Doctors are prescribing antidepressants rather than providing counselling and other treatments Mothers with postnatal depression are being failed by the National Health Service, which is ignoring international guidelines on the condition. Researchers from the charity 4Children surveyed all health trusts in England and Wales to find out what sort of treatment was being received by the one in 10 new mothers who suffers from the condition. They found that, of those whose symptoms were recognised at all by their GPs, the vast majority were being prescribed antidepressants, against guidance from the National Institute for Clinical Excellence, which recommends “talking therapies” – counselling and cognitive behavioural treatments – for mild and moderate cases of the so-called “baby blues”. The survey, by parenting club Bounty on behalf of 4Children, also found that few health authorities were collecting information on the prevalence or severity of postnatal depression, while others seemed to have only a patchy understanding of the issue. There were vast disparities between those who did hold information – two primary care trusts claimed they had had only one case in the past year, while another reported 1,350 cases. Only 9% of health trusts were keeping track of the condition in their area. “That’s pretty unlikely given the one in 10 figure that is widely accepted for postnatal depression,” said Anne Longfield, chief executive of 4Children. “This is not a rare condition. You’d think it might have rung an alarm bell with them, but what is perhaps more astonishing is that the Department of Health holds no statistics at all.” Longfield said that the results of the report were shocking and showed that postnatal depression was not being taken seriously: “It just reveals so much in terms of lack of empathy and sympathy for these people. It’s a complete disregard for their health and wellbeing. “It seems that, from the Department of Health’s point of view, it’s not an issue; they don’t even ask the questions or collect the information. It’s seen as an everyday little personal issue and GPs, I’m afraid, are not proving very sympathetic to those mothers that are coming through their door. At the end of the day, no one is taking it seriously.” Of more than 2,000 mothers questioned, 70% were given antidepressants when they approached their doctor. The Nice guidelines recommend early diagnosis and quick access to treatment to limit the damaging effect postnatal depression has on the baby, the partner and other children in the family. The international health body states that psychological therapies should be offered as an alternative to antidepressants. “The Nice guidelines are clear, just as it’s clear they are being flouted. This report shows a massive default towards antidepressants when proper care is within the gift of health professionals,” said Longfield. Several celebrity mothers, including Gwyneth Paltrow, Sadie Frost and Zoe Ball, have testified to the damaging effects of postnatal depression: “At my lowest, I was a robot. I just didn’t feel anything,” said Paltrow. One woman, identified only as Natalie, told the researchers: “I was concerned that I was losing weight, not eating, not myself. The GP was dismissive. He said: ‘You’ve just had a baby. It’s just your hormones. Antidepressants will help you get through it.’ I felt pushed out of his surgery with a prescription in my hand that I had said I didn’t want. “I’m the single mother of three children and need to be alert if I am to look after them properly,” she said. “Eventually, I went to the health centre just to get some food vouchers. The health visitor recognised the symptoms of postnatal depression immediately and organised counselling for me. After four weeks I started to feel a great improvement, but it was sheer luck that I finally got help.” For others, help came too late. Jess Stoneham, 36, suffered postnatal depression after the birth of her baby three years ago. It contributed, she says, to the breakup of her marriage. “I knew things were very different from the first time round, but everyone just said I was more tired because I had a toddler as well as a baby. It’s true I was shattered, too tired to stand up for myself – certainly with everyone, from the doctor to the health visitor to my mother, telling me I would be fine. “Well, I wasn’t fine, but no one recognised the symptoms and it makes me really sad that my son had to be without a mother for the first year of his life because I, effectively, was a wreck. It didn’t have to be like that.” Postnatal depression Depression Mental health NHS Health Women Health policy Tracy McVeigh guardian.co.uk
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Doctors are prescribing antidepressants rather than providing counselling and other treatments Mothers with postnatal depression are being failed by the National Health Service, which is ignoring international guidelines on the condition. Researchers from the charity 4Children surveyed all health trusts in England and Wales to find out what sort of treatment was being received by the one in 10 new mothers who suffers from the condition. They found that, of those whose symptoms were recognised at all by their GPs, the vast majority were being prescribed antidepressants, against guidance from the National Institute for Clinical Excellence, which recommends “talking therapies” – counselling and cognitive behavioural treatments – for mild and moderate cases of the so-called “baby blues”. The survey, by parenting club Bounty on behalf of 4Children, also found that few health authorities were collecting information on the prevalence or severity of postnatal depression, while others seemed to have only a patchy understanding of the issue. There were vast disparities between those who did hold information – two primary care trusts claimed they had had only one case in the past year, while another reported 1,350 cases. Only 9% of health trusts were keeping track of the condition in their area. “That’s pretty unlikely given the one in 10 figure that is widely accepted for postnatal depression,” said Anne Longfield, chief executive of 4Children. “This is not a rare condition. You’d think it might have rung an alarm bell with them, but what is perhaps more astonishing is that the Department of Health holds no statistics at all.” Longfield said that the results of the report were shocking and showed that postnatal depression was not being taken seriously: “It just reveals so much in terms of lack of empathy and sympathy for these people. It’s a complete disregard for their health and wellbeing. “It seems that, from the Department of Health’s point of view, it’s not an issue; they don’t even ask the questions or collect the information. It’s seen as an everyday little personal issue and GPs, I’m afraid, are not proving very sympathetic to those mothers that are coming through their door. At the end of the day, no one is taking it seriously.” Of more than 2,000 mothers questioned, 70% were given antidepressants when they approached their doctor. The Nice guidelines recommend early diagnosis and quick access to treatment to limit the damaging effect postnatal depression has on the baby, the partner and other children in the family. The international health body states that psychological therapies should be offered as an alternative to antidepressants. “The Nice guidelines are clear, just as it’s clear they are being flouted. This report shows a massive default towards antidepressants when proper care is within the gift of health professionals,” said Longfield. Several celebrity mothers, including Gwyneth Paltrow, Sadie Frost and Zoe Ball, have testified to the damaging effects of postnatal depression: “At my lowest, I was a robot. I just didn’t feel anything,” said Paltrow. One woman, identified only as Natalie, told the researchers: “I was concerned that I was losing weight, not eating, not myself. The GP was dismissive. He said: ‘You’ve just had a baby. It’s just your hormones. Antidepressants will help you get through it.’ I felt pushed out of his surgery with a prescription in my hand that I had said I didn’t want. “I’m the single mother of three children and need to be alert if I am to look after them properly,” she said. “Eventually, I went to the health centre just to get some food vouchers. The health visitor recognised the symptoms of postnatal depression immediately and organised counselling for me. After four weeks I started to feel a great improvement, but it was sheer luck that I finally got help.” For others, help came too late. Jess Stoneham, 36, suffered postnatal depression after the birth of her baby three years ago. It contributed, she says, to the breakup of her marriage. “I knew things were very different from the first time round, but everyone just said I was more tired because I had a toddler as well as a baby. It’s true I was shattered, too tired to stand up for myself – certainly with everyone, from the doctor to the health visitor to my mother, telling me I would be fine. “Well, I wasn’t fine, but no one recognised the symptoms and it makes me really sad that my son had to be without a mother for the first year of his life because I, effectively, was a wreck. It didn’t have to be like that.” Postnatal depression Depression Mental health NHS Health Women Health policy Tracy McVeigh guardian.co.uk
Continue reading …Police pay review chief faces claims report misrepresents officers’ views
October 1, 2011 No Comment
Lawyer risks being drawn into political row after Police Federation accuses inquiry of quoting officers ‘that do not exist’ The senior lawyer appointed by the government to conduct an inquiry into police pay is at the centre of a row amid accusations his report has misrepresented the views of officers, some of whom, it is alleged, do not exist. The row is threatening to become political after Keith Vaz, chairman of the home affairs select committee, suggested it might summon Tom Winsor, appointed last October by home secretary Theresa May, to explain himself. Winsor is currently conducting what is described as “the most comprehensive review of police officer and staff pay and conditions in over 30 years”. The former rail regulator has told MPs that 60% of police officers will be better off as a result of his recommendations, which follow consultations with hundreds of officers and staff. But in early July the Police Federation asked Winsor to “verify the evidence presented in your report, especially as these comments appeared to directly contradict the views of officers articulated to the Police Federation”. Now, in an explosive letter sent to Winsor and copied to Vaz, the federation says it has discovered some of the officers interviewed by Winsor and his team “do not actually exist and many of those that do have rejected the statements attributed to them”. In its letter, which was leaked to the Observer , the federation, which speaks for some 140,000 officers in England and Wales, cites several examples to back up its claims. These include two officers, purportedly from Kent police, who were named in the report but not known to the force. The letter says a third officer from Kent quoted in the report “had not spoken to you because he was on holiday”. The letter, written by Ian Rennie, the federation’s general secretary, continues: “Another officer said about the statement attributed to him: ‘It was not me … I basically told him [Winsor] I have no money as it is, and asked him not to take any more off me, as I have three children to feed and clothe.’” An officer named as being from Greater Manchester Police is not known to the force. Another quoted in the report told the federation: “I recall the meeting with Tom Winsor quite clearly. At the start of the meeting he set up a digital recorder and made it quite clear that the meeting was being recorded. I suggest he discloses its contents if he believes that we have asked for these changes.” The claims threaten to embarrass Winsor and his team, whose findings are crucial to determining the future of policing at a time when there are claims of plunging morale in the force. The federation alleges: “It would appear that you are trying desperately to present a view that officers support and welcome your proposals.” Last month the home affairs select committee issued a report suggesting Winsor should “consult with police more widely before making any further recommendations”. Winsor told the committee he had interviewed 200 police officers and staff. His first report identified 69 officers by name and rank. Winsor claimed frontline officers and staff he had interviewed had said morale was low because they were receiving the same pay, and in some cases less than those in back-office roles. Vaz expressed shock at the federation’s claims. “I was most surprised to see the letter from the Police Federation and their concerns that the evidence that Tom Winsor gave to the select committee contained information that was not accurate,” Vaz said in a statement. “I am sure that the committee will want to look at these matters again and I will be writing today to Mr Winsor to ask him to confirm the evidence he has given. If he does not do so, I will expect him to be recalled by the committee.” A spokesman for the Winsor review said it had consulted more than 200 police officers and staff and received more than 7,100 comments on the review’s website. “This is more than any other previous police pay review,” the spokesman said. “Part one of the review of police remuneration and conditions consulted widely with frontline officers and staff. All of the names were given by officers themselves or by their supervisors subsequently. The report is clear that officers who regularly work unsocial hours and who are using especially critical skills would, in general, earn more under the recommendations, if implemented in full.” Police Keith Vaz Public sector pay Jamie Doward guardian.co.uk
Continue reading …Police pay review chief faces claims report misrepresents officers’ views
October 1, 2011 No CommentLawyer risks being drawn into political row after Police Federation accuses inquiry of quoting officers ‘that do not exist’ The senior lawyer appointed by the government to conduct an inquiry into police pay is at the centre of a row amid accusations his report has misrepresented the views of officers, some of whom, it is alleged, do not exist. The row is threatening to become political after Keith Vaz, chairman of the home affairs select committee, suggested it might summon Tom Winsor, appointed last October by home secretary Theresa May, to explain himself. Winsor is currently conducting what is described as “the most comprehensive review of police officer and staff pay and conditions in over 30 years”. The former rail regulator has told MPs that 60% of police officers will be better off as a result of his recommendations, which follow consultations with hundreds of officers and staff. But in early July the Police Federation asked Winsor to “verify the evidence presented in your report, especially as these comments appeared to directly contradict the views of officers articulated to the Police Federation”. Now, in an explosive letter sent to Winsor and copied to Vaz, the federation says it has discovered some of the officers interviewed by Winsor and his team “do not actually exist and many of those that do have rejected the statements attributed to them”. In its letter, which was leaked to the Observer , the federation, which speaks for some 140,000 officers in England and Wales, cites several examples to back up its claims. These include two officers, purportedly from Kent police, who were named in the report but not known to the force. The letter says a third officer from Kent quoted in the report “had not spoken to you because he was on holiday”. The letter, written by Ian Rennie, the federation’s general secretary, continues: “Another officer said about the statement attributed to him: ‘It was not me … I basically told him [Winsor] I have no money as it is, and asked him not to take any more off me, as I have three children to feed and clothe.’” An officer named as being from Greater Manchester Police is not known to the force. Another quoted in the report told the federation: “I recall the meeting with Tom Winsor quite clearly. At the start of the meeting he set up a digital recorder and made it quite clear that the meeting was being recorded. I suggest he discloses its contents if he believes that we have asked for these changes.” The claims threaten to embarrass Winsor and his team, whose findings are crucial to determining the future of policing at a time when there are claims of plunging morale in the force. The federation alleges: “It would appear that you are trying desperately to present a view that officers support and welcome your proposals.” Last month the home affairs select committee issued a report suggesting Winsor should “consult with police more widely before making any further recommendations”. Winsor told the committee he had interviewed 200 police officers and staff. His first report identified 69 officers by name and rank. Winsor claimed frontline officers and staff he had interviewed had said morale was low because they were receiving the same pay, and in some cases less than those in back-office roles. Vaz expressed shock at the federation’s claims. “I was most surprised to see the letter from the Police Federation and their concerns that the evidence that Tom Winsor gave to the select committee contained information that was not accurate,” Vaz said in a statement. “I am sure that the committee will want to look at these matters again and I will be writing today to Mr Winsor to ask him to confirm the evidence he has given. If he does not do so, I will expect him to be recalled by the committee.” A spokesman for the Winsor review said it had consulted more than 200 police officers and staff and received more than 7,100 comments on the review’s website. “This is more than any other previous police pay review,” the spokesman said. “Part one of the review of police remuneration and conditions consulted widely with frontline officers and staff. All of the names were given by officers themselves or by their supervisors subsequently. The report is clear that officers who regularly work unsocial hours and who are using especially critical skills would, in general, earn more under the recommendations, if implemented in full.” Police Keith Vaz Public sector pay Jamie Doward guardian.co.uk
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Picture the scene: you’re checking your emails on a shiny new device (worth two months pay) and from nowhere, a greasy-fingered infant is screaming at you to play. Reluctantly, you pass it over, watching your own hands cup the air beneath any potential drop zone, wondering how best to explain the jam-smeared calamity to your insurance company . Then you wonder if there isn’t a useful, hard-wearing and cheap device you could let them play on without fear of bankruptcy. That’s what prompted Norwich-based bedding magnate Andrew Kerry to conceive the AndyPad, an inexpensive, 7-inch Android tablet he could fling at kids. It wasn’t long before jealous adults were demanding their own version, so a tooled-up edition of the device called the AndyPad Pro was born. The tablet is currently UK-only and it retails for a lot less than the Samsung Galaxy Tab 7 (
Continue reading …NATO says it captured a leader of the Haqqani network, the militant group that has emerged as major anti-American player in Afghanistan and Pakistan. (“The Sopranos of the Afghanistan war,” as the New York Times described the clan in a previous profile .) Haji Mali Khan reportedly oversaw the group’s…
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Proposed changes will play into the hands of greedy developers, say conservation groups Strict rules compelling house builders to include affordable homes in private developments will be scrapped under the government’s controversial changes to the planning system. The revelation has raised fresh questions about the proposals, which ministers claim are vital for tackling the housing crisis. They have already drawn fire from conservation groups, who fear they will lead to an increase in building on greenfield sites. The National Planning Policy Framework, which will edit down more than 1,000 pages of legislation to just 52, removes a threshold under what are known as section 106 agreements, requiring that private developments of 15 properties or more contain an element of affordable housing. It also abandons stipulations that councils set a target for the number of affordable properties they intend to be built in their area and, on larger sites, to establish the proportion of private and affordable housing needed. Instead, the new framework says only that planning authorities should “use an evidence base to ensure that their local plan [in which a local authority sets out its building strategy] meets the full requirements for market and affordable housing in the housing market area”. The National Housing Federation, which represents England’s housing associations and has been broadly supportive of the framework, warned that the combined impact of the measures will represent a major setback for affordable home building. It said more than half of the 50,000 affordable homes built each year in England are built under section 106 agreements, worth more than £2bn annually. There are also concerns that a reduction in mixed housing developments will see poorer people “ghettoised” in less attractive areas. “While we broadly support the government’s planning framework and its potential to help get more homes built, there are serious dangers that it could let private developers off the hook in terms of delivering thousands of affordable homes on their developments,” said David Orr, the federation’s chief executive. “With no targets for local authorities to meet in terms of building affordable housing in their area, the new framework could see these section 106 deals ripped up in future and many developments built without any social homes at all. This would be a disaster for the millions of people stuck on housing waiting lists.” The federation estimates there are 700,000 people on waiting lists in rural England. But critics fear the framework plays too much into the hands of property developers who favour building expensive properties on greenfield sites. The issue is likely to cause heated debate at this week’s Tory party conference. Many backbenchers are nervous about the strategy. John Redwood appeared to criticise the government’s plans recently when he attacked the “myths” of housing shortage on his blog. Redwood claimed “there were 738,414 empty homes in the UK in 2010 – there will be around the same number today. Yet I read we are short of houses and need to build more.” The issue has angered conservation groups, with many members considered traditional Tory voters. More than 100,000 people have signed a National Trust petition urging the government to rethink the reforms. “There is a desperate need for new, affordable housing, especially for young families in areas of the country where the number of households is growing rapidly,” said Ben Cowell, the trust’s director of external affairs. “But this fact alone cannot be used to overturn the need for a properly balanced approach to decision-making.” Cowell warned that the scrapping of the affordable housing threshold “could do a huge disservice to the provision of proper levels of housing”. A spokeswoman for the Department for Communities and Local Government defended the plan to scrap the affordable housing threshold and target. “Five million people are languishing on social housing waiting lists,, the average age of a first-time buyer is 37 and house building has fallen to its lowest level for any peacetime year since 1924,” she said. “The draft framework will help to deliver more affordable housing by requiring councils, in consultation with the community, to make sure local plans meet the full requirements for market and affordable housing so that it caters for the demand in their area.” Planning policy Social housing Communities Housing Jamie Doward guardian.co.uk
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Charities and voluntary groups are sounding alarm bells at the number of people going hungry as benefits fall and prices rise Stuck around the walls of the church hall at St Paul’s in the heart of Leicester is a series of green laminated signs. There’s one for the Centre Project and another for The Bridge. There’s the Welcome Project, the Leicester Aids Support Service, the St Paul’s over-60s group and more besides. Stacked up tidily in front of each one, awaiting collection, is food. Lots of it. Boxes of fresh vegetables sit alongside bags of freshly baked bread; jars of seafood pasta sauce, still under plastic wrap, are tucked in alongside sacks of rice. Each one of these heaps, obtained by the Leicester branch of the food waste charity FareShare, is a marker for chronic hunger; a profound hunger that, as the economic forecasts worsen and the Conservative party meets in Manchester this weekend to argue over what can be done about it, is only deepening. “There’s a big increase in demand,” says John Russell of the Centre Project, a drop-in project in the heart of Leicester supporting people in need. “We used to feed 30 or 40 people a week. Now it’s 70 or 80.” Housing provision and benefit rules have changed, he says, and that’s creating need. Keith Harrold of Project 5000 in Loughborough, which runs a hot food service once a week from a local church, agrees. “People are struggling. Supermarket prices are shooting up and they aren’t coping.” Yvonne Welford, who runs the over-60s group for St Paul’s, is seeing the same picture. “There’s been a major increase in demand, especially in the last six months, and I’m afraid it’s only going to get worse.” Poverty has al ways been a fact of life, even in good times. But FareShare is now seeing a serious growth in the number of people without the resources to feed themselves properly that is, experts say, without precedent in modern Britain. All of the organisations in Leicester that are supplied by FareShare describe themselves as being dependent on the charity, which obtains food from manufacturers and supermarkets that might otherwise end up rotting in landfill sites, and supplies it to groups helping those in need. Founded in 2004, the charity works from 17 sites in the UK and shifts 3,600 tonnes of food a year, worth more than £8m. In the past 12 months the number of people it feeds has risen from 29,000 to 35,500. The number of organisations signed up to receive food has risen from 600 to 700. And 42% of those organisations are recording increases of up to 50% in demand for their services. John Willetts, a former NHS trust chief executive and now the volunteer project director for FareShare in Leicester, said: “It’s a constant ramping up in demand all the time. The volume of food we’re distributing has risen from 41
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BALTIMORE — The Boston Red Sox completed their September collapse in horrific and historic fashion, falling out of the playoff chase by allowing two ninth-inning runs in a 4-3 loss to the Baltimore Orioles on Wednesday night. The Red Sox held a nine-game lead in the AL wild-card race after Sept. 3, but a 7-19 swoon left them tied with Tampa Bay entering the final day of the regular season. Only minutes after this game ended, the Rays completed their comeback from a 7-0 deficit with an 8-7 win over the New York Yankees in 12 innings. Even if Tampa Bay lost, the Red Sox faced the prospect of a quick turnaround following a long night at Camden Yards that included a rain delay of 1 hour, 26 minutes in the middle of the seventh inning. When the rain came, Tampa Bay trailed 7-0. By the time play resumed, the Rays and Yankees were tied at 7 heading into the 10th inning. The Orioles won the game in the ninth against Boston closer Jonathan Papelbon (4-1), who struck out the first two batters before giving up a double to Chris Davis. Nolan Reimold followed with a double to score pinch-runner Kyle Hudson, and Robert Andino completed the comeback with a single to left that Carl Crawford couldn’t glove. Boston became the first team to miss the postseason after leading by as many as nine games for a playoff spot entering September, according to the Elias Sports Bureau. Jim Johnson (6-5) worked the ninth for Baltimore. Dustin Pedroia homered for the Red Sox, who went through the entire month of September without winning consecutive games. Pitching on three days’ rest, Jon Lester limited the last-place Orioles to two runs and four hits over six gritty innings. But it wasn’t enough to prevent the Red Sox from absorbing one final blow. Boston had several chances to pad a 3-2 lead it took in the fifth inning but was never able to complete the task. After Pedroia hit a solo homer off Alfredo Simon in the fifth, the Orioles got the potential tying run to third base in the bottom half and in the sixth before Lester worked out of trouble. In the seventh, Boston’s David Ortiz was thrown out trying to stretch a single, and with two outs rookie catcher Ryan Lavanway bounced into a fielder’s choice. Lavanway, who homered twice in an 8-7 win Tuesday, went 0 for 5 and stranded nine runners. The Red Sox blew another chance to increase the lead in the eighth when Marco Scutaro took off from first base on a double by Crawford. But Scutaro stutter-stepped before getting to third and was out at the plate. In the ninth, Lavanway grounded into a double play with one out and the bases loaded. It was the third time he came to the plate following an intentional walk to Adrian Gonzalez. The Red Sox went up 1-0 in the third when Mike Aviles walked, took second on a single by Jacoby Ellsbury and scored on a single by Pedroia. Ellsbury’s single extended his hitting streak against Baltimore to 36 games, dating to April 2009. J.J. Hardy hit a two-run homer in the bottom half, only minutes after the scoreboard showed the Yankees increasing their lead over Tampa Bay to 5-0. Hardy’s 30th homer followed a leadoff walk to Davis. Boston pulled even in the fourth when Scutaro doubled, advanced on a groundout and scored on a balk. NOTES: Boston activated RHP Clay Buchholz (back strain) from the 60-day DL and placed 3B Kevin Youkilis (back strain) on the 60-day DL. … Hardy’s homer gave Baltimore two players with 30 (Mark Reynolds 37) for the first time since 1996, when Brady Anderson had 50 and Rafael Palmeiro hit 39. … Lester’s performance lowered the ERA of Boston’s starters this month to 7.08. … Baltimore RF Nick Markakis left after eight innings with a bruised pelvis.
Continue reading …No Credit to Perry for Texas Economy, But Lots of Blame for Texas Health Care in NYT
October 1, 2011 No CommentThe New York Times may not give Texas Gov. Rick Perry credit for his state’s booming economy , but it will certainly attack him for his state’s supposedly awful record on providing health care. Emily Ramshaw reported “ Few Bright Spots in Perry’s Health Care Record ” for Friday’s edition. Ramshaw, a reporter for the Texas Tribune, a left-leaning nonprofit news organization based in Austin that has a content partnership with the Times, played the same sour notes on Perry and Texas health-care statistics as the paper’s regular reporters. At campaign stops and in the three Republican presidential debates he has participated in so far, Gov. Rick Perry has made a sport out of bashing the 2006 state health insurance plan of former Gov. Mitt Romney of Massachusetts. He has not missed a chance to yoke “Romneycare” to “Obamacare,” the federal health care reform that Republicans largely revile. But while Mr. Perry condemns both efforts to make carrying health insurance mandatory, Texas faces a staggering crisis in health coverage: the state leads the nation in the number of uninsured residents, has the third-lowest percentage of people covered by their employers and spends less per capita than all but one other state on Medicaid, the joint state-federal insurance program for the disabled and poor children. Ramshaw’s story was slightly less slanted than the headline, allowing Perry’s aides room to challenge the governor’s liberal opponents. His aides point to legislation that Mr. Perry signed to let insurers offer lower-cost, smaller-scale health plans to consumers, to let single-employee businesses join health care cooperatives and to help employers pay for their workers’ health care without negative tax consequences. During his tenure, Texas created a health insurance pool to sell policies to people with uninsurable medical conditions, Mr. Perry’s office said, and received a multimillion-dollar federal grant to develop tools to increase private insurance coverage. Texas enters the health insurance game at a disadvantage. Mr. Perry likes to remind voters that the state is responsible for more than 40 percent of new jobs created in America since June 2009. But many of those jobs are in the service industry, in agriculture, construction and the small-business sector, which either do not provide insurance or do not pay their workers enough to buy it. Texas Medicaid is austere — many low-income Texans who might qualify for public insurance in other states do not qualify in Texas
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