Saturday, May 12, 2012

Getting Care When You Can't Afford Coverage: Part 2 Fig.1




Issues around reproductive health are really heating up in some parts of the world this year, particularly in the U.S. as it's in the throes of a madness known as "an election year". As access to birth control is turned into a political football, thousands of men and women find themselves with decreasing or no access to important reproductive health services. Reproductive health often gets reduced to contraceptive issues, and while contraception is an important component, reproductive health issues encompass so much more including: ovarian cancer screening, STD testing, prevention, treatment and management, prostrate cancer screening, prenatal care, fertility counseling and advisement, and breast cancer screening.

Unfortunately, the usefulness of the following guide on obtaining reproductive health services if you don't have health insurance will vary widely depending on where you live in the U.S. Many states this year are dramatically cutting funding for health clinics, often in the interests of pandering to political interest groups, instead of acting in the interests of supporting affordable, accessible healthcare for their constituents.

Finding a Clinic


The first step is to locate the nearest clinic that can provide the services you need. Which services you'll need will vary depending on your gender, age, and whether or not you're already sexually active. The National Association of Free and Charitable Clinics directory is one place to start looking for clinics in the US. It can be difficult to find a clinic that can provide the services you're looking for, as the clinics listed in the directory aren't limited to providing reproductive health services.

A fairly obvious but perhaps more apt starting point for a clinic search, is to locate your nearest Planned Parenthood. In addition to providing the contraceptive and pregnancy services for which they are well known, Planned Parenthood provides a wide array of reproductive health services including: mammograms, pelvic exams, colon cancer screenings, intestinal parasite testing and treatment (or treatment referral), vasectomies, menopause treatments, and fertility testing and referral. Many Planned Parenthood clinics also offer general health services such as: flu vaccines, thyroid testing, smoking cessation, physicals and cholesterol screenings. Most of the services are provided on a sliding scale, with fees adjusted according to your income, or your parents' income if you're under 18.

Unfortunately, many parts of the country only have one or two Planed Parenthood clinics serving an entire state. While staff are dedicated to and passionate about providing affordable reproductive care to clients, areas with few clinics may face exceptionally high demand and potentially longer wait times for appointments. Fortunately, many of the services provided, are done so on a walk in basis, with no appointment necessary in many Planed Parenthood clinics for emergency contraception, pregnancy testing, counseling and referrals. Other clinics may provide STD testing, vaccinations and treatment, and birth control prescriptions or refills on a walk-in basis. Be sure to check the "view hours and service details" link when you use the "find a health center" widget on the right side of the main page.

If visiting a Planned Parenthood is not an option for you, due to extreme distance or long wait times for an appointment, try heading to your state's department of public health and social services. This may take a bit of leg work as each state seems to call this department something different, but if you search for your state's name and "division of public health" or "department of health and social services", the relevant page should come up in the top results. Once you've found the the correct webpage, look for reproductive clinic listings under headings like "family planning services", "division for children, youth, and families", "services for adults", or "clinics". Many of the services offered at these kinds of clinics are free, or offered on a sliding scale basis.

If your main concern is STD testing, vaccinations, and treatment or treatment referral, the following directories will locate your nearest HIV testing or STD testing facility. Some of the clinics listed in these two directories provide testing services for free and they are often marked in the results as doing so. Other facilities provide testing, vaccination and treatment services on a sliding scale.

HIVtest.org: provides listings for the nearest health facilities that provide HIV testing, marking in the results what type of test the clinic provides (Conventional HIV blood testing, rapid HIV blood testing, or both), and what other STD testing and vaccination services they may offer.
National HIV and STD Testing Resourcesis a subdivision the HIVtest.org website, and allows you to target your search to find clinics that provide testing services for a variety of STDs. By ticking the boxes under the search bar, you can also search specifically for clinics that provide vaccinations for HPV and Hepatitis B.


Crisis Centers ≠ Medical Clinic


Be wary of any organization calling itself a "pregnancy center", "pregnancy care center", "pregnancy resource center", "pregnancy concern center" or "pregnancy crisis center". These centers pose as reproductive health facilities, but the majority of them are not licensed to provide any actual medical services. The few that are licensed generally limit their services to pregnancy testing and sonograms, with a limited number also providing STD screenings and some prenatal care. Seeking services from these centers is not recommended as they have a history of disseminating false medical information and fabricated statistics. However, they sometimes provide sonograms at no cost, so if you want to get a free ultrasonic look at your fetus, consider seeking out a CPC. Odds are you've already paid for it with your tax dollars, and as there are over 4,000 CPCs compared with only about 750 fully comprehensive reproductive health clinics in the U.S., there should be a center near you, even if the nearest comprehensive clinic is over 100 miles away. Though they often use unscrupulous tactics in their counseling programs, CPCs can be a useful resource for lower income families that are ready to start expanding their family, and want to have a baby. However, if you're seeking contraception advice, cancer screenings, or accurate information regarding abortion, it is best to seek services elsewhere.

We'll be covering contraception, what's available, how to get it, and ways you might find it more affordably in our next article. If you have any advice on how to find affordable reproductive health care, or any questions about getting contraception when you're on a budget, we'd love to hear from you! Email us: cheerfullycheap@gmail.com or join us on Twitter: @cheerfulcheep. 

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