Friday, November 09, 2012

Status update

A few days ago saw a grim date in American history, one that will long be remembered as an ominous turning point for America- nay, the entire world- and looked upon with horror by future generations cursed to live in its cold, bleak shadow...

'Cause it was my birthday on Wednesday! And it was a pretty nice birthday, in spite of some sad events in the past year that played were one of the main reasons for the rarity of new posts at The Superfluous Man in 2012. If you're one of the people who likes this place, I apologize for that, and I hope to make 2013 a much more interesting year.

If you're reading this, thank you; being able to write things that people actually read means a lot to me, even if I haven't been able to do so here as much lately, and I hope you'll keep reading here for a long time to come.

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Thursday, November 01, 2012

This must be that "common-sense regulation" I hear such good things about

The state of Virginia's Board of Health recently enacted new regulations on abortion clinics. Ostensibly enacted to protect women's health, in practice they serve as an interesting example of how the regulatory state can be, and often is, used by governments to chip away at rights that are impractical to simply abolish wholesale. (Found via Reason.)

Last year, the state's General Assembly passed, and Governor Bob McDonnell signed, legislation requiring the state's Board of Health to institute new regulations requiring all existing abortion facilities performing five or more first-trimester abortions per month to comply with regulations similar to those that apply to new hospital construction (but not preexisting hospitals) in the state. The Board did so, creating an extensive list of new regulations last year, covering all existing and future facilities in the state, and finally voted to approve them this September. They will go permanently into effect next year, contingent on approval from Gov. Bob McDonnell. The board had voted back in June to include a grandfather clause exempting existing facilities, but reversed itself under pressure from Virginia's Attorney General, Ken Cuccinelli.

(For a more in-depth history see this article at Mother Jones. Detailed and refreshingly light on the conflation of forcing women to carry a pregnancy to term and failing to force some third party to subsidize recreational sex when a woman demands it that now infests left-of-center commentary on the subject.)

The new requirements (see this PDF file, starting on page 27) imposed on existing buildings are taken mostly from the 2010 Guidelines for Design and Construction of Health Care Facilities published by the Facility Guidelines Institute. These include things things a minimum size of 80 feet for exam rooms for exam rooms, corridors at least 5 feet wide and seven feet ten inches tall, hands-free sink faucets, water fountains in waiting rooms, and new ventilation systems. Many of these are not trivial modifications to make to an existing building, and some existing facilities in the state will have to undergo costly renovations in order to continue legally operating.

Now, it's fairly obvious that the real point of this measure is to make it harder for abortion clinics to operate in Virginia, with the supposed public health justification serving as a fig leaf. The naked opportunism of the new regulations is made plain by the fact that they require existing abortion facilities to comply with building codes that apply only to new hospitals, which makes very little sense if protecting the health of patients at these facilities is really what this is about. Surely protecting the health and safety of people with heart problems or inflamed appendixes or stab wounds is no less important than protecting that of women undergoing abortions, after all. The improbability of the regulations' conservative supporters being driven by the genuine belief that women getting abortions ought to have more government-mandated protection for their health than everyone else should be obvious.

(Adding to the absurdity, the reason the regulations specify five or more first-trimester abortions is that abortions later in the pregnancy are required by law to be performed at a hospital, which may or may not be obliged to follow the same rules- so late-term abortions entail less potential risk to patients and so warrant less oversight than early ones, I guess.)

Indeed, calling the public health justification for these regulations a cynical ruse is actually a more charitable interpretation of their supporters' motives then taking them at face value. If these regulations are really such a good idea, so good that they should be imposed on existing facilities at considerable cost, their supporters in the legislature are guilty of an unconscionable betrayal of their constituents by wasting time and energy imposing them on only a very small niche of healthcare in the state when they should be fighting tooth and nail to get them in place everywhere, in old and new hospitals alike. While they dither, countless Virginians are apparently being imperiled every year in hospitals that were built before the current hospital construction regulations and exempted from current building standards, allowing their irresponsible owners and administrators to wantonly gamble with human life in miasmic corridors only 7'9” in height.

The vast scope of modern government power gives it tremendous latitude to attack freedoms that it supposedly still respects, either because they are supposed to be legally guaranteed rights the government cannot take away or because public opinion wouldn't tolerate their overt elimination. For instance, if it can't simply announce that no one can own a gun, it can still impose “reasonable regulations” to make it more burdensome, possibly to the point of a de facto ban. For instance, contrary to what is often thought, the city of Chicago has never actually banned owning handguns- you're just required to register them. Which you can't do without a time machine, because the city stopped accepting new registrations in 1982. It can't deny people the right to travel, but it can put all sorts of strings on any means of travel other than your own likes. You want to fly, you jump through whatever intrusive or degrading hoops the government demands- movement may be a right, but flying is only privilege. You want to drive- a driver's license is a privilege, not a right, and the government owns the roads, so you've “agreed” to give up some of your protections regarding search and seizure.

And it can't make abortion illegal, but it can do quite a bit to make legally getting one as burdensome as possible. The government of Virginia is no stranger to that, being one of the states requiring women to undergo a medically pointless abdominal ultrasound before receiving an abortion, supposedly to ensure that women can make an “informed choice” about the procedure. And that was the compromise solution, of course, enacted after supporters of the notorious original version of the law requiring transvaginal ultrasound compromised.

(Again, the limits of the measure's scope betrays the actual intent. The version of the ultrasound bill eventually passed in Virginia exempts women whose pregnancy is the result of rape or incest. That makes sense if the real purpose of the bill is to make getting an abortion a more burdensome and unpleasant experience- many people might like that idea in general but draw the line at doing it to a rape victim. It makes much less sense if the mandatory ultrasound really is supposed to be for the benefit of the woman. If you genuinely think it helps women considering abortion, and in fact helps them so much that it should be mandatory, why in God's name would you single out victims of rape and incest as the only women who aren't guaranteed this help?)

This is one of the problems with so many governmental powers that the great majority of people support. Like the power to tax, the power to regulate is the power to destroy, or at least the power to cripple, and when a governments' powers and activities intertwine with virtually every area of life in one way or another- as they inevitably do in any regulatory/interventionist state- very little if anything is out of reach.

The right to have an abortion is particularly vulnerable to this. It's an invasive medical procedure, making it part of one of the most regulated sectors of the economy- strict government regulation and licensing in the field of healthcare ranks high among those things everybody within spitting distance of the political mainstream mainstream “knows” is obviously necessary. It requires a permanent facility for both production and (for lack of a better word) consumption, and it's frequently done- as is the case here- in specialized facilities, which makes it highly vulnerable to attacks via zoning regulations. All of this makes it vulnerable in a way many things large numbers of people would like to restrict aren't. (There are certainly ways to interfere with or discriminate against homosexuals while still nominally respecting their right to sexual freedom, but making homosexuality de facto illegal by driving all of the gay sex factories in your state out of business with burdensome regulations is not one of them.) Given how intensely controversial abortion is, it's unsurprising that there are plenty of people ready to use the tools available to them.

It's a perverse irony that there's so much overlap between people who support abortion rights and people who wants to make the government's power to assail those rights even stronger. If you think there are powerful forces arrayed against women's ability to have an abortion now, what do you suppose it would be like in a single-payer system where every abortion is funded by the taxpayers, where people who want it restricted or outlawed are outraged at not merely having to tolerate something they consider murder but being forced to pay for it themselves every single time it happens, where people who think abortion should be legal but recoil at the notion of having any part of it themselves are told that simple tolerance is no longer an option, where the only source of money for a legal abortion is a perpetual political battlefield and comes with whatever strings Congress chooses to attach? As things stand now, making abortion inaccessible through legal channels nationwide would require a Supreme Court decision overturning a maor past decision or a constitutional amendment. Turn medicine into what many "progressives" want it to be, an arm of the state, and it gets a lot simpler.

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