Portland observer. (Portland, Or.) 1970-current, June 14, 2017, Page Page 6, Image 6

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    Page 6
June 14, 2017
New Prices
April 1, 2017
Martin A Feminist Perspective on Trumpcare
Cleaning Rife
problems and
Service gender bias
l aura f inley
Although the Amer-
ican Health Care Act
(AHCA) of 2017 is rife
with problems, one of
the most disturbing is its shock-
ing gender bias. But why should
we be shocked that the AHCA, or
“Trumpcare,” privileges males, as
it was crafted by a group of privi-
leged males and is being champi-
oned by the most privileged of all,
Donald Trump himself?
The House bill now goes to
the Senate, where majority leader
Mitch McConnell initially con-
vened a healthcare working group
composed of 13 men. Amidst crit-
icism, they invited Sen. Shelley
Moore Capito (R-WestVirginia)
to join, although it is not clear that
she will be a regular contributor.
The fact that 13 men, and a
woman who may or may not be
a regular contributor, are crafting
this bill is not the issue, but rather
that the architects of the AHCA are
treating women as second-class
citizens while taking care of their
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own interests.
While the AHCA maintains the
federal provision requiring that in-
surance companies provide cover-
age to people regardless of
their medical history, states
will be allowed to seek a
waiver from the federal
law. An amendment to the
bill appears to allow insur-
ers to charge people more
if they have certain pre-existing
conditions or even to deny them
coverage entirely.
There’s an exhaustive list that
penalizes women. Rape and sex-
ual assault themselves are not
listed as pre-existing conditions
in the proposed bill, yet the most
common physical and emotional
effects can be used to deny health
insurance coverage to women un-
der the proposed law. Research is
clear that victims of sexual assault
suffer higher rates of HIV and oth-
er sexually transmitted infections,
depression, anxiety, eating disor-
ders, and sleep disorders—all on
the proposed list of pre-existing
Victims of domestic violence
often struggle with these same
things. Given that approximately
one in six women are sexually as-
saulted and 30 percent experience
domestic violence, the potential
impact is huge.
If you have troublesome periods
or menstrual irregularities, expect
your premiums to go up. Pregnan-
cy and the need for a C-section are
also on the list of pre-existing con-
ditions, and premiums for women
who have given birth might be as
much as four times higher than
for men. In case it’s not yet clear
– only women menstruate and get
The bill would also allow insur-
ers to opt-out of what Obamacare
considered the 10 essential health
benefits, or services that all in-
surance plans must cover. These
include maternity and newborn
care, preventive care like mammo-
grams, cervical cancer screenings,
birth control, and access to free
or low-cost breast pumps. Before
Obamacare, 62 percent of health-
care insurance plans available on
the individual market did not cover
maternity care, and only nine states
mandated maternity coverage.
The AHCA will defund Planned
Parenthood for one year and
blocks that agency from receiv-
ing Medicaid reimbursements.
That essentially eliminates birth
control access and sexually trans-
mitted infection screenings for an
estimated 390,000 low-income
women. About half of the 2.5 mil-
lion patients who visit Planned
Parenthood centers every year
rely on Medicaid for their health
The champions of Trumpcare
really don’t seem to get it. Or
maybe they do, and just don’t
care. Rep. John Shimkus ques-
tioned why men have to pay for
prenatal care, while White House
press secretary Sean Spicer even
joked that older men didn’t need
maternity care. Funny? Not so
At the same time, the archi-
tects of the bill deliberately left
erectile dysfunction off the list of
pre-existing conditions. So, be-
ing a woman is a chronic medical
condition that must be controlled
by men but getting an erection (or
not) is protected. If we ever need-
ed more proof that men think with
one head more than the other, look
no further.
This healthcare bill will contin-
ue to entrench male superiority, to
the detriment of more than half of
the country’s population.
Laura Finley, Ph.D., teaches in
the Barry University Department
of Sociology & Criminology and
is syndicated by PeaceVoice.
Medicaid Essential for Mental Health Services
Cuts would
actually increase
overall spending
k enneth e. t horPe
President Trump and
Republican Congressio-
nal leaders justifiably
want to curb the alarming
growth in government
Their proposed solution?
Cut $880 billion in fed-
eral funds from Medicaid over the
next 10 years.
Their plan wouldn’t necessar-
ily reduce government spending.
At best, it would just shift the
burden from federal taxpayers to
state taxpayers. In fact, such cuts
could increase overall government
spending. That’s because Medic-
aid is the most important financing
source of mental health services.
Expanding access to mental health
services would yield billions in
savings -- and produce a healthier
Roughly one in five American
adults will suffer from a mental
health condition this year. Half of
Americans struggle with mental
health conditions such as depres-
sion, anxiety, bi-polar disorder,
and schizophrenia, at some point
in their lifetimes.
Mental health conditions are
the most expensive medical con-
ditions in the country. In
2013, the United States
spent more than $200
billion treating mental
health disorders. That
total is about $50 billion
higher than what was
spent combating heart
Patients are all too famil-
iar with this financial burden.
Healthcare costs for the aver-
age Medicaid adult who doesn’t
have any chronic conditions total
$4,600 each year, according to
the Partnership to Fight Chron-
ic Disease, the non-profit I lead.
But for Medicaid adults suffering
from a mental health condition,
annual healthcare spending more
than doubles, reaching a whop-
ping $11,200.
It’s no surprise, then, that men-
tal health conditions are also a
serious drain on state healthcare
systems. States can expect to
spend nearly $70 billion on men-
tal health conditions over the next
15 years.
In addition to increasing medi-
cal costs, mental health conditions
also drain money from the econ-
Consider the workplace. Due
to decreased performance, absen-
teeism, and other factors associat-
ed with mental health conditions,
mental illnesses cost employers
billions each year.
Or consider the prison system.
Unfortunately, more than eight of
every ten inmates don’t have ac-
cess to metal health services and
support. Without proper treatment,
inmates are put at a severe disad-
vantage when they’re released.
Many succumb to homelessness.
Others relapse into criminal be-
havior and wind up back in prison.
Lost productivity, additional
jail time, and other societal costs
associated with mental illness will
drain an additional $3 billion from
state budgets by 2030.
But that doesn’t have to be the
case. Depression, anxiety, schizo-
phrenia and other mental health
disorders are treatable diseases.
With sensible policy solutions that
prioritize access to mental health
services, states could realize enor-
mous savings -- and cultivate
healthier populations.
For example, by boosting in-
mate access to effective mental
health services and innovative
treatments, states could drastically
reduce the number of mentally-ill
inmates who received extended or
recurring jail sentences. That adds
up to nearly $9 million dollars per
year in savings.
The same is true for the work-
place. Increasing access to neces-
sary services and detecting mental
health issues early on would slash
cases of absenteeism and help em-
ployees become more productive.
Businesses could save millions of
dollars each year.
Adopting these new policies
could save states upwards of $475
million each year. That’s $7.1 bil-
lion in savings by 2030.
The solution to rising health-
care costs is simple: our govern-
ment saves money when we have
a happier and healthier popula-
tion. Any lawmaker -- or business-
man president -- would be foolish
to cut mental health services that
yield tremendous savings.
Kenneth E. Thorpe is a profes-
sor of health policy at Emory Uni-
versity and chairman of the Part-
nership to Fight Chronic Disease.