Tuesday, March 27, 2012

Why such a fuss about health insurance?

Tomorrow, the Supreme Court gets down to brass tacks on the health care mandate and whether it is constitutional. For those “pro-choice” advocates out there, consider the hypocritical dichotomy of being against a federal requirement that you be smart enough to provide some kind of health insurance (in the same way that there is a mandated requirement to have auto insurance coverage if you drive), and yet favor any kind of mandate requiring women to have an ultrasound exam before they can have an abortion. I am frankly sick of the denial, let alone the hypocrisy, of whatever this particular breed of Republicans is. A mandate for national universal health insurance is an argument nearly a century old. It was led 20 years ago by Republicans. If there are those who don’t want health insurance (you can either choose the federal program or get one of your own under the “Obamacare” law), should we just let you die, rather than help cover your care in an emergency room? Ok. I’m cool with that. How about an alternative health care law that says you have three choices: Kick in for the national health insurance system; opt out of the national plan and buy a plan of your own; leave it to fate, in which case, don’t come whining to me expecting me to cover your care costs. In Japan, lived under a pragmatic national health care plan for 35 years. I paid my share, and I got good care. The program has flaws, and there are still loopholes subject to abuse. But it works. So does the Affordable Care Law. For those of you who think the mandate for health insurance that was a bipartisan notion until President Obama actually got it done is now suddenly a bad thing, it would be easy to offer a simple noun-and-verb response. But I will take the high ground here. If you don’t want to have health insurance, and you need care and don’t have a way to pay for it, die!

Friday, March 16, 2012

Women Are Not Stupid

I’m in Idaho, where the state Senate is being asked to consider a badly flawed piece of legislation that would require a woman contemplating an abortion to undergo an ultrasound exam before the abortion. I was among several who testified yesterday in a Senate State Affairs Committee hearing on the bill, before it was passed 7-2 (Republicans over Democrats) with a “do pass” recommendation to the full Senate.
Whatever you think about the merits of an ultrasound as a precondition for an abortion, consider this: This particular bill is bad because:
 It is discriminatory. It singles out a specific segment of the population – pregnant women contemplating abortion – and requires them to undergo a medically “optional” procedure as a precondition for another medical procedure.
 It does not specify the type of ultrasound exam required. This could mean that a woman who opts for one of the “free” ultrasounds would be subjected to an invasive vaginal probe ultrasound, rather than a less intimate abdominal scan.
 It requires that the doctor performing the abortion also sign off on the ultrasound exam. It is unlikely that a doctor would do such a thing without knowing the conditions under which the ultrasound was conducted. This would mean the patient would have to undergo another ultrasound, at her own expense. Idaho has only one other mandated medical procedure: the blood test required for suspected drunk drivers who refuse to undergo a breath test. In that test, the state pays.
 It requires the physician to file with the state (within 30 days), documentation that includes the name of the patient and date of procedure for the abortion and the ultrasound. Although the bill’s language talks about protecting the identity of the patient, this would be in direct violation of existing state law regarding privacy of medical records, as well as a violation of the protected right of doctor-patient relationships.
About a half-century ago, I was a reporter covering the proceedings of a 23-year-old mother on trial for second-degree murder in the death of her eight-month old baby. She told the court, “The baby wouldn’t stop crying. I just couldn’t stand it any more.” In testimony, the jury was told the mother had grabbed her daughter by the heels and slammed her into the wall. Brutal stuff. But trial testimony also brought out the fact that the young mother was a churchgoing (Baptist) high school dropout who essentially didn’t know where babies came from until she learned she was about three months pregnant.
A half-century ago, America was still “Ozzie and Harriet” land, in which Dad was pretty much the guy who got the paycheck and Mom stayed home with the kids. But it was also a time in which abortion, which had been practiced by various civilizations for thousands of years, was being legalized in many states, to the point that the Supreme Court, in the landmark 1973 “Roe vs. Wade” ruling, struck down the last remaining restrictions to the procedure.
In the decades since then, America has undergone a considerable departure from the classic “Ozzie and Harriet” lifestyle norm. For a variety of social and economic reasons, it has become increasingly difficult to sustain a single-income family. Regardless of or in spite of the biblical (Genesis 9:7) call, women, with better education and with forms of birth-control choices (including abortion), were increasingly able to decide when or whether to make babies.
I don’t mean this Blog entry to be about abortion, except to say that it has become one of the most commonly performed medical procedures, to the point that more than 40 percent of American women of childbearing age have had or will have an abortion at some point. Although abortion, like any surgical procedure, is invasive and does involve some risks, women have a broad range of resources, in addition to their own medical practitioners, to be fully informed before making the decision to have one. And for the whole spectrum of reasons for unwanted/unplanned pregnancies, women are fully capable of making an abortion decision on their own.
Some people, whether or not with noble intention, seem intent upon pressing their particular religious or moral convictions upon others. Evangelical Christians are especially keen about pushing their beliefs with missionary zeal, to the point that the term “conservative” in the political sense, once primarily conveying a notion of “the government that governs least governs best,” has become so colored by religious overtones that the term “libertarian” has become a pejorative. Even though “Roe vs. Wade” has been an established precedent throughout the United States synonymous with a woman’s right to self-determination in reproductive decisions, politicians have elevated the effort to restrict this right as a moral issue. The common thread in the “abortion is immoral” position seems to be some degree of presumption that life begins at conception, and that therefore “a woman who terminates a fetus is guilty of murder.”
Debate on whether morality can be legislated is not new. It was part of political rhetoric in England long before the United States was formed. Anyone who knows much about American history will know that our famous attempt to legislate morality failed miserably. Between 1919 and 1933, when the nation was struggling under an awesome postwar depression, unemployment, poverty, and other, far more life-altering concerns, Congress saw fit to impose, and then retract, the prohibition of manufacture, transportation, sale and consumption of alcohol.
As an old man, I do not know firsthand all the things that go through a woman’s mind when she weighs whether to have an abortion. But I do know firsthand that it is not a decision that a woman makes lightly, nor is it a decision that a woman would be very keen about sharing with others, and certainly not with government.
So, here we are, in the 21st Century, a half-century beyond “Roe vs. Wade,” but still confronted by a certain set of religiously or politically (or both) motivated people who are out to intrude upon this very personal and private process by imposing obstacles designed to shame women and, I believe, ultimately to overturn the right to freedom of reproductive choice set out in that Supreme Court decision. An example now coming to a vote in the Idaho Senate, is a bill that would amend existing law on abortion to require that a woman contemplating an abortion undergo an ultrasound exam before the procedure. Idaho is one of at least 10 states that have imposed or are considering imposing an ultrasound examination as a precondition for abortion.
The Senate has already received a petition, signed by more than 4,000 registered voters, opposing the legislation. The Senate State Affairs Committee held a two-hour hearing with testimony both for and against the bill, before a motion to hold it for clarification of the questions on possible conflict with existing state law and constitutional issues by the only two Democrats on the panel was overshadowed by a “do pass” motion by the seven Republicans. The purported concern the Republicans express for making sure women are “truly fully informed”* before having an abortion is a red herring, dragged across the path of a misguided sense that, once a woman sees that cute little fetus, she’s bound to want to keep it and nurture it.
I can’t help but wonder whether that young mother whose murder trial I sat through in the mid-20th Century was “truly fully informed.”

*The actual language of the Idaho Senate Bill. The full text of the legislation soon to come before the full Senate is here: http://legislature.idaho.gov/legislation/2012/S1349.htm