Planned Parenthood: Assessing Claims of Irreplaceable and Lifesaving Healthcare
In its most recent annual report, the Planned Parenthood Federation of America makes two fundamental claims: first, that Planned Parenthood health centers are “an irreplaceable component of our country’s healthcare system”, and second, that Planned Parenthood provides “lifesaving care.” These claims would suggest that Planned Parenthood’s services are unique and not easily available from other providers, and that the level and intensity of services have a direct and measurable impact on the likelihood of fatal occurrences.
Organizational Scope and Scale
Planned Parenthood, by almost any measure, is a large organization with nearly 650 health centers in the U.S. alone and an international presence through Planned Parenthood Global Health Partners in 12 other nations. It has $1.5 billion in net assets and $1.1 billion in current annual revenue. Approximately $555 million of this revenue in the fiscal year ending June 30, 2016, came from government funding for its services. The organization is undoubtedly intensely and strategically managed, with $165.8 million in management expenses annually and $73 million spent annually on fundraising.
The Service Profile and Clinical Data
In 2015, Planned Parenthood health centers saw 2.4 million patients during 4 million clinical visits and provided 9.5 million services. A service is defined as a “unique clinical interaction” – a term vague enough to be insufficient for any health insurance claim. Below is a breakdown of the services provided by the organization:
- Sexually Transmitted Infection (STI) testing and treatment: 4,266,689 services (44.9% of total). According to the annual report, nearly 99% of Planned Parenthood STI services involve testing – not treatment.
- Contraception: 2,808,815 services (30% of total). Of that group, 68.9% were for reversible contraception clients, including oral pills, IUDs, and implants.
- Other women’s health services: 1,317,582 services (13% of total). 1,079,836 of those services, or 81.9%, are pregnancy tests, which are a prerequisite for abortion.
- Cancer screenings and prevention: 665,234 services (7% of total). This includes breast exams (321,700) and pap tests (293,799).
- Abortion services: 328,348 abortion procedures (3.4% of total services).
- Other services: 108,309 services (1.1% of total), including small numbers of primary care services and nominal numbers of adoption referrals.
Clinical Capabilities and Diagnostic Limitations
Planned Parenthood centers are largely focused on contraceptive services, sexually transmitted infection testing, and abortions. There is little or no demonstrable capability for definitive diagnosis or a range of treatments for any disease or condition at Planned Parenthood centers. For example, breast exams are insufficient for a confirmatory diagnosis of breast cancer, as additional diagnostic testing or technology (e.g., mammogram, biopsy) is required. Planned Parenthood centers can only refer to other providers for such procedures.
Abortion Services and Regional Accessibility
Planned Parenthood Great Rivers provides medication and procedural (in-clinic) abortion services. In Illinois, abortion is safe and legal, and the organization provides abortion up to 27 weeks of pregnancy. In Missouri, patients can access procedural abortion up to 18 weeks of pregnancy in St. Louis at the Central West End health center. A medication abortion with the abortion pill can be done up to 12 weeks of pregnancy.
Financial and Legal Considerations
In Illinois and Missouri, there is no mandatory waiting period or mandated counseling prior to an abortion. Regarding financial coverage:
- In Illinois: Medicaid may pay for all or most medically necessary abortions.
- In Missouri: Medicaid does not cover abortion, except in very rare, limited circumstances.
Case managers at the Regional Logistics Center help assess needs and create a plan to ensure patients can access appointments without logistical and financial barriers. Furthermore, partners cannot legally interfere with decision-making regarding a pregnancy, though they can offer support before, during, and after the abortion process.