Commentary Health Systems

Governor Perry, WHP Has Been a Lifeline for My Family. Why Are You Eliminating It?

Rene Resendez

My name is Rene, and I am graduate student. I am also on the Women's Health Program (WHP). Many of the women on the WHP are college students like myself, trying to better their lives with a higher education. We shouldn't have to choose between paying for a cancer screening and paying our bills while we're trying to further our education.

For all our coverage of the cuts to the Texas Women’s Health Program, click here.

In Texas, a state where more than one-quarter of women are uninsured, the Women’s Health Program provides preventive health care, including birth control and lifesaving cancer screenings, to more than 130,000 low-income women each year. The federal government, which covers 90 percent of the cost of this program, has made clear to Texas — and to all 50 states — that a rule excluding a comprehensive women’s health care provider like Planned Parenthood restricts the rights of patients and will not be allowed in the Medicaid program. However, Governor Rick Perry and Texas lawmakers are moving forward to disallow Planned Parenthood from participating in the WHP, today.

On March 8, in the midst of a budget deficit, Gov. Perry said the state would reject the nine- to-one federal matching dollars and instead find money in the state budget to pay for the WHP, although it is not clear where the money will be found. Already in the past few months, budget cuts passed by the state legislature and signed by Gov. Perry cut the state’s family planning program by more than two-thirds, taking away health care from another 160,000 women a year.

Planned Parenthood is the single largest provider of care within the Texas Medicaid Women’s Health Program. More than 40 percent of the women who received vital health care through the Texas Women’s Health Program rely on a Planned Parenthood health center for their preventive health care.

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My name is Rene, and I am graduate student. I am also on the WHP. I’ve been a WHP patient for five years. My mom was diagnosed with cervical cancer when she was my age, while pregnant with my sister — this means I am at a 2-3 times increased risk for cervical cancer than other women. Because of my family history, I need to get a check-up every year.

My sister is a college student and also on the WHP. She needs contraception to keep her ovarian cysts under control. Because of the WHP and Planned Parenthood, we can focus on our studies instead of worrying about paying for contraception and cancer screenings.

Basic health insurance costs are out of reach for most college students since we work full- or part-time and keep up a full class load. Many of the women on the WHP are college students like myself, trying to better their lives with a higher education. We shouldn’t have to choose between paying for a cancer screening and paying our bills while we’re trying to further our education.

I know people stereotype people that use programs like the WHP, saying things like “They need to get a job and not rely on the government,” but college students are some of the hardest working people I know. My generation was told by our parents and teachers that we need to go college to follow our dreams and to ensure we would be financially stable in adulthood. Here we are trying to do just that and people criticize us, somehow believing that it’s possible to make enough money in college to pay all of our bills, focus on school, and still afford health insurance or medical care. That’s just not realistic for college students who work entry-level jobs just at or above minimum wage.

It’s important for lawmakers to realize that just having a job doesn’t mean you can afford health insurance. Basic health insurance for most students I know is over $150 a month plus co-pays for visits and medications. I don’t know many students who can afford that, pay their bills, and still get good grades.

When I heard about the possible demise of the Women’s Health Program I was shocked to see the attacks on women’s health hit so close to home. I searched online to try and see if there was a movement to help save this program. My search came up empty, so I decided start a petition myself, and spread it the best and fastest way I knew how, through email and social media. We have now gathered nearly 1,000 signatures from women and men that think Texan women deserve affordable access to basic women’s healthcare.

Many times injustice happens because people think “What can one person do?” But I believe one person can make a difference. Sandra Fluke stood up for women and brought the issue to light that women have a right to representation in Congress in regards to their health care. She was an inspiration for me. I knew I had to try and make a difference, be it with 50 signatures or 5,000. Each one is a voice to try and save the WHP, a voice saying “I think Texan women deserve access to basic women’s health care.”

Women in Texas need to have a choice when it comes to their medical providers. If Planned Parenthood is cut from the plan, many women will be losing care from a place we’ve come to know and trust. (And the fact is that many parts of Texas lack comprehensive clinics, and where they do exist, they’re already overwhelmed. For many women, Planned Parenthood is their only place to access affordable quality care.)

Planned Parenthood discovered my mother’s abnormal Pap, arranged for further testing, and arranged for the removal of her cancerous cells. She went to them when she was pregnant to find out how far along she was and where to go for further prenatal care. Planned Parenthood was there for my mother, and now it’s there for my sister and me. I know I can rely on Planned Parenthood when it comes to staying on top of my increased risk for cervical cancer.

A few years ago, in the name of fighting cervical cancer, Gov. Perry signed an executive order mandating HPV vaccinations for Texan girls. In a September 2011 presidential debate, Perry stated that “Cervical cancer is a horrible way to die” – yet he is moving to end cervical cancer screenings covered by WHP for over 130,000 Texan women. We are asking him why. The women of Texas are waiting for your response, Rick. And no, we aren’t talking about abortion – don’t change the subject – we are talking about cancer. We are talking about women’s lives.

And this is about women’s lives. Here are just a few of the comments left on my petition:

“I use[d] to go and get my annual check-ups at Planned Parenthood. I live in El Paso, TX and all of our clinics have been shut down due to the lack of funds. I am self-employed without any medical insurance. It has been so difficult for me to get reasonable medical care. This issue represents a problem not only for indigent women but for the female population in general. Something needs to be done.”

“I’m a low income woman, I already have one son, I love him very much. I remember how hard it was to raise him without a job, and even though I have one now, it’s just not enough. I need the PP services [such as pap smears] [provided by WHP]…I [also] want to live to a decent old age and I use BC to make sure I do not bring another child into this world until I AM READY.”

“When I lost my job I used the women’s health program. If it were not for this program I would not have been able to afford the follow up exams that I needed after I had an abnormal Pap smear.”

And this last one is short but maybe the sweetest: “Dude, Where are my rights?”

Some of us may have thought that women were done fighting for their rights, but it’s time to stand up again. I’ll leave you with a quote by women’s suffragist Alice Paul in which I’ve found strength. I would like to remind my fellow Texans that you have a right to a voice when it comes to women’s lives and women’s health: “There will never be a new world order until women are a part of it.”

Culture & Conversation Human Rights

Let’s Stop Conflating Self-Care and Actual Care

Katie Klabusich

It's time for a shift in the use of “self-care” that creates space for actual care apart from the extra kindnesses and important, small indulgences that may be part of our self-care rituals, depending on our ability to access such activities.

As a chronically ill, chronically poor person, I have feelings about when, why, and how the phrase “self-care” is invoked. When International Self-Care Day came to my attention, I realized that while I laud the effort to prevent some of the 16 million people the World Health Organization reports die prematurely every year from noncommunicable diseases, the American notion of self-care—ironically—needs some work.

I propose a shift in the use of “self-care” that creates space for actual care apart from the extra kindnesses and important, small indulgences that may be part of our self-care rituals, depending on our ability to access such activities. How we think about what constitutes vital versus optional care affects whether/when we do those things we should for our health and well-being. Some of what we have come to designate as self-care—getting sufficient sleep, treating chronic illness, allowing ourselves needed sick days—shouldn’t be seen as optional; our culture should prioritize these things rather than praising us when we scrape by without them.

International Self-Care Day began in China, and it has spread over the past few years to include other countries and an effort seeking official recognition at the United Nations of July 24 (get it? 7/24: 24 hours a day, 7 days a week) as an important advocacy day. The online academic journal SelfCare calls its namesake “a very broad concept” that by definition varies from person to person.

“Self-care means different things to different people: to the person with a headache it might mean a buying a tablet, but to the person with a chronic illness it can mean every element of self-management that takes place outside the doctor’s office,” according to SelfCare. “[I]n the broadest sense of the term, self-care is a philosophy that transcends national boundaries and the healthcare systems which they contain.”

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In short, self-care was never intended to be the health version of duct tape—a way to patch ourselves up when we’re in pieces from the outrageous demands of our work-centric society. It’s supposed to be part of our preventive care plan alongside working out, eating right, getting enough sleep, and/or other activities that are important for our personalized needs.

The notion of self-care has gotten a recent visibility boost as those of us who work in human rights and/or are activists encourage each other publicly to recharge. Most of the people I know who remind themselves and those in our movements to take time off do so to combat the productivity anxiety embedded in our work. We’re underpaid and overworked, but still feel guilty taking a break or, worse, spending money on ourselves when it could go to something movement- or bill-related.

The guilt is intensified by our capitalist system having infected the self-care philosophy, much as it seems to have infected everything else. Our bootstrap, do-it-yourself culture demands we work to the point of exhaustion—some of us because it’s the only way to almost make ends meet and others because putting work/career first is expected and applauded. Our previous president called it “uniquely American” that someone at his Omaha, Nebraska, event promoting “reform” of (aka cuts to) Social Security worked three jobs.

“Uniquely American, isn’t it?” he said. “I mean, that is fantastic that you’re doing that. (Applause.) Get any sleep? (Laughter.)”

The audience was applauding working hours that are disastrous for health and well-being, laughing at sleep as though our bodies don’t require it to function properly. Bush actually nailed it: Throughout our country, we hold Who Worked the Most Hours This Week competitions and attempt to one-up the people at the coffee shop, bar, gym, or book club with what we accomplished. We have reached a point where we consider getting more than five or six hours of sleep a night to be “self-care” even though it should simply be part of regular care.

Most of us know intuitively that, in general, we don’t take good enough care of ourselves on a day-to-day basis. This isn’t something that just happened; it’s a function of our work culture. Don’t let the statistic that we work on average 34.4 hours per week fool you—that includes people working part time by choice or necessity, which distorts the reality for those of us who work full time. (Full time is defined by the Internal Revenue Service as 30 or more hours per week.) Gallup’s annual Work and Education Survey conducted in 2014 found that 39 percent of us work 50 or more hours per week. Only 8 percent of us on average work less than 40 hours per week. Millennials are projected to enjoy a lifetime of multiple jobs or a full-time job with one or more side hustles via the “gig economy.”

Despite worker productivity skyrocketing during the past 40 years, we don’t work fewer hours or make more money once cost of living is factored in. As Gillian White outlined at the Atlantic last year, despite politicians and “job creators” blaming financial crises for wage stagnation, it’s more about priorities:

Though productivity (defined as the output of goods and services per hours worked) grew by about 74 percent between 1973 and 2013, compensation for workers grew at a much slower rate of only 9 percent during the same time period, according to data from the Economic Policy Institute.

It’s no wonder we don’t sleep. The Centers for Disease Control and Prevention (CDC) has been sounding the alarm for some time. The American Academy of Sleep Medicine and the Sleep Research Society recommend people between 18 and 60 years old get seven or more hours sleep each night “to promote optimal health and well-being.” The CDC website has an entire section under the heading “Insufficient Sleep Is a Public Health Problem,” outlining statistics and negative outcomes from our inability to find time to tend to this most basic need.

We also don’t get to the doctor when we should for preventive care. Roughly half of us, according to the CDC, never visit a primary care or family physician for an annual check-up. We go in when we are sick, but not to have screenings and discuss a basic wellness plan. And rarely do those of us who do go tell our doctors about all of our symptoms.

I recently had my first really wonderful check-up with a new primary care physician who made a point of asking about all the “little things” leading her to encourage me to consider further diagnosis for fibromyalgia. I started crying in her office, relieved that someone had finally listened and at the idea that my headaches, difficulty sleeping, recovering from illness, exhaustion, and pain might have an actual source.

Considering our deeply-ingrained priority problems, it’s no wonder that when I post on social media that I’ve taken a sick day—a concept I’ve struggled with after 20 years of working multiple jobs, often more than 80 hours a week trying to make ends meet—people applaud me for “doing self-care.” Calling my sick day “self-care” tells me that the commenter sees my post-traumatic stress disorder or depression as something I could work through if I so chose, amplifying the stigma I’m pushing back on by owning that a mental illness is an appropriate reason to take off work. And it’s not the commenter’s fault; the notion that working constantly is a virtue is so pervasive, it affects all of us.

Things in addition to sick days and sleep that I’ve had to learn are not engaging in self-care: going to the doctor, eating, taking my meds, going to therapy, turning off my computer after a 12-hour day, drinking enough water, writing, and traveling for work. Because it’s so important, I’m going to say it separately: Preventive health care—Pap smears, check-ups, cancer screenings, follow-ups—is not self-care. We do extras and nice things for ourselves to prevent burnout, not as bandaids to put ourselves back together when we break down. You can’t bandaid over skipping doctors appointments, not sleeping, and working your body until it’s a breath away from collapsing. If you’re already at that point, you need straight-up care.

Plenty of activities are self-care! My absolutely not comprehensive personal list includes: brunch with friends, adult coloring (especially the swear word books and glitter pens), soy wax with essential oils, painting my toenails, reading a book that’s not for review, a glass of wine with dinner, ice cream, spending time outside, last-minute dinner with my boyfriend, the puzzle app on my iPad, Netflix, participating in Caturday, and alone time.

My someday self-care wish list includes things like vacation, concerts, the theater, regular massages, visiting my nieces, decent wine, the occasional dinner out, and so very, very many books. A lot of what constitutes self-care is rather expensive (think weekly pedicures, spa days, and hobbies with gear and/or outfit requirements)—which leads to the privilege of getting to call any part of one’s routine self-care in the first place.

It would serve us well to consciously add an intersectional view to our enthusiasm for self-care when encouraging others to engage in activities that may be out of reach financially, may disregard disability, or may not be right for them for a variety of other reasons, including compounded oppression and violence, which affects women of color differently.

Over the past year I’ve noticed a spike in articles on how much of the emotional labor burden women carry—at the Toast, the Atlantic, Slate, the Guardian, and the Huffington Post. This category of labor disproportionately affects women of color. As Minaa B described at the Huffington Post last month:

I hear the term self-care a lot and often it is defined as practicing yoga, journaling, speaking positive affirmations and meditation. I agree that those are successful and inspiring forms of self-care, but what we often don’t hear people talking about is self-care at the intersection of race and trauma, social justice and most importantly, the unawareness of repressed emotional issues that make us victims of our past.

The often-quoted Audre Lorde wrote in A Burst of Light: “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”

While her words ring true for me, they are certainly more weighted and applicable for those who don’t share my white and cisgender privilege. As covered at Ravishly, the Feminist Wire, Blavity, the Root, and the Crunk Feminist Collective recently, self-care for Black women will always have different expressions and roots than for white women.

But as we continue to talk about self-care, we need to be clear about the difference between self-care and actual care and work to bring the necessities of life within reach for everyone. Actual care should not have to be optional. It should be a priority in our culture so that it can be a priority in all our lives.

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (D-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

CORRECTION: A previous version of this article included a typo that misidentified Sen. Tim Kaine as a Republican. We regret this error.