Transcript: December 7, 2012

Need to Know
Episode 265
Airdate: December 7, 2012

ANNOUNCER [narration]: THIS IS NEED TO KNOW WITH … JEFF GREENFIELD… MARIA HINOJOSA…. RAY SUAREZ… AND THIS WEEK SCOTT SIMON.

SCOTT SIMON [narration]: ON THIS EDITION…CONTROVERSIAL BUDGET CUTS TO FAMILY SERVICES IN TEXAS.

SARAH WHEAT: This wasn’t a public health debate. This had a political goal.

WAYNE CHRISTIAN: It’s a drastic change. But to say that we just cut that all for health care for women I think is a fallacy.

SCOTT SIMON [narration]: HOW WILL THE TEXAS CASE PLAY OUT IN THE REST OF THE COUNTRY? AND FROM AMERICAN VOICES…

JUDY NORSIGIAN: It was simply women coming together, acknowledging their ignorance and saying we’re going to do something about this.

SCOTT SIMON [narration]: NEXT ON NEED TO KNOW.

FUNDER BED

SCOTT SIMON [narration]: Welcome to Need to Know. Thanks for joining us. A great deal of effort, rhetoric and spin in the weeks leading up to the last election was spent analyzing the votes of American women. Many believe those votes were key to President Obama’s re-election. But when it comes to what are often labeled women’s issues – including family planning and abortion — it might be that the 2010 mid-term elections were at least as important. In 2010, Republicans won a decisive majority in the US House of Representatives and in many state legislatures around the nation. And lawmakers in several of those states have cut funding to Planned Parenthood and other family planning organizations. That’s the case in Texas, where the budget for family planning services has been slashed by tens of millions of dollars for 2012 and 2013. Need to Know’s Mona Iskander traveled to Texas last summer and recently filed this report.

MONA ISKANDER [narration]: THIRTY-EIGHT-YEAR-OLD SARAH NUNEZ IS A RECENTLY DIVORCED MOTHER OF FIVE WHO LIVES IN COPPERAS COVE, TEXAS – A SMALL TOWN ABOUT 2 HOURS NORTH OF AUSTIN. SHE’S ALSO UNINSURED AND NEEDED TO FIND A CLINIC WHERE SHE COULD HAVE A GYNECOLOGICAL EXAM.

MONA ISKANDER: So you called how many places total?

SARAH NUNEZ: Ummm, let’s see, 1, 2, 3, 4, 5…

MONA ISKANDER [narration]: EVERY PLACE SHE CALLED WAS EITHER TOO EXPENSIVE OR DIDN’T PROVIDE THE ROUTINE GYNECOLOGICAL SERVICES SHE WAS LOOKING FOR. WHEN SHE FINALLY DID FIND ONE, SHE DISCOVERED SHE’D HAVE TO DRIVE 90 MINUTES TO GET THERE. AND GETTING THERE WOULD REQUIRE BORROWING MONEY.

SARAH NUNEZ: It costs me at least $20 to $30 in gas if not more. And then in time because I’m away from my children and I kinda had to say no to making some money today to go to this doctor’s appointment.

MONA ISKANDER [narration]: SHE MIGHT HAVE MADE IT TO HER TEMP JOB AND KEPT HER APPOINTMENT IF THERE WAS A WOMEN’S HEALTH CLINIC IN HER OWN TOWN. FOR 38 YEARS THERE WAS ONE.

BUT ON THIS HOT JUNE DAY THIS PAST SUMMER, STAFFERS PACKED UP SUPPLIES, EQUIPMENT, AND YEARS OF MEDICAL RECORDS AS THE CLINIC PREPARED TO CLOSE DOWN.

GINA: These are going back to the central office in San Saba. Medical records, medical records, big deal

MONA ISKANDER [narration]: THIS CLINIC WAS PART OF TEXAS’ PUBLICLY-FUNDED FAMILY PLANNING PROGRAM. IT PROVIDED BASIC REPRODUCTIVE HEALTH SERVICES FOR ABOUT 700 WOMEN A YEAR.

GINA: Having to close down, it’s a shame.
MONA ISKANDER [narration]: WOMEN CAME HERE FOR PAP SMEARS, CERVICAL EXAMS AND STD SCREENINGS… THEY ALSO GOT FREE OR DISCOUNTED BIRTH CONTROL.

MONA ISKANDER: Describe to me what the day was like, the day that you were closing this clinic

TAMA SHAW: It felt like the death of a child for me. Because I love this program. My heart was there. And it- and with the women that we- we helped so much.

TAMA SHAW: This is the lab area where we did all the work…

TAMA SHAW IS THE EXECUTIVE DIRECTOR OF THE HILL COUNTRY COMMUNITY ACTION ASSOCIATION, WHICH RAN THE CLINIC IN COPPERAS COVE.

TAMA SHAW: So, it’s going to place a big hardship on our- on our patients, who we’ve been seeing, some for 20, 30 years. They’ve been coming to us since they were young. And they stayed with us.

MONA ISKANDER [narration]: THE CLINIC LOST ITS FUNDING AFTER REPUBLICANS WON A MAJORITY IN BOTH CHAMBERS OF THE LEGISLATURE IN 2010, AND SLASHED FAMILY PLANNING FUNDS BY TWO THIRDS LAST YEAR DURING BUDGET CUTS.

THE PROGRAM USED TO OPERATE OVER A TWO YEAR PERIOD WITH OVER $111 MILLION IN FEDERAL AND STATE FUNDS. BUT, UNDER THE NEW BUDGET, LAWMAKERS DECREASED THE FAMILY PLANNING FUNDS TO JUST $37.9 MILLION. THE BULK OF THE MONEY WAS REALLOCATED TO OTHER PROGRAMS LIKE CHILDREN’S MENTAL HEALTH SERVICES, AN AUTISM PROGRAM AND CRISIS PREGNANCY CENTERS.

WAYNE CHRISTIAN: We selected the agenda and the items to put the money in areas that we believed in. Autism, nursing homes, other areas – we fought to make sure they were adequately as best possible funded. It wasn’t that those- those dollars were thrown away somewhere. They were put in areas that women, men, children care for.

MONA ISKANDER [narration]: WAYNE CHRISTIAN IS A SEVEN TERM REPUBLICAN IN THE TEXAS HOUSE OF REPRESENTATIVES. HE HELPED PUSH THE CUTS TO FAMILY PLANNING THROUGH THE LEGISLATURE LAST YEAR. BUT THE CUTS WERE CONTROVERSIAL, PROVOKIMG PROTESTS FROM CRITICS WHO SAID THEY WERE AN ATTACK ON WOMEN’S REPRODUCTIVE HEALTH…

WAYNE CHRISTIAN: There was no attack on family planning. There was no- it was a reallocation of the dollars.

MONA ISKANDER: But two-thirds, two-thirds of a program that was serving more than 200,000 women a year.

WAYNE CHRISTIAN: But, look-

MONA ISKANDER: Doesn’t that seem drastic to you?

WAYNE CHRISTIAN: Well- well, it’s a drastic change. But to say that we just cut that all for health care for women I think is a fallacy.

SARAH WHEAT: It’s basically taking a system that’s worked for 40 years that has been built up over 40 years and really shredding and dismantling it overnight.

MONA ISKANDER [narration]: SARAH WHEAT IS THE VICE PRESIDENT OF COMMUNITY AFFAIRS FOR PLANNED PARENTHOOD OF GREATER TEXAS. IT WAS ONE OF THE LARGEST PROVIDERS OF FAMILY PLANNING SERVICES.

SARAH WHEAT: Family planning programs are incredibly successful. They help keep women healthy. They help women bring healthy new children into the world.

MONA ISKANDER [narration]: BUT WHEN THE FAMILY PLANNING FUNDS WERE REDUCED, DOZENS OF FAMILY PLANNING CLINICS CLOSED DOWN, SOME AFFILIATED WITH PLANNED PARENTHOOD AND SOME NOT – LIKE THE ONE IN COPPERAS COVE. THE ABSENCE OF THESE CLINICS IS EXPECTED TO DIRECTLY AFFECT UNINSURED AND LOW INCOME WOMEN WHO LIVE IN POOR AND RURAL AREAS OF TEXAS.

SARAH WHEAT: This wasn’t a public health debate. This wasn’t something where nurses, doctors, community health workers came together and- and sort of re-prioritized. This was- this had a political goal.

WAYNE CHRISTIAN ACKNOWLEDGES THAT HE AND OTHER REPUBLICAN LEGISLATORS’ PRO-LIFE AGENDA DID COME INTO PLAY WHEN REVIEWING THE BUDGET. AMONG THEIR TARGETS: PLANNED PARENTHOOD. HE SAYS THE ORGANIZATION IS RESPONSIBLE FOR ENCOURAGING ABORTIONS.

WAYNE CHRISTIAN: There’s wrongdoers in all different areas of life. But Planned Parenthood in more than one location and activity has been shown to be not handling the situation like the public thinks they are of just giving people- giving young girls just the full story and full information. I mean, why- why not give them information on- on adoption? It would take care of a pregnant girl, the baby, try to help them, provide them with whatever their needs are?

MONA ISKANDER [narration]: BUT PLANNED PARENTHOOD’S STATED MISSION INCLUDES A COMMITMENT TO PROVIDE “…COMPREHENSIVE REPRODUCTIVE AND COMPLEMENTARY HEALTH CARE SERVICES…” AND CLINICS THAT PROVIDE ABORTIONS ARE BANNED FROM RECEIVING ANY FAMILY PLANNING FUNDS.

MONA ISKANDER: Legally, Planned Parenthood – cannot use those funds for abortions.

WAYNE CHRISTIAN: You know, if I’m- if I’m sitting here with this money here and say, “Okay, I’m hiring staff and secretaries, et cetera, and I have this much money.” And I come in and- but with this hand over here I’m performing abortions. Any way you go about it, that organization has more money. And so, that’s more money to do what? We’d use the federal money, so we’ll just move this money we’re doing with administration over here to this pocket and perform more abortions. So, it’s a shell game.

MONA ISKANDER: So, the GOP lawmakers have said that they don’t believe that organizations like Planned Parenthood can actually keep their funding for health care separate from their funding for abortions. And they think that family planning money is just a funding stream for the abortion clinics. What do you say to them?

SARAH WHEAT: Our books are poured through and gone through line by line by auditors that the taxpayers pay for. So, were there an issue where funds were being misused, I mean, I think we would all, you know, be aware of that and we would address that. If you are opposed to abortion being available and legal in this country, that is absolutely, you know, that’s your right. And there are certainly things that you can do. But defunding cervical cancer screenings, annual exams, HIV tests, birth control for uninsured women doesn’t in any way help make abortion less accessible.

MONA ISKANDER [narration]: THE FACT IS THAT OF THE CLINICS THAT CLOSED, NOT ONE PROVIDED ABORTIONS.

MONA ISKANDER: None of them perform abortions. None of them.

WAYNE CHRISTIAN: Yes, but they’re ju-

MONA ISKANDER: So, is that- does that public policy makes sense?

WAYNE CHRISTIAN: Well, but understand – if you go somewhere that’s a recruiting office for an aborting facilities. And they recruit people and that’s what-

MONA ISKANDER: What do you mean recruit?

WAYNE CHRISTIAN: That means if ladies go to those Planned Parenthood clinics that were closed then their option is given them of having an abortion. In fact, they’re encouraged to have an abortion.

MONA ISKANDER: Are they given the option or are they encouraged? I mean.. isn’t it…

WAYNE CHRISTIAN: It’s one and the same. They go there… And our job as pro-life legislators is to make sure we fund the pro-life agencies that take care of life.

MONA ISKANDER [narration]: TAMA SHAW OF THE HILL COUNTRY COMMUNITY ACTION ASSOCIATION BELIEVES THAT SMALL CLINICS LIKE HERS IN COPPERAS COVE SIMPLY GOT CAUGHT IN THE CROSS HAIRS.

TAMA SHAW: We were the collateral damage. We just were in the wrong place at the wrong time and got caught up in the- in the legislature trying to close down Planned Parenthoods.

MONA ISKANDER [narration]: LAST YEAR SHAW EVEN MET WITH LEGISLATORS TO TRY TO MAKE HER CASE THAT FUNDS SHOULDN’T BE CUT, BUT ULTIMATELY IT WAS NO USE.

TAMA SHAW: We didn’t have a dog in this fight, as they say in the South. And so, we lost. And the women lost. The women we served lost the most.

MONA ISKANDER [narration]: IN MAY OF LAST YEAR, THE STATE’S OWN NON-PARTISAN LEGISLATIVE BUDGET BOARD ESTIMATED THAT THE CUTS TO FAMILY PLANNING COULD RESULT IN MORE THAN 20,000 ADDITIONAL UNPLANNED BIRTHS WHICH WOULD COST MEDICAID OVER $230 MILLION DOLLARS.

BUT WAYNE CHRISTIAN BELIEVES THAT EVEN AS DOZENS OF CLINICS HAVE CLOSED, WOMEN ACTUALLY HAVE BETTER OPTIONS FOR HEALTHCARE NOW. HE AND OTHER LAWMAKERS DIRECTED MOST OF THE REMAINING FAMILY PLANNING FUNDS TO GO TO LARGER HEALTH CENTERS LIKE THIS THAT COVER A WIDER RANGE OF SERVICES, LIKE PRIMARY CARE, OBSTETRICS AND DENTAL CARE.

BUT THE REALITY IS THAT MOST OF THOSE CENTERS NOW OPERATE WITH LESS MONEY AND MORE PATIENTS.

DR. THOMAS PHELPS: It’s like controlled pandemonium sometimes. It’s- it’s busy. The waiting room’s busy. We move a lot of patients through.

DR. THOMAS PHELPS RUNS THE OBSTETRICS UNIT AT THIS HEALTH CENTER LOCATED ABOUT AN HOUR NORTH OF AUSTIN. THIS CENTER LOST ABOUT 65% OF ITS FUNDING WHENTHE FAMILY PLANNING CUTS WERE MADE LAST YEAR. AND WHEN FAMILY PLANNING CLINICS CLOSED NEARBY, PHELPS SAYS HIS JOB BECAME HARDER.

DR. THOMAS PHELPS: Instead of them taking care of, like, the bread and butter things, the normal annual exams, STD checks, birth control, now those patients are- we’re starting to see them here. So, that just increases the load a little bit.

MONA ISKANDER: Is that manageable?

DR. THOMAS PHELPS: We’re managing. We do whatever we can. We’re not- we’re not immune to this, to having the cuts. But this is one of the larger cuts. That affected us as well. But we have patients that come from pretty far away.

MONA ISKANDER [narration]: SARAH NUNEZ IS ONE OF THOSE PATIENTS. HAVING ACCESS TO TRANSPORTATION ENABLED HER TO GET BIRTH CONTROL AND GYNECOLOGICAL SERVICES. BUT SHE SAYS THAT OTHERS IN HER AREA MIGHT NOT BE SO LUCKY.

SARAH NUNEZ: This is a pretty big state and cutting that type- especially out in the country where I live, you know, is a big deal. And I just worry about teens and young adults who don’t have the opportunity to get health care and to be educated.

MONA ISKANDER [narration]: JUST A MILE DOWN FROM NUNEZ’S HOUSE, THE FAMILY PLANNING CLINIC IN COPPERAS COVE IS NOW OFFICIALLY CLOSED AND HAS BEEN TURNED INTO A CHILD DEVELOPMENT CENTER. EXECUTIVE DIRECTOR TAMA SHAW SAYS THAT THERE IS NO WAY TO REVERSE WHAT HAPPENED.

TAMA SHAW: And the sad part is once we’re dismantled, we won’t be able to start up again. It’s kinda sad to see it disheveled right now… but I did a lot of work here back in the day

MONA ISKANDER [narration]: AND SHE DOESN’T ANTICIPATE THAT THE FUNDING WILL EVER BE RESTORED FOR CLINICS LIKE HERS. SHE’S ALSO HEARD FROM OTHER CLINIC DIRECTORS WHO ARE IN DANGER OF CLOSING IN THE MONTHS AHEAD.

TAMA SHAW: I’m afraid that the- that day of reckoning is going to come when they realize that all of these women who can’t afford children are going to have children and the sexually transmitted infections are going to run rampant. Because that’s something we screened for. There’s just many, many bad outcomes that I don’t think was thought about when the decision was made to close down clinics such as ours.

SCOTT SIMON: Is what’s happening in Texas unique to that state? For more about this, we’re now joined by Pam Belluck. She is a health and science writer for The New York Times. For the past year, much of her work has been women’s health and family planning issues.

INTERVIEW WITH PAM BELLUCK

ANNOUNCER [narration]: THIS WEEK ONLINE… TAKE PART IN OUR WEEKLY POLL…THE TOPIC: GOVERNMENT FUNDING OF FAMILY PLANNING. And Emily Ranshaw, editor of The Texas Tribune, on the history of family planning in Texas.  LET US KNOW WHAT YOU THINK AND WHY. VISIT PBS.ORG/NEED TO KNOW.

SCOTT SIMON: And now to our “American Voices” segment featuring essayists with diverse voices and diverse points of view.

JUDY NORSIGIAN: The Library of Congress recently named Our Bodies, Ourselves as one of 88 books that shaped America. It’s had a profound impact on our consciousness, on the– ability of women to see the importance of asking questions.
Back in the late ’60s and early ’70s, there was nothing, nothing out there. There was so little information, even college educated women knew very little about our bodies, about pregnancy, about birth, about birth control.

And it was out of that dire need to educate ourselves that we created what was a wonderful self-help project. It was– simply women coming together, acknowledging our ignorance, and saying, “We’re gonna do something about this.” So the group in Boston, which formed after a women’s liberation conference in 1969, continued to meet, went to the Countway Library at Harvard Medical School, talked to the few physicians who were responsive and nurses and others who wanted to work with us in educating ourselves.

We ultimately translated into lay language some fairly technical jargon. And we, over the years, began to see that much of what was done in OBGYN wasn’t even evidence-based that we started to adopt a public health perspective, began to work with those kinds of researchers, and say, you know, “We have a right not only to know how our bodies work, but to have the kind of research done that establishes an evidence basis for the drugs we take, for the surgical procedures that are performed.” And now we see much more of an evidence base to much of women’s health care.

When Our Bodies, Ourselves first came out, it was a newsprint booklet, put out by the New England Free Press. Between December of ’70 and about March of ’72, it sold like hotcakes. It was word of mouth, several hundred thousand copies. And it’s because of its popularity that several commercial publishers immediately became interested.

We ultimately decided to create a contract with Simon and Schuster, whereby the book would be available at a 70% discount to those clinics and educational organizations that did health counseling in a nonprofit setting. And this made the book available to many low-income women.

Over the years, we saw repeated attacks on good sex education. So much so that we then ended up with federally-funded abstinence-only sex education in many of our schools. And the damage done there is still showing, well into the 21st century. I’ve met professors at medical schools who have said incoming medical students have said that using– condoms promotes HIV/AIDS. And that comes straight from their abstinence only sex-education in high school.
There is no question that right now the majority of low-income women have access to reproductive health services like S.T.I. screening and services only because we have federally-funded clinics, including Planned Parenthoods. Without those federal funds, without that kind of public support, a huge swathe of this country is not gonna be able to go and access basic reproductive health information.

So we’ve got to educate our members of Congress. We’ve got to educate incoming college students who really need information like that in Our Bodies, Ourselves, and hope that they will pass on the valuable sources of information this book, the websites that really tell it like it is, and make sure that we don’t step backwards, after so many years of working hard in these arenas.

SCOTT SIMON: That’s it for this edition of Need to Know.  For more please visit us at PBS.org/ need to know, and don’t forget to take part in our weekly poll while you’re there. Ray Suarez will be with you then.  I’m Scott Simon, thanks for watching.

 
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