Posts Tagged ‘healthcare reform’

Arizona’s draconian new immigration law has prompted calls from civil rights groups for a boycott of the state’s industries and sports teams . But don’t get too excited. It turns out that the new law is quite popular – and not just in Arizona. Two recent national polls – one by Gallup , the other by CBS – have found that a majority of Americans strongly approve of the state’s immigration crackdown.

In fact, some even some think it doesn’t go far enough. Have Americans become rightwing nuts? Hardly. But Washington’s endless dithering on immigration policy has the whole country at a boiling point. And if Arizonans want to vent their anger, well, bully for them, say voters – including a majority of independents, and even a solid third of Democrats . With the midterm elections just six months away, and Democratic fortunes fading fast, immigration is fast becoming an albatross for Obama.

Egged on by his disaffected Latino base, Obama decided to denounce the Arizona law. But voters obviously don’t agree with him. And Obama has also decided to urge Congress to begin work on comprehensive immigration reform, even though his key GOP ally, Senator Lindsey Graham, a moderate, isn’t playing ball. Graham warned Obama months ago that if he rammed healthcare reform through Congress, he could kiss immigration reform goodbye. Apparently, the president wasn’t listening. And neither was Senate majority leader Harry Reid, who is trailing both of his GOP opponents in the polls, and could well lose his seat this November.

Reid tried to rally Latino voters in Nevada last month by promising that Democrats would try to pass immigration reform this year, even if the GOP won’t help. Apparently, though, Reid forgot to consult with other Democrats. Because it turns out, post-Arizona, that there aren’t enough Democratic votes to pass immigration reform. In fact, Reid may not even be able to get the 50 votes necessary to bring a Democrat-only bill to the Senate floor – let alone secure its passage. What’s Obama to do? Right now, he’s caught between his angry and mobilised Latino base, which is demanding that he push forward with a plan to legalise undocumented immigrants, and mainstream voters, who seem to be leaning toward the GOP’s view that border and workplace enforcement should come first. It’s a recipe for disaster. Many Democrats – and not just Reid – need Latinos and other base groups to turn out in large numbers if they hope to prevail against Republicans this November – and preserve their party’s control of Congress. According to political experts, in some 35 congressional election contests in the West, a high Latino voter turn out could well provide the margin of difference. Also up for grabs, depending on Latino voting, are critical races in high-density Latino states like Florida.

There, a rising GOP star, Marco Rubio, who is Latino, is seeking to win a three-way Senate race in which former GOP Gov. Charlie Crist is running as an independent. On the other hand, there are just as many competitive districts in the South and Midwest where key swing voters overwhelmingly support the new Arizona crackdown, according to polls. Any move by Obama and the Democrats in the direction of legalization – even stepped criticism of Arizona’s new law, perhaps – could well doom Democratic fortunes there. For the GOP, meanwhile, it’s a question of how to balance the short-term political gain of holding out on immigration reform with the potential long-term damage to the party of appearing hostile to Latino aspirations. Everyone knows, Latinos especially, that the Arizona GOP was responsible for the Arizona law. And since many Republicans at the national level have refused to criticize the law, they are not winning any new friends among a key swing constituency they lost in 2008. But most Republicans are calculating that Latinos are just as concerned as mainstream voters about the deficit and the state of the economy – and won’t penalise the GOP for not focusing on immigration before November. And, in fact, like many Democrats, the GOP is also finding itself boxed in by its nativist wing. Just ask Senator John McCain, who has enthusiastically backed the state’s new immigration crackdown because of nativist pressure from GOP challenger, and Tea Party favorite, JD Hayworth. If he hadn’t, he wouldn’t stand a chance of getting re-elected, observers say. With only a narrow legislative window remaining – Congress takes a break on May 28, and when it returns, candidates start ginning up their election campaigns – serious action on immigration is unlikely. Reid, already under fire from the GOP for his grand-standing on immigration, has promised to focus on an energy, bill first and foremost.

Obama, meanwhile, recently took advantage of the annual White House “Cinco de Mayo” celebration to say that he still hoped that Congress would “start work” on immigration this year. In the game of verbal inches that often passes for Washington politics, that statement was taken as a positive sign. Of what, though, no one’s exactly sure.

In Japan, being thin isn’t just the price you pay for fashion or social acceptance. It’s the law.So before the fat police could throw her in pudgy purgatory, Miki Yabe, 39, a manager at a major transportation corporation, went on a crash diet last month. In the week before her company’s annual health check-up, Yabe ate 21 consecutive meals of vegetable soup and hit the gym for 30 minutes a day of running and swimming.

“It’s scary,” said Yabe, who is 5 feet 3 inches and 133 pounds. “I gained 2 kilos [4.5 pounds] this year.”In Japan, already the slimmest industrialized nation, people are fighting fat to ward off dreaded metabolic syndrome and comply with a government-imposed waistline standard. Metabolic syndrome, known here simply as “metabo,” is a combination of health risks, including stomach flab, high blood pressure and high cholesterol, that can lead to cardiovascular disease and diabetes.

Concerned about rising rates of both in a graying nation, Japanese lawmakers last year set a maximum waistline size for anyone age 40 and older: 85 centimeters (33.5 inches) for men and 90 centimeters (35.4 inches) for women.

In the United States, the Senate and House health care reform bills have included the so-called “Safeway Amendment,” which would offer reductions in insurance premiums to people who lead fitter lives. The experience of the Japanese offers lessons in how complicated it is to legislate good health.

Though Japan’s “metabo law” aims to save money by heading off health risks related to obesity, there is no consensus that it will. Doctors and health experts have said the waistline limits conflict with the International Diabetes Federation’s recommended guidelines for Japan. Meantime, ordinary residents have been buying fitness equipment, joining gyms and popping herbal pills in an effort to lose weight, even though some doctors warn that they are already too thin to begin with.

The amount of “food calories which the Japanese intake is decreasing from 10 years ago,” said Yoichi Ogushi, professor of medicine at Tokai University and one of the leading critics of the law. “So there is no obesity problem as in the USA. To the contrary, there is a problem of leanness in young females.”

One thing’s certain: Most Japanese aren’t taking any chances.Companies are offering discounted gym memberships and developing special diet plans for employees. Residents are buying new products touted as fighting metabo, including a $1,400 machine called the Joba that imitates a bucking bronco. The convenience store chain Lawson has opened healthier food stores called Natural Lawson, featuring fresh fruits and vegetables.

Under Japan’s health care coverage, companies administer check-ups to employees once a year. Those who fail to meet the waistline requirement must undergo counseling. If companies do not reduce the number of overweight employees by 10 percent by 2012 and 25 percent by 2015, they could be required to pay more money into a health care program for the elderly. An estimated 56 million Japanese will have their waists measured this year.

Though Japan has some of the world’s lowest rates of obesity — less than 5 percent, compared to nearly 35 percent for the United States — people here on average have gotten heavier in the past three decades, according to government statistics. More worrisome, in a nation that is aging faster than any other because of long life spans and low birth rates, the number of people with diabetes has risen from 6.9 million in 1997 to 8.9 million last year.

Health care costs here are projected to double by 2020 and represent 11.5 percent of gross domestic product. That’s why some health experts support the metabo law.“Due to the check up, there is increased public awareness on the issue of obesity and metabolic syndrome,” said James Kondo, president of the Health Policy Institute Japan, an independent think tank. “Since fighting obesity is a habit underlined by heightened awareness, this is a good thing. The program is also revolutionary in that incentivizes [companies] to reduce obesity.”

Though the health exams for metabolic syndrome factor in blood pressure, cholesterol, blood sugar, weight and smoking, waist size is the most critical element in the Japanese law — and perhaps the most humiliating.The hesitancy of some Japanese to expose their bare stomachs to the tape measure has led the government to allow the tape measures to be administered to clothed patients. Those who elect not to strip down are permitted to deduct 1.5 centimeters from their results.

The crudeness of the system has alarmed some doctors. Satoru Yamada, a doctor at Kitasato Institute Hospital in Tokyo, published a study two years ago in which several doctors measured the waist of the same person. Their results varied by as much as 7.8 centimeters.“I cannot agree with waist size being the essential element,” Yamada said.Perhaps more astounding, even before Japanese lawmakers set the waistline limits last year, the International Diabetes Federation (IDF) amended its recommended guidelines for the Japanese. The new IDF standard is 90 centimeters (35.4 inches) for men and 80 centimeters (31.5 inches) for women. But the Japanese government has yet to modify its limits.On the day of her exam, Yabe arrived at the clinic at 8:30 in the morning. The battery of tests lasted an hour. The result: her waist was 84 centimeters — safely under the limit. She had shed 6.5 pounds thanks to her diet and exercise.

A week later, however, Yabe was back to eating pasta and other favorite foods.“I want to keep healthy now, but I don’t know,” she said. “Maybe in December, I will have many bonenkai [year-end parties]. And next summer I will drink beer, almost every day.”