In which women’s access to abortion becomes public-optional

From GT 2009-08-20: Tonight, in News of the Obvious:

And in breaking news from NARAL Pro-Choice America, it turns out that government provision of healthcare means that women’s healthcare will be allocated through a political process, and when women’s reproductive healthcare is allocated through a political process, women’s reproductive healthcare ends up being subjected to the vicissitudes of political debate over abortion.

NARAL may not draw the conclusion from its report, but the editorial board here at News of the Obvious will: setting aside outright political prohibitions, which aren’t likely to pass in the near future, a broad expansion of political control over women’s healthcare is the single worst thing that could possibly happen towards undermining women’s access to abortion and reproductive medicine.

— GT 2009-08-20: Tonight, in News of the Obvious

The House of Representatives just recently passed an omnibus health insurance bill which includes extensive new government involvement in health insurance and a strong public option of broad-based government-provided health insurance. The explicit purpose of this bill is to expand political control and political funding in the health insurance industry — to expand government’s role and responsibility in directly paying for healthcare and medical procedures, and to shift more of the money coming in to for-profit health insurance companies away from private sources, and towards government funding sources.

So-called Progressive While so-called Progressive organizations on the male Left — groups like MoveOn and SEIU and the AFL-CIO — have been celebrating the passage of the House bill as a great big win. MoveOn.org calls it historic health care reform and headlines their front page Victory!; now they are staging Countdown to Change rallies to thank those representatives who stood with the American people (by this, they mean those that voted for expanding the scope of the American government). In an e-mail circulated to their mailing list, the AFL-CIO called it a truly historic movement and called on supporters to pressure their Senators to pass a similar bill in order to ensure final victory.

Well, wait.

Just one little problem about this Huge Step Forward: turns out that, if it passes the Senate too, it will strip millions of women of access to abortion, by using strings attached to the new government funding to stop both the public option health insurance plans and plans offered by existing insurance companies from covering abortion procedures.

Oops.

From the National Organization for Women:

The House of Representatives has dealt the worst blow to women’s fundamental right to self-determination in order to buy a few votes for reform of the profit-driven health insurance industry. We must protect the rights we fought for in Roe v. Wade. We cannot and will not support a health care bill that strips millions of women of their existing access to abortion.

Birth control and abortion are integral aspects of women’s health care needs. Health care reform should not be a vehicle to obliterate a woman’s fundamental right to choose.

The Stupak Amendment goes far beyond the abusive Hyde Amendment, which has denied federal funding of abortion since 1976. The Stupak Amendment, if incorporated into the final version of health insurance reform legislation, will:

  • Prevent women receiving tax subsidies from using their own money to purchase private insurance that covers abortion;
  • Prevent women participating in the public health insurance exchange, administered by private insurance companies, from using 100 percent of their own money to purchase private insurance that covers abortion;
  • Prevent low-income women from accessing abortion entirely, in many cases.

NOW calls on the Senate to pass a health care bill that respects women’s constitutionally protected right to abortion and calls on President Obama to refuse to sign any health care bill that restricts women’s access to affordable, quality reproductive health care.

Terry O’Neill, National Organization for Women (2009-11-08): NOW Opposes Health Care Bill That Strips Millions of Women of Abortion Access Says Bill Obliterates Women’s Fundamental Right to Choose

Once again, this should come as no surprise. Government health insurance means political allocation for women’s healthcare — for any and every one of the women who is moved over to public options and public-private partnerships on the public health insurance exchanges.

Political allocation of women’s healthcare means that women’s healthcare will be subjected to political debate and sacrificed in the name of political compromises — which, in this country, means being subjected and sacrificed to the Gentleman’s Agreement between anti-choice partisans, on the one hand, and, on the other, the doughface politicos, who just don’t give much of a damn about women’s lives or health or freedom, and are happy to treat them as optional as long as they’ve got a bill to pass or a Democrat to elect.

This healthcare bill, authored by Democrats, pushed by Democrats, and supposedly a key aspect of the male liberal’s agenda for Progressive social change, will almost certainly mean a massive government-sponsored assault on women’s access to abortion. Women’s bodies are not public property; women’s health should not be subject to public controversy or dependent on the approval of the public (which means, in fact, the loudest and most belligerent voices in politics). But as long as government is calling the shots on women’s healthcare, women’s healthcare is always going to be compromised and sacrificed in the name of political agendas. The only way to make sure that women’s healthcare will no longer be treated as public-optional is real radical healthcare reform — not by preserving the government-regimented corporatist status quo, but rather by getting government out of healthcare entirely — by cutting the government strings that always come attached to government money — by getting rid of government subsidy and government regimentation and replacing them with grassroots mutual aid, abortion funds, community-supported free clinics, and other forms of low-cost healthcare free of political control because they are supported by free association and community organizing, rather than taxation and political allocation. That is to say, by taking the funding for women’s healthcare out of the hands of politicians, and putting in the hands of women themselves.

Expanding government control of healthcare funding is anti-choice, anti-woman, and would represent the single biggest assault on women’s access to abortion in the last 30 years.

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  1. MBH

    Expanding government control of healthcare funding is anti-choice, anti-woman, and would represent the single biggest assault on women’s access to abortion in the last 30 years.

    So if the Stupak amendment is taken out of the bill, it’s still anti-choice and anti-woman?

  2. Rad Geek

    MBH,

    Yes.

    Even without Stupak, it would still be anti-choice and anti-woman — just in a more subtle and longer-term way. First, because even without the Stupak Amendment, the Hyde Amendment would remain on the books and would substantially restrict abortion access for those taking part in directly government-managed healthcare options.

    But, at a deeper level, because political control of medical coverage always means subjecting politically controversial healthcare — which in this country at this moment mainly means women’s reproductive healthcare — to the vicissitudes of political debate and political horse-trading. The question is not if, but only when, the second blow of the one-two punch will happen — whether it will be simultaneous with the passage of the bill, or if it will wait a few years until such a time when the anti-choice politicos have gained a few seats in Congress.

    The basic problem is not the specific details of any one particular healthcare bill. The details are only the end result of a more fundamental problem: that expanding government provision, government subsidy, and goverment regulation of health insurance always means — by definition — making access to healthcare dependent on the limits and the outcome of political debates, rather than on individual choice or community organizing. Anyone whose basic healthcare is treated as being subject to debate, or morally suspect, or politically expendable — which, in malestream political debate in a patriarchal society, typically means women’s reproductive healthcare, especially abortion — is going to find her position constantly endangered, and is going to find herself constantly embattled in political fights to try and defend their access to basic healthcare against assaults from organized and well-funded political factions. Whether or not those factions end up winning a particular battle, the need to fight it to begin with is a sign that something is surely wrong.

    And the only way out of that trap is to put control in the hands of women themselves, rather than in the hands of legislators. Which means not government solutions, but rather direct action. Grassroots mutual aid, unlike government options, is not contingent on majoritarian approval or subject to the demands of the Beltway consensus. Antis can’t endanger it or take it away, because antis aren’t part of the project to begin with.

  3. MBH

    Charles,

    Your argument against government expansion is your same argument against government itself. What sense does it make then to label a potential bill a threat to natural rights? Surely you’re correct in some sense, but in the same way you’d be correct to look at a tree and call it a seed.

    I agree with you: “the need to fight [a particular battle over natural rights] to begin with is a sign that something is surely wrong.” Natural rights ought to be so sacred and ritualistically protected that we would no more think of violating them than we would the law of gravity.

    But our world is determined by the situations in which we find ourselves. And we cannot discard those situations. The nation-state system is our situation. It’s fucked up. It’s crazy. It doesn’t make any sense. But that’s the situation.

    The best we can hope is to identify the cause of the situation and eliminate the cause. What caused the system?

    I’d suggest it’s a way of thinking which caused the system. Take out the system but don’t touch the way of thinking which caused it and we’re fucked even worse.

    Physical anarchy is nothing compared to mental anarchy.

    If we want a world in which Justice dwells, then let’s break down incoherent structures of the mind. Make the nation-state system irrelevant. Hell, push this enterprise through the system!

  4. Sameul Haque

    There are problems with current system, but it really isn’t fair to place the burden of caring for weak on those of us that are healthy without our consent. Obama portrays government run health care as free, but those of us with private insurance will pay for it in the form of higher premiums, and if taxes aren’t raised to pay for the government plan we will all pay for it in the form of spending induced inflation. Our government needs a good lesson in economics.

  5. MBH

    Samuel, who pays for emergency care given to those without insurance?

  6. Sameul Haque

    People without insurance are still obligated to pay their medical bills. They can declare bankruptcy if they can’t afford to pay, but if someone doesn’t have insurance, that doesn’t absolve them of their responsibility to paying their medical bills.

  7. MBH

    Hospitals and physicians in 2008 provided an estimated $116 billion in care to the uninsured, of which approximately $42.7 billion was uncompensated, according to a report released today by Families USA. The study, conducted by Milliman, Inc., found that privately insured U.S. families last year subsidized uncompensated care through $1,017 in additional premiums, a practice referred to as cost-shifting.“

    http://www.familiesusa.org/assets/pdfs/hidden-health-tax.pdf

    You cool with that?

  8. Sameul Haque

    There’s still no such thing free lunch with a government run plan. You’re just shifting the cost of covering the uninsured from the hospitals to the general public. You cited a study that shows that treating the uninsured raises the cost of insurance for the average person, but you haven’t shown that a government run program would save the average person money. If government subsidized insurance is any good, then private insurance will have to charge more to offset lost business. Furthermore, the general public would have to bear higher taxes and/or higher inflation. I’ll agree that treating the uninsured costs the average person money, but a government run plan won’t save money.

  9. MBH

    There’s still no such thing [as a] free lunch with a government run plan.

    No. There’s never a free lunch. There’s always opportunity costs. I haven’t claimed or implied otherwise.

    You’re just shifting the cost of covering the uninsured from the hospitals to the general public.

    No. The cost is shifting from those who get charged twice to those who don’t compensate for their care. Many of them will be subsidized and so the shift is not total. But it is a movement away from socialized risk/privatized gain.

    If government subsidized insurance is any good, then private insurance will have to charge more to offset lost business.

    No. Government subsidies do not limit choice. Anyone subsidized can still use that money to select private insurance.

    … the general public would have to bear higher taxes and/or higher inflation.

    … a government run plan won’t save money.

    No and no. The CBO estimates that from 2010-2019, the enactment of HR 3962 would result in a $104 billion reduction in the federal deficit.

  10. Sameul Haque

    No. There’s never a free lunch. There’s always opportunity costs. I haven’t claimed or implied otherwise.

    You are arguing that a government run plan will save the average person money, correct?

    No. The cost is shifting from those who get charged twice to those who don’t compensate for their care. Many of them will be subsidized and so the shift is not total. But it is a movement away from socialized risk/privatized gain.

    How is the general public footing the bill any better than the hospitals footing the bill? And how is it a shift from socialized risk/privatized gain? Do you even know what that means?

    No and no. The CBO estimates that from 2010-2019, the enactment of HR 3962 would result in a $104 billion reduction in the federal deficit.

    Pardon me while I laugh in your face.

  11. MBH

    You are arguing that a government run plan will save the average person money, correct?

    Yes. And you’re assuming that cost-savings presupposes a free lunch. Correct?

    How is the general public footing the bill any better than the hospitals footing the bill?

    The hospitals never — by themselves — foot the bill. Insurance premiums rise every time uncompensated care rises.

    And how is it a shift from socialized risk/privatized gain?

    Uncompensated care falls. Insurance monopolies and cartels lower premiums. They’ll be less likely to price gouge.

    It will be illegal to deny coverage for pre-existing conditions or to revoke coverage because someone gets sick. Insurance companies will have to take on more risk in order to compete. Anti-trust laws will likely break-up monopoly and cartel revenues.

    Do you even know what that means?

    I know your question means that you’d rather shift the subject.

    Pardon me while I laugh in your face.

    Nice rebuttal.

  12. Sameul Haque

    Government run health care will not save the average person money. If the bill passes, rates will rise for everyone. You seem to think that if government pays for the care of the uninsured that those costs just go away when in fact the public has bear those costs. Why is it better for the public to pay those costs as opposed to hospitals? Also, you do not know socialized risk\privatized gain means. That is when corporations take risks and the government bails them out. That’s not how health care works. In fact, it’s quite the opposite of how private health care works.

  13. Dr. Swaraj

    You seem to think…

    Let’s try to focus on what I actually think — not what some straw man, who you’re projecting onto me, thinks.

    Why is it better for the public to pay those costs as opposed to hospitals?

    Did you read my last response? Or are you still listening to your internal straw man? When uncompensated care rises, insurance companies raise premiums.

    …[Y]ou do not know [what] socialized risk\privatized gain means.

    You don’t know what socialized risk/privatized gain means. You list one instance in which it happens — as if that’s the only way it can happen.

    Insurance company A contractually agrees to cover Patient B so long as B pays monthly premiums. A honors the contract, and associated risk, with B until and unless B gets sick and minimizes A’s gains. A researches B’s record for contract-nullifying-causes. Domestic abuse, acne, typo’s, etc. are all A needs to drop coverage of B.

    The most obvious examples of socialized risk/privatized gain are in relations between government and corporation. But, the same concept applies in relations between corporation and customer.

    I’m sorry if that makes your anti-statist views more complicated — since evil exists irrespective of the state. But that’s the reality. Deal with it or don’t.

  14. Curiosity Fed the Dog

    I wonder what would happen to health care costs if all of the government’s cartelizing, subsidizing and restrictive interventions were to cease? They just might fall to the point where a trip to the clinic is no more expensive than a trip to the grocery store.

    And what would become of health insurance then? (Hint: There is no “grocery insurance.”)

  15. Rad Geek

    MBH,

    Your argument against government expansion is your same argument against government itself.

    Actually, my argument at the moment has to do with a much more specific target: the effect of expanding government involvement in daily life on people whose lives and bodies are politically targeted. The point is that government involvement means political allocation, which will always tend to cut against those who are politically marginalized. Which, in a male supremacist society, means women. (Inter alia.) Consider it a particular application of my general view about the class structure of the State.

    I agree with you: the need to fight [a particular battle over natural rights] to begin with is a sign that something is surely wrong.

    Actually, this post isn’t about abortion rights per se; it’s about abortion access which is a related but separate issue. (It’s something of a hot topic in the post-Roe repro rights movement; because many anti-choice politicos have focused their efforts not so much on trying to make abortion illegal again, as in trying to use regulatory restrictions to cut off women, especially young or poor women, from the physical facilities needed to get an abortion, or the money needed to pay for it.) Stupak would not make abortions illegal; it would just make them significantly harder for many women to get, by ensuring that most or all women get their healthcare coverage through plans which are legally forbidden from paying out for abortion procedures. So the complaint is not that the bill would directly violate abortion rights; it’s that it would directly violate other rights, in such a way that one of the ripple effects is to limit women’s access to abortion.

    But our world is determined by the situations in which we find ourselves. And we cannot discard those situations. The nation-state system is our situation.

    I have no idea what any of this has to do with the point. I’m not proposing to ignore the nation-state system. I’m proposing to resist it, and to focus energy on building alternatives that bypass it, rather than on trying to implement schemes to reform it. (Schemes which — and here we come to the point of the post — invariably end up hurting identifiable classes of politically-marginalized folks in the process of trying to help other folks.)

    Take out the system but don’t touch the way of thinking which caused it and we’re fucked even worse. … If we want a world in which Justice dwells, then let’s break down incoherent structures of the mind. Make the nation-state system irrelevant.

    Well, whatever you want, but I don’t see what any of that has to do with advocating grassroots organizing rather than governmental reforms as a response to the healthcare crisis. Part of the reason I advocate grassroots organizing efforts (like free clinics, abortion funds, etc.) is precisely as a means of providing alternatives that bypass the nation-state system, and hence make it that much more irrelevant.

    Hell, push this enterprise through the system!

    Well, good luck with that. But what has it got to do with supporting a bill that will clearly subject basic health care for more than 1/2 of the population to political allocation and hence make it a subject for political debate?

  16. MBH

    Your theory is beautiful. I just don’t think it’s likely that we enact it. Maybe that makes me a sell-out. I’m OK with that. I’ve done my calculations and — even though a polycentric legal system is superior in theory — I still believe that the system we have, in concert with underground education systems, is our best shot at Justice. I’m convinced that the systemic fault is in the way we think and interact — the oligarchy is just a by-product, not the root.

    I understand your point — that my way of thinking further marginalizes the already marginalized. Yeah. Any form of gradualism runs that risk. But a shift from a monocentric legal system into a polycentric legal system runs those risks too.

    I know all this seems to dodge the merits of HR 3962. And it does. I mean, structurally: the public-option is terribly weak compared to a polycentric legal system. Then again, the public-option is a few steps away; implementing a polycentric legal system (other than sense in which it already exists) is thousands of steps away.

  17. Rad Geek

    MBH:

    Your theory is beautiful. I just don’t think it’s likely that we enact it.

    Well, whatever, but I don’t see how that’s a reason for supporting measures that make things actively worse for the majority of the population.

    I’m convinced that the systemic fault is in the way we think and interact — the oligarchy is just a by-product, not the root.

    I’m not concerned about the olig- nearly as much as I’m concerned with the -archy. I agree that that last is rooted in systemic fault … in the way we think and interact (Or rather, the way that many of us think, and the way that a few of us treat the rest of us.) But the question is how you go about changing that. Let me just say that, in spite of all the ritual invocations of pragmatism and realism that people often make on behalf of working inside the system, I’m not at all convinced that this is a strategy well-justified by its real world success. I would argue that most real changes to how people think and interact have come from radical challenges from outside the establishment (Socrates, Jesus, the abolitionists, satyagraha, SNCC, first- and second-wave feminism, Solidarnosc, et al.), by exerting pressure from the outside, by unconventional means, rather than from the players and backroom reformers of the time trying to game the system from within.

    Then again, the public-option is a few steps away; implementing a polycentric legal system (other than sense in which it already exists) is thousands of steps away.

    If you say so. But my point is that the so-called public option (and the related system of new government mandates and public-private partnerships) represents a definite step backwards for a large segment of the population. (Like all government programs, whatever gains it may make come with strings attached for those who get the gains, and come at the expense of others.) Whether or not it is easier to achieve than peaceful anarchy, the point is that it’s not worth achieving in the first place.

  18. MBH

    I don’t think it’s either work within the system or work outside the system. I think it’s work within the system and work outside the system.

  19. MBH

    Curiosity Fed the Dog,

    Government cartelizes often. But corporations can form cartels without the state.

  20. Laura J.

    MBH,

    But corporations can form cartels without the state.

    Can they? It is not clear to me that behemoth corporations as we know them - or anything particularly like them - would exist at all without the numerous legal privileges granted to them by state force at the expense of other common or possible forms of business association, much less that they’d be able to form cartels without huge political machines (or even military forces, in some cases) to manipulate in their favor.

  21. MBH

    All it takes is manufactured consent. Any institution(s) in any context can do that. That should be clear.

  22. Laura J.

    What exactly do you mean by “manufactured consent”? What is necessary for institutions to create it?

  23. MBH

    What exactly do you mean by “manufactured consent”?

    Buying a belief system.

    What is necessary for institutions to create it?

    Numb minds.

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