Good News & Bad

Major news today for two attempts at universal health coverage, San Francisco and Massachusetts.

First, the bad (or good, depending on how you look at it): Massachusetts receives additional federal funding for its health plan. I see this as a bad, and so does Kevin, M.D., because it indicates that the state is having problems funding the program on its own. And it most definitely is.

The plan’s rapid growth has generated fiscal pressures. The legislature and Mr. Patrick filled a health care spending gap that approached $200 million for this fiscal year by increasing the tobacco tax by $1 a pack, levying one-time assessments on insurers and hospitals, and raising more money from businesses that do not contribute to their employees’ insurance. The state expects to spend $869 million on subsidized coverage this year.

It's great the government gave them to money to continue the program, but bad that they needed it to begin with. It's not exactly replicable on the federal level if a small state can't do it. As Kevin writes, "If enacted nationally, who will bail out Washington?"

The good: A panel of US Court of Appeals judges rule in favor of San Fran's universal health plan, by saying that the charges on businesses who don't provide health insurance to workers are constitutional. I've liked this program from the beginning because it provides very basic health insurance (so basic, by definition, it's not health insurance) to city residents. Given the groundbreaking nature of the ruling, we'll have to wait and see how/if it holds up in high courts.

I should trademark my blog name

Today I attended a blog launching event for Disruptive Women in Healthcare(TM), a blog created and promoted by the CEO of Amplify Public Affairs. The event and the blog bugged me on a variety of levels.

1) They started the event 40 minutes late. That is just rude.
2) The blog's name is trademarked. I don't think I've ever seen this before, and I think it runs counter to everything a blog stands for. Blogs are supposed to be about openness and collaboration and the sharing of ideas, and trademarking implies just the opposite. It screams, "This name is mine, don't you dare try to use it in anyway." It screams corporate.
3) At the event, each of the "guest bloggers" as they are called (this is their name for all the bloggers, of which there about about 20) in attendance talked for a couple of minutes about why they are a "disruptive woman" and what their first post is about. This took all of 20 minutes, and then they didn't take any questions. This wasn't exactly a hostile crowd. [In fact, I would say it seemed most everyone knew each other.] Why wouldn't they take questions? Were they afraid they'd get asked something tough/uncomfortable? Blogs are about having a conversation... why wouldn't they get that conversation started at the launch?

The whole thing smacks of being corporate. I know there are corporate blogs out there (I run one), but I do think there should have been an attempt to be less so. I think they wanted to come off as, "look we know how to run a corporate blog," and really I left thinking that they know nothing about the purpose of blogs at all. To be honest, they didn't even give a great explanation as to why only women are writing it. That women can change the health care landscape is a given, it's not a reason for launching a blog.

Overall, though, I think it's a great concept, I just wish it had been started by someone a little more knowledgeable about blogs and a little more open to openess. To see all those powerful women up there talking about their views on health care was great. I think it has great potential, I just hope its brainchild doesn't screw it up.

In Massachusetts, you better hope nothing's wrong with you

Lots of coverage today of a Boston Globe article citing the difficulties of Massachusetts residents in finding a primary care doctor, with waits for appointments as long as 100 days. Luckily, the government sees what a problem this is and is taking action:

Now, as the state's health insurance mandate threatens to make a chronic doctor shortage worse, the Legislature has approved an unprecedented set of financial incentives for young physicians, and other programs to attract primary care doctors. But healthcare leaders fear the new measures will take several years to ease the shortage.

I personally agree that action needs to be taken ... but not just in Massachusetts; it needs to happen across the country. There was a study recently that found that the number of medical students entering primary care or internal medicine is dropping, which over time is going to lead to even less access. If people with decent health insurance (I would consider myself one of them) have difficulty find a physician to see them within a decent period of time, the government needs to step in and increase the incentives for medical students to become PCPs.

See additional coverage here, here and here.

"Sweet icing on a bitter cake"

I'm a little late on this, but author Susan Faludi wrote a New York Times op-ed about Hillary's speech on Tuesday at the DNC. What she wrote really resonates with me (I had some of the same ideas in the post I wrote directly after the speech) and it's nice to know I'm not the only one. Here's some highlights:

MUCH has been made of the timing of Hillary Clinton’s speech before the Democratic National Convention tonight, coming as it does on the 88th anniversary of women’s suffrage. Convention organizers are ... pay[ing] homage to the women’s vote in particular and women’s progress in general. By such tributes, they are slathering some sweet icing on a bitter cake. But many of Mrs. Clinton’s supporters are unlikely to be partaking. They regard their candidate’s cameo as a consolation prize. And they are not consoled.

“I see this nation differently than I did 10 months ago,” reads a typical posting on a Web site devoted to Clintonista discontent. “That this travesty was committed by the Democratic Party has forever changed my approach to politics.” In scores of Internet forums and the conclaves of protest groups, those sentiments are echoed, as Clinton supporters speak over and over of feeling heartbroken and disillusioned, of being cheated and betrayed.

The despondency of Mrs. Clinton’s supporters — or their “vitriolic” and “rabid” wrath, as the punditry prefers to put it — has been the subject of perplexed and often irritable news media speculation. Why don’t these dead-enders get over it already and exit stage right?

Shouldn’t they be celebrating, not protesting? After all, Hillary Clinton’s campaign made unprecedented strides. She garnered 18 million-plus votes, and proved by her solid showing that a woman could indeed be a viable candidate for the nation’s highest office. She didn’t get the gold, but in this case isn’t a silver a significant triumph? ... Many Clinton supporters say no, and to understand their gloom, one has to take into account the legacy of American women’s political struggle, in which long yearned for transformational change always gives way before a chorus of “not now” and “wait your turn,” and in which every victory turns out to be partial or pyrrhic.

For all the talk of Hillary Clinton’s “breakthrough” candidacy and other recent successes for women, progress on important fronts has stalled. ...Today, the United States ranks 22nd among the 30 developed nations in its proportion of female federal lawmakers. ... Women's real annual earnings have fallen for the last four years. ... Women’s numbers are stalled or falling in fields ranging from executive management to journalism, from computer science to the directing of major motion pictures. ...

Again, many daughters of a feminist generation seem pleased to proclaim themselves so “beyond gender” that they don’t need a female president. ... As it turns out, they won’t have one. But they will still have all the abiding inequalities that Hillary Clinton, especially in defeat, symbolized. Without a coalescing cause to focus their forces, how will women fight a foe that remains insidious, amorphous, relentless and pervasive?

via Broadsheet.

A Mass. mess

Just as I got on my high horse yesterday to tout the greatness of Massachusetts' health care plan, it comes to light that tens of thousands of state residents, most of who are involved in Commonwealth Care, a state-run program, have been dropped from their plans. According to the Globe:

The state's eligibility documents are complex, advocates said, leading some patients to have their insurance terminated - even though they are eligible for coverage - because they made mistakes filling out the forms. Mail sent by the state to the wrong address is also cited as another reason coverage is dropped.

In other instances, the state misinterprets information on the forms and mistakenly bounces people out of the program, advocates said.

Patients terminated by the state can unknowingly rack up thousands of dollars in medical bills only to discover that those expenses will not be reimbursed. The only way they can get the money back is to sue the state.

Said the office manager of a hospital who helped one her employees navigate the system: "I would consider myself a fairly educated person," Smidy said, "and I got confused."

The state responded that it is working to upgrade its computer systems and that should fix some of the programs. We'll see. It's problems like this that make me wonder if the U.S. as a whole could ever run a government health program, let alone the ONLY government program.

[See WSJ Health Blog for additional coverage.]

18 Million Cracks

I saw Hillary give her concession speech two months ago in D.C. I admit it, I cried. My sister who came with me, she cried. The middle-aged woman standing next to us, she cried, too. And even as I review the text of her speech to post below, I tear up.

...[W]hen I was asked what it means to be a woman running for President, I always gave the same answer: that I was proud to be running as a woman but I was running because I thought I’d be the best President. But I am a woman, and like millions of women, I know there are still barriers and biases out there, often unconscious. ...

I ran as a daughter who benefited from opportunities my mother never dreamed of. I ran as a mother who worries about my daughter’s future and a mother who wants to lead all children to brighter tomorrows. To build that future I see, we must make sure that women and men alike understand the struggles of their grandmothers and mothers, and that women enjoy equal opportunities, equal pay, and equal respect. Let us resolve and work toward achieving some very simple propositions: There are no acceptable limits and there are no acceptable prejudices in the twenty-first century.

You can be so proud that, from now on, it will be unremarkable for a woman to win primary state victories, unremarkable to have a woman in a close race to be our nominee, unremarkable to think that a woman can be the President of the United States. And that is truly remarkable. ...

Although we weren’t able to shatter that highest, hardest glass ceiling this time, thanks to you, it’s got about 18 million cracks in it. And the light is shining through like never before, filling us all with the hope and the sure knowledge that the path will be a little easier next time. That has always been the history of progress in America. [emphasis mine]

Her speech today, and in June, marks the end of something spectacular. But, taking a step back, it shouldn't be. It shouldn't be unusual in this day and age for a woman to run for president. I shouldn't be this upset that a woman lost, knowing it's another 8 years before another woman (or the same!) will have the chance to run again.

We like to think we live in a society without sexism, and I think a lot of people fool themselves into believing its true. And even I -- despite spending a decent amount of my working years as a professional feminist -- managed to become complacent.

Her loss is a slap in the face to women. It's like I'm being told to get back in the kitchen. I don't want a glass ceiling with 18 million cracks in it. I want no glass ceiling at all.

Even tonight, as I watched the coverage on MSNBC directly prior to her speech, some man came on (I'm not sure who) and said that former Hillary supporters were just waiting for Hil to give the word and then they'd be fine with voting for Barack. Because obviously I've been waiting around for someone to TELL me to vote for Barack. I'm just a silly woman who can't make up her own mind, I need to be told what to do (even if by Hillary). To that, unnamed political commentator, I say fuck you. Fuck. You. Part of me really wants to give up on the Democratic Party in general (despite being told its the "women's party" I'm starting to have my doubts) and become an Independent ... but then I remember its my registration as a Democrat that let me vote for Hillary at all.

So when Hillary asked her supporters tonight: "Were you in this campaign just for me?" I have to honestly answer, "Yes, yes I was." If I wasn't, I wouldn't tear up every time I see or hear you. If I wasn't, I wouldn't still be this upset. If I wasn't, I wouldn't feel like your loss was my loss. And despite my love and idolism of you, I simply cannot support your request that I "must support Barack Obama." Sorry, Hil.

No love for the mandate

The Health Care Blog had an interesting piece today comparing Joe Biden's health plan when he was in the primaries (I barely even remember him being an option, to be honest) to Obama's current plan. According to HC blog:

Both cover the usual list of Democrat health care touchpoints -- making coverage affordable with subsidies to people and businesses, creating new public options to supplement private offerings, preventing insurers from denying coverage to the sick, emphasizing prevention and chronic disease treatment, etc., etc., etc., yada yada and so forth.

Neither plan, significantly, follows the Hillary Clinton proposal for mandating coverage for all people. Neither does the vaporous plank on health care in the Democrat's party platform draft.

This makes me sad. I guess you consider Obama's statement that he'd support a single-payer system at some point in the future as his support from universal coverage, but I don't think that goes far enough. I mean, I get it. It's political doomsday to support a mandate (look at Hil now) but really look at Massachusetts. I admit that I haven't looked closely the personal effect of its mandate, or the effectiveness of the coverage, but the resulting increase in coverage is remarkable.

Oh well.

Not concrete = Not important

This makes me so sad.

"For a lot of people who have health insurance, they are paying more for health care, but it may not show up as concretely as paying $70 to fill their gas tank," said Anna Greenberg, a Democratic pollster.

Gas, people? Really? That's your top concern? Somehow, I think it's highly unlikely our next president is going to do anything about gas prices. Buy a Prius and get. over. it.

From the Democratic camp:

Obama's spokesman, Bill Burton, said the problem is the press, not the campaign.

"The issue of health care may be getting less attention than it deserves from the media, but it's still a top concern for voters and among the top issues that Sen. Obama talks about on the campaign trail," said Burton.

That better be true, Obama. I still don't like you, I'm still not voting for you, but you better keep it as a "top concern."

Best quotes:

On why gas is more in people's minds than health care: "If people had to pass that many signs that announced how much health care costs, you can bet it would be at the top of the agenda," said Matt Bennett, a founder of Third Way, a Democratic think tank, and former adviser to Vice President Al Gore.

And of course Drew Altman: "Beneath all that, when you probe, when you ask people what's bothering you about the economy right now, in economic downturns — problems paying for health care and health insurance really loom large," Altman said. "After people's fixations paying for gas prices, problems paying for health care are right at the top with job issues."

[Of course, if I was the head of a huge non-profit dedicated to health care, I might think that health care was a big issue, too.]

Harry and Louise are back!

via WSJ's Health Blog.



Although I found them annoying the first time around... Scratch that, it's not like I'm old enough to really remember the ads the first time ... I remember finding them annoying when looking at them as an adult, in favor of health care reform and a huge Hillary fan.

I wonder if bringing Harry and Louise back will have an large an impact as it did the first time. I would say that most people in some way dislike the current health care system, either in the form of long waits for appointments, high bills, lack of coverage, etc. But is that enough for the country to fall into line for large scale reform? I have my doubts. Problematic as it may be, at least you know how the current system works (or maybe "resigned to the current system" is a more accurate way of putting it).

However, I still have my optimism. Large scale reform will happen someday.

Let's go Harry! Let's go Louise!

[View the old Harry and Louise.]

But if I do OD on Red Bull, prospects are dim

This is just screaming for a D2B campaign (perhaps, D2CT?... neurologists, you are totally slacking).

Red Bull Gives You Wings ... and an increased stroke risk, apparently

Australian researchers said yesterday that Red Bull increases your risk of stroke ... even for young people like me.

"One hour after [research participants] drank Red Bull, (their blood systems) were no longer normal. They were abnormal like we would expect in a patient with cardiovascular disease." said Scott Willoughby, lead researcher from the Cardiovascular Research Centre at the Royal Adelaide Hospital.

I have no degree in chemistry, nor do I know, or want to know, the full ingredient list for Red Bull. I do know from my research one late night that Red Bull only has as much caffeine as a cup of coffee (a depressing fact to learn, let me tell you). So is it all the un-named ingredients causing this increased stroke risk? Or should I also be limiting my coffee consumption to stop increasing my stroke risk? And what about Diet Coke? If one could have a stroke from excess consumption of diet soda, believe you me, I would have had one already.

Final opinion: While I'm sure there are all sorts of disgusting things present in my sugar-free Red Bull, and while it might only have the same amount of caffeine as a cup of coffee, I still love it. Something about it's bubbly unknown goodness really ... gives me wings, you might say. However, given that even the manufacturer says don't consume more than two Red Bulls a day, and the fact that it's banned in several countries, it's unlikely that I'll be abusing the beverage any time soon.

"Bitch is the new black"

Very funny segment on Hillary, via Salon.

If you say health care isn't important, you're wrong

So says Leavitt in his latest blog post on Medicare, which is in response to the legislation he sent to Congress as a result of the Medicare trustees' report. According to Leavitt:

The problem is we are using more and more regular tax dollars, those usually used on other parts of the budget, to pay for Medicare. So, if you worry about education, you should worry about Medicare. Because, Medicare will get its money before education does. Likewise, if you want good roads, you should worry about Medicare. If you think medical research is an important priority, you should be worried about Medicare. Health care costs paid by the federal government are eroding our capacity in other important areas. (emphasis mine)

An important point. I feel like the media doesn't do a good enough good stressing the importance of Medicare/Medicaid funding and the problems with the funding running out (small details, I know). Which is most certainly the fault of lawmakers for not caring enough. I would consider myself a solid liberal, but at some point, sacrifices in the name of financial stability have got to be made. Democratic lawmakers go on and on about not cutting back services, not cutting benefits, etc., but really, we all have to make sacrifices in order to keep the budget afloat. It needs to be addressed and no one's doing it.

For example, great op-ed this week in the Washington Post on the subject on both refusing to compromise AND my nemesis Barack Obama (Also featured in the last post on the election). Columnist Robert Samuelson writes:

A favorite Obama line is that he will tell "the American people not just what they want to hear but what we need to know." Well, he hasn't so far. Consider the retiring baby boomers. A truth-telling Obama might say: "Spending for retirees -- mainly Social Security, Medicare and Medicaid -- is already nearly half the federal budget. Unless we curb these rising costs, we will crush our children with higher taxes. Reflecting longer life expectancies, we should gradually raise the eligibility ages for these programs and trim benefits for wealthier retirees. Both Democrats and Republicans are to blame for inaction. Waiting longer will only worsen the problem."

Instead, Obama pledges not to raise the retirement age and to "protect Social Security benefits for current and future beneficiaries." This isn't "change"; it's sanctification of the status quo. He would also exempt all retirees making less than $50,000 annually from income tax. By his math, that would provide average tax relief of $1,400 to 7 million retirees -- shifting more of the tax burden onto younger workers. Obama's main proposal for Social Security is to raise the payroll tax beyond the present $102,000 ceiling.

Samuelson goes on the say this isn't just Obama's problem, all politicians do it (agreed). But if lawmakers continue to avoid the problem, and on top on that Democrats win both Houses and the presidency (not trying to say I oppose that situation), what will happen in the future? What happens to the people of my generation (and basically anyone living past year 2019, according to the trustees)? Then what?

**

Very funny.

Bringing it back to health care

In a break from my feminist rantings, I found this post from the Health Affairs blog (in an effort to to read other health care blogs). Frank Opelka, a professor of surgery and vice chancellor for clinical affairs at the Louisiana State University Health Science Center, discusses the problems with the way the sustainable growth rate is currently calculated, a better way that it could be calculated and the problems that would be encountered (and overcome!) in implementing his suggested system.

I'm not going to go into the problems with the SGR (see my previous post on Leavitt's blog post of the subject), but I think Opelka's endorsement of a MedPAC suggestion has merit. MedPAC suggested, as part of a Deficit Reduction Act mandate, that the government create "unique Service Category Growth Rate (SCGR) targets as well as payments based on participation in a system of care," noting, "In each proposal, the goal is to avoid the blunt, lofty economic drivers and provide physician incentives to moderate growth in volume and intensity within a geographic setting, specialty base, or system of care," i.e. regional, rather than a national, targets.

In general, when it comes to measures based on economic indicators (like eligibility guidelines for public programs), I think that regional is always better. It does not cost the same to practice medicine in middle-of-nowhere Nebraska as it does in New York City. Regional just makes more sense.

He adds a bit about incorporating quality measures into the SCGR:

These quality tools could serve as a valuable resource for regions and systems of care to promote evidence-based, efficient care. Physicians, medical groups, and hospitals will need to use the current measurements available for comparison against their peers and national benchmarks. Through payment incentives and a clinically focused approach, regional efforts and systems of care will have a greater opportunity to reach individual providers.

Concluding

The best model for modifying the SGR likely includes both regional targets and assessment of spending by specialty. The true answer lies in changing the reward system so that physicians are rewarded for collaborating and making decisions in the best interest of the patient and the overall health care system. The payment system can no longer pay blindly on volume, but must instead financially encourage providers to remove waste and promote efficient, high-quality care. The SGR is too far removed to change behavior at the individual provider level. Regional and service category proposals will bring the requirements closer to the individual, but it is important that unintended consequences be modeled in advance and offset by mandatory quality targets.

I think Congress is supposed to tackle this sometime this session, although I seriously doubt that they will (seems a bit too complicated for lawmakers to handle). But maybe next session, if Democrats can manage to win control of both houses and the presidency. Even if they don't, someone needs to tackle the SGR revision, and soon.

Pent Up Anger

While out for happy hour last weekend in D.C., my friends and I managed to pick a bar that was part of a Obama supporter bar crawl. Standing around with my roommate, we were approached by bar crawl participants, who asked us if we wanted a sticker. We politely told them no thank you, we support Hillary. Which led to a 30 minute discussion about why I was supporting Hillary (my roommate had escaped by this point). So annoying 1) because I was a happy hour, and 2) because speaking/thinking about Obama makes me uncontrollably angry.

I've been doing a lot of thinking lately about why I hate Obama so much. It's not rational, and I would consider myself a rational person by nature. So why the pent up anger?

The only thing I can come up with is that Clinton's downfall is so obviously in part because of sexism. In the media, in people's minds. The media bugs me the most. I expect everyday people to be ignorant, that's just how it goes. But the media? Our society's opinion leaders? I expect them to hold themselves to a higher standard. But they really have not, and completely represent how sexist is still so prevalent, albeit in a more subversive form than in the past. NOW's president Kim Gandy I think sums up my feelings best in her most recent "Below the Bet" post:

The press have been brutal to Clinton, no doubt about it. Whether consciously or not, too many reporters, commentators, pundits and the like appear unable to critique Hillary Clinton without dusting off their favorite sexist clichés, stereotypes and insults. Some of these remarks seem mild, while others are offensive and truly outrageous. Taken together, they create an environment of hostility toward all women, not just Senator Clinton. At this moment it feels like she is a stand-in for every woman who has ever tried to get ahead and be taken seriously by the powers that be.

For me, it's not just the sexist comments about Clinton, it's also the media's absolute inability to critique Obama. Certainly, he's done something to merit scrutiny. They just won't look.

For example, last week (I started this post awhile ago) I was reading the coverage for Maryland's primaries (where I'm from) in the Baltimore Sun. On the front page, there were three stories: one about Clinton, one about Obama, and one about McCain. The tag lines telling readers where to find the rest of the stories were slightly ridiculous: Clinton's was "campaign," McCain's "GOP," and Obama's was "believer." Believer?? Are you kidding me? How about "Obama" or "Democrat" or something without such a blatantly biased connotation? It's little things (so small you wouldn't even realize that you read it unless looking) like that that really drive me insane. Read Gandy's post for more ingratiating remarks.

I've been collecting articles over the last two weeks that I think either resonate with the sexism problems in the media or in society. Here are the highlights:

• "Between 'inspiration' and health care," Froma Harrop: "From his Chicago headquarters, Obama ended the exhausting Tuesday night with an almost mechanical 'we have to choose between change and more of the same.' ... How odd that when it comes to the Democrats’ top concern, health care, Obama offers very much 'more of the same' -- as in more of 'no universal coverage.'"
• "When women rule," Nicholas Kristof: "In monarchies, women who rose to the top dealt mostly with a narrow elite, so they could prove themselves and get on with governing. But in democracies in the television age, female leaders also have to navigate public prejudices -- and these make democratic politics far more challenging for a woman than for a man."
• "Democrats need to understand that racism and sexism still count in elections," Mary Sanchez: "In the final primary weeks, Democrats should ask themselves this question: Is the U.S. more prone to racism or to sexism? And how should the answer affect party strategy if the goal is a Democratic White House. ... I vote sexist. Hillary haters are much more numerous and vocal than those who can’t stomach the idea of a black man globetrotting for the next four years on Air Force One."
• "A calumny a day to keep Hillary away," Stanley Fish: "The majority of posters agreed with the characterization of the attacks on Senator Clinton as vicious and irrational, but in not a few posts the repudiation of Hillary-hatred is followed by more of the same. ... Comments like these would seem to lend support to the view (voiced by many respondents) that sexism is what ultimately motivates the Clinton bashers. ... If so, they face it from women as well as from men, at least on the evidence provided here."
• "Women hold key to Clinton's fate," Bill Maxwell: "The country has had a number of women who have sought the White House, but none could garner wide support. So far, Clinton has been the most viable, but she is facing the 'damned-if-you-do-and-damned-if-you-don't' syndrome. She cannot be too feminine for fear of appearing weak and not up to the job. She cannot be too wonky or too tough for fear being labeled a 'bitch.'"

***

Since writing this post, there has been a slight shift in the media, although it's too little too late, I think. Here's a couple of opinion piece that (finally) realize that Obama's "hope" might not be all it's cracked up to be:

• "Obama's spell memorizing but empty," Charles Krauthammer: "Democrats are worried that the Obama spell will break between the time of his nomination and the time of the election, and deny them the White House. My guess is that he can maintain the spell just past Inauguration Day. After which will come the awakening. It will be rude."
• "The Obama delusion," Robert Samuelson: "Repudiating racism is not a magic cure-all for the nation's ills. The task requires independent ideas, and Obama has few. If you examine his agenda, it is completely ordinary, highly partisan, not candid and mostly unresponsive to many pressing national problems."

Ellen Goodman is my role model

See related coverage about the last post here and here.

It's not nice to mock women in general...

Not related to health at all, really, but I read this piece today in the Houston Chronicle by nationally syndicated columnist Froma Harrop. I thought it touched on a couple of really nice points about women in politics.

Harrop writes, in response to Clinton winning the N.H. primary:

You could feel the swell of female angst. It wasn't even about Hillary Clinton. It was about what she was put through. It was about running while female.

The Democratic race for president was supposed to herald a new era for blacks and women in politics. What became clear was that for the African-American, it is the 21st century. For the woman, it is 1955.

...

Towering over the personal attacks was the monstrous double standard. The woman was the diligent worker, studying the minutiae of health care, terrorism and taxation, but portrayed as an over-the-hill broad, who every 10 minutes had to answer a question about why people didn't like her.

...

By Tuesday, the broads had had enough. Seeing that it had become socially acceptable to mock mature women, they were determined to prove that it was not politically acceptable. Many of their daughters joined them.

My mom told me the other day that she was watching Fox News (please don't ask me why) and as their scrolling headline, they had "Iowa voters don't vote for Hillary because she sounds like a nagging wife." I mean, that's disgusting. And, I realize it's Fox -- not exactly the most enlightened news network -- but really, what were they thinking?

Women have a particularly difficult time in politics, because of the subconscious double standard we hold women to. To be seen as a leader, you have to be bossy. To be a bossy women, is to not be a leader, but a bitch. And it's not just men that hold women to this unattainable standard, I've heard women do it, too.

I think Hillary is amazing because she has somehow managed to navigate this very fine line so well as to be on her way to becoming president. In fact, I like that she's bitchy/bossy. It says something really great about her. She gives a shit enough to buck societal expectations. Way to go Hill, you've got my vote.