I Am Going to Regret This: on Komen and Planned Parenthood

[rowyn]

To start:

(A) I like Planned Parenthood. During my college-student years, I obtained birth control pills through them, and because they had a policy that required annual exams to get birth control pills, I actually had regular health screenings and tests for . It was pretty much the only medical care I received during my years uninsured. Their services were cheap and professional.

(B) I like Susan G. Komen for the Cure. I do not have fond personal memories of them as I do PP, and I think they spend too much money on "education" (as opposed to screening, treatment or research programs). But a large part of breast cancer prevention is convincing women to do self-exams and get mammograms, and breast cancer is a big killer of women that is mostly preventable if caught in a timely fashion. So I can't say the education is wasted.

Given that I like both charities and think they do good work, you'd think I might have mixed feelings about Komen's recent de-funding and re-funding of grants to Planned Parenthood.

As it happens, though, all I can think is that this is one darn silly inconsequential kerfluffle.

Susan G. Komen for the Cure has total assets of almost $500,000,000. Its total expenses, including grants, were over $400,000,000.

I can't readily find current financial information for Planned Parenthood Federation of America, but their 2008 balance sheet showed $1,078,000,000 in total assets.

Komen's last grant to PP was $680,000. That figure represents about:

• 0.14% of Komen's total assets 2011 *


• 0.06% of Planned Parenthoods total assets 2008

* Yes, I'd rather compare this to expenses and revenue for a more apples-and-apples effect, but I can't find expenses for PPFA at all, so assets it is.

The point is, the amount of money at stake here is tiny for either charity. PPFA is not going to shut down without money from Komen. Komen is not going to be providing Funds for Abortions if they grant money to PPFA for breast-care services**. Komen can still do plenty of good whether or not it grants less than half a percent of its revenues to PP. It is Just Not That Big a Deal. It is not proof that one side or the other is Losing the Abortion Debate. It is such a tiny amount that it doesn't even get a footnote on either's financial statement.

** Yes, PP provides breast exams and related services. Most of their services are health-care related, and not connected to either contraception (about a third of their services) or abortion (3%). For a lot of low-income, uninsured women -- just like me sixteen years ago -- PP is their main health care provider, sad as that is.

The only good thing that came out of any of this is that a bunch of people who are passionately for or against abortion gave a lot of money that they probably wouldn't've thought to donate otherwise to two perfectly good causes. -.-

Comments

[level-head.livejournal.com]

While the monetary amounts are small, the media treatment of this leverages a relatively small event to have much greater impact.

So it became something of a self-fulfilling prophecy: statements that this funding decision was meaningful were overstated, but the notoriety of these news statements themselves made it meaningful.

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[minor-architect.livejournal.com]

More recent financial information on the PPFA can be found here: http://www.plannedparenthood.org/about-us/annual-report-4661.htm (Their latest Form 990 covers the period of July 1, 2009 through June 30, 2010.)

I doubt these new numbers will change the core of your argument but I thought you'd like to see them. :)

[terrycloth.livejournal.com]

On the radio they were making Komen out to be a bad charity because of huge salaries paid to executives and them suing other charities for trademark violations? I think that sentence took longer to write than the blurb I heard on the subject though.

[rowyn]

They are not my favorite charity, but pretty much every large charity pays big salaries to their executives -- United Way and Planned Parenthood are the same way. Komen gets a 66.2 out of 70 on their score at Charity Navigator, which is better that PP (54) or my local United Way (61). So I don't think they're doing anything grossly inappropriate.

[rowyn]

Cool, thanks! My Google-fu was totally failing me. :)

[rowyn]

Yeah, it was sad how hard I had to look just to find out the approximate value of the grant. :/

[tuftears.livejournal.com]

Okay, so question here is, why is one big charity giving money to another big charity? Doesn't it make sense to give money directly to those in need, or providing help to the installations that need help, rather than incur a 'double administrative overhead'?

[rowyn]

I would guess that it's a matter of Planned Parenthood having locations in areas that Komen wants to serve -- poor neighborhoods that don't have any other clinic, for example. Komen doesn't run any clinics themselves: they mainly do awareness- and fund-raising, then use their funds to support research efforts and clinics that other charities operate.

On the one hand, it's less efficient to give to Charity A who gives to Charity B; on the other hand, it does save Charity B some money in doing their own fundraising and brand-building. Which is not really the case with PP, but since PP does have a lot of clinics nationwide, it's not surprising that they could be the best place to provide some of the services that Komen wants to support.

[alltoseek.livejournal.com]

I'm not completely up on my breast cancer stuff, but things I have seen lately include:
*The BC killer is the fast-growing kind, that usually isn't caught with either mammograms or self-exams in time.
*False positives on mammograms and self-exams cause a lot more headaches, tests, doctor visits, aggressive treatment of mild forms of slow-growing cancers, etc. than they prevent deaths via the aggressive cancer.
*Not everyone thinks annual mammograms are that great an idea, although I think the mainstream doctors' establishments still recommend it.

So in all I think I'd prefer if Komen directed their efforts towards curing/preventing/treating cancer, ameliorating its effects on patients and survivors, than to education.

If you are really looking to reduce cancer through education/prevention, you'll focus on stopping smoking and proper nutrition. Women in developed countries are more likely to get breast cancer in part to eating excessively, so it's also linked to the 'obesity epidemic'.

The aggressive breast cancer is genetic-linked, and also affects men.

[rowyn]

And there can be another advantage to giving to a big charity that provides funds to smaller charities -- something like United Way, that's in the business of monitoring charities, has put a lot of time and effort into researching their needs, strengths, weaknesses, etc. So the big charity can be in a better position to see which little charities will benefit most from more support, and making sure funds get allocated in an optimal way.

I'm not saying it's necessarily worth the overhead, but it's not without merit.

[level-head.livejournal.com]

This is actually very common. I'm on the board of one charity which pursues grants with larger ones and gives grants to smaller ones. My involvement is both program committee (approving grants) and assistance with writing grants. Separately, I write lots of grant proposals -- six this year so far, totalling about $45 million. One more to do this weekend.

What's happening here is areas of specialization. Many foundations that want to do a particular kind of good (or bad, and there are some like that), don't have the detailed knowledge and staff to do that. So they fund organizations that specialize in those areas.

There is some loss through layers of overhead (though my work in the medical foundation is as a volunteer board member and donor; there are only two paid people but 26 members of the board). The benefit is getting money in the hands of people who know how best to make it do the desired job.

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[rowyn]

My doctor still recommends the annual for women over 40, yep, but I know it's debatable.

I did not know that, about there being a fast-developing kind that's unlikely to be caught in time. Yikes.

[level-head.livejournal.com]

This is an area of interest for me, and I've been researching this and related topics in recent weeks. It's odd how contradictory the information published can seem.

Here's an example, on "fatty" breasts and relationship to breast cancer risk. Worse. And better:
http://www.biomedcentral.com/content/pdf/bcr3081.pdf

And studies like this one, just published, do indeed show significant positive value from annual screening:
http://cebp.aacrjournals.org/content/21/1/66.short

Results: We included 755 cases and 3,739 matched controls. Among the cases, 29.8% was screen-detected, 34.3% interval-detected, and 35.9% never-screened. About 29.5% of the never-screened cases had stage IV tumor compared with 5.3% of the screen-detected and 15.1% of the interval-detected cases. The OR (95% CIs), all ages (49–75 years), was 0.51 (0.40–0.66) and for the age groups 50–69, 50–75, and 70–75 years were 0.61 (0.47–0.79), 0.52 (CI 0.41–0.67), and 0.16 (0.09–0.29), respectively.

Conclusion: The study provides evidence for a beneficial effect of early detection by mammography screening in reducing the risk of breast cancer death among women invited to and who attended the screening.

Impact: This is the first case–control study that accurately accounts for equal screening opportunity for both cases and matched controls by number of invitations before case's diagnosis. Cancer Epidemiol Biomarkers Prev; 21(1); 66–73. ©2011 AACR.

The upshot: For women without screening, the cancer when finally detected was, on average, much more advanced.

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[tuftears.livejournal.com]

*ponder*

I guess the real news is the gotcha of indirection. You imagine that you are supporting cause A, then you find out the charity is giving money to cause B. If you didn't like cause B, you might feel betrayed.

I can see the rationale behind big charity giving to smaller charity, or to charity that actually has clinics and support facility. That makes sense. And I personally agree that giving money to support women in need should include providing breast cancer exams and health screening. So it's not a big deal to me either. I just fuss about efficiency because, well, we like to know MOST of our money is going to a good cause.

[tuftears.livejournal.com]

I think that's awesome of you to volunteer your time as such! And given we're only four weeks into the year, that is indeed a lot of grant proposals.

[rowyn]

Honestly, I don't think Komen or other charities like this are being particularly deceptive by granting funds to other charities. United Way doesn't make any secret of being a broad-based clearinghouse funding all kinds of charitable organizations. Komen provides funding for breast cancer education, prevention, treatment, & research -- I think *they* are a little more deceptive because their name is "for the Cure", but a lot of their funds go to education, but that's not because they're granting money to other charities so the other charities can do breast cancer education, prevention, treatment, & research work.

I mean, it's kind of like saying Apple is being deceptive when they sell you an iPad because you think Apple is an American company but it turns out that the iPad is assembled in China, or has components from Japan. I can certainly see people being upset about Apple having Chinese factories (especially given Chinese labor laws or lack thereof), or about Komen giving money to Planned Parenthood. But I think that these are things that don't worry *most* people, and that means that the minority for whom it's a dealbreaker needs to do a little research. Charities can be transparent about what they do with the money -- Komen generally is -- and that's good. But there are too many things that someone, somewhere, might object to for some reason. When you're selling your charity on a 25-word pitch, you can't possibly mention them all.

[level-head.livejournal.com]

Thank you. Let me correct an impression, though: I volunteer time for the medical foundation, but I also get paid for writing grants. Those things are connected: a grant-writing company whose proposals were critiqued by me at the medical foundation asked if I'd like to do work for them for other clients. I ultimately accepted -- and now head up their scientific research grantwriting. I was the sole writer on three of the grants this year (I'd forgotten about one!), and part of a team on the four. Three were scientific/medical research (one neurology and two opthalmology), one healthcare (for a hospital), one women's health, one community information services (with one more due Monday), and one new charter school for mostly-minority kids.

In each case, these are seeking money from organizations (government or private) who want to accomplish something in particular. Their job is to find (and fund) the organizations who specialize in that thing. The federal and state governments are big sources of this. For example, a lot of university and other research is funded by the National Institutes of Health.
http://grants.nih.gov/grants/oer.htm

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[kelloggs2066.livejournal.com]

I found it interesting that 26 Senators decided to get involved in a matter of charitable donations that amounted to far less than a million dollars.

If only they would show such diligence in how they spend each million dollars of taxpayer money.

[terrana.livejournal.com]

I think I missed whatever this is a response to. Am I correct to assume something loud and shouty has occurred between the two aforementioned charities?

[terrana.livejournal.com]

That's what got my mother, in fact. They were *just* too slow in catching it, and it spread before they could cut it out.

[tuftears.livejournal.com]

I see! I did not know there was such a thing as grantwriting as a profession, but it does seem reasonable.

[level-head.livejournal.com]

It's a bit like writing business plans. Many people wing it, but there are lots of folks who do that work professionally.

Grants are the same -- but in many cases, have strict formats and arcane rules that are hard for folks to navigate.

An example: A research grant proposal to one of the National Institutes of Health agencies will be rejected if it uses Times New Roman font, but can use Georgia (which looks very much like TNR). Some grants require headers and footers; the NIH will reject one if it has headers and footers, as their system adds these after submission.

What you say, and how much space you have to say it, are strictly governed. And many researchers are decidedly better at science than writing.

It is relatively rare that writer-types are also science folks enough to speak that language comfortably. I've been fortunate enough to have a foot in both camps, and every day I try to get better. Not only that, I get to meet and work with some wonderful folks.

One side "benefit" so to speak is having my nose rubbed in the many government and foundational funding practices. Some of my clients consider me an expert on scientific research and financial modeling related to Obamacare (even they call it that) -- but they have no idea that I opposed it, and still do. (The system needs fixing, but this makes it worse.) The clients, though, are funded by it and its predecessor programs, so they have no choice but to really like it. There are actually mixed feelings, which various medical professionals are careful about expressing.

A couple of days ago, a person asserted that "most of Bush's $15 billion in aid to Africa was spent on abstinence-only programs." Because of my work researching and writing grants for related programs, I happened to know that the number was closer to $1b out of the $15b, an arcane tidbit that I would not likely have known otherwise.

I get involved in everything from gang prevention to disease prevention to cutting-edge research to special education to domestic violence prevention to building new city parks. It's very interesting -- and my $5m city park proposal (I was the lead writer) has just advanced to the finals, beating out a few hundred competitors so far. We'll know in March or so whether it is approved -- only about 4% are.

For most research grants, the approval rate is about 25%. It's very competitive work -- and, sadly, rather politicized in some respects. But I do what I can to keep politics out of it.

My clients are all over the map, politically, and we generally don't talk about it. When we do, I'm content to simply listen, with the occasional nudge toward different information.

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[tuftears.livejournal.com]

Nifty! That's definitely something you should stick in your blog as something interesting for folks to know about you.

I... have no idea why they would reject a grant proposal for using Times New Roman. That just seems terribly arbitrary.

[level-head.livejournal.com]

Thanks. I might do that.

From the SF424 Guide, accessible here:
http://grants.nih.gov/grants/funding/424/index.htm#inst

Font

Use an Arial, Helvetica, Palatino Linotype, or Georgia typeface, a black font color, and a font size of 11 points or larger. (A Symbol font may be used to insert Greek letters or special characters; the font size requirement still applies.)

Type density, including characters and spaces, must be no more than 15 characters per inch.

Type may be no more than six lines per inch.

There's such a dramatic difference between Arial and Georgia that you wonder how these two were both allowed. I tend to use Georgia, as it's much friendlier to read. You'll see NIH reviewers complaining online about yet another proposal in minimum-size Arial, an uninviting gray wall of text. Georgia, bumped up a point size, with a bit of air and some diagrams, makes the document more approachable.

But other reviewers have been seen noting that they are turned off by "anything non-standard."

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[tuftears.livejournal.com]

Testing!

This is Arial.
This is Helvetica.
This is Palatino.
This is Georgia.

Arial and Helvetica seem to be sans serif, Palatino and Georgia seem to be serif, but apart from that I couldn't tell them apart at a glance!

[level-head.livejournal.com]

It's crucial how much space they take up, because the space you're given is never enough. And reviewers hated looking at Arial Narrow, a very tedious font to read.

As I am vision-impaired, pirate patch and all, I appreciate a readable font.

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[level-head.livejournal.com]

Two things occurred to me:

1. You need to add Sparta to your list.
2. I need an updated eye-con.

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[level-head.livejournal.com]

"Where you money is going" applies to purchases as well as charities. For a long time, you could by a Honda or Toyota (built in the US) or a Chevy (built in Canada) or a Pontiac (built in South Korea).

One's perception of nationality of vehicle can be very far from the reality. I bought a CTS in 2003 when they first came out, partly because it was the first Cadillac in years actually built in the United States. It came from their brand-new factory in Lansing.

So for people who want to know where their money is going, a little research is useful.

Moreover, private charities are, in general, tremendously more efficient than government in accomplishing the same mission (including in terms of dollars contributed that actually reach the intended beneficiary). But with government, we don't have a choice.

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[level-head.livejournal.com]

When you donate money, you can mark it "restricted funds" with requirements that it be spent only on "X" (whatever you decide). That restriction is usually not involved in small donations, but often figures into larger ones.

The restrictions must be taken seriously. The charity must track restricted funds separately, and for some charities the restricted funds make up the largest part of their assets.

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