Should the Boy Scouts and other youth groups that exclude LGBT members lose their tax exempt status? We'll discuss the California senate bill that could change things. We'll also look into laws that allow the IRS to read emails without a warrant and weigh the pros and cons of seeing the doctor in a group. Later, we'll consider the comeback from scandal to success in politics and talk about the latest gun control developments in the senate. Author Naomi Schaefer Riley joins us to speak about her book, "’Til Faith Do Us Part: How Interfaith Marriage is Transforming America.”
CA bill seeks to end tax breaks for Boy Scouts for gay ban (poll)
A bill introduced by California Senator Ricardo Lara would take away certain nonprofit tax benefits away from certain youth groups that ban gay, lesbian, bisexual, and transgender people from becoming members. The move is largely seen as a way to pressure the Boy Scouts of America to lift its ban on gay members.
The Youth Equality Act is the first state legislation in the country linking a nonprofit’s tax-exempt status to its stance on gay rights. Having cleared a Senate and Finance Committee vote yesterday, the bill now heads to the Senate Appropriations Committee for review. It needs a two-thirds vote from both houses of the California Legislature and Gov. Jerry Brown’s signature to become law.
If passed, certain youth non-profit groups would need to pay corporate taxes on donations, membership fees and other sources of income. In addition, they’d need to pay sales taxes on food and beverages sold at fundraisers. Is the bill constitutional? Should the tax code be used to put an end to certain forms of discrimination?
Guests:
Matthew McReynolds, staff attorney at the Pacific Justice Institute
Jenny Pizer, Senior Counsel and Director of the Law and Policy Project at LAMBDA Legal
IRS reading emails without search warrants
It's tax time and the Internal Revenue Service (IRS) is offering another reason to stay honest in your tax returns. Internal IRS documents show the agency can obtain your private emails without a search warrant if the emails are older than 180 days. The documents, obtained by the American Civil Liberties Union, that govern how IRS investigators operate state “the Fourth Amendment does not protect communications held in electronic storage, such as email messages stored on a server.”
The IRS is using a 1986 law, the Electronic Communications Privacy Act (ECPA), to get around Fourth Amendment restrictions. Currently, new Senate legislation aims to update the ECPA, but until then, is the IRS within their rights? Is there no expectation of privacy for emails sitting around on a server for months?
Guest:
Nathan Wessler, Staff Attorney, American Civil Liberties Union
Are shared medical appointments a solution to physician shortages?
Under the Affordable Care Act, a surge of people will need healthcare, but how will medical professionals be able to accommodate everyone? The Annals of Family Medicine projects that an additional 34 million people will receive health insurance and will need over 51,000 more primary care physicians by 2025 to meet that need. When Massachusetts law mandated health care coverage for its estimated half a million uninsured, wait times for primary care physicians increased.
To solve this problem, some physicians in Massachusetts started practicing “shared medical appointments” (SMA), also known as group visits. In this model, five to 13 patients see the doctor at once for a session that can last up to two hours. For example, patients with diabetes who have similar difficulties share an appointment. After each patient signs a confidentiality agreement, the doctor and perhaps a team of various medical personnel examine each patient one-by-one. Then the doctor leads a discussion with the entire group about questions and symptoms.
Seeing the doctor in a group isn’t a totally new idea. The pioneer of SMAs, Dr. Edward Noffsinger, started practicing group visits in 1996. By 2010, 12.7 percent of family physicians have tried group visits, according to the American Academy of Family Physicians. But for most of these physicians, they tried it out of curiosity. Now groups like the North Shore Medical Center in Massachusetts have been using group visits regularly for a few years and are starting to see the results.
On AirTalk today, Evelina Sands, the Administrative Director at North Shore Physicians Group said she has been instituting SMAs for three years to deal with the increasing number of people who need health care. At North Shore Medical Center, a typical follow-up visit is 15 minutes, so in 90 minutes, a physician can see six patients. In a shared appointment, an internal medicine physician can see 8-10 patients in the same amount of time. Sands said somewhere between 25-30 percent of their patients have tried a shared appointment.
In this model, the benefits are that the patients get more time with a physician, they’re able to ask more questions and they learn from one another’s medical experiences. For doctors, they are able to see more patients in a day and do not need to repeat general information over and over. Also, instead of waiting for months for an individual appointment, patients would not have to wait as long for a group visit.
There are plenty of concerns about shared medical appointments. Many patients are reluctant to discuss private information with other people, and some doctors also find the group setting to be awkward and prefer the confidentiality of individual appointments.
“All our patients must sign a confidentiality agreement, which states that they will not disclose any confidential information about others after the visit. It also allows the physician to discuss the patient’s medical history in front of the group. Our hope is that this provides the patient peace of mind so that they can speak freely and openly in this group setting,” said Sands.
Kyle from Burbank, an AirTalk listener, called to ask about doctor-patient confidentiality. He wondered if the other patients in the group are legally under the same protection as the physician. Sands responded that she has not yet come across that scenario.
Dr. Wells Shoemaker, Medical Director of the California Association of Physician Groups and co-leading Governor Brown’s Health System Redesign for California, said that he was a pediatrician who tried group visits in the 1980s. He discussed on AirTalk why group visits work very well for some illnesses like diabetes but are not practical for other issues because of the lack of intimacy and confidentiality.
Shoemaker said concerning issues like child abuse or a husband who’s drunk, “if I fail to recognize that threat, then I let that family down.”
Sands explained that the patients often attend group appointments out of respect for the physician.
“The physician says to a patient, ‘I think it would be great for you to attend this. I’m going to be running this. We can talk about you.’ That in itself is gold to them. The physician is the expert, and if the patient has that trust in the physician, they’re easily swayed,” she said on AirTalk.
Sands and Shoemaker both spoke on how the comfort of the physician is important. While some physicians do well in group settings, others shy away.
“You have to be really comfortable ‘in your skin,’ so to speak, because they’re really in a fishbowl,” said Sands.
Shoemaker also mentioned other difficulties related to shared medical appointments, namely scheduling and billing. He found group visits to be most effective with an “almost homogenous ethnic group,” but it was difficult to coordinate everyone’s schedules and fill an appointment. If the groups are too small, then this model would be financially unsustainable for physicians. Also, because of different insurance plans with different rules, SMAs are difficult to bill.
“The practicality of administering this in a cottage-based office is a challenge. I eventually had to abandon mine despite my enthusiasm for the idea and despite seeing how well it worked,” said Wells. “But beyond thinking in terms of the usual visit, which is the way a lot of people think about doctors, we’re really looking at new ways of communicating with our patients in a modern world.”
Have you ever participated in a shared medical appointment? Is this new model a plausible solution to health care needs? If group visits gain popularity, would those unwilling to be in a group visit wait longer for individual visits? Are group visits a step forward in health care reform or an attempt to stretch resources?
Guests:
Evelina Sands, Administrative Director at North Shore Physicians Group in Massachusetts; she has been instituting shared medical appointments for three years.
Wells Shoemaker, M.D., Medical Director of the California Association of Physician Groups, practiced primary care pediatrics for 25 years on the Central Coast and has conducted shared medical appointments. He currently works with medical groups across the state for quality improvement, health disparities, and primary care revitalization. He co-leads Governor Brown’s current task force on Health System Redesign for California.
What’s next for the gun bill?
The senate voted Thursday 68-31 to block the filibuster the Republican filibuster on gun-control bills and re-open discussions on new gun control legislation. The vote only signals the beginning of formal discussions, and there are no guarantees that any meaningful legislation will come to pass, but 16 Republican senators voted to re-open debates and it may signal some bipartisan support in the senate.
Senator Joe Manchin (D-W. VA) and Sen. Patrick J. Toomey’s (R-PA) proposal yesterday, which included mandating background checks for all commercial sales of guns, is expected to be among the first amendments to be debated. One thing of note is that, according to the Washington Post, 21 of the 68 senators who voted Thursday to proceed to debate on gun control hold an A rating from the National Rifle Association, which grades lawmakers on their voting records on guns.
Does this signal a watershed moment in the gun debate? Or will putting together meaningful gun reform prove once again too difficult?
Guest:
David Grant, Congressional Reporter, Christian Science Monitor
Are Weiner and Sanford the Next Comeback Kids?
Scandal-plagued Mark Sanford is close to winning back his old seat in the House. And now Anthony Weiner tells The New York Times Magazine that he's thinking about running for Mayor of NYC.
Is a sex scandal still the career ruiner it once was or has the art of the comeback made it possible to get past those public relations nightmares? How easily do we forget things that once outraged us? Do we love a return to glory as much as we love a fall from grace? Is it harder for politicians than it is for celebrities or sports stars? Does it take a special kind of person to be able to regain the public trust?
Guest:
Lisa Gritzner, President of Cerrell Associates public relations firm
Do interfaith marriages last?
Author Naomi Schaefer Riley’s new book, “’Til Faith Do Us Part: How Interfaith Marriage is Transforming America,” examines why interfaith marriages are becoming more common but sometimes end in unhappiness and divorce.
In a national study that Riley commissioned, she found that over 40% of marriages are between people who hold different religious beliefs. Her study showed that Jews are the most likely to marry people of other faiths and Mormons are the least likely. But the most interesting finding is that interfaith couples are generally more unhappy and unstable than marriages where only one belief is involved. Couples with different political affiliations are happier than those with different religious beliefs.
In an interfaith marriage herself, Riley is a Conservative Jew married to a former Jehovah’s Witness. She admits that it’s been tough. Interfaith couples most often run into difficulties when raising children, and Riley says interfaith marriages may be why less young Americans identify themselves with a religion.
Why are interfaith marriages becoming more common? If you’re in an interfaith union, what has your experience been? What are the struggles involved?
Guest:
Naomi Schaefer Riley, author of “’Til Faith Do Us Part: How Interfaith Marriage is Transforming America” (Oxford University Press), former Wall Street Journal editor and writer
Naomi’s holding a panel discussion in LA about interfaith marriage: Sunday, April 14th, from noon-1:15 PM at the Islamic Center of Southern California. Click here to RSVP.