Category: Family Planning

A recent Durango Herald article detailed the “New Year’s resolutions” of three Southwest Colorado lawmakers. There is an important issue that was not mentioned in this article, and Rep. Coram may have part of its solution.
Let me start by trying to summarize what is on each of the legislators has said. State Senator Ellen Roberts is focusing on rural healthcare costs—for good reason! Although we in the USA spend the most per capita of any country in the world, our health statistics lag behind many other countries. Senator Roberts is also concerned about problems brought up by the Gold King Mine spill. I am confident that her excellent legal mind can help pass a “good Samaritan” law for mine mitigation, and decrease barriers between states in dealing with emergencies. Finally, she is concerned about the monstrous wildfires we have experienced recently.
J. Paul Brown, our Representative in the Colorado House, rightly picks transportation and water as key issues for the legislative session that has just begun. He and I probably disagree about transportation because I support public transportation as well as highway improvement. But we definitely agree about water! J. Paul’s website states: “Water is the most precious resource on Colorado’s West Slope…. As your State Legislator, I will work tirelessly to protect our water.” Globally, water is the most precious resource.
Don Coram represents people a bit to the north and west of La Plata County, nevertheless he was included in this article. The only issue mentioned is voter registration, but I admire him for another topic. In 2015 he was one of the sponsors of a bill to provide safe, effective contraception to low-income women. A Republican, the bill had a Democratic cosponsor. Unfortunately, the bill failed. Fortunately, however, a coalition of private donors has temporarily picked up part of the slack.
You probably recall that a foundation funded provision of Long Acting, Reversible Contraceptives (LARCs) here in Colorado. LARCs consist of IUDs and a hormonal implant, all of which are safe and appreciated by women, but are usually out of the price range of those who don’t have insurance. They are much more effective than over-the-counter methods such as condoms, and are even 20 times as successful at preventing pregnancy as “the pill”. That grant was for a 5-year period which ended in 2015. This funding had a remarkable effect! There were fewer abortions in Colorado, and our teen pregnancy rate dropped by 40%.
Despite Representative Coram’s best efforts, the legislature would not approve funding to continue the program. The reason given for disapproval by other legislators was that IUDs sometimes cause abortions. The best medical knowledge is that IUDs do not cause abortions—but it is well known that unplanned pregnancies often end up being aborted.
Public health sources state that each dollar spent on family planning saves from 4 to 7 healthcare dollars. This is a better return on investment than just about anything else! Personal benefits, such as allowing a young woman to finish college are of even greater value. Other advantages, however, go beyond the obvious. The cost of insurance is lower if there are fewer unplanned pregnancies, Senator Roberts. Some of the highest healthcare costs are those associated with premature birth. The pregnancies that LARCs prevented in this study would have likely been to the women most likely to give birth prematurely—young and poor.
What is causing those terrible wildfires that we are having trouble paying for? Climate change is a major factor. What is the least expensive way to slow greenhouse gas emissions? You guessed it—family planning! Fewer people mean fewer emissions. LARCs won’t provide a short-term solution for either climate change or wildfires, but they can help in the long term.
Representative Brown, please remember that the more people who drive on our highways, the more costly they are to maintain. Likewise, the more people there are in Colorado, the greater the need for water. Most of the growth is on our state’s Eastern Slope. As its population increases, the pressure for them to get our Western Slope water will increase. Again, LARCs won’t solve transportation or water problems right away, but funding them can reduce the size of the problems that our children and grandchildren have to deal with.
Thank you for your courageous stand, Representative Coram. I am sorry that I cannot vote for you, but hope that you will find new allies in support of another bill to pay for LARCs.

© Richard Grossman MD, 2016