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Health Care Reform: Moving onto the Next Barriers to Care

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September 4, 2013

The Affordable Care Act is law of the land and that’s a good thing. More people who previously weren’t able to access health care due to financial restraints will now have an easier time doing so. Issues like lack of insurance and under insurance will be alleviated through implementation of The Affordable Care Act.

We’ve come a long way baby, that is why I will Debbie Downer all over the celebration party by  reminding us of how far we still have to go. Removing financial barriers to health care is a HUGE step to eliminating health disparities. Now we can begin to tackle the non financial barriers that impede access to care and sustains disparities. Some of the egregious, in no particular order:

Plan B

 Plan B (emergency contraception) no longer has age restrictions,  which means that technically anyone who can afford it can now purchase the drug regardless of how old they are. But of course it’s not that simple. I believe the first and biggest obstacle to getting Plan B is the cost: last time I checked at a local Planned Parenthood, it was $35. Generics are slowing making their way onto shelves, but even getting over the financial barriers, there are still problems with accessing the drug. Problems like stigma and slut shaming.

There are six states that allow pharmacies and pharmacists to refuse to sell Plan B due to personal, religious and “moral obligations.”  Not only do they refuse to sell the drug, but they also don’t have to “refer or transfer prescriptions” according to the National Women’s Law Center. Then there the pharmacies that refuse to sell the drug to men. As if the stigma was not bad enough, now we have to deal with gender policing.

LGBT inclusion

I like to fill out forms at the doctor’s office. I especially like to judge doctors’ offices based on which ones only have “male, female” options under their sex/gender checkbox. It’s a little thing that helps me gauge how LGBT friendly that particular office is. It also helps me prepare myself for stigma. Even though 13 states currently have same sex marriage and the Obama administration now makes it possible to same sex couples to receive federal tax benefits, there a still a lot of stigma associated with being LGBT in this country.

The health care system is not free from this stigma. Stigma often times means that individuals don’t tell their healthcare providers about their status as LGBT person which can result in them not receiving treatment tailored to their specific identities. Trans individuals face open discrimination and hostilities by the health care system. The Center for American Progress reports that “over half of medical school curricula include no information about gay and lesbian people. Programs in public health schools are also unlikely to include such information beyond work related to HIV/AIDS.”

Teaching medical students about  LGBT specific healthcare needs is important,  “students with exposure to lesbian, gay, bisexual, or transgender patients are more likely to perform more comprehensive patient histories, hold more positive attitudes toward LGBT patients, and possess greater knowledge of LGBT health care concerns.”


Did you know that there are racial  disparities in health care? Did you also know that racial disparities are especially pronounced in maternal and infant health outcomes among blacks and whites?  So much so that even after researchers controlled for socioeconomic differences, there were disparities in preterm and low-birth weight deliveries among black and white babies.

The disparities seen in maternal and infant health among blacks and whites has led researchers to hypothesise that “racial discrimination, as a psychosocial stressor, may increase the risk of preterm and LBW deliveries.”  There have been cases of Blacks and Latinos not getting as much pain medication as whites, because of persisting stereotypes of racial minorities’ high tolerance for pain. Black women in labor sometimes also face this problem. The problems only worsen if you happen to be a an LGBT person of color.

For some, money is only half the problem. By making our policies are intersectional, we can go about eliminating these systemic oppressions.


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