Tuesday, February 2, 2016

Possible Pro-Choice/Pro-Life Compromise on Defunding Planned Parenthood? (Part 2)

Wow, it's been several months since I wrote my last post as a prelude to this one, which I was supposed to write right away. But instead I got busy and kept putting it off "just one more day." But now that my 3rd child is due to arrive any day, I need to get this written or it'll NEVER happen! I don't have time to include all my research; just know that whenever I state a number or fact I've done my best to verify it from original sources. If you have questions about anything please let me know.

Ok, let's do this.

Let's talk about this whole defunding Planned Parenthood thing.


If you haven't read my previous posts, here's a quick intro. For the last 5 years I mostly avoided politics, but especially the issue of abortion. Ever since I got pregnant with my first child, I decided I "couldn't handle" hearing/reading/thinking about the issue. Other than participating in peaceful prayer vigils I kept my distance from it.

But then I began taking my civic duties more seriously, and being a good citizen requires being informed, and being informed requires getting ones' head out of the sand to pay attention to what's going on in the world and why. 

A big reason I had avoided politics for so long was distaste for the acrimony on both sides of our country, which seems to be getting more partisan every year. This new interest in my civic duties came with a fervent desire to somehow get past partisan divides and starts discussing issues with "the other side" to arrive at mutual understanding so we can maybe actually start getting things done. 

Idealistic? Perhaps. But it's worth a try.

Of course this would happen right when the Center for Media Progress began releasing videos from its undercover investigation of Planned Parenthood's alleged illegal sale of fetal tissue, and people began calling for defunding of Planned Parenthood. It was the last issue I wanted to face when I had just started to feel my own unborn baby kick in my womb.

But duty calls.

So I've spent a ton of time researching this subject, trying to see both sides, in an attempt to arrive at some ideas for bipartisan solutions to unify rather than further divide the country.

In my last post, I wrote about the difference in worldviews at the heart of the pro-life/pro-choice divide. Basically, it comes down to disagreement over when life begins. Since this cannot be empirically proven, people will always disagree about it. But does it necessarily follow that people on both sides of the issue don't have any mutual goals? Can't we brainstorm some ideas for reaching those goals without trampling on each other's non-negotiables? Can we come up with some political compromises to allow our government to start functioning as designed once again?

If it can be done with the issue of defunding Planned Parenthood, it can be done with any issue. So that's the one I tackled first.

Here's what I came up with.

Understanding the Misunderstanding

First, I've got to be honest with you, my initial reaction to all the hubbub was, "Defund Planned Parenthood? You mean we're funding Planned Parenthood? But I thought it was illegal to use federal funds for elective abortions!"

This reveals the fundamental difference in perspective at the heart of all the acrimony over defunding Planned Parenthood. Pro-lifers see Planned Parenthood is the nation's largest abortion provider and promoter. Pro-choicers see Planned Parenthood as the nation's largest provider of women's health services. So when we start talking about defunding Planned Parenthood, pro-lifers hear "let's stop funding abortions" and pro-choicers hear "let's stop funding women's health."

Which side is right? My conclusion after all my research is that both sides are right...and neither side is right.

Is Planned Parenthood a Women's Health Provider...?

A statistic that is often used by Planned Parenthood defenders is that abortions only account for 3% of their services. The majority of their services, numerically speaking, are STI/STD testing and treatment, prescribing contraceptives, performing pregnancy tests, etc. These are the services for which they get federal funding, largely in the form of Medicaid reimbursements for poor patients (other patients pay out of pocket or through private health insurance). This federal funding accounted for $553.7 million in 2014-2015, or 43% of their total revenue.

Honestly this was news to me. I didn't know that Planned Parenthood provided all of these other services, let alone that a good chunk of their funding came from taxpayers. I have only ever heard of Planned Parenthood in the context of abortion. So I appreciated being educated about this aspect of the debate.

...Or is Planned Parenthood an Abortion Provider?

But the 3% statistic doesn't quite paint an accurate picture of the relative importance of abortion to Planned Parenthood's mission and bottom line--or of their importance to the abortion industry. In 2014-2015 they provided almost 9.5 million distinct services, but only served 2.5 million patients. So many of their patients receive multiple services, making the percentage of their patients who receive abortions likely much higher than 3% (for example, say a patient gets a pregnancy test, an STI screening, and abortion). Planned Parenthood does not provide this particular statistic so we can only speculate about the proportion of their patients actually receive abortions. But it is certainly higher than 3%.

Abortions are much more complicated procedures than simple tests for pregnancy or an STD, so it's really comparing apples to oranges to say tests are a more important part of Planned Parenthood's offerings than abortions just because they do more of them. Also, abortions bring in more revenue. Again, Planned Parenthood does not provide specific statistics, so such numbers can only be guessed at. Multiplying the number of abortions they perform each year by average abortion costs indicates that Planned Parenthood receives 22-40% of its income from abortions--it is far more important to their business model than the 3% statistic would lead one to believe.

Almost one third of abortions in America are performed by Planned Parenthood, making them the largest single provider of abortions in the U.S. Abortion is a vital part of Planned Parenthood's mission. Reading through their annual reports (available online) makes this clear. They regularly report on their successes in lobbying for and promoting abortion. Since 2013 Planned Parenthood has required that all its affiliates provide abortion in at least one of its clinics (at that time 10% did not).

It is clear that abortion is an indispensable part of Planned Parenthood.

The Answer: Both.

After doing this research, I concluded that both sides are right about Planned Parenthood, and both sides are wrong. Yes, Planned Parenthood provides a broader range of women's health services than just abortions. But they are also the nation's largest abortion provider and promoter.

This raised several more questions in my mind. Must we choose between supporting women's health or opposing abortion? Is it true that opposing abortion means opposing women's health, as the "War on Women" rhetoric used by many on the pro-choice side implies?

To answer these questions I researched the impact defunding would actually have on abortion and women's health services.

How Would Defunding Impact Women's Health Care?

I am not unsympathetic to the argument by Planned Parenthood defenders that defunding Planned Parenthood will hurt women by cutting off their access to important health services. However, Planned Parenthood defunders point out that many alternative federally funded comprehensive health clinics exist. Defunding Planned Parenthood would free up funds for these clinics that offer a wider range of services to a broader range of patients, improving health care for all low-income patients. Planned Parenthood defenders retort that alternatives do not exist everywhere, and in many cases are not prepared to handle the deluge of family planning needs that would be created by the sudden absence of Planned Parenthood in an area.

Who is right?

I did some research into the number and placement of alternative clinics. There are currently more than 9,000 publicly funded Community Health Clinics in the U.S. providing a comprehensive range of services to over 23 million male and female patients of all ages, compared to 650+ Planned Parenthood clinics providing mostly reproductive services to 2.7 million patients who are mostly females of reproductive age.

And that's just clinics that are eligible for federal funding. There are also many other privately funded health care clinics like The Neighborhood Christian Clinic in Phoenix.

So alternatives do exist. And with almost 14 times the number of locations, I find it extremely difficult to believe the pro-choice claim that Community Health Clinics would be completely unable to handle displaced Planned Parenthood patients. Perhaps some time and money might be required to prepare every alternative clinic to handle every single displaced Planned Parenthood patient--more on that later. And no doubt some women on Medicaid might prefer to go to Planned Parenthood over a Community Health Clinic. But even patients with private health insurance are not guaranteed access to their preferred providers, so I don't understand why those on Medicaid are entitled to this privilege. 

How Would Defunding Impact Abortion?

Ok, so defunding Planned Parenthood might not be the death blow to women's healthcare that it is being made to be. But what impact would it really have on abortion?

Planned Parenthood defenders say they fear defunding Planned Parenthood might actually lead to more abortions because of more unplanned pregnancies due to lower access to contraceptives for poor women. No one wants that, right?

This is not merely theoretical, since several states have already reduced funding of Planned Parenthood. We can look at unplanned pregnancy and abortion rates from before and after the defunding in these states to get an idea of what impact we might expect from attempting such defunding on a federal level. I spent hours inputting statistics from government websites into spreadsheets and generating charts and found that abortion and unplanned pregnancy rates did not go up as a result of states reducing funding.

Whew! But would defunding have any impact on abortions? Planned Parenthood defenders point out that the Hyde Amendment already prohibits the use of federal funds for elective abortions, so defunding Planned Parenthood would not cut off funding for abortions, just for the other women's health services that Planned Parenthood offers.

That might be technically true, but I keep coming back to the fact that we're talking about 41% of Planned Parenthood's revenue. Forty-one percent! That means that taxpayers provide a huge chunk of the overhead that makes possible almost one third of the abortions performed in this country. Even if on paper those funds aren't going directly to abortions, it's safe to say that many abortions are taking place because of those funds. Put another way, many abortions would not be taking place if those funds weren't there.

Funds that have come, in part, from my pocket. That makes me partly complicit in what I believe to be the murder of innocent human beings.

Pro-choice friends, I know you don't believe abortion is murder, and I respect your belief. But can you also respect my belief, and understand the guilt that I now feel as I understand more fully than ever before the part that I have had--and continue to have--in the death of innocents?

Abortion is no longer something theoretical that other people do, that I can safely discuss from a distance. It is something that I am unwillingly being forced to participate in, to support, to make possible through my tax dollars. This weighs heavily on my mind.

This is why the question of defunding Planned Parenthood will not go away with this election cycle, or after the CMP investigative videos have faded from the public mind. This is not the first time Congress has attempted to defund Planned Parenthood and it will not be the last, because funding Planned Parenthood directly violates the conscience of nearly half of the country. And that will not change or go away.

A False Choice and An Alternative

At the same time, I understand that defunding Planned Parenthood is not a palatable idea for pro-choicers even if doing so might not devastate women's healthcare and cause more unplanned pregnancies and abortions. 

I get that. I really do.

But I do not believe that the choice we are being offered is the only choice available. Must we either continue the status quo and leave Planned Parenthood funding as is, or suddenly and entirely remove all federal funding of Planned Parenthood?

I don't think so.

While doing all this research, I've been trying to come up with a solution that, while not preferable to either side, might be acceptable to both sides, and therefore might actually have a chance of passing without tearing the country apart.

Here's my idea: we could gradually move funding from clinics that perform abortions (such as Planned Parenthood) to other clinics that do not provide abortions during a transition period that would allow the needs of each area currently being served by an abortion-providing clinic to be evaluated to ensure that alternative clinics are prepared to handle any patients that might be displaced.

It might cost a little more in the short run, but this way not only is there no disruption to women's healthcare needs, in the end women will have access to a greater variety of services, as will the general public. And while pro-lifers I'm sure would prefer to not have any delay in ending their forced financial support of the abortion industry, this would at least give a distinct timetable for ending it -- say two years -- which is arguably better than never ending it!

I'm sure this compromise would be hard to swallow for those on both sides of the issue. But it's better than the all-or-nothing approach being taken right now.

Also I really like the idea of putting control/input back at the local level. The more I learn about history and politics, the more convinced I am that top-down decision making and central planning removes most citizens from the process and forces everyone to abide by one moral code--not at all what our founders envisioned.  

With this solution, those who feel strongly either way on this issue could be encouraged to get involved at the local level--helping conduct impact studies, becoming informed on local health care issues, perhaps even volunteering or personally giving to clinics they support. 

After all, almost one-third of Planned Parenthood's funding comes from private donations, and the 2,300 pro-life Pregnancy Resource Centers (which I didn't include in my statistics for alternative clinics since they do not provide all the women's health care services that Planned Parenthood does, though they do provide free pregnancy tests and, in many cases, other pre- and post-natal services) are largely volunteer-run and privately funded by those who believe in the sanctify of life beginning at conception.

I'm all for all of us putting our money where our mouth is and supporting the causes important to us rather than attempting to force our neighbors to support them in violation of their own personal beliefs.

Friends, what do you think? Whether you're pro-choice or pro-life, could you come to see this as an acceptable solution? Or does this spark some creative thinking? Do you have any other ideas for alternatives to the false choices being presented to the country right now?

Please dream with me, and share your thoughts. Change starts with seeing possibilities!