Say What? Real Talk about Health Exchanges

My name is Jasmine Burnett and I have joined the Raising Women’s Voices team in NYC this week as a part-time community organizer building support for a NYS Health Exchange.  My work with RWV-NY has been made possible by grants from the Ms. Foundation for Women and Health Care for All NY.  My background is in reproductive justice organizing, as lead organizer for SisterSong NYC/Trust Black Women.  I was asked to provide some tips on how to talk about state health exchanges in a way that I understand it which for me means, simple and easy to understand.

Policy is not my favorite topic.  I find any way to avoid it. But if the political is personal, then I better take my understanding of politics and policy personally.  The current war on women’s rights and women’s health puts policy at our doorstep, in our homes and our communities.  Here are some quick and easy tips that have been successful for me in talking about health reform to my community, and might help you.

Become Informed

It is important to become informed about the discussion you are trying to get your community engaged in.  The fact sheets provided by Raising Women’s Voices offer the hard facts about the policies.  The RWV conference calls can help you tease out the information that’s relevant to the communities you serve and help you identify examples to make your messaging clear. You can also ask questions to clarify things you and your constituents might find confusing.

Use storytelling in everyday language

Part of engaging others in health care reform discussions is being able to explain policy in everyday language.  While we typically call the exchange a “marketplace” where individuals can buy affordable health insurance, I like to use the analogy of Walmart.

Walmart buys merchandise in bulk and passes the savings onto the shopper. Ideally, exchanges will work the same way. Exchanges could serve as “active purchasers” of health coverage for everyone who needs it and make sure the plans offered are affordable and have good quality.

Some people, though, choose not to shop at Walmart because of concerns about its employment practices or conditions in particular stores and neighborhoods.  With the health insurance exchange, we won’t have another store to shop in for quality, affordable health coverage.  That is why we will need to hold our state exchange accountable for using ethical standards in determining what kind of health coverage and which health plans are in the best interest of our communities.

Fortunately, our state health exchanges will not be operated by private businesses like Walmart.  In most states, the health exchanges will be operated by public authorities or state agencies.  This means the people who are running our exchanges must take into account the public interest when making decisions about our health coverage.  We need to make sure these exchange board members do not have conflicts of interest, such as working for the same health insurance companies that want to sell us coverage.

The exchange also must work to address long-standing health disparities based on race, ethnicity, gender, primary language, sexual orientation and disability.  That is why our exchange board members and the members of any advisory boards that are created must be diverse, and represent the interests of all our communities.

Appeal to your visual learners

Reading content through emails or documents can be boring sometimes.  Seeing the same font over and over on a page is like listening to someone speak monotone about policy.  Not fun.  Spice it up with fun colors, fonts and images on a PowerPoint presentation! 

These 3 quick tips will have you on your way to making policy conversational, fun and relevant.  If you would like more information and tips, reach out at: jasmine[at]raisingwomensvoices[dot]net.

Even Doctors Have Trouble Accessing Mental Health Care for Patients

Beyond Parity: Primary Care Physicians' Perspectives On Access to Mental Health Care, an article featured in health policy journal Health Affairs, explores accessing mental health care from a different point of view.  According to Peter Cunningham, a senior fellow at the Center for Studying Health System Change, found that in 2004-2005, more than 60% of primary care physicians were unable to obtain out-patient services for their patients seeking mental health care, a rate that is twice as high as barriers to other health related services.  The report concludes that since the 1990's, a little over 30% of patients in need of mental health care actually receive it.  Among those providers that reported difficulty in accessing mental health care for patients were pediatricians.  Problems also stemmed from the fact that there are shortages of mental health providers in the community.

Nationwide Call to Action on Breastfeeding

The Department of Health and Human Services, in conjunction with the Office on Women's Health, Office of the Surgeon General and the Centers for Disease Control and Prevention,  has announced a Call To Action on Breastfeeding, in which it is asking for comments from individuals and organizations about breastfeeding promoting  policies and activities. According to the group, "Breastfeeding is unquestionably healthier for mothers and babies compared to feeding with infant formula. We are especially interested in new ideas that will increase equity in breastfeeding rates among all racial, ethnic, and socioeconomic groups. Ideas should build on programs and policies that are recognized to be effective or evidence-based. In addition, we welcome suggestions to adopt, expand, implement, research, or improve existing strategies." 12 topic areas have been created for individuals to submit comments. They include: 

1. Maternal and Infant Care Practices: Prenatal, Hospital, and Post-Delivery Care
2. Access to Lactation Care and Support
3. Health Professional Education, Publications, and Conferences
4. Use of Banked Human Milk
5. Work-site Lactation Support, On-site Child Care, and Milk Expression
6. Paid Maternity Leave
7. Portrayal of Breastfeeding in Traditional Popular Media and New Electronic Media
8. Support for Breastfeeding in Public Settings
9. Peer Support and Education of Family Members and Friends
10. Community Support for Breastfeeding in Complementary Programs (e.g., Early Head Start, Home Visitation, Parental Training)
11. Research and Surveillance
12. Other Areas

Submit your comments and recommendations before the May 31st, 2009 deadline.

Abstinence-Only Education Failing Texas

According to The National Partnership for Women and Families , Texas has the third highest teen birth rate in the nation -- 50% higher than the national average, yet 94% of Texan students receive abstinence-only sex education. Texas is also the nation's largest recipient of abstinence-only funds, totaling more than $18 million. Texas state Rep. Joaquin Castro (D), vice chair of the Texas House Committee on Higher Education, expressed his feelings on the subject in an opinion piece written for San Antonio Express News.  Castro mentioned that teen pregnancy can lead to high drop-out rates; 60 % of mothers who have a child before they turn 18 do not graduate from high school.  According to Castro, "Texas students need a complete, medically-accurate and age-appropriate sex education curriculum. And, if parents desire, they can opt-out their children from receiving any type sexual education curriculum." House Bill 741 has been introduced in the Texan Legislature, a measure that would continue to provide abstinence education, but also information related to birth control and protection from sexually transmitted infections.

Nebraska's Abortion Debate

Nebraska's Legislature Judiciary Committee voted 6-0 to pass legislation that    would require doctors to show women seeking abortions to an ultrasound of the fetus one hour prior to the performing the procedure.  The bill is now set to move to Nebraska's full legislature for a vote.  The bill passed by the Judiciary Committee states that the woman must look at the monitor to view the image, while the full legislature will consider alternate language that may allow women the choice to avert their eyes.  According to The National Partnership for Women and Families, another amendment called for by Senator Kent Rogert (D),  removed legislative language that would require doctors to inform women that the procedure places them at risk for psychological trauma.

HHS Secretary Nominnee Sebelius and Abortion

On April 2nd, 2009,  HHS Secretary Nominee Gov. Kathleen Sebelius (D) answered a number of questions at the Senate Finance Committee confirmation hearings.  Answering Senator Kyl's queries about abortion, the Kansas Governor responded, "I am personally opposed to abortion, and my faith teaches me that all life is sacred. Throughout my career as a public official I have tried to reduce unwanted pregnancies, and thus curtail the need for abortion. In Kansas, the abortion rate dropped over 10 percent during my administration. I also signed into law bills to support adoption." While Sebelius does not hide the fact that she is personally opposed to abortion, she believes in protecting the Constitutional rights of America's citizens.  Sebelius went on to answer Senator Kyl's question about her position on abortion and legislation that she vetoed while serving as Governor of Kansas.  "Most of the abortion-related bills I vetoed as Governor threatened the constitutional rights or medical privacy of women. Some sought to provide people other than a woman's doctor access to her medical records. Like most Americans, I strongly believe the privacy of medical records must be protected. In addition, I vetoed two bills that attempted to put specific regulations on abortion facilities without applying those same standards to all outpatient surgical centers. I favored treating all outpatient surgical centers equally."

States Cut Cost-Saving Health Programs

In lieu of the budget crisis that our nation faces, many states are reacting by cutting health care programs.  While these cuts may offer a benefit in the short-term, the programs being slashed are ones that provide long-term cost savings.  According to Center for Budget and Policy Priorities, 34 states have cut programs. What are some of the real-life implications to these cuts?

• States like Ohio that have had to reduce funding to child welfare are likely to see an increase of the number of children in foster care.  Ohio's cuts have translated into a loss of 75% of its child welfare investigators.
• California has eliminated Medicaid Dental Coverage for adults.
• States like Arizona now have over 1,000 individuals who are forced to go without home medical care, who now struggle to perform basic functions such as bathing and domestic chores, which means many will enter nursing homes, an option that is more costly than home care.

According to the  New York Times, the hardest hit state has been Arizona, where Gov. Jan Brewer (R) has cut $1.6 million this year, and a proposed $3 million from next year's budget.   States foregoing practices that are cost effective in the long-term and beneficial for well-being of its constituents.  Families in situations of child abuse and neglect, for example,  are now faced with 2 drastic options:  remove children and place them in foster care, or wait until a serious incident occurs within the home.