Ano is a Justmeans staff writer for health, and an instructional designer for the newly created Master of Health Care Delivery program (mhcds.dartmouth.edu) at Dartmouth College. Ano brings over a decade of evidenced-based health research and writing, and a Masters of Public Health from Dartmouth Medical School to the Justmeans Editorial section. Special interests include health policy, conflict ...
H. 1 Cuts to Title X Would Increase Abortions, and Death from Cancer & HIV
Among the funding placed on the chopping block by the House of Representatives' recent passing of the H. 1 bill is Title X, which funds Planned Parenthood as well as an array of other family planning, breast and cervical cancer screening, HIV screening and HPV vaccine efforts. The Guttmacher Institute estimates that this Republican assault on access to women's health may lead to 973,000 unplanned pregnancies and 400,000 more abortions as a result of the reductions in effective, community-based family planning services. Ironic for a party that has generally positioned itself as "anti-abortion." Cutting off access to cervical and breast cancer screening for poor women, as well as the HPV "cancer" vaccine and HIV prevention services will no doubt increase rates of those diseases, not to mention the costs of dealing with more advanced cases not prevented or detected earlier. Because of it's preventive, public health nature of programs it supports, each $1 of federal funding spent on Title X saves tax payers an estimated $3.74.
This seemingly singleminded targeting of women's rights and health may also be bad for business: One critique of the HPV vaccine by skeptics has been that it is the rare vaccine that actually provides a windfall for the pharmaceutical industry. This decision stands to potentially harm pharma's financial bottom line, despite their typical alignment as allies of the Republican party.
Not to be outpaced in the race towards policy-mediocrity, the Obama administration has proposed its fare share of net harm-inducing health policies:
Homelessness for Patients on Medical Marijuana
Housing and Urban Development recently notified state housing authorities that patients receiving medical marijuana will now have their housing subsidies revoked. HUD could have opted for a "don't ask don't tell" policy, but has instead decided to resolve this clash of state versus federal policy at the expense of the sick, disabled and poor. Medical marijuana is of course legal in several states, though it remains illegal under federal law. HUD's new policy means folks following state health law now face homelessness if they depend on any form of federal housing subsidy. When you consider that most medical marijuana usage is for compassionate care, this policy appears to redefine compassion as "go sleep under a bridge."
Cold Kids as Public Health
Then there is Obama's proposal to cut by 50% the already chronically underfunded Low Income Heating Assistance Program, LIHEAP. This program helps families, mostly the working poor, pay for heating during the winter. While the relative pennies saved will contribute absolutely nothing to budget deficit reduction there are two guaranteed results: Cold and sick kids, and deaths from the use of unapproved heating devices (primarily carbon monoxide poisoning, though fire is also a possibility).
Irrationality and Ideology
What do these policies have in common? All are irrational, potentially unethical, and ideologically based. They do not account for the real complexities of society, policy, or long term consequences which run counter to stated goals. Elected officials have also not encumbered their decision making with actual data, or cost effectiveness analyses. For all their cheering for government to run more like business, any good business person knows that this type of decision making is a short road to bankruptcy court. In the case of these regressive health policies, the road for some individuals will end prematurely in the morgue.
While the Senate is unlikely to pass these measures unchanged, and the White House would likely veto, the mood for irrational compromise, and willingness to sacrifice the health and wellbeing of everyday Americans, including children, the poor and sick make these uncertain times for the nation's public health.
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