Healthcare costs in the U.S. have risen year-over-year for decades, creating tremendous strain on the healthcare system and placing an undue burden on patients. Despite medical innovations and advances, the U.S. healthcare system ranks last among 11 high-income countries when it comes to affordability, administrative efficiency, equity and outcomes. While the progress being 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 healthcare in the U.S., one that continues to illuminate the ongoing challenges faced by so many Americans today, including evolving and confusing legislation, regulations, affordability and access to care. Not only do individuals struggle to access critical products and services, especially those that rely on community and public healthcare centers, but also do providers who struggle to serve them because they don’t have reliable access to cost-effective products.
To more effectively implement meaningful solutions that help ensure that access to affordable sexual and reproductive healthcare is treated as a right and not a privilege, we must identify and examine why these challenges persist.
The inaccessibility of affordable care continues to be pervasive. Every year, more than 31 million Americans rely on community and public health centers to receive essential care, including sexual and reproductive health services. Insufficient consideration of underserved populations has also resulted in perpetually overlooked populations and a wide disparity in care. The gap will most likely widen following 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 cannot reliably access cost-effective products. For providers who serve sexual and reproductive needs, certain contraceptive options may be unavailable to patients without commercial insurance coverage, or a patient might need to change their preferred contraceptive method because the supplier raised the price or supply was unpredictable.
All of these factors result in a significant disruption for patients, particularly the many who take medications that require consistent, daily dosing, like contraception. It also places an undue burden on health centers that operate within razor-thin budgets, which already stretch across a variety of healthcare needs to support as many people as possible.
Inequality in access to sexual and reproductive healthcare puts many patients at a disadvantage. Discrimination due to gender, sexuality, race, religion, socioeconomic or financial status, and other factors is an unfortunate reality—particularly for women and minorities. Such discrimination translates into differences in how care is delivered. It is an infuriating domino effect.
Addressing the unmet needs
First, the collective “we” must work together—across public, private, government and other sectors—to ensure there is investment in community and public health centers. By investing funds, resources, and time, vast improvements can be made for these health centers, positively impacting those that work there and the patients they serve. For example, if more funds and resources are invested in community and public health centers around the country, education and access to medicines like contraception can more readily and steadily be provided to better meet the current needs of patients. In the context of sexual and reproductive care, better access to and education on contraception helps prevent unintended pregnancy and contributes to improved health outcomes.
There also continues to be opportunity to innovate the healthcare delivery model. During the Covid-19 pandemic, we saw uptake in telehealth and telemedicine technologies and services for those in need of healthcare. Trends around these healthcare delivery models will continue as it allows for more flexible care. It is critical that “we” help healthcare providers and centers build the technological infrastructure and train staff to run a robust telehealth program to ensure accessibility to the millions of patients who rely on community and public health centers.
Change is possible
Through accountability, transparency and education, impactful change is possible. All patients must be treated equal and have autonomy over personal healthcare decisions that directly impact their future. This can, in part, be achieved by treating sexual and reproductive healthcare as a right, not a privilege, and delivering consistent access to affordable, quality, FDA-approved products and services for all patients seeking sexual and reproductive healthcare.
Easy, affordable, reliable access to contraception accomplishes more than preventing unwanted pregnancies; it is directly linked to improved economic futures and positive social impacts, especially for individuals who are economically challenged. A person having control of their reproductive life gives them control of their destiny. Without the power to decide for themselves, people can be at a substantial disadvantage with little control over their future—economically and otherwise.
There are many organizations in the healthcare ecosystem across public, private, and government sectors, and most, if not all, speak to the importance of patient-centricity. But, to impart the scope of change that is needed, those words must be authentically and measurably turned into action.
The umbrella issue of affordable access is greater than any one entity, and we all have a responsibility to do the right thing by patients and providers. To put us on the most effective and efficient path to truly solving the issues of access and affordability of sexual and reproductive healthcare, and be part of the solution, we must work together. Together, we can make good on delivering reliable access to quality, affordable healthcare products and services for all—including affordable contraceptive care—regardless of race, sexuality, income, or zip code.