Contraception must be part of improved health care

Quick, how many children does each of the presidential and vice presidential candidates have?

I knew that Michelle and Barack Obama have two daughters, but I had to search to find out about the other candidates. Joe and Jill Biden had four; two sons and two daughters, but tragically one daughter was killed in an accident. Ann and Mitt Romney have five sons, and Paul and Janna Ryan have two sons and one daughter.

Demographers have found that normal, healthy couples who don’t use any birth control will have an average of at least eight children during their fertile years. In the past, many of those children would have died, causing human populations to be stable. With modern health care (such as all the candidates’ families have) fortunately, almost all children will live to adulthood. Because of the small family size of all candidates, we can assume that they all have used contraception.

Yet some of these candidates wish to limit access to contraception. Vice-presidential candidate Paul Ryan cosponsored H.R. 212, the “Sanctity of Human Life Act,” which is at variance with the medical definition of conception. This bill defines a human being’s life as starting at the unknowable instant sperm and egg unite. Courts could use this rule, if it were to become law, to prevent not only all abortions but also to outlaw the most effective methods of contraception. If it were to become law, H.R. 212 would be a public-health disaster!

For centuries, well-to-do people have had smaller families than the poor. Indeed, limiting family size has been a way that the rich have gained their wealth. Poor people currently have less access to birth control, unfortunately, and are less reliable in its use.

The United States of America was created on the premise of equal opportunity (“all men are created equal”). One way of increasing equality is to provide the means for all people to regulate their fertility. The Affordable Care Act is certainly one of the largest steps our country has ever taken toward equality.

We live in an outstanding nation. We have the richest economy in the world, but we are far from having the best health care in spite of spending more money per capita on health than any other nation.

Here are some health facts. Almost half (49 percent) of pregnancies conceived in the United States are unplanned. This helps to explain why our abortion rate is so much higher than the rate in any other rich country. International statistics show that where abortion is illegal it is actually more common. Outlawing abortion, as some candidates promise, might increase its frequency, and women would suffer from illegal procedures.

The numbers are a bit out of date, but (according to the World Health Association) the U.S. is inferior to many poorer countries in the quality of its health care. We ranked No. 37, behind Greece, Costa Rica and Dominica. Why is this? All of the world’s 25 richest countries have universal health coverage – except for the United States. Even our neighbor to the south, Mexico, recently instituted universal health coverage.

The rich can afford insurance and access to excellent health care in the U.S. Unfortunately, our lack of universal health coverage leaves more than 48 million people in our great country without health insurance. Many of these poor people wait until too late to access care, and others inappropriately seek routine treatment through emergency rooms. It is no wonder that our health statistics are so bad.

Throwing more money at health cannot solve this public health tragedy. This point is proven by the fact that many countries with poorer economies have better health statistics. We need a new system of health-care insurance with universal coverage.

One of our two presidential candidates has designed a health insurance system that will provide coverage to most people in our country. It will provide coverage for people with pre-existing conditions, for young people before they have insurance through work and it will protect people with terrible illnesses from bankruptcy. The other candidate has promised to tear down universal coverage. If Mitt Romney is elected I expect that our health statistics will get even worse.

Please vote in this election. Please think about what will happen if women lose the reproductive rights that we have fought for. And please consider the state of our health-care system when you are considering which candidates to choose for president and vice president. Our present lack of universal health-care coverage is a national (and international) disgrace.

Richard Grossman practices gynecology in Durango. Reach him at richard@population-matters.org. © Richard Grossman MD, 2012

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