Does Better Health Care Coverage Reduce Abortion?

In his most recent column, T.R. Reid posits a connection between the absence of national health coverage in the United States and the unusually high number of abortions. Comparing the U.S. to other industrialized nations, Reid points out that the U.S. has a substantially higher rate of abortion than countries that have adopted national health care systems. The author uses this as evidence to suggest that opponents of abortion should be more willing to accept national health care as a way to advance their cause.

However, Reid’s argument ignores at least two other important points.

First, Reid fails to acknowledge the wide range of abortion rates among countries that have adopted national health care systems. The variation among states with universal health care is far greater than the variation between the United States and the United Kingdom. In Germany, for example, the number of abortions for women ages 15 to 44 is 7.8 per 1000 women, compared to 17 per 1000 women in the United Kingdom. (The rate in the United States is 20.8 per 1000 women.) This suggests that, when it comes to abortion rates, the health care system may not be as important as more subtle forces like culture.

Second, Reid does not take into account national teen pregnancy rates, which are far higher in the United States than in other industrialized countries. Because higher rates of teen pregnancy are likely connected to higher abortion rates, it seems plausible that there is a third variable – perhaps some measure of social responsibility – contributing to both the absence of a national health care system in the United States and the higher rates of teen pregnancy and abortion. Isn't it possible that American couples are less responsible about pregnancy because they have less of a sense of responsibility to society? Wouldn't this lack of social responsibility also make Americans less concerned about the uninsured?

Unfortunately, Reid chooses not to even consider this possibility. He simply asserts that there are “various reasons” why universal health care reduces the rate of abortion, acting as though correlation automatically implies causation.

As a supporter of national health care and abortion rights, I wish Reid’s contention were true. But wishing does not make it so. In his eagerness to connect national health care with lower rates of abortion, Reid overlooks essential details and relies far too extensively on testimonial evidence.