Missing Pieces

For the past two weeks I’ve been talking to lots of people on Twitter and blogs about health care reform. Because it’s an issue that there is a lot — a LOT — of misinformation about, I’ve focused mainly on trying to dispel the myths and lies about the presence of abortion funding in the health reform bill. (For the record, there is no abortion funding in this bill, and if you want to discuss specifics on that point, do it somewhere else. You could see Jill Stanek’s blog, where I’ve been over, and over, and over all of the evidence and explained it in detail in comments on some of her recent posts.)

The more I’ve talked to people about this issue, the more I’ve heard absolutes like, “I’m happy to go my whole life without health insurance rather than support the murder of unborn babies” and “I will be in jail before I give you a penny to kill poor people’s children.” I could give you a dozen more examples like these, and I’m not insensitive to the sentiment or the emotion behind those statements.

Except for the fact that there is something missing from this argument, something missing from all of the so-called “pro-life” blogs that have been discussing this health reform bill. Now that the bill has passed, I thought maybe I’d start seeing it. Maybe I’m just not looking at the right blogs. Maybe I’m not missing the tweets talking about it. But you’d think, with all the talk about reducing, preventing, and stopping abortions, there’d be some talk, somewhere, about all the things that this bill would do to support that cause.

First of all, though you may have heard differently, there’s ample data supporting the theory that universal health care reduces abortion rates. In the developed world, the United States has the highest abortion rate, despite the fact that women often pay out of pocket for abortion services. The developed countries with lower abortion rates include Canada, Denmark, and the UK — all countries that provide abortion services for free as part of universal health care — as well as Germany and Japan, where they have universal health care but abortion services are not covered.

Why does universal health care reduce abortion rates? Consider a young, low-income woman who gets pregnant unexpectedly in the United States. She doesn’t have insurance and earns too much to qualify for Medicaid. She knows that even if the man who got her pregnant helps, having a baby is expensive — starting as soon as you get pregnant, with the cost of prenatal care. Add in the cost of labor and delivery, plus anything unexpected that might mean her baby staying in the hospital for weeks or months, and already she can see it’s impossible for her to manage. She hasn’t even started to calculate the cost of formula and diapers.

If this young woman was in a country with universal health care — let’s say the UK — she wouldn’t have to worry about any of those things. She probably wouldn’t even give it a thought. She’d be thinking about how to handle the expenses when the baby comes, and would be able to spend the 9 months of pregnancy saving money and preparing for the expenses of having a baby, instead of using all the money she can scrape together to pay for medical care. For many young women, it is the difference between choosing to keep their babies and choosing to abort them.

That one is pretty obvious, but there are more ways universal health care reduces abortion rates. With universal health care comes very much improved access to contraceptives and family planning services. Better access to contraception means fewer unplanned pregnancies, which translates directly into fewer abortions.Ā Remember Angie Jackson, who live-tweeted her abortion? If she had been in a country with universal health care, she could have had that tubal ligation, and there would most likely never have been an abortion to live-tweet. As it stands, she can’t have her tubes tied because the cost is so prohibitive — as she is one of the 45 million people in this country who are uninsured.

Looking more specifically at the health reform bills, there are a number of specific measures that, by improving prenatal and early childhood health care, are likely to reduce abortion rates and ensure that babies are born healthier. It’s also conceivable that over time the infant mortality rate, which is an absolute disgrace in this country, could improve along with advancements in prenatal, perinatal, and postnatal health care for the poorest women and children.

One measure that’s gotten a lot of flack because someone, somewhere decided that it could be twisted and used to fund abortions, is the $11 billion the bill sets aside for Community Health Centers. CHCs are critically important in reaching the neediest people in our communities. It’s estimated that the money would allow them to serve 15 million new patients — and since currently they provide prenatal care for 1 in 8 children born in this country, that means a lot more kids will be born healthier and their mothers will be, too. And with the Executive Order to be signed by Obama, those funds can’t be used for abortions — well, they couldn’t be used for abortions before, either, because the money falls under laws that prevent HHS-administered programs from using federal funds for abortion.

In addition to the CHCs, here are some other interesting snippets from the original senate bill and the house reconciliation bill that will help reduce abortions by improving access to health care for women and children and reducing the out of pocket costs. Note: This is based on a search-and-read review of the bills, and my interpretations may be incorrect or missing details. I am just trying to give an overview of all the things that are in this bill that we haven’t heard word one about from the pro-lifers.

  • Comprehensive tobacco cessation services for pregnant women on Medicaid
  • Outreach program to enroll vulnerable and underserved populations in state exchanges
  • Coverage for women who give birth at “freestanding birth centers” instead of hospitals, including coverage of midwife and other profession services used in the process of labor and delivery
  • Creation of home visiting programs to assist high risk and vulnerable populations, including pregnant women under the age of 21
  • Comprehensive education for adolescents (contraception, sex, abstinence, relationships, etc) using proven and studied methods to reduce youth pregnancy and birth rates

There’s a lot more in there — that’s just what I pulled out in about 20 minutes of skimming the bills. It surprises me every time I spend a little while going through the bills how much I find that I haven’t heard word one about, especially when it comes to things you’d think the pro-lifers would be celebrating.

So when I went to check out a couple of pro-life blogs tonight — well, this morning — I was hoping to find both satisfaction that abortion is really and truly not in the bill thanks to the EO, and discussion of the measures in the bill that are going to work for the antiabortion cause. Instead, all I’ve seen is disappointment with Stupak (and other antiabortion democracts) for caving in, and the same vitriolic fear and hatred we’ve seen since Obama won the election pointed at anyone and everyone who supports choice or isn’t kicking and screaming about the passage of the bill. Even if they are antiabortion.

The reality is that there are a LOT of wins for the antiabortion crowd in this bill. That we had to give so much to them to get the almost-universal heath care that this country desperately needs is frustrating, but we need the reforms in this bill so badly that I’m hoping it will end up being worth it. And in the long term, the Executive Order could eventually be overturned, given the right situation and majorities. Who knows. What I do know is that the number of deaths due to lack of insurance are going to start falling, and the number of people who lack access to medical care — and by that I mean access that doesn’t result in exorbitant bills that are impossible to pay — will be reduced to something approaching zero.

This is a start. It’s a good start. And maybe one day, the antiabortion people will get their heads out of the ground and realize that this bill is going to be working for them, too.

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