Master’s Policy Paper

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Question

Your local, state, or federal legislator is aware that you are a recognized as a nurse leader, health care expert, and constituent in their local community. As a recognized subject matter expert, they ask you to assist them in evaluating pending health legislation by submitting a position paper on this health policy issue. You are to identify a current or emerging health care system and/or policy issue identified as critical to the future of health care in your community. This position paper should include a summary of evidence-based research and pertinent background information on the topic providing the legislator with a substantive yet concise briefing on all aspects of the health policy issue. Be sure to provide and cite substantial (pertinent) evidence from the literature that supports your discussion.
OUTLINE OF PAPER
• Identification of the issue
• Position statements
• Substantive background information
• Supportive evidence for both sides
• Potential solutions
• Defense of position/ making the argument for the position
• ONE PAGE Summary/ conclusion of argument with position statement
• 10 – 15 pages, double spaced, APA style

This Health care policy position paper, I am OPPOSING the H.R. 354- Defund Planned Parenthood Act of 2017.

SO, MY ARGUMENT IS THAT PLANNED PARENTHOOD SHOULD NOT BE DEFUNDED! Please see attached articles and journals supporting my position.

Answer

Health Paper Policy: Planned Parenthood Should Not Be Defunded

Contents

Introduction. 2

Bone of Contention. 3

Background Information. 3

Supportive Evidence against the Law. 7

Supportive Evidence for the Law. 9

Potential solutions. 11

Writer’s Stand. 12

Conclusion. 15

References. 16

Introduction

Access to quality, affordable health care is a universally acknowledged fundamental human right highlighted in numerous domestic and global human rights instruments such as laws and conventions (Human Rights Watch, 2009). The instruments confer on all human beings the right to enjoy mental and physical health care. To this end, the American government has put in place various measures aimed at ensuring that all citizens access reasonable and quality health care. For instance, various health-related programs and policies such as Medicaid and Obamacare have been introduced while federal funding in the health sector has increased. With the imminent risk of the population explosion that is set to face the world, the provision of reproductive health services continues to empower people both locally and internationally particularly in regards to birth control measures. Unfortunately, there has been increased controversy over the right to access as well as federal funding to reproductive health, and this has triggered questions regarding the suitability of this health care provision.

            On 6th January 2017, Republican Lawmaker Diane Black tweeted that she had just reintroduced legislation to defund Planned Parenthood, eliciting mixed reactions from American citizens (Yoder, 2017). A few weeks later (on23rd January 2017), the newly sworn-in American President, Donald Trump, signed a presidential executive order aimed at defunding International Planned Parenthood, an issue that has since triggered an ongoing debate. But what does this Defund Planned Parenthood legislation mean to the millions of American citizens and others around the world who benefit from its services? This health policy paper seeks to present the author’s position on this debate and puts forward a rights-based vision of reproductive health.

Bone of Contention

            The H.R. 354 bill that was introduced in the House of Representatives on 6th January 2017, sponsored by Republican Lawmaker Diane Black and cosponsored by 133 Republicans, seeks to provide for a freeze on federal funding to Planned Parenthood Federation and other providers of pregnancy termination services. As such, the legislation would cease the federal-supported health program that offers Medicaid waivers while simultaneously funding the provision of family planning services to low-income citizens. One of the bill’s proposal stipulates that the program will then be replaced with a state-funded program.

            H.R. 354 is largely being supported by Republicans and members of the pro-life or pro-choice movements who either feel that the government needs not to engage in the abortion business or that public funds should not be used to fund abortion through medical schemes such as Medicaid. Those on the opposing side posit that defunding Planned Parenthood Inc. is an ill-informed move that seeks to deny women access to reproductive health services. The underlying issue at hand revolves around legality and morality of abortion in the US following the Center for Medical Progress’ release of a series of videos indicating that Planned Parenthood allegedly profits from the contributions of fetal tissue. A major question here is whether people should impose their moral and religious beliefs on other people’s health care. Similarly, it is imperative to determine whether the provision of reproductive health services by Planned Parenthood Inc. should be stalled just because of the single act of providing abortion services.

Background Information

            A country’s reproductive health is an important aspect of its health sector. Reproductive health addresses citizens’ reproductive functions, systems, and processes at all stages of life. As such, it seeks to ensure every individual is able to enjoy satisfying, safer and responsible sex life and that he/she not only has the capacity to bear children but also the freedom to choose when, if and how frequently to do so. This implies that individuals should be informed of and given access to effective, safe, acceptable and affordable methods of controlling birth as well as programs that ensure safe pregnancies and childbirth. Hall and Moreau (2012) posit that huge disparities exist in the provision of reproductive health services based on education levels, socio-economic status, ethnicity, religion, and age. Low-income earners have been found to lack access to apt reproductive health services and the requisite knowledge to know what it takes to sustain reproductive health.

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            Abortion or pregnancy termination has for long been considered in the context of reproductive health (family planning), population control and gender selection. While abortion has been legalized in some countries, issues of its morality still rock the country and the world at large. In the US, for instance, abortion is legal. However, the Hyde Amendment of 1976 outlaws federal funding of abortion services (Primrose, 2012) and continues to affect’s Planned Parenthood’s operations. With increased propagation of human rights and the right to life for this matter, this ongoing abortion debate will not be ending any time soon. The question is whether a fetus is a human being and whether it’s right to life surpasses the mother’s right to physical and mental health. In relation to the paper’s debate, there is controversy regarding whether Planned Parenthood Inc.’s activities should be stifled just because of the singular issue of abortion.

            Planned Parenthood is America’s largest provider of family planning services such as cancer screening, birth control, abortion, or STD tests. The organization also extends its services across the globe through Planned Parenthood Global and as an affiliate of the International Planned Parenthood Federation. It dates back to the establishment of the first American birth control clinic by Margaret Sanger in Brooklyn in 1916. The clinic was founded to distribute birth control devices and offer advice as well as related information. She later established the American Birth Control League in 1921. In 1942, the association changed its name to the Planned Parenthood Federation of America (to reflect an alteration in its philosophical approach from focusing on birth control to focusing on family planning) and has continuously grown over the years. The organization consists of 159 health and non-medical associates that operate over 650 health clinics in the United States.

            Planned Parenthood directly offers a wide range of reproductive health services as well as sexual education; advocates for the protection and expansion of reproductive rights; and contributes to research knowledge in reproductive health technologies. In addition, the organization also engages in electoral and educational activities such as voter education and legislative advocacy. Planned Parenthood has always attracted controversy from social conformists. For instance, the founders were convicted of violating the Comstock Act provisions by distributing alleged obscene materials at the clinic. Their campaign efforts, however, led to far-reaching changes in laws governing birth control and sex education in the US (McVeigh & Wolfer, 2004).

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            Similarly, prior to the legalization of abortion by the Supreme Court in 1973, the network would offer diaphragms in a society that abhorred contraception. Over the years, the organization has increased its efforts in legalizing abortion procedures and played key roles in milestone abortion rights court cases such as the 1973 Roe v Wade and 1992 Planned Parenthood v Casey cases. Following the legalization of abortion in the early 1970s, the organization began providing abortion services and has grown to be America’s leading and visible abortion services provider.

            Federal funding of the organization began after the then Planned Parenthood president, Allan Guttmacher, lobbied the American government to sustain the provision of reproductive health. This culminated with President Nixon’s signing into law the Family Planning Services and Population Research Act. In Title X of the Abortion Provider Prohibition Act, federal authorities are mandated to assist low-income earners to access family planning services such as family planning and contraception information (Lepore, 2011). The organization has been receiving annual federal funding amounting to $500 million (Brandhors & Jennings, 2016). It also receives funding from several foundations such as the Buffett Foundation, the Bill & Melinda Gates Foundation, the Cullman’s, the Ford Foundation, the Turner Foundation and just to mention a few.

            While Planned Parenthood has been subjected to criticism over the years, a series of videos released by the Center for Medical Progress indicating that the organization engages in the illegal activity of fetal tissue donation used in therapy and research reignited the debate (Brandhors & Jennings, 2016). In one of the videos, a Planned Parenthood officer is seen explaining to two anti-abortionists advocates masquerading as scientists on how to procure an abortion while saving its organs for medical scientific study. The videos serve to question the organization’s legitimacy as well as its right to offer or donate fetal tissue. However, the videos have been disputed after a private research company established that they were deceivingly fabricated and failed to present accurate or complete evidence of the events they allege to show.

            In addition, a twist of fate ensued when a Texas-based court handling the legal case threw out the charges made against Planned Parenthood and opted to indict the two anti-abortionists from the Center for Medical Progress (Fernandez, 2016). These videos offered pro-life advocates a platform to demand the investigation and defunding of Planned Parenthood. The ensuing congressional investigation by the House Energy and Commerce Committee and the H.R. 354 bill have placed the organization’s federal funding at risk; a move that may stifle its provision of other reproductive health services. As Primrose (2012) argues, anti-abortionists are too blinded by their quest to see the abolition of abortion that they fail to see the great role played by Planned Parenthood in providing preventive care as well as other vital health care services such as immunization, cancer screening, pap smears, family planning and testing and treatment of sexually transmitted diseases. While the organization indeed provides abortion services, these services represent a mere three percent of its operations.

Supportive Evidence against the Law

            Planned Parenthood has numerous benefits for the community. The organization goes a long way to safeguard the sexual and reproductive rights of women in the US. The provision of family planning services such as information and pills give women control over their biological destiny. According to Primrose (2012), there are over five million people across the world receiving healthcare education through Planned Parenthood. Bearing in mind that seventy-three percent of Planned Parenthood clinics are based in underserved or rural clinics, these clinics go a long way in providing necessary health care services.

            Planned Parenthood currently supports 800,000 patients with life-saving breast tests, 2.5 million with contraceptive services and over 4 million with STD testing and treatment services. Primrose (2012) further argues that three-quarters of people receiving Planned Parenthood services have relatively low incomes that fall way below the federal poverty line (Topulos et al., 2015). For instance, the average patient of Planned Parenthood clinics in New Jersey not only lacks health insurance but is ineligible for Medicaid expenses. This means that the freezing of funds will not only affect women who seek abortion services but also a large percentage of poor citizens.

            Contrary to what people think, the provision of reproductive health services does not increase the rate of abortion in the United States. According to statistics provided by the Center for Disease Control and Prevention (CDC), there has been a general reduction in the number of reported abortions in the country since 1990 (Willingham and Christensen, 2016).  Willingham and Christensen (2016) further cite a 2014 report that showed that 62% of women who had procured abortion were religiously affiliated.

            Defunding the organization will have adverse effects on women’s reproductive health and to the nation at large. Basu (2017) argues that freezing federal funding of Planned Parenthood Inc. could increase abortion. Failure to access birth control information and devices means that the number of unplanned pregnancies is set to rise. According to a 2001 survey cited by Primrose (2012), fifty percent of all pregnancies in the United States were accidental. The survey further showed that women with unplanned pregnancies are more probable to access little or no prenatal care or engage in unsafe behaviors such as drinking and smoking. This only implies that the proposed defunding of Planned Parenthood will have adverse effects on individual lives and the economy.

            Defunding the organization will increase unwanted pregnancies which will in turn increase government spending unnecessarily. According to Berg (2017), the Congressional Budget Office estimates that defunding Planned Parenthood clinics would cost taxpayers more than 130 million in a timeframe of ten years due to increased unwanted pregnancies. As such, it is imperative that Planned Parenthood continues to provide the necessary reproductive health care services such as birth control.

            Opponents of the law also argue that contrary to what people believe, federal funds do not go into abortion services due to the Hyde Amendment (Berg, 2017). The 1976 amendment blocks the federally funded Medicaid program from funding abortion services except for rape and incest cases as well as in situations where the pregnancy endangers the woman’s life. As such, Planned International is already banned by this law from using federal funds to pay for abortion services. With states increasingly legalizing abortion within their jurisdiction, it is evident that Americans need to wake up and accept the reality that abortion still occurs in the state.

Supportive Evidence for the Law

Proponents of the bill cite various reasons as to why Planned Parenthood should be defunded. First of all, the organization has been accused of failing to report incidences of child sexual abuse. It is unfortunate that while the United States of America has remained a key defender of human rights especially child rights, Planned Parenthood stands accused of covering up incidences of violation of child rights. Federal laws further posit that minors need to obtain parental consent or notification. As a professed women rights advocate, Planned Parenthood opposes restrictions to the provision of reproductive health services such as parental approval laws for underage children. Besides, Torre (2013) faults Planned Parenthood for its apparent willingness to abet sex trafficking activities targeting minor girls.

            Proponents of H.R. 354- Defund Planned Parenthood Act of 2017 further argue that Planned Parenthood has often incurred huge political spending through its Action Fund as well as its related entities with support tilting to the Democratic Party. For instance, during the 2008 and 2012 presidential elections, Planned Parenthood openly endorsed Barrack Obama (Jacobson, 2015). Cameron (2012) concurs with this claim, citing that Planned Parenthood had endorsed Obama with a $1.4 million ad buy.

            Moreover, while Planned Parenthood seeks to promote women’s health services, the organization does not provide necessary services such as mammography. Torre (2013) argues that it does not provide mammograms that are quite essential in the wake of today’s growing cancer problem. Instead, Planned Parenthood only refers to women who require breast screening and mammogram services to Planned Parenthood affiliates and local health care providers. Casey Mattox of the Alliance Defending Freedom posited that the Planned Parenthood affiliates do not even possess the necessary licenses under federal law to conduct mammograms (Torre, 2013).

            Supporters of H.R. 354- Defund Planned Parenthood Act of 2017 also holds the view that Planned Parenthood procures abortions and targets pro-life organizations. Abortion or pregnancy termination has for long been considered in the context of reproductive health (family planning), population control and gender selection. While abortion has been legalized in some countries, issues of its morality still continue to rock the country and the world at large. In the US, for instance, it is legal. Bilger (2016) cites a case in point when an Idaho Planned Parenthood clinic filed a court case against a neighboring women’s healthcare group that does not support abortion. The charges held that Stanton Healthcare was violating the rules for using the common area for its health unit to carry out consultations and ultrasounds. In addition, Idaho’s Planned Parenthood clinic held that pro-life activists associated with Stanton Healthcare were intimidating Planned Parenthood’s patients and directing the latter’s patients to the Stanton clinic. Stanton clinic provides free baby care supplies, medical exams and other assistance to the refugees such as alternatives to abortion advice.

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            Another major argument being fronted in opposition to Planned Parenthood through H.R. 354- Defund Planned Parenthood Act of 2017 is that patients would be able to access health care services elsewhere once Planned Parenthood clinics are closed. While opponents of the bill argue that other healthcare service providers are under-equipped to offer advanced health care services initially provided for by Planned Parenthood, proponents hold that the funds would be diverted to those health centers. This means that rural health care providers would now be equipped to ensure access to care for those rural women. They insist that though Planned Parenthood does not fund abortion services through federal funding directly, allocating money to it to provide other health services allows the organization to reallocate some of the funds under its control for abortions.

            Lastly, Planned Parenthood has been accused of fraud (Torre, 2013). These claims are substantiated in a 2011 investigative report on the organization that reported that Planned Parenthood was misusing federal funds (Torres, 2013). Admissions by former staff and state audit report detailed a pattern of mismanagement of federal funds by some of its affiliates. The report further faults the organization for misusing RU-486, an abortion drug, in contravention of the provisions of the Food and Drugs Administration.

Potential solutions

From the onset of his presidential campaign bid, President Donald Trump announced his public stand against abortion and to an extent against Planned Parenthood. He is on record stating that he supports the defunding of Planned Parenthood and has even signed a presidential order aimed at defunding International Planned Parenthood. As such, it is evident that the Republican-led government will aggressively push for the passing of H.R. 354- Defund Planned Parenthood Act of 2017.

            To avert the emergence of a precarious position arising from the defunding, I would propose that the federal government delays the move. At the moment, eight American states which include Indiana, Kansas, Utah, Ohio, Alabama, New Hampshire, Arkansas, and Louisiana have already enacted proposals aimed at defunding the organization. To begin with, these states should serve as a pilot projects to determine whether defunding Planned Parenthood nationally would have adverse effects in the health sector. Alternatively, the government should put in stringent enforcement measures that would deter the organization from carrying out abortions.

Writer’s Stand

It is often said that women are the cornerstone of many homes and the nation at large. They not only give birth to children but also nurture them. While the proponents of this bill offer several reasons to justify their position, such as Planned Parenthood being an abortion group, I believe that defunding the organization will curtailing the country’s development agenda. First of all, the video clips released by the Center for Medical Progress seem baseless and only aimed at tarnishing Planned Parenthood’s reputation. Their authenticity was disputed after a private research company established that they were deceivingly fabricated and failed to present accurate or complete evidence of the events they allege to show. The rulings of a Texas-based court opting to indict the two anti-abortionists further compounds to the illegality if the video clips. Similarly, evidence from the Center for Disease Control and Prevention indicates that the provision of reproductive health services by an organization such as Planned International has resulted in the reduction of reported abortions carried out in the US (Willingham and Christensen, 2016).

            Access to quality and affordable health care is undoubtedly a fundamental human right. Women have a right to decide when to be expectant and should be protected from undue stress brought about by unplanned pregnancies. Through Planned Parenthood, they have managed to acquire the freedom and capacity to space childbirths, leading to the best possible birth outcomes as well as protection against unplanned pregnancies. The provision of family planning services by the organization has reduced the need for abortion in the country. Congress has the obligation to ensure that all Americans are not only safe but healthy. As such, all leaders need to throw out this bill that would slash millions of mainly poor women from accessing effective birth control services as well as other vital reproductive health care services. This will not only leave them prone to unplanned pregnancies but also the risk of acquiring life-threatening diseases such as STDs. Now is the time for our congressmen to stand up and defend the rights of women.

            Planned Parenthood has been prone to incidences of vandalized offices, arson, chemical attacks as well as bombings. For instance, Turkewits and Healy (2015) cite an incident in Colorado Springs that resulted in the deaths of three people following a shootout at a Planned Parenthood clinic. Coupled with these threats, it is evident that defunding the organization will not only be the last blow that will result in massive layoffs but will curtail the access to quality and affordable reproductive health care services.          With advances in the information and communication technology, the ease of editing and even photoshopping documents, photos and videos has only made the situation worse as malicious people can easily tarnish one’s reputation. As such, it is important that organizations are keen on these technologies.

            Moreover, the healthcare organization currently supports 800,000 patients with life-saving breast tests, 2.5 million with contraceptive services and over 4 million with STD testing and treatment services (Brandhors & Jennings (2016). Several researchers argue that three-quarters of people receiving Planned Parenthood services have relatively low incomes that fall way below the federal poverty line (Primrose, 2012; Topulos et al., 2015). Brandhors and Jennings (2016) further argue that Planned Parenthood has been receiving annual federal funding amounting to $500 million which goes towards meeting the organization’s operations.

            With increased secularization and advances in technology, teenagers will continue to engage in premarital sex thus predispose themselves to unwanted pregnancies and STDS. This situation can be avoided by Planned Parenthood through the provision of birth control services, screening, and treatment of STDs as well as sex education. Similarly, expectant mothers often resort to Planned Parenthood for support throughout the pregnancies. Amidst all the accusations leveled against Planned Parenthood by proponents of the law, the burden of proof rests with the organization to demonstrate that its operations are in line with state and federal laws. As Primrose (2012) argues, anti-abortionists are too blinded by their quest to see the abolition of the practice that they fail to see the great role played by Planned Parenthood in providing preventive care as well as other vital health care services such as immunization, cancer screening, pap smears, family planning and testing and treatment of sexually transmitted diseases.

            Lastly, Planned Parenthood has numerous benefits to the community that should never be ignored. The organization’s services go a long way in safeguarding the sexual and reproductive rights of women in the US. The provision of family planning services such as information and pills give women control over their biological destiny. Defunding it will increase unwanted pregnancies which will in turn increase government spending unnecessarily. As Berg (2017) reports, the Congressional Budget Office estimates that defunding Planned Parenthood clinics would cost taxpayers more than 130 million in a timeframe of ten years due to increased unwanted pregnancies. As such, it is imperative that Planned Parenthood continues to provide the necessary reproductive health care services such as birth control services

Conclusion

            A healthy nation is a working nation. Access to quality and affordable comprehensive healthcare is a universal human right and basic need that should be provided to all. While the American government has put in various measures aimed at ensuring that all citizens access reasonable and quality health care, access to reproductive health has continued to receive national criticism across different quarters. While we need to safeguard the right to life, it is important to ensure every woman leads a happy and fulfilling life. As such, it is important that public awareness is raised about the need to nurture and protect the wellbeing and health of women. Access to affordable reproductive health services such as birth control and related information is very essential. Not only does it empower women to space their childbirths thus promote the best possible birth outcomes but also to avoid unwanted pregnancies. The provision of reproductive services also goes a long way in deterring illegal abortions which are in nature more likely to be life-threatening and unsafe to a woman’s well-being and health.

            Having been established over a century, Planned Parenthood has been instrumental in propagating the reproductive and sexual rights of millions of people locally and internationally. With the imminent risk of the population explosion that is set to face the world, the provision of reproductive health services continues to empower people both locally and internationally particularly in regards to birth control measures. In Planned Parenthood, women have the freedom and capacity to space childbirths, leading to the best possible birth outcomes as well as protection against the dire socioeconomic effects of unplanned pregnancies. In a nutshell, controlling access to providers such as Planned Parenthood that offer wide-ranging reproductive health services does not lower the need for abortion. On the contrary, such a move will only drive low-income earners to seek unsafe abortion procedures thus risk their lives. 

References

Basu, R. (2017). Defunding Planned Parenthood could increase abortions. The Des Moines            Register. Web

Bilger, M. (2016). Planned Parenthood sues the pregnancy center for offering women abortion alternatives. LifeNews.com. Web.

Brandhors, J. & Jennings, F. (2016). Fighting for funding: Values advocacy and Planned           Parenthood’s right-to-life. Sciencedirect.com. Web

Cameron, J. (2012). Planned Parenthood endorses Obama with $1.4 million ad buy. The Hill.          Web.

Fernandez, M.  (2016). Two abortion foes behind Planned Parenthood videos are indicted.          The New York Times. Web

Hall, K. & Moreau, C. (2012). Determinants of and disparities in reproductive health service use among adolescent and young adult women in the United States, 2002-2008.      American Journal of Public Health, 102(2), 359-367.

Human Rights Watch (2009). ‘Please, do not make us suffer any more….’: Access to Pain    Treatment as a Human Right. New York, NY: Human Rights Watch.

Jacobson, L. (2015). Carly Fiorina says Planned Parenthood gives ’millions’ to candidates.      Politifac. Web.

Lepore, J. (2011). ‘Birthright’: What’s next for Planned Parenthood? The New Yorker. Web.

McVeigh, F. & Wolfer, L. (2004). A brief history of social problems: A critical thinking approach. Princeton, NJ: Princeton University Press.

Primrose, S. (2012). The Attack on Planned Parenthood:  A Historical Analysis. UCLA             Women’s Law Journal, 19, 165-211.

Topulos, G., Greene, M. & Drazen, J. (2015). Planned Parenthood at Risk. The New England          Journal of Medicine, 373(10), 963.

Torre, S. (2013). Planned Parenthood Sets Record for abortions and government funding.          Dailysignal.com. Web.

Turkewits, J. and Healy, J. (2015). 3 are dead in Colorado Springs Shootout at Planned             Parenthood Center. The New York Times. Web.

Willingham, A. & Christensen, J. (2016). The abortion debate is more complex than you think.        CNN. Web

Yoder, K. (2017). ‘50 Shades’ author, Media Attack Congresswoman for the ‘Defund Planned           Parenthood Act’. Newsbusters. Web.

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