Universal Health Care Tends to Cut Abortion Rate

The Summer 2010 Glenn Fellows currently are Reading Eugene Bardach's A Practical Guide to Policy Analysis and working up proposals for their own foray into public policy research and analysis. I hope we'll have a chance this Wednesday to talk about the following article, which appeared in The Washington Post on March 14, 2010:

Universal Health Care Tends to Cut Abortion Rate

By T.R. Reid, Sunday

Countless arguments have been advanced for and against the pending bills to increase health-care coverage. Both sides have valid concerns, which makes the battle tight. But one prominent argument is illogical. The contention that opponents of abortion should oppose the current proposals to expand coverage simply doesn't make sense.

Increasing health-care coverage is one of the most powerful tools for reducing the number of abortions -- a fact proved by years of experience in other industrialized nations. All the other advanced, free-market democracies provide health-care coverage for everybody. And all of them have lower rates of abortion than does the United States.

This is not a coincidence. There's a direct connection between greater health coverage and lower abortion rates. To oppose expanded coverage in the name of restricting abortion gets things exactly backward. It's like saying you won't fix the broken furnace in a schoolhouse because you're against pneumonia. Nonsense! Fixing the furnace will reduce the rate of pneumonia. In the same way, expanding health-care coverage will reduce the rate of abortion.

At least, that's the lesson from every other rich democracy.

The latest United Nations comparative statistics, available at http://data.un.org, demonstrate the point clearly. The U.N. data measure the number of abortions for women ages 15 to 44. They show that Canada, for example, has 15.2 abortions per 1,000 women; Denmark, 14.3; Germany, 7.8; Japan, 12.3; Britain, 17.0; and the United States, 20.8. When it comes to abortion rates in the developed world, we're No. 1.

No one could argue that Germans, Japanese, Brits or Canadians have more respect for life or deeper religious convictions than Americans do. So why do they have fewer abortions?

One key reason seems to be that all those countries provide health care for everybody at a reasonable cost. That has a profound effect on women contemplating what to do about an unwanted pregnancy.

The connection was explained to me by a wise and holy man, Cardinal Basil Hume. He was the senior Roman Catholic prelate of England and Wales when I lived in London; as a reporter and a Catholic, I got to know him.

In Britain, only 8 percent of the population is Catholic (compared with 25 percent in the United States). Abortion there is legal. Abortion is free. And yet British women have fewer abortions than Americans do. I asked Cardinal Hume why that is.
The cardinal said that there were several reasons but that one important explanation was Britain's universal health-care system. "If that frightened, unemployed 19-year-old knows that she and her child will have access to medical care whenever it's needed," Hume explained, "she's more likely to carry the baby to term. Isn't it obvious?"

A young woman I knew in Britain added another explanation. "If you're [sexually] active," she said, "the way to avoid abortion is to avoid pregnancy. Most of us do that with an IUD or a diaphragm. It means going to the doctor. But that's easy here, because anybody can go to the doctor free."

For various reasons, then, expanding health-care coverage reduces the rate of abortion. All the other industrialized democracies figured that out years ago. The failure to recognize this plain statistical truth may explain why American churches have played such a small role in our national debate on health care. Searching for ways to limit abortions, our faith leaders have managed to overlook a proven approach that's on offer now: expanding health-care coverage.

When I studied health-care systems overseas in research for a book, I asked health ministers, doctors, economists and others in all the rich countries why their nations decided to provide health care for everybody. The answers were medical (universal care saves lives), economic (universal care is cheaper), political (the voters like it), religious (it's what Christ commanded) and moral (it's the right thing to do). And in every country, people told me that universal health-care coverage is desirable because it reduces the rate of abortion.

It's only in the United States that opponents of abortion are fighting against expanded health-care coverage -- a policy step that has been proved around the world to limit abortions.

T.R. Reid, a longtime correspondent for The Post, is the author of The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care.