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This paper is the final paper for the public administration course, PPA601 Foundations of Public Administration / Ashford University/masters of Public Administration.
Public Policy Issue/Controversy (Public Administration)
Title of Paper
The paper seek to explore the factors effecting abortion as a public policy issue; a case study of the United States of America. The topic has been a matter of controversy facing the US for over decades. It has dominated the flour of the US parliament, the media, and the placards of the activists. Abortion is legalized in the country though there are some individual states that have enacted laws that make abortion illegal. The study gives reasons why women consider abortion over giving birth and also the pro and cons of abortion. The paper also seeks to explain the cost of abortion to the US economy. In conclusion, it explains policies that can be effective in curbing the abortion menace in the country. The policies are also evaluated to see if they are administratively feasible and their sustainability is also assessed.
According to Anderson, J. E. (2014), abortion can be defined as the premature ending of a pregnancy by way of removing the embryo or fetus before it can be able to hold and survive outside the uterus. The subject of abortion has been full of controversy for many decades. The paper will explore the factors effecting abortion as a public policy issue; a case study of the United States of America. There are those who feel that abortion should be abolished, other feel it should be legalized (Finer, L. B., & Zolna, M. R. 2014). Abortion can be spontaneously or inform of a miscarriage or an induced abortion. The paper will focus on the induced abortion which is a public issue of controversy. An induced abortion can happen in the following ways can be therapeutic; that is abortion done out of some medical reasons. There is another type of induced abortion that happens out of the request of the woman for non-medical reasons. The paper will majorly focus on the latter and critically address the public policy concern.
It is also noteworthy to state that abortion in the federal government of the U.S is legal according to the landmark case of Roe vs. Wade (Baumgartner, F. R., Jones, B. D., & Mortensen, P. B. 2014). The decision concluded that abortion is illegal but individual states have the power to restrict the practice to a varying degree. Conversely, there are states that have created laws to make the act of abortion illegal. There are six states that have already criminalized abortion while others are in the process of outlawing abortion. The paper will also look at the right of an individual to make a choice to abort and also analyze on legal rights of the fetus.
Reasons for Abortion
The key reason for performing abortions is lack of enough funds to raise the kid (Watt, H. 2016). The other reason associated by the women is lack of readiness to partake the task of raising the kid. The other popular concern is the change in women life in terms of age, and lack of a stable relationship. Abortion can also be done when there is health problems associated with the mother or the fetus. In case of teenage pregnancy, they may fear the violence reaction by the parents. They may also consider the effect of abortion on their academic life. The financial constraints and the fear of rejection by the society are also some of the underlying reasons that can prompt them to procure an abortion.
Pros and Cons of Abortion
Pros – it helps to protect and defend the health of the woman. Abortion safeguards the right of parents to make a decision on whether to keep or not keep the child. It assists them to keep check of the family size so as to have that which they can manage. In a mental retarded lady, abortion may be an option if it was due to rape.
Cons – It can result to medical snag such as recurring or repeated miscarriage, sepsis, and infection. It can badly injure or have a worse impact on the mental status of the woman. It can make her depressed resulting to numerous mental ailments (Finer, L. B., & Zolna, M. R. 2014). The practice is unethical and can lead to a couple behave in a reckless manner. Lastly, abortion practices can be termed as s viciousness or brutality. The religious institutions do not allow abortion as it diminishes the right of the fetus to life.
Roe vs. Wade
The Roe vs. Wade (1973) is a milestone decision that was made by the supreme court of the United States of America. The decision was unanimously agreed by seven out of nine judges that were tasked with making the verdict. The decision gave women a right to make decision regarding abortion. Nevertheless, the rights must be enshrined against the two interests that the states hold that include protecting the health of the woman and the protection of human life (Baumgartner, F. R., Jones, B. D., & Mortensen, P. B. 2014). The case is the foundation of the debate that questions to what extent is abortion lawful, the person tasked with deciding the legality of abortion, the methods that the Supreme Court should consider in constitutional decree, and the role of religious and ethical views in the political scope. The Roe vs. Wade divided the nation into pro-choice and pro-life movement that activated grassroots activities to discuss the issue.
History of Roe vs. Wade Case
The case started when one lady by the name Norma L. McCorvey discovered that she was expectant with her third kid. The period was in June 1969. Norma returned to Dallas, Texas where her friends suggested to her to falsely claim that she had been raped in order to be granted the legal right to procure an abortion. The woman had a full understanding that Texas granted/allowed abortion in case of rape or incest. The woman on attempting an unlawful abortion found that the facility had already been closed by the authority.
The ploy did not succeed as there was no any documentation to show the purported rape. However, McCorvey filed a suit against the Dallas District Attorney through Linda Coffee and Sarah Weddington. The plaintiff in this suit retrieved her claim that the pregnancy wasn’t as a result of rape. The case was decided by a three-judge board who declared unanimously that the Texas laws were unconstitutional. At the time of verdict, McCorvey had already conceived the child. They judges stated that the decision violated the privacy rights of the woman. However, the court refused to grant an injunction to hinder the execution of the law.
Pro-life vs. Pro-choice
The American has dwelt over the abortion issue for decades. The major concern is answering the question of abortion as a moral issue. The precarious issue is to agree on when life begins. The pro-life believes that life begins at conception and abortion is comparable to murder. The pro-choice argues that women have the right to abort because they have control over their bodies. They maintain that legalizing abortion will make the US formulate policies and ways of securing safe abortions (Watt, H. 2016). It will also eliminate death and trauma of proscribed abortion. The controversy has shifted from the rights of women to abort and the right of child to live and now it’s focusing on the social implication of abortion.
Decline in Fertility and the Urge for Abortion
There is a serious public health responsibility that comes with unwanted and unplanned pregnancies (Anderson, J. E. 2014). Abortion is seen to work as a contraceptive or as one of the means of reducing fertility. The common reason for abortion is failure of contraceptives thus leading to unwanted pregnancy. In the US, abortion is used by women when a contraceptive fails.
Abortion and Morality
According to Baumgartner, F. R., Jones, B. D., & Mortensen, P. B. (2014), the Christian teaching forbids the destruction of life by abortion. In most society, the act is seen as a dreadful and awful action. There is major prohibition and sanctions against anybody who kills a fetus, an infant, a child or an adult. In legal term, the fetus becomes a human person when it’s born. Conversely, the society and the church view the fetus as a life when it starts developing in the mothers. The moral and ethical position is determined by the definition of persons regarding the time life starts. The prolife also support the church by supporting the argument that life starts at conception and performing abortion is same as killing or committing murder. The prochoice have no concern on morality and argue that abortion will occur whether it’s illegal or immoral. Therefore, they conclude that it’s better to legitimize abortion so as to provide safe methods that will save the life of the women.
Stakeholders and affected Constituencies
According to Finer, L. B., & Zolna, M. R. (2014), there are a number of stakeholders and affected constituencies on this issue. The federal and the state governments have the greatest burden on the issue. The media has been part of the struggle in the abortion debate as it has been highlighting the plight of women. The young population is the major affected constituency in the US. The social activists are also a player in the issue. In addition, the institutions of learning are where majority of these issues occurs.
Stem-cell research is a medical possibility that is creating new-fangled constituencies. The members are likely to benefit from the dissertation by undermining the holiness of the embryos. The abortion debate is largely about interests that women hold in different life situations. It has also not changed the cast of partakers as it has been stable over a period of years. Nevertheless, the impending medical advances by the use of the term fetal tissue bring new accomplices to the debate. It is unthinkable that the addition of new interest and partakers in the public debate about the unborn life would not alter the treatise in a major way (Watt, H. 2016). Correspondingly, opposition to bio-technology innovations has generated a left-right coalition flanked by environmentalists and conventional Protestants. The conflict draws political conscription that makes it easy for essential alteration.
The Political Institutions relevant to the policy discussion about Abortion.
The topic is a complex and intricate one that affect population, parental consent, freedom, and sacrosanctity of life. In the political context, abortion is seen as an individual privacy right. Due to the following issues, it’s true that political institutions are part of advancement and enactment of abortion policies.
The function of Political Institutions in shaping the Law
In the US, the judicial system has been politicized. The US Supreme court espoused the federal law that burned abortion policies and gave politicians the right to inhibit the private healthcare choice of women and families. The other venues that the reforms can be addressed are a critical issue on the political circle. The professional bodies that have the power to redress the issue have associated themselves to the state. That has led to the professional bodies such as the American Medical Association allow abortions but with little restrictions. Thus, the issue moved from a medical one to a political issue (Finer, L. B., & Zolna, M. R. 2014). The issue has been long been discussed by state and federal legislatures, governors, judges, and politicians. That has led to reduction in abortion practices due to a decline in public spending. The political institutions have led to abortion being recognized as a citizen’s right rather than a medical obligation. The government has over years listened to both the pro-life and pro-choice resulting to endless debate on the issue.
Abortion issue both at the Federal Government and State Government
The issue of abortion faces both the federal government and the state government. The federal government ban abortion that is in its second trimester of pregnancy. The ban affects the women who are in need of second trimester abortion and the medical practitioners who help them procure an abortion. The reason for this is that it is the safest way to protect the health of the women. The decision by the Supreme Court to abolish abortion was to ensure that the women’s health was given precedence (Anderson, J. E. 2014).
The states have also followed the precedence set by the federal government. They are making rules to restrict or ban women from practicing abortion. For instance, Trent Franks, the representative of Arizona has been in the forefront to push for a bill that will prohibit abortion after 20 weeks in the District of Columbia.
The Public Issue and the Cost to the Americans
The truth of the matter is that the American taxpayers are compensating for abortion. It estimated that they bankroll about 24 percent of the cost of abortions in the US. The 6.6 percent of the cost is borne by federal taxpayers while 17.4 percent is borne by the taxpayers from states. The sum covers for 250,000 abortions in a year which represents 70,000 for federal taxpayers and 180,000 is financed by the taxpayers in the states.
The state under Medicaid is a federal version of the Hyde Amendment that allows the government to fund abortion that results from rape cases and incest. The fund is also used when there is life endangerment in the side of the women (Watt, H. 2016). Medicaid only permit the women to pay for the abortion fee incase her life is threatened by physical illness, injury and disorder that is as a result of the pregnancy. The Hyde Amendment has not unequivocally banned the federal funding for abortions. If the restrictions aforementioned were not there, the Medicaid would be accountable to about 300,000 to 500,000 abortions annually (Baumgartner, F. R., Jones, B. D., & Mortensen, P. B. 2014).
Preventing Taxpayers from Subsidizing Abortion
The Obama health care law seeks the states to offer a health insurance exchange or let the federal government help them set one. The health insurance that offers coverage is permitted to partake in a state’s exchange and be granted the federal subsidies. It is in exemption of any state laws that are legislated to abolish abortion. In the Obama care law, it authorizes the respective states avert the abortion coverage in the exchanges. The following are states that restrict abortion coverage ploy in the interchange: Wisconsin, South Carolina, Virginia, South Dakota, Utah, Pennsylvania, Virginia, Tennessee, Alabama, Mississippi, Arizona, Missouri, Florida, Indiana, Missouri, Idaho, Kansas, Michigan, Kentucky, South and North Carolina, and North Dakota.
Affordable Care Act
The Affordable Care Act (ACA) includes provisions that affect the abortion services. There is the essential benefit that inaugurates the least level of benefits that individuals must be offered in an abortion incidence. Nevertheless, the abortion coverage is banned from federal benefits packages that are established. The second endowment that was signed by President Obama is the restriction on federal funding on health exchanges. It extended the Hyde Amendment restraint to the federal sponsored coverage on the ACA health interactions.
The third provision is the restrain on the state funding on health restrictions. The ACA gives power to the state to enact superior restriction than the Hyde Amendment on any abortion coverage that provides plans in their states. The power has enabled over twenty states to make laws that offer restrictions on the abortion coverage. The forth provision is the segregation of funds by exchange plans (Watt, H. 2016). The provision has given the private owned healthcare including coverage of abortion past Hyde limitations. They must approximate the actuarial value of casing the abortions by taking into consideration the cost versus the gains of the abortions.
The fifth provision is the military personnel and their dependents. The funds should only be used to execute abortions excluding in cases of life endangerment, incest or rape. The restraint apply to care that is provided by martial health facility and staff and care that is delivered by inhabitants and financed through Tricare, health care and insurance program for military personnel, spouses, and their children. The Indian Health Services (IHS) is also a provision of the ACA. The hundreds of IHS clinics and health care’s provide Medicare to over 2.1 million American Indians and the Alaskan Natives. The funding for the abortion is subject to Hyde amendment that permits only in cases of rape, incest or life threatening situation. However, the hospitals under IHS are unequipped and only provide about two funded abortions per year (Baumgartner, F. R., Jones, B. D., & Mortensen, P. B. 2014).
The federal employees and dependents only provide funding when the abortion is as a result of incest, life threatening situations or rape. The women in federal prisons are also denied funding for abortion in a case of life threatening case or rape. The female prisoner or inmate who can afford abortion is permitted to do that outside the premise of the prison by use of their private funds. The inmate should be provided free escort by a police officers while visiting the hospital outside the prison.
Proposed Policy Issue to Address the Abortion Issue
There is no single policy that can be able to solve the intricate question of abortion. There is somehow a policy that can reduce the public tension that is brought by the controversial issue concerning abortion. The policies are drafted considering their political and social consequences, and elements that make it acrimonious. The paper suggests the following issues that we advise its adoption to curb the quagmire and challenges that come as a result of the abortion controversy.
Abortion should be made Legal under Certain Guidelines
The public opinion and information gathered from both primary and secondary research suggests that abortion is made legal under certain guidelines. It is due to procreant and sexual health reproductive health research. The constraint on abortion should be parental notice and consent for minors who are under the age of 18 years. There is also a recommendation that women to undergo abortions and the father of the fetus must receive intimate lesson about contraceptives and how to avert unwanted pregnancies.
The sexual education should be integrated in the public scholastic systems. That will diminish the number of unsolicited pregnancy as a whole. The medical profession such as the American Medical Association (AMA) indicates that there is surge promiscuity in women but may downscale the annual degree of abortions. There should be repeal in the laws to allow pharmacies to access contraceptives to allow availability contraceptives.
USAID Dogma Determination 3 on Voluntary Neutering
The policy was issued by USAID in 1982 with the intention of guaranteeing that voluntary sterilization services that were funded by the U.S government safeguard the needs and rights of persons. The USAID insists that such policy and protections are essential given the distinctive nature of VS and an exceedingly personnel and perpetual surgical procedures. It outlines a number of USAID requirements for USAID voluntary sterilization services that includes:
Informed Consent – The USAID assistance to the voluntary sterilization service program is liable on suitable fortitude that the services, performed in full or partly by the USAID funds. The procedure must be executed only after the acceptor has voluntary represented him or herself to the health care facility and had given an informed consent of the procedures.
Ready Access to other Procedure – There should be other available family planning methods apart from voluntary sterilization. The options give the acceptor a chance to have choices on the other methods of family planning.
Non Incentive Payments – The USAID funds cannot be used to facilitate for impending acceptor of sterilization to accept the voluntary sterilization. The fee for the voluntary sterilization should be structured in a way that no financial incentives should be given to potential candidates of sterilization over other family planning methods.
It should be noted that there should be assistance on payments from the acceptors of the sterilization services, federal agents, and providers. The pay is not considered as an incentive as long as they are reasonable. The fortitude of a sensible payment must be grounded on a country and program specific foundation using acquaintance of social and economic circumstances (Baumgartner, F. R., Jones, B. D., & Mortensen, P. B. 2014).
Such payment include voluntary acceptors who may receive recompense for authentic extra expenses related to the procedures such as transportation, medicines, foods, and lost wages during a salvage period. The service providers may be awarded payment and be compensated for personal cost, anesthesia, pre and post-operative care, and transportations cost. The last payment may be awarded to voluntary sterilization agents that receive payment for extra cost incurred from referring voluntary sterilization clients.
The USAID policy is a permanent solution to the abortion menace. Successful voluntary sterilization gives the person an assurance of nonoccurrence of pregnancy cases to almost a hundred percent. If the policy is implemented, it will save the federal and state government from the abortion crisis.
Private Insurance Coverage of Abortion
There are twenty four states that have laws and regulations that are vital in prohibiting abortions coverage in ploys that are offered through Reasonable Care Act’s health insurance in the states. There are nine states that completely prohibit insurance treatment of abortion in all private insurance ploys controlled by the state (Vaughn, L. 2015). In the federal government, those politicians who are for against antiabortion have inhibited in poor women’s health choice by limiting the coverage of the practice for those who rely on Medicaid.
The result of the restraint is crucial. The deprived women being unable to use the coverage, they are forced to postpone the abortion because of the financial constraints (Wilson, W. J. 2012). The resolve of health insurance is to enable the manager manage the unanticipated therapeutic bills in case of uncertainties or unintentional events. The move to curb the medical coverage stigmatizes those women who really require the abortion services.
Solution to the Policy
Legalizing abortion through enacting laws that favors abortion is a right foot towards solving the unsafe abortion. The US women should be given the right to decide on the fate of the fetus. It will give the government an opportunity to enact policies and guidelines that will ensure that abortions are safe. It will reduce unsafe abortions that lead to death. Also, the incorporation of reproductive health lessons in the curriculum will help reduce cases of unwanted pregnancies among young people.
According to Vaughn, L. (2015), the USAID Dogma Determination 3 on Voluntary Neutering should be adapted. Voluntary sterilization is a permanent solution to the abortion peril. If a person is sterilization, his or her fertility is destroyed. It in turn reduces the number of unwanted pregnancy that leads to abortion. The policy should be given federal and state support until the dream of a free abortion country is realized.
The private insurance coverage on abortion should be legalized and given the requisite support by the government. The practice will ensure that women acquire better health care from both the state funded health care and private institutions. The coverage should be increased so that those who are unable to procure an abortion due to health reasons can be able to have one.
Administrative Feasibility of the Abortion Solution
As a student of public administration, there is need to answer the most fundamental question in this research. Are the solutions that the paper is giving administrative feasible? The question goes long way to confirm if the solutions are the best among the alternatives that the people of America have. The solution should have the capacity of reducing abortion cases in the United States of America.
The first solution is administrative feasible and can be implemented with ease. The legislatures can enact bills that can guide practitioners on instances that they should allow the abortion practices. In case the lady was raped or the pregnancy is as a result of incest they can perform abortion. In addition, if the women health or that of the fetus is threatened, the doctors can assist them procure an abortion.
The second solution on voluntary sterilization is not administrative feasible. It is so because the nature of the practice is multifarious that is difficult to be implemented in a given span of time. The public view on the policy is that it is not sustainable (Baumgartner, F. R., Jones, B. D., & Mortensen, P. B. 2014). If it is passed into law, the legislatures who sponsored the bill may face the wrath of the public. There are very few men who can accept to be sterilized or made infertile in a bid to contain abortion.
The private insurance coverage regarding abortion is an administrative feasible solution. The legislatures can enact laws that allow women to access the insurance policies that support abortions. Conversely, the cases that prompt abortions must be genuine and those that are within the law. Such conditions that may make abortion legal include: when the woman health or that of the embryo is threatened, the pregnancy is as a result of incest or rape (Vaughn, L. 2015).
Advantage and disadvantage of the Abortion Solution
The legalization of abortion will ensure that the abortion procedures become safer. On that view, the change of law is a prerequisite and any conflicting move is doomed. The legal change will ensure that safety sustainability is achieved. Safety refers not only better medical procedures but minimizing the effect of exposure that can lead to imprisonment and disciplinary measures for the medical providers and women (Watt, H. 2016). The threat of prosecution, violence and coercion has been experienced in urban Latin America. Safety is also a sure way of getting skilled personnel perform the operation to avoid endangering the lives of women. The laws enacted will also act as a measure of public acceptance to check fertility and control population.
There are a lot of political institutions responsible for the formulation and implementation of the policy. The federal and state lawmakers are one strong political institution that should guide the policy formulation. The recommendation of legalizing abortion is both a task of the federal and the state government. They should both legislate on policies that will support sustainable safety procedures during abortion. The stakeholders such as activist groups and medical association should support the government in the implementation of the policy. The cost of the abortions to the American people will reduce as women will have options on either using Medicaid or private insurance (Baumgartner, F. R., Jones, B. D., & Mortensen, P. B. 2014).
The paper has explored on the factors effecting abortion as a public policy issue; in the United States of America. It has tackled on the reasons that people take to perform abortion together with. The paper has explained the pros and cons of abortion. The pro-life and pro-choice is also discussed in depth. The debate has sparked intense tension over the years on which side is right between the pro-life and pro-choice. There is also a discussion for the decline in fertility and the urge to have abortion practiced. The paper also explored on abortion and morality. It also outlined the stakeholders and those constituencies that are affected by the abortion controversy/ issue. There is also the issue of political institutions that are seen to bear the greatest responsibility in shaping the policy to solve the abortion quagmire.
The research outlines the abortion issue as both a federal and state responsibility. It also discuss on the cost that the American people have to burden to fund abortion in the country. The Affordable Care Act and its implication on the issue have also been highlighted. In a bid to solve the abortion problem, the paper has also analyzed the policies that are effective in policy formulation. The three policies that are embraced in this paper is legalizing abortion, allowing private health insurance to take care of abortions, and lastly allow the USAID dogma determination 3 on voluntary neutering. Lastly, the paper explains the administrative feasibility of the three policies where two are seen as feasible and the one is seen as not administrative feasible.
Anderson, J. E. (2014). Public policymaking. Cengage Learning.
Baumgartner, F. R., Jones, B. D., & Mortensen, P. B. (2014). Punctuated equilibrium theory: Explaining stability and change in public policymaking. Theories of the policy process, 59-103.
Finer, L. B., & Zolna, M. R. (2014). Shifts in intended and unintended pregnancies in the United States, 2001–2008. American Journal of Public Health, 104(S1), S43-S48.
Reiman, J. F. (2013). The Deliberately Induced Abortion of a Human Pregnancy Is EthicallyJustiﬁable.
Vaughn, L. (2015). Doing ethics: Moral reasoning and contemporary issues. WW Norton & Company.
Watt, H. (2016). The Ethics of Pregnancy, Abortion and Childbirth: Exploring Moral Choices in Childbearing. Routledge.
Wilson, W. J. (2012). The truly disadvantaged: The inner city, the underclass, and public policy. University of Chicago Press.