Professional Documents
Culture Documents
Autonomy
Sagufta Muktadir
Professor Jan Babcock
English 138T
17 April 2023
Brief Healthcare Background
individuals through trained medical professionals1. The United States has a very complex
healthcare system that is dependent on medical providers, payers, and patients. Currently, the
hospitals receive fixed payments, known as diagnostic-related group (DRG), based on the
treatment or procedure being done, and physicians receive wages separate from the DRGs3,
which are billed to the insurance company. On average, private insurance companies exceed the
hospital costs whereas public companies are usually underachieving those costs. On a separate
note, people who are without healthcare have to pay out-of-pocket, and those costs are
substantial. In fact, it is estimated that $800 billion will be spent for out-of-pocket spending in
Healthcare Effects
As it can be seen, healthcare is a very convoluted and expensive venture for everyone.
However, this issue is exacerbated for certain minority groups, especially women. There is a lack
of awareness and prioritization of female issues that leads to gaps in funding for women’s
COVID-196. This percentage is higher among women who considered themselves as in either
fair or poor health, who usually do not have health insurance to cover doctor visits. When
women skip preventive health services, their health is more likely to deteriorate further and
“invisible” diseases are less likely to be caught, which increases the mortality rate.
Period Poverty
The current healthcare system is also unable to cover feminine hygiene products. The
lack of access to these products produces many problems for women in the United States. 1 in 5
teens are unable to afford tampons or pads and 4 in 5 miss school due to the lack of period
resources7. This is collectively known as period poverty and can have emotional, physical, and
mental health effects8. However, as problems arise with period poverty, the lack of access to
healthcare prevents many women from seeking the right care to manage the period symptoms.
Additionally, there are cultural taboos and stigma that prevents further healthcare for women and
Furthermore, access to contraceptives is a hassle and prevents many women from being
on any hormonal contraceptives. In fact, it wasn’t until 1972 when women had legal access to
birth control regardless of marital status10. However, with health care, birth control pills are not
that expensive and can be completely free with some government assisted programs. Not all
Main Issue
As a result, women need more healthcare coverage than men, threatening their health and
economic security11. Women are also more likely to face economic hardships, making it
substantially harder for them to garner healthcare. In a social and economic way, women are not
at the same status as men in that regard. From birth, women are barred from the resources that
would make them more productive individuals in a society. As women are considered inferior in
their roles as wives, mothers and daughters, their poverty is further highlighted when these roles
are no longer controlled by men as there is a lack of resources for them to become functioning
members of society, making them even poorer12. People in lower socioeconomic classes are
more likely to be in poor health and not go to medical professionals as often, further making their
health worse13. As healthcare coverage increases substantially each year, more and more women
will not be able to go to their preventative healthcare services and gather the required medical
attention they need. The World Health Organization states that one of the fundamental rights of a
human is to enjoy the highest standard of health, but they also say that many women are being
denied this right14. For every woman to have a right over their body and decision-making
policies, it is up to policymakers to ensure that they are getting quality healthcare services 15. In
the United States, there is a discrepancy in healthcare services as the prices have skyrocketed.
However, this issue is intensified for women through the inequal access in feminine hygiene and
sexual health products and preventative healthcare services. The United States can resolve this
issue by providing a more universal and free healthcare for women of all socioeconomic
backgrounds.
Current Regulations
In the United States, the Department of Health and Human Services (HHS) manages
anything health related for American citizens and provides funding for initiatives to further
medical research and reduce medical costs16. Currently, there are eight regulations in act that
have impacted American health: Healthcare Quality Improvement Act of 1986, Medicare,
Health Insurance Portability and Accountability Act of 1996, Patient Safety and Improvement
Act of 2005, and Affordable Care Act of 2010. Although all the regulations impact women
directly, the three main that has the biggest impact on healthcare services prices are Medicare,
Medicaid, and Affordable Care Act of 2010, which are all types of public insurance programs.
Medicare
disease and allowed certain people under 65 in long-term disability to make use of this insurance.
In 2017, 15% of federal spending was used on Medicare and 20% in national health spending18.
Part A of the insurance allows Medicare usage if the patient or their spouse is eligible for Social
Security payments and have paid their taxes for 10 and more years 19. In general, if patients
qualify for Social Security benefits, they are eligible for Medicare. However, this program can
have substantial out-of-pocket costs. Part A premium-free deductible includes $1,600 in 2023
and Part B allows $226 per year20. As the elderly face more challenges in health, the costs can
increase to significant amounts that forces many patients to pay out-of-pocket, which many may
not have the right of funds to do so. This is even worse for elderly women who are already at a
Medicaid
Alongside with Medicare, another type of insurance was proposed that covered a larger
portion of the public – Medicaid. As such, it is United States’ public health insurance for people
with low income. The program covers 1 in 5 Americans and is the principal program of long-
term care21. Medicaid is a federal-state partnership, meaning that states can regulate the coverage
programs, but states have a huge restriction on how much is offered. Due to the lack of
standardization of Medicaid for every woman, there are discrepancies of health care for them in
the country – some people may get benefits in one state while others do not in another state.
On March 23, 2010, the Patient Protection and Affordable Care Act was signed into law
by President Barack Obama and allowed for every American to have health insurance23. The
main goals of this program were to make health insurance affordable, innovative, and expand
Medicaid, especially to families living in poverty24. The Affordable Care Act provides a lot of
benefits to everyone, especially women. Some benefits include that women do not have to pay
more than men for insurance policies, they cannot be denied coverage due to past medical
histories, and they are guaranteed coverage for reproductive health such as birth control,
mammograms, and cervical cancer screenings25. However, as with Medicaid, the ACA allowed
for the expansion of federal authority of healthcare but still allows states to regulate a vast
majority of health care for women. For example, Planned Parenthood is a fundamental
organization that provides family planning and reproductive health services. However, there are
instances in which ACA allows some states to exclude Planned Parenthood to be covered by
Medicaid26. There is still a lack of standardization for health coverage for women, despite ACA
Pink Tax
which are treated as luxury items. Women need 40 period products each time they complete their
cycle29, but the pink tax makes the consuming of these products very expensive and a hassle for
women. Period products are not recognized as healthcare items and such insurance companies
are unable to pay for these items. Currently, only 23 states remove taxation from period products
As seen with current healthcare policies implemented for women, a major disadvantage
for all the policies is that there is a lack of standardization of what services are offered. The ACA
has expanded the federal requirements for adequate healthcare, but in the end, states do control
majority of what is offered, especially to women. This can be fixed through employing universal
health coverage in the nation. The World Health Organization prioritizes universal health
coverage and plans to allow 1 billion more people to this service by 202531. A country that
participates in providing universal health coverage is Canada. It has a decentralized and universal
healthcare system called Canadian Medicare, which is funded by the country’s 13 provinces and
territories32. Each territory has their own set of regulations, but any necessary medical visits are
completely free for Canadian citizens and permanent residents. The Canadian government
finances and organizes health services from taxation. About 24% of funding is provided by the
Canada Health Transfer, the primary federal program that funds healthcare33. To receive federal
funding, each territory needs to accept the five factors of the Canadian Health Act: to be publicly
administered, comprehensive in care, universal, portable across locations, and accessible34. The
United States relies heavily on employer-based insurance and many of the working poor do not
qualify for government-funded programs, and to make matters worse, many jobs do not offer
satisfactory health insurance35. The United States can replicate Canadian’s model of universal
health coverage. Instead of relying on employer-based insurance, the United States can amend
ACA to allow for all Americans to have some hospital and patient-stay insurance, regardless of
job status. The private insurance can be used to fund more specific specialties such as dental and
vision care. Since majority of the working poor is comprised of women, they can have basic
health insurance to have the care they require immediately, instead of relying on their
1. Amending The Affordable Care Act to include basic insurance for all. This can be done
through bill revisions and the Democratic party supporting this revision (the ACA was
2. The healthcare would come out of taxpayers’ dollars, but higher income earners would be
taxed more than lower income earners. The revenue would then be used by the
Department of Health and Human Services to fund healthcare services under the new
ACA.
3. The United States government should have a higher negotiation power with the hospitals
and drug companies than private insurers. This ensures that costs of the taxes are low, and
For women to garner the full capability of their reproductive health, the ACA should
expand to prevent the taxation of period products for the whole nation. The ACA allows for
health insurance to cover birth control medication and other reproductive rights for women. As a
result, health insurance should also cover period products, which is a significant part of
reproductive health for women. If male external condoms are not taxed as means to not hinder
male reproductive systems, then why should period products be taxed? The implementation can
occur in:
1. Expanding the ACA section of what is allowed for women to include tampons, pads, and
menstrual cup consumption as part of their unrestricted right to health insurance without
additional costs.
2. In 1981, Minnesota prevented all health products from sales tax and Massachusetts
declared period products as health devices in 2013 and stopped taxation36. The whole
nation can replicate this process and prevent all health products and devices from being
Backlash
As with all new proposed policies, there can be significant backlash to the proposed
regulations. One significant backlash could be that if health insurance is standardized to fit the
nation, the government would be involved in health decisions, making healthcare a political
issue. The United States values the separation of federal and state governments in decisions, but
with this proposed regulation, the separation would be blurred. However, the benefit of having
universal insurance will allow the country to be healthier, and everyone, regardless of gender and
socioeconomic status, will have their own control of their heath. Another backlash will be the
rising taxes for American citizens, but that can be controlled if the government negotiates with
Conclusion
As mentioned earlier, the access to quality healthcare is a fundamental right for all.
Unfortunately, not all women are able to have the same access to healthcare, as they are
considerably poorer than their male counterparts, and their occupations may prevent them from
qualifying for current government-assisted programs. For women to have their autonomy and to
prevent increasing mortality, it is important to implement some changes in the current healthcare
systems. This can be done by expanding the Affordable Care to a universal health coverage and
allowing period products to be covered, like how reproductive services are covered under the
current ACA policies. This can only be done when government officials and parties take the
initiative to understand that female healthcare is an important investment for the future. After all,
the future only starts when everyone has equal access to necessities and being healthy is a
fundamental right.
Footnotes
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