New England Journal of Medicine Says Texas' Family Planning Cuts Are A Public Health Disaster

Leo Berman.jpg
"It was an easy choice to cut out a family planning organization like [Planned Parenthood]," state rep Leo Berman told the Observer last year.
It's been nearly a year since Texas legislators slashed the state's family planning funding, diverting $73 million to a variety of other programs. That was about two-thirds of the total family planning budget, and the conservative lawmakers who orchestrated the cuts were vocal about why they'd done it: to harm Planned Parenthood and other "abortion providers." That's despite the fact that under state and federal law, this money has never gone toward abortion services.

"Of course this is a war on birth control and abortions and everything," Rep. Wayne Christian told the Texas Tribune. "That's what family planning is supposed to be about."

Now, the New England Journal of Medicine has published the results of a three-year study on the impact of the family planning cuts and other changes to the state's public reproductive-healthcare system. They call Texas' family planning legislation "the most radical" in the United States, and warn that it is dismantling the social safety net.

Over the course of three years, the study's authors interviewed 56 leaders of state organizations who received Title X and other public funding, both before and after the cuts went into effect. Title X is the money Texas receives from the federal government that's earmarked for family planning and contraception.

What researchers found is that most of the clinics have stopped being able to provide more effective, long-term contraceptive methods, like IUDS, because of their higher costs. Women are being steered toward birth control pills, the authors found, but being provided with fewer pill packs per visit. It's "a practice that has been shown to result in lower rates of continuation with the method and that may increase the likelihood of unintended pregnancy -- and therefore that of abortion."

Women who don't qualify for the Medicaid Women's Health Program are also affected by the lack of state funding, they found. Many clinics are now requiring those women to pay for services, where before they could have been covered by public funds. And the women who do pay the new fees are purchasing fewer packs of birth control pills and opting out of STD testing to save money. It's not yet clear what will happen when the federally-funded WHP, in which Planned Parenthood previously saw almost half of all clients, disappears entirely, replaced by a state-run, Planned Parenthood-less alternative .

Before the cuts there were 76 funded family-planning organizations in the state; now there are 41. The 35 organizations who lost funding can no longer buy discount birth control pills through a special state program. The higher costs they pay are passed on to their patients. And because they no longer receive Title X money, they're no longer eligible for the state law that lets Title X organizations provide confidential contraceptive services to teenagers. Teens who don't want their parents notified that they're seeking birth control will have to travel further to find an organization that will treat them -- or will simply go without.

In making the cuts, lawmakers argued that public hospitals, Federally Qualified Healthcare Centers (FQHCs) and other organizations would step in to fill the gap. But the study's authors found "considerable variation across Texas in terms of the willingness and ability of communities to cover the shortfall." In one community, the main public hospital is relying on the county indigent care program to treat women, and running up a deficit in the process.

The authors are blunt: the cuts were meant to harm Planned Parenthood, but instead have hit every family planning provider. "We are witnessing the dismantling of a safety net that took decades to build and could not easily be recreated," the authors write. "Even if funding were restored soon."

Which it won't be. That much we can count on.

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132 comments
1qaz7ujm
1qaz7ujm

Stop having sex. It is that simple.

jeneheffer
jeneheffer

It is a darn shame that Family Planning has to come from the government , inept as they are and not from concerned and loving parents. All the unwed children having children beget more poor souls without fathers, then more unwanted babies. These generations who grow up without direction are morally bankrupt in a world that hates God. Go figure.

holmantx
holmantx topcommenter

See: (Chart) No. of Births, birth rate, and percentage of births to unmarried women: United States 1940 - 2007. http://tinyurl.com/23q8hwk

 

So what is causing this?  the advent of social programs that have destroyed the family unit.  They are not part of the problem - they are THE problem.

 

And how have we been paying for them?  We have been borrowing it.

 

And how many times has Congress tried to break themselves from their fiscal heroin addiction?

 

Tax Equity and Fiscal Responsibility Act of 1982

Deficit Reduction Act of 1984

Gramm-Rudman-Hollings Balanced Budget and Emergency Deficit Control Act of 1985

Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)

Budget and Emergency Deficit Control Reaffirmation Act of 1987

Deficit Reduction Act of 1993

Deficit Reduction Act of 2005

American Recovery and Reinvestment Tax Act of 2009

Emergency Economic Stabilization Act of 2008

S.552 - Emergency Deficit Reduction Act - Senator Bernard Sanders I-VT

 

But over the past fifty years we have continued to spend FAR more than we collect in taxation and now, Congress won't even bass a budget.

 

Now we can either put this 747 down on a crowded freeway or we can slam it in to the side of a hill.

Myrna.Minkoff-Katz
Myrna.Minkoff-Katz topcommenter

Just think.  If we didn't spay cats we'd be overrun in no time.  Not that I, personally, would mind.

ObserverHatesFacts
ObserverHatesFacts

"That's despite the fact that under state and federal law, this money has never gone toward abortion services."

 

I don't give homeless people money to buy booze.. but I'll give them my take out leftovers...

Myrna.Minkoff-Katz
Myrna.Minkoff-Katz topcommenter

We're in trouble in part because of overpopulation.  The environment suffers.  There aren't enough jobs for everyone.  And population centers are busting at the seams.  Planned Parenthood should get unanimous approval by anyone with a working brain.

scottindallas
scottindallas topcommenter

 @jeneheffer but, failing to support these lost souls is not Christian, and costs more than giving them care.  So, we withhold our judgment and do the prudent and loving thing, which, fortunately is more cost effective than the vindictive, un-Christian policy you seem to prefer.  See how Satan works, he'd deceived you into hating the poor, and the innocent.  Now, go and have pity on those less fortunate than you, and sin no more.

scottindallas
scottindallas topcommenter

 @holmantx Again, without these programs, we'd be spending more.  You're also drawing a false dichotomy.  We could simply make qualifying more family/marriage friendly.  See there, your issue is a red herring, and not at all an essential element of women's health.  Unless you don't want women and girls getting medical care without a man there so co-sign.  Maybe we should reconsider women's suffrage, so your indefensible economic theories will get electoral support

scottindallas
scottindallas topcommenter

 @Myrna.Minkoff-Katz I think we should eat the animals we put down.  Or, should be open to it, why not.  Once plotted to get a dog and cat from the pound and grill 'em up.  Seems better than incarcerating animals as we do in commercial ag.

Myrna.Minkoff-Katz
Myrna.Minkoff-Katz topcommenter

On a side note to my fans:  Big Kitty is crushed to find out that Skinny, the 40 pound cat, turned out to be female.

WhiskyT73
WhiskyT73

 @ObserverHatesFacts  You assume that all homeless people are alcoholics? If not, what business is it of your to seek to control the actions of others? Are you God? What is the assumed homeless alcoholic that you are giving you leftovers to trades them for booze? You cannot control the actions of others. You have no right to even try.

RTGolden1
RTGolden1 topcommenter

 @Myrna.Minkoff-Katz We're nowhere near overpopulating the planet.  We could fit the entire population of the world in the continental US and have a lower population density than the City of Dallas has.  That leaves 6 1/2 continents for agriculture and industry to support and feed us.

I wholeheartedly agree with your final statement there, even if for other, more supportable reasons.

jeneheffer
jeneheffer

 @scottindallas One thing I know is that you certainly don't know scripture though you are trying to write something into what I said as hating the poor. Wrong! I do not have the  faith in the government being the parent from birth to death you obviously have.  Sounds like you like being God. 

everlastingphelps
everlastingphelps topcommenter

 @scottindallas  @jeneheffer Supporting them through charity is Christian.  Sticking a gun in someone's face and telling them to pay for it (which is what taxes are) is most certainly not Christian.

holmantx
holmantx topcommenter

 @scottindallas Again, without these programs, we'd be spending more.

 

No, we would not.

 

Men and women would be forced, once again, to become monogamous in the interest of procreation and perpetuation of the species.  One to provide, one to bear and raising children.

 

Horrifying.  Isn't it.

 

Any coward can cook up loopy social programs with no thought of our finite sources to fund them.  It take courage to first identify the pool of available funds THEN decide to apportion it.

 

but kids want what they want, without the responsibility of paying for it.

 

Hello wall.  Meet Mr. speeding train.

everlastingphelps
everlastingphelps topcommenter

 @scottindallas  @holmantx That reasoning reminds me of something Ben Franklin wrote:

 

 The whole Proceeding would put one in Mind of the Frenchman that used to accost English and other Strangers on thePont-Neuf, with many Compliments, and a red hot Iron in his Hand; Pray Monsieur Anglois, says he, Do me the Favour to let me have the Honour of thrusting this hot Iron into your Backside? Zoons, what does the Fellow mean! Begone with your Iron, or I'll break your Head! Nay, Monsieur, replies he, if you do not chuse it, I do not insist upon it. But at least, you will in Justice have the Goodness to pay me something for the heating of my Iron.

everlastingphelps
everlastingphelps topcommenter

 @RTGolden1  @Myrna.Minkoff-Katz Silly, the overpopulation argument isn't about space.  It's about having too many of the "wrong kind" of people.  They never include THEMSELVES in the group causing the problem, or they could contribute to the solution with a plastic bag and some duct tape.

everlastingphelps
everlastingphelps topcommenter

 @scottindallas  @jeneheffer Negative.  Distinction made, Matthew 17:24-27 and 22:15-22.  The tithes were separate in Jesus' time, because taxes went to Caesar and tithes went to the temple.  

scottindallas
scottindallas topcommenter

 @everlastingphelps  @jeneheffer Jesus never made such a distinction.  In fact, the Bible supported "official" charity.  Remember the OT established a theocracy, and charity was provided.  That the Jews weren't strong enough to form their own state when Jesus was about doesn't alter a word of the OT goals. 

anon
anon

 @holmantx  @scottindallas please cite the society in the history of human civilization that has ever functioned this way because I will bet you my entire fortune that it has never existed. in fact, single women and the poor still got pregnant - they just killed their babies, or society let them starve and die. there have always been lots, and lots, and lots of babies born outside a stable family life, and there will always be very poor people. our society was just beginning to actually believe that children should not suffer for the sins of their parents, but the last 20 years or so tells me that we no longer believe that as a society.

RTGolden1
RTGolden1 topcommenter

 @everlastingphelps  @Myrna.Minkoff-Katz Yeah, I've noticed that about the overpopulation alarmists.  You'd think they'd want to set the example and be the first ones to embrace the trend of self-depopulation, but they never do.

RTGolden1
RTGolden1 topcommenter

 @ashlyschilling  @everlastingphelps Are you sure 'dear' is being used as condescension?  Aren't you, in effect, asking all men and all women in the nation who are taxpayers to consider you 'dear' enough to pay for your healthcare?

You also fail to consider any point other than your own as having validity.  Just because you and Phelps have differing points of view doesn't invalidate his point and validate yours.  If you were truly desirous of having a 'meaningful conversation about the state of women's healthcare', you'd try to approach the issue FROM Phelps' point of view and follow his logic until you reach an obvious pitfall.  Then you'd use that to try to show him where his views are false or misguided.

Anyone claiming that WHP doesn't affect men is disingenuous from the start anyway.  It is a taxpayer funded program, it affects everyone.

RTGolden1
RTGolden1 topcommenter

 @everlastingphelps  @mavdog  @scottindallas  @ashlyschilling I know that argument, Phelps, I'm a fan of O'Rourke as well.  However, that is fantasy and I'm trying to deal with reality.  The reality is: We have a welfare system that WILL, right or wrong, take unwanted pregnancies from cradle to grave.  That is the reality of our current situation.  I'd like to seek the most cost effective means of achieving that welfare goal, and prevent or eliminate unwanted pregnancies, provide access to basic preventive medicine and information, rather than simply pay for a lifetime of fuckups by a life that may have been a fuckup from conception.

RTGolden1
RTGolden1 topcommenter

 @everlastingphelps  @scottindallas  @ashlyschilling Whose morality?  Yours? Mine? Myrna's? Scott's? Anna's?

Morality is a personal issue, not a public one.  Tax expenditures are a public issue, not a personal one.  I am, personally, against abortion.  I believe there is a responsibility by the two people involved in creating a pregnancy to take care of it.  However, our current welfare situation, which, despite all the wailing by the Right, isn't going away, says the public will pay for this pregnancy.  At that point, those who administer public funds have a financial responsibility, not a moral one, to seek the avenue of greatest return on the investment.  

 

Remember Phelps you can't legislate morality, but you can legislate responsible fiscal policy.

mavdog
mavdog topcommenter

 @everlastingphelps  @RTGolden1  @scottindallas  @ashlyschilling

 

ok, here's the issue of morality included:

 

it is immoral to not provide lower income people access to preventive health services, for to deny women contraception services, breast cancer screening and PAP smears to identify problems early (which are directly correlated to survival rate) merely because they are uninsured or cannot afford such services is against basic moral principles that are a thread in American ideals.

 

RT is correct in pointing out the positive cost/benefits these services produce. that really is the icing on the cake.

RTGolden1
RTGolden1 topcommenter

 @everlastingphelps  @scottindallas  @ashlyschilling I don't think you got my initial point, Phelps.  My demographic musings were just a mathematical curiosity.  This entire line of discussion has absolutely nothing to do with the article, the study behind it, or the validity of either.  The question is: Is the women's health program a responsible use of taxpayer money? The only way to judge it is on the gross ROI of the program.  The WHP, including contraception and abortions (regardless of demographics and keep in mind, tax dollars do not pay for the abortions), provides a better return for taxpayer dollars than does the Perry option of these weird pseudo-religious crisis pregnancy clinics.  It costs the taxpayer less for a woman to not have an unwanted baby, or to not get pregnant in the first place, than it does for the state to take care of that child from cradle to grave.

That doesn't even consider the other women's health services provided by PP in the federal program.  Breast cancer screening, pap smears, simply educating women on how their bodies work and why they work that way, information on proper hygiene and preventive medicine will always save more money than taxpayer supported ER visits.

scottindallas
scottindallas topcommenter

 @everlastingphelps  @RTGolden1  @ashlyschilling Actually, not at all, as here is another example.  Arabs are counted as white along similar hypocritical lines.  Another group of "Whites" far less inclined to resort to abortions, or, to get pregnant outside of marriage. 

RTGolden1
RTGolden1 topcommenter

 @scottindallas  @ashlyschilling  @everlastingphelps You might very well be correct in that, since Hispanics are, for the most part, much more family oriented, and it would significantly reduce the percentage 'white' women occupy in the total population.

RTGolden1
RTGolden1 topcommenter

 @ashlyschilling  @everlastingphelps I'm not arguing for against either side of this argument, it adds nothing to the relevant conversation.

However I do find it interesting how demographers get to pick and choose when Hispanics are a separate demographic category, and when to lump them in with other races.

Also, the point you're arguing is mathematically ludicrous.  If white women are 72% of the female population and seek 53% of the abortions, versus black women at 13% of the female population and seeking 40% of the abortions, then there is clearly a higher RATE of black women seeking abortions.  If you separate the hispanics out of the white category, the disparity becomes even more glaring.

everlastingphelps
everlastingphelps topcommenter

 @WhiskyT73  @mavdog  @Myrna.Minkoff-Katz You guessed wrong.

 

Why this urgent need to try to smear me with anti-abortionists?  I'm not for criminalizing it.  You people really are your own worst enemies.  If I DON'T buy your line 100%, then I must either be stupid, ignorant or evil, right?  There's NO way that intelligent people can look at the same situation and come to different conclusions, and there's also NO way that you could be wrong, so that's all that's left, right?

 

Let me try to use your logic and "guess."  OK, I guess that you are one who stands by Obama's support for late-term abortions and allowing doctors to leave infants born viable and healthy to die.  If you believe that PP is an organization with a noble goal based on feminist propaganda and ignore Sanger's sordid past, then you are likely to believe all manner of absurd.

WhiskyT73
WhiskyT73

 @everlastingphelps  @mavdog  @Myrna.Minkoff-Katz @phelps, let me guess you are one who stands by Akin's assertion that 'legitimate rape" will never produce a pregnancy.  If you believe that PP is an organization whose mission is to promote genocide of minorities based on outdated quotes from a fossil then you are likely to believe all manner of the absurd.

mavdog
mavdog topcommenter

 @everlastingphelps  @Myrna.Minkoff-Katz

 

are you frigging serious? you believe the quote says the goal WAS to "exterminate the Negro population"???

 

wow.

 

when confronted by sheer stupidity, it's better to just go away rather than take advantage of the less intelligent.

 

you sir are exhibiting sheer stupidity. I knew you had comprehension problems, but this one is so over the top it is unbelieveable.

everlastingphelps
everlastingphelps topcommenter

 @ashlyschilling Congratulations.  You have successfully rebutted a statement that I never made.  

 

You win the Internets.  I suggest that for an encore you go and race other cars on the way home.  (Hint: it's easier to win when they don't know you are racing!)

everlastingphelps
everlastingphelps topcommenter

 @mavdog  @Myrna.Minkoff-Katz Again, you fail to read the article you cite:

 

"“We do not want word to go out that we want to exterminate the Negro population and the minister is the man who can straighten out that idea if it ever occurs to any of their more rebellious members.”

 

 

miss-ashly
miss-ashly

@everlastingphelps  Your condescension by calling me "dear" is noted.

I stand by my comment - white women seek the larger percentage of abortions. Period. Lower income families, such as minorities, often lack access to reproductive health and contraception, which is to be made all the worse for them because of the lack of funding for WHP. Your lack of  understanding of how this program benefits women and families is obvious. You are clearly more interested in being pedantic than having a meaningful conversation about the state of women's healthcare (because it doesn't affect you!).

everlastingphelps
everlastingphelps topcommenter

 @ashlyschilling This is basic reading comprehension, dear.  Follow me here.  This is what I wrote:

 

"Abortion is used at a much higher race by black people in America."  Maybe you are confused by my typo ('race' instead of 'rate')

 

In any event, this is what your own source says:

 

" In contrast, black women had higher abortion rates and ratios than white women and women in the other races category (Table 12)."

 

I said, abortion is used at a higher rate by black people.  The report says, black women have higher abortion rates.  That's known as "the same thing."

 

miss-ashly
miss-ashly

 @everlastingphelps "Among the 35 areas that reported race for 2008, white women (including Hispanic and non-Hispanic white women) accounted for the largest percentage (52.4%) of abortions; black women accounted for 40.2%, and women in the other races category accounted for 7.3% (Table 12)"

everlastingphelps
everlastingphelps topcommenter

 @ashlyschilling You're aware that white women are 72% of the population, right?

 

From your OWN link, had you bothered to read it:

 

" In contrast, black women had higher abortion rates and ratios than white women and women in the other races category (Table 12)."

 

 

everlastingphelps
everlastingphelps topcommenter

 @Myrna.Minkoff-Katz You're the one using racist dog whistles.  Abortion is used at a much higher race by black people in America.  When you say "population centers", you mean the inner city, which is another euphemism for black people.

 

Of course, that makes sense, because Margaret Sanger founded Planned Parenthood with the intention of aborting and sterilizing "undesirables", starting with the "negro race".

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