Some members of Congress have described this move as “eliminating a big increase for physicians.” They point out that Medicare will pay more to physicians in 2012 than in 2011. This is true when speaking of total dollars spent by Medicare.

Medicare will pay more to physicians as a group for all services to all Medicare patients because, with the aging of the Baby Boom generation, the number of Medicare patients grows by almost 10,000 people per day. In addition, the current Medicare population keeps getting older, requiring more medical care. However, what your doctor will be paid for providing a single episode of medical service to you will be reduced by 27.4 percent. This is an extremely important and relevant distinction.

Washington views Medicare from a global perspective, but it ignores the impact this cut will have on you and your doctor as individuals. Simply put, your doctor will have little economic incentive to provide care to you as a patient. In fact, such a cut could result in some services costing the physician more to provide than he will be paid. The bottom line is that seniors may find it increasingly difficult to find a physician who is either willing or financially able to provide services to Medicare patients if the cuts go through as planned.

We also live in a culture of reproductive violence against women, and against trans people with uteruses. We live in a culture of reproductive violence against anyone who can get pregnant. And so, so much of the violence is invisible, even to the people who experience it, because it’s normalized. When my boyfriends tried to pressure and coerce me not to use birth control, it was a form of violence. When I was raised, as a devout Catholic, without any reliable or scientifically accurate information about abortion and birth control — when I was encouraged throughout my own life to value my health less than I valued fetuses — it was a form of violence. When condoms broke, or guys “accidentally” had sex with me without condoms, and I was treated with hostility and shamed for being upset about it, it was a form of violence. When I wasn’t given information about how Plan B worked, when I was told it was “a form of abortion,” when information proving that wrong wasn’t widely accessible to me, it was a form of violence. Having to go 45 minutes away to get it? Violence. Not being taught, as an essential part of self-care, where to access it? Violence. I should have been told “it is a normal part of self-care to brush your teeth, shower frequently, use tampons or pads, always use birth control and to know that Planned Parenthood will give you emergency contraception for $15,” ALL of those messages should have been TOTALLY NORMAL AND WIDESPREAD throughout my adult life, but they weren’t. Very probably being given the wrong medication, and experiencing intense, unnecessary physical discomfort? DEFINITELY violence. Yeah, obviously, being slut-shamed and thrown out of a clinic was violence. But everything that occurred along the road, everything that got me there, was a totally normalized form of reproductive violence, and I didn’t see it, because no-one ever told me to identify it as violence when it happened.

The best interests of the patient can be understood from two perspectives. The most ancient of these in the history of medical ethics is the perspective of the physician. Based on scientific knowledge, shared clinical experience, and a careful, unbiased evaluation of the patient, the physician is able to identify those clinical strategies that will serve the health-related interests of the patient and those that will not. The health-related interests of the patient include preventing premature death and preventing, curing or at least managing morbidity. That these matters are constitutive of any patient’s health-related interests is a function of the competencies of medicine as a social institution. They are not a function of the personal or subjective outlook of the physician but rather of rigorous clinical judgment. Interestingly, they are also not a function of any particular patient’s perspective.

The International Agency for Research on Cancer (IARC) also said that almost 21.4 million new cases of the disease will be diagnosed annually in 2030. Launching a new database on global incidence of cancer in 2008, the latest year for which figures are available, the IARC said the burden of cancer was shifting from wealthier to poorer nations.

Historically, black women’s childbearing has been portrayed as irresponsible and in need of government regulation, Roberts says. Practices reflecting these stereotypes have included such things as family caps for welfare recipients, forced sterilization, and the distribution of risky birth-control medicines such as Norplant and Depo-Provera to poor black women. “It’s no wonder black people would think there’s an effort to stop us from having children, and that affects how we think about abortion,” Roberts says.

Another reason for the silence may be a lingering belief that grew out of the 1960s black nationalist movements: that abortion and birth control are tools of whites in power to limit the black population. “Even if people aren’t nationalistic,” says Roberts, “there’s a sense that childbearing is a positive thing that contributes to your whole community, and therefore having an abortion violates that.”

Because of this complicated history, Roberts says, black women frequently feel a tension between asking for government support for access to family planning and opposing efforts by policymakers and others to use birth control to limit their fertility. It has also created schisms between black and white reproductive rights activists.