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Should Abortion Be Included in a National Health Insurance Plan?

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As a good liberal, I am on the e-mail lists of many advocacy groups, the result of which is that I receive about 14,000 "action alerts" every day, 99.9% of which I delete without even opening. However, last week, two emails caught my attention: Planned Parenthood and the Religious Coalition for Reproductive Choice both asked me to contact Congress and the Obama administration to protest the potential exclusion of abortion services from any national health care plan that is enacted.

This poses a pragmatic and moral dilemma for me. I really want national health care to pass. I believe that abortion is health care. I understand that there are many people who believe that abortion is morally wrong, and thus will fight national health care tooth and nail if abortion is included as an option. A part of me is willing to compromise on abortion, and say that as long as contraceptives and comprehensive family planning services are covered, I could live with a plan that passes without abortion, then work towards adding it later. On the other hand, it makes me insanely angry that groups that are against legal abortion would put the health and lives of millions of uninsured people at risk just to impose their morality upon me. Legal, accessible abortion to me is a just and moral cause in the same way that these groups feel about "fetal rights." Why should I be the one to continually bend on my values for the greater good?

I have witnessed the dire consequences of lack of affordable abortion. For several years, I served with the Haven Coalition, a network of volunteers who open their homes to women forced to travel to New York City to obtain second trimester abortions. While second trimester abortions are a very small percentage of the number of abortions performed in the United States (more than 90% of pregnancies are terminated in the first 12 weeks), it turned out that many of the women I met tried to get first trimester abortions. The problem was that federal Medicaid funds would not cover the procedure (other than in cases of rape or incest, or if the woman's life is in danger), and by the time they scraped together the money to pay for an abortion, they were into their second trimester. (The irony of this, of course, is that it forces the people who can least afford to have children - the same people that conservatives bitch about using welfare, food stamps, housing assistance, etc. - into having children.) So if we want to prevent second trimester abortions (and I know that I do), we really need to include abortion services in any health care plan.

It is not unusual for insurance to cover the costs of abortion. My private insurance, which I have through my husband's employer, would cover me if god forbid I found myself needing an abortion. The National Health Service in the UK covers the cost of abortion, except for women from Northern Ireland. Abortions in Canada are also funded by their national insurance plan. In the US, 17 states use state money to cover the cost of abortions for low income women. I am proud to live in one of those states.

Finally, I am disturbed by the slippery slope that is presented by leaving abortion out of any national health care plan because some people have moral objections to it. Many of these same people have moral objections to contraception. They also have moral objections to family planning and comprehensive sex education. The Catholic Church, for example, has battled long and hard to keep insurance plans from covering birth control pills (but not, of course, medications for erectile dysfunction - those drugs, it seems, are medically necessary to men's health). I will be damned (although of course, I already am in their eyes) if I give in to their moral imperatives - which are no better or worse than MY moral imperatives, and certainly in no way reflect the values and beliefs of every religious group in the world - on birth control. And that is absolutely the next step once abortion funding is eliminated.

There is a part of me that is sympathetic to the idea that people should not be forced to pay for things that they consider morally wrong. The problem with this

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donalda 5 pts

Of course abortion should be covered.  It’s part of a woman’s reproductive care.  Saying I don’t think it should be used as birth control is silly.  Abortion in fact IS birth control, often of a last result because conventional birth control failed.  If the health care bill is paying for ED medicines it should definitely pay for abortion. 

Frankly I don’t know why we’re still arguing over this.  It’s a medical procedure!  Often it is a needed one for any number of reasons.  Also, you have to ask yourself how “elective” is abortion?  Most women who seek them for non-medical health reasons feel they must.  Usually it’s an economic decision and not because the woman in question is some selfish wonton whore who doesn’t want to get stretch marks. 

If you’re against abortion work to make birth control more widely available.  Work to ensure women are paid as much as men.  Lobby for universal child care.  But you and I know the majority of people who are against abortion are people who don’t believe in these things.  They want women to stay prisoners of their biology because it serves the patriarchal system in which men have all the power!  That’s what this debate is really about.  The Pro-life lobby leadership cares about keeping women under the thumbs of men because their religion tells them this is how it should be.  They disguise this message in rhetoric about caring for women ,  right to life, and concern for the precious “unborn,” but it’s a lie.  

Frankly, it doesn’t matter to me why someone seeks an abortion.  I’m interested in people who know they don’t want children not having those children – there are enough neglected unwanted children in the world without enough to eat.  Especially children of color.  And that’s one of the things that bothers me about the health care bill.  It will disproportionately affect women of color.

LucindaA 5 pts

Some of the reasons why an abortion is medically necessary are clear cut it would seem.  The life of the mother is at risk and/or the fetus is clearly nonviable (eptopic pregnancies come to mind). 

But accusations of rape are a whole 'nother can of worms.  I fear that women, out of desperation, will start making accusations just so they can get the abortion.  It scares me.

This isn't like the eye surgery my dad had back in the 80's.  Optional for most.  Except he wore contacts and as a cop, he was going in to meth labs (before they realized how necessary protection was) and his contacts were getting filled with chemicals.  So they covered the surgery to protect his eyes.  But he could get supporting documentation from work to support the argument.  Do we want to subject women of rape and incest to this?

I so wish it were simpler.  I really, really do.  Even if you hate abortion (like I do), we must stop villifying the women who get them and look to the larger support network around them.  They didn't get in this fix by themselves and the assumption that all women seeking abortions are irresponsible is self-rightous.  I know too many women on birth control, taking reasonable measures, who found themselves pregnant with no support.  All I could say is there but for the grace of God go I.

Sadly, I think this is an include it or don't issue and I will state again, I think we need to include it with provisions for education and prevention as well as vigorously trying to eliminate the need to begin with by providing support (not preaching).

Erin White 5 pts

I have not been discussing choice here.  That's a done deal, it's legal to have an abortion, and I'm glad for that.  The issue I'm addressing is under what circumstances medical insurance should cover the cost of an abortion. 

Erin

The Single Rider ( http://TheSingleRider.com ) - about being single

My Mobile Adventures *~*~* ( http://MyMobileAdventures.com ) - mobile/photo blogging

( http://TheSingleRider.com )

evilslutopia 5 pts

So just to be clear, you ARE saying that if a woman is using birth
control to prevent pregnancy and she gets pregnant anyway because, through no fault of her own, her birth control failed, you would basically say to
her "sorry, tough luck, no choice for you, but no hard feelings cause it's just economics!"  

~Jezebel

The Evil Slut Clique
( http://evilslutopia.blogspot.com )

EvilSlutopia ( http://evilslutopia.blogspot.com )

DD 5 pts

I'm struggling with the term "elective" when it comes to whether or not a medical procedure should be covered. Broadly speaking, all medical procedures are elective. Deciding to get a mastectomy when breast cancer is discovered is elective. Deciding to get reconstructive surgery after said (elective) mastectomey is elective. No one forces a patient to get any procedure done. We do them to improve our quality of life.

I understand the argument regarding elective quite clearly as many think that infertility treatments should not be covered by insurance. It's not life-saving. It's not my "right" to have a child.

One just needs to sit down and logically tally what it costs to raise a child on welfare (with little or no health coverage) compared to the cost of a safe and professionally performed abortion; or what it costs society when a woman can only afford reproductive technology that has higher risks of multiples compared to the more stringent and monitored IVF to see that it really is the bottom line that matters if you are really trying to keep the nation's finances in check.

~ DD ~

Fighting Dementia Pugilistica since 2005!

Punch Drunk ( http://ddtko.wordpress.com/ ) : Miscarriages, Infertility, Pregnancies, Parenting...all lead to a whole lotta bitchin'.

Erin White 5 pts

Abortion is legal.  There is no question about it being "allowed".  The question here seems to be - under what circumstances should abortion be considered medically necessary and therefore covered under health insurance?  These are two different things.

Erin ( http://TheSingleRider.com )

The Single Rider ( http://TheSingleRider.com ) - about being single

My Mobile Adventures *~*~* ( http://MyMobileAdventures.com ) - mobile/photo blogging

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Erin White 5 pts

I do believe abortion can be an elective procedure as well as a medically necessary procedure.  For instance, if the preganancy puts a woman's life at risk, that's clearly a medically necessary situation.  If the fetus is determined to be non-viable, that is also clearly a case where abortion would be medically necessary.  If the woman becomes pregnant against her will (for instance, she was forced to have sex), that for me is also a no brainer - this should be covered by insurance as surely as any other injuries sustained due to rape would be.  However, if the abortion is not due to one of  those reasons, then I'd consider it elective, and I do not believe it should be covered by insurance.

Erin

The Single Rider ( http://TheSingleRider.com ) - about being single

My Mobile Adventures *~*~* ( http://MyMobileAdventures.com ) - mobile/photo blogging

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snigdhasen 5 pts

Suzanne, your post and some of the comments are incisive and thorogh. Couldn't have argued this better :)

leyla.a 5 pts

My first thought, is "let's get something passed!" and then I read the comments on "compromise is not a starting point" and I have to agree.  But, in history, much of our great accomplishments have been achieved through compromise.  We are an extremely divided country and we have no choice but to compromise in many respects.

I really like this thought provoking post and I am happy to learn that many 2nd term abortions happen due to lack of funds.  I had no idea that was a problem as I don't even know how much an abortion would cost.  I will take some time and educate myself on that charity that helps women who need abortions and cannot afford them.  I cannot imagine anything more scary than finding myself pregnant and too broke to terminate the prengnany.  It's like adding insult to injury.

At the same time, I agree with some of the other comments, we wouldn't cover plastic surgery!  

I would rather see a health care plan passed for necessary things - I have a friend who is self insured with Diabetes (childhood diabetes, I forget if that is type 1 or 2) and his insurance premiums are $1300 a month.  Plus he pays for many office visits out of pocket in order to maintain a steady premium rate.  

At the end of the day, I believe an abortion is an elective procedure and I am not sure how I feel about including any elective procedures in a health care plan.  

http://www.twitter.com/leyla_a

http://www.sundaymorningsoliloquy.com

suebob 7 pts

I know a woman who has several children, all the result of failures of different forms of birth control. Fortunately she is happily married and could raise and love the children, but what if she hadn't? Would women whose primary form of birth control failed be allowed abortions? Just something to think about.

avengingophelia 5 pts

I've given this a lot of thought, and have come down at about the same place you do, Suzanne. This isn't something that can be compromised on. Losing reproductive rights may well mean never getting them back, you know?

As far the comparison between abortion and cosmetic surgery, I think that's false. Abortion is not an elective procedure the same way plastic surgery is--abortion keeps something from happening (a pregnancy from continuing and usually a baby from being born). Comparing it to something that is truly optional doesn't really work.

Accidental Olympian 5 pts

On the other hand, it makes me insanely angry that groups that are against legal abortion would put the health and lives of millions of uninsured people at risk just to impose their morality upon me.

I COMPLETELY AGREE. We've already seen time and time again how religious groups can clump together, pool their money and squash a political idea/proposal/plan not for the good of ALL Americans, but simply because it goes against their religion. It's not right to put one groups idea of morality above the good of the entire country.

Being a person who has NEVER had reliable health coverage in this country since the day I walked out of my parents home at 18, I need this plan, some play, ANY plan to allow me to feel safe. The idea that I could lose it because ONE procedure goes against their beliefs is terrifying. If suddenly religious groups are allowed to stand up and exclaim that they don't want abortion, and we allow this, what is next? Birth control? Fertility drugs? Genetic testing? Vasectomies?

Abortion is legal. Plain and simple. It should be covered. As long as it is a protected right in this country, then there should be no backdoor ability to hinder people from being able to receive the medical attention they need or wish through our national health care plan.

Oddly enough, I just blogged this morning about my health care struggles here, The Accidental Olympian ( http://www.accidentalolympian.typepad.com ).

--Ashley

Suzanne 5 pts

I can't thank you enough for sharing your thoughts on why you oppose abortion in general. Although we disagree on the topic at hand, I am so grateful for your respectful tone and rational explanation. I know that there are fire spitters on both sides of the debate, but if everyone could keep it like you did, I think it would be great.

Suzanne Reisman ( http://www.blogher.com/member/suzanne-reisman ), Contributing Editor - Feminism & Gender ( http://blogher.org/topic/feminism-gender )
Campaign for Unshaved Snatch (CUSS) & Other Rants ( http://cussandotherrants.com/ )

Suzanne 5 pts

I want to thank everyone who has commented for their thoughtfulness and civil tone in the discussion.

Suzanne Reisman ( http://www.blogher.com/member/suzanne-reisman ), Contributing Editor - Feminism & Gender ( http://blogher.org/topic/feminism-gender )
Campaign for Unshaved Snatch (CUSS) & Other Rants ( http://cussandotherrants.com/ )

evilslutopia 5 pts

The problem with that (well, one of them) is that prevention sometimes fails.  All methods of birth control have failure rates, however small they may be.  So you're basically suggesting that some women should be punished for the fact that the condom broke or they were on the pill and got pregnant anyway or some other similar situation.  And what about rape victims?  Would you consider their abortions to be "medically necessary"?

~Jezebel

The Evil Slut Clique
( http://evilslutopia.blogspot.com )

EvilSlutopia ( http://evilslutopia.blogspot.com )

Summerm 5 pts

I have to agree with you. Once we start allowing the morality police to decide what should and should not be covered it is a fast slippery slope to loosing more services, such as birth control. Abortion is a medical procedure that improves the life of the woman undergoing it, far more so than a nose job or a tummy tuck. Comparing it to cosmetic surgery is, to me, a touch absurd. Having a few wrinkles won't hurt anyone, being forced to carry a child to term does.

Summer

http://wiredfornoise.com 
http://twitter.com/summer

Erin White 5 pts

Cosmetic surgery is legal too, but that doesn't mean that a national health insurance plan should cover it.  Any medical procedure that is elective in nature should not be covered.

Erin

The Single Rider ( http://TheSingleRider.com ) - about being single

My Mobile Adventures *~*~* ( http://MyMobileAdventures.com ) - mobile/photo blogging

( http://TheSingleRider.com )

LucindaA 5 pts

I hate the idea of abortion under any circumstance being covered.  But that's because I hate abortion in general.  Not because of my religion (which does oppose it) but because it is a pretty horrible procedure by any standard I think.  You are preventing the development of a human life. 

That said, I would like to see us vigorously eliminate the need for abortions through birth control, support for preganant women financially, emotionally, physically, accountablility for the men who father these children, and research into birth control for men (who are fertile 365 days a year vs women who are fertile only a few days each year).   I also want world peace and rainbows every day.  : )

So despite my strong dislike for it, it probably should be included for all the reasons listed by Suzanne.  But I do hope there will be a provision for birth control education, required counseling (the hey-your-hormones-will-really-be-out-of-whack-so-expect-these-things-to-happen kind), explanation of medical risks and an ultrasound before the abortion were performed so the mother would be fully informed, just as we would inform for any invasive procedure.

kleja 5 pts

While I believe that compromise is integral in most situations I feel strongly that this isn't the place or the time for us to start giving in to those who would otherwise let us and our children fend for ourselves. I don't see how, even if you disagree with the procedure, this is even an issue to be considered and discussed as a bargaining chip. Abortion is legal and it's a medical procedure. I would imagine that most Americans would expect all legal medical procedures to be covered under their health plan. Even those who are against it probably already have health insurance that covers it. So why, WHY would we even want to put something like abortion on the table? Talk about taking a giant leap backwards.

Janers0217 5 pts

It is true that it would be best if these pregnancies are not the result of lack of birth control.  However, I wouldn't object to it covering all abortions.  This belief will probably cement me in one of those dreadful positions as a "pro-abortion" person by people who do take issue to it for purely moral reasons.

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Erin White 5 pts

If the abortion is deemed medically necessary, then it should be covered.  However, I do not want to see abortion covered if it is being used as a form of birth control. This is not a religious or moral point of view - it's an economic one.  Pregnancy can be prevented far less expensively than it can be aborted.

Erin

The Single Rider ( http://TheSingleRider.com ) - about being single

My Mobile Adventures *~*~* ( http://MyMobileAdventures.com ) - mobile/photo blogging

( http://TheSingleRider.com )

adjunctmom 5 pts

I agree with Janet, women should not consistently have to pay for others' morality.

The great thing about this country is that you do not have to get an abortion if you do not want one. I am very, very tired of people attempting to impose their morality on my body.

I do not want to compromise on this point any more than I want to see any more pharmacists protected for refusing to fill a birth control prescription.

Janers0217 5 pts

I don't understand how anyone could fathom having a bill that didn't cover it.  Women are constantly forced to compromise their health for the morality of some people.  Men never seem to have to face that consequence.  This seems like something that our society would only stand for if we were truly as misogynist a people as some organizations seem to want us to be.

If the golden standard of this country is to be equal, then shouldn't our medical costs all be covered?  If a man can get an erection, then why can't a woman deal with the repercussions of that man's erection?

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