The letter also outlined economic arguments for legalization. For one, state regulation would better protect Kazakhstani prostitutes from competition on the part of migrant sex workers from other FSU states, in particular Kyrgyzstan, Uzbekistan and Ukraine, it contended. In addition, the letter emphasized that the taxation of the commercial sex trade could contribute a tidy sum to Kazakhstani government coffers at a time when state revenue streams in other areas, most notably in the energy sector, are declining. The positions staked out in the Kazakhstani open letter are similar to those advocated by the global rights watchdog Amnesty International (AI), which in 2015 came out in support of the decriminalization of all aspects of consensual sex work not involving coercion exploitation or abuse. The concept of regulating the flesh trade is a tough sell for legislators. Many are opposing legalization on moral grounds, and at least one nationalist MP has characterized prostitution as a Western value that is undermining young peoples understanding of Kazakh culture. Outside of parliament, the debate on legalization has focused mostly on economic questions. The idea has gained modest support from one womens advocacy organization, the Feminist League of Kazakhstan, but the groups representatives have nonetheless expressed skepticism that legalization would generate a bonanza of revenue for the state. The group contends that the number of prostitutes in Kazakhstan is comparatively low, thus, if taxed, the amount collected by the government would not be able to plug many budgetary gaps. Data on the number of sex workers in Kazakhstan is hard to come by. Estimates in recent years have not been made public: the Ministry of Interior does compile such statistics, but the information is classified and for internal use only.
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The proposed MaineCare rules would require medication-assisted treatment facilities to regularly talk to patients about withdrawing from medication and increase counseling requirements to one hour a week during the first stage of treatment. The rules would also limit initial medication levels for MaineCare patients to 40 milligrams, though state and federal law allows physicians to establish higher dosage levels, if needed. Charles Zelnick, a Stonington doctor, in public comments called addiction treatment “one of the most rewarding aspects” of his practice. But Zelnick wrote that amidst an “epidemic,” Maine doesn’t “need more regulations or barriers on an already highly controlled practice.” LePage and public health experts agree that counseling and proper oversight of treatment is an important part of an addicted person’s recovery. But the state is reviewing 14 public comments from groups and doctors who described the LePage administration’s new rules as unfunded mandates that clash with existing regulations, lack evidence and create barriers to treatment. LePage has said he wants to shut down such methadone clinics, which he’s claimed don’t provide adequate counseling. His spokeswoman, Adrienne Bennett, said LePage wasn’t available for an interview Friday. A 1996 U.S. District Court ruling found Maine’s Medicaid program is federally obligated to provide methadone treatment and transportation to methadone clinics. Several Maine advocacy groups wrote that Maine’s proposed rules violate such law. MaineCare reimbursement for outpatient methadone treatment decreased in 2010 and again in 2012 to a weekly rate of $60 the lowest in the nation.
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