Mara Kardas-Nelson is a U.S. citizen who spent four years in Vancouver, B.C. while studying at the University of British Columbia. She writes to her Washington state senators about health care reform.

Dear Senators,

I write today both relieved and horrified.

I am relieved that the U.S. House of Representatives has taken a small but truly historic step towards comprehensive health care reform, passing a bill that includes a (much watered down, but still viable) public option. I am relieved that the thousands of hours of hard work by volunteers, activists, veterans, mothers, doctors, nurses and the un- or under-insured, coupled with the dedication of key law makers, has resulted in the House recognizing the need for Americans to be covered at least in part by their government so that they are not left entirely to the whim of insurance companies, who are motivated by profits not people.

But I am horrified that the passing of the bill was only made possible by restricting women’s access to abortion services: I, along with women and pro-choice activists across the country and the world, was devastated to watch hard-fought reproductive rights taken away by an 11th hour amendment. Furthermore, health care reform and the public option as they currently stand are by no means enough to provide health care for all Americans. I believe that our necessary and moral fight towards universal health care has only just begun, and could even be hindered by the current bill. And so I write to you today to encourage you follow the House in voting for health care reform, but in doing so to vote against the Stupak amendment and re-instate a previously dropped proposal for the federal government to ease legal barriers so that states can choose a single-payer system. I am a firm believer that health care is a human right, and as one of your constituents I strongly encourage you to represent my interest that comprehensive health care be available to all Americans.

The Stupak amendment on abortion services was proposed just hours before the House was set to vote on health care reform. Proposed by Reps. Bart Stupak (D-Mich) and Joe Pitts (R-Pa), the amendment puts restrictions on abortion services under the new insurance marketplace (commonly referred to as “the exchange”), where Americans could shop for a public option or subsidized insurance plan. According to pro-choice and universal health care advocate Rep. Dennis Kucinich (D-Oh), “it effectively removes any kind of insurance support and any federal subsidy for abortion.” Since public monies could not be used for abortion services, women in need of such services would only be covered by insurance if they bought it privately, thereby hindering lower income women’s ability to access reproductive care.

Under the Stupak amendment, abortions would essentially be rendered a luxury item, as a woman’s ability to have an abortion would be directly related to her ability to pay for it. This is a severe violation of women’s reproductive rights and turns the clock back on decades of work done to ensure that a woman has the right to choose what is best for her body. As a woman, the thought of having my access to reproductive services stymied is one of the most terrifying and infuriating things imaginable; but I am lucky to be a member of a family that would support me both financially and emotionally were I to need to “buy” an abortion. For women who could afford such a service — and who could not rely on their families for financial support if their insurance would not cover them — I cannot imagine the fear, guilt, and shame that they would be faced with, in addition to emotional and physical turmoil that comes with a termination of pregnancy.

I have had the chance to travel to many parts of the world, and many countries that I have visited do allow for safe, free, and confidential abortion services. Even those that we see as “repressive” or “conservative” often offer such services, and it is a personal point of shame that my country, which boasts to be the freest in the world, does not provide the same. By dangling the Stupak amendment as the necessary carrot for conservative Democrats to vote “yes” on health care reform, this three-page piece of legislation has further encouraged an already violent environment in which women’s reproductive rights are daily threatened, and I firmly oppose it. I hope you will do the same.

Furthermore, I believe that while the health care reform bill as it stands is better than our current system, I do not believe that it is the best system possible for the American people. I lived in Canada for four years, and during that time received comprehensive medical care in public clinics, paying only dollars for each visit. I have benefited first-hand from a single-payer system, and in my opinion such a system is the only way to ensure that health care as a human right is fulfilled. Earlier this year, Rep. Kucinich proposed an amendment to the health care reform bill in which legal barriers barring individual states from pursuing a single-payer, not-for-profit health care system would be removed. While the amendment passed the House Education and Labor Committee, it was later nixed by the Obama administration.

I agree with Rep. Kucinich’s argument that the current health care reform bill will only strengthen America’s dependence on a for-profit system, and specifically that it will aid insurance company’s profits rather than ensuring that all American people have access to health care. While I understand that the bill going to the Senate is better than our current system, I also believe that states should have the option to introduce single-payer if they so choose. Canada’s single-payer system started at a provincial-level before becoming the robust national system we see today: as a proponent of single-payer in the U.S., I believe that if a system were to ever go nationwide, it would need to begin at the state level.

Therefore I encourage you, as a representative of my interests, to re-introduce an amendment similar to that of Rep. Kucinich, so that states may decide what system of care is best for their own residents.

I look forward to your support for comprehensive health care reform that continues to champion women’s access to reproductive services and that leads this country on the road towards health care for all, not profits for some.


Mara Kardas-Nelson
Olympia, WA


Mara Kardas-Nelson

After graduating from the University of British Columbia, Mara Kardas-Nelson decided to pursue her latent dream of becoming a journalist, and has since been published in Canada, the U.S. and South Africa....

Alex Samur

Alex Samur

Alexandra Samur was’s managing editor from 2010 to 2012, books and blogs editor from 2007 to 2012. Alex’s career in independent media spans more than a decade and includes stints...