One tidbit
It’s awfully hard to track down straight numbers about private insurance coverage of abortion. A 2001 Guttmacher study presents the following:
The average cost of an abortion was under $400, and
74% of abortions are paid for by the patient. Thirteen percent more by Medicaid.These numbers aren’t nearly as bad as I expected. I do not seek to be cavalier about the 13% of abortions covered by private insurance, and the $400 price-tag of the procedure.
However, anyone who would kill our best chance at health care reform in a generation to save 13% of abortion patients $400 each makes decisions in ways I don’t understand.
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Believe it or not, I have even more to say…
by: sabutai @ Wed Nov 11, 2009 at 14:22:40 PM EST
Sabutai is (I believe) a Capuano supporter, but it does seem to me that his point goes to both Coakley’s and Capuano’s positions, since both have now promised to vote “no” if something like Stupak is in the final bill. Perhaps moreso to Coakley’s, unless Frank is right that she never actually said what Cap says she said.
Discuss.
neilsagan says
Frank is wrong.
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p>The candidate sabutai supports is irrelevant.
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p>The cost issue is of less interest to abortion rights proponents then how to allow insurance plans on the exchange offer abortion insurance without violating the Hyde amendment.
petr says
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p>I agree. And I further think it a huge mistake on the part of any putative pro-choice coalition (in which I would ordinarily eagerly count myself) to paint this as catastrophic set-back for womens reproductive rights. It is no such thing and it is counter-productive in the extreme to try to make it seem so. I get the insult and the paternalism from Stupak. Ok. But the end of the world? Hardly.
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p>And how much, I’m compelled to ask, will a saner health care funding system prevent unwanted pregnancies? How many wanted pregnancies will be more successful and less problematic? From where i sit, at worst, it’s a wash in terms of either increasing or decreasing the number of abortions… unless, of course, somebody nukes the whole process and we end up stuck with the system we got now, which isn’t sustainable in the least.
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stomv says
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p>You raise a really great point, and it would be wonderful if the number of unwanted pregnancies is reduced as a result of this bill. But, to wave your hands and call it “a wash” is lazy analysis. Just saying that there are two forces in opposite directions and determine that their impacts are perfectly canceled defies sound reasoning.
petr says
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p>Perhaps so. I will note that I said ‘at worst’, which means I don’t think they would perfectly cancel, but that a net benefit would accrue to women.
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p>I think it’s pretty clear that a gain of access to health care, on the part of 36 million fellow citizens, would be a net gain in every aspect of health but particularly, IMHO, with respect to womens health. Further, as Sabutai pointed out, this legislation would not impact nearly that many persons…. so I feel justified in a ‘back of the envelope’ calculation on this that posits a worst case scenario of parity but a probable much better outcome.
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p>Or, put another way, why all the sound and fury??
jconway says
I have basically been saying the same thing sabutai has been saying but have been getting far more flack for it with people calling me sexist and such. But again, the actual number of women that would be significantly affected by Stupak is much smaller than the number of women, and Americans in general, that would be gravely affected, one would even say afflicted, if they were still denied access to basic healthcare coverage. This bill is not perfect, I speak for most of us when I say I wish single payer had been on the table, I wish Wyden-Bennet was given more consideration, hell I wish Max Baucus wasn’t in the Senate. But in real life you don’t always get what you wish for, better to insure 36 million Americans even at the cost of funding some abortions, than to not insure them at all. That is the debate. And thus far Coakely has come out on the wrong side of this important issue.
sabutai says
Same study estimates 1.3 million abortions yearly in the US. That means that on the order of 160,000 covered by private insurance. Some women have had more than one abortion, but for argument’s sake let’s say 150,000 patients would be affected directly by Stupak. Considering that these women have private insurance, and given the state of the current system, that means they likely have a job where saving $400 is difficult, but not insurmountable.
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p>While I doubt that chance that Congress will create a $60 million “abortion fund”, I imagine there are ways to assemble programs that could step into this breach.
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p>Regardless, I think ensuring that 36 million people receive coverage has a greater impact than 150,000 people having to pay a notable but not impossible sum for a medical procedure.
rupert115 says
I recently took my dad in for a CT scan and the cost was $3,500. (He had insurance, but we were curious what the true cost was.)
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p>I have a hard time believing an abortion procedure is just $400. No medical procedure is that cheap. That sounds more like a co-pay.
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p>This isn’t a comment on the underlying issue itself, just some skepticism as to the figures.
ed-poon says
is that, precisely because so many people pay out of pocket and do not rely on insurance for the service, providers have an incentive to compete on price and seek efficiencies to lower the cost. If people paid out of pocket for CT scans, you can bet the price would be much lower and, more importantly and unlike the current healthcare market, would decline over time.
christopher says
…the real answer to health care reform is to ban entirely the business of health insurance, then the cost of everything would plummet and accessibility and affordability would take care of itself. Am I reading this correctly?
dhammer says
The people you’re quoting, kindly ask you to stop quoting them inaccurately…
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p>As to it’s just $400 bucks…
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p>Removing Stupak doesn’t solve this problem, but letting in stay makes solving it harder.
farnkoff says
Typical insurance company stinginess?
melora says
There are a lot of employer-sponsored health plans that specifically exclude abortion, so even people who have pretty decent coverage may not have it for this one thing. Another thing to consider is the number of women who DO have insurance that would cover an elective termination but choose to self-pay for privacy/safety issues. (If you’re in college, you might not want your abortion showing up on your parents’ billing statement. If you’re in an abusive relationship and don’t want to bring a kid into the middle of it, but you’re covered by your husband’s/boyfriend’s plan, he’s gonna see the line item.) It’s distressing to me, the number of people suddenly taking up the banner of “abortion must be covered at all costs” who don’t actually know what the status quo is and has been for decades. (Not aiming that last part at you! Just a general gripe.)
farnkoff says
petr says
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p>eh…
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p>Keep in mind that Sabutai was making a comment in another context: which comment was then posted here as a ‘comment of the day’. If I might be allowed to recontextualize (always a danger…) the numbers in question aren’t as important as the differing responses to what is essentially the same situation: if, as you and the Guttmacher Inst contend, women are being driven ‘off billing’ with respect to abortion (for whatever reason…), where’s the outrage? Why does the Stupak bill get all the sound and fury when, essentially, it’s already happening under the present system?
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p>Sabutais point, I take it, was that affecting billing was minimized already and why would Stupak change that all that much? And, furthmore, why hold up the whole train because of Stupak?
neilsagan says
We had a full day of front page posts by David and Bob about what a HUGE mistake Capuano made in race for US Senate with regard to the debate between Cap and Coak on the Stupak Amendment, their votes, what their pragmatism or ideology means for their candidacy, and how that played into the horse race aspect of this primary. As we have continued to learn more about what happened – who said what when why – I think it is only fair that posts correcting the record find their way to the front page today.
ed-poon says
The initial posts were, if anything, anti-Coakley. It was only when Capuano completely reversed himself that people began characterizing it as a huge mistake. If he stuck with his initial position, as Pags is doing right now, I venture to say the editors would be more supportive of Capuano than Coakley.
david says
Didn’t you hear? The fairness doctrine has been repealed. đŸ˜‰
neilsagan says
I just want to hear from you and Bob today (after a full day of Capuano critical judgment yesterday) and everyone else who wants to comment on a frontpage reassessments based on a more comprehensive set of facts.
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p>For example:
neilsagan says
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p>Q: And that someone who should have known what they were talking about is…who?
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p>A: Martha.
trickle-up says
The implication of sab’s post, at least the fragment of it here, is to weigh an apparently modest loss against a significant gain by comparing their costs and benefits. This is hardly a remarkable thing to do, and certainly useful.
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p>Totally lost in these kinds of analyses, however, are such non-economic ideas and justice and civil rights. Choice is a health issue, of course, but it is also about women controlling their bodies.
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p>Suppose the quid pro quo were not limits on insurance coverage, but a modest poll tax on naturalized citizens wishing to vote. You might say, heck, it’s unfair, but what’s five bucks against health care for all? Or you might say that justice is neither negotiable nor subordinate to cost-benefit analyses.
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p>I suspect there are two kinds of voters, those for whom choice is a civil right and those for whom it is something else. I expect that this whole episode plays out very differently for each group. (Ironically so, since Coakley and Capuano’s positions are, at the end of the news cycle, functionally identical.)
sabutai says
Although there used to be talk that the lack of healthcare (which we’re told is a right) is an issue of fundamental justice and dignity as well. I think the case can be made that both issues bring this in…we’re trying to defend freedom on abortion, while expand it on health care. IF we can’t do both, which do you choose?
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p>Oh, and if the same people who voted for and enforced the anti-freedom “Patriot Act” turn around who stand against the Stupak Amendment, that would be…curious.
mikberg says
There are two large groups opposed to the new law. Fiscal conservatives and anti-abortionists. Between them, they could scuttle the new law. Why not pass the law with the anti-abortion language in it, then, after it is signed into law, go back and reverse the anti-abortion language. At that point, Joe Lieberman and the Maine senators, for example, would not use their “fiscal conservatism” to block the attempt to remove the anti-abortion language. Pass the bill in two stages so it gets passed.
sabutai says
You can get pro-choice health care and public-option health care through Congress…just not in the same bill. This is the type of situation that calls for a smoke-filled room.
pbrane says
… the percentage of women currently with insurance that pays for abortion services is much higher than 13% … clarification from Guttmacher Institute
melora says
The percentage of women who are currently covered by insurance that would pay for an elective termination is NOT the same as the percentage of women who, when they DO have an abortion, actually USE that private insurance. If you’re going to talk about potential changes to policy and their effect on the status quo, it’s the latter number that makes a difference.