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Health Insurance Reform, Abortion, Conspiracy Theories, Etc.

Tomorrow the House will vote on the Senate health reform bill and a set of amendments to it.  They will do it with explicit votes rather than the "deem and pass" strategy that had been floated.  Although the Senate will still have to pass the amendments itself via reconciliation, it is assumed that those votes are there.  That means tomorrow's votes will likely be decisive.

Much of today's drama surrounded whether or not Bart Stupak could be brought back on board by addressing his concerns about the Senate bill's abortion language.  Apparently that's not going to happen.  On the other hand, an executive order incorporating Stupak's language is apparently being considered.

The debate over whether or not the Senate bill subsidizes abortion is quite odd.  Folks like Stupak and the United States Conference of Catholic Bishops say it does.  Folks like Brad Ellsworth, The Catholic Health Association, and Catholics in Alliance for the Common Good say it doesn't.  The status quo (via the Hyde Amendment) is that the federal government doesn't pay for abortions, and President Obama has made it clear that he doesn't want the health insurance reform bill to change that status quo.

A look at the bill's abortion language makes if difficult to understand why so many people are apparently so sure that it funds abortions.  While not requiring or preventing insurance plans to include abortion coverage, it prevents public money from funding them. It requires that the state-based exchanges have at least one plan available that doesn't cover abortions and allows a state to rule out abortion coverage if it chooses.  Nevertheless, there seem to be two remaining threads to the pro-life opposition to the Senate bill.

First, the bill stipulates that anyone who wants to purchase a plan that includes abortion coverage in the state-based exchanges must make a separate payment for that coverage, and the insurer must keep that pool of money separate from any governmental subsidies so that they don't directly fund abortions.  This is not adequate to Stupak because there will be people who would not have insurance at all without the federal subsidies who then purchase abortion coverage for their subsidy-enabled health insurance.  Stupak seems to take the view that once you give someone aid you are effectively subsidizing any other way that they choose to spend money. By that logic I'm sure I have "paid for" all kinds of bad things (by giving money to a church that gives aid to people who also spend their money on bad things), but of course I haven't actually "paid for" those things.  Also, many employer-sponsored insurance plans cover elective abortions.  A Guttmacher Institute Study indicated 87 %, while a Kaiser Family Foundation said 46 % (LifeNews believes the KFF numbers).  I checked on mine (Aetna), and it does.  Famously, the Republican National Committee's plan covered elective abortion until it became a news story, and the argument could be made that even Focus on the Family indirectly pays for abortions.  By Stupak's logic, isn't everyone who pays premiums to those plans indirectly funding abortions?  Furthermore, the tax exclusion for employer sponsored health care is (by Stupak's logic) an enormous abortion subsidy that dwarfs the small, theoretical one that is his current focus.

Secondly, the bill includes funding for "community health centers" which some have claimed could provide abortions.  This may in fact be (theoretically) true since that funding would come via a route that might not be subject to the Hyde Amendment.  However, it's been argued that there are other long-standing regulations that would prevent programs administered by the Health Resources and Services Administration (programs such as the community health centers) providing abortion services and that the funds will end up in the same pot as other funds subject to the Hyde Amendment, effectively making it subject to the same restrictions.

Here is what National Association of Community Health Centers has to say about it:

Community health centers "have never performed abortions," said Dan Hawkins, senior vice president of policy and programs for the group. "They do not plan to or seek to become a provider of abortions. They don't do that."

Community health centers are focused on their mission of providing primary and preventive health care -- things like immunization and prenatal care -- to those typically underserved by the health care community, he said.

Community health centers were around for 11 years before the Hyde Amendment went into effect in 1976 and they never provided abortions, he said. And last year, they got $2 billion in federal stimulus funds. Of that, $500,000 was for operational funding. It has already been used to provide health care to more than 2 million additional people, he said. Like the Senate bill's proposal, the stimulus money came separate from the HHS appropriation funds (with its Hyde Amendment limits) and contained no specific abortion language. And again, none of it was used for abortions.

Hawkins makes one last point: the $7 billion over five years through the Senate health care bill would be combined by the secretary of HHS (currently Obama appointee Kathleen Sebelius) with the roughly $2.2 billion the centers receive through the annual appropriations bill.

"In our opinion, once this money is combined with the appropriated funds, the Hyde restrictions will apply to the whole thing," Hawkins said.

Together with repeated assurances from Sebelius that no federal funds will be used to pay for abortions, Hawkins said, "We feel confident the restriction (against abortions) will apply."

"And again," Hawkins said, "they haven't done abortions and they aren't looking to do them in the future."

To summarize, it's debatable (but very unlikely) that there is a theoretical risk that the bill could enable direct funding of abortions...but even if it is theoretically possible, it is still highly unlikely.  Even so, claims like "monstrously anti-life" and "the most anti-life piece of legislation in the history of our country" are common.  Such hyperbole is especially puzzling because there is good reason to think that the health insurance reforms will actually reduce the abortion rate.  As T.R. Reid recently argued:

There's a direct connection between greater health coverage and lower abortion rates. To oppose expanded coverage in the name of restricting abortion gets things exactly backward. It's like saying you won't fix the broken furnace in a schoolhouse because you're against pneumonia. Nonsense! Fixing the furnace will reduce the rate of pneumonia. In the same way, expanding health-care coverage will reduce the rate of abortion.

At least, that's the lesson from every other rich democracy.

The latest United Nations comparative statistics, available at http://data.un.org, demonstrate the point clearly. The U.N. data measure the number of abortions for women ages 15 to 44. They show that Canada, for example, has 15.2 abortions per 1,000 women; Denmark, 14.3; Germany, 7.8; Japan, 12.3; Britain, 17.0; and the United States, 20.8. When it comes to abortion rates in the developed world, we're No. 1.

No one could argue that Germans, Japanese, Brits or Canadians have more respect for life or deeper religious convictions than Americans do. So why do they have fewer abortions?

One key reason seems to be that all those countries provide health care for everybody at a reasonable cost. That has a profound effect on women contemplating what to do about an unwanted pregnancy.

Reid summarizes:

When I studied health-care systems overseas in research for a book, I asked health ministers, doctors, economists and others in all the rich countries why their nations decided to provide health care for everybody. The answers were medical (universal care saves lives), economic (universal care is cheaper), political (the voters like it), religious (it's what Christ commanded) and moral (it's the right thing to do). And in every country, people told me that universal health-care coverage is desirable because it reduces the rate of abortion.

It's only in the United States that opponents of abortion are fighting against expanded health-care coverage -- a policy step that has been proved around the world to limit abortions.

Michael New disputes Reid's thesis, claiming the figures Reid uses exaggerate the abortion rate in the U.S., ignores the impact of our racially-diverse population, and ignores the "experience of states that have offered more generous provision of public health benefits."  However, as David Gibson points out:

A study published in the latest New England Journal of Medicine shows that abortion rates declined during the first two years that Massachusetts implemented a near-universal health coverage program much like the nationwide plan currently before Congress.

As Ezra Klein put it:

...abortions were on a longer-term downward trend in Massachusetts, so it's possible (I might even say likely) that the reform didn't matter and abortion was dropping for other reasons. But it's hard to look at this data and say that the reforms led to a large increase in abortions.

Ron Sider, President of Evangelicals for Social Action, said the following about the bill:

It is a moral outrage for the richest nation in history to leave 47 million of its people without health insurance. This legislation substantially extends coverage and also retains the long-standing stance of the Hyde Amendment against federal funding of abortion. It will save thousands of lives, cover millions of people, and prevent federal funding of abortion."

It's disappointing to me that so many pro-life groups have opposed health reform so so vehemently and with so much hyperbole.  This is not the only way I've recently been disturbed by the tactics of the pro-life movement. 

Conspiracy theories seem to be flourishing these days: for example, 911 Truthers, birthers, and whatever nonsense Glenn Beck is pushing this week.  Here is one more: as reported in the New York Times:

Across the country, the anti-abortion movement, long viewed as almost exclusively white and Republican, is turning its attention to African-Americans and encouraging black abortion opponents across the country to become more active.

A new documentary, written and directed by Mark Crutcher, a white abortion opponent in Denton, Tex., meticulously traces what it says are connections among slavery, Nazi-style eugenics, birth control and abortion, and is being regularly screened by black organizations.

Black abortion opponents, who sometimes refer to abortions as “womb lynchings,” have mounted a sustained attack on the Planned Parenthood Federation of America, spurred by a sting operation by young white conservatives who taped Planned Parenthood employees welcoming donations specifically for aborting black children.

William Saletan has questioned the consistency of the messages of some of the conspiracy theorists.  Admittedly, the figures regarding abortion in the black community are certainly tragic:

Data from the federal Centers for Disease Control and Prevention show that black women get almost 40 percent of the country’s abortions, even though blacks make up only 13 percent of the population. Nearly 40 percent of black pregnancies end in induced abortion, a rate far higher than for white or Hispanic women.

...but I'm not glad to see pro-life groups encouraging conspiracy theories about racists specifically targeting blacks for elimination or to hear claims that blacks are worse off now than they were under slavery...

Why are So Many Christians Supporting Obama?

That's a question I've seen people asking lately.  For example, here's a conversation I had on Facebook:


Below are some links that might help for anyone else asking that same question, but first here are a few of my reasons:

  • I desire a foreign policy that is less bellicose and more reliant on international cooperation and diplomacy
  • I support generous treatment of immigrants
  • I believe that the policies of the Democrats are more likely to reduce the abortion rate
  • I believe that we need to protect the environment and can't depend on "the market" to do it for us
  • Though I realize this is a gross oversimplification, I feel more kinship with a party whose focus is on the poor and powerless rather than on the rich and powerful
  • I am confident that Obama has a first-class intellect and temperament, qualities that are highly desirable for the job of president

How a Christian Can Vote for Obama (link)
Henry Neufeld

Frank! As A Former Pro-Life Leader How Dare You Support Pro-Choice Obama? (link)
Frank Schaeffer

I'm Catholic, staunchly anti-abortion, and support Obama (link)
Nicholas Cafardi

Pro Life - Pro Obama (link)

Interview with Donald Miller (link)

On the Campaign Trail in MI, IN, NC, VA and OH This Week (link)
Donald Miller

From Reagan to Obama, a brief Political History (link)
Donald Miller

Endorsing Obama (link)
Doug Kmiec

My Support for Obama (link)
Mark Love

Why I'm Voting for Obama, and Why I Hope You Will Too (link)
Brian McLaren

Why I'm Voting for Obama (link)
Ryan Bolger

If you're a Christian planning to vote for Obama, tell us why...

If You Love Jesus, Vote For...

I'm sure many people who read today's HuffPo piece by Christine Wicker titled "If You Love Jesus, Vote for Obama" (link) won't appreciate it, won't get it.  I do.  Though I wouldn't tell anyone that a love of Jesus requires voting for any particular candidate (which, by the way, is what many on the religious right actually do), I'm in agreement with much of what Wicker writes in the article.  For example:

After more than 20 years during which the Religious Right has been the dominant ethical and moral voice in the public square, the reputation of American Christians is at an all time low, especially among young people. As the political ambitions of the most right wing Christians have soared, the influence of Christian teachings on popular culture has plummeted.

I recommend following the link above and reading the whole piece.  Personally, I like Wicker's article because it expresses in a clever and provocative way ("If you love Jesus, vote for" is certainly provocative language) something that I believe to be true: the strong association of the religious right with the political far right is a liability in accomplishing the mission of the church among about half of the population.

I think there is a real danger for the stink of politics to mask the beautiful aroma of the gospel.  Look at the way the current campaign has inevitably ended up in the gutter despite the initial promise of a different kind of campaign from these two candidates.  And the way people like Dobson wield political power is so distasteful to me. And the culture war? That's the way to engage outsiders? There's a reason why they like Jesus but not the church.

I don't think the answer is for the religious left to become the new religious right in the political realm, but I think it would be very healthy for it to be more obvious that Christianity and Republicanism are not synonymous.

Obama on the Born Alive Infant Protection Act

I have said repeatedly that I would have been completely in, fully in support of the federal bill that everybody supported - which was to say --that you should provide assistance to any infant that was born - even if it was as a consequence of an induced abortion. That was not the bill that was presented at the state level. What that bill also was doing was trying to undermine Roe vs. Wade. By the way, we also had a bill, a law already in place in Illinois that insured life saving treatment was given to infants.

So for people to suggest that I and the Illinois medical society, so Illinois doctors were somehow in favor of withholding life saving support from an infant born alive is ridiculous. It defies commonsense and it defies imagination and for people to keep on pushing this is offensive and it's an example of the kind of politics that we have to get beyond. It's one thing for people to disagree with me about the issue of choice, it's another thing for people to out and out misrepresent my positions repeatedly, even after they know that they're wrong. And that's what's been happening.


Obama and Abortion

A friend recently wrote:

This election ignore all the lies about obama is a terrorist, or obama is anti christ, or obama will destroy the u.s. those things are ridiculous and they are gonna continue to go out of conrtol. but here's one thing that is true and is equally as disturbing:

In a failed abortion situation, when the baby survives, the question is what do you do with that baby? The united states congress voted on this and there was a general consensus that it was wrong to just let that baby die. However, Obama did not feel the same way. He voted for letting the baby die. Hillary Clinton voted to let the baby live. This is not propaganda, google this, I'll even give you what Obama said to defend his side:

"that we live in a pluralistic society, and that I can't impose my religious views on another."

Its not a matter of religion, it's a matter of the right to life, the most important right in America. Some people will argue in the case where a baby will harm the health of the mother that the abortion is fair. But in a failed abortion the baby is outside of the mother and if everyone shared Obama's view they just let the baby lay out to die.

This is an extremely ugly and graphic topic, but I think its necessary to hear. Maybe McCain is old, pretty boring, and just kind of a weird guy, but he at least has never in his 200 years of congress life voted against life.

If you don't like either just do what I'm doing write in Ron Paul.

Ron Paul: Youtube him

As a HuffPo article (of course, sympathetic to Obama) points out (link), my friend's summary gets some of the facts wrong (e.g., Obama's vote was in the Illinois senate not the US senate and there are reasons other than a disregard for life that may have prompted Obama to vote against the Illinois bill).  That's not to say that Obama's position/votes related to abortion don't bother me.

Regardless, I see in this appeal from my friend (and most conversation about abortion) a perpetuation of the focus on ideology rather than practicality.  The American public is pretty evenly divided between the view that abortion should be safe, legal, and rare and that it should be illegal and rare. Ideologically those two views are very different, but practically they are very similar. Both parties focus on ideology as a wedge issue, dig in to give no ground, and as a result do things that don't help.  Rather than focus on ideological differences, an approach that has led to stalemate with little hope for significant change in the foreseeable future, I'm more interested in both sides focusing on where they agree and can work together to do practical things to reduce the abortion rate.

Some examples are suggested in an article by Tony Campolo: Pro-Life Democrats Call for an Abortion Reduction Plank

Global Abortion Trends

From an AP article on MSNBC:

Over the past 10 years, more than a dozen countries have made it easier to get abortions, and women from Mexico to Ireland have mounted court challenges to get access to the procedure.

The trend contrasts sharply with the United States, where this week South Dakota's governor signed legislation that would ban most abortions in the state, launching a bitter new battle that activists seem ready to take to the Supreme Court.

Most European countries have legalized abortion, with limits, for years and the issue rarely makes news. Many Latin American countries ban abortion or severely limit it. In the Middle East, Islamic law forbids abortion, although most countries allow it if the mother's life is endangered. Asia is a mixed bag, with the procedure banned in the predominantly Roman Catholic Philippines, but common in China and India.

Nevertheless, the question is not entirely settled: Court cases in Mexico, Poland, Colombia, and Ireland have sought to broaden access to abortion.

Each year, 46 million women worldwide have abortions, according to the Alan Guttmacher Institute, a reproductive rights think tank. About 60 percent live in countries where abortion is broadly permitted. Twenty-five percent live in nations where it is banned or allowed only to save a woman's life. The rest live in countries where abortion is allowed to protect a woman's life or health.

On the other side, there are new Vatican-backed efforts to call into question Italy's liberal abortion law, and women's rights activists say they fear a new tightening of Poland's law, already one of Europe's strictest.


UN Population Fund

There was an interesting article about the UN Population Fund and pregnant women in Africa recently in the New York Times.  It's available here. It questions whether the policy of the US government not to release $34 million in funds allocated by Congress for the UN Population Fund is really a "pro-life" policy in practical terms.  The UN Population Fund has been accused of supporting forced abortions and sterilizations in China, and therefore the US government refused to support the fund in recent years.  The Population Fund denies the accusation, a denial that seems credible to me.  The article argues that the move of the US government is not pro-life because of the loss of life that will result from less funding for the organization's activities in Africa such as equipping maternity hospitals and promoting contraception and safe child birth.  African women have a 1 in 16 chance of dying in childbirth.  Tragic.

On a related note, Steven Chapman made an interesting point about the "morning-after pill" in his column.  He argues that the typical "pro-life" opposition to Plan B is actually not pro-life.  Rather than being "abortion in disguise," Chapman claims that:

The best scientific evidence we have indicates that the morning-after pill serves to block fertilization, while having no effect on implantation. That makes it contraception, not abortion.  As a longtime pro-lifer, I think anti-abortion groups had solid grounds to oppose the morning-after pill when its function was unclear--as I did. But given what we now know, it's a grave mistake to keep opposing it. In fact, there are grounds for celebration: A drug once believed to produce abortion is found to prevent abortion.

Regarding the concern that the pill may have abortifacient properties, he writes:

The drug...can prevent pregnancy by impeding sperm and by delaying ovulation, but it has "not been shown to cause a post-fertilization event--a change in the uterus that could interfere with implantation of a fertilized egg."   There is no way to be 100 percent sure that emergency contraception never interferes with implantation. But the mere possibility of an adverse event is a poor reason to reject its use.  After all, breast-feeding is known to cause uterine changes that can prevent a fertilized egg from being implanted. No one in the pro-life movement would say mothers should therefore abstain from nursing. Just as nursing is morally and ethically permissible because it advances worthy purposes, so is the morning-after pill. [emphasis mine, JDM]

Even conventional birth control pills have come under attack as causing abortions.  A friend recently sent us an email warning and linked to an article criticizing the pill.

To conclude his article, Chapman writes:

If emergency contraception were widely and easily available, it could prevent a lot of pregnancies that would otherwise end, tragically, in abortion. That's reason enough for the FDA to approve over-the-counter sales. For anyone who believes in the sanctity of life from the moment of conception, Plan B is not an enemy but an ally.

Homegrown Democrat quote 6

Don't get me wrong.  I definitely think abortion is a very bad thing, but I think what Keillor is saying here is that there is more than one way to respond to evil and that some responses are more effective than others.  If what you care about is the welfare of children, then getting involved in a child's life is much more likely to have a practical positive effect than a symbolic, generic condemnation of abortion.  The condemnation is cheap in the personal investment it requires compared to the act of service.

The pro-lifers who demonstrate at Planned Parenthood clinics and hold up pictures of bloody fetuses should rather hold up signs with the number of hours per week they're volunteering for child care, and then we'd take them more seriously.

That's a quote from p. 111 of Homegrown Democrat: A Few Plain Thoughts From the Heart of America by Garrison Keillor.  I read it during our get-away trip to the UP.  Get yourself a copy or ask to borrow mine.

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