Universal Health Care and Abortion

I think many people will agree that sex education, family planning, and access to contraception are the best ways to reduce teen pregnancies, sexually transmitted diseases, and the need for abortions.  For example, the Colorado Family Planning Initiative made these interventions available to low income women and to teenage girls with their parent’s permission.  Within two years the program attained these results:

  • Teen birth rate was nearly cut in half.
  • Teen abortion rate was nearly cut in half.
  • Births to women without a high school education fell 38 percent.
  • Second and higher order births to teens were cut by 57 percent.
  • Birth rate among young women ages 20-24 was cut by 20 percent.
  • Average age of first birth increased by 1.2 years among all women.
  • Rapid repeat births declined by 12 percent among all women.
  • Costs avoided: $66.1-$69.6 million.[1]

It is my understanding that IUDs were offered as one form of contraception, but I couldn’t find data about pregnancies and abortions among that cohort.  As IUDs are 99% effective, I assume that unplanned pregnancies and abortions were essentially eliminated among that group, as long as they stayed on that form of birth control.

We also have evidence that these interventions work based on other sources.  For example, abortions have been declining in the U.S. in part due to the Affordable Care Act, which requires that health insurance plans pay for contraception.[2]  Similar findings have been observed when comparing the U.S. to countries with universal health care, which have even lower rates than the U.S. because contraception is more readily available.[3]

As a society, if we’re really serious about addressing the issue of abortion, teen pregnancy, and STDs, then funding for these interventions should be at the top of our list and universal health care is the mechanism to assure people have access to them.  For example, the universal health care plan I’m proposing funds abortions, but places an emphasis on prevention such as expanding health and sex education as well as access to contraception.  When it comes to human sexuality, many Americans are woefully uniformed and misinformed.  Funding will be provided to school systems to hire health educators to teach sex education following standardized, evidence-based curriculum.  Additionally, national health insurance will pay for medical office visits where an individual can obtain individual counseling from a physician, nurse, and/or health educator.

While abortion should be legal, as a society we should set goals to reduce the need for this intervention, particularly as modern birth control methods are effective 95% or more of the time.  An unplanned pregnancy should be a rare occurrence and therefore the need for abortion should also be infrequent.  For the past three decades, the number of abortions in the United States has been declining as access to contraception has improved.[4]  It’s a trend that, as a nation united, we should continue to support.

Unfortunately, the Republican Party has other ideas.  For example, Republicans have tried to repeal the ACA’s requirement that health plans pay for contraception and they have cut funding to Planned Parenthood; funding that is used for women’s health initiatives including family planning and paying for birth control.  And in Colorado, the Republican led state legislature held up funding for the state’s Family Planning Initiative despite the successful results the program was achieving.

Now the Republican Party, in an attempt to overturn Roe v. Wade, is passing legislation to make abortion illegal at the state level.  They do so knowing that even if the Supreme Court decided that these state laws are constitutional, it wouldn’t stop abortions.  That’s because making something illegal doesn’t mean it goes away; like the prohibition of alcohol in the 1920s, it will just go underground.  Keep in mind that many abortions are performed by prescribing a woman two pills to be taken 48 hours apart.  These pills, which are taken at home and not in a doctor’s office, induce a miscarriage.  The pills are readily available in other countries, so even if the sale of the medications is made illegal in the U.S., they’ll still be ubiquitous and easy to obtain. 

Let’s be honest.  The Republican Party is not interested in ending abortions in this country.  If they were, they would support programs that actually work.  They just want to make it illegal to appeal to their political base.  Deplorable.

[1] https://www.colorado.gov/pacific/cdphe/cfpi-report

[2] https://ihpi.umich.edu/news/access-birth-control-through-aca-drives-down-abortion-rate

[3] https://www.cbsnews.com/pictures/abortion-around-the-world-where-are-rates-highest/

[4] Based on CDC data, between 1990 and 2015, the number of abortions in the U.S. was cut in half; from 1,429,247 to 638,169.  At the same time, the U.S. population increased by 77 million, including the number of women of childbearing age. o

1 thought on “Universal Health Care and Abortion”

  1. Great points on an incendiary topic! Denying contraceptive options and muting sex education in schools is a formula for more abortions. Human nature doesn’t abide by the fantasy of voluntary abstinence and people will seek abortions whether they legal or not. It will simply be clandestine, dangerous and unregulated if criminalized.

    The GOP’s effort to deny sex education, contraceptive availability as well as to criminalize abortion is a formula for disaster. A complete no win scenario. If you look at the public health data from Western Europe (The Scandinavian nations, Germany and France to be exact) and you’ll find the incidence of STDs, unwanted pregnancies, teen pregnancies and, of course, abortions being at significantly lower levels than in the US. The reason? Science-based sex education and universal contraception as well as unfettered and professional woman’s health initiatives. In the spirit of keeping abortions rare and safe, this seems to be the solution. This is a solvable problem. Sadly the GOP, like many cynical politicians, are using the topics of contraception and abortion on the table as leverage with which they can sway voters on an emotional level to retain power and privilege. The common good be damned!

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