Beyond Stupak: Reproductive Coercion in the Health Care Bill

The Stupak amendment isn’t the only troubling intrusion into reproductive rights in the House version of the health care reform bill — low-income women are also facing attempts at fertility control from the federal government. The bill requires that Medicaid recipients who are having their first baby or who have a child under the age of two be visited at home by nurses in order to advance certain reproductive and family goals. Sounds like a good thing, right? New parents could use some help, and a nurse should be able to give them decent tips. These kinds of visits happen all the time in countries like France and England. I’m pretty sure a similar visit was recordered in Michael Moore’s Sicko. It’s about time that we gave new parents the support that they need.

Except this program isn’t about support. It’s about the same old social engineering wherein a particular class of people is deemed unfit to reproduce, and the folks in charge go to great lengths to either force or coerce the less powerful class out of making babies. The goals of this program include “increasing birth intervals between pregnancies,” “reducing maternal and child involvement in the criminal justice system,” “increasing economic self-sufficiency,” and “reducing dependence on public assistance.”

I will just let Dorothy Roberts and Gwendolyn Mink explain why this is a problem:

These goals of the home visitation program have nothing to do with providing health care. Instead, they are based on the false premise that poor mothers’ childbearing is to blame for social problems. The proposed visitation program is eugenicist, deceptive, discriminatory against low-income women, and utterly inappropriate to the medical work of nurses.

Under the program envisioned in the House bill, government-sponsored medical professionals are charged with exhorting fertility control among poor women, based on the mistaken premise that reproduction among the poor leads to crime, neglect, low educational attainment, and dependency. Yet according to the government’s own statistics, families receiving welfare have, on average, only 1.8 children; half the families receiving welfare have only one child, and only one in ten have more than three children.

Although the data show that poverty is not correlated with family size — and that childbearing does not cause poverty — the U.S. House of Representatives seeks to tell low-income women who receive medical assistance how many children to have and when to have them.

If you read the actual language of the bill, it’s not all bad — but there was obviously some tinkering to pull in the lines about the criminal justice system and public assistance. I would have no problem with this bill if it were about helping women and offering resources. Parenthood is hard, and there’s an unreasonable expectation that women naturally know what to do without any sort of community support. Offering that support — including information about childhood nutrition, reproductive health, age-appropriate punishment, intimate partner violence and school preparation — would be wonderful. I would love to see it offered in the health care bill.

But the current bill is a different animal. It gets off to a good start, but then there are a slew coercive, quietly racist and classist mechanisms thrown in. It is a damn shame that we can’t simply extend help to new parents without playing into harmful stereotypes and treating low-income mothers as if they are unfit parents simply by virtue of reproducing.


Similar Posts (automatically generated):

33 comments for “Beyond Stupak: Reproductive Coercion in the Health Care Bill

  1. Sheelzebub
    November 24, 2009 at 11:49 am

    :::Twitch:::

    This kind of stuff makes me crazy. The same folks who want to force a certain race and class of women to birth would keep other women childless. And they’re the first ones to bring up the Welfare Queen strawwoman.

    And not for nothing, but isn’t it a value of the conservatives that the government should butt out of our private lives? Or is it just the private lives of wealthy men?

  2. FashionablyEvil
    November 24, 2009 at 12:03 pm

    Visiting nurse programs have been very successful (pdf) at improving outcomes for mothers and children. I would hope that these proposed programs would be implemented in a way that builds on the successes of these existing programs, rather than trying to reinforce stereotypes of low-income mothers.

  3. November 24, 2009 at 12:17 pm

    I’m bothered by my fellow progressives’ response to ongoing healthcare reform, by the idea that our goals have to be attained in a single broad sweep and that anything less than that is entirely unacceptable.

    The wingnuts have managed to chip away at things like abortion rights by working by degrees, by making small and consistent victories over the long term. We would benefit from a similar approach to the present struggle.

    The current healthcare bill is hugely flawed in many areas but the point is that it’s actually happening. It’s a huge step towards equitable and universal health care. I think we’ll be better off taking that one big step and then working out the kinks once the a first phase of reform is under way. Otherwise, we run the risk of accomplishing no reform at all.

    • November 24, 2009 at 12:24 pm

      I’m bothered by my fellow progressives’ response to ongoing healthcare reform, by the idea that our goals have to be attained in a single broad sweep and that anything less than that is entirely unacceptable.

      Who is saying that? You should actually look at the pro-choice response to the health care amendment. We made HUGE concessions when it comes to abortion rights. Huge. But a line has to be drawn somewhere.

  4. jellybeanaddict
    November 24, 2009 at 12:53 pm

    I’ve been under the impression that the federal government is trying to control (and lower the birth rate) of low-income women.

    Long story short, I had to go on Medicaid during my 8th month of pregnancy. I loved my midwives and my doctors, yet was surprised how vehemently and ardently I was suddenly being told to get an IUD. Talking to the mothers in a parenting group, I learned that those with private insurance had no such conversation with their doctors, even if they had the SAME doctor. Those of us who were on Medicaid during our pregnancies, however, were pushed to get an IUD. (I refused.)

  5. November 24, 2009 at 1:22 pm

    thanks so much for sharing. Definitely classism & racism at work here. This language plays into the same age-old trope that lower income women aren’t sufficient mothers. Ugh.

  6. William
    November 24, 2009 at 1:34 pm

    Person 1: “Hey, this visiting nurses thing works great in England, except for the fact that politicians over there have consistently used it to turn medical professionals into state reporters and observe/coerce service recipients. Lets try it here, where I’m sure everything will go fine…”

    Person 2: “Uh, hey, anyone else bothered by the racist/classist/conservative language aimed at coercing observed persons here?”

    Person 1: “I’m shocked! No one could have foreseen this! But hey, we need this bill so shut the hell up.”

    Color me unsurprised.

  7. CP
    November 24, 2009 at 2:29 pm

    Similar programs that already exist in the US (Nurse-Family Partnership specifically) have a pretty great track record for improving school readiness, decreasing childhood injuries, decreasing youth involvement in the criminal justice system, and helping mothers achieve their own personal goals. I think such programs *absolutely* have to deal with the racism and classism that inevitably seeps into the work due to the dynamic of usually more privileged nurses providing a service to less privileged clients. Furthermore, it is critical that participation in these programs remain *completely* optional, or it essentially turns into an invasion of people’s homes. That said, however, nurse home visitation for new mothers has had a really positive impact on many women and children’s lives, and I would love to see the work expanded and improved upon, not torn down because it is fraught with the same issues ALL of our institutions face.

  8. motanio
    November 24, 2009 at 2:59 pm

    This has been happening in the U.S. for years – I remember it being part of the record of Dean as a governor and googled for this:

    The governor cited his state’s “Success By Six” initiative, in which parents of every child born in Vermont receive a home visit by a state worker within two weeks of an infant’s birth. During the visit, the worker offers the parent a variety of services, based on the parent’s need. Dean said the intent is to expose parents to a friendly face who can address family concerns.

    “Those who do (need help) get it starting when they’re two weeks old, not when they get to kindergarten,” Dean said. “By the time you get to kindergarten, you’ve got a tough time trying to reverse the trouble you’re in.”

    Dean said that even though he didn’t expect results immediately, Vermont has seen its child abuse rate drop 70 percent among children from birth to age 3, and 50 percent from birth to age 5. “That is an extraordinary statistic that I bet is not duplicated anywhere else in the United States,” he said.”

    Like any liberal policy, it could be used for illiberal purposes, but it doesn’t have to be.

  9. bwaller
    November 24, 2009 at 3:10 pm

    This is about *outcomes*. The program *works.* Reading racism and classism into this is simply ridiculous, paranoid, and politically counterproductive in every imaginable way.

  10. William
    November 24, 2009 at 3:22 pm

    Like any liberal policy, it could be used for illiberal purposes, but it doesn’t have to be.

    Sure it does, because once something has been established it is established and the Good Guys won’t always be in charge. Thats how we got to Bush. Bush didn’t just show up out of thin air and begin trashing civil liberties. There was a disaster, people got scared, and he used the tools at his disposal to enact the policies he wanted to enact. Those tools were brought in by politicians who came before him, each of whom did exactly what he did (to greater or lesser extents). Does that mean that home visits ought to be abolished? Probably not, but it is naive to imagine that someone won’t figure out how to abuse them. It isn’t that something “could” be used for illiberal purposes but that it will be simply because it is there and the country will swing hard to the right eventually.

  11. William
    November 24, 2009 at 3:27 pm

    This is about *outcomes*. The program *works.* Reading racism and classism into this is simply ridiculous, paranoid, and politically counterproductive in every imaginable way.

    So…the ends justify the means and any concerns someone might have are irrelevant because you say so. And even if they weren’t irrelevant having concerns is being crazy/oversensitive/emotional? And even if the concerns were reasonable voicing them would be politically counter productive so we all ought to just shut the fuck up?

    Also, not to be hysterical/foolish/empirically wrong/politically heretical but how, exactly, can you say that a program works when it has yet to be implemented in the form that is being discussed? Do we have detailed pilot program data from wide-spread programs created with identical language? Or are we just guessing that these kinds of programs work because we have faith in our leaders and similar programs have worked well in other places?

  12. Colleen
    November 24, 2009 at 3:39 pm

    If anything this program should be extended to all new parents. The insurance company mandated microscopic hospital stays leave many parents wanting more interaction with medical professionals. Many new parents have no experience with infants, a visiting nurse could encourage breast feeding, monitor for signs of postpartum depression and domestic violence, offer advice on immunizations and give practical advice on household issues like childproofing. This is a good program that has proven to reduce violence against kids. What kind of an loon do you have to be to be against reducing violence. Cause kids just love when their parents go in the slammer? Isn’t it great poor people have over educated blogers getting rid of government programs that might help them not hit their kids. Whew!

    • November 24, 2009 at 4:10 pm

      This is a good program that has proven to reduce violence against kids. What kind of an loon do you have to be to be against reducing violence. Cause kids just love when their parents go in the slammer? Isn’t it great poor people have over educated blogers getting rid of government programs that might help them not hit their kids. Whew!

      Good thing we have people who don’t bother to read the whole post before commenting. Like the part where I said:

      I would have no problem with this bill if it were about helping women and offering resources. Parenthood is hard, and there’s an unreasonable expectation that women naturally know what to do without any sort of community support. Offering that support — including information about childhood nutrition, reproductive health, age-appropriate punishment, intimate partner violence and school preparation — would be wonderful. I would love to see it offered in the health care bill.

  13. November 24, 2009 at 3:55 pm

    The section that’s creating all this angst reads like this:

    (1) Improving maternal or child health and pregnancy outcomes or increasing birth intervals between pregnancies

    Now, I think part of the reason this is creating angst is because the science of birth spacing is very new and most of the public hasn’t heard about it. Until very recently, the only factor considered relevant in choosing how far apart to have your babies was personal preference: do you want to get it all over with at once, or space them out? But a recent body of evidence has piled up, demonstrating that putting at least two years between pregnancies means that you have a better “womb environment” for each individual baby. Which means stronger bodies and better functioning brains, for reasons that should seem obvious—how well our bodies are made depends a great deal on how much our mothers’ bodies were able to give us to start off with.

    But if you hadn’t heard about this—and most people hadn’t—then the whole birth spacing thing probably seems kind of weird. The most immediate interpretation, in light of past and ongoing coercive practices aimed at women on welfare, is that this is an attempt to discourage further pregnancies.

    In all honesty, I don’t think that it is. I think the belief ungirding it is that the woman being advised has every right to want another baby in the future, and the advice to have her wait two years to maximize that baby’s health is offered for her and the potential child’s benefit. The assumption that this advice will be helpful seems right to me; most people in all classes are not aware of the tremendous benefits of pregnancy spacing.

    The major problem I see is that some nurses might be bullying and disrespectful. The program is voluntary, but we all know that someone can be leaned on really hard. But these dangers are no reason to skip offering services that have been shown to go a long way in improving the health of small children, as well as long term outcomes. What needs to be done is to have good training and accountability, so that nurses don’t get judgy, and that those who do are stopped from participating in the program.

    Frankly, I think this needs to be expanded to all classes of people, because, as I said before, most people are ignorant of this cutting edge research in child health and nutrition. Everyone could benefit from learning about pregnancy spacing.

  14. November 24, 2009 at 3:56 pm

    I’ll add that I think sometimes these scientific innovations are so interesting and exciting that they’re just thrown out there without taking the time to consider what sensitive buttons might be accidentally pushed.

  15. shah8
    November 24, 2009 at 3:58 pm

    First of all, Matt Yglesias can really be an idiot on any topics relating to children. I read his take before coming here.

    Now:
    The primary problem is that Roberts and Mink is absolutely correct. This is more of an initiative at state control than it is about helping people. One, this program can be done in hospitals during the day or second day after birth. This program also can be available in offices that people go to. This program can be aimed at the entire mom-to-be population (as with Vermont). It’s not as if rich moms know any better than poor moms what to do automatically.

    Also, Social Services are a nightmare in many states due to underfunding, poor/unorganized workers etc, etc…What makes you think that this program is capable of being administered to a whole population efficiently? That would be quite a few jobs for would be nurses, no? Who would pay for it? Who would stop nurses from being assholes in people’s home? All this makes me think that the aim of the applied language does not match the promises given, and therefore suspicious.

  16. shah8
    November 24, 2009 at 4:18 pm

    Man, I am just not having my day when it comes to comments on the internet…

    Anyways, the earlier comment is supposed to highlight the simple ways this admendments could be structured better in terms of its stated purpose. Not doing these things, and not really being clear at all about how this plan is supposed to work makes me very inclined to believe the worst intentions.

  17. November 24, 2009 at 4:20 pm

    To reiterate: No one is saying that home nursing programs are bad. No one is saying that they shouldn’t be included in the health care bill. They SHOULD be included in the health care bill! What I object to are the parts of the home visit section which emphasize getting women off of welfare and onto birth control, rather than promoting a full range of reproductive health care options and resources — i.e., giving women the information and letting them decide what is best for themselves, rather than coercing them into a particular choice. The majority of the proposed program is great. I just object to a handful of lines.

  18. shah8
    November 24, 2009 at 4:29 pm

    Another thing that bothers me, now having read the specific language, is how vaguely health is outlined, but how specifically the socio-economic desired outcomes are detailed.

  19. Alara Rogers
    November 24, 2009 at 4:29 pm

    In fact, much of the racism and classism in the program would *disappear* if it was targeted at *all* new mothers, and new fathers as well.

    Programs that are intended to benefit a small group of people, such as the poor or the disabled, raise American ire. How dare that undeserving lowly person of a lower social status than me get a benefit when I don’t! But programs that benefit everyone are very popular, and are run in a way where they treat the beneficiary as a customer, not a lowly peon. Medicare and Social Security are not classist, racist programs, but Medicaid and welfare totally are.

    Make the program for *everyone*, not just poor or “at-risk” women, the way Governor Dean did in Vermont, and hire more goddamn nurses and social workers to do the job, and pay them better wages so they don’t leave, which attracts more social workers and nurses to the profession and pressures private entities who hire those people to raise their wages, which benefits women disproportionately because women are 90% of nurses and a large percentage of social workers. Then the only pushback you’re going to get are from the religious right who want the right to beat their children without state interference, the MRAs who resent that women get a benefit and don’t bother to consider that fathers could participate in the program as well, and childfree extremists who resent that people with children get a benefit they don’t. (You know who I mean. Not the childfree in general, but the ones who come out of the woodwork every so often to say “Why *should* parents get paid as much as non-parents when we work so much harder? Why isn’t my right to go skiing when I feel like it considered equal to a mother’s right to go tend her sick child? Hey, why do people who have kids get a tax benefit anyway?”)

    If you don’t do that, the program *will* be misused, full stop, even if implemented with the best of liberal intentions. Every program intended for the benefit of the poor has been misused in that way (if not by being used to actively coerce people, then by being underfunded and treating the people it services like garbage.)

    So I’d agree with some of the above posters that this was a great idea, if it was implemented for all new parents, but if it’s just the poor and “at-risk” new parents then I agree with Jill, it’s going to be misused to pressure poor women not to have kids. And it’s going to treat poor women as if they don’t deserve the kids they have. And it’s going to end up taking children away from women who were perfectly capable of being good mothers because the social workers will go into it with the understanding that these are bad mothers and the goal is to make them good mothers, not the understanding that these are new mothers and the goal is to help them learn, and with such a bias in their minds the social workers will look at harmless behavior as if it’s child abuse or neglect. (You live in a house that’s being renovated! There’s access to paint! It’s not lead paint, but it’s still paint! And there’s exposed electrical wiring in the ceiling where your baby can’t possibly reach because there’s renovation going on, so you’re a bad mom and I have to take your kids out of your home!… I wish I was exaggerating here.)

    • November 24, 2009 at 4:32 pm

      Just want to reiterate that Alara’s last paragraph is spot-on:

      So I’d agree with some of the above posters that this was a great idea, if it was implemented for all new parents, but if it’s just the poor and “at-risk” new parents then I agree with Jill, it’s going to be misused to pressure poor women not to have kids. And it’s going to treat poor women as if they don’t deserve the kids they have. And it’s going to end up taking children away from women who were perfectly capable of being good mothers because the social workers will go into it with the understanding that these are bad mothers and the goal is to make them good mothers, not the understanding that these are new mothers and the goal is to help them learn, and with such a bias in their minds the social workers will look at harmless behavior as if it’s child abuse or neglect. (You live in a house that’s being renovated! There’s access to paint! It’s not lead paint, but it’s still paint! And there’s exposed electrical wiring in the ceiling where your baby can’t possibly reach because there’s renovation going on, so you’re a bad mom and I have to take your kids out of your home!… I wish I was exaggerating here.)

  20. William
    November 24, 2009 at 5:42 pm

    with such a bias in their minds the social workers will look at harmless behavior as if it’s child abuse or neglect.

    I wish more people understood that point. Observation is never, and can never, be neutral. Once you begin observing you begin comparing, you begin applying a standard, you begin the process of normalization and coercion. Its downright foolish to believe that individual nurses and social works, or whole groups of politicians, aren’t going to observe these poor (and thus disempowered) women and see them as less than. Mandated reporting will kick in, the preferences of government agents will kick in, delusional fears about welfare queens having kids for the money will kick in, politicians looking to get the populist vote by smacking around people the mob thinks are leeches will kick in. Observation, by it’s very presence, creates oppression.

  21. Tlönista
    November 24, 2009 at 8:03 pm

    Yeah, I call “the poor are breeding like rats, get women on welfare to close their legs!!!!” fear-mongering here.

  22. November 24, 2009 at 9:02 pm

    Yeah, this seems very reminiscent of eugenics.

    Like others said I would be a lot more comfortable with this if it was for all new parents.

  23. November 25, 2009 at 5:28 am

    Wait, they don’t want poor women to have abortions but they don’t want them to have so many kids either?
    Am I missing something here?

  24. William
    November 25, 2009 at 10:01 am

    Wait, they don’t want poor women to have abortions but they don’t want them to have so many kids either?
    Am I missing something here?

    Don’t you know that poor women are overly-sexual creatures who are too stupid/uneducated/crass to keep their legs shut? Abortion murders future priests, but celibacy is holy. After all, instead of spending all that time having sex and popping out babies (on my dime no less!!!!11!1elventyone) they should be spending that energy finding a job and being less lazy so they can get off the dole. Or something. Since when have assholes been internally consistent?

  25. jemand
    November 25, 2009 at 12:08 pm

    “I wish more people understood that point. Observation is never, and can never, be neutral. Once you begin observing you begin comparing, you begin applying a standard, you begin the process of normalization and coercion. Its downright foolish to believe that individual nurses and social works, or whole groups of politicians, aren’t going to observe these poor (and thus disempowered) women and see them as less than. Mandated reporting will kick in, the preferences of government agents will kick in, delusional fears about welfare queens having kids for the money will kick in, politicians looking to get the populist vote by smacking around people the mob thinks are leeches will kick in. Observation, by it’s very presence, creates oppression.”

    This continues to bother me…. a lot. Mandated reporting is a very good thing. It’s a lot better than ignoring “domestic disputes” and pretending nothing bad ever happens to children. Yes, sometimes, there are horror stories from it… but the alternative… is even more horrific. I think we can point out the classism in this bill without implying that society should not worry about the welfare of children.

    There’s an undercurrent of “leave it in the family” in this thread that is *very* disturbing to me, as that is the mentality that allowed abuse to fester without respite and with so many, many silenced victims. Yes, there are problems between us adults, BUT, I don’t think we can solve those problems by adults ignoring the most powerless of all, the children.

  26. Alara Rogers
    November 25, 2009 at 3:22 pm

    There’s an undercurrent of “leave it in the family” in this thread that is *very* disturbing to me, as that is the mentality that allowed abuse to fester without respite and with so many, many silenced victims. Yes, there are problems between us adults, BUT, I don’t think we can solve those problems by adults ignoring the most powerless of all, the children.

    Society should try to help children, but at the same time, society should not assume prima facie that some people are more likely to be abusers because they are poor.

    You can send a person in to help a new mother, and when Dean did that in Vermont I thought it was a fantastic idea. But if you only send them in to help *poor* mothers, you’re setting up the notion that poor mothers need the help because otherwise they will abuse their kids, and therefore they’re likely to be abusers, and therefore everything they do is potentially wrong. Whereas if you just say “all new mothers could use a helping hand and some information”, you’re not defining a class of people as likely to be abusive and then sending social workers in to rescue their children from them.

  27. William
    November 25, 2009 at 4:41 pm

    Mandated reporting is a very good thing.

    Maybe if the system worked properly, wasn’t terribly underfunded, cared about the people it was supposed to protect, and wasn’t overrun by racists, classists, and burn outs, you’d be right. Maybe if the alternatives to “bad” parent’s wasn’t a foster care system that systematically rapes, beats, and otherwises abuses it’s wards, you’d be right. Thats not the reality I’ve lived. I’m a mandated reporter in the state of Illinois for three disempowered groups and I’ve had to make six reports so far. Every single one has ended badly. Every. Single. One.

    It’s a lot better than ignoring “domestic disputes” and pretending nothing bad ever happens to children.

    Its neither better nor worse, its simply different and it gives moralistic white people something to feel good about. I’m not talking about ignoring domestic abuse or pretending bad things don’t happen to children, I’m talking about the problems that come with using the potential abuse of children as a cover for applying coercive observation to vulnerable groups.

    Yes, sometimes, there are horror stories from it… but the alternative… is even more horrific.

    Sometimes yes, sometimes no. I was directly told by DCFS that they would not investigate a report of a father who had tried to murder his daughter because it had happened more than 72 hours ago and no sexual assault was involved, but that he would be informed that a report had been made. The act of making the report ruined the rapport I had with the child in question, leaving her alone with no one to trust and facing a father who was going to be told that she reported him to the authorities.

    I think we can point out the classism in this bill without implying that society should not worry about the welfare of children.

    You seem to be making the assumption that the point (or outcome) of this bill will have more to do with protecting children then about controlling people who have been deemed undesirable.

    There’s an undercurrent of “leave it in the family” in this thread that is *very* disturbing to me, as that is the mentality that allowed abuse to fester without respite and with so many, many silenced victims.

    I haven’t seen that in this thread. Calling out a society on using the pretense (and thats all this is, make no mistake) of protecting children to control their parents is not the same as saying the abuse of children ought to be ignored. No one has said we should keep things in the family, no one has said we should silence victims. I’m all for victims being empowered to speak out and force their abusers to account for their crimes, what I’m against is privileged people deciding what is best for vulnerable groups and forcing the issue against their will. Part of my job is to help victims I see to get the resources they need, but it has to be on their terms and tailored to their needs. Thats not what mandated reporting does.

  28. colleen
    November 26, 2009 at 2:45 pm

    “The same folks who want to force a certain race and class of women to birth would keep other women childless”

    Women on TANF are, by definition, not childless. They’re poor and have at least one child, otherwise they would not be on TANF. They are women who, for a whole host of reasons, are in a situation where they are forced to rely on public assistance to support themselves and their child/children. I greatly dislike the stigma this culture places so unfairly on such woman but am not nearly as upset by a visiting nurse as I am by the stupid and cruel idea put forth by centrist Democrats and republicans alike that it’s both dignified or possible to raise a child on ones wages from Burger King.

  29. Katherine
    November 30, 2009 at 7:07 am

    For the record, since it was referred to in the post, the system in the UK is of health visitors who visit you fairly frequently in the first couple of weeks post-birth and give you advice or answer questions etc etc.

    It does apply to every woman/child/family, and I found it pretty useful. It has been, however, threatened at various points with funding cuts, to the extent that the number and frequency of visits now have to be “prioritised” according to need. A few years ago, every new parent would get a daily visit for the first 10 days. I got two. But then, I’m a middle-class white woman, who had her mother and husband conspicuously around and being helpful and wasn’t begging for more help.

    Now, to my knowledge, this has not lead to an oppressive monitoring atmosphere around those households where visits are more frequent because of a perceived need. But (a) I’m not in a position to know, so I could easily be talking ignorant bull and (b) there is a different culture in the UK around social assistance – to a certain extent, it is seen as a right rather than a privilege. It is also ubiquitous. The vast majority of the population use the NHS, even those who also have private insurance. Most people have at some point or another claimed a benefit, even if it was just claiming the dole for a few weeks when you were a student. Etc etc.

    There was talk a year or so ago of the Conservative Party adopting a policy like that of Holland, where every household gets a dedicated maternity nurse initially. Now that, in the UK social context, was considered by lots of people to be potentially oppressive and monitoring behaviour. I, for example, whilst happy to have the health visitor come round, would have been extremely unhappy to have had a stranger living in my house.

    Which just shows how culture specific it all is.

  30. RD
    December 1, 2009 at 1:28 am

    Holy shit that is scary. If this passes, I hope I’m off Medicaid and have other insurance by the time I have kids (if I have them). I already have this fear that any kid I had would be taken away because of my mental health history, or sex work history.

Comments are closed.