Health care costs in the US have risen year after year for decades, placing enormous strain on the health care system and placing an undue burden on patients. Despite medical innovations and advances, the US health care system ranks last among 11 high-income countries when it comes to affordability, administrative efficiency, equity and outcomes. While the progress made should be celebrated, it also highlights the systemic changes needed across the healthcare landscape to continue the movement toward meaningful change.
For more than 50 years, there has been a spotlight on sexual and reproductive health in the U.S. that continues to illuminate the ongoing challenges facing so many Americans today, including evolving and confusing legislation, regulations, affordability, and access to care. Not only do people struggle to access critical products and services, especially those who rely on public and community health centers, but so do providers who struggle to serve them because they lack reliable access to cost-effective products.
To more effectively implement meaningful solutions that help ensure that access to affordable sexual and reproductive health care is treated as a right, not a privilege, we need to identify and examine why these challenges persist.
Inaccessibility to affordable care remains widespread. Every year more than 31 million Americans rely on community and community health centers to receive basic care, including sexual and reproductive health services. Underreporting of underserved populations has also resulted in a persistently neglected population and a large disparity in care. The gap is likely to widen after the recent SCOTUS decision to overturn Roe v. Wade.
Many community and public health providers depend on politically vulnerable government funding, grants or donations and struggle to serve patients because they lack reliable access to cost-effective products. For providers serving sexual and reproductive needs, certain contraceptive options may not be available to patients without commercial insurance coverage, or the patient may need to change their preferred contraceptive method because the provider has increased the price or supply has been unpredictable.
All of these factors lead to significant disruption for patients, especially the many who take medications that require consistent, daily dosing, such as contraception. It also puts an undue burden on health centers that operate within extremely thin budgets that already cover a variety of health care needs to support as many people as possible.
Inequality in access to sexual and reproductive health care places many patients at a disadvantage. Discrimination based on gender, sexuality, race, religion, socioeconomic or financial status, and other factors is an unpleasant reality—especially for women and minorities. Such discrimination translates into differences in how care is delivered. It’s a maddening domino effect.
Addressing unmet needs
First, a collective “we” must work together – across the public, private, government and other sectors – to ensure that there is investment in community and community health centres. By investing funds, resources and time, huge improvements can be made to these health centers that will positively impact those who work there and the patients they serve. For example, if more funds and resources are invested in community and community health centers across the country, education and access to drugs such as contraception can be provided more easily and stably to better meet the current needs of patients. In the context of sexual and reproductive care, better access to and education about contraception helps prevent unwanted pregnancy and contributes to improved health outcomes.
There also continues to be scope for innovation in the health care delivery model. During the Covid-19 pandemic, we have seen an influx of telehealth and telemedicine technologies and services for those in need of healthcare. Trends around these healthcare delivery models will continue as they allow for more flexible care. It is critical that “we” help health care providers and centers build the technology infrastructure and train staff to manage a robust telehealth program to provide access to the millions of patients who rely on community and community health centers.
Change is possible
Through accountability, transparency and education, impactful change is possible. All patients should be treated equally and have autonomy over personal health decisions that directly affect their future. This can be achieved, in part, by treating sexual and reproductive health care as a right, not a privilege, and ensuring continued access to affordable, quality, FDA-approved products and services for all patients seeking sexual and reproductive health care .
Easy, affordable and reliable access to contraception does more than prevent unwanted pregnancy; it is directly related to an improved economic future and positive social impacts, especially for individuals who are economically disadvantaged. A person in control of their reproductive life gives them control over their destiny. Without the power to decide for themselves, people can be at a significant disadvantage with little control over their futures – economic and otherwise.
There are many organizations in the healthcare ecosystem in the public, private and government sectors and most, if not all, talk about the importance of being patient-centric. But to deliver the scale of change needed, those words must be authentically and measurably translated into action.
The overall issue of affordable access is bigger than any one entity, and we all have a responsibility to do right by patients and providers. To get us on the most effective and efficient path to truly solving the problems of sexual and reproductive health access and affordability, and to be part of the solution, we need to work together. Together, we can tackle ensuring reliable access to quality, affordable health care products and services for all—including affordable contraceptive care—regardless of race, sexuality, income, or zip code.