quote:Komen gave Planned Parenthood almost $700,000 in 2011 to provide poor women with breast cancer screenings who otherwise would not have received them; mammograms aren't free. About 170,000 women benefitted. Withdrawing the money and reducing the number of early detections of breast cancer will hand some of those women a death sentence. How pro-life is that?
Komen CEO Nancy Brinker, sister of the late Susan G. Komen, asserts that the decision wasn't political. Give us a break. Brinker is a major Republican donor who was ambassador to Hungary in the George W. Bush administration. The foundation's relationship with Planned Parenthood was never a warm one. Then, in 2010, Brinker hired Karen Handel as senior vice president for public policy. When Handel ran for governor of Georgia, she drew the endorsement of Sarah Palin by describing herself as "staunchly and unequivocally pro-life."
At Komen, she immediately began a full review of the foundation's grants and declared a policy of denying funding to any organization under investigation by federal, state or local authorities. Imagine how shocked, shocked, she was when Florida Rep. Cliff Stearns soon after announced a congressional investigation of Planned Parenthood.
This is the same Stearns who was ridiculed this past spring for filing an amendment that forces all 9/11 first responders requesting compensation for injuries to first be checked against the terrorist watch list to make sure they're not terrorists. The Stearns whose stated goal is to strip Planned Parenthood of all federal funding, "now and forever," even though the Hyde Amendment prohibits federal funding for abortions.
Then the encouragingly quick and powerful response:
quote:As the controversy erupted, donations to Planned Parenthood poured in. Besides $400,000 in smaller donations from 6,000 people, Planned Parenthood is receiving a $250,000 pledge announced Thursday by New York Mayor Michael Bloomberg to match future donations.
Komen, meanwhile, has been deluged with negative emails and Facebook postings, accusing it of knuckling under to pressure from anti-abortion groups, since The Associated Press reported on Tuesday that the charity was halting grants that Planned Parenthood affiliates used for breast exams and related services. The grants totaled $680,000 last year.
Some of Komen's local affiliates were openly upset, including all seven in California, and at least one top official has quit, reportedly in protest.
Followed by the dire straits damage control:
quote:The Susan G. Komen Foundation finally responded Thursday to critics of the breast cancer charity’s decision to withdraw funding from Planned Parenthood. But it did so by releasing a video of the group’s grim-faced ounder, Nancy Brinker.
Though groomed to perfection, Brinker looked about like you’d expect of someone who’d spent years building something, brick by brick, and then driven a truck through the front window by accident.
One thing she did right, however, was take responsibility for the controversial decision: “I,’’ she said, stressing the word, initiated a comprehensive review of our grants and standards. This isn’t unusual; we’re always looking at our policies and procedures.’’ ...
Brinker also clarified that Komen is not pulling any grants this minute, and said the group had always intended to make sure there were no gaps in service by contracting directly with service providers when the current contracts are up.
And she repeated that the decision had nothing to do with politics.
But she did not address the fact that Komen’s new vice president, for policy, Karen Handel, is a long-time critic of Planned Parenthood, and had made the group an issue in her unsuccessful Republican gubernatorial run in Georgia.
quote:Susan G. Komen for the Cure, a breast-cancer advocacy organization, reversed its decision to end $680,000 in funding for Planned Parenthood Federation of America Inc., and said it is changing its grant criteria as a result of controversy over the original ruling.
The new criteria say the investigations must be “criminal and conclusive in nature and not political,” Komen’s Chief Executive Officer Nancy Brinker said in a statement today.
Komen for the Cure's reversal is just as unsurprising as its initial unforced error, given its patterns and its leadership. It's at least learned how fragile its position is. It could either reform, or try to hold fast with such extremely divisively political appointees at the head of its somewhat exploitative and revealingly mercenary structure. I could care less which way they go, but I do care that people remind them that there's no going back for them. Brinker has withered and struggled in pressing television interviews while trying to hold to the story that this was not a political decision, but it absolutely was. They've absolutely shot themselves in the foot on this one by baldly politicizing their mission — and in so doing, also brought attention to how litigious they've been at maintaining their hold on the lucrative income of their charity, and how there's enough hands in the pot to strip the percentage of money actually going to prevention and the cure down to something like 27%.
Oh well. All's well that ends well, even if it means that pink is the new right-wing pariah.
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After their aggressively territorial response to other charitable groups regarding the phrase "for the cure" and the colour pink, I think that they are, perhaps, getting bigger than their desire to do good. It is pretty typical for a successful organizations to become about the organization itself.
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quote:Nonprofits can spend 20 percent of the first $500,000 of annual expenditures on lobbying, 15 percent of the next half-million, and so forth, up to $1 million per year, according to an IRS fact sheet. Spent this way, the entire amount is deductible, allowing the Komen Foundation to emphatically state -- as it has whenever asked -- that it spends "zero dollars" on lobbying.
Ha! I love it. It's right up there in with legislating pizza as a vegetable: a million dollars in lobbying becomes zero dollars in lobbying!
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I have read in various blog postings that PP does not actually provide mammograms. Does anyone know if that's true?
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Like what do they mean? Are they trying to make the case that planned parenthood doesn't provide the mammograms unless it's directly providing and they literally have the mammogram machine right in their clinics?
Heh. You could say that, I guess. As long as you cut out referral, assistance, and screening as part of the mammogram process whatsoever. While I'm at it, I better defund my family physician because he doesn't directly provide me with medication, the pharmacy does!
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I think so? I'm pretty sure planned parenthood hasn't ever had mammogram machines, they do the breast exams and the initial screenings and then do the referral work to get women the screenings at medical centers with mammography. They might have in-house mammography in some places but I would honestly doubt the need for it.
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Nevermind, I asked about this. I guess my wording is wrong, and PP does provide mammograms, and there's actually plenty of places in the country (usually rural) where they are the only referral and appointment system available for mammograms .. which is a little amazing, I have no idea how that's allowed to work. They also cover plenty of mammograms across the country.
I guess what you can't say is that they don't provide in-house mammograms.
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quote:Originally posted by Minerva: Do you have a source for that?
It seems to me you're the one trying to press a point: that PP doesn't provide mammograms. Do you have a source that they don't, or have I misread your posts?
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I've read the same thing in a few places, that Planned Parenthood doesn't actually provide screenings. But none of them mentioned the difference between providing in-house screenings and providing financial assistance and referrals to other facilities that do so. If that's the rub, it looks like a non-issue.
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They do perform "screenings" which may include a physical examination, instruction on self-examination, discussion with medical professionals, and referrals for mammograms and other follow-up treatment.
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I want to get this out of the way first: I disagree with the decision made to stop funding PP, as I am pro-choice.
That said, money is fungible. Framing this as them taking away money that "Was used to help with mammograms" is disingenuous. If the Susan G Komen foundation wants to take a stand against abortion, then not donating to PP is a perfectly logical choice.
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Sure. But they claim to be non-partisan. If they wanted to take a stand against abortion (and likely lose the donatios they get from pro-choice folks) that would have been their choice. But they didn't take a stand; they tried to duck making a stand. And got caught.
All in all, though, I think this is shining a much needed light on the organization.
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Oh, sure, I agree. I was especially amused (in a disgusted sort of way) when Sam mentioned the way they're able to claim to spend nothing on lobbying.
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quote:Originally posted by Lyrhawn: I've read the same thing in a few places, that Planned Parenthood doesn't actually provide screenings. But none of them mentioned the difference between providing in-house screenings and providing financial assistance and referrals to other facilities that do so. If that's the rub, it looks like a non-issue.
I think after reading more on the issue today it's because when Komen was trying to dodge and weave, they tried to change the stated reasoning behind why they dropped PP (from one lie/justification to another lie/justification) and the second one was trying to say 'look they didn't do mammograms anyway'
I'm making it sound too complicated, but it can be distilled into a short statement:
It's a non-issue created by people who are ignoring what the word "provide" means in order to claim that PP does not provide mammograms. Being pointed to a dictionary (as I was) clears up any misinformation that isn't purposeful, I hope. Planned Parenthood provides mammograms.
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quote:Originally posted by Lyrhawn: I've read the same thing in a few places, that Planned Parenthood doesn't actually provide screenings. But none of them mentioned the difference between providing in-house screenings and providing financial assistance and referrals to other facilities that do so. If that's the rub, it looks like a non-issue.
I don't see it as any more insidious or misleading a use of the language than when a parents says, "I'm going to the pediatrician to get antibiotics for my son's ear infection," or when a doctor says, "I give antibiotics for that."***
Well, yeah, the physician doesn't usually have a stack of boxes of Amoxicillin under the desk. But nobody's going around saying, "Aha! You don't give me the antibiotic; the pharmacist does. You just do the assessment, rule out benign conditions and other possible confounders, make the diagnosis necessary to do the prescription, and send me somewhere else to get the medicine before you follow up for any concerning complications."
[In other words, what you guys said. ]
--- Added: Mind you, having the equipment to do mammograms and being able to charge insurance or medical assistance programs for it would be a money-making process for PP. The fact that they do not have the equipment themselves is part of the reason they need funding assistance. The mammogram part of the process is what one can charge well for,if there is insurance. The primary care of hands-on assessment and brainwork to sort through the history and physical in an educated way never has paid that well, comparatively.
Looks like some PP sites do run the local mammogram machines, such as in some areas of Texas. I would guess most don't though. But if you take PP out of the process, for many women you take out the access to mammograms. Good luck showing up at the radiology center door without a prescription or appointment. Just try to look ... cancer-y?
--- Added: ***[i.e., what Samp said: "While I'm at it, I better defund my family physician because he doesn't directly provide me with medication, the pharmacy does!"
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There are really places where planned parenthood is the only way to get a breast exam?
I have never liked the Komen foundation anyway, and have felt vindicated from the day I saw a pink ribbon on flippin' Doritos.
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The first two times, sure, kmbboots. But when asking other people-twice-to do one's own research on a point and then asking again, after having a detailed response to the questions-questions asked, by the way, identically in spite of the detailed answer-well.
Sure, she could just be asking, but it hardly seems likely. If she were just asking, I think she would actually have started discussing the responses rather than insisting on verification while contributing nothing.
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What are they doing with the money now? Is it still going to the same cause through different organizations? Have they redirected it for some nefarious purposes?
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I was literally asking if they provided mammograms. I would consider paying for someone to have a mammogram elsewhere as providing them, they don't have to have the actual machine/radiologist in their office.
I did some googling and could not find the answer. Frankly, if they are just providing screening and not providing/heavily subsidizing the mammograms, it's not terribly helpful. I can only imagine being told that they think I may have cancer, but I can't actually find out for sure. If a doctor tells you that you need antibiotics but you can't afford them and/or there is no pharmacy accessible, it's not very useful.
The article I read implied this was true, normal "hand-screening" but no actual mammograms. Sam said that wasn't true, but I could find anything to confirm that (or I wouldn't have had to ask the question). I would love to tell those posting against it that they were wrong, but I would be as bad as they if I just said, "Because someone on the internet said so."
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Minerva, you generally can't get a mammogram without a referal. For example, I have to go to the doctor to get referal, then take that to the place that does the test. Women past a certain age are supposed to get them every year or couple of years regardless of risk, so it isn't like PP is telling a woman they likely have cancer by referring her. Of course, if they did find something in the prescreening that indicated urgency they would tell her just as my doctor would. This service is essential for women without access to a regular doctor.
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A referral is necessary but not sufficient for a mammogram, regardless of whether it's routine or urgent. If a woman doesn't have the means to access a regular doctor, she probably doesn't have several hundred dollars for a mammogram, especially a routine one.
My question is not political, I'm just asking whether PP either gives mammograms or pays for mammograms elsewhere. For all I know, they do and I would be happy to try to set the record straight with those who are saying they don't. I'm just trying to figure out what exactly they provide. Subsidies for routine mammograms? In-house mammograms for those who have had something suspicious found a pre-screening? Just the pre-screening and referral?
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quote:Originally posted by Minerva: I would consider paying for someone to have a mammogram elsewhere as providing them, they don't have to have the actual machine/radiologist in their office.
Okay then, this may be your answer.
This is from LifeNews, a site that appears to be critical of Planned Parenthood, quoting a letter from the Susan G. Komen for the Cure "to clear up any misinformation that you may have heard:"
quote:When a mammogram is indicated, a patient is often referred to a local program, such as the state’s breast and cervical cancer program. In other cases, the Komen Affiliate’s grant to Planned Parenthood may include funds to pay for mammograms outright. When this happens, a local provider performs the mammogram, and is then reimbursed by Planned Parenthood using the Komen grant funds.
During the past five years, these grants have paid for the following education and screenings:
· Breast cancer and breast health education for nearly 160,000 women
· Clinical breast exams for more than 139,000 women
· 4,866 mammograms
· Detection of 177 breast cancers
Does this answer your question, Minerva? If not, there are other sources, but the one I thought might best suit the context for you was the explication from the SGKFTC Foundation itself reported by LifeNews, specifically directed to clear up misinformation.
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quote:Planned Parenthood doesn’t provide mammograms. Planned Parenthood clinics don’t perform mammograms on site (and PP doesn’t claim otherwise). (My gynecologist doesn’t, either–mammograms are performed by radiologists, not gynecologists.) Instead, PP refers women to radiology offices for the procedure and then foots the bill themselves. If you got pissed off when you mom said she got you a massage for your birthday and then handed you a gift certificate and not an actual masseuse, this will bother you. Otherwise, you’re probably okay with it.
quote:While the Komen organization was still flailing publicly for a credible rationale for defunding Planned Parenthood, Pavlich latched on to another ephemeral talking point. The new story was that Komen didn’t suspend pass-through funding to Planned Parenthood for political (anti-choice) reasons, but rather because Planned Parenthood doesn’t actually provide mammograms in their facilities. The article is annoying on several levels, but before I attend to Pavlich’s blindly ideological nonsense, I must regrettably point out a blindingly obvious fact: few other doctors and clinics provide in-house mammograms either.
My wife gets an annual checkup with our family doctor, who performs a manual breast exam and instructs (and chides) my wife on the topic of self-exams, but—shocker!—she doesn’t actually have a half-million dollar full-field digital mammography system purring away next to the tongue depressors and rubber gloves. Rather, she provides a referral to a nearby radiology lab where the mammogram is actually performed. Any woman who has ever been to a doctor knows this, but apparently not Katie Pavlich.
quote:“I had a lump and I didn’t have health insurance,” she explained. The agency sent her for a free mammogram, which led to her cancer being diagnosed and treated.
It’s not known exactly how many cancers Planned Parenthood has found. But just last June, Komen said screenings it paid for caught 177 cancers over the last five years.
posted
Planned Parenthood does this through partnerships with local radiology providers, which may include reduced fees. For some women it pays for the mammogram outright--whether via SGKFTC money (as the SGKFTC foundation expressly acknowledges in the letter quoted above, posted by LifeNews) or money funnelled from other donors to PP.
I expect that PP may merely subsidize other mammograms to bring them into affordability for the women involved, as many services are provided on sliding scale there. But I cannot claim that as known fact. It does seem to be abundantly clear that PP funds many mammograms outright.
And again, I don't see why a primary care clinic not having a mammogram machine in the closet would trouble anyone. It doesn't seem to trouble Minerva either, and that seems perfectly sensible to me.
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I'm kind of two minds about this issue, because it seems to be such a non-issue. But then, much like death panels, non-issues are often big issues. Likely a great number of anti-abortion groups well hinge on this as 'what's REALLY going on' or whatever.
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This is going to freak you out, Samp, but when I went to get my driver's license, they didn't really give me my driver's license. I just got a piece of paper, and then the actual driver's license was mailed to me at home WHAT IS GOING ON???!!!
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Breast self-exams have uncertain support in the literature, to put it mildly. This has lead to a flurry of professional organizations to back off from recommendations (used to be that they were routinely recommended). I don't know where it settled, but it has remained clear that the sensitivity and specificity of a professionally trained examiner far outweighs that of self exams, even if self exams can be useful.
One of the problems is that women find a lot of things on self exam that are not suspicious for cancer, and they cannot know that without the perspective of having done exams on thousands of other breasts and the specific training that goes with that. So unless you have another level of assessment--a clinician who can say "yes, this is worrisome" or "no, this is not"--you will get a lot of false positives, and those are associated with their own risks and negative outcomes.
More false positives means more people lobbying for a spot at the mammogram machine or MRI, and thus longer waits. Longer waits can mean delays in diagnosis and treatment. (That has its own issues, but that's beond the scope of this for now.) And that means more unnecessary biopsies along with more complications of biopsies, etc. Already 4 out of 5 breast lump biopsies are benign, and that is after filtering requests though multiple layers of clinical and technological preassessment.
The evidence we have shows that breast self examinations ("BSE") do not increase survival rates.
In part this is because early detection doesn't seem to affect outcome. You may expect it would, and you may wish it would, but it doesn't--not yet, at least. As new therapies develop, that may change, and there are other reasons to examine your own breasts as well (see page 6 of the article below).
You don't want to have a straight jump there. You just don't. There are lots of (often) unforeseen consequences ahead, and Minerva, you are right to say that they are wrong. There's a 2010 article in the Journal of Nurse Practioners that does a pretty good summary: The Breast Self-Examination Controversy: What Providers and Patients should Know.
quote:Although there are organizations that still recommend the practice of BSE, the use of this technique has come under scrutiny since newer screening technologies have been developed. Disadvantages of BSE include increased number of healthcare visits and twice the number of benign biopsy results, leading to increased healthcare costs.[15, 33] Another disadvantage is that increased biopsies lead to a higher risk of breast cancer.[6] According to the ACS,[34] 4 of every 5 breast biopsy specimens are benign. With BSE, women detect changes in their breasts more often and are more likely to seek professional help and more definitive testing to rule out cancer, which increases healthcare costs.[15] Additionally, when women discover abnormalities in their breasts, their feelings of anxiety and depression are likely to increase concerning what could possibly be a benign condition.[15] This disease-specific anxiety could increase adherence to BSE in women; however, it could also lead to high levels of anxiety that require counseling or treatment.[35]
Researchers have examined the efficacy of BSE in reducing breast cancer mortality. A study of 266,064 women in China, who were randomized to either receive instructions or not receive instructions in BSE, examined whether this instruction had any effect on the mortality of breast cancer. Thomas and colleagues[36] concluded "intensive instruction in BSE did not reduce mortality from breast cancer…Programs to encourage BSE in the absence of mammography would be unlikely to reduce mortality from breast cancer. Women who choose to practice BSE should be informed that its efficacy is unproven and that it may increase their chances of having a benign breast biopsy."
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TSEs aren't as well studied, but I think there is a similar lack of evidence that they improve mortality rates. This is in part because current interventions are very effective even when the disease is more advanced, so catching it early doesn't much improve one's chances of survival. However, there are other reasons than avoiding death from testicular cancer to examine your testicles, just as for breasts.
quote:Testicular self-examination remains an unproven screening modality that is suboptimally performed by at-risk patients.
Mind you, there may be more recent data of which I am unaware.
Nonetheless, this just underscores that underinformed people who tout self-screeening for cancer as a replacement for professional clinical visits are doing nobody any favors. It may sound good to them, and it may make them feel empowered and courageous, but it is not about them. It is about everyone, including them, and about the truth of what is actually helpful and what isn't.
I'm fine if someone wants to promote that cause at the expense of actually decreasing mortality if they say up front, "Hey! You may be more likely to die of cancer, but you'll feel better (unless you get the diagnosis, sorry)," but they don't. I honestly think it doesn't occur to many such proponents even to check whether the advice they are giving is valid.
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In case it isn't clear, I am typing with clenched fingers and a face red with rage. The more I live and learn, the more angry this sort of thing makes me. It is why I am taking a general leave of absence from most forum posting for awhile.
Note that this isn't a rage directed at anyone here. I cannot see where any of the posters in this thread have been anything but focused on accurate information. But articles such as the one Minerva linked as something she finds objectionable make me grind my teeth right through my own jawbone.***
I gotta get out more.
-----
***Added from Minerva's link:
quote:The only breast health services Planned Parenthood provides women is teaching them how to do a self-exam at home, and performing that same exam for them in the office. If any abnormality is detected, Planned Parenthood immediately refers their patient elsewhere, as they are unable to provide medical care outside of what a woman could do at home with a basic fact sheet.
quote:Originally posted by kmbboots: On the other? hand, they are now offering pink handguns! "Don't shoot the boobs!" Just in time for Valentine's Day.
Something entrenched in the pro-life community makes them extremely saturated with misinformation, lies, propaganda-like narratives. I guess I should hearken back to when the Abortionplex story first came out and exploded Literally Unbelievable with some of the most mindblowing responses, and think — well, all this we're seeing here hasn't been unusual for, like, how long? A decade?
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quote:Originally posted by Dan_Frank: I want to get this out of the way first: I disagree with the decision made to stop funding PP, as I am pro-choice.
That said, money is fungible. Framing this as them taking away money that "Was used to help with mammograms" is disingenuous. If the Susan G Komen foundation wants to take a stand against abortion, then not donating to PP is a perfectly logical choice.
Sure. But they claim to be non-partisan. If they wanted to take a stand against abortion (and likely lose the donatios they get from pro-choice folks) that would have been their choice. But they didn't take a stand; they tried to duck making a stand. And got caught.
All in all, though, I think this is shining a much needed light on the organization.
Alright.
Still, every single time I've glanced at a major news article on this subject (flipped through the paper today waiting for a sandwich, reminded me) I always see that "donations for mammograms" line in there, as if the money SGK gives PP goes into a special little mammogram pot that would otherwise be empty.
It's a blatantly manipulative way to frame the situation. Money is fungible. Susan G Komen gave Planned Parenthood money, full stop.
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Sure, but SGK can request how that money is allocated. It is certainly conceivable that they requested that money be set aside to subsidize mammograms. Perhaps with that money, PP can more fully subsidize mammograms or subsidize a greater number.
Just as money given to a university is fungible, but the donor can request that they set it aside for a new football stadium or a new department.
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quote:It's a blatantly manipulative way to frame the situation.
I'm not sure why you think this. Could you elaborate?
To me, they are giving money to PP in order to support PP's work in providing mammograms and that money is explicitly used only for providing mammograms. Both the purpose and the use of the money is "for mammograms".
I don't get why you think providing this accurate information is manipulative. It would strike me as more misleading if you got what seems to be your wish and people were prevented from labeling it accurately and instead was represented as them basically handing PP a check to do whatever they want with.
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The issue re: fungibility is that if I am an institution with multiple investment of resources, and one of those resources is a ~controversial political practice~, and another organization or funding source gives me a large portion of support, I can simply drop my investment of resources into that portion that they earmark their support for and .. uh, funge it over to the controversial portion. By way of this happening, their monetary support is definitely aiding my controversial portion even if we both pretend it is not.
I brought this up in terms of tithing -> intermediate institutions -> political or commercial grab-bag for the mormon church, it's completely fair to note it for komen -> planned parenthood -> abortions
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Are the monies given to PP for breast cancer screenings fungible? Or are they earmarked and untouchable for any other reason?
Please do not answer with "of course it is" or "probably not." Documentation, yes or no.
Personally, I have no problem with Komen giving or withholding their grants on any terms they deem fitting. It's their money. I also have no problems with supporters speaking their minds or stopping their support. It's their money.
I have big problems with Komen lying about the reason and then trying to weasel out when they realized how big the backlash was. If they don't want to fund companies that provide abortions, they should say so and stop, and hold their ground. I would still stop supporting them, but I'd respect the decision.
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