Thursday, February 23, 2012

Romney is Severely Conservative, at Least on Women's Health

In a speech to the annual Conservative Political Action Committee (CPAC) meeting in Washington two weeks ago, Mitt Romney tried to beef up his conservative bona fides with a quintessential Romneyism:  "I was a severely conservative Republican governor."  The effort brought forth lots of gleeful commentary by the media and real conservatives who found the characterization, in a word, weird.  Rush said the next day on his program: “I have never heard anybody say, ‘I’m severely conservative'." 

Paul Krugman in an op-ed piece in the New York Times commented:
Mitt Romney has a gift for words — self-destructive words. On Friday he did it again, telling the Conservative Political Action Conference that he was a 'severely conservative governor.'
As Molly Ball of The Atlantic pointed out, Mr. Romney 'described conservatism as if it were a disease.' Indeed. Mark Liberman, a linguistics professor at the University of Pennsylvania, provided a list of words that most commonly follow the adverb 'severely'; the top five, in frequency of use, are disabled, depressed, ill, limited and injured."
 I was prepared to write off the CPAC self-description as simply in-artful.  Similar to his "I like to fire people,"  and "Corporations are people, my friend."  After last night I have now decided I was wrong.  Romney is, in my view, a certifiable severely conservative politician. 

Last night in the final Republican presidential debate in Mesa, Arizona, Romney needed once again to establish himself as a true conservative.  He decided he needed to move right of Rick Santorum, who is currently leading him in the national polls, on social issues.  He chose to criticize Santorum for voting numerous times in favor of Title X funding.  His verbal challenge to Santorum clearly conveyed the impression that Romney thought this was an utterly wretched thing for a true conservative to do.  I wondered after the debate if Romney really felt that Title X funding for family planning was something that needed to end.  It turns out that he does. Here is a section of his campaign website explaining how he intends to bring about a "fiscal turnaround:"
First, eliminate every government program that is not absolutely essential. There are many things government does that we may like but that we do not need. The test should be this: “Is this program so critical that it is worth borrowing money to pay for it?” The federal government should stop doing things we don’t need or can’t afford. For example:
  • Repeal Obamacare, which would save $95 billion in 2016.
  • Eliminate subsidies for the unprofitable Amtrak, saving $1.6 billion a year.
  • Enact deep reductions in the subsidies for the National Endowment for the Arts, the National Endowment for the Humanities, the Corporation for Public Broadcasting and the Legal Services Corporation.
  • Eliminate Title X family planning programs benefiting abortion groups like Planned Parenthood.
  • End foreign aid to countries that oppose America’s interests.
The Washington Post's Wonkblog described Romney as being unique among the candidates in proposing to end Title X:
In calling for Title X’s defunding, Romney is a bit of a rarity. No other candidate has taken a stand on the issue. Anti-abortion groups haven’t asked candidates to oppose Title X. The Susan B. Anthony List, for example, only goes as far as asking candidates to pledge to “defund Planned Parenthood and all other contractors and recipients of federal funds with affiliates that perform or fund abortions,” but not eliminate Title X outright. In moving to eliminate Title X, Romney is venturing into a new territory where the party doesn’t have much in the way of a definitive platform.
Romney is also now staunchly anti-abortion, having undergone a metamorphosis in this area.  As NPR reported in November, in campaign runs in Massachusetts in 1998 and 2002, Romney was expressly committed to preserving a woman's right to chose an abortion.  He claims to have undergone a Road to Damascus moment on abortion in November, 2004 while delving into a policy fight in Massachusetts on embryonic stem cell research. 

So how well do Romney's anti-abortion views comport with his desire to eliminate Title X and his desire to eliminate unnecessary spending on health care?  Not very well according to one non-partisan research institute. In an August 2011 Fact Sheet, the Guttmacher Institute made the following findings from 2008 data:
• The typical American woman, who wants two children, spends about five years pregnant, postpartum or trying to become pregnant, and three decades—more than three-quarters of her reproductive life—trying to avoid pregnancy.
• About half of all pregnancies in the United States each year—more than three million—are unintended. By age 45, more than half of all American women will have experienced an unintended pregnancy, and three in 10 will have had an abortion.
• There were 66 million U.S. women of reproductive age (13–44) in 2008.
• More than half of these women (36 million) were in need of contraceptive services and supplies; that is, they were sexually active and able to become pregnant, but were not pregnant and did not wish to become pregnant. The number of women in need of contraceptive services and supplies increased 6% between 2000 and 2008.
• Of the 36 million women in need of contraceptive care in 2008, 17.4 million were in need of publicly funded services and supplies because they either had an income below 250% of the federal poverty level or were younger than 20.
• Public expenditures for family planning services totaled $1.85 billion in FY 2006.
• Medicaid accounted for 71% of total expenditures, state appropriations for 13% and Title X for 12%. Other sources together accounted for 5% of total funding.
• Publicly funded family planning services help women to avoid pregnancies they do not want and to plan pregnancies they do. In 2006, these services helped women avoid 1.94 million unintended pregnancies, which would likely have resulted in about 860,000 unintended births and 810,000 abortions.
• Contraceptive services provided at Title X-supported centers helped prevent 973,000 unintended pregnancies in 2008, which would likely have resulted in 432,600 unintended births and 406,200 abortions.
Thomson Health Care did a study for the March of Dimes in 2007 that pegged the average costs of a live vaginal birth at about $7,700 and $11,000 for a caesarean birth for the privately insured population in the United States.  (There are probably much more recent estimates for both types of maternity care.)   The breakdown for both types of maternity care was about two to one vaginal births over caesarean births.  This would make the average cost of both types of births about $8,800.  At that price tag, the Title X savings in terms of maternity costs are almost eight billion dollars.  That price tag doesn't take into account post-natal preemie care, care of children with birth defects, and any number of other medical costs for newborns beyond maternity costs of delivery.. It doesn't take into account the significant societal costs of teen-age pregnancy.  It also does not, of course, take into account the potential societal benefits of  having an additional 430,000 births each year.

So eliminating the annual costs of Title X, $317 million in 2010 dollars according to Kaiser Health News, will cost the nation almost eight billion dollars in added health case costs for maternity care, and lead to an additional 400,000 abortions. 

If eliminating abortions and controlling medical expenses is your goal, Mitt, you have to be "severely conservative" to push to eliminate Title X. 

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