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Fostering Abortion With Soviet Gusto

• October 07, 2009 • 12:03 PM

One way America resembles the old Communist bloc can be found in the nexus of abortion and public health care.

Europe, of course, is a decadent place where spoiled, cheese-eating hedonists tolerate socialist taxation and sexual perversion of almost any kind. European national health systems even pay for abortions.

President Obama has tried to be very clear that any American system won’t — “Under our plan,” he told Congress on Sept. 9, “no federal dollars will be used to fund abortions” — but that hasn’t kept the issue from flaring up.

An amendment to strengthen anti-abortion language in the controversial Baucus bill was voted down by the Senate Finance Committee on Sept. 30. Republican senators argued that the bill would allow health plans with government subsidies to offer elective abortion. That would be illegal, though — federal law already prohibits federal money from flowing to abortion doctors. The hitch is that Congress has to renew the prohibition every year, and the anti-abortion senators were trying to make the ban permanent.

Europe confronted this problem a generation ago. (“Solved” is not the word.) It now has a patchwork of abortion policies: Catholic nations like Ireland, Poland and Spain have tighter laws than others — the mother, in general, has to prove a threat to her health — and Malta prohibits any abortions at all. Some Protestant-minded countries cover the procedure at no cost through their medical programs (Denmark, the Netherlands); others, like Germany, don’t. French national health schemes have covered the procedure since the ’80s, but French law also lets doctors “conscientiously object” to performing it.

So Europe is less predictable than it seems. I happen to think public money shouldn’t fund abortion, but abortion rates don’t seem to depend on whether it does or not. In fact, one transatlantic trend is as clear as it is consistent: More abortions happen in America.

In 2007, the United Nations recorded a (falling) rate in America of 20.8 abortions per 1,000 women between 15 and 44 years old. Meanwhile, rates were 7.8 in Germany, 10.4 in the Netherlands and 16.9 and 14.3, respectively, in France and Denmark —the highest in Europe. The transatlantic gap has narrowed; in the ’90s the American rates were higher and the European numbers lower.

So what accounts for the difference? Well, teen pregnancy — rates in America are much higher than rates in Europe — and, of course, contraception.

European kids are both more frank about sex and less promiscuous, according to Advocates for Youth, an American group that compares U.S. and European policies on adolescent sexual health every year. That means they’re more likely to buy condoms and pills, which are advertised freely on billboards in European cities and easier to obtain through national health plans. European kids, overall, also receive better sex education.

The spur for these policies in Europe was the AIDS epidemic in the ’80s and ’90s. “A national desire to reduce the number of abortions and to prevent sexually transmitted infections, including HIV,” reads one conclusion by the group in 2001, after looking at policies in Germany, the Netherlands and France, “provide[d] the major impetus in each country for unimpeded access to contraception, including condoms, consistent sexuality education and widespread public education campaigns.”

The more American pattern of high teenage pregnancy, high rates of abortion and low contraception was also typically communist. Abortion rates have plummeted in Eastern Europe since the fall of the Wall because of a generally higher standard of living and more access to good contraception, according to the U.N. But Russia still has one of the highest abortion rates in the world — 53.7 per 1,000 women in 2007.

The reason abortion became so popular in the Soviet Union had to do with both dogma and poor health care management. It’s a cautionary tale for the U.S. “First, Soviet ideology hindered the development and spread of effective contraception,” writes a Rand Corporation report on Russia. “Second … until the late 1980s, obtaining a legal abortion required a subsequent three-day hospital stay, a boon to Soviet hospitals financed by their number of occupied beds.”

So that’s one thing to look forward to if Congress passes a functioning health care plan (a big if) — a culture war over whether Washington should pay for contraception. The abortion question can be left where it is, on the floor of the Senate Finance Committee, but condoms for American kids might just be one of those preventative public-health measures — like mosquito nets in Africa — that are both inexpensive and eminently sane.

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Michael Scott Moore
Michael Scott Moore was a 2006-2007 Fulbright fellow for journalism in Germany, and The Economist named his surf travelogue, "Sweetness and Blood," a book of the year in 2010. His first novel, "Too Much of Nothing," was published by Carroll & Graf in 2003, and he’s written about politics and travel for The Atlantic Monthly, Slate, the Los Angeles Times, and Spiegel Online in Berlin, where he serves as editor-at-large.

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