Tuesday, August 25, 2009

Devil's Advocate

I'm all about abortion. I love that it's an option. I love that it's legal. I love that it's so common.

But then again....

While I do dislike those ambiguously pro-choice statements (e.g. abortion should not be used for birth control), and wish they didn't pervade anti- and borderline pro-abortion rhetoric, I can't say I disagree 100%. And it's not because the thought of abortion weirds me out, or because I have moral/ethical limitations on my pro-choice stance.

The primary reason I will concede that abortions should occur less frequently in this country has to do with the state of health care. Our providers and facilities are operating in a free market system, virtually unregulated. Abortion services, like any other material goods, follow the rules of supply and demand, and subsequently price, in this lame for-profit health market. A high number of abortions, like a high number of any other type of procedure or health service, drives up the cost of health care in the United States and makes all types of health services prohibitively expensive, even for us insured folk. Condoms: cheap. Abortions: expensive. And even though abortion procedures have taken the smallest blow as far as inflation, they are still expensive enough to raise eyebrows.

Let's say Heaven smiles upon us and blesses us with a single-payer system (thanks, God! We knew it would take nothing short of a miracle!). While the proverbial public option would open doors (literally!) for millions of people, we would have to control costs. That means no coverage for certain services, potentially salary caps for providers, and the promise of some red tape. In the family planning/reproductive health segment, cost-cutting can be accomplished most easily by providing damn good preventative services and reducing the demand for abortion. I'm all for that. It's analogous to providing nutrition and exercise counseling to obviate the potential for open-heart surgeries and diabetes testing supplies. And I don't think anyone can argue with me that gastric bypass should not be used as "obesity control". It's just downright risky. Why treat when we can prevent? And not that we can prevent everything, and not that good treatment ain't worth it's salt. It most certainly is. But either way we make sacrifices; I am willing to sacrifice a few abortions if I knew that equally many pregnancies could be avoided. And it's not just pregnancies we avoid. Do you know how many teenagers are infected with chlamydia and gonorrhea every year? Hundreds! Literally hundreds! These kids need education, they need treatment, they need to understand that CT/GC are the least of their troubles, and that the HIV/AIDS prevalence in the District of Columbia is three times the national prevalence. Yikes! If a new health plan can make health information and services accessible to young people, minorities, rural folks, everyone, then we wouldn't need to fight so hard and so tirelessly to keep abortion legal.

1 comment:

  1. I've used the gastric bypass analogy as well. It's not that we WANT to have abortions, it's not like going through that experience is something FUN and EXCITING that women aspire to. It's a medical necessity, a last resort. Why is it a last resort? Because mistakes happen. Because birth control is too expensive if you don't have insurance, or just lost your insurance. Because there is not enough education -- and in some places, there is gross MISeducation telling kids condoms don't work. Because there is shame in sex and condoms. Because there is rape.

    Also, because there are complications in pregnancy. It sucks, but it happens, and it's real.

    This is why we need to keep the last resort of abortion open as an option for women. Why doctors need to be trained in these procedures.

    We all want abortion to be less common, but in order to get there, we need to provide information and access to birth control. We need to make sex less taboo.

    But even if everyone were on mandatory birth control, mistakes would still happen. Rape, sadly, would still happen. And preempclampsia (sp?) and other complications would still happen. So we still need to keep the option open.


This is not a debate forum -- there are hundreds of other sites for that. This is a safe space for abortion care providers and one that respects the full spectrum of reproductive choices; comments that are not in that spirit will either wind up in the spam filter or languish in the moderation queue.