Health Care Deserves More Attention on the Campaign Trail

  SEPT. 23, 2016  New York Times

The reaction to opening a medical bill these days is often shock and confusion — for the insured and the uninsured. Prices and deductibles keep rising, policies are drowning in fine print, and doctors are jumping on and off networks. So why hasn’t the growing burden of health care gotten more attention in the presidential campaign?

One reason may be the sheer complexity of the system. Yet Hillary Clinton, if you look closer at her proposals, has a range of interesting ideas on how to tackle costs and improve care. Donald Trump, meanwhile, rarely ventures beyond his “end Obamacare” slogan.

With incomes for most Americans stagnant, individuals and families insured under the Affordable Care Act or through employers are bearing more of the cost of medical treatment.

Deductibles for individual coverage increased 63 percent on average, to $1,221 per year, from 2011 to 2016 for people who get health insurance through their employers, according to a report released last week by the Kaiser Family Foundation and the Health Research and Educational Trust. Workers’ contributions to premiums grew more slowly than in previous five-year periods but still jumped 23 percent, to $1,129 a year. By contrast, average incomes were up just 11 percent, which means many people are being forced to cut back elsewhere to pay for care. And some people are choosing to forgo or delay going to doctors and hospitals when they are sick.

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Soaring Premiums Since 1999, premiums for family health plans have grown much faster than inflation and wages. Data for employer plans; yearly figures from April to April. Source: Kaiser Family Foundation By The New York Times

The cost of prescription drugs is another big problem for people with or without coverage. The average price of brand-name medicines jumped 164 percent from 2008 to 2015, according to Express Scripts. And 24 percent of Americans find it very or somewhat difficult to afford prescription drugs, according to a 2015 Kaiser Family Foundation survey.

Mr. Trump says he would replace the law’s subsidies and Medicaid expansion with tax deductions for health insurance premiums paid by individuals and families. But that would primarily benefit the rich, not the millions of low-income and middle-class people who would lose coverage if the law were dismantled. Mr. Trump’s plan also includes several vague ideas for lowering costs. One of them is to increase competition among pharmaceutical companies, but Mr. Trump does not say how he would do that.

Mrs. Clinton clearly understands the issues and has some plans that could help. Deductibles and other out-of-pocket costs have risen for workers covered by employer-based plans as businesses have shifted more costs onto employees. Mrs. Clinton wants to provide a tax credit of up to $5,000 to help people pay out-of-pocket costs, including for prescription drugs. That’s a good idea, but it would be even better if people received assistance when they faced expenses rather than when they filed their tax returns.

Another proposal from Mrs. Clinton would lower prescription drug costs by allowing Medicare to negotiate with pharmaceutical companies. Drug makers, of course, hate this idea because it would reduce their revenue, and they would surely lobby Congress to defeat a bill. She has also suggested ways to lower costs by hastening the arrival of generic medicines. And she has promised to provide detailed policies to reduce needless medical procedures and to root out fraud and inefficiencies, moves that could prove effective in the longer run.

Health care is just the kind of difficult subject that presidential candidates ought to talk about more. If Mrs. Clinton were to speak regularly and in more detail about her health ideas, she could start building support for them with lawmakers and the public. She would also further expose the shallowness of Mr. Trump’s agenda.

A version of this editorial appears in print on September 24, 2016, on page A20 of the New York edition with the headline: Taking On the Health Care System.

How We Changed the Conversation on Safe Sex at Our High School

September 22, 2016 by

As a Latina, I have been taught that I am more likely to have a child in high school than to go off to college. I have spent the last two years fighting this stereotype, pushing to be heard and bringing the voice of low-income women into the halls of power. At my high school, that meant fighting stigma and social norms in pursuit of a simple, but revolutionary, conversation-sparking tool: a condom machine.

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Less than 10 percent of Latinx students are enrolled in a 4-year college, but 53 percent of Latinas become pregnant at least once before age 20. I’m from San Rafael, California, where a majority of my peers are on free and reduced lunch. My school district of just three high schools has our own daycare center—but conversations about consent, safe sex and contraceptive access are scarce.

I became an Auntie at nine, when my 17-year-old brother and his girlfriend became pregnant. While everyone else around me was silent, they spoke to me about their lives as teen parents. I learned the very real barriers to contraceptive access for low-income teenagers. It made me frustrated and angry—so, like my immigrant parents, I searched for a solution.

With the help of Next Generation Scholars, I began to brainstorm ideas to create change in my community, but I needed to find out for myself what was truly accessible. I tried to get condoms, Plan B and information about birth control options at my school. After nine attempts at meeting the school nurse, I realized I needed to look elsewhere. I was directed to a local youth health program for sex-related questions, which came with its own issues—long lines, lots of paperwork and a three-hour wait.

Local stores aren’t an option, as most students don’t have extra cash, and almost all of the stores have people we know working in them. There’s a Planned Parenthood nearby to my neighborhood, but it isn’t advertised within the district because of feared community repercussions. Still I went. I found, to my surprise, that it was clean, private and free. It even offered bilingual support—yet no one was telling us about it.

I decided the only option was to lobby the school to get condom machines installed in the bathrooms. It would require a trip to the school board, which seemed simple enough. It wasn’t. The school board seemed excited by my plan, but was not able to give immediate feedback. I waited for five months and was continually denied a chance to speak. During that time, two more Latinas left my school to have children.

I took to the halls to distribute condoms from my backpack. What started as a few dozen condoms turned into hundreds. It may seem extreme to turn yourself into what my friends called a “human condom machine,” but I needed to take matters into my own hands. Next I launched a school club, held a parent meeting, surveyed students on sex and contraceptive access and interviewed teachers to build my case.

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Two years later, when I was a senior, I was finally called back to the school board to get my answer. When my proposal passed, my family and community celebrated. But—and there is always a “but”—we would have to fund the condom machines ourselves.

The resources I had relied on for the first condom donation were running out until I was connected with the National Coalition of STD Directors (NCSD). Not only did NCSD use their existing partnership with TrojanTM to donate 10,000 condoms to my school district, they enabled us to see the power of our voices. As soon as people began to find out that our school was going have access to TrojanTM condoms, the news spread like wildfire. When we filled the condom machines for the first time, they were empty within an hour. To have donations from such a well-known brand like Trojan™ was a huge contribution to the success of our project.

My school and my community are so often counted out. Like so many communities in America, we are poor, we are Brown and we are struggling to make our way in this country. To be seen, to be acknowledged, to be protected is revolutionary and transformative.

For the first time, conversations on safe sex are happening freely in San Rafael. Across campus—in two languages—the conversation about safe sex spread quickly. I created posters and used Snapchat and Instagram to spread the word, even reaching students in other districts.

I am the first in my family to attend college. Here at Wesleyan, I hope to gain the education and experience I will need to become a changemaker in this field. College is a whole new world, and my family and I will struggle to make ends meet, but after all I have gone through to get to this moment I stand ready to keep fighting for sexual healthcare access for all.

I know my story is small and that there is still work to be done—but if a 17-year-old kid can get this far, just imagine what more could be done.

 

alba-photoAlba A. Alvarado is a freshman student at Wesleyan University in Middletown, Connecticut. She is a first-generation college student. She hails from San Rafael, California where she was heavily involved in extracurricular activities, specifically community service. Her condom campaign changed countywide school policy and provided free access to students.

How We Changed the Conversation on Safe Sex at Our High School

Community Discussion on Sept. 27 in Newport on Report on Status of Oregon Women & Girls

The Central Oregon Coast Chapter of the National Organization for Women (NOW) will host a community discussion at 6 p.m. on Tuesday, Sept. 27, on the Oregon Women’s Foundation “Count Her In” Report (https://womensfoundationoforegon.org/ uploads/CountHerInreport. pdf ), which was released Sept. 21 on the status of women and girls in Oregon.    The discussion will be held at Central Lincoln PUD meeting room, 2129 N Coast Highway, Newport.   

More than 100 Lincoln County women, and a few men, participated in the “listening tour” stop that was held earlier this year in Newport and that contributed to the “Count Her In” report.  

The Central Oregon Coast Chapter of NOW believes the findings raised some major concerns and that it important to have a community discussion about how the coast can respond to some of those findings.   

Among the concerns identified by NOW are:   

An estimated 1 million Oregon women and girls — more than half of the state’s female population — have experienced some form of sexual or domestic violence. This     is one of the highest rates in the country.   

Oregon is one of the least affordable states in the nation for child care. A year of day care is now more expensive than annual tuition at a state university in Oregon.   

Women and girls of color in Oregon experience disproportionate barriers to success, including poverty rates that are nearly twice as high as those of white women and girls.    Hundreds of thousands of women lack access to the information   and services they need to decide if, when, and how they become pregnant. Almost half of Oregon pregnancies are unintended, a rate that has barely dropped in 20 years.   

Oregon women earn between 53 and 83 cents (depending on race or ethnicity) for every dollar white men in Oregon earn. The gender wealth gap, based on the sum of a person’s assets, is even larger: approximately 35 cents on the dollar. Oregon’s gender wealth gap is among the largest in the nation.   

Oregon women have the   highest incidence of reported depression in the country, as well as the highest rate of alcohol use. Women are almost twice as likely to attempt suicide than men, and Oregon women have higher rates of childhood trauma than the national average.   

The purpose of this meeting is to work on solutions to the obstacles facing women and girls in the local community. The public is encouraged to attend. For more information, email centraloregoncoastnow@gmail.com or go online at www.centraloregoncoastnow.com.

Newport News Times, September 29, 2016, Section B 4

Women still struggling

BY CALLEY HAIR    Of the News-Times, September 23, 2016

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SALEM — A detailed report on the status of women and girls in Oregon reveals the state has a long way to go in achieving gender parity, from wage equality to child care to sexual assault.    However, that same report also shows Lincoln County is slightly more equitable than  the rest of Oregon in most categories.   

“Count Her In: A Report About Women and Girls in Oregon,” from the Portland based Women’s Foundation of Oregon, was released Wednesday, Sept. 21. The report is the result of comprehensive   data collection and a 14-stop listening tour, the first of its kind in 18 years.   

“We took our eye othe ball for a generation,” said Emily Evans, director of the foundation. “We wanted the data, because we wanted to know where our investments would make the most impact.”   

Statewide, the report turned up some discouraging results for women of all races and socioeconomic statuses.   

It found that the state’s females have the highest rates of reported depression and alcohol use in the country, and more than half have experienced some form of sexual or domestic violence. The report also shows that nearly half of Oregon’s pregnancies are unintended, while the cost of child care remains among the highest in the nation.   

Women and girls of color face poverty rates twice as high as their white counterparts, the report indicates.   

“It’s alarming”, Evans said. “But the first step in solving the problem is identifying the problem — especially in a   state used to coasting on the progressive reputation of its Pacific Northwest neighbors”.   

“We’re really hoping that it changes the perception of gender equality in the state,” Evans said. “In many ways, Oregon is kind of the stepchild that’s doing a lot worse than its regional counterparts. And we really need to grapple with that.”   

While Lincoln County remains far from immune to gender-specific struggles, the region appears, on the whole, slightly more hospitable to women than the rest of the state — or, more skeptically, equally inhospitable to both genders in some regards.   

Lincoln County’s employment numbers are low, but more even between genders than Oregon’s average.    “It usually means men and boys of that county are doing worse,” Evans said. “Places where there used to be a lot of robust, male dominated industries   , like logging or fi shing.”   

Women in the region are 4 percent less likely than men to join the workforce, but that disparity is smaller than the 9 percent statewide one.   

The wage gap in Lincoln County also remains slightly tighter than the rest of Oregon, with women earning $0.81 on the dollar compared with a statewide average of $0.79.   

The region’s women hold 38 percent of local leadership positions compared with the state average of 30 percent. The county’s 41 city council positions include 17 women, although top spots — including three county commissioners and four paid city managers — are all held by men.     

That’s a pretty common pattern across the state”, Evans said.    “The less accolades and less money involved in a position, the more women are involved in it,” she said. “Counties are so critical to the administration of services, (and) the fact that we have largely men making decisions about the distribution   of these resources seems a little out of proportion.”   

Child care is cheaper on the coast. Keeping a toddler in day care costs around $6,000 per year, half of Oregon’s $11,976 median.   

However, Lincoln County ranks second lowest in economic mobility for women, followed only by Jefferson County. By the time she’s 25, a Lincoln County girl’s location will negatively impact her earnings by an annual average of $1,485.    “There’s not that much opportunity to pull yourself up the economic ladder,” Evans said.     

Lincoln County also lacks a comprehensive reproductive health clinic that offers sexual health, family planning and abortion services.    “Being the most populous county on the coast, that’s a little alarming,” Evans said.   

Evans and her team stopped in Newport on April 5, the second sojourn in a spring listening tour that gathered personal stories from more than 1,000 women. Around 130 women showed up to the   event at Samaritan Health Education Center.   

“It was pretty uncanny, the way that the stories and the text polling we got during the tour lined up with the data,” Evans said.    The report isn’t all doom and gloom. It also found that Oregon’s women participate in public service and serve in the military at some of the highest rates in the nation. They’re also the country’s most physically active females.   

“We tried to have a hopeful report, as much as some of these things are startling,” Evans said. “Oregon women are giving more and getting less … Think about how much they would be contributing if they weren’t facing these daily   challenges.”   

A full copy of the 120-page report can be read at womensfoundationoforegon.org/ uploads/CountHerInreport. pdf   

Contact reporter Calley Hair at 541-265-857 1 ext. 211 or chair@newportnewstimes. com  

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