LETTERS TO TIE EDITOR Abortion To the Editor: Once again abortion is a really hot topic. The political arena is full of advocates and opponents, all for apparently self-serving motives. Major elections, both locally and nationally, are being determined by the furor of the abortion issue. Many local and federal dollars are being spent to influence public opinion. Social and political pressure groups are springing up all over the country and all of them are posturing for recognition as the voice of the female conscious. It is ironic to see that so many of those voices are white males, upper-class conservative white females, bourgeois black females, and virtually nonexistent black males. The significance of that alone carries an important social message. Unfortunately, the human aspect of this emotionally and physically invasive procedure is being lost in the controversy. And the result is an irreversible down spiral of negative psycho-physiological effects on black women. Why single out black women over other ethnics? Well, it appears that a disproportionate number of black women are choosing pregnancy termination for convenience as a form of birth control. This is historically uncharacteristic of black women who are revered for their approach to child bearing, child rearing, and family survival. Blacks have always tended to keep their offspring at all cost. This trend is changing precipitously. Greater numbers of this socio-
economically depressed group are following the lead of organized white organizations whose real concerns are at best suspect. Their agendas give only lip service to the real plight of the Afro-American female. These women are frequently confused by the cliches such as "right to life," "pro choice," "genocide," "infanticide," etc. The intelligence level of the women in question is a nonissue. The point is that out of fear, destitution, lack of education, frustration, and social pressure, increasing numbers of females are having abortions. Note that I specifically did not say "women" which implies adulthood. Hence, an alarming number of "babies" 11 to 15 years old are having to decide whether to keep their "babies" or have an abortion. The decision is often made alone, without appropriate consultation. I have personally given medical services to many of these patients in both the public and private sectors of medicine. The greater majority are in the public sector, which means they are more likely to receive poor health care or none at all. I do not mean to trivialize the abortion decision when made by older women whose lives may be adversely affected by an unplanned pregnancy. However, one does not have to be a genius to understand how catastrophic an unwanted pregnancy can be to an adolescent. The United States has the highest infant mortality rate (10.5 infant deaths per 1000 live births) among
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 83, NO. 2
non-third world countries and a large contribution to that figure is from adolescent pregnancy losses. Further, pregnancy loss in the United States among black women is twice that of white women. I propose that the abortion movements (pro or anti) are not concerned about the plight in the black community. Pro choice people do not necessarily feel that all mothers should get abortions on demand, but that the ability to obtain such should be available and not legislated away. Right to life proponents give lots of commentary about having the baby once the woman is pregnant, but no plans are issued for improving the quality of the child's life after birth. The strict antiabortion groups speak frequently of genocide and infanticide as a means of creating extreme guilt for any mother who might choose to terminate a pregnancy regardless of reason. It is insufficient to tell people to have an unwanted child without indicating the mechanism for caring and nurturing that child after birth. Where does the crack addict take her baby once born? Where do the 11-, 12-, 13-, and 14-year-olds take their babies who are frequently premature and require intensive care and respiratory support? The perinatal centers in most major cities are already overcrowded and poorly funded. The advocates of "have the baby" do not follow up on the products of their advocacy. If those people were required to support with money their advocacy, a great many of them would become silent. 117
It is unreasonable to believe that one could be for the right to life when there are no preparations being made to take care of babies in trouble and sustain life after birth. All of us are too comfortable about infants dying after birth. We are not as impassioned about babies dying from malnutrition, socioeconomic devastation, or psychological genocide. There is a high infant mortality rate in the blackC community. The level overall is 2 to 3 times that of the white community. That is abominable, yet we are dreadfully comfortable with those numbers. Our primary impassioned viewpoint is vigorously against abortion. Some arrogant conservative politicians feel that it is acceptable to have unwanted babies as they watch the ultimate demise of new life through one of the above mechanisms. The lesson plan is clear. Blacks must address their own internal problems as other ethnics do. Focus in on the issues, determine the best solutions, and move unscaffed with vigor and determination to resolve the problems. There continues to be a rather grievous misunderstanding as to who is responsible for whom. My brothers and sisters are still laboring under the misconception that "somebody will take care of us," "somebody will look after my babies," "somebody will take care of my own personal health." I appeal to the black community, do not be misled. Why would you believe that some other ethnic group is ordained to look after your welfare? It is ludicrous to expect others to care for you more than you care for yourself. Helping oneself is godly. Doing for self and regulating ones own life is not improper, sinful, or misguided. Fear of being called a bigot, an 118
isolationist, a nonconformist, and a hate-monger is unrealistic and continues to be used by those who wish to oppress freedom. As an obstetrician-gynecologist, my personal position on abortion is perhaps not relevant. People frequently approach me for abortion services without success. Suffice it to say that I am for the rights of women to make choices just as men do. I appreciate life as granted to us by God. And, I respect all mankind with a special love for the blacks, Afro-Americans, Africans in America, and Negroes, in that order! Odie Payne, III, MD South Shore Hospital Chicago, Illinois
National Health Insurance Program To the Editor: Our existing health care system in the United States is failing and demands reviews, reevaluations, and revisions. The current health program is exceedingly expensive, wasteful, inadequate, and discriminatory. Every American citizen does not have equal access to quality medical and surgical care. We have a two-tier health care system, which implies that those who can afford it may acquire good and adequate health care, but that those persons who are poor and many others of specific ethnic backgrounds, colors, national origins, or circumstances may not receive adequate medical care. Diagnostic related groups, second surgical opinions, outpatient or ambulatory surgery, preadmittance testings and authorizations, strict hospital utilization procedures, the sequences and consequences of the medical malpractice dilemma, and depreciation of physicians and pa-
tients by the US health system have not substantially improved our health care system in its prime objectives to extend, improve, and maintain high quality preventive, diagnostic, and therapeutic methods for all American citizens. Medical issues and problems in our society are: 1. High infant mortality statistics, especially for blacks and other poor minorities. 2. Millions of uninsured Americans without health care cost protection. 3. Inadequate health care for the poor. 4. Necessity of copayments by American consumers to insurance companies. 5. Diminishing average life span for blacks and other minority citizens in comparison with white Americans during the last 2 years. 6. Inadequate health care for blacks and other minorities. 7. Increasingly higher costs of health care. 8. High costs for governmental bureaucracy and insurance companies. 9. Shortages and unavailability of medical personnel, including nurses, physicians, etc. 10. Too many empty hospital beds (overoccupancy of space). It is my opinion that a United States national health insurance plan could be more relevant, more economical, more efficient, and more comprehensive for every America citizen than the current two-tier system. In one survey, over 50% of consumers, as reported by Woolhandler and Himmeistein, favored a national health insurance program in order to obtain comprehensive health care costs and free continued on page 177
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 83, NO. 2
economically depressed group are following the lead of organized white organizations whose real concerns are at best suspect. Their agendas give only lip service to the real plight of the Afro-American female. These women are frequently confused by the cliches such as "right to life," "pro choice," "genocide," "infanticide," etc. The intelligence level of the women in question is a nonissue. The point is that out of fear, destitution, lack of education, frustration, and social pressure, increasing numbers of females are having abortions. Note that I specifically did not say "women" which implies adulthood. Hence, an alarming number of "babies" 11 to 15 years old are having to decide whether to keep their "babies" or have an abortion. The decision is often made alone, without appropriate consultation. I have personally given medical services to many of these patients in both the public and private sectors of medicine. The greater majority are in the public sector, which means they are more likely to receive poor health care or none at all. I do not mean to trivialize the abortion decision when made by older women whose lives may be adversely affected by an unplanned pregnancy. However, one does not have to be a genius to understand how catastrophic an unwanted pregnancy can be to an adolescent. The United States has the highest infant mortality rate (10.5 infant deaths per 1000 live births) among
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 83, NO. 2
non-third world countries and a large contribution to that figure is from adolescent pregnancy losses. Further, pregnancy loss in the United States among black women is twice that of white women. I propose that the abortion movements (pro or anti) are not concerned about the plight in the black community. Pro choice people do not necessarily feel that all mothers should get abortions on demand, but that the ability to obtain such should be available and not legislated away. Right to life proponents give lots of commentary about having the baby once the woman is pregnant, but no plans are issued for improving the quality of the child's life after birth. The strict antiabortion groups speak frequently of genocide and infanticide as a means of creating extreme guilt for any mother who might choose to terminate a pregnancy regardless of reason. It is insufficient to tell people to have an unwanted child without indicating the mechanism for caring and nurturing that child after birth. Where does the crack addict take her baby once born? Where do the 11-, 12-, 13-, and 14-year-olds take their babies who are frequently premature and require intensive care and respiratory support? The perinatal centers in most major cities are already overcrowded and poorly funded. The advocates of "have the baby" do not follow up on the products of their advocacy. If those people were required to support with money their advocacy, a great many of them would become silent. 117
It is unreasonable to believe that one could be for the right to life when there are no preparations being made to take care of babies in trouble and sustain life after birth. All of us are too comfortable about infants dying after birth. We are not as impassioned about babies dying from malnutrition, socioeconomic devastation, or psychological genocide. There is a high infant mortality rate in the blackC community. The level overall is 2 to 3 times that of the white community. That is abominable, yet we are dreadfully comfortable with those numbers. Our primary impassioned viewpoint is vigorously against abortion. Some arrogant conservative politicians feel that it is acceptable to have unwanted babies as they watch the ultimate demise of new life through one of the above mechanisms. The lesson plan is clear. Blacks must address their own internal problems as other ethnics do. Focus in on the issues, determine the best solutions, and move unscaffed with vigor and determination to resolve the problems. There continues to be a rather grievous misunderstanding as to who is responsible for whom. My brothers and sisters are still laboring under the misconception that "somebody will take care of us," "somebody will look after my babies," "somebody will take care of my own personal health." I appeal to the black community, do not be misled. Why would you believe that some other ethnic group is ordained to look after your welfare? It is ludicrous to expect others to care for you more than you care for yourself. Helping oneself is godly. Doing for self and regulating ones own life is not improper, sinful, or misguided. Fear of being called a bigot, an 118
isolationist, a nonconformist, and a hate-monger is unrealistic and continues to be used by those who wish to oppress freedom. As an obstetrician-gynecologist, my personal position on abortion is perhaps not relevant. People frequently approach me for abortion services without success. Suffice it to say that I am for the rights of women to make choices just as men do. I appreciate life as granted to us by God. And, I respect all mankind with a special love for the blacks, Afro-Americans, Africans in America, and Negroes, in that order! Odie Payne, III, MD South Shore Hospital Chicago, Illinois
National Health Insurance Program To the Editor: Our existing health care system in the United States is failing and demands reviews, reevaluations, and revisions. The current health program is exceedingly expensive, wasteful, inadequate, and discriminatory. Every American citizen does not have equal access to quality medical and surgical care. We have a two-tier health care system, which implies that those who can afford it may acquire good and adequate health care, but that those persons who are poor and many others of specific ethnic backgrounds, colors, national origins, or circumstances may not receive adequate medical care. Diagnostic related groups, second surgical opinions, outpatient or ambulatory surgery, preadmittance testings and authorizations, strict hospital utilization procedures, the sequences and consequences of the medical malpractice dilemma, and depreciation of physicians and pa-
tients by the US health system have not substantially improved our health care system in its prime objectives to extend, improve, and maintain high quality preventive, diagnostic, and therapeutic methods for all American citizens. Medical issues and problems in our society are: 1. High infant mortality statistics, especially for blacks and other poor minorities. 2. Millions of uninsured Americans without health care cost protection. 3. Inadequate health care for the poor. 4. Necessity of copayments by American consumers to insurance companies. 5. Diminishing average life span for blacks and other minority citizens in comparison with white Americans during the last 2 years. 6. Inadequate health care for blacks and other minorities. 7. Increasingly higher costs of health care. 8. High costs for governmental bureaucracy and insurance companies. 9. Shortages and unavailability of medical personnel, including nurses, physicians, etc. 10. Too many empty hospital beds (overoccupancy of space). It is my opinion that a United States national health insurance plan could be more relevant, more economical, more efficient, and more comprehensive for every America citizen than the current two-tier system. In one survey, over 50% of consumers, as reported by Woolhandler and Himmeistein, favored a national health insurance program in order to obtain comprehensive health care costs and free continued on page 177
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 83, NO. 2
