Feeding the Poor is a SNAP

by Sean Philpott, Director of the Center for Bioethics and Clinical Leadership

Political brinksmanship now seems as inevitable as the changing of the seasons. Currently, our illustrious leaders in Washington are playing a game of chicken, with House Republicans threatening to shut down the federal government and default on the national debt unless Senate Democrats or Obama Administration agree to defund the Affordable Care Act.

This schoolyard spat between the political parties would be almost comical if it didn’t threaten the health of the US economy or the wellbeing of so many American citizens. The only sure winners in this fight are media pundits and political comedians, both of who now have plenty of fodder for their Saturday night monologues and Sunday morning gabfests.

Largely drowned out by all the chest beating in Congress is something as equally disturbing to me, as it will adversely affect millions of Americans: the recent House vote to strip nearly $40 billion dollars from the Supplemental Nutrition Assistance Program. Policymakers refer to that program as SNAP, but you know it as ‘food stamps’.

That program, funded by the federal government but distributed by individual states, helps low-income individuals and families by food. Currently, almost 50 million Americans use food stamps. That’s more than 15% of the US population.

The percentage of people receiving benefits is increasing at a startling rate. Since the financial crisis of 2007, the number of SNAP participants has nearly doubled. This is true despite the fact that the US economy is again growing, despite the fact that the unemployment rate is dropping, and despite the fact the stock market is at a record high. So why the sudden push to gut this desperately needed program?

First and foremost, conservative politicians point to those very numbers to justify these cuts. If the economy is recovering and the number of jobless Americans decreasing, they argue, there shouldn’t be such a need for social welfare programs like SNAP. Unfortunately, that argument overlooks the tepid and unbalanced nature of the economic recovery.

Yes, corporate profits are up 50% since the start of the recession, but that has been achieved at the expense of the average worker. Companies are again hiring employees, but most of the positions currently available are low paying service jobs. These jobs simply do not pay enough the enable people to get off food stamps. For someone earning minimum wage, a full-time job yields a whopping $1,200 a month in income. That’s unlikely to cover even basic living expenses like rent, utilities, transportation and clothing, let alone food. So it’s no wonder that working families make up 72% of those receiving food stamps.

Opponents of social welfare programs like SNAP also like talk about fraud. When the House of Representatives voted to cut funding last week, one Congressman cited the example of Jason Greenslate as a reason why programs like SNAP should be eliminated. An unemployed 29-year-old surfer from California, Mr. Greenslate became a media sensation when a Fox News reporter filmed him going on a “food stamp binge,” buying lobster and sushi with his SNAP benefits. He is the modern day example of the 1980’s welfare queen.

Mr. Greenslate is also an outlier – one I suspect will soon be off the food stamp rolls. The vast majority of food stamp recipients are not able-bodied surfers manipulating the system. They are, as I mentioned before, the working poor. They are also children, the elderly, and the disabled. And they are veterans. Nearly a million SNAP recipients are active or former members of the US armed services.

Moreover, the stories we’ve heard about people using food stamps to buy champagne or caviar are just that … stories. The average benefit amounts to about $4.50 per person a day, barely enough to meet basic human caloric needs let alone buy filet mignon. If you doubt that, I suggest you take on Feeding America’s SNAP Challenge and live for a week on a food budget of $31.50.

Current cuts to SNAP will not address issues of unemployment, hunger and food insecurity, or welfare fraud. The only thing it will do is prevent nearly 4 million poor veterans, children, and elders from receiving food stamps. It is also penny-wise but pound-foolish. The $40 billion in savings from this program may lead to higher expenditures for other programs like Medicare and Medicaid. Hunger and malnutrition are key determinates of health; those living in food-insecure households have higher rates of diabetes, hypertension, high cholesterol, and a host of other chronic ailments.

If Congress really wants to reduce the number of people receiving food stamps, the proposed cuts to SNAP are not the way to go. Rather, they should focus on more fundamental problems with the US economy: income inequity, stagnant incomes, and minimum wage laws that fall far below an actual living wage.

[This blog entry was originally presented as an oral commentary on Northeast Public Radio on September 26, 2013. It is also available on the WAMC website. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]

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Three’s a Crowd

by Theresa Spranger, Bioethics Program Alumna (MSBioethics 2012)

There is a new IVF (In Vitro Fertilization) procedure being developed in the United Kingdom.  The procedure aims to prevent diseases of the Mitochonidria.  These include certain types of Muscular Dystrophy that are genetically passed down from the mother.  This procedure would introduce DNA from a third parent by the transfer of the nucleolus from a donor egg.   99.8% of the genes of the resulting child would be from the biological mother and father.  Approximately 0.2% would come from the donor woman’s egg.  This would result in the child having 3 biological parents.

The whole idea is an interesting one and it’s a noble goal to want to protect these children from Mitochondrial disease.  However, I think it’s a “slippery slope.”  Yes, yes, there it is…the standard conservative argument for everything.  I hate making it as much as you probably hate reading it, but I think it applies in this case.

When you talk about genetically modifying humans (which is what we are talking about here), you open some very scary doors.  If a person’s genetics can be modified to correct a genetic disease at conception, could they be modified to ensure the child will be tall?  Or, to ensure she will have blue eyes?  The potential is “designer children,” or children whose genetic makeup has been specifically chosen.

I can already hear some of you out there: “That will never happen.”  “No one is going to pay that kind of money to pick out their child’s eye color.”  And so on, and so on.

For those who are skeptical of the idea, please allow me to give you an example of who this technique could be marketed to:

Kim Kardashian – a woman with more money than brains, whose maternal instinct didn’t stop her from naming her daughter North West.  Could you honestly tell me that someone like Ms. Kardashian wouldn’t want to create her “perfect” child?  Or, that no company would allow her to do this for the right price?

There is an epidemic in our society right now of “trophy babies.”  Some parents have babies and forget that they are tiny people.  That those children need to be nurtured and taught, and that one day they are going to need to be functional adults.  I think the ability to have “designer children,” would only make this trend worse.  It would allow those with enough money to choose qualities in their child like a little girl picks a doll from the American Girl store.  I don’t think this would be good for the child or society.

What if the “designer baby” trend then really took off?  What would society look like?  Naturally, there would be the haves and the have-nots.  People who could afford it would select for: intelligence, athleticism, beauty, etc., and the gap would widen between socioeconomic classes in our country.

As much as I would love to see a cure for mitochondrial diseases, any time we manipulate a person’s genes we are playing with fire.

[This blog entry was originally posted in a slightly edited form on Ms. Spranger’s blog on September 17, 2013. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]

Do Androids Smoke Electronic Cigarettes?

by Sean Philpott, Director of the Center for Bioethics and Clinical Leadership

Many of my friends, family and co-workers smoke cigarettes. They, like the other 20% of Americans who smoke, do so despite the known health risks and the fact that a pack of cigarettes now runs over $12 in New York. That they continue to smoke given the physical and financial cost demonstrates just how powerful nicotine addiction can be. In fact, some studies suggest that nicotine is more addictive than alcohol, cocaine or heroin. So it’s really no surprise that nicotine addiction is the most common form of chemical dependence globally.

Many who do smoke want to quit. Most have tried repeatedly, but have failed despite their best efforts. According to the US Centers for Disease Control and Prevention, nearly half of all smokers are actively trying to quit. In a given year, however, only about 1 in 20 will succeed. Nevertheless, the number of adults who do smoke has decreased steadily over the last several decades. There are now more former smokers than current smokers in the United States.

A lot of this success can be attributed to aggressive anti-smoking campaigns. High taxes, local and state ordinances that limit where people can light up, and graphic advertising campaigns have all had an impact.

Most of us have seen, for example, television spots that unabashedly show some of the health effects of smoking: facial disfigurements, stomas and surgical scars. The latest ad campaign cost $54 million to run, a pittance compared to the $9 billion the tobacco industry spends on advertising cigarettes or the $100 billion in annual medical costs directly attributable to smoking. Yet those advertisements alone inspired more than 100,000 people to stop smoking.

Anti-tobacco efforts have also been bolstered by the increasing number of smoking-cessation aids available to those who want to quit, such as nicotine patches, psychotropic drugs like varenicline, and electronic (or E-) cigarettes. E-cigarettes in particular have become particularly trendy.

Physically resembling a tobacco cigarette, e-cigarettes use a battery-powered heating element to produce an inhalable nicotine-containing vapor. Nicotine cravings can be satisfied, but without exposure to the thousands of other toxic chemicals found in tobacco smoke. E-cigarettes may thus be “healthier” than actual cigarettes, despite the fact they are specifically designed to deliver nicotine, a highly addictive carcinogen and teratogen.

E-cigarettes may also help people stop smoking. Just this week a study published in the British medical journal The Lancet reported that e-cigarettes do help active smokers cut back on actual tobacco use.

So e-cigarettes are a good thing, right? Maybe, but there are a number of reasons to be concerns about their growing use and popularity.

E-cigarettes are largely unregulated. So long as they are not marketed as smoking cessation aids, a federal court ruled, the US Food and Drug Administration (or FDA) does not have the authority to regulate them as drugs or drug delivery devices. While the FDA can regulate e-cigarettes as a tobacco product under the Tobacco Control Act, they have yet to do so.

In fact, there are currently no federal laws that restrict the sale and use of e-cigarettes, even to children. Nor will any such laws be passed in the near future, given that the nation’s leading e-cigarette company recently appointed Former U.S. surgeon general Dr. Richard Carmona to its Board of Directors as part of a strategic lobbying and marketing strategy. Thankfully, twenty states (including New York and Vermont) place restrictions on the sale and use of e-cigarettes.

Call me cynical, but I believe that e-cigarette manufacturers want to market their products to minors, despite the health risks associated with nicotine use and nicotine addiction. That they produce a variety of candy-flavored versions suggests a deliberate campaign to target children. And that campaign seems to be working. The number of middle- and high-school aged kids who have tried e-cigarettes has doubled in the last four years. Get them hooked on nicotine early and they’ll be dedicated customers for life.

Public health officials have voiced concerns similar to mine, calling for tighter restrictions on the sale and use of e-cigarettes, particularly to minors. Of course, manufacturers are resisting this, railing against regulations that “stifle what may be the most significant harm reduction opportunity that has ever been made available to smokers.” That argument, however, implies that e-cigarettes are a safer alternative to smoking, even though no studies have yet been done on the long-term health effects of e-cigarette use. It also suggests that e-cigarettes are smoking cessation or reduction aids, which would make them subject to strict FDA oversight.

More needs to be done. E-cigarettes are a good thing in that they seem to help some smokers cut back or eliminate tobacco use. But their use by children and young adults could lead to nicotine addiction, which is a bad thing. At a minimum, the FDA needs to regulate them more tightly to ensure that they are as safe as possible for nicotine-addicted adults and to prevent their use by children.

[This blog entry was originally presented as an oral commentary on Northeast Public Radio on September 12, 2013. It is also available on the WAMC website. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]

Update on September 17, 2013: One of the cancer-struck women who featured so prominently in the recent anti-smoking ads passed away. She was 53.