Family Planning ~ Abstinence-Only!

Did you know that the proposed 2005 budget funding for family planning programs almost equals that for abstinence-only programs? I didn't. (The original article* is subscription-only, so I'll quote extensively.)

With record deficits, it may seem counter-intuitive to suggest that it makes sense now, more than ever, to establish full funding for family planning in the United States and internationally. There is good evidence, however, that family planning programs are not just cost-effective, but cost-saving: these programs save money in both the short- and long-term and thus remain a key priority, even in times of budget deficit.

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Unfortunately, the $2.4 trillion budget proposed for the U.S. for the next fiscal year goes almost exactly against this evidence, leaving family planning funding to stagnate while doubling money for abstinence-only programs.

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Consider the example of family planning. Every dollar invested in family planning saves $4 or more in public costs—including at least $3 in Medicaid expenditures, with savings starting in the very first year. A recent study of family planning care provided through Medicaid waivers found that every state studied saved money, even while increasing access to care. Yet, despite the great dividends—economic and otherwise—generated by family planning, the 2005 budget request for Title X, the U.S. family planning program for low-income men and women, is the same as the total for last year. At the proposed funding level of $278 million, the program's funding is not keeping up with inflation, and currently provides care for only about half of the low-income women and men who need family planning services.

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While family planning and reproductive health programs are being subjected to “fiscal abstinence,” “abstinence-only” programs are receiving unprecedented levels of funding. Abstinence-only-until-marriage programs teach that sex within marriage is the only acceptable context for sexual activity, without giving accurate information about contraceptives and safe sex. Very few abstinence-only-until-marriage programs have been rigorously evaluated and, thus, there is no compelling evidence to date that they actually change sexual behavior. In the new U.S. budget, the funding level proposed for abstinence-only-until-marriage programs is doubled from last year, from $140 million in 2004 to more than $270 million in 2005. Money for “marriage promotion” is also increasing, as part of the President's proposed $1.5 billion marriage initiative.

From the Ministry of Silly Walks and Stating the Obvious: we'd be much better off if we could only give science a chance.

*original article: Stewart FH, Shields WC, Hwang AC, et al. The 2005 United States budget: Wasteful expenditures, foregone opportunities. Contraception. 2004 Aug;70(2):87-8.