Why the the cost of Planned Parenthood is worth it

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Planned Parenthood is under attack, and certainly not for the first time. The organization, federally funded by the Family Planning Services and Population Research Act since 1970, provides a wide range of medical services to women (and men), including routine physical exams, STI screenings, contraception, and abortion. This latest movement against the organization gained traction following a series of heavily-edited videos from the so-called Center of Medical Progress, accusing the women’s health organization of trafficking fetal parts and going as far as calling it a “baby parts vendor.” Where we stand now is considerably more worrisome, with House Republicans essentially holding the government hostage if their demands to defund the organization are not met. The timing is, of course, too close to be a coincidence. Unfortunately, this pairing of outspoken moral outrage and a new focus toward Planned Parenthood’s budget spells out the biggest challenge the organization has ever faced.

The accusations against Planned Parenthood’s alleged role in fetal trafficking have been addressed thoroughly by the organization in a recent letter, and the medical community has responded with wealth of information about the use and importance of fetal tissue in research and therapy. The debate between pro-choice and pro-life can and should continue, but as some have opted to point out, the call to defund the organization is not precisely the same as a call against abortion.

To see things properly in that light, we need to look at Planned Parenthood’s numbers. Based on the estimates from Planned Parenthood and the Congressional Budget Office, about 1/3 of its funding is received from federal sources. The organization reports an annual budget of $1.2 billion, of which $450 million are estimated to come from federal funds, primarily Medicaid. In 2013, the organization provided healthcare services to 2.7 million men, women, and young people in the U.S, reaching an average federal spending of $167 per person.

Compare this to our nation’s average Medicaid spending of $5,760 per enrollee, or $2,463 per child, and you’ll see that Planned Parenthood accounts for a fraction of our nation’s medical spending. Taking into account educational and outreach programs, the number for whom Planned Parenthood has made an impact approaches 4.2 million.

Perhaps most importantly to this conversation, only 3 percent of Planned Parenthood’s health services are abortion services, compared to contraceptive services which contribute 34 percent. Much of the research that comes out of Parent Parenthood has given us important findings in non-abortion topics, from smoking cessation and STI prevention to the safety of new sterilization techniques. In essence, Planned Parenthood is so much more than an “abortion clinic,” and given its size and scope the distinction is crucial.

There is a light at the end of this tunnel, which is that more than half of Planned Parenthood’s funding comes from non-federal sources. If the most drastically proposed measures to de-fund Planned Parenthood are taken, the effects would be crippling but perhaps not fatal. Regardless, this tunnel is long and dark. The proposed bill, H.R. 3134, would effectively eliminate Medicaid spending on Planned Parenthood care, its largest source of federal funding, cutting off care to women who need it most. Worse yet, the anti-abortion vernacular is targeting an organization that clearly does so much more, for so many people. The same Congressional Budget Office report estimates that 15 percent of Planned Parenthood’s patients will lose access to care, and this includes the health maintenance and disease prevention services mentioned above. The Republican-championed “community health centers” hardly seem like a proper alternative, lacking the coordination of central oversight and the opportunity for women-centered care that Planned Parenthood provides. More importantly, Planned Parenthood is a nationwide bastion for full access to the care, including abortions, that women are afforded in the constitution.

Those targeting Planned Parenthood for its specific abortion services are blind to the vast benefits the organization provides, though I suspect such ignorance is voluntary. At the same time, it does none of us any good to ignore the abortions that Planned Parenthood provides, and how they have benefited so many lives. That brings me to my final point: the cost of de-funding Planned Parenthood.

Today, a friend of mine posted on her Facebook page that she had undergone two abortions in the last year. She did so to support the #ShoutYourAbortion hashtag, a movement started by Amelia Bonow to give a voice to her very personal decision, and de-stigmatize the discussion. As I read her post, one of the bravest things I have seen put to words, I was reminded of the patients I’ve seen during my medical education. In medicine, we train heavily so that we are worthy of our patients’ utmost honesties and innermost privacies. We are taught to respect the weight of sensitive but medically-important topics, such as gynecologic histories, so that we may support our patients both physically and mentally. Asking these things of our patients is never easy; often, neither are the answers. We in medicine understand too well the consequences of opening doors that were meant to stay locked.

I’ve now seen a dear friend unlock these doors of her own accord. She did so to challenge, rightfully, the idea that her liberties can be discussed back-and-forth while she is expected to remain silent. Unfortunately, I believe she paid a price that no man, woman, or child should be expected to pay. We have already done these men and women a disservice by letting the discussion get this far, and we have forced them to begin demonstrating just how much is at stake. As it turns out, there is a legal precedent for the price of protected health information, in the realm of $50,000 and upward. But I can’t imagine how it must feel to picture a life without the choice she was given, and I suspect no amount of money would correlate. That is the price we would pay for defunding Planned Parenthood, and it is frankly too much to bear.

Aaron Jen is a medical student.

Image credit: Susan Montgomery / Shutterstock.com

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