Did Limited Access to Abortions Keep Kermit Gosnell in Business?

On one hand, the responses of Planned Parenthood and the National Abortion Rights Action League (NARAL) have not surprised me. Because they are advocacy groups, I expected them to defend abortion even as they applauded the verdicts.
On the other hand, I wondered if perhaps they would seek some common ground. Surely, everyone should be able to agree that killing babies after they are born should be condemned.  In addition, it seems that all concerned should welcome strict enforcement of laws regulating abortion as a means of finding and stopping any future Gosnell-like clinics.
Such reactions are not happening.
Planned Parenthood tweeted:

NARAL issued a statement missing any direct reference to the babies murdered by Gosnell. The statement begins by citing Ilyse Hogue, president of the group:

“Kermit Gosnell has been found guilty and will get what he deserves. Now, let’s make sure these women are vindicated by delivering what all women deserve: access to the full range of health services including safe, high-quality and legal abortion care.”

It seems to me that these statements confirm the worst fears of every pro-life advocate. Whether deliberate or not, by failing to even mention the murder of infants, these groups communicate a callous disregard for the lives of these children.
Apparently hoping to use the verdict to advance the cause, a NARAL tweet blames pro-life sentiment for Gosnell’s crimes:

NARAL spinners find numbers they like, but regarding both regulation and funding, they miss the facts of this case. Regarding funding, sources existed to pay for abortions at Gosnell’s clinic or for options other than his clinic. Delaware Pro-Choice Medical Fund paid for abortions at Gosnell’s clinic as well as at other abortion providers around the Philadelphia area. In fact, this funding source and others helped keep Gosnell going.
In 2007, three representatives from the Delaware Pro-Choice Medical Fund toured Gosnell’s Womens Medical Society in West Philadelphia. They saw nothing wrong. Even though the representatives were greeted by two people who called themselves doctors, the funders did not check credentials and continued to pay for abortions at Gosnell’s house of horrors.
When Gosnell’s crimes were first exposed in 2011, pro-choice advocates blamed the Hyde Amendment for driving women to low-cost providers like Gosnell. At that time, I responded that Gosnell had access to funding for the women who were seeking his services. As noted, various medical funds paid for abortions at his clinic. As this rate sheet demonstrates, it appears he billed Medicaid for allowed abortions. I suspect he stretched the truth on some of those billings.
As is now obvious, none of these funding sources provided adequate oversight. The funding was there but the horrors continued.
Despite the smoke screen from NARAL, one central issue in this case, whether one is pro-life or pro-choice, is the appalling lack of regulation of a so-called medical clinic.
The issue here is oversight, or rather the lack of it, and let’s not forget why that oversight was lacking. Kenneth Brody, Department of Health lawyer said there was consideration given to restarting abortion clinic regulation in 1999. However, the state did not resume inspections. Why? Brody told the grand jury:

…there was a concern that if they did routine inspections, that they may find a lot of these facilities didn’t meet [the standards for getting patients out by stretcher or wheelchair in an emergency], and then there would be less abortion facilities, less access to women to have an abortion.

Worries over access kept Gosnell unregulated. Generally, pro-choice advocacy groups oppose laws which tighten oversight on clinics. Why should those who operate properly fear rational regulation? Only those acting in the darkness fear the light. For the sake of women and babies, let the light shine.
 

Kermit Gosnell Found Guilty of Murder and Other Charges

A variety of sources are reporting what is emerging from Philadelphia. The first source I saw was this tweet from J.D. Mullane, reporter for the Bucks County Courier Times who is in the court room.

Here is the AP story which provides more details.
According to Mullane, he is guilty of most of the other 200-plus counts against him.

When this story first broke, I posted extensively about it, including some original reporting:
Gruesome abortion/murder case in Philadelphia (1/19/11)
Abortion clinic regulation scandal in PA (1/20/11)
PA Senate to hold hearings on failure of abortion clinic regulation (1/21/11)
PA Abortion clinic inspections stopped to avoid barriers to abortion(1/21/11)
Did the Hyde Amendment keep Kermit Gosnell in business? (1/25/11)
National Abortion Federation quietly removes reference to Gosnell’s Delaware clinic (1/29/11)
National abortion funding network member visited notorious Philadelphia abortion clinic (1/31/11)
National Abortion Federation suspends Delaware abortion clinic(1/31/11)

Media Blackout on the Kermit Gosnell Case May Be Lifting

The local Philadelphia press has been covering the case, but today Yahoo news carried a lengthy reprint of a story on Gosnell’s trial first published by The Atlantic. Slate’s Dave Weigel also wrote about the case and the lack of coverage. #Gosnell is now trending on Twitter. In what could be titled, “Confessions of a Pro-Choice Journalist,” add Daily Beast to that list. Now WaPo…
I was glad to see these articles which pull no punches in reporting the case of Gosnell who performed abortions in violation of numerous health codes and is accused of overseeing a killing field of women and newborn babies. The story is not for the weak but needs to be told.
When this story first broke, I posted extensively about it, including some original reporting:
Gruesome abortion/murder case in Philadelphia (1/19/11)
Abortion clinic regulation scandal in PA (1/20/11)
PA Senate to hold hearings on failure of abortion clinic regulation (1/21/11)
PA Abortion clinic inspections stopped to avoid barriers to abortion (1/21/11)
Did the Hyde Amendment keep Kermit Gosnell in business? (1/25/11)
National Abortion Federation quietly removes reference to Gosnell’s Delaware clinic (1/29/11)
National abortion funding network member visited notorious Philadelphia abortion clinic (1/31/11)
National Abortion Federation suspends Delaware abortion clinic (1/31/11)
UPDATE: Anderson Cooper’s AC360 show covered the Gosnell trial tonight.

Jake Tapper too…

National abortion funding network member visited notorious Philadelphia abortion clinic

In 2007, three representatives from the Delaware Pro-Choice Medical Fund toured Kermit Gosnell’s Womens Medical Society in West Philadelphia.  According to a statement from the National Network of Abortion Funds (full statement here), the visitors saw nothing that prevented them from funding abortions there. According to the NNAB,

The Network has reached out to the Delaware Pro-choice Medical Fund and can share the following information about the relationship between the Fund and Dr. Gosnell’s clinic. Three volunteer board members of the Fund toured Gosnell’s clinic in 2007. They were met by Dr. Gosnell and two other doctors as well as some administrative staff. Their tour took place on a day when abortions were not being provided, but other health care services were and the women saw several elderly patients in the waiting room. One of the other doctors, not Gosnell, showed the Fund members around the clinic. Nothing they saw, including the ultrasound room, waiting room, and recovery room, gave them any reason to be concerned about the practices of the clinic. After the tour, the Fund also did some research on Dr. Gosnell on a website that rates doctors and hospitals. On that site they discovered one sanction against another employee at the clinic but it appeared from the information available that the matter had been resolved eleven years prior. The Fund did not consider the one sanction to be sufficient reason to deny help to women obtaining abortion services at the clinic.

The Philadelphia grand jury report noted that Gosnell directed his staff to lie to the Delaware Pro-Choice Medical Fund about the address of women seeking abortion. Apparently, the DPCMF worked directly with clinics rather than giving money to women. Thus, the fund was vulnerable to this kind of fraud.

The statement from NNAF, if it can be taken at face value, illustrates at least one more reason why state government needs to regulate abortion clinics. We already know that the National Abortion Federation observed Gosnell’s clinic and found reasons not to include it in their membership. However, the evaluator told no one about the conditions there and they continued. Now we find that another pro-choice group entered the clinic and didn’t see the problems that others saw.

Apparently the conditions were continuously bad. According to the grand jury, the Philadelphia Health Department visited the clinic in 2007 and found some problems but apparently overlooked others. In fact, the grand jury was surprised that no one reported the other problems.

Health department employees who visited the clinic between 2001 and 2007 recorded that they dealt with “Drs.” O’Neill and Massof, but never Gosnell. These inspectors noted problems with the refrigerator, the clinic’s record-keeping, and expired vaccines. They were apparently oblivious, however, to other obvious deficiencies that did not relate directly to vaccines.

Perhaps Gosnell cleaned up for the visit in ways that would fool untrained people. However, in hindsight, it seems to be an oversight to only do an internet search about Gosnell. According to the NNAF statement, the Delaware group met with Gosnell and two “doctors.” According to the grand jury report, there were no other doctors at the clinic. Instead, two people called doctors at the clinic were not licensed as physicians anywhere. An inquiry of the state medical board would have uncovered that.

In the case of Women’s Medical Society, two private abortion groups visited the clinic with no consequences. The bottom line is this: if the state is not going to regulate abortion clinics, then in essence they will  be unregulated.

National Abortion Federation quietly removes reference to Gosnell’s Delaware clinic

Sometime Friday, the National Abortion Federation removed reference to the Atlantic Women’s Medical Services in Wilmington, DE from their website. Atlantic is the clinic where Philadelphia abortion doctor and accused murderer, Kermit Gosnell, worked one day per week until early last year. For now, the clinic remains in the search cache.

Late Thursday, the NAF issued a statement to me indicating confusion about why the Philadelphia grand jury recommended that the NAF “reassess” the membership of Atlantic. At least six illegal abortions were paid for and began at the Delaware clinic. The Director of the clinic, Leroy Brinkley, failed to produce records relating to three of the clients in question. One of Gosnell’s staff, Lynda Williams, also worked at both clinics and has been charged with murder. An NAF spokesperson told me via email:

NAF has been cooperating with the District Attorney’s office in Philadelphia. We take the Grand Jury Report seriously and we need to understand why they made the recommendation that they did in order to determine how to proceed.

The grand jury report made clear why the recommendation to reassess was made.

We recommend that NAF reassess the membership of Atlantic Women’s Medical Services, the Delaware abortion clinic where Gosnell worked part-time before losing his license in that state. We learned that at least six patients were referred from Atlantic to Gosnell’s clinic in Philadelphia for illegal late-term abortions. These patients paid Atlantic for late-term procedures performed by Gosnell in his Lancaster Avenue clinic.

We heard evidence that Gosnell would insert laminaria in patients in Delaware and then have them come to his Philadelphia office for the abortion procedure itself. The director of Atlantic Women’s Medical Services, Leroy Brinkley, was unconcerned. He did not properly supervise the doctors he hired as “independent contractors” to assure that they were complying with the law. Remarkably, despite Gosnell’s long time association with Atlantic, Brinkley only produced three files for patients seen by Gosnell at Brinkley’s clinic.

Although, the NAF statement implies lack of understanding about why Atlantic should be removed, the clinic is not now showing up on the NAF website via search of clinics in DE. The membership status of Atlantic is not clear.

On Friday, the DE Attorney General, Beau Biden, announced the beginning of an investigation into the Atlantic clinic.

Did the Hyde Amendment keep Kermit Gosnell in business?

By now, the facts are well known. Kermit Gosnell, a physician in charge of Women’s Medical Society in West Philadelphia, was charged last week with the deaths of a former patient via a botched abortion and seven infants who were born alive and then murdered. The grand jury report of the investigation is here and another post on the matter is here.

Some pro-choice advocates are blaming restrictions on abortion and abortion funding, such as the Hyde Amendment for the tragedy. For instance, Amanda Marcotte, writing for RhRealityCheck.org, asks, “Why can’t anti-choicers accept that restricting abortion means more predators like Kermit Gosnell will get customers?” Susan Schewel, executive director of the Women’s Medical Fund, a group that funds abortion for low income women, suggests that the lack of Medicaid funding caused by the Hyde Amendment drives women to low cost horror factories such as operated by Gosnell. In a letter to supporters about the Gosnell tragedy, Schewel writes, “This prohibition on Medicaid payment for abortion leaves desperate women vulnerable to sub-standard providers.

The problem with this line of thinking is that Gosnell was able to accept Medicaid funding, at least for vaccines. The grand jury report indicates that he took insurance payments, at least some from Medicaid via a City of Philadelphia program that paid for vaccinations. I have also learned this afternoon that he was a network provider for the insurance giant Aetna until early 2010.

According to the grand jury report, at least one pro-choice group, the Delaware Pro-Choice Abortion Fund paid for abortions at Gosnell’s clinic. The issue here was not access but lack of oversight. Incidentally, I can find no indication that the pro-choice funding group ever checked up on Gosnell.

If Medicaid paid for abortion, yes, Gosnell’s clients would have had free or nearly free services, but without oversight, those free services could have been pretty costly. The issue here is oversight, or rather the lack of it, and let’s not forget why that oversight was lacking. Kenneth Brody, Department of Health lawyer said there was consideration given to restarting abortion clinic regulation in 1999. However, the decision was not to inspect. Why? Brody told the grand jury:

…there was a concern that if they did routine inspections, that they may find a lot of these facilities didn’t meet [the standards for getting patients out by stretcher or wheelchair in an emergency], and then there would be less abortion facilities, less access to women to have an abortion.

Gosnell was performing procedures that few others would do even if the Hyde amendment was not in force. But those Medicaid did allow (rape, health of the mother), he did perform, at least according to this rate sheet obtained at Gosnell’s clinic.

I agree with the Philadelphia grand jury; the massacre in Philadelphia was due to a lack of oversight impure and painfully simple.

PA Senate to hold hearings on failure of abortion clinic regulation

I just received this statement from Erik Arneson, Communications and Policy Director for Sen Dominic Pileggi, PA Senate Majority Leader, Speaking about the case of Kermit Gosnell and the grand jury report on the atrocities alleged at the Women’s Medical Society in Philadelphis, Arneson said:

The grand jury report shows a massive systematic failure by the state agencies responsible for overseeing this facility. We intend to hold at least one public hearing to examine the problems in detail.

I hope the hearing will be sufficient to cover the “massive systemic failure” as well as any other factors that led to the scandal in Philadelphia. Given the scope of the situation, I suspect one hearing may not be enough.

PA Abortion clinic inspections stopped to avoid barriers to abortion

The grand jury report on Kermit Gosnell’s Women’s Medical Society in Philadelphia carefully details the shocking negligence of many people. From those responsible for regulating health under two administrations to outside certifying agencies, many people knew something was wrong in West Philly and they did little or nothing. Here is a passage (pp.148-149) from the grand jury report that finds a change in policy regarding abortion clinics when Governor Tom Ridge took over from Bob Casey. In essence, the change in regulatory posture was justified by the belief that such negligence would make abortions more accessible.

Since February 2010, Department of Health officials have reinstituted regular inspections of abortion clinics – finding authority in the same statute they used earlier to justify not inspecting.

Staloski blamed the decision to abandon supposedly annual inspections of abortion clinics on DOH lawyers, who, she said, changed their legal opinions and advice to suit the policy preferences of different governors. Under Governor Robert Casey, she said, the department inspected abortion facilities annually. Yet, when Governor Tom Ridge came in, the attorneys interpreted the same regulations that had permitted annual inspections for years to no longer authorize those inspections. Then, only complaint driven inspections supposedly were authorized. Staloski said that DOH’s policy during Governor Ridge’s administration was motivated by a desire not to be “putting a barrier up to women” seeking abortions.

Brody confirmed some of what Staloski told the Grand Jury. He described a meeting of high-level government officials in 1999 at which a decision was made not to accept a recommendation to reinstitute regular inspections of abortion clinics. The reasoning, as Brody recalled, was: “there was a concern that if they did routine inspections, that they may find a lot of these facilities didn’t meet [the standards for getting patients out by stretcher or wheelchair in an emergency], and then there would be less abortion facilities, less access to women to have an abortion.”

Brody testified that he did not consider the “access issue” a legal one. The Abortion Control Act, he told the Grand Jurors, charges DOH with protecting the health and safety of women having abortions and premature infants aborted alive. To carry out this responsibility, he said, DOH should regularly inspect the facilities.

Nevertheless, the position of DOH remained the same after Edward Rendell became governor. Using the legally faulty excuse that the department lacked the authority to inspect abortion clinics, Staloski left them unmonitored, presumably with the knowledge and blessing of her bosses, Deputy Secretary Stacy Mitchell and a succession of Secretaries of Health. The department continued its do-nothing policy until 2010, when media attention surrounding the raid of the Gosnell clinic exposed the results of years of hands-off “oversight.” Now, once again, the regulations, which have never been modified, apparently allow for regular inspections. This is, and always was, the correct position. The state legislature gave DOH the duty to enforce its regulations; the authority and power to do so are implicit in that duty. The department abandoned this responsibility without explanation, and without notice to the public or the legislature.

This is a scandal which requires an investigation. The legislature in PA developed statutes which required clinics to be investigated and the law was not followed. The new chief executive in PA, Tom Corbett, is reportedly upset about this case. I hope he turns his upsetness into action.

I should also mention that I have contacted the DOH’s chief counsel in PA for comment but have not had a reply.