpha Natural Resources.

The Republican association also received funding from Freedom Partners, backed by the conservative billionaires Charles G. and David H. Koch. Dravis worked for that group as well, which recently identified regulations it wants eliminated. Among them are EPA rules relating to clean-water protections and restrictions on greenhouse gas emissions.

Liz Bowman, an EPA spokeswoman, declined to say whether Dravis had recused herself from issues dealing with previous employers or their backers, or had discussed regulations with any of them.

“As you will find when you receive Samantha’s calendar, she has met with a range of stakeholders, including nonprofits, industry groups and others, on a wide range of issues,” Bowman said.

Bowman said the calendar could be obtained through a public records request. ProPublica and The Times had already filed a request for records including calendars, but the agency’s response did not include those documents. (An appeal was filed, but the calendar has not yet been released.)

“We take our ethics responsibilities seriously,” Bowman said. “All political staff have had an ethics briefing and know their obligations.”

Addressing the agency’s regulatory efforts, she said, “We are here to enact a positive environmental agenda that provides real results to the American people, without unnecessarily hamstringing our economy.”

At the Agriculture Department, the only known appointee to the deregulation team is Rebeckah Adcock. She previously lobbied the department as a top executive both at CropLife America, a trade association for pesticide makers, and the American Farm Bureau Federation, a trade group for farmers.

The department deals with many issues involving farmers, including crop insurance and land conservation rules, but it would not disclose whether Adcock had recused herself from discussions affecting her past employers.

At the Energy Department, a member of the deregulation team is Brian McCormack, who formerly handled political and external affairs for Edison Electric Institute, a trade association representing investor-owned electrical utilities.

While there, McCormack worked with the American Legislative Exchange Council, an industry-funded group. Both organizations fought against rooftop solar policies in statehouses across the country. Utility companies lose money when customers generate their own power, even more so when they are required to pay consumers who send surplus energy back into the grid.

Though the Energy Department does not directly regulate electrical utilities, it does help oversee international electricity trade, the promotion of renewable energy and the security of domestic energy production. After joining the department, McCormack helped start a review of the nation’s electrical grid, according to an agency memo.

Clean-energy advocates fear the inquiry will cast solar energy, which can fluctuate, as a threat to grid reliability. Such a finding could scare off state public utility commissions considering solar policies and serve as a boon for electrical utilities, said Matt Kasper, research director at the Energy and Policy Institute, an environmental group.

Disclosure records show that while McCormack was at Edison, the trade group lobbied the federal government, including the Energy Department, on issues including grid reliability.

The department would not answer questions about McCormack’s involvement with those issues.

Across the government, at least two appointees to deregulation teams have been granted waivers from ethics rules related to prior jobs, and at least nine others have pledged to recuse themselves from issues related to former employers or clients.

Some of the recusals involve appointees at the Small Business Administration and the Education Department, including Bob Eitel, who leads the education team and was vice president for regulatory legal services at an operator of for-profit colleges.

Another recusal involves Byron Brown, an EPA appointee who is married to a senior government affairs manager for the Hess Corporation, the oil and gas company.

Hess was fined and ordered to spend more than $45 million on pollution controls by the EPA during the Obama administration because of alleged Clean Air Act violations at its refinery in Port Reading, N.J. Disclosure records show that Brown’s wife, Lesley Schaaff, lobbied the EPA last year on behalf of the company.

An EPA spokeswoman declined to say whether Brown or Schaaff owned Hess stock, though an agency ethics official said Brown had recused himself from evaluating regulations affecting the company.

The agency declined to say whether Brown would also recuse himself from issues affecting the American Petroleum Institute, where his wife’s company is a member. The association has lobbied to ease Obama-era natural gas rules, complaining in a recent letter to Brown’s team about an “unprecedented level of federal regulatory actions targeting our industry.”

Before being selected to lead the deregulation team at the Department of Housing and Urban Development, Maren Kasper was a director at Roofstock, an online marketplace for investors in single-family rental properties. Financial disclosure records show Kasper owned a stake in the company worth up to $50,000.

Changes at HUD could increase investor interest in rental homes, affecting a company like Roofstock. The agency, for example, oversees the federal government’s Section 8 subsidies program for low-income renters.

Ethics officials allowed Kasper to keep her stake, but she pledged not to take actions that would affect it. (A spokesman for HUD said Kasper’s tenure on the deregulation task force has since ended.)

***

One by one, scientists, educators and environmental activists approached the microphone and urged government officials not to weaken regulations intended to protect children from lead.

The forum, run by the EPA in a drab basement meeting room in Washington, was part of the agency’s push to identify regulations that were excessive and burdensome to businesses.

Few businesspeople showed up. As public hearings on regulations have played out in recent weeks, many industry and corporate representatives have instead met with Trump administration officials behind closed doors.

Still, the EPA has asked for written comments and held about a dozen public meetings. The agency has received more than 467,000 comments, many of them critical of potential rollbacks, but also some from businesses large and small pleading for relief from regulatory costs or confusion.

After a quiet moment at the meeting to discuss lead regulations, the owner of a local painting company, Brian McCracken, moved to the microphone.

McCracken was frustrated by what he described as costly rules that forced him to test for lead-based paint in homes before he could begin painting. Each test kit costs about $2, and he may need six per room. If a family then declines to hire him, those costs come out of his pocket.

“I don’t think anyone is sitting here saying that lead-based dust does not hurt children,” he said. “That’s not what we are talking about. What the contractor needs is a better way to test.”

His voice quavered: “Why do I have to educate the general public about the hazards that generations before me created? It doesn’t make sense at all.”

Trump is not the first president to take on such frustrations.

President Bill Clinton declared the federal government was failing to regulate “without imposing unacceptable or unreasonable costs on society.” He assigned Vice President Al Gore to collect agencies’ suggestions for rules that should go. One rule dictated how to measure the consistency of grits.

President George W. Bush’s regulatory overhaul focused more on how new regulations were created. The administration installed a political appointee inside each agency who generally had to sign off before any significant new rule could be initiated. At the EPA for a time, that official came from an industry-funded think tank.

President Barack Obama ordered regular updates from each agency about the effectiveness of rules already on the books.

“When you raise the profile, when it’s clearly an executive priority, it gets attention,” said Heather Krause, director of strategic issues at the Government Accountability Office, the main auditor of the federal government. According to the auditor’s analysis, the effect under Obama was mostly to clarify and streamline rules, not eliminate them.

Like Bush, Trump has empowered political appointees. Though some agencies have included career staff members on their review teams, an executive order from Trump creating the teams does not require it — nonpolitical employees are generally believed to be more wedded to existing rules. And like Obama, Trump has imposed regular reporting requirements.

But Trump, who spent his business career on the other side of government regulations, has put an emphasis on cutting old rules.

The same day he signed the executive order initiating the review, he addressed a large crowd of conservative activists at a Maryland convention center.

“We have begun a historic program to reduce the regulations that are crushing our economy — crushing,” Trump said. “We’re going to put the regulations industry out of work and out of business.”

Amit Narang, a regulatory expert at the liberal advocacy group Public Citizen, said Trump’s decision to create teams of political appointees — formally known as regulatory reform task forces — should make it easier for the White House to overcome bureaucratic resistance to his rollback plans.

“To the extent there’s a deep state effect in this administration,” Narang said, “the task force will be more effective in trying to get the agenda in place.” §

Robert Faturechi covers campaign finance at Propublica. Email: Robert.Faturechi@propublica.org. Twitter: RobertFaturechi. The New York Times’ Danielle Ivory covers the intersection of business and government, including contracts and regulation. NYT’s Kitty Bennett contributed reporting to this story. This article is displayed with permission from ProPublica, and was co-published with The New York Times.

Sixty years after ‘The Pill,’ the war on contraception continues

by Dr. Erin Saleeby, OB-GYN

The Pill was controversial when it was approved 60 years ago and remains so today as Congress aims to roll back affordable access to contraception.

Sixty years ago, the FDA approved a medication called Enovid for treating menstrual problems and infertility. Three years later, this combination of the synthetic hormones norethynodrel and mestranol, was approved as a contraceptive. The medication, which came to be called “The Pill,” was controversial then and remains controversial today, largely because of shenanigans in the health care bills aimed at replacing the Affordable Care Act.

The pill was revolutionary. It allowed women to take charge of their sexual and reproductive health and, in turn, plan their families and their futures and define their own lives. Contraception opened doors for me and millions of other women, creating a pathway for our full participation in society and in the workforce, while also contributing to better outcomes in maternal and child health.

As an OB-GYN, I have seen firsthand the benefits of access to affordable contraception for women of all ages, races, and socioeconomic status.

From healthier pregnancies and birth spacing to economic and educational attainment, we have much to celebrate. Women’s participation in the workforce grew from 40 percent in 1950 to nearly 60 percent in 2015, improving living standards along the way. More women have been attending college since the 1970s, and last year women accounted for 57 percent of the undergraduate student body. Some of these gains can be attributed to women being in charge of their reproductive health.

Today, most women can choose the contraceptive that works best for them without facing financial barriers. The ACA requires coverage for contraception without copays in most insurance plans. Whether that method is the pill, which has been the choice for 2 out of 3 women at some point in their lives, or the newer and more effective long-acting and reversible contraceptive devices, such as IUDs and implants, women can make their own decisions about their reproductive health based on the medical evidence and their own preferences.

Within just three years of the ACA’s no cost-sharing policy for contraception taking effect, insurance claims for IUDs increased from 36.6 percent in 2010 to 87.6 percent in 2013. This shows that when there is no financial barrier and women are free to choose, utilization of contraception increases.

Expanding access to contraception and making it affordable also improves women’s health. For the first time in decades, the unplanned pregnancy rate is declining and the abortion rate is the lowest since Roe v. Wade.

Despite this clear evidence for the benefits of contraception, the fight for universal access to affordable contraception wages on. Instead of celebrating the progress we have made over the past six decades, we are fighting off policy threats that could harm women’s health. The Senate is currently debating a health care bill that would not only devastate Medicaid and the public health care delivery system that pays for nearly half of all births in the country, it would also defund Planned Parenthood and allow states to let private insurance plans deny women preventive services and maternity coverage.

Such ill-advised policy proposals would jeopardize access to affordable contraception for many of my patients in California and millions of women across the nation. The potential repeal of the ACA, plus threats to undermine the Title X federal family planning program, could roll back contraceptive coverage and endanger access to essential sexual and reproductive health care for more than 20 million women in need of publicly supported contraception.

This isn’t bad just for women’s health. It is also fiscally irresponsible. The return on investment for contraception — every dollar invested in family planning saves $7 — should be compelling to all taxpayers.

It is unconscionable for our representatives in Congress, most of them men, to play politics with access to contraception. In this time of uncertainty in health care, let’s call on our lawmakers, from both sides of the aisle, to show they are invested in the health of women from all walks of life who depend on the security of safe, effective, and accessible contraception to realize their myriad critical roles in our society. Our representatives should start by preserving access to the full range of FDA-approved contraceptive methods without cost sharing, fully funding the Title X program for 2018, and not discriminating against women’s health providers who play vital roles in the health care safety net.

We cannot afford to turn back the clock on access to contraception and threaten the progress we have made in women’s health. §

Erin Saleeby, M.D., is the medical director of Essential Access Health, the administrator of California’s Title X federal family planning program. This article is displayed with permission from STAT.