Women's Rights and Health Insurance Reform

[zandperl]

An open letter to my senators and representatives.

I am writing to you today regarding the health care reform bill currently before the house and senate

Comments

[lurfmonkey]

While it would be bad if these things were left out of the health care reform bill, I cannot find any of the things you are talking about in H.R. 3590, the current Senate bill. Nowhere are birth control or contraceptives mentioned. Is there another word they use? It actually encourages education on contraception

About the bill

[zandperl]

(My reply was too long, so this part is about the bill.)

I admit to not having read either the Senate or House version of the bill myself - there have been so many versions bandied about I'm not even sure where to start looking to find the full text of them. Do you have a link to the full text of both versions where it confirms that those are the versions that either were just approved or are currently under debate?

The source of my concern was a post by hrafn , which links to this article (the link in her post is bad) and this one. I tried asking around to see if anyone knew conclusively if the current versions do include coverage for abortions, HBC, or pelvic exams, and when no one knew conclusively, I decided to write this letter anyway.

how is this reform any worse? For two reasons: (1) I expect that more people will be on the new plan after this reform than currently are on Medicare/caid, and (2) I have read arguments that this will result in changes in the practices of private insurance companies. The arguments go that if a

Re: About the bill

[lurfmonkey]

I'm currently referring to HR 3590, the bill that it's in the Senate right now. I also previously read much of HR 3200, the previous House bill, though it changed a bit before passage

About abortion

[zandperl]

I don't think taxpayers should pay for non-medically necessary ones. There should be some consequence for just accidentally getting pregnant.I know that you didn't intend to insult the intelligence of women when you said this, but please be aware that that is how it comes out. (Your words imply that women don't understand that abortions are a major medical procedure; your words imply that women are not able to decide what is a "worthy" reason for abortion and that someone else needs to decide it for them.) You are speaking from a place of privilege in this conversation, and you need to be careful with the words and phrases you choose not to perpetuate the inequities

Re: About abortion

[lurfmonkey]

I realize my comment was oversimplified and condescending, and I apologize. I know there are consequences beyond monetary concerns for unwanted or dangerous pregnancies. I just think people put a lot of emphasis on the fixing of the problem rather than the prevention. The bill addresses some of that. Nobody wants to get an abortion, but I feel that while there's not enough education out there about contraception, there's also not enough education out there about what an abortion entails. Many women don't really learn about it until it's too late. I think tax dollars would be well spent on that. But if it does happen, then yes, you should have the option of abortion, and it should be your choice after adequate counselling on options. Using taxpayer money for it doesn't sit well with me, but if the woman has no other reasonable choice, then I guess I'm ok with it. But in relation to the open letter, I don't think the bill takes a step backward. It just doesn't go forward very much

...and more about abortion

[zandperl]

Both bills allow coverage in instances of rape, incest

Exceptions for rape and incest put the burden of proof on the victim, and few of these victims actually report when the incident takes place. There is no way to effectively put in a clause that forbids abortion except in cases of rape and incest that does not exclude the majority of rape and incest victims. The only way to make sure that the majority of rape and incest victims have access to abortions is to not ask any questions about the reason for the abortion. Don't worry, women know when they've been raped, you don't need a doctor or police officer to double-check.

Re: ...and more about abortion

[lurfmonkey]

While rape may be tricky to prove sometimes, it doesn't seem like incest would be. Couldn't a DNA test confirm that? Or does the baby actually have to be born for a test to be performed?

Re: ...and more about abortion

[zandperl]

Proving it would not be difficult - an amniocentesis can get fetal DNA, that's how they screen for Down syndrome. I'm not sure if they can tell from just fetal DNA and the woman's DNA that the fetus is the product of incest though, they may need to compare DNA to potential fathers. If that's the case, the pregnant woman would have to admit to the incest and ID the man involved. While there are also other circumstances of incest, it's often a subset of rape. Do you think a 13-year-old girl would be willing to admit to being raped by her uncle? Do you think she'd even necessarily understand that it's rape

Re: ...and more about abortion

[lurfmonkey]

In the case of a 13 year old girl, I don't think she has to admit to anything. By definition, if she is pregnant, she has been raped, incest or not. It just gets more difficult after the age of consent. So the only option is to cover all abortions because the burden of proof is often too difficult to ascertain. I totally understand your argument. It's just in my personal opinion, I have a hard time justifying all cases. But if it must be done because it's the only way to cover legitimate reasons, then it's something that I'll just have to swallow

[hrafn]

The Stupak/Pitts amendment did not provide an exception for the health of the pregnant woman, only for her life (or for pregnancies caused by rape or incest). Leaving out an exception for health is huge, and probably unConstitutional, since Roe requires health exceptions.

The George Washington University School of Public Health and Health Services did a study on the likely outcome if the Stupak/Pitts amendment stayed in the final bill, and their conclusions are pretty grim - they concluded that the amendment would lead to no private insurers offering abortion coverage, period. Since the Senate has already gotten rid of Stupak/Pitts in favor of something closer to the status quo, I am hoping that is how the final bill will be (well, to be honest, I'd like them to ditch the fucking Hyde amendment, but we all have unrealistic hopes

[lurfmonkey]

Yes, there should be a stipulation for the woman's health. If the Senate bill holds, it should be better on that front.

Rather than repeat myself, see my comments above on abortion. I just wanted to address this:

It is much less expensive to provide an abortion than pay for the medical costs of pregnancy, delivery, and the child's medical expenses, some of which -are- mandatory for insurers to cover.Part of me believes that expense shouldn't be such a big factor in the decision to have an abortion. It's kind of implying that the less costly an a abortion is, the more likely the woman is going to have one. You could also argue that it's cheaper to execute a prisoner than it is to keep him or her in prison for life or rehabilitate them. Should these decisions be driven by cost? It's a tricky line. For those who need abortions, it shouldn't bankrupt them. On the other hand, the woman shouldn't have an abortion if she would have carried the baby to term without issue if she couldn't afford the abortion

[hrafn]

Re:costs - one of the reasons given to leave contraception out of the list of things that must be covered was cost. As in, "if we have to pay for X amount, that will increase the total cost of the bill too much," ignoring the fact that -not- covering contraception will lead to a variety of more expensive results, including things that the bill said must be covered, like costs for some children's health coverage.

[sildra]

On the other hand, the woman shouldn't have an abortion if she would have carried the baby to term without issue if she couldn't afford the abortion.

How would she even know if she could have carried a baby to term without issue? I say this because a good friend of mine nearly bled to death during childbirth--despite being at a first-rate hospital--and ended up with sufficiently severe permanent brain damage due to the loss of blood that she had to quit her job. Now, three years later, she still collapses if she tries to walk too far or go up more than a small flight of stairs. In her case it was a wanted pregnancy. But in the case of an unwanted pregnancy, the risks--including ones like this that can't be predicted--seem sufficiently high that a woman shouldn't be coerced into going through with it.

[lurfmonkey]

Of course you can't predict what will happen in childbirth. You can't even get an abortion after a certain point, so whether or not you're covered has no bearing. In the case of your friend, I'm sure there was no reason up until childbirth to abort. All indicators probably pointed to a successful pregnancy. That's the situation I'm referring to. If you have warnings about the health of the woman or the baby, then that changes things

[sirroxton]

It's funny. My impression is that your views are deeply offensive to one or more of the people you're communicating with, and yet instead of shouting you down, they're arguing within your selected framework. I've always found that to be kind of a liberal failing. If this conversation were happening in my space, you'd be castigated roundly.

[lurfmonkey]

It's a failing to argue within a framework rather than engage in shouting matches? How exactly are shouting matches helpful? Look, I'm expressing my opinion. If there are reasonable arguments to the contrary, I will listen. If I'm just denigrated, then no, I will not listen. Personally, I'm not offended if someone disagrees with me if they can tell me their reasons. If they just yell at me and say they're right and I'm wrong, then that accomplishes nothing for either side