Why Don’t Fetuses Get Free Health Care?

It’s a curious feature of the Republican approach to reproduction that the fetus has the right to life but not to medical care*. The life belongs to the fetus, so the money required to bring that fetus to term—including the cost of the birth—should be calculated not as part of the “expense” of being a woman in the health care system but rather as a Fetal Birthday Gift From America.

Women are more costly, the prevailing Republican wisdom goes, because of their child-bearing years. Pete Sessions will be greatly relieved to learn that this has all been a mistake over in in Accounting. The cost of an entire pregnancy (and any in vitro treatments that led to the conception) redounds on the fetus’ unborn head.  Luckily insurance rates will be low—no preexisting conditions as it is not yet technically a smoker, an adolescent male driver or a woman. America’s gift will be both moral and cost-effective.

Back in the day, England introduced the idea of a “window tax” which amounted to a tax that was (it was felt) roughly proportionate to income. Wikipedia informs me that “it was designed to impose tax relative to the prosperity of the taxpayer, but without the controversy that then surrounded the idea of income tax.”

Replace “income tax” with “abortion” and “window tax” with “health care reform” and you’ll get a window into the way reproduction gets mentioned and evaded during the depressing dance that is US health care reform. Uteruses are the new windows. It’s the having them that matters, and it’s a luxury for which women have to pay.

Republicans: Being a Woman is a Preexisting Condition. Pregnancies Cost Money. So Does Birth Control. No You Cannot Abort.

First, thanks to the Stupak Amendment (which has led apolitical me to write not only my representatives but those in Georgia as well), insurers are to be instructed that the plans the vast majority of the population will be using Shall Not include abortion. Abortion is already seldom taught in medical schools—a change from the time my own father received his training.  Now there will be a stranglehold on market demand. Abortion will become a subspecialty, an “elective procedure” that has, in many discussions raging on this issue, been lumped in with breast augmentations. (That is a subject for another time.) It seems a foolish comparison until one realizes that as abortion becomes more and more divorced from the standard repertoire of obstetrics and gynecology, it may be priced accordingly.

It’s popular to talk about Republican stupidity, but I want to take a moment to applaud the tacticians behind this move. It was nothing short of brilliant for the Republicans, coming from a position of numerical weakness, to pen the Democratic party so that they squabble over whether to sacrifice one major issue in order to achieve nominal victory in another.

They are, however, in need of some additional help which I am in a position to provide.

I learned, courtesy of Politico and Courthouse News, that Pete Sessions believes women to be in the same class as smokers, and that both groups should pay more (or nothing) accordingly:

In promoting the House health bill, New Jersey Democrat Frank Pallone made reference to discrimination by insurance companies, citing their reluctance to insure people with preexisting conditions and differences in costs based on gender. “But that’s not against the law,” Texas Republican Pete Sessions said.

Pallone replied, “No, but we would make it against the law. Why do you have a problem with that?” he asked. “Why should a woman pay more than a man?”

“Well, we’re all different,” Sessions explained. “Why should a smoker pay more,” he said before getting interrupted by a burst of chatter throughout the room.

Why indeed? It’s an interesting parallel: smokers weigh the system down by jeopardizing their own health through the voluntary ingestion of known carcinogens. Women weigh down the system by having the potential to reproduce. Being a woman is a preexisting condition. Like having diabetes. In fact, being a woman is functionally identical to a disease.

(How smokers should be treated by our health-care system is an important subject for another time; what interests me here is the rhetorical move of equating the two.)

“Oh please,” a commenter on Glenn Thrush’s post on this in Politico writes, “young men have to pay more for car insurance than young women, it’s the way the world works…no need to cry about it.”

In this argument (which crops up more than you might expect) the logic goes thusly: women are statistically more expensive than men, just as young male drivers are statistically more expensive than female drivers. Therefore it is perfectly reasonable for women to pay more for basic medical care. Q.E.D.

I nod. This makes excellent sense. But there’s a tickle somewhere around my left uterine syllogism-maker that suggests that something important is being missed. Ah! I have it. It is this: I don’t necessarily have to drive.

Yes, that’s it. I can opt out of the unequal pricing of car insurance by not owning a car.  The higher cost of which exists, incidentally, because of patterns of irresponsible behavior, not irresponsible uterus ownership. My uterus is harder to opt out of, as it was not of my choosing. It is (at least in principle) a harder thing to reject.

My fallopian fallacy-feeler tells me something else about this is not 100% absolutely accurate. Here it is. Health insurance is arguably more important than car insurance in that the latter deals mainly with what happens to a chunk of metal in case of an accident, whereas the former addresses whether you will live or whether you will die.

In both cases, though, the analogies correlate irresponsible behaviors with actually being a particular sex.

My cervix has some questions as it contemplates possible methods of payment:

Does infertility earn you a tax break?

(Oh good! But wait—might taxing women for their reproductive function not be the best way to solve the problem of the declining birth rate in the US?)

(Never mind—someone will support us when we get old and Social Security is bankrupt.)

All this is luckily only a problem for pro-choice people. The pro-life champions can sleep easy. Stupak will take Sessions gently by the hand tonight and explain to him that while he agrees In Principle that women are just like smokers (and like bad teenage drivers too), fetuses have done nothing wrong and deserve to have the cost of their arrival fall squarely on the nation’s shoulders. It’s an unfortunate side effect that the smoker-driver carrying the fetus will receive care too, but that is one of those biological injustices to which we need pay no mind.

God Bless America. May we all someday be rich enough to have luxury windows and convertible uteruses of our very own.

*This is in some ways the opposite of the fungibility argument, which Aimai addresses nicely here.