Texas Reproductive health, in a sad state.

Abstinence. The only 100% effective way to avoid unwanted pregancy and STDs. It's great until it isn't.

A ten year study by Mathematica Policy Research Inc |
2 showed that abstinence only education was not more effective in preventing sex among students, and beyond that, other studies show it was ineffective at preventing unwanted pregnancies.

...[A] paper by researchers at Columbia University and the Guttmacher Institute, published in the January issue of The American Journal of Public Health, attributed 86 percent of the decline to greater and more effective use of contraceptives — and only 14 percent to teenagers’ deciding to wait longer to start having sex.

Source: http://www.nytimes.com/2007/04/28/opinion/28sat1.html
Study: http://www.ajph.org/cgi/content/abstract/AJPH.2006.089169v1

14% versus 86%. The vast majority of people are going to have sex, eventually. They need to know what works. And it's not just unintended pregnancy. It's STD's as well.
As the APA puts it

Research shows that one in five adolescents will have sex before the age of 15 and most who continue to be sexually active do not use condoms consistently. Although some youth acknowledge their fears about HIV/AIDS, many do not perceive themselves to be at risk and lack accurate information about what circumstances put them at risk for HIV infection.

Over and over, we find evidence that comprehensive sex education is the only way to improve chances that those having sex, do it safely.

Texas continues to use an abstinence focused sex ed program. While Federal funding may require such a curriculum, how much is such an ineffective policy costing us in the long run? Be it in the health costs of mothers, or possibly the cost of the state raising foster children, sexually transmitted disease, or any other long term impacts that ineffective education may have.




On access to to alternative and emergency plans.

The Guttmacher Institute Ranked Texas very poorly in sexual health policies:

Among the 50 states and the District of Columbia, Texas ranked
* 43rd in service availability;
* 48th in laws and policies;
* 19th in public funding; and
* 45th overall.

Source: http://www.guttmacher.org/pubs/state_data/states/texas.htm

What's a straightforward way to help Texans gain access to reproductive health and treatment? For one, we could make sure that they have access to birth control

There have already been cases in Texas of a pharmacist refusing to dispense birth control on moral grounds, including "Plan B". And in at least one case, this was not in the usually expected case of condom failure, or other consensual actions, it was a the victim of a sexual assault.

Source: http://www.kvue.com/news/state/stories/020304kvueprotest-jw.7c050c55.html
Source: ocw.mit.edu



Some states (Wisconsin and Illinois among others) have already passed laws obligating a pharmacist to dispense prescriptions for birth control, clarifying existing laws obligating them to dispense prescriptions that would not cause harm to the patient. In other words, obligating them to do their jobs. And this is supported by the vast majority of Americans.

A November 2004 poll conducted by CBS News and the New York Times found that eight out of ten Americans believe that pharmacists should not be permitted to refuse to dispense birth control pills.

Source: http://www.cfpa.org/issues/issue.cfm/issue/PharmacistRefusals.xml#endnotes

By preventing access to birth control pills or Plan B on the grounds that they cause abortions (Which is patently untrue), they increase the rate of unwanted pregnancies, and therefore abortions.

Isn't Texas based on independence? Let the people own their own bodies, let them own the choices and consequences of what goes on with them.

Emergency Room care is a national policy, but the price tag is very local.

Young: Rethink the emergency-room logic when it comes to health care

"People have access to health care in America. After all, you just go
to an emergency room."

— President Bush

That's right, Mr. President. And thanks for pointing out what's wrong
with a status quo you've done almost nothing to alter. Welcome to the
ER. It is America's answer to a phony debate. Health care: Is it a
right? Of course it is.

Bush, in that quote, is referring to
EMTALA, a policy that seems absolutely reasonable on its face (It specifies that a person cannot be refused emergency medical care at an ER, regardless of their citizenship, ability to pay, etc). But despite being mandated at the federal level, there is no federal funding specifically to cover the uninsured who arrive at the E.R.

The association's "Texas Medicare Manifesto" demands reimbursement rates that keep up with the cost of providing services. The National Governors Association sounds just as furious. It has denounced Medicaid regulations proposed by the Bush administration to shift billions of dollars in costs to the states. Where states don't pick up the slack, hospitals and ERs will.

That's how everyone ends up paying for the uninsured. Stop assuming the free market will resolve this.

This is not just a problem of uninsured citizens.
For example, if an illegal immigrant goes into labor, they can go to the local E.R. for their delivery. Since they're likely working illegally, they're almost certainly going to be uninsured. The costly price of that delivery is never paid for, and the hospital eats those costs, which they have to make up elsewhere.
I understand that illegal immigrants are paying huge amounts of taxes for government services that they never use (like 7 Billion dollars in Social Security a year) but these funds are not directly connected to the services they DO use.
The uninsured man unable to go in for check ups who then suffers a massive heart attack is a tragedy that could have been avoided, and a huge expense that will need to be paid. That he will even live long enough to collect social security is in question.

But when it comes to the cost of national coverage, statists' concerns about the price tag are disingenuous. We already pay for the uninsured through hospital costs and insurance rates. If more had health insurance, with real preventive care and health maintenance, we would have a healthier country with fewer pressures on hospitals and health-care costs.

The illegal immigrant angle is the only aspect missing from John Young's article that I can see, but since the list of "Gotcha's" on healthcare reform is so long, I can understand missing it, or deliberately omitting such a complication from this solid commentary. It'd confuse the message he's presenting, the the ER is not a local doctor's office, nor a health insurance fix.

The ER is expensive, it's "cataclysmic" care, for the unexpected tragedies. We don't rely on just the fire department to control fires in the home. We have smoke detectors, fire extinguishers, buckets of sand. It's far cheaper to keep a clean stove than it is to have the fire trucks hose down your burning home.

My personal point is, there will need to be ways to pay for everyone for health care reform to work. Taxing even low income workers (illegal or legal) directly will at least make sure there is some system in place for them, so that their first visit to a doctor is at an earlier, safer, cheaper time than when they have to be driven there in all-too-expensive ambulance.