Congress - Who's Side are You On, Anyway?

Congress trying to de-fund Title X without a clue

as to what it does

New York Times
Nicholas Kristof

Nicholas Kristof

TO appreciate the dumbing down of American politics, consider this: Conservative Republicans, indignant about abortion, are trying to destroy a government program that helps prevent 345,000 abortions a year.

Inevitably in politics there are good ideas and bad ideas. But occasionally there are also moronic ideas — such as the House Republican proposal to kill America’s main family planning program, Title X.

The upshot would be more pregnancies, more abortions, more AIDS, more sexually transmitted infections and more women dying of cervical and breast cancer. Ending the program would impoverish young mothers and impede the formation of stable two-parent families that conservatives rightly argue help overcome poverty.

It’s baffling that House Republicans are trying to eliminate a 45-year-old bipartisan initiative that is one of the country’s anti-poverty successes — and also perhaps America’s most successful anti-abortion initiative.

Title X began in a Republican administration, that of Richard Nixon. Today, 4,100 clinics supported by Title X provide family planning and also often test for H.I.V., cure sexually transmitted infections and screen for cervical and breast cancer.

I visited a Title X clinic in Baltimore. Republican members of the House, this is what you’re trying to destroy:

A tall 16-year-old girl, nicknamed China (she doesn’t know why; she’s not Chinese), is being treated for gonorrhea and chlamydia.

“The last time you had sex, did you use a condom?” asks Courtney Pate, a nurse practitioner. China shakes her head.

Pate hands her a bag of condoms and warns her that if she doesn’t use one every time, she risks serious health problems, “like not being able to have a baby when you want to.” Pate also grills her on whether she has told her sexual partners about the infections and whether they are getting treated.

When Pate steps out for a moment, I ask China if her boyfriend will accept condoms. China looks doubtful and says, “Maybe.” Pate overhears and comes roaring back. “If he doesn’t wear a condom, he doesn’t get any sex,” Pate declares. “These are the rules: No condoms, no sex.”

China tells me she doesn’t have any other way of getting birth control or treatment for sexually transmitted diseases. Without this clinic, she says, she might well be pregnant and be spreading infections.

As China leaves, Pate cautions her again: “Somebody says, ‘Let’s have sex without a condom,’ you say, ‘No, I don’t want any needles in my butt! I don’t want to see that crazy lady in the clinic again!”

I also met Doretta, who after a pelvic exam at the clinic received a diagnosis of possible cervical cancer. The good news is that it was found early and was treated, and she is expected to be fine.

Title X isn’t directly related to the furor over video footage showing Planned Parenthood staff members speaking cavalierly about fetal tissues; the Republican effort to eliminate Title X goes back much earlier. To those offended by the Planned Parenthood videos, if you’re infuriated by abortion, you should be channeling more money to Title X, not less.

Since 1980, inflation-adjusted spending on Title X family planning has fallen by two-thirds. Now the House proposes eliminating it altogether, while the Senate proposes a 10 percent cut.

This in a country where half of all pregnancies are unintended, where 30 percent of American teenage girls become pregnant by age 19.

The Guttmacher Institute, which studies reproductive health, calculates that Title X family planning centers prevent about one million unintended pregnancies a year, of which 345,000 would have ended in abortion. It says that every year Title X clinics avert some 53,000 cases of chlamydia and 8,800 cases of gonorrhea, and save the lives of 1,100 women who would otherwise die of cervical cancer.

In other words, Title X prevents an abortion about once every 90 seconds.

Family planning investments also offer hedge fund-like returns, for a condom or IUD can avert more than $12,000 in average Medicaid spending on a childbirth. Guttmacher calculates that every $1 invested in public family planning services saves $7 in public expenditures. This is a program that saves money as well as lives.

Opponents of Title X preen and moralize, even as their behavior has dreadfully immoral consequences. Conservatives emphasize that poverty is often linked to personal irresponsibility. Are youths like China irresponsible when they have sex without a condom? Sure they are! They’re kids. What’s harder to understand is the irresponsibility of Republican House members.

My question to them: Do you really want to increase the odds that kids like China will get pregnant, will spread disease, will become impoverished single mothers, will get mired in a cycle of poverty, will get abortions — or will die of breast or cervical cancer — and do you really think this is moral behavior to be proud of?