Who Gets Access to Health Care?

 “If access to health care is considered a human right, who is considered human enough to have that right?” —  Dr. Paul Farmer, human rights activist

We all agree that everyone in a civilized society should have access to proper health care, including reproductive care.  Aside from the obvious need of families to stay healthy and productive, as a nation our overall health – good or poor – affects everyone.  We don’t live in a vacuum. Even if you are fortunate enough to have great insurance coverage and a healthy bank account, your medical costs and your taxes are impacted at least in part by the economic cost to state and federal programs of those who don’t have health care available to them.  This is not only the obvious – you are footing part of the bill for the often inadequate care they receive, but are also paying long-term for the cost of poor health on children’s ability to learn in school. (An interesting note is that the Federal Employees’ Health Plan and Veteran’s Administration plans cover contraceptive and reproductive health care, one item at the top of the heated argument over access.)

The debate over national health care continues.  Take Senator Chuck Grassley’s comment about government managed healthcare access, which as written would provide some end-of-life counseling. “We should not have a government program that determines if you’re going to pull the plug on grandma.” —Sen. Chuck Grassley (R-IA), Aug. 12, 2009.  That’s quite a leap Chuck.  Perhaps we should have a new sport added to the Olympics – ‘Political Fact Leaping’.  Of course, the Senator has not declined his own government run federal health plan, which, by the way, ranks in the top 1% of plans by way of providing the best care for the least cost to the consumer.  Tell his Grandma to keep her nightlight on (and since Grassley staunchly supports the second amendment, she might want to have her Glock under her pillow too.)

Access to proper health care is governed by numerous factors, not all of them political.  A paper published by James B. Kirby in 2004 for Princeton University’s Agency for Healthcare Research and Quality looks at the socioeconomic factors by neighborhood.

This paper discusses, in part, the effect of access as it relates to education about healthful habits.  A regular visit to a doctor whom one trusts translates into making positive changes in diet, exercise and environment, including the use of condoms and other forms of birth control.  When an entire neighborhood lacks access to proper healthcare, the environment becomes unhealthy.  Residents learn that this is the ‘norm’ and begin to expect no more.  

Kirby found that in disadvantaged areas, air and water quality were likely to be less adequate, and even police, fire and sanitation was not as accessible. One huge disparity seems to be that preventive care is much less likely to be provided to residents of these areas; in favor of providing what is termed ‘necessary’ – treating illness or other conditions only after they occur; often providing sketchy pre and post-natal care instead of adequate contraception in the first place.

If we dig a little deeper, however, we can find a river of problems regarding access to healthcare that seem to be spreading from poor urban areas out to main street America like a virus.  Rural and suburban areas are full of the working poor, or those who are insured but have to carry such high deductibles they cannot afford to see a doctor.  For many of these people, who some estimate to represent at least 50% of the population, there is no financial assistance available. 

There are other constraints.  Cultural or religious beliefs can not only affect how we seek medical treatment (and where), but it can also determine how successful that treatment will be.  Charles Feng, a PhD Candidate at Stanford University shared his personal experience in a peer-reviewed science journal article http://www.jyi.org/volumes/volume6/issue5/features/feng.html  in which he describes his 78 year old grandmother, a Taiwanese native, having a distrust of Western Medical Doctors to the extent that she flew home to Taiwan to see her regular doctor and get the herbs she needed to treat her chronic bronchitis and osteoporosis.  Psychiatric journals are full of stories about Culture-bound Syndrome, where a patient with a condition such as somatic disorder may have numerous specific complaints that cannot be explained by Western medicine.  Often, folk remedies are successful in ridding the patient of the symptoms.  A case in point is Koro, a psychological disorder characterized by the delusion that the penis is shrinking.  Widespread ‘outbreaks’ have been reported in China with no underlying medical condition. (While it seems doubtful that any American male would even admit to worrying about Koro, they have their own set of worries, represented by the amazing proliferation of little blue pills)   For an interesting list of Culture-bound disorders, see http://listverse.com/2009/08/21/top-10-bizarre-cultural-disorders/

Citizens for Choice advocates access to quality healthcare, reproductive and otherwise.  Through The Clinic!, we provide affordable, confidential family planning services and the most up-to-date, medically accurate information about one’s reproductive health care.  Visit us at www.citizensforchoice.org , or on Facebook.

Missed any of our blogs?  They are all on the website under ‘blog’ and ‘recent posts’.  We aren’t afraid to tackle delicate or controversial subjects and would like to facilitate healthy dialog on any subject relating to reproductive health.  We invite your comments and civilized dialog.

 

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    2 comments on “Who Gets Access to Health Care?
    1. Elaine Sierra says:

      Provocative article on some barriers to affordable healthcare access. Let’s keep our eyes on the critically important, aptly named Affordable Care Act, and its implementation in California. We can be proud of policymakers and health officials who are dedicated to taking advantage of the opportunity to provide low-cost insurance coverage or Medi-Cal coverage to many of the millions of uninsured and underinsured in our state. Citizens for Choice and other reproductive health and justice advocates are working to ensure that such coverage includes adequate reproductive healthcare services.

      • Freddy says:

        Great point, Elaine! There are many policymakers working tirelessly to ensure affordable care is available to all. We are so fortunate to have Citizens for Choice!

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