Status Of Women’s Healthcare: Analysis of Donald Trump's Activity

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For decades women in the United States have been struggling to gain good and fair access to health care. The cost is either too high, or they just do not have enough knowledge. There are many programs and organizations that have the main purpose of helping women with health care, however not all women are eligible for them. Then there are women that are eligible, but in our current circumstances, the president has taken certain actions that are against these grants. The Affordable Care Act and Title X are examples of programs that have helped out the women of the U.S. and made the whole process of health care easier, however President Trump set up a “Gag Rule which prohibits health care providers serving in Title X funded institutions from referring patients for abortion care” (What Is Title X). Women should be knowledgeable about medical care and should have the right to fair care. Since Title X grants access for women in the U.S. who do not have fair and good healthcare, Trump’s gag rule should be repealed.

Background

In the past, things like birth control and abortion were illegal for women to access. “In 1960, the Federal Drug Association (FDA) approved the safety of birth control pills and then eventually it became legal for married couples to purchase in 1965 but remained illegal for unmarried couples until the year 1972” (“Advances in Women’s Healthcare”). There was a movement called The Women’s Health Movement, also referred to as the WHM, during the 1960s and 70s that emerged, and it had the primary goal of improving health care for all women (History of the Women’s Health).

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The activists involved in this movement (WHM) were fighting for fair reproductive rights for women, because at this time abortion was illegal in every state, unless it was to be done in an instance to save a woman’s life. “Approximately one-third of the women who had illegal abortion experienced complications requiring hospital admittance. Between 500 and 1,000 women died annually as a result of an illegal abortion” (History of the Women’s Health). Eventually, thanks to the persistance of the WHM, along with feminists, abortion was offically legalized in the year 1973. The WHM then moved to fight for other rights along with the reproductive ones. Although the members of the movement did not have the same approaches and exact goals, there was one that united them all which was “a demand for improved health care for all women and an end to sexism in the health system” (History of the Women’s Health). These women wanted to be in control of their own health.

The WHM flourished in the 1960’s and 70’s, but with the 1980’s came a lot of setbacks. Although abortion was now legalized, antiabortion activists followed with the legalization and they came to attack. “Feminist’s health clinics became the targets of violence, and many clinics closed. In 1989, the Webster v Reproductive Health Services decision by the Supreme Court placed increased restrictions on abortion” (History of the Women’s Health). Although women approved some of the unfair circumstances that came with the health system in some parts, there are still problems in the system, including issues from the past that are recurring such as antiabortion activists and organizations.

Current conditions and effect

Women in the United States struggle to get the care that they need. This is an important issue because compared to other countries the U.S. is very low ranking when it comes to health care. U.S. women face a chronic disease burden that is especially greater than other countries (U.S. Women’s Health), and compared to other high-income nations “Pregnancy and childbirth are more dangerous for women in the U.S. because they have the highest death rate from complications during pregnancy and childbirth — 14 deaths per 100,000 live births “(U.S. Women More Likely to). Along with that, data that came from a 2016 Commonwealth Fund survey of women in multiple countries including the United States proved that U.S. women have comparatively higher rates of obesity and diabetes, along with more cesarean sections which is a leading factor of greater maternal mortality” (U.S. Women’s Health). The U.S. citizens, more specifically the women citizens, seem to need the care the most compared to those in other countries because of the poor health conditions, and since the United States is a country that spends the most on their health care system (Status of Women’s Health), it would make sense for the care to be superior, but instead it is both inadequate and unsatisfactory.

There are men in power who believe that they have the right to decide what a woman is allowed to do with her body when it comes to her reproductive freedom. This should be the woman’s choice. States are attempting to set restrictions on or ban abortion all together, and some have been successful in meeting their goal. “As President Trump has reshaped the federal courts, the efforts of abortion opponents have shifted into high gear, with their tactics becoming even more deceptive and extreme” (Timeline of Attacks). Although there may be some women who have abortions because they just do not want a baby, other women make the choice of having an abortion because they feel like they have no other option and feel that it is the best decision in their current circumstances. For example, having a child could interfere with their education or career, and also they may not be financially stable enough and cannot afford to care for a child. It should be allowed for one to make a decision regarding their own body without being judged, hated or threatened. It is unfair to try to take reproductive health rights and options away from women.

Causes

The high cost of healthcare is not easy to handle. “Out-of-pocket costs for women in the United States were many times higher than those in most other countries studied. About 1 out of 4 women between the ages 18 and 64 said that they spent $2,000 or more on health care in the past year for both themselves and their families” ( U.S. Women’s Health). In order to avoid these high costs, women are sometimes left with no other option than to back out of necessary care. “In the years 2017-18, about Thirty-eight percent of women said they passed up on recommended care, and failed to fill prescriptions because of cost. (Status of Women’s Health) Problems with medical bills were reported by almost half of American women (44%) those in “which they had to spend time disputing or difficulty paying” (U.S. Women’s Health). Those with low incomes and greater health needs are the most likely to be left with outstanding medical bills. “This includes roughly four in ten Black women (44%), those in poorer health (45%), those who live in rural areas (39%), and four in ten low-income women (40%)“ (Women’s Health Survey). It is quite unfair and illogical that the women who either do not have the funds or the women who are in desperate need of help tend to have to pay the most money or are left with the extensive, ongoing medical bills.

Another issue contributing to the problem is that some women still do not have a good enough insurance coverage, or no coverage at all. “In the states that still have not expanded their eligibility for Medicaid, coverage options are more limited for women, resulting in uninsured rates that are often much higher “(How the Affordable Care Act has ). Those who hold a greater risk of being uninsured include: women with low income, women of color, and immigrants (Women’s Health Insurance). Uninsured women often have insufficient access to care, get a lower standard of care when they are in the health system, and have poor health outcomes” (Women’s Health Insurance). Uninsured individuals are diagnosed at more advanced stages of illness and have higher mortality rates than insured people (The Impact Poverty Has). Women without insurance have less use of important preventive services like mammograms, timely blood pressure checks and Pap tests compared to women with insurance, and are also less likely to have a regular doctor (Women’s Health Insurance Coverage). Although there are services that can help out women with insurance , “gaps in private sector and publicly-funded programs left a little over one in ten women uninsured”(Women’s Health Insurance). Due to their immigration status, some women who are uninsured are ineligible for Medicaid and “One in five (2.1 million) uninsured women are low-income and currently eligible for Medicaid but are not enrolled” (Women’s Health Insurance). “Women who are uninsured do not have coverage to offset the charges and may even be charged higher rates than insured women are“ (Women’s Health Survey). There are even insurance companies that see being a woman as a “preexisting condition that signals the potential for higher health care use and higher costs”, so automatically young women involved with these insurance planners are charged more than a young man would be (How the Affordable Care Act has Helped Women).

Women are sometimes not aware of cost information and are at times given unnecessary treatments. Patients usually do not know about local price variations because they’re generally not given cost information by health care providers or insurers”(Ways to lower health care costs). Out of the 26 tests or treatments that were widely recognized to be of no benefit or proved to actually be outright harmful, there was a study of over 1 million Medicare patients that proved up to 42% of them received these unnecessary tests in a year (Ways to lower health care costs).

President Donald Trump and anti-abortion activists and organizations try to attack abortion and anything that involves it, such as funds, clinics, and other helpful programs. A federal grant program called The Title X Family Planning Program was established in 1970. Title X was created to provide fully extensive and confidential family planning and health services (What is Title X). “The program prioritizes serving people and families with low-incomes and is implemented through grants to over 3500 clinical sites, including public health departments and non-profit health centers”.“In the year 2016, Title X-funded providers served more than 4.0 million family planning users through almost 6.7 million family planning encounters” (What is Title X). “It provides $286 million in funding for programs that provide services like birth control, screening for breast cancer and cervical cancer and screening and treatment for sexually transmitted diseases” (Trump Administration blocks funds). With the providers of programs like Title X, a vulnerable population, most of whom are young, female, and have low income, are able to be represented.

The Trump administration is ruthless. They are fighting hard to end the helpful reproductive health care provided by planned parenthood and has now announced… that it will bar organizations that provide abortion refferals from recieving federal family lanning money”. “These programs serve about 4 million patients each year, many of them poor, at more than 4,000 clinics. About 40 percent of those clinics are operated by Planned Parenthood, which receives close to $60 million through the family planning program each year” (Trump Administration blocks funds). On February 22, 2019, “The Trump-Pence administration issued a gag rule against Title X… in an attempt to ban providers in the program from telling millions of patients how they can safely and legally access abortion — and “defund” Planned Parenthood health centers by making it impossible for Title X patients to obtain birth control there” (Timeline of Attacks). “This is a clear violation of medical ethics and flies in the face of all health care providers and their value of the patient-provider relationship” (What is Title X). “After the Trump-Pence administration issued the draft of the rule, nearly 500,000 people submitted public comments opposing this outrageous rule. Every major medical association also denounced the rule along with hundreds of federal, state, and local elected officials. The vocal opposition was so loud because our nation depends on Title X to ensure that every person – regardless of income, identity, or whether or not they have insurance, can access basic, preventive reproductive health care” (What is Title X). “according to a prediction by several medical organizations, the new rule would ultimately leave large numbers of patients, especially low-income and minority women, without access to the basic care that they need” (Trump Administration blocks funds). “Without Title X services, many patients would lose access important family planning-related health care services. The majority of Title X patients are people of color who already have less access to health care”(What is Title X).

There are people in power, along with other anti-abortionists that are trying to set up bans and restictions on abortion. “On May 7, 2019, Georgia Govenor Brian Kemp signs 6-week abortion ban into law… making the state the fourth in 2019 to enact an unprecedented — and unconstitutional — ban on abortion at a point in pregnancy before most people even know they’re pregnant.” (Timeline of Attacks) “ On May 15, 2019, Alabama enacted a near-total ban on abortion. The Alabama legislation — the most extreme signed into law in any state since Roe v. Wade in 1973 — includes no exceptions for rape or incest“(Timeline of Attacks). These acts are not only unfair but also ignorant and inhumane.

Case study and counterclaim

The Affordable Care Act (or ACA) , which “is a comprehensive healthcare reform”(Affordable Care), was “first enacted on March 23, 2010”(Patient Protection).“The Act expanded Medicaid eligibility, created health insurance exchanges, and prevents insurance companies from denying coverage (or charging more) due to pre-existing conditions”(Affordable Care). “In the year 2014, the law’s major insurance reforms helped millions of women who did not have employer insurance to gain coverage through the ACA’s marketplaces or through Medicaid”(How the Affordable Care Act has Helped Women). “During the years prior to the enactment of the ACA, one-third of women who tried to buy a health plan on their own were either turned down, charged a higher premium because of their health, or had specific health problem excluded from their plans” (How the Affordable Care Act has Helped Women), but 7 years after the act was passed more women than ever had some sort of health coverage (Women’s Health Survey).

The Affordable Care Act has improved circumstances and has been a tremendous aid to women when it comes to their healthcare coverage, however, although “there has been much progress in expanding coverage and reducing the number of uninsured women since the act was passed, affordability continues to be a challenge for many women and 10.6 million of them still lack coverage”(Women’s Health Insurance Coverage). The ACA “required many health plans to cover a number of women’s preventive care services with no copay. But despite this effort, stubborn financial issues remain, making care anything but affordable and women’s health in the United States is still ranked quite low” (U.S. Women’s Health). The women who are in the most need of help are sometimes not aware of their eligibility for the aid. A study showed that “One in five (2.1 million) uninsured women are low-income and currently eligible for Medicaid but are not enrolled” (Women’s Health Insurance Coverage). Then there are the women who are not able to get help, “Over 3.7 million uninsured women are not eligible for assistance” Women’s Health Insurance Coverage), for reasons including their immigration status, (as mentioned previously), which is not fair. Also compared to other countries, the United States still tend to have higher out-of-pocket payments and deductibles despite the ACA (U.S. Women’s Health).

Solutions

A woman’s body is hers, and hers only. She deserves to have control of her own reproductive rights. A person should not be allowed to tell or determine what woman is allowed to and not allowed to do with her body, especially if that person is a man who does not and never will understand the circumstances she has to endure. Women deserve to have the right to choose whether they want to have an abortion or not or if they want to use birth control. They deserve to be able to know about the options they have and be fully aware of them. When going for help from a medical professional, she should be informed on tests she is given and other information necessary like price variations for cost information. Other countries have found ways to make coverage more affordable for their residents, so the U.S. should be able to as well. The high out-of-pocket costs should be lowered. Health care should not be a burden to women and their families. Health care should not be seen as a luxury because it is not. It is a necessity. Women should not have to choose between health or a roof over their head. The cost they have to pay should not be so high. Without Title X many low income, young women and their families will be left without a source of health care services that provide important tests, screenings, treatments. They will lose access to services that can help them with any questions they have about their health and well being. Women should be knowledgeable about medical care and should have the right to fair care. Since Title X grants access for women in the U.S. who do not have fair and good healthcare, Trump’s gag rule should be repealed.

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