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DEAR READER, In your hands is the inaugural issue of FIRESIDE: The University of Chicago Undergraduate Journal of Public Policy. It represents a years worth of student effort analyzing complex policy issues and excellent student work on a variety of ideas in a variety of fields. Since 2004, the Roosevelt Institute has been dedicated to promoting student ideas and providing them with a public forum. While the organization itself is progressive, we are interested in all student ideas and care not for liberal or conservative government, but smart government. In this spirit we inaugurate FIRESIDE and are proud to present it to you. Michael Francus Editor-in-Chief
SPECIAL THANKS GO TO VITAS ZUKOWSKI, WHO WAS RESPONSIBLE FOR THE DESIGN OF THE JOURNAL AND COORDINATING THE PUBLICATION PROCESS FROM START TO FINISH.

Email us at rooseveltchicago@lists.uchicago.edu or visit the Roosevelt Institute at the University of Chicago online at facebook.com/UChicago.Roosevelt
Opinions expressed in FIRESIDE are solely the opinions of the authors and do not represent the policy positions of the Roosevelt Institute at the University of Chicago, the Roosevelt Institute Campus Network, or the University of Chicago. This publication was made possible through the generous support of the Roosevelt Institute Campus Network.
Cover photo (Nostalgic hues) is copyright 2009 Justin Kern and made available under a Creative Commons Attribution-NonCommercial-NoDerivatives 2.0 license

TABLE OF CONTENTS
Morally Sound Investment ............................................................................... 3 James Duehr Swedens Model for the Regulation of Prostitution.................................. 5 Eleanor Easton Healthcare and States Rights: A New Cure for Americas Health Woes ..................................................... 7 Sam Fell Reforming the Filibuster: Making Good Governance Possible .............................................................. 9 Basil Halperin The Cholera Epidemic in Haiti: A Human Rights Issue that Demands Our Attention ........................... 12 Yaniv Kleinman Ending Employment Discrimination in Ohio ......................................... 14 Cecile Murray Federal Funding for Public Television Should Be Increased ............. 17 Osita Nwanevu ESL Education for Skilled Immigrants ...................................................... 20 Samah Rizvi Physician Labor Supply and Health Care Legislation .......................... 23 Igor Vasiljevic

Morally Sound Investment


James Duehr

As one of the top-tier educational institutions in the United States, and the possessor of an endowment ranking among the top ten controlled by private universities1, it is inevitable that the University of Chicago will encounter thorny issues regarding its investment policy. While a number of these decisions may be purely speculative or financial, and the University must invest its money in a profitable fashion in order to maintain the research and education that takes place on campus, it is nonetheless inevitable that investment decisions come to be weighed against political, social, and moral concerns. One of the first such confrontations affecting investments by the University of Chicago involved the issue of divestment from South Africa during apartheid, a period when many major institutions and organizations (ranging from state governments to peer institutions such as Harvard and Princeton) were opting to do so2. This case set a precedent for the handling of investment questions; the University of Chicago chose to disregard both outside examples and internal calls for divestment. As a result, while other universities developed the institutional framework required to address the issue of socially responsible investment policy, the University of Chicago did not.3 As an indirect result of this policy, the University has become financially involved with a number of corporations and businesses with dubious ethical standards, as well as others that have engaged or continue to engage in illegal, dangerous, or otherwise questionable business practices4. For instance, the University currently owns 10% of HEI Hotels and Resorts, a hotel management company currently cited in an official complaint and under investigation by the National Labor Relations Board of the United States for suppressing union activity, for which it is facing legal action5. The University also invests in Allegheny Energy, an electricity provider that was sued in 2005 by the states of Connecticut, Pennsylvania, New York, and New Jersey for failure to comply with the Clean Air Act by producing sulfur dioxide and nitrogen oxide
Sofen and Wirzbicki, A Conflicted Relationship: Harvard Supported South Africa through Investments but Partially Divested Under Protest. http://www.harvardsquarelibrary.org/mandela/20_conflicted_relationship.html
2 Tsoi, Crystal. Zimmer Calls SRIC Creation Unlikely at Student Meeting. May 27, 2011. http://chicagomaroon.com/2011/05/27/zimmer-calls-sric-creation-unlikely-at-student-meeting/ 3 Endowment data is taken from the 2009 NCSE Public Tables Endowment Market Values, published by the National Association of College and University Business Officers and Commonfund Institute. 4 See SEC filings for 13-HFR University of Chicago September 2008. http://www.sec.gov/Archives/edgar/data/314957/000031495708000009/0000314957-08-000009-index.htm 5 Documentation of the complaint is unavailable on the NLRB website; the complaint is referenced in Yale Daily News, Caplan-Bricker and Yee, Univ. to reconsider controversial investment, March 23, 2010. 1

emissions in excess of legal limits6. Another example of questionable investment is Arch Coal, which was the target of the first Federal Court Ruling against strip mining and mountaintop removal, both of which are environmentally destructive mining methods7. These examples illustrate the manifestly irresponsible manner in which the University has invested and continues to invest its endowment. In the absence of even basic standards pertaining to sites of investment, such as requiring a potential target to have an antidiscrimination policy, the University has no way of ensuring that its money is invested in a manner that is both socially and morally responsible. This raises three major concerns. First, the University runs the risk of investing in disreputable businesses, a risk unfortunately realized in current investments. Second, the reputation of the University may be tarnished by association with such businesses. Third, and most importantly, by investing in organizations with illegal or harmful business practices the University furthers and participates in the irresponsible activities of such organizations. Moreover, as it lacks the institutional framework for evaluating the ramifications of continued investment in any particular organization or business, the University is currently without recourse in such situations. Given its position as a prominent and highranking institution for research and education, and its significant financial wherewithal, it is unacceptable for such a situation to endure. I propose, therefore, that this situation be resolved via the creation and institution of a committee for the monitoring and regulation of investments.

6 News Item 2: Judge Allows Suit Against Allegheny to Proceed, June 1, 2006. http://eponline.com/articles/2006/06/01/legal-news.aspx 7

Arch Coal May Close Two Mines and Eliminate Jobs, New York Times, Oct 29th 1999. http://www.nytimes.com/1999/10/29/business/company-news-arch-coal-may-close-two-mines-and-eliminatejobs.html?src=pm

Swedens Model for the Regulation of Prostitution


Eleanor Easton

INTRODUCTION Prostitution is called the worlds oldest profession, and continues to thrive worldwide regardless of laws or restrictions. Many countries, such as the Netherlands, have legalized prostitution in order to protect the rights and health of sex workers.1 However, the overwhelming majority of studies on prostitution suggest that legalizing prostitution inevitably is tied to human trafficking, abuse, rape, and crime.2 To counter these issues without putting prostitutes at risk, Sweden, and later Norway and Iceland, passed a law that criminalized buying sexual services but not selling them.3 I propose that this policy also be implemented in Austria, where prostitution is legal but not as popular, in order to decrease human trafficking without putting sex workers in danger or denying them health care. BACKGROUND The current Swedish provisions were put in place under the Kvinnofrid Law in 1999. Earlier, Amsterdam had legalized prostitution in 1988, and in 2000 permitted brothels to become fully legal businesses. This was intended to de-stigmatize prostitution and to allow sex workers access to healthcare.4 However, the policy did not succeed, as evidenced by the United Nations Office on Drugs and Crime, which now lists the Netherlands as a top destination for human trafficking. This suggests that legalization has led to more human rights violations rather than fewer. In Sweden, however, human trafficking has been greatly reduced, and although sex workers have a harder time finding business, they are more able to seek protection and care without fearing law enforcement.5 The number of foreign women in Norway has also declined in the past few years, suggesting that trafficking has been reduced.6 Prostitution is also legal in Austria, though it is a much smaller industry than in the Netherlands.7
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"Prostitution in Amsterdam." Amsterdam.info. Web. 24 Apr. 2012. <http://www.amsterdam.info/prostitution/>.

"Policy Innovations The Central Address for a Fairer Globalization." Does Legalizing Prostitution Work? Web. 23 Apr. 2012. <http://www.policyinnovations.org/ideas/commentary/data/000107>.

"The Same Policy, But Different Ideas: The Ideational Underpinnings of the Norwegian and Swedish Bans on the Purchase of Sexual Services By Gregg Bucken-Knapp, Johan Karlsson, Karin Persson Straembaeck. Web. 24 Apr. 2012. <http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1452294>.nppr.se/wp-content/uploads/NPPR_ECPG_2011.pdf
4 Prostitution Policy in Europe: A Time of Change? Judith Kilvington, Sophie Day and Helen Ward Feminist Review , No. 67, Sex Work Reassessed (Spring, 2001), p. 78.

Mees, Helen. "Policy Innovations The Central Address for a Fairer Globalization." Does Legalizing Prostitution Work? Web. 26 Apr. 2012. <http://www.policyinnovations.org/ideas/commentary/data/000107>.
6 "Prostitution in the Nordic Countries." Nordic Gender Institute. Web. 30 Apr. 2012. <http://www.nikk.no/Prostitution in the Nordic Countries.9UFRDY54.ips>.

Prostitution Policy in Europe: A Time of Change? Judith Kilvington, Sophie Day and Helen Ward Feminist Review , No. 67, Sex Work Reassessed (Spring, 2001), p. 79

PROPOSED PROGRAMS I propose that Austria implement the same law regarding prostitution as has already been implemented in Sweden, Norway, and Iceland. As in Sweden, the policy should be implemented by the government and similarly enforced. If the policy succeeds, it would demonstrate that Swedens model is effective outside of the Nordic countries, and so can be expanded to more countries in Europe. ALTERNATIVES The Swedish model is innovative in providing prostitutes with rights while inhibiting trafficking. Making prostitution illegal forces prostitutes underground and makes them unable to safely obtain basic healthcare. Legalizing prostitution, however, encourages it as a trade and goes hand in hand with trafficking. Swedens model can in some cases force sex workers to go underground, and because their customers are breaking the law, prostitution tends to be more dangerous. However, these problems are more easily regulated when sex workers can find assistance without fearing legal consequences. Research on Swedens model has found that it has effectively and significantly cut down on trafficking.8 CONCLUSION The Swedish model of regulating prostitution is innovative and has proven effective in the countries where it has been implemented. It should next be implemented in Austria, and if this initiative is successful, the feasibility of expanding the law to other countries in Europe should be analyzed.

"Nordic Prostitution Policy Reform." Nordic Prostitution Policy Reform. Web. 23 Apr. 2012. <http://nppr.se/>.

Healthcare and States Rights: A New Cure for Americas Health Woes
Sam Fell

As commentators and spectators across the political spectrum have noted, the Supreme Court looks ready to strike down the Affordable Care Acts (ACA) individual mandate, and with it, the health insurance component integral to President Obamas healthcare reform. The defeat of the ACA by the Supreme Court could, however, open a great opportunity for proponents of universal, singlepayer healthcare to further their cause, while using a traditionally conservative platform to do so. Even with the provisions of the Affordable Care Act, healthcare in the United States continues to be plagued not only by problems of accessibility, but also of affordability. Much of Obamas planned solutions, which are planned to come into effect in 2015 and afterwards, have yet to take hold, and we have seen the current system struggling under the burgeoning weight of growing premiums and high rates of un- and under-insurance. Even in Massachusetts, the state whose landmark healthcare reform was the model for Obamas national plan, healthcare costs have continued to rise. In new legislation put forth by governor Deval Patricks administration, intended to curb inflationary costs in the states system, the state admits that, left unchecked, per capita health spending in the commonwealth is expected to continue to outpace the annual rise in the gross domestic product, with total health care spending reaching $123 billion by 2020.1 With the defeat of the Affordable Care Act in the Supreme Court, the states would once again find themselves on their own on regarding issues of healthcare. In such a scenario, the Supreme Court would find it unconstitutional for the government to regulate a product by mandating that all citizens purchase it, and as such, President Obamas solution to the healthcare crisis would become untenable. More liberal solutions, like a public option to compete with private insurers, or a tax levied to provide basic care for all, while perhaps more constitutionally viable, remain in the realm of political fantasy, given the Republican stranglehold on the House of Representatives Left to their own devices, the states will find themselves with serious challenges to overcome in order to control costs and manage care. Massachusetts, for instance, has tried numerous methods to manage costs, including rejecting premium increases for major insurers2, and attempting to move the state away from the costly fee-for-service model, in which doctors are paid for all the procedures

1Act

Improving the Quality of Healthcare and Controlling Costs by Reforming Health Systems and Payments. 2011. https://docs.google.com/file/d/1xSAMKW9sCv0HgEaih6MUBX03rL4XRlV1fTkzGMETW1A78iLPrW4mdegSskJI/edit?hl=en

Wesiman, Robert. Health Care Hikes Rejected. http://www.boston.com/business/healthcare/articles/2010/04/02/state_rejects_health_insurance_rate_hikes/

they perform, towards a more general global payment for each patients care3. Massachusetts need only look to her northern neighbor, however, to see a much more streamlined, cost-effective, and ultimately fairer plan to implement real healthcare reform. On May 26, 2011, Vermont Governor Peter Shumlin signed into law a bill that would pave the way for the Green Mountain state to, define an minimum standard of benefits for all Vermonters that includes coverage of services with proven cost effectiveness in preventing illness and enhancing health status4. Thus, Vermont will become the first state in the union to provide universal, singlepayer health coverage to its citizens. Not only will the state provide quality, universal access to health care, but the states Green Mountain Care will be able to unilaterally determine rates for patients, save money on administrative costs, and eliminate advertising costs and other such problems borne by private, competing, companies. The state would finance care mainly through a payroll tax (similar to the way healthcare is currently financed by employer-based plans) and all Vermonters would enjoy a universal package of benefits. Justice Louis Brandeis noted, A single courageous state may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country.5 Vermont, in this case, serves more as an example than a laboratory to the rest of the country. As states struggle with ballooning costs, rising premiums, and burgeoning rolls of uninsured and underinsured residents, the Vermont solution may become necessary. Indeed, the idea has already taken hold in California66 and Oregon77. With the impending defeat of the Affordable Care Act, as many states begin to tackle healthcare on their own, more states will join them. The Supreme Courts decision on ACA is due back in June. If it is defeated, we may see the conservative rallying cries of states rights and localized government turned on their head. Following Vermont, states may direct the United States towards fair, equitable, affordable healthcare for all.

3 Goodnough and Sack, Massacheusetts tries to Rein in its Health Costs. http://www.nytimes.com/2011/10/18/us/massachusetts-tries-to-rein-in-its-health-care-cost.html?pagewanted=all 4 5

Lunge, Robin. http://hcr.vermont.gov/sites/hcr/files/Strategic%20plan%201%2016%2012.pdf

http://blavier.newsvine.com/_news/2008/10/25/2039551-the-laboratory-of-democracy-alternative-voting-methodsapproval-voting http://blogs.sacbee.com/capitolalertlatest/2012/01/california-universal-health-care-bill-clears-state-senate.html http://www.pnhp.org/news/state-single-payer-news

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Reforming the Filibuster: Making Good Governance Possible


Basil Halperin

INTRODUCTION The skyrocketing use of the filibuster over the past decade has made Congress unable to govern. The filibuster should be eliminated to promote good governance and to increase bipartisanship. HISTORY The filibuster, the obstructionist Senatorial tactic of extending debate on a bill to prevent a vote on passage, was an accident of history. Vice President Aaron Burr, in his 1805 retirement speech following his indictment for the murder of Alexander Hamilton in a duel, advised the Senate to clean up its rulebook. During the revisions that followed, the previous question motion that allowed for a simple majority to cut off debate (like the one still used in the House today) was deleted merely as part of an effort to shorten the rulebook, not as a deliberate decision to allow for obstruction1. The first filibuster did not occur until 18412. In 1917, due to wartime pressures, a cloture rule was created, allowing two-thirds of Senators to vote to end debate. Creating a two-thirds rule, rather than a simple majority one, was a compromise measure to appease the minority political party at the time, not a deliberate decision to protect minority rights in the Senate3. Later, following the Watergate scandal, the cloture rule was lowered to the three-fifths level where it remains today, and the filibuster was changed so that legislation could be obstructed without the filibustering senator having to take the floor and speak. Despite the ease of its use since the first decade of the 19th century, the filibuster was extraordinarily rarely used up until the 1990s. Even during the contentious 1960s, only eight percent of major bills faced a filibuster. In contrast, seventy percent of major bills in the last decade were filibustered4.

Binder, Sarah A. "The History of the Filibuster." Brookings Institution. 22 Apr. 2010. Web. 06 May 2012. <http://www.brookings.edu/testimony/2010/0422_filibuster_binder.aspx>. "U.S. Senate: Art & History Home Origins & Development Senate Chronology." Senate.Gov. Web. 06 May 2012. <http://www.senate.gov/pagelayout/history/one_item_and_teasers/chronology.htm>.
3 4 2

Ibid.

Klein, Ezra. "After Health-care Reform, Senate Reform." Washington Post. 26 Dec. 2009. Web. 06 May 2012. <http://voices.washingtonpost.com/ezra-klein/2009/12/after_health-care_reform_senat.html>.

In the 2000s, cloture was invoked on average 95 times per Congress; in the 1980s, cloture was invoked on average 41 times per Congress; and in the 1960s, cloture was invoked on average a mere six times per Congress5. Further, these cloture data do not capture the full growth in use of the filibuster since not every filibuster faces a cloture vote. ANALYSIS This dramatic rise in the abuse of the filibuster has made passing legislation significantly more difficult. The last five congresses passed nearly 50% fewer bills than the five congresses of the 1950s, when the filibuster was rarely used6.

Cloture votes by Congress (1951-2011)


160 140 120 100 80 60 40 20 0

Cloture motions filed Votes on cloture Cloture invoked

82 84 86 88 90 92 94 96 98 100 102 104 106 108 110

Congress
Data: senate.gov

This partly indicates the legislative trend of combining multiple individual measures into omnibus bills, but also correlates with and reflects the increasing use of the filibuster to block legislation. In the 112th Congress, every piece of legislation that has passed the Senate has required the filibuster-proof 60 votes to pass7 8.
5 "Senate Action on Cloture Motions." Senate.Gov. Web. 06 May 2012. <http://www.senate.gov/pagelayout/reference/cloture_motions/clotureCounts.htm>. Authors calculations. 6 United States. Government Printing Office. About United States Statutes at Large (Digitized). Web. 06 May 2012. <http://www.gpo.gov/help/about_united_states_statutes_at_large_digitized.htm>. Authors calculations. 7 "U.S. Senate: Legislation & Records Home Votes Roll Call Vote Summary - 112th Congress, 1st Session." Senate.Gov. Web. 06 May 2012. <http://www.senate.gov/legislative/LIS/roll_call_lists/vote_menu_112_1.htm>

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This decline in the number of bills passed would not be an issue if either the number of challenges facing America has decreased or the quality of legislation has increased. Neither, however, is the case. In an increasingly complex and interconnected world, the number of challenges facing the United States has grown and will only continue to do so. It is also difficult to conclude that the quality of legislation has improved when the approval rating of Congress is at an all-time low of 10%9. NEXT STEPS The filibuster should be eliminated from the Senates parliamentary procedure and the original question motion should be reinstated in the Senate. Debate could be cut off by a simple majority vote, and the effective three-fifths requirement for passing legislation would disappear. This would make legislation easier to pass, allowing for more flexible and responsive governance. Also, such a solution would increase bipartisanship. While some argue that the filibuster promotes moderation by necessitating negotiation and bipartisanship, this is not the case. On the contrary, the filibuster incentivizes the minority party to vote in lockstep to frustrate the majority partys agenda at any cost. If instead the filibuster were eliminated, the minority party would not have such an incentive to vote merely for obstructionisms sake. Consequently, the minority party would be incentivized to negotiate with the majority party. This is no radical solution. It is a return to the status quo of two decades ago, and a return to the way that the Senate operated for the vast majority of its existence. It has proven functional in the past, and is the proper remedy for a dysfunctional present.

8 "U.S. Senate: Legislation & Records Home Votes Roll Call Vote Summary - 112th Congress, 2nd Session." Senate.Gov. Web. 06 May 2012. <http://www.senate.gov/legislative/LIS/roll_call_lists/vote_menu_112_2.htm>
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Newport, Frank. "Congress' Job Approval at New Low of 10%." Gallup, 08 Feb. 2012. Web. Accessed May 6, 2012. <http://www.gallup.com/poll/152528/congress-job-approval-new-low.aspx>.

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The Cholera Epidemic in Haiti: A Human Rights Issue that Demands Our Attention
Yaniv Kleinman

The devastating earthquake that hit Haiti on January 12, 2010 will be forever remembered as one of the darkest moments in the countrys history. The 7.0 magnitude earthquake tragically revealed the weak public infrastructure left by decades of stultifying debt and the haunting legacies of interventions and corruption.1 With over 300,000 lives lost in the earthquake, the international community responded by sending vast infusions of aid and rescinding Haitis debt.2 However, as Haitians continue to recover from the damage of the earthquake, another reckoning force continues to take a severe human toll on Haitians: the cholera epidemic that has spread throughout the country. The first documented case of cholera occurred in October 2010 only nine months after the earthquake. After extensive medical research, repeated tests showed that cholera was introduced by UN peacekeepers from Nepal, where cholera is endemic. Since the first case was reported two years ago, the disease has spread unrelentingly, and the consequences have been catastrophic: 500,000 Haitians have been affected, and over 7,000 have died, approximately 5% of the total population.3 Originally discovered in the 19th century, cholera is a water-born illness caused by bacteria. The infected person experiences persistent diarrhea, ultimately leading to death due to electrolyte imbalances and extreme dehydration.4 Currently, over 200 new cases of cholera occur daily in Haiti, where less than half of the population has access to safe water.5 Given the extent that cholera has spread, the problem must be assessed systemically; the lack of proper water and sanitation systems in Haiti has exacerbated the situation.

The Center for Human Rights and Global Justice et al., Woch Nan Soley: The Denial of the Right to Water in Haiti, http://www.chrgj.org/projects/docs/wochnansoley.pdf World Bank, World Bank Statement on Haiti Debt, http://go.worldbank.org/2BQD8Q7ER0

3 Sean Casey, Cholera in Haiti: Still an Emergency, The Guardian, November 7, 2011, http://www.guardian.co.uk/global-development/poverty-matters/2011/nov/07/haiti-cholera-still-emergency-donors 4 Lloyd Denis, Haiti Cholera Epidemic Causes and Effects, Yahoo! Voices, November 4, 2011, http://voices.yahoo.com/haiti-cholera-epidemic-causes-effects-7127644.html?cat=5 5 Meera Dalal, Cholera in Haiti: From Control to Elimination, Al Jazeera, January 13, 2012, http://www.aljazeera.com/indepth/features/2012/01/2012111193155842439.html

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Compare the two countries in Hispaniola: whereas few in Haiti have access to proper sanitation, over 93% of people in neighboring Dominican Republic have access to safe, drinking water. Efforts in the past to remedy the lack of public health infrastructure have failed due to external interference by other states: in 1998, when the International Development Bank approved $58 million to repair Haitis water and sanitation systems, the United States blocked the initiative and prevented the funds from being disbursed. As a result, the countrys infrastructure was compromised. Notwithstanding, we must find ways to address structural conditions afflicting Haiti while finding immediate solutions. The first step is to acknowledge that access to safe water and sanitation is a human right. As recognized under international law, under the International Covenant on Economic, Social and Cultural Rights, access to safe water is a fundamental aspect of international development.6 Because the United Nations continues to have an active presence in Haiti after the earthquake, it is necessary for the organization to uphold and implement international human rights law in its missions and operations. In the case of Haiti, there are steps we can take to remedy the crisis. First, the neglected public water and sanitations systems must be repaired. Given the current rain of the spring season, it is imperative to contain cholera by rebuilding the countrys weak infrastructure. Second, the international community must continue vaccination programs and help those in the most vulnerable conditions who are likely to catch cholera. Vaccination programs have been instituted since the epidemic began and have proven successful when implemented, but more funding is needed to extend their reach. Third, global development institutions like the World Bank must expand and accelerate aid to Haiti. Dr. Jim Kim, cofounder of Partners in Health and recently appointed President of the World Bank, ought to facilitate the provision of aid to Haiti while simultaneously addressing Haitis structural issues. Lastly, the UN must take responsibility for responding to the cholera epidemic. As the Institute of Justice and Democracy has argued, the UN has a duty to help with rebuilding Haitis infrastructure under the Status of Forces agreement signed with the Haitian government.7 The UN peacekeepers in Haiti, MINUSTAH, have a budget of over $800 million per year. If those funds were spent on vaccinations and public health, tens of thousands of lives could be saved. We have a moral responsibility to help Haiti recover. Dozens of people continue to be infected daily. We can stop cholera, and we must start now. It is the least we can do.

This is implied in Articles 11 and 12 of the convention. See Office of the United Nations High Commissioner for Human Rights, International Convenant on Economic, Social and Cultural Rights, http://www2.ohchr.org/english/law/cescr.htm#art11

7 Kim Ives, Lawyers for Haiti Cholera Victims Tell UN: Immunity Cannot Mean Impunity, Institute for Justice and Democracy, April 11, 2012 http://ijdh.org/archives/26227

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Ending Employment Discrimination in Ohio


Cecile Murray

INTRODUCTION The notion of equality is a fundamental part of the cultural fabric of the United States, yet inequalities still exist in our society, especially in the workplace. Despite the last centurys advances in civil rights, it remains legal in the state of Ohio to: not hire, underpay, or fire someone on the basis of sexual orientation or gender identity. Moreover, such discrimination is not uncommon. In a 2009 study, more than 1 in 10 lesbian, gay, or transgender people in the United States reported having experienced employment or housing discrimination.1 According to a 2002 study, gay males earn between 16% and 28% less than their heterosexual male counterparts.2 Furthermore, 90% of the transgender population has experienced some kind of employment discrimination.3 Studies have also shown that sexual orientation and gender identity are personal characteristics with no inherent impact on workplace performance, so this discrimination is completely unfounded.4 To stop this abuse of civil rights and safeguard the welfare of all Ohioans, the state of Ohio should add sexual orientation and gender identity to existing law protecting against such discriminatory employment practices. HISTORY The first instance of legislation designed to extend such protections was proposed in 2003, when House Bill 147 and its compliment, Senate Bill 77, were introduced in March and April, respectively.5 They were the first in a chain of similar bills to fail in committee. The Ohio House of Representatives did pass one such bill, H.B. 176, in 2009, but the Senate version never came to the floor. In September 2011, two similar measures, Senate Bill 231 and House Bill 335, were introduced in the Senate and the House respectively. The Senate Bill has not yet been assigned a
1

Herek, Gregory M, Hate Crimes and Stigma-Related Experiences Among Sexual Minority Adults in the United States, Journal of Interpersonal Violence, 24, no. 1 (January 2009), 54-74, http://jiv.sagepub.com/content/24/1/54 (accessed February 20, 2012).

Nathan Berg, and Donald Lien, "Measuring the Effect of Sexual Orientation on Income: Evidence of Discrimination," Contemporary Economic Policy, 20, no. 4 (2002): 394-414, http://www.uwlax.edu/faculty/giddings/ECO336/Week_6/Berg_Lien.pdf (accessed December 1, 2011). Grant, Jamie M, Lisa A. Mottet, and Justin Tanis, Injustice at Every Turn: A Report of the National Transgender Discrimination Survey, Executive Summary, February 3, 2011, http://thetaskforce.org/reports_and_research/ntds (accessed December 1, 2011). Sears, Brad, Nan D. Hunter, and Christy Mallory, Relationship of Sexual Orientation and Gender Identity to Performance in the Workplace in Documenting Discrimination on the Basis of Sexual Orientation and Gender Identity in State Employment, Williams Institute at UCLA Law, September 2009, http://wiwp.law.ucla.edu/wpcontent/uploads/4_PerformanceInWorkplace.pdf (accessed December 1, 2011).
5 Ohio Legislative Service Commission, Final Status Report of Legislation, 125th General Assembly, http://www.lsc.state.oh.us/status125/srl125final.pdf, accessed 25 January 2012. 4 3

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committee, but the Houses Committee on Commerce & Labor is currently considering H.B. 335.6 The two bills are identical, but since H.B. 335 has made more progress and the House has previously passed such a bill, this analysis will focus on it. ANALYSIS The definitions of sexual orientation and gender identity as given in H.B. 335 are insufficiently clear. Currently, the bill defines sexual orientation as actual or perceived heterosexuality, homosexuality, or bisexuality, a definition similar to many used by other states. However, in 2006, an international panel of human rights experts generated a set of more comprehensive definitions. Their improved definition of sexual orientation reads: the capacity for profound emotional, affectional and sexual attraction to, and intimate and sexual relations with, individuals of a different gender or the same gender or more than one gender, or lack thereof.7 This definition guarantees protection to a wider section of the population and is similar to the legal definition currently used in Minnesota.8 More importantly, defining sexual orientation without creating specific subcategories of attraction helps ensure that the law protects everyone, regardless of their orientation. It underlines the fact that this bill is not just about gay rights, but about the rights of all Ohioans including heterosexual ones to discrimination-free employment. Similarly, the bill should redefine gender identity to ensure that the expression of that identity will be protected. Currently, the bill defines gender identity as the gender-related identity, appearance, or mannerisms or other gender-related characteristics of an individual, with or without regard to the individuals gender at birth. While this definition covers the bare minimum, it is not particularly comprehensive. Once again, the definition generated by the international panel would be an improvement: Gender identity refers to each persons deeply felt internal and individual experience of gender, which may or may not correspond with the sex assigned at birth, including the personal sense of the body (which may involve, if freely chosen, modification of bodily appearance or function by medical, surgical or other means) and other expressions of gender, including dress, speech and mannerisms.9

6 Information from the Ohio Legislative Service Commission, http://www.lsc.state.oh.us/default.html, as of January 25, 2012 7 The Yogyakarta Principles on the Application of International Human Rights Law in relation to Sexual Orientation and Gender Identity, http://www.yogyakartaprinciples.org/principles_en.htm (accessed December 1, 2011). These principles were generated at a summit of international human rights experts in 2006 to outline a set of international definitions related to sexual orientation and gender identity for use in international law. 8 9

Definition of sexual orientation 2011, Laws of Minnesota, 2011: 363A.03, Subd. 44. The Yogyakarta Principles

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In addition to clarifying the legal wording, this second definition better explains gender as an internal concept that is expressed through dress and behavior, among other means. Essentially, both of these definitions would help eliminate legal division between LGBTQ and binary-gender-conforming heterosexual individuals. Rather than emphasizing the particular label with which a given individual associates, the bills focus on the real issue that the law should protect people against discrimination on the basis of their sexual orientation or gender identity, regardless of how they identify. The elimination of employment discrimination not only protects especially vulnerable sections of the population, but also makes economic sense. The poverty rates for homosexual men and women are above the national average, and they are more likely to be receiving public assistance than their heterosexual counterparts.10 Transgender people, meanwhile, have unemployment and homelessness rates at nearly double that of the general population, likely as a result of the widespread prejudices they face.11 By eliminating discrimination in the workplace, Ohio could provide these vulnerable individuals with the opportunity to better their situation without needing to spend significantly more state funds. NEXT STEPS Since discrimination contributes to the economic disadvantages LGBTQ communities face, ending it could help thousands of Ohioans improve their economic status. Therefore, the Ohio Legislature should pass H.B. 335, amended to more inclusively define sexual orientation and gender identity, to protect all Ohioans from pointless discrimination on the job.

10 Albelda, Randy, M.V. Lee Badget, Alyssa Schneebaum, and Gary J. Gates, Poverty in the Lesbian, Gay, and Bisexual Community, Williams Institute at UCLA Law, March 2009, http://williamsinstitute.law.ucla.edu/research/census-lgbtdemographics-studies/poverty-in-the-lesbian-gay-and-bisexual-community/ (accessed December 1, 2011). 11

Grant, Mottet, and Tanis.

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Federal Funding for Public Television Should Be Increased


Osita Nwanevu

HISTORY Ever since its inception in the early 1970s, the Public Broadcasting Service (PBS) has provided communities with high-quality television programming either not commonly found within or not made universally accessible by the profit-driven commercial television industry. A wide body of research has demonstrated the superior educational value of shows like Sesame Street, Mr. Rogers Neighborhood, and Arthur over childrens programming typically offered by the commercial networks.1 2 3 Similarly, both nationally broadcast PBS news programs like PBS NewsHour, Frontline, and Independent Lens, as well as news programming broadcast by PBS member stations in local markets, have been lauded for journalistic excellence and covering news items overlooked by profit-seeking commercial television networks.4 5 6 However, PBSs funding scheme prevents it from reaching its full potential. The national overarching organization referred to as PBS and the local public television stations with PBS membership operate largely independently of each other. Unlike other public television networks like the British Broadcasting Company (BBC), PBS does not produce original content. Instead, it buys programming from independent producers like Sesame Workshop or wellestablished member stations like WGBH-Boston, which it then distributes to other member stations.

Levin, Robert A., and Laurie Moses Hines. "Educational Television, Fred Rogers, and the History of Education." History of Education Quarterly. 43. no. 2 (2003): 262-275. http://www.jstor.org/stable/3218313 (accessed March 23, 2012).
2

Kirkorian, Heather L., Ellen A. Wartella, and Daniel R. Anderson. "Media and Young Children's Learning." The Future of Children. 18. no. 1 (2008): 39-61. http://www.jstor.org/stable/20053119 (accessed March 23, 2012).
3 Wright, John C., Aletha C. Huston, Kimberlee C. Murphy, and Michelle St. Petersast. "The Relations of Early Television Viewing to School Readiness and Vocabulary of Children from Low-Income Families: The Early Window Project." Child Development. 72. no. 5 (2001): 1347-1366. http://www.jstor.org/stable/3654391 (accessed March 23, 2012). 4

Public Broadcasting Service, "PBS NewsHour: Awards." Accessed April 28, 2012. http://www.pbs.org/newshour/aboutus/awards.html.
5

Public Broadcasting Service, "Frontline: Awards." Accessed April 28, 2012. http://www.pbs.org/wgbh/pages/frontline/about-us/awards/.
6

Public Broadcasting Service, "Independent Lens: Awards and Accolades." Accessed April 28, 2012. http://www.pbs.org/independentlens/about/awards.html.

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Funding is similarly dichotomized. In total, PBS reported receiving about $475 million in revenue last year, while a 2007 Government Accountability Office (GAO) report on the state of public television stated that in 2005 public television licensees made $1.5 billion in revenue.7 For both PBS and its member stations, the majority of funding comes from donations from private individuals, foundations, and businesses. Most federal dollars are provided through the Corporation for Public Broadcasting (CPB), a non-profit organization created by Congress in 1967, which accounts for roughly 15% of public television funding7, a proportion which totaled around $280 million in fiscal year 2010.8 Allocations from that pool are split between PBS itself and grants to its member stations and independent producers. ANALYSIS Post-recession declines in non-federal support have made federal funding an increasingly important part of the finances of PBS and its member stations. Funding for local stations from all non-federal sources decreased by $260 million dollars between 2008 and 20099 and recent months have seen states like Virginia and Florida promise more cutbacks.10 11 Increased federal funding would not only provide PBS and its member stations with the financial means to overcome these recent developments, but would also allow them to avoid some of the inherent problems with non-federal funding. These problems include dependence on a largely socioeconomically homogenous group of donors that leads to similarly homogenous programming that often neglects the issues facing and interests of minority and marginalized groups,12 13 14 15 and the ongoing trend of enhanced underwriting in which corporate donors
7 8

"Public Television Funding: Government Accountability Office Report." Congressional Digest, May 2011.

Corporation for Public Broadcasting, "2010 Annual Report: Financials - How Does CPB Distribute Its Funds?." Accessed March 28, 2012. http://www.cpb.org/annualreports/2010/financials/how-does-cpb-distribute-its-funds.html.
9

Jensen, Elizabeth. "Big Bird to the Rescue." Columbia Journalism Review, July 2011, 33-37.

10

Meola, Olympia. "Public stations to cut 11 positions." Richmond Times-Dispatch, April 21, 2012. http://www2.timesdispatch.com/news/virginia-politics/2012/apr/21/tdmet01-public-stations-to-cut-11-positions-ar1858513/ (accessed April 21, 2012).
11

Kennedy, John. "Budget vetoes seen as less likely in Gov. Scott's second year." The Palm Beach Post, April 8, 2012. http://www.palmbeachpost.com/news/state/budget-vetoes-seen-as-less-likely-in-gov-2290654.html (accessed April 27, 2012).
12

Balas, Glenda R. "From Underserved to Broadly Served: The Class Interests of Public Broadcasting."Critical Studies in Media Communication. 24. no. 4 (2007): 365-369. Kropf, Martha, and Stephen Knack. "Viewers Like You: Community Norms and Contributions to Public Broadcasting." Political Research Quarterly. 56. no. 2 (2003): 187-197. http://www.jstor.org/stable/3219897 . (accessed April 28, 2012).
14 Kropf, Martha. "Won't You Be My Neighbor?: Norms of Cooperation, Public Broadcasting, and the Collective Action Problem." Social Science Quarterly. 90. no. 3 (2009). 15 13

Loomis, Kenneth D. "American Public Broadcasting: Will It Survive Adolescence?." Journal of Broadcasting & Electronic Media. 45. no. 3 (2001): 522-530.

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are enticed by PBS with more elaborate recognitions of support before and after shows that resemble the kinds of ads that the Federal Communications Commission (FCC) prohibits on public television.16 NEXT STEPS In 2010, the CPB was allocated $420 million in federal funding 0.012% of the total $3.456 trillion federal budget that year.17 Increasing that allocation by just 0.038% to 0.05% of the federal budget would have given the CPB $1.728 billion in federal funds, and, through an allocation formula stipulated in the Public Broadcasting Act of 1967, given the public television system, about $1.153 billion.18 This money could potentially be raised either through cuts in other areas or the use of entirely new sources of funding from nominal taxes or fees on television purchases, commercial advertising, and radio spectrum use by networks.19 In sum, increased federal funding would, in keeping with PBSs mission of providing unique, quality, non-commercial content, allow PBS and its member stations to transcend many of the preferences and pressures imposed by corporate interests and private donors and enable both the continued production of existing programs and the potential production of entirely new and diverse original content intended to serve resource-strapped local communities and groups currently underrepresented by public television.

16

Paradise, Angela. "No Longer "Just a Word" from Your Sponsor: The Increasing Presence (and Power) of Corporate Sponsorship on PBS Kids Television." Kaleidoscope. 3. (2004): 22-42. Kropf, Martha. "Won't You Be My Neighbor?: Norms of Cooperation, Public Broadcasting, and the Collective Action Problem." Social Science Quarterly. 90. no. 3 (2009).
18 Corporation for Public Broadcasting, "2010 Annual Report: Financials - How Does CPB Distribute Its Funds?." Accessed March 28, 2012. http://www.cpb.org/annualreports/2010/financials/how-does-cpb-distribute-its-funds.html. 19 17

Paradise, Angela. "No Longer "Just a Word" from Your Sponsor: The Increasing Presence (and Power) of Corporate Sponsorship on PBS Kids Television." Kaleidoscope. 3. (2004): 22-42.

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ESL Education for Skilled Immigrants


Samah Rizvi

There are over 1.6 million immigrants living in Illinois, of which 60% are in need of ESL instruction. Language competence is a necessary tool for individual integration into the workforce and for socioeconomic mobility. Partnering ESL education with immigrant job training programs, especially those geared toward more educated immigrants (those with a college or graduate degree) will reduce poverty and inequality in both the short-term and in the long-term, as educated immigrants who are also competent in English have higher rates of socioeconomic mobility. This will also benefit the economy, since the U.S. depends on welltrained and educated immigrants to fill many skilled occupations. Illinois is a major destination for recent immigrants. There are currently over 1.6 million immigrants in the state, nearly 600,000 of which need ESL instruction.1 Many immigrants are already well-educated and highly skilled in their profession. However, due to limited English skills, their education and work experience may not be recognized, which can hinder their career development.2 Studies show that the most important individual factor that influences immigrant acculturation is education,3 which also has an intergenerational effect, aiding or hindering each successive generations acculturation.4 Language competence plays a large role in determining an individuals level of integration and potential for socioeconomic mobility.1,5 English language proficiency is correlated with improved economic situation, and even small improvements to English language skills are correlated with higher incomes, lower poverty and lower unemployment rates.1 Among immigrants with a college degree, English competence can mean an additional $20,000 in annual income.6
Paral, R. & Associations for the Illinois Coalition for Immigrant and Refugee Rights (2010). Meeting the Need? English Language Learners and Immigrant Adult Learners in the Illinois Adult Education System. 37 pp. http://www.usdiversitydynamics.com/nj/id8.html 2 Charlotte-Mecklenburg Workforce Development Board (CMWDB) (2002) Cultural and Language Barriers In the Workplace. Third in a Series of Workforce Development Board Position Papers on Barriers to Successful Employment in Charlotte-Mecklenburg. www.charlotteworks.org/clbpositionpaper.pdf 3 Haskins, R. & Tienda, M. (2011). The Future of Immigrant Children. Brookings Institution, Future of Children Policy Brief. http://www.brookings.edu/~/media/Files/rc/papers/2011/0420_immigrant_children_haskins/0420_immigrant_child ren_haskins.pdf 4 Zhou, M. (1997). Segmented assimilation: issues, controversies, and recent research on the new second generation. International Migration Review, 31(Winter), 975-1008. 5 Young, M. Y., & Gardner, R. C. (1990). Modes of acculturation and second language proficiency. Canadian Journal of Behavioral Sciences, 22, 59-71. 6 Commonwealth Corporation (2011). Breaking the Language Barrier. Hindley, B. (ed) The Boston Foundation. Boston, MA. http://www.commcorp.org/resources/documents/Breaking%20the%20Language%20Barrier%20(March%202011).pdf
1

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The U.S. is reliant on well-trained and educated immigrants to fill certain skilled occupations. Yet it is not uncommon to see skilled immigrant professionals, such as doctors and engineers, working as janitors or dishwashers in the United States.7 There are many college-educated immigrants in the U.S. who are underemployed, such that some authors have even described their underemployment as "staggering - lost wages, lost productivity, and a squandering of human capital." 7 A prominent immigration destination such as Illinois could do more to utilize this underused resource. ESL training incorporated into career development programs would be an excellent way for immigrants in Illinois to improve their English and further their education and training. Whatever their background, it is very important for immigrants to become fluent in English if they want to succeed, especially in a monolingual country like the United States.8 Providing educated immigrants effective ESL training will accelerate the process of socioeconomic mobility even faster and allow immigrants and their families to live more productive lives and contribute more to the economy.3 Limited English Proficient (LEP) adults are defined by the US Consensus Bureau as those who speak a language other than English and may have difficulty speaking English.9 To help LEP immigrants improve their English skills, job-training programs should partner with local community college programs to offer ESL classes that can be taught during the evenings or weekends. The program would include funding for books and school supplies, as well as teacher salaries.2 Class topics will cover necessary survival skills such as interviewing etiquette, resumes, cover letters, transportation, American culture and job expectations, filling out various forms and applications relating to work, health care, and housing. Classes will be short and highly focused, ranging from 4-8 weeks, as LEP adults are more likely to complete them than classes that span several months10. Shorter classes with convenient meeting times are less likely to conflict with LEP adults outside obligations and will increase completion rates. Along with classes, supplementary tutoring should be provided to both advanced and remedial students who would like or need more individualized instruction. For example, the program can recruit volunteers to
7 IMPRINT (2011). Talent is Ready: Promising Practices for Helping Immigrant Professionals Establish Their American Careers. 30pp. http://imprintproject.org/images/download_files/talent%20is%20ready%20-%20imprint.pdf 8 Lopez, D. & Estrada, V. (2007). Language. In M. C. Waters & R. Ueda (Ed.), The new Americans a guide to immigration since 1965 (pp. 228-242). Cambridge, MA: Harvard University Press. 9 Capps, R., Fix, M., McHugh, M. and Yi-Ying Lin, S. (2009). Taking Limited English Proficient Adults into Account in the Federal Education Funding Formula. Washington, DC: Migration Policy Institute. 10 Burt, M. (2004). Issues with Outcomes in Workplace ESL Programs. U.S. Department of Education, Office of Adult and Vocational Education &The Institute for Work and the Economy. http://www.workandeconomy.org/images/Issues_in_Improving_Immigrant_Workers_English_Language_Skills__Burt.pdf.

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provide LEP adults opportunities for extra tutoring or practicing their spoken English through individual conversations. Leveraging employers interest in job training programs can play a critical role in the programs success.11 Classes can be offered on-site for already employed immigrants during lunch break and can range from beginning, intermediate, and advanced levels depending on LEP workers needs. 2 Employers are more likely to take advantage of the program as it would come as no cost to them and it can be modified to relate their more specialized job training; they would only need to provide space and time for LEP adults to receive instruction. Incorporating effective ESL education into workforce development programs can aid in immigrant integration in Illinois and improve socioeconomic mobility. Although the program is highly focused on college-educated immigrants within the state, the policy is flexible and can be modified to expand the pool of people it serves. If the pilot program is successful and costeffective, it could be expanded to other LEP learners and further aid them and the state.

Fix, M. Papademetriou, D. G., & Cooper. B. (2005). Leaving Too Much to Chance: A Roundtable on Immigrant Integration Policy. Migration Policy Institute. http://www.migrationpolicy.org/pubs/LeavingTooMuch_Report.pdf , pp. 1-27

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Physician Labor Supply and Health Care Legislation


Igor Vasiljevic An increase in Medicaid availability under the Patient Protection and Affordable Care Act (PPACA) may have the unintended consequence of decreasing physician labor supply, defined as the number of hours that doctors are willing to work and see patients. This would exacerbate a projected 150,000 physician shortage over the next decade1. By increasing physician reimbursement under public insurance, lawmakers can ensure that enough doctors will be available to care for the uninsured. Physicians play a central role in the provision of health care, and their response to incentives created by the PPACA will help determine the eventual success or failure of both it and future healthcare legislation. A decrease in physician labor supply due to the legislation would only exacerbate an already troubling shortage of physicians2. Thus, while significant social welfare gains may result from covering the uninsured, ignoring the effects of legislation on physician supply will cause longer wait times and shorter doctor visits3. The PPACA will increase Medicaid availability to those at or below 133% of the poverty line4. Research into previous expansions of public insurance coverage has shown a crowding out effect, in which people with previous private coverage, not only the uninsured, take advantage of the new plans5. Reimbursement rates under public plans are lower than that for private insurance. Therefore, physicians may see a decrease in income resulting from decreased private reimbursement as enrollment in Medicaid expands. While this effect would increase physician participation in public health insurance, it would also reduce the supply of physician services6. To rectify a mounting physician shortage, future legislation needs to focus on the supply of physicians in addition to coverage for the uninsured. Physicians need to be reimbursed for lost income due to any crowding out effects. Thus, reimbursement rates under public insurance need to be raised if coverage under public insurance is to be increased; higher reimbursement will have the dual effect of increasing physician supply and increasing their participation in public insurance.
1 2 3

Sataline, Suzanne and Wang, Shirley S. Medical Schools Cant Keep Up. Web. Accessed 13 Apr. 2012. Ibid.

Garthwaite, Craig. "The Doctor Might See You Now: The Supply Side Effects of Public Health Insurance Expansions." Web. Accessed 13 Apr. 2012. Hislop, Reginald M. "Health Reform and Medicaid Expansion." 13 July 2010. Web. Accessed 18 Apr. 2012. <http://www.healthcarereformmagazine.com/article/health-reform-and-medicaid-expansion.html>.
5 6 4

Garthwaite 2011 Ibid.

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ANALYSIS Expansion of public health insurance coverage causes a crowding out effect whereby some people previously covered by private insurance switch to the public plan7. Substitution of previously held private coverage by public health insurance under new legislation lessens the impact of expensive public health plans, resulting in only a partial increase in overall coverage8. This crowding out also has an adverse effect on the supply of physicians.

SIMPLIFIED FROM FIGURE 1 (GARTHWAITE 2011) Following Garthwaite, I compare physician labor supply before and after a change in public insurance coverage. Garthwaite models the effect of crowding out on labor supply due to the State Childrens Health Insurance Program (SCHIP), which I apply here to the recent Medicaid expansion. Much like the PPACA, the passage of SCHIP expanded public coverage to those who had previously not qualified. This result can be represented graphically in the above figure. For physicians who did not see any patients on Medicaid (given by the MC curve above), the crowding out effect decreases physician marginal revenue (MRMR). This resulted in an
7

Garthwaite 2011.

8 Cutler, David M., and Jonathan Gruber. "Does Public Insurance Crowd Out Private Insurance?" May 2011. Web. Accessed 13 Apr. 2012. <http://www.nber.org/papers/w5082.pdf>.

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increase in physician involvement in public health care, but it also resulted in a decrease in labor supply (QQ). Analysis of the effects of SCHIP has shown that doctors decreased the number of visits by Medicaid patients that lasted more than ten minutes9. This decrease is the result of crowding out; doctors are less willing to see patients on public insurance plan with lower reimbursement rates. The consequence of the decrease in labor supply will exacerbate an already troubling physician shortage10. CONCLUSION Given the increased demand for physicians under PPACA and the already sizeable physician shortage11, a decrease in labor supply due to crowding out would further harm a healthcare sector already in disarray. One solution to this issue is to increase physician reimbursement under public insurance plans, allowing for a rate closer to that offered by private plans. This would have the dual effect of increasing physician participation in Medicare, Medicaid and SCHIP, and at the same time increase labor supply, keeping the amount of time doctors see patients relatively unchanged. In order to provide adequate healthcare for the uninsured, we must ensure that there will be physicians to take care of them; increasing reimbursement allows us to do so.

Garthwaite 2011. Sataline, Suzanne and Wang, Shirley S. 2011.

10Ibid. 11

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