Federal ‘Family Planning’ Spending: Domestic Population Control, Part Two

[Part one of this series on domestic population control by Dr. Jacqueline Kasun was titled “Contraception in the Classroom,” and appeared in the March-April 2000 issue of PRI Review.]

The Clinton-Gore administration’s call for $35 million more spending on Title X domestic family planning comes at the same time as the Malthusian forecast by the US Commerce Department that the population of the United States will double by the end of this century (see: PRI’s Weekly Briefing, “Commerce Spin Aids Domestic Family Planning Proposal,” 23 February 1999, https://www.pop.org/briefings/commercespin.htm). Such alarmist scare tactics are nothing new.

According to the Population Reference Bureau, which first coined the term “population explosion,” a “tacit objective” of family planning legislation from the beginning in the United States was “to lessen the pressure of excessive population growth…”1 While the legislation did not explicate the aim of population control or reduction, “clear evidence in the legislative history” shows this implicit intention, according to the Bureau.2 As William B. Ball has noted, speakers at the hearings preceding early domestic population control legislation urged the need for family planning motivation and possibly coercion.3

During the 1960’s and 1970’s, many influential Americans joined the drive to control population growth in the US. Mary Calderone. one-time medical director of Planned Parenthood and founder of the Sex Information and Education Council of the United States, expressed concerns when she called for “family planning practice and contraceptive practice…in the service of population practice” She insisted that “control of population growth in…developed countries is crucial.”4 In 1970 Planned Parenthood, the major recipient of US family planning subsidies, published a list of suggestions for fertility reduction, similar to measures enforced by Chinese family planning officials. Planned Parenthood‘s suggestions included: “fertility control agents in water supply,” measures to “encourage increased homosexuality,” a “substantial marriage tax,” “discouragement of private home ownership.” “permits for children,” “compulsory abortion,” and “compulsory sterilization of all who have two children.”5

Given the population control propaganda which has flooded the airwaves and classrooms for the past two decades or more, the concern of many well-meaning Americans about population growth is perhaps understandable. Remarkable new medical discoveries have greatly reduced the death rates. Average life expectancy in the US is on the rise. Hence, even though fertility was falling, population growth was seen as high; but this has now changed. Fertility is plunging in every continent and is below replacement levels in countries containing 44 percent of the world’s population, including the United States. The one-child family has become the standard throughout much of Europe and Asia and birthrates are apparently still falling. If the growth of population was surprising a few decades ago, the present decline in fertility is without precedent.

This means that the Clinton-Gore administration’s continuing zeal to curb births both at home and abroad is remarkably out of step with present realities. Several facts point to this conclusion.

In the first place, the US death rate has been rising, slightly but perceptibly, in recent decades because the population is aging. People have been living longer and death rates are higher among older populations. For example, the death rate in healthy but elderly Sweden is 11 per 1000, compared with 5 for youthful Mexico and 9 for our country.6 Our population, whose median age has risen from 28.0 in 1970 to 35.6 in 1999,7 is becoming more like Sweden, and this trend promises to continue. An increasing death rate during future decades in the United States has, indeed, been predicted by the United Nations Population Division.8

Secondly, the birth rate in the United States has fallen from 24.3 per thousand population in 1950–55 to 14.6 in 1998.9 It would be very surprising if this trend did not continue, in view of declining marriage rates, rising urbanization, longer educations and more careers for women, all of which are associated with lower birth rates. Also the size of the female population of reproductive age will decline by several million during the next decade, unless this is offset by immigration.10

Doubling the United States population, as predicted by US Commerce Department, might occur if there were a reversal of present trends in births and/or deaths or a major increase in immigration. This is one scenario projected by the US Census Bureau: rising births, declining death rates, and a Hood of immigration to swell the population by 2050 to a size that is 54 million greater than the prediction of the UN Population Division.11 From then on, only the wonders of compound interest and pure fantasy carry the projection forward to 571 million in the year 2100, which cannot not be compared with any other projection because no other agency would hazard such a guess. This projection is at odds with present realities and with forecasts by other, equally qualified specialists.

Making a forecast of population a century hence, when the population of reproductive age will not have been born for many years from now, is an expedition into the unknown. Even a forecast 50 years into the future requires assumptions about things that will not be known for years from now, It is clear, however, that the immediate prospects are for a continuing decline in the rate of natural increase as a result of the rising death rate and falling birth rate. And indeed, the United Nations Population Division (UNPD) has predicted such a decline, from a population growth rate of 0.79 percent per year in the 1995–2000 period to a “medium variant” rate of 0.20 in 2030–2035 and even lower rates thereafter.12 By way of contrast, the Commerce Department’s forecast of a doubled US population would require a rate of growth of 0.69 per cent per year maintained on the average throughout this century, several times as high as the UN predictions.

Two-thirds of the population increase promised by Commerce for the end of the century is accounted for by immigration. The highest variant projections of the US Census Bureau, from which the Commerce spin was derived, hypothesizes that concerns over the aging of the domestic population and increasing dependency will lead to higher acceptance of immigrants, and the inflows would swell to 1,450,000 a year by the year 2030.13 This compares with the present level of less than a million a year. In its highest and least historically likely variant projection, the Bureau forecasts that, in the absence of immigration, the population would grow by 40 percent, rather than doubling. Even in the absence of immigration, however, the Bureau predicts that the population will continue to grow throughout the period as a result of increasing fertility (which is contrary to present trends) and life expectancy. At this point, of course, no one can know these things; and an examination of the current trend of declining fertility would suggest that such population growth is extremely unlikely.

Contrary to the Census Bureau’s high range projection, the immediate future does not promise a surge of population growth that requires strenuous counteraction by government. Present trends, indeed, suggest a continuing decline in the rate of growth and an approach to stabilization and possibly decline. The fears of a population “explosion,” which family planning promoters have used in the past to justify their government subsidies, are less reasonable now than ever.

And one thing is already happening. The advancing age of the population and the decline in the proportion of youthful workers will require adjustments. Unless it is redesigned, the Social Security system will have more pensioners and fewer taxpayers, Service industries, such as health care, which depend on youthful workers, will have more customers and more problems finding employees.

The evidence suggests that the real problem is not to stern the arrival of too many babies but to cope with the fact of too few. In fact, domestic population reduction programs more than ever present a clear and present danger to America.

Siren Song

The so-called “teenage pregnancy epidemic” has been another major justification for government family planning. At the time this cry was raised in 1976, the rate of births to women 15–19 years old was in fact at its lowest level in almost 40 years. Nevertheless, years of propagandizing by such groups as Planned Parenthood, the Guttmacher Institute, Zero Population Growth, the Population Council, and the Population Reference Bureau (as well as the Department of Health, Education, and Welfare) persuaded Congress that the epidemic was real and required strenuous government action.

Here again there were population control objectives in addition to the professed concern for the health and welfare of teenagers. In 1972 the Commission on Population Growth and the American Future said that the rate of population growth could be reduced by lessening or eliminating births to teenage women.14 In 1974 the Population Council published a major study showing the same thing.15

Accordingly, Congress appropriated still more money, in addition to the sums already available which had provided birth control for the poor since 1967. The expenditures have continued their upward trend since then, especially during the Clinton-Gore years. It is Title X of the Public Health Services Act which President Clinton increased by $25 million in 1999 and now proposes to increase by $35 million this year. Although Title X, amounting to $240 million in 1999, is only a fraction of total public family planning outlays, it is a major source of funding for the 4,200 family planning clinics, including 78 percent of Planned Parenthood clinics, and their thousands of employees in all states.16 Title X recipients are a voting bloc which the Clinton-Gore administration cannot afford to ignore.

Even if Title X were defunded entirely, the much larger birth control expenditures by Medicaid and other federal programs would continue to make sure that no poor person is without family planning. In the mid-1990’s total public expenditures on domestic family planning were estimated at about a billion dollars.17 Since 1997, Temporary Assistance for Needy Families (TANF) and the Children’s Health Insurance Program (CHIP) have added to the flow.18

Since 1985 the population of 15–24 year-old females, the high school/college age group targeted by the Title X clinic funding, has shrunk by more than l million persons. This alone would suggest that the program might be reduced. Instead it has expanded by tens of millions of dollars, The result has been to increase such activities as the clinics’ lobbying for more funds and their “outreach” programs which pay students to go into the schools and recruit their classmates for birth control services and show them how to put condoms on bananas. (In February of 1999 Six Rivers Planned Parenthood of Eureka, California hired and trained a group of youngsters to present at Arcata High School a program in which the performers demonstrated how to fit condoms on bananas.)

Another result of the increased spending has been the increase in clinics’ net income. Although Planned Parenthood clinics are called “non-profit” organizations, this only means that they pay no taxes on their income. A typical clinic with 7000 contraceptive clients added 14 percent to its net assets, tax free, in 1997.19

In its eagerness to make sure that everyone has complete access to all means of family planning, Congress may have overlooked one fact: There is a powerful tendency in any government-funded family planning program to become excessively persuasive, if not coercive, because the clinics’ income depends on the size of their clientele. They increase their income by increasing the number of their clients by any means that work. This explains the industry’s efforts to get into the schools with its “outreach” programs and its fierce opposition to requiring parental consent for minors’ contraceptives and abortions.

And what has happened to teenage pregnancy as Title X spending has increased? Teenage fertility continued its long decline until 1986, by which time the new programs had been in place for several years. It then began a sharp increase, which continued until 1991. There ensued another decline, which left the rate at the same level in 1997 as it had been in the mid-1970s.20 This data suggests that if there had been no Title X, the sharp increases in births to teenage mothers during the early 1990s might not have occurred.

Other things also happened as Title X programs expanded. Sex activity among unmarried adolescents increased. Abortions increased. The proportion of babies born and raised out-of-wedlock increased explosively. Sexually-transmitted diseases increased.21 None of these suggest that Title X has been promoting the “sexual health” of the younger generation, as claimed by the family planning lobby.

There was no improvement in any of these trends until parents began to insist that schools teach abstinence as the only, or at least the preferred, behavior for unmarried adolescents, and until some state governments began to require that parents be notified before their grandchildren could be aborted.

Title X can make one indisputable claim: it has encouraged and nourished the growth of the family planning lobby which unswervingly supports the Clinton-Gore administration.

Jacqueline R. Kasun is Emeritus Professor of Economics at Humboldt State University in Arcata, California and the author of The War Against Population: The Economics and Ideology of World Population Control, (San Francisco: Ignatius Press, 1988, 1999).