The confrontations between the GOP, the Democrats and their supporters in this health care debate have reached hysterical proportions. But not once in all the media coverage have I heard a conservative Republican pontificating on the sacredness of the doctor-patient relationship asked how one reconciles that position with the governmental restrictions their party has championed on women's health care for the better part of three decades.
Senator Chuck Grassley (R-IA) is one of the Gang of Six, the three Republican and three Democratic senators charged with hammering out a health reform compromise. Speaking to Iowans recently, he set himself apart from those who think that "when Grandma's lying in a hospital bed with tubes in her," government policy has a place, by declaring: "I am just the opposite." In a recent NPR interview, he singled out, as markers of progress in making health care reform more palatable to Republicans, his caucus's staunch opposition to rationing care and its insistence on "no interference in the doctor-patient relationship."
Carrying the banner for patients' rights on the subject of end-of-life care, Senator Tom Coburn (R-OK) passionately declared on Meet the Press that "The idea that we ought to talk about our future health and what our family and what we want done is a good idea, it's legitimate. What is not legitimate is having the government even weigh in on it. It is intensely personal, your health care, your plans, your family. There is no role for government in it."
What's stunning is that these are the same people who, with their party, have brought us an avalanche of governmental regulations dictating the availability of women's reproductive health care. It's even more stunning that the media is failing miserably to call them on it.
Indeed, conservative Republicans have spent years limiting the access of American women to birth control, emergency contraception, and pregnancy termination services, while requiring expensive medical tests, irrespective of medical need, and literally putting words into doctor's mouths in order to impede if not prevent women from getting reproductive health care.
Grassley has a 100 percent rating from National Right to Life Committee. Call it by any other name, but he's apparently quite content letting government ration women's reproductive health care, enthusiastically supporting efforts to withhold access to a legal procedure, to family planning services, and to birth control.
Coburn has the dubious distinction at this moment of being from the first state in the Union where Republicans are fighting -- first in the legislature, now in the courts -- to pass a uniquely onerous law. As one of its elements, the law would require that any woman who chooses to end a pregnancy have not just an abdominal ultrasound -- irrespective of medical need--but that she have a transvaginal ultrasound, if that would "display the embryo or fetus more clearly."
It's hard to imagine any test more "intensely personal" than a transvaginal ultrasound. It is an extremely invasive test wherein the woman lies half naked on an examining table while a cold, plastic probe is inserted inside her and painfully maneuvered for image clarity.
According to this legislation, the woman has no right to refuse -- even if her pregnancy is the result of rape or incest. Here's her choice: an invasive sodomization with a transducer, upon orders of the State, or carrying an unwanted pregnancy to term.
Nor does her doctor have a right to refuse. If the woman is terrified, does not want a transvaginal ultrasound, or has already suffered forced penetration, her doctor is helpless to protect her. If the doctor does refuse to do the test, he or she can be fined $10,000, have his or her license suspended or revoked, or be sued by the woman, the spouse, parent, sibling, guardian, or "current or former licensed health care provider" -- this from the party that fights so vociferously for tort reform. (The statute generously adds that the woman will not be prevented from "averting her eyes," and that if she does, neither she nor her doctor will be subject to prosecution.)
Beyond the facile dismissal of pregnancy termination as a covered service, thereby restricting access to a safe, legal procedure for hundreds of thousands of women each year, what has happened with women's reproductive health care in this country, despite its pertinence to health care reform, is essentially invisible in this debate. Yet we have to ask: Would people stand for it if the health care reform model being promoted gave the State the power to mandate a non-medically indicated, invasive, costly test as a prerequisite for the open heart surgery Grandma needs to save her life? If it countenanced State mandates forbidding her to refuse to have the test or the doctor to refuse to give it? If it put words into her doctor's mouth?
While many are fretting over the notion of a government takeover of health care in the spirit of Big Brother, for women in America, in the area of reproductive health care, that takeover has already occurred.
It's time this came up in the health care reform conversation.
This piece was written for The Women's Media Center website, a non-profit organization founded by Jane Fonda, Gloria Steinem, and Robin Morgan, dedicated to making women visible and powerful in the media.