Will Truman

Before Mike Dwyer wrote the post on abortion he did not intend to write, I had one thought out that I intended to write but had not wrote. This isn’t the first time this has happened. I need faster turnaround time. However, the above map was used for a Monday Trivia post, but was designed in good part out of curiosity.

The above is a map based on the percentage of pregnancies ending in termination within each state. It is not looking specifically at teen pregnancies or unintended ones or whatnot. Here is what I take from the map:

1. I was genuinely surprised by the results of this map when I put it together. I knew that there would be some differences from state-to-state, but did not think it would be any more than State X is twice as much as State Y. I expected a range of 10-25% or 15%-25% and not 1%-33%. I actually started this search to respond to a suggestion that abortions are relatively rare in Utah. It turns out, they are.
2. Culture seems to matter – It’s difficult for me to look at the map and reduce the substantial disparities to everything except culture. The State of Montana has no barriers to abortion provisions but distance (there are eight providers spread throughout the state), but to suggest that access is the issue is to suggest that almost 2/3 of women having abortions in New York wouldn’t be having them if it was a couple hours away.
3. What makes for the cultural distinctions? North Dakota and South Dakota appear to be very similar, yet one has a notably higher abortion rate than the other (though both are well below-average). South Dakota has two providers and North Dakota has one. Why the difference?
4. Culture can be defined any number of ways, of course. From the values that one picks up to the social norms one is raised around. It is impossible to detangle these things, of course, but both are relevant. Law arguably should be included with culture, but for discussion reasons I am separating it out.
5. If it’s not culture, then restrictions are really effective – One would think that the demand for abortion would be relatively inelastic (financially or hassle-wise). That does not appear to be the case and adding hoops to jump through makes a difference. (I think this is the case even if culture is responsible for some of it.). I would be quite interested in statistics demonstrating the elasticity of abortion demand with regard to the nearest clinic. How much does 20 miles reduce the rate? 40? 80? This doesn’t have immediate policy repercussions, but I am interested nonetheless.
6. With culture and access, there is a chicken-egg question. Certainly, cultural objections would manifest themselves in laws, but one really interesting thing: If you look at rates-per-woman-of-reproductive-age (RPWORA) over time (and a lot of anti-abortion laws are recent), you’ll see they track above or below the national average very closely. This is true for states with no restrictions, and states that have been instituting many restrictions. (Note, RPWORA statistics are a little less reliable because it looks at the state where the abortion occurs, rather than where the mother lives).
7. To be honest, I find it really difficult to wave away cultural influence as one of the explanations, and it requires a degree of ideological devotion to suggest that it is probably that.
8. These statistics possibly mitigate the RedFam/BlueFam meme, depending on how you look at it. If illegitimacy and teen motherhood rates make red states look bad, the dearth of abortions are arguably a reason for that. This loses all value if all you care about is illegitimacy and motherhood rates and don’t care about abortion rates. Also, Gutmacher’s numbers suggest that regardless of abortion, unplanned pregnancies tend to be higher in southern and southwestern states.
9. Abortion rates appear to be low in states with limited economic opportunity. It suggests, to me, that raising the minimum wage and such wouldn’t necessarily help. The economics of this decision, in my view, have less to do with income, and more to do with the cost of raising children. Expensive states have higher rates than inexpensive one. This could completely be effect from other factors, but I don’t think it is.
10. In addition to being economic, the cost issue is also cultural. Low-cost states attract and hold on to people who want families. A Mormon family of six reduces the abortion rate of Utah.
11. Do these statistics tell us anything about sex ed? Well, not especially since the purpose of sex-ed is not limited to reducing abortions. It does suggest that to the extent that abortion-reduction is a goal, sex-ed’s influence is limited.
12. With enough ideological effort, any of the findings can be waved away. After all, we can’t prove that there the gap is not made up entirely by backalley abortion industry in these low-abortion states. And causation itself is difficult to prove.

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If I had thought about it, I would have written the following back on Opposite Day:

In Roe v Wade, the right of privacy – and that of a woman over her own body – was decided. The court, in its wisdom, determined that it was no place for the government to essentially force a woman to carry a fetus to term against her will. We have come to understand that control over one’s own body, and a woman’s control over her reproduction, is essential to full personhood.

Since that decision, a woman’s right to choice has been constantly under threat. From anti-abortion laws placing undue burden on women to networks of hospitals and health care providers refusing to offer abortion services. Too many people cling to the notion that we can place an undue burden on women by forcing them to carry fetuses to term. As a society, we have not given up on the notion that a woman’s sexuality is something to be controlled. Restricting access to abortion is merely one manifestation of that misguided – and misogynistic – idea.

It is not enough that abortion be legally permissable. For a woman to have control over her own body, she must have the ability to terminate her pregnancy. When women cannot afford the procedure, cannot find a doctor, or must confront loud and hateful voices when she can, the right to choice is not complete.

Abortion clinics were never supposed to exist. It was assumed, that once legal, it would become a part of standard training for obstetricians and many general practitioners and these procedures would be performed in community clinics and hospitals all across the country. Instead, the medical community turns its back on women, leave these provisions to standalone clinics that are subject to intimidation and violence.

Attempts have been made to train more obstetricians and general practitioners to do the procedure, but these attempts have proven largely unsuccessful. As a result, a woman that becomes pregnant in many parts of the country must arrange transportation to drive hours, often alone, into other cities and towns they have never been, in order to utilize a right guaranteed to them in the Constitition. A right over control over their own body. A right to full, autonomous, personhood.

Meanwhile, there are hospitals in the towns where they live. There are doctors in these hospitals that perform D&C procedures with regularity. They are either already capable of performing these procedures or would need only minimally more training to do so. But they choose not to.

It is not nearly so simple as to say that it should be their decision to perform, or not perform, whatever procedures they deem fit. Many of these hospitals accept preferential tax treatment. Most accept payments from Medicare or Medicaid. They required public help to become doctors in the first place, and enjoy privileged status as a result of the laws of various states and the federal government.

With these privileges come responsibilities. One such responsibility is to take care of patients. When women are forced to travel long distances to have basic – and constitutionally protected – health care, too many in the medical community are failing to live up to these responsibilites.

It therefore should be the policy of the federal government that every hospital (and any clinic of more than a certain number of physicians that offers obstetrical and gynecological services must offer a full range of services, including giving women control over their reproductive rights. Any hospital or clinic that declines to do so will lose any tax-exempt status they might have and will, at the government’s discretion, possibly be no longer be eligible for Medicare and Medicaid reimbursements.

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What bothers me about the above argument is not that it is offensive. It is not that it is absurd. In fact, it’s that the above argument is not absurd. It relies on two general premises:

1) The right to access to abortion is paramount to a woman’s health and full-personhood.

2) Any Freedom of Conscience by medical professionals, or anyone, really, does not supercede a right to a woman’s autonomous decisions regarding reproduction.

I have heard the argument for #1 many times. It is, at least arguably, the very reason for the intermittently proposed Freedom of Choice Act (FOCA)*. It rests on the notion that not only can the state not actively prohibit, but that it cannot the provisioning of facilities and services.

It has also been one of the themes of the contraception discussion. That not only should the government not prevent facilitating access to contraception, but rather that it should assist in it. To an extent, we should all assist. To do otherwise is to deny women control over their health (or their own view thereof).

The FOCA includes a religious exemption, though the recent discussions about the contraception mandate have suggested that the government’s idea of exemptions, and the provider’s idea of exemptions, may not be the same thing.

I am not particularly worried about the above coming to fruition. In large part due to the pro-life people that abortion-rights advocates love to loathe. This was, at least partially, why my initial inclinations were with the church on this. They are, when it comes to the nitty-gritty stuff, likely to be my ally.

It may seem like a frivolous fear, that one day my wife might be required to perform abortions as a part of her job**. But when it’s your wife, and your beliefs, and her beliefs, it ceases to be frivolous. And anything that moves us closer to that possibility is something to be concerned about. This is especially true when a number of the arguments being used in this case (the HHS mandate) apply to that case as well.

Ultimately, this was not a decision-maker for me. In part because the Catholic Church itself screwed up when they formed the initial argument that it was their specific prerogative as a religious organization that should exempt them from this. As it pertains to my wife, she left the Catholic Church – on bad terms – long ago. Her views are based in moral philosophy and other factors. She doesn’t have a particular religious membership to hang her exemption hat on.

But it’s also because of the differences. The difference between paying for something and doing something. The difference between contraception and abortion.

Despite all this, I do remained concerned about tomorrow will hold. My primary hope is that abortion will remain sufficiently controversial that it would be politically toxic to require provisioning on the part of physicians, nurses, and hospitals that object to the procedure. And that it would be the breaking point where hospitals would start closing down. It is something I will be keeping an eye on.

* – Also, the requirement that hospitals perform abortions for the life/health of the mother in emergency circumstances.

** – For those who don’t know, she is a physician with extensive obstetrical training that could perform abortions. Doing D&Cs with fetal remains is an unfortunate, but necessary part of her job. Taking a live fetus and doing the same is more difficult than what she does, but not something she cannot do. Anyone in the town we live in that wants an abortion has to drive three hours or more to get one.

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When the discussion over the HHS mandate started, I was more-or-less on the fence. If I leaned in either direction, it was against applying the mandate to the church. Over the course of the discussion, I changed my view and now tentatively support the administration (court rulings pending). Here is a general rundown of the various arguments and how they did, or did not, affect my thinking:

Arguments in favor of the mandate non-waiver that I found unpersuasive:

1) The Catholic Church defended child molesters. I haven’t seen this argument as much here, thankfully, but it is counterproductive as it lends credence to the argument that this is at least partially a punitive measure against people the proponents of the law simply don’t like. It doesn’t always work out this way, but I prefer issues be approached on the merits and not on who we like and do not like.

2) This isn’t about anything but contraception, which isn’t about anything but a misogynistic need to control women’s sexuality. If there is one thing I have learned over the course of this discussion, it’s exactly how many supporters of this law believe various views I have to being misogynistic. They are, of course, within their rights to think anything of my positions that they like. But in the game of shirts-and-skins, they have drawn the line in the sand and put me on the other side of it (despite the fact that I am supportive of contraception and do not believe in criminalizing abortion). Fortunately, per #1, I try not to make decisions on this sort of basis. And in this case, I didn’t.

3) Eight/Twelve/Twenty-eight states already do this, so it’s only a big deal because people are making a phony show of it. There is actually some merit to this (see below), but one major problem with it: If you want me to disregard potential slippery slopes, do not use what has been done to justify what is being done now. It sets off red flags.

4) It is an unreasonable burden for people to have to make career decisions based on the ideology of the employer. I am actually a little bit sympathetic to this… if they weren’t saying at the same time that it is reasonable for institutions to have to do backflips to avoid having to pay for something they see as immoral.

5) The contraception mandate pays for itself because contraception is cheaper than pregnancy. This assumes facts not in evidence. They may be facts, and I can be convinced on this, but I need to see harder data that I can examine. Right now I am mostly seeing assertions. Some of the skepticism may be rooted in a natural resistance to the notion that the cake is actually free. I actually want to believe this is true, but I have nothing to take to someone who doesn’t already agree with the proposition.

6) Why do Church’s even feel it necessary to enter what could be secular enterprise? It’s irritating. This was an early argument by Kevin Drum echoed by others. I don’t know why they feel it necessary, other than the reasons they give, but I consider it a good thing that they do. They often provide very good services and if they picked up their stakes it is far from clear that anyone else would take on the load.

Arguments in favor of the mandate non-waiver that I found persuasive, and changed my mind:

1) Nobody is requiring anything. Hospitals don’t have to close down to avoid to avoid chipping in for something they don’t approve of. They can put employees on the exchanges. This may seem like an undue burden, but the entire notion of employee benefits is a product of government incentivizing and disincentivizing employer behavior. This, as much as anything, strikes me as an extension of that. Arguably, this is less punitive than a number of statewide measures because there actually is an exchange to put them on.

2) In a pluralist society, numbers matter. The fact that the Catholic Church cannot muster up even a minimal amount of compliance with their own church, moves objections to contraception from the category of beliefs we have to account for over to beliefs that are sufficiently marginalized as to be disregarded. A couple caveats on this: (1) This assumes courts determine compliance with the Constitution. Without such compliance, the popularity or marginalization of any belief doesn’t matter, (2) This doesn’t mean that we should target these beliefs, but when considering reasonable accommodations of a belief held by 3% of the population and one held by 33% of the population, numbers matter from a practical standpoint. It’s harder to justify putting the laws of the land on hold for 3% than it is for 33%.

3) There is little indication that the Constitution has a problem with it. While the 8/12/28 states don’t make a great argument about alleged disingenuousness, they do make a fair argument that, Constitutionally-speaking, this isn’t particularly new ground. I haven’t heard a good counter on this, other than that it’s closer to 8 states than 28. Just because it has been done in 8 or 12 states does not mean that there aren’t good objections to taking it national, or that doing so is a good idea, but it does suggest that it’s not an unconscionable idea. And won’t lead Catholic organizations to shutter their doors.

4) Contraception isn’t just about birth control. Well, it’s in the name and all, but estrogen/progestin combinations serve other medical applications as well. This isn’t some fiction.

5) The rules are the rules. I was not a big fan of PPACA, but it is the law of the land and contraception access was a part of it. While I might question giving McDonald’s a hardship exemption and not the Catholic organizations, the latter is not being singled out here. It’s not like suddenly passing laws against snake-handling just as Pentacostals are arriving in large numbers.

In summary, the arguments I found most persuasive were nuts-and-bolts arguments. Nob did some of the heavy lifting here by pointing out what the alternatives here were, and that they were not put up or shut down. The arguments I found lease convincing were People Who Disagree With Me Are Bad (or are operating on bad faith). In good part because a lot of the people saying this are people I disagree with on tangential-but-related matters.

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One of the things that makes me a less-than-stellar blogger is that my mind works on a time delay. It takes me time to process information and determine what I think about it. And so naturally, it’s the week following all of the interest in South Carolina that I finally piece together my thoughts. I will try to do better in the future and white about any damn fool thing that comes to mind.

What jumps out at me with the whole affair is the degree to which we were often talking about the wrong things, stuck in gears of racist/not-racist. Very little good, in my experience, comes from racist/not-racist conversations. Or maybe, as a white guy with southern roots, it’s something that just makes me feel tremendously uncomfortable regardless of where I come down on the matter. That doesn’t mean it’s not a conversation worth having, of course. But in the accusation/counteraccusation tone that the conversation took, I didn’t get a lot out of my reading of it and I don’t regret my relative non-participation.

Juan Williams’s original question related to Gingrich’s comments on what he would say to the NAACP and whether or not he was concerned about the racial implications of what he said and if he could understand how one might be offended. Intended or not, this question does come across as an accusation of racism, at least to some people. And once the accusation is made, the conversation takes on a life of its own. I think a different question might have yielded better results. Something along the lines of:

TRUMAN: Speaker Gingrich, you recently said black Americans should demand jobs, not food stamps. You also said poor kids lack a strong work ethic and proposed having them work as janitors in their schools. As a cursory review of the statistics on poverty and food stamps will reveal, it is not limited to a single race or single subculture. How comfortable would you feel going to pockets of poverty in West Virginia and questioning the West Virginian work ethic? Would you hold them to the same standard, or do you think there are differences? If there are differences, what do you think they are?

I choose West Virginia based largely on stereotype and because it’s a state that nominee Gingrich would need to win. If WV is a bad example, there are pockets in Idaho, Montana, and just about everywhere. Look under some rocks and find the best example. The point is that there is white poverty and it absolutely needs to be accounted for when a presidential candidate accuses another subculture of being too content with public assistance and not content with work.

I don’t know how Gingrich would have answered my question. He might have given the exact same answer. He might have thrown WV under a bus. He might have tried to outline some differences. Regardless of his answer, though, I think that you have to confront this issue when you talk about poverty and government support. And by shining the light on poor whites, the ensuing conversation here and elsewhere might have been dedicated less to accusation/counteraccusation and more towards how we look at poverty in different groups and the distinctions we make or don’t make.

Personally, I don’t think that Republican contempt for a perceived lack of worth ethic is entirely based on race. There are small government people who resent welfare in any capacity. There are also cultural issues that are not entirely racially defined. There was a lot of scoffing at #OWS protesters, a great many of whom were white (but they fit other demographics that conservatives often reflexively mistrust). But once you’re talking about West Virginia, or Montana or Idaho, you’re talking about people who are at least perceptually a part of a culture that Republicans, and white South Carolinians, are less enthusiastic to dismiss as lazy, entitled, or what have you. That’s why I consider the question important.

For my own part, my perceptions of poverty and government support changed a great deal as my wife and I have moved from here to there. She has worked at one government or county or charity hospital after another serving different kinds of poor: Urban black, rural white, immigrant, Native American, urban white, and urban Asian. And, because we have tried to live near the downtown hospitals, we have lived in all sorts of poor communities. Some characteristics – the type that Gingrich decries in the black community – transcend specific culture. It’s something to remember apart from accusations of racism. It’s something that needs to be a part of the discussion if only to keep the discussion from being a proxy for race (as much as we can).

I have found that many liberals often have a disdain for rural, poor white folks. But one thing you can’t get around is that they do favor policies that will help them get by. Conservatives have made it more than clear that they are willing to be vocal about poor minorities needing to solve their own problems. It is an open question the degree to which they are willing to say the same about poor whites from the Heartland. A question that should be answered.

[Header image modified from original image at Wikimedia Commons, c.berlet/publiceye.org]

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In a post about Huntsman’s Perplexing Appeal, Elias wrote:

Another way of saying the same thing is that, for a politician, Huntsman seems semi-normal and almost kind of cool. We — Lefties and Righties alike — tend to unconsciously assume that someone we like not only likes us in return but is like us, too. So while it’s probably the case that some Democrats like Huntsman because so many Republicans don’t, I’d guess that what’s happening is actually simpler and even more superficial: they just like the guy, and any policy-based cognitive dissonance is shrugged off or waved away.

I could be wrong, but I think there is something else going on here. Particularly among us wonky sorts. I can’t speak to the left’s motivations, as I am not among them. But I can speak, at least to some extent, as to why a moderate or moderate-conservative would sign on with Huntsman. In addition to having a cooler persona than the other Republicans, Huntsman is interesting. For those of us that like political discussion, he seems to be the most likely candidate to actually deliver it. Presidential debates between Huntsman and Obama would be interesting (and not just because one used to work for the other). And if Huntsman is more conservative than he lets on? All the better! It would draw a great contrast during the election discussion. Huntsman could even help redefine the right into something less piquish and flesh things out.

Huntsman may be conservative, but he is also (if that) a different sort of one. He has gone after the banks in a way that few other candidates have. His platform includes opening up energy exploration and eliminating oil subsidies. These are things he seems ready and able to talk about. The other Republicans, for the most part, don’t.

Right now we have a Democratic Party lead by a man that has only a vague idea of where he actually wants the country to go. I don’t mean that as an insult. Sail-setting is one of the premier jobs of the presidency. And, of course, we have a Republican Party that is trying to press on with its electoral coalition without defining a (realistic) governing one. Unless Romney’s next face is one radically different from the ones he has shown so far, we are in for a pretty depressing election. Huntsman, I believe, and I believe a lot of other people believe (whether they have articulated this belief or not) would provide for something more interesting. The degree to which the two men are tied together limit the likelihood of Satan Incarnate arguments (not that people wouldn’t try).

This is a political geek’s dream. And a wonk’s dream.

On a less high-minded note, it’s also easy to back a candidate when they’re not likely to win. The downsides are less “real” when they’re less likely to be in a position to execute them. Right now Huntsman is being compared to a bunch of people spouting a lot of righty rhetoric. Put him up against Obama, and the perspective changes. Huntsman’s cool demeanor is less remarkably because Obama has the same. He starts going after Obama and stops going after other Republicans, so one of the big things they like about him dissipates. His policy ideas become more important. Huntsman would be further proof of oh-so-concerned tut-tutting about how the Republicans have Lost Their Way.

Ultimately, though, it’s one thing to have strong disagreements with someone that you think you can have a conversation with. It’s another thing to have an argument with someone that’s hurling insults your way. The vast majority of the time, you’re going to prefer the former. This gets to what Elias was saying about personality mattering. I would argue, though, that it is not entirely frivolous. A big part of the presidency is how you respond to the incoming missiles (figuratively speaking). Another part is the 100,000 decisions they make outside the public’s eye. We don’t know what the issues are going to be from 2013-16. Who they are matters.

It may be foolish to think that we have any idea who Jon Huntsman (or Barack Obama, for that matter) actually is. Some, like Mitt Romney, seem to go out of their way to make sure that you have no idea. But even aside from that, everyone wants to project a positive image (especially politicians). I do believe, however, that the temptation is there for a reason. And that there are limits to the degree to which they can pretend.

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