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Gig and part-time workers have been left out of the healthcare conversation in the United States for far too long

It is no secret that the healthcare system within the United States is flawed. In large contrast to other countries, there is no universal healthcare. As such, the U.S. government does not provide healthcare for most of its citizens. Instead, healthcare is provided by multiple distinct organizations. These include insurance companies, healthcare providers, hospital systems, and independent providers. Such healthcare facilities are widely owned and operated by private businesses. 

Millions of people are left vulnerable to falling through the cracks as public and private insurers set their own rates, benefit packages, and cost-sharing structures within the bounds of federal and state regulations. 

Employer-sponsored health insurance was first introduced in the United States in the 1920’s. This method indicates that employers might contract with private health plans and administer benefits for their full-time employees as well as their dependents. By 1965 public insurance programs such as Medicare and Medicaid were introduced as a means to compensate for some, but certainly not all, of the already existing flaws. 

Medicare ensures a right to hospital and medical care for all persons aged 65 and older, and later those under 65 with extreme long term disabilities or end-stage renal disease. On the other hand Medicaid, which covers around 17.9% of the American population, is state-administered and is meant to provide health care services to low-income families, the blind, low-income pregnant women and infants, and individuals with disabilities. Eligibility for Medicaid is largely dependent on criteria which vary by state. Individuals need to apply for medicaid coverage and to re-enroll annually. 

As of 2021, the U.S. ranks 22nd globally in terms of quality healthcare with countries like Finland, Japan, and Canada placing above it. In 2018, nearly 92% of the country was estimated to have health coverage, either through their employer or based upon other factors. That statistic leaves roughly 27.5 million people, or 8.5% of the population, uninsured. 

Those flaws intensify dramatically when it comes to the gig or part-time workforce. For one, it is no coincidence that struggles in regards to access to affordable healthcare also run along the lines of race, gender, and income in this country, just as it does with the countless other social issues which persist here. 

For one, those who work within a gig or part-time capacity are often not offered an employer-sponsored health insurance plan. Not to mention that they are also not salaried, so their income is often limited or unreliable, leaving these workers with little opportunity or access to the healthcare system that is in place. Such workers are either required to purchase their own health insurance or apply for Medicaid. Now, while Medicaid eligibility varies between each state, many people who are classified as low-income wind up making too much money to actually be an eligible candidate for the narrow assistance program. At the same time, however, many of the private health insurance plans are extremely expensive, leaving workers stretched thin financially or in danger medically.

This dynamic effectively allows for inequality to flourish. This is no surprise considering that the gig and part-time economy is mostly made up of minority groups, thus being complicit in the racially skewed power structures which exploit people based on their race, religion, gender, sexuality or socioecomic status. That includes single mothers, previously incarcerated people, immigrants and Indigenous, Latinx or Black adults to name a few. In fact, nearly a third or 31% of Latinx adults aged 18 or over earn money through the gig economy. This is compared to 27% of Black Americans and 21% of white adults.  

Workers rights groups in the gig and part-time sphere have been advocating in the name of things like workers compensation for various minutia including maintenance of drivers vehicles, the right to organize, access to 401K, paid family leave and proper employment classification, among other things. This is especially important when you consider that, contrary to popular belief, most people are not using their gig or part-time job as a “side hustle” to compliment their salaried and health-insurance sponsoring full-time position. Instead, this is likely their primary source of income, along with perhaps a second or even third job doing something similar. They are doing as much as they can to make ends meet and survive within a world and system which layers on barriers to their success and sustainability. One that fails to acknowledge their exhaustion and that remains complicit in their vulnerability. 

At the root of what workers are demanding is dignity on the job. 

Workers are fighting to dismantle the system of exploitation that has further isolated and damaged vulnerable communities across the country. To put this better into perspective: there is an unprecedented number of care deserts in the United States. Medical care deserts are best defined as a region which is more than 60 minutes away from the closest hospital. Nearly 1 in 5 residential areas in America, or around 640 entire counties, fall under this definition. 

Also affecting access to healthcare and employment status substantially are child care deserts. Child care deserts are areas in which there are little to no licensed child care providers. An estimated 51% of all residents in the United States live in a child care desert. Plus, child care is especially limited among particular populations such as for low-income families, rural families, and Latinx or Hispanic families. 

Each and every person is deserving of the right to proper healthcare, especially that which is free of the leaps and bounds of a system that oppresses and makes it extraordinarily difficult to access or afford. 

That said, the COVID-19 pandemic without a doubt boosted the telemedicine industry dramatically, putting more accessible and affordable healthcare on the map. A rainbow behind storm clouds, telemedicine has the potential to help people in many ways beyond what we saw over the past year. 

For one, people don’t have to worry as much about transportation, making virtual appointments not only cheaper but also less time consuming. Similarly, because such appointments can take place right from your home, the patient is offered a lot more flexibility to accommodate their work schedules and things like child care. Not to mention stressors in regards to scheduling, the possibility of domestic violence or even religion that can make traditional medical care difficult.  Therefore, due to its asynchronous nature, this intrusive care modality can be much less anxiety-inducing for patients. 

One telemedicine option, Alpha, has been offering such services for much longer than those which were forced into it by the pandemic. Alpha is a growing platform that allows for patients to receive primary care or talk therapy from home. It specializes in holistic treatments for women ranging from regular checkups to ongoing mental health appointments, nutrition and reproductive care – including postpartum depression – acknowledging that women often carry the burden of handling healthcare for their entire families (spouses, children, elderly parents, siblings, etc.) while also working. In this way, Alpha’s services are entirely patient led and personalized. 

Women’s health in particular is ignored, invalidated, and not taken seriously within the medical industry of the United States. Through the asynchronous telemedicine that Alpha offers, patients have a direct line of written conversation with their physician to ask questions or address concerns, unlike an in-person setting where phone calls are screened or a patient might see a different doctor each time they visit. This way, visits are much more private, personal, and accessible. 

Additionally, by allowing patients to pay with cash or in an a-la-carte fashion, the company stands by its mission to meet patients where they are. According to its website, Alpha has a few external/local partnerships in 43 states in the case that a patient needs a procedure done or to go to a lab to receive a test which cannot be completed from an at-home kit – remaining dedicated to combatting the issue of care deserts across the country. 

Alpha’s Chief Medical Officer, Dr. Jacobsen, highlighted a mission of the platform. “We educate patients on their medical condition. We are always involved with the patient because involving the patient in their care, making an informed and fair treatment plan and decisions about prescription medications is going to increase adherence to the plan by the patient.” 

 “And obviously,” Jacobsen continued, “support the relationship between the patient and the provider. We know that a good relationship with the provider actually shows better patient outcomes.” 

Alpha encourages all employers to consider health plans which include telemedicine, citing its inherent ability to provide a less stigmatized experience for patients. More specifically, much of the patient demographic using Alpha are people either without insurance or moving in and out of insurance.

“It is a great fit for gig workers and very convenient, given the fact that you don’t have to take time out of business hours.” Gloria Lao, co-founder and CEO, added, “you can solve your medical issues at midnight on your couch and still get cared for.” 

It is surely going to be difficult to return to fully in-person treatments after the pandemic considering the cutting-edge programs which have emerged and its potential to drive affordability. Perhaps, with a more urgent shift toward progressive politics in the United States and as the unions formed by workers across the country begin to catch fire, we can expect to see more attention focused on finally making healthcare accessible, affordable, and non-discriminatory.


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Tech Now + Beyond

Artificial Intelligence is changing the way we help domestic violence victims

Domestic violence is a serious problem in the United States. On average, three or more women in the country are murdered every day by their boyfriends or husbands. About 74 percent of all murder-suicides involved an intimate partner of which 96 percent of the victims were women.

Stephanie Whack, an outreach program counselor at the Haven Hills domestic violence shelter in the San Fernando Valley, routinely helps victims of domestic violence obtain restraining orders through an AI-assisted platform called HelpSelf Legal. The program asks victims emotionally sensitive questions to fill out the necessary court documents against their abusers.

This platform was founded by Dorna Moini, who developed it after quitting her job as a corporate trial attorney, in an effort to help low-income victims of domestic violence. Almost a year after its launch, Moini says the service seems to be the most effective when it is used through a legal aid organization or a domestic violence shelter.

“While individuals can find and use the platform on their own, we have found it is better to have victims use it through an organization because those organizations can help with anything that comes after filing the paperwork like helping the victim find a counselor,” relayed Moini in a personal interview.

The service aims to help lawyers, not replace them.

The HelpSelf site “interviews” users by having them answer a number of easy to understand, friendly questions that are designed to be sensitive to trauma-victims. Explanations are also provided throughout the process so that the victim can truly understand what is being asked. The questions are asked in a bite-size manner so the process doesn’t emotionally overwhelm. If it does become too overwhelming, the user can leave the system and come back to finish the interview at any time. Users can also upload evidence and screenshots throughout the process.

Once the interview is complete, the documents are ready to be e-filed, mailed or filed in person depending on the court’s requirements.

The time a victim spends on the platform depends on their state of mind but ultimately reduces the overall process time. “The process can take up to five hours if a victim is extremely distressed. We provide emotional support while they are answering questions. If a victim is triggered during the process, we take a break and help them calm down,” said Whack.

The platform drastically reduces the time a lawyer has to spend looking at the final paperwork because there is no longer a need to talk through the documentation each time. Once the paperwork is complete, it is printed out at the shelter and reviewed by a lawyer. If there are any mistakes, they are corrected before the documents are filed.

The platform works best for relatively easy and straightforward cases, according to Whack. If cases are extremely complicated involving child protective services, for example, counselors at Haven Hills will refer them to agencies that provide on-site attorneys for legal advice.

Of course, the HelpSelf platform is not a victim’s only option to get a restraining order. There are traditional ways to file restraining orders for low-income victims such as self-help lessons at the courthouse or workshops at the police station but these avenues typically have long wait times. The other challenge is that these programs are only available at set times, which may not always work for victims.

“The self-help lessons at the nearby courthouse are usually only offered in the mornings and are on a first come first serve basis, which can be difficult for clients who have children,” Whack explained.

There are also safety concerns. The courthouse is open to everyone and sometimes the abuser is trying to file a restraining order at the same time as the victim.

HelpSelf isn’t the only AI tool helping victims of domestic violence. Deevi is an Australian emotionally intelligent Chatbot that asks victims with a list of questions and provides them with a list of services at the end.

In California, Jael.AI helps victims by helping them find a safe place to stay, the service contacts nearby shelters and gives them other resources as well. Deevi and Jael.AI, however, connect victims to legal professionals as opposed to guide the victim through the legal process itself.

AI-based resources in the realm of domestic violence are relatively new and their large-scale effectiveness remains to be seen. One thing is clear, however, it is an area of law that will always require a component of empathy, which is why the most effective tech solutions will likely involve a human element.

Love Advice Wellness

This year I signed up for healthcare for the first time. Here’s what I learned

This year I got a friendly reminder from my university that I no longer had health care. Because of that, they’d be adding an additional fee of almost a thousand dollars on my tuition that would serve as my health care for the year. It quickly had me panicked because I had no idea how I was going to pay for this year’s tuition let alone an added fee of Medicare. A thousand dollars may not seem like much to others but to me, it was a death sentence.

[bctt tweet=”It’s so expensive just to live and health care should be a universal right but alas it’s not.” username=”wearethetempest”]

Sad to say that my concern wasn’t really on health at all but on the cost, which really speaks to why we need universal health care. It’s so expensive just to live and healthcare should be a universal right but alas it’s not. So on the last day to enroll in “Obamacare,” with only a few hours until the deadline I put my Christmas vacation on hold and sat down in my best friend’s kitchen to sign up for healthcare for the first time in my life.

Honestly, the first hurdle was finding the right website. There were so many others that claimed to be the signup but really were just scamming and looking to flood your email for the next year and a half. Once I did find the website it started off simple. I filled out all my information like address, bio, and employment information. They determined I had no money, which I already knew, and decided what supplemental help I’d be eligible to receive from the government. Thanks, Obama.

barack obama GIF
[Image description: President Obama sarcastically says “thanks obama”]
Then came time to actually pick a health care plan and that’s when it all went downhill. Obviously, I wanted the cheapest plan so I didn’t have to pay anything out of pocket, but I also didn’t want a crappy plan. I had no idea what actually constitutes a good healthcare plan, I just didn’t want to be screwed if something actually happened to me and then I’d be stuck with a really expensive medical bill. There was A LOT to consider, pre-existing condition limitations, mental health coverage because a girl has issues, primary care, prescription coverage, access to a provider who was near me, specialist referrals and coverage, maternal care coverage, copays, and deductibles.

[bctt tweet=”The big kicker is understanding deductibles. What’s a good deductible or a bad one? What the fuck does it even mean!?” username=”wearethetempest”]

Half of these don’t even make sense of how they work, and others we don’t even realize are important and providers will slyly keep them out of coverage to fuck us over later. For instance, it doesn’t help if a doctor can diagnose you for free but then you have to pay for him to write a prescription to fix whatever’s wrong and pay for the actual medicine. No, you want a plan that covers that prescription writing and gets you a discount on medicines from accessible pharmaceutical companies like Walmart and CVS. I tried to be cautious of this as well as mental health and specialist coverage.

Primary care doctors aren’t the be-all end-all, and sometimes you just need to go straight to a specialist without a referral. Why pay to go see your primary care doctor in order for him to refer you to the gynecologist you initially wanted to see? Cut the middle man, cut the processing time, and cut your cost. Now, the big kicker is understanding deductibles. What’s a good deductible or a bad one? What the fuck does it even mean!? Here’s what I found.

list scroll GIF
[Image description: Scene from Aladdin; Jafar unrolls a large list that rolls down and bumps into the Sultan.]
Basically a deductible is the amount you have to pay out of pocket before your health insurance kicks in. For instance, say you break your leg and your hospital bill is $5,000 because you took an ambulance ride to the hospital and underwent emergency surgery. If your insurance plan has a deductible of $2,000 you are required to pay that much of your bill before they kick in. Once you pay that, they cover the rest.

This is different than a copay. A copay is what you pay for “regular” visits, so every time you go to the dentist or your primary care doctor you pay a small fee, and your insurance covers the rest. When I was on Medicaid, I had to pay $20 every time I went into my eye doctor for an annual check-up, but then my insurance paid for the rest of the visit, my prescription, and a free pair of glasses. Some plans also offer certain deductibles for prescription drugs, so if you are a person who needs a prescription every month you want to be aware of that as you choose plans.

[bctt tweet=”This is all a confusing process and I wish it could be less complicated” username=”wearethetempest”] explains that plans with lower monthly premiums – what you pay in the bill – have higher deductibles, and those with higher monthly premiums have lower deductibles. Generally, you want that lower deductible so in an emergency you don’t have to scrounge up $10,000 out of pocket in order to get the care you need.

This is all a confusing process and I wish it could be less complicated, but I think the important thing to remember when signing up for a health care plan or evaluating one provided by your job or school is to evaluate your own health. Do a self-analysis and think of all the things you would need, a low deductible, maternal health care, dental, mental health, prescriptions if you have a condition, etc. Once you have an idea then you can move forward and choose the best plan for you. It’s complicated and reading all the plans can make your head swim, but I luckily had a friend I trust and love by my side and that helped more than anything.


4 unique gifts your bridesmaids will actually love – and they won’t break the bank

The stress of planning a wedding can sometimes get to you if you’re doing it all on your own. Having a group of your closest friends and family members helping you out as bridesmaids and maid of honor makes the whole process a lot easier! But when the time comes to finding a meaningful and affordable gift to show your appreciation, nothing seems right.

In fact, let’s be honest, nothing seems affordable. But no need to fret, because there are options out there. That’s why we put together this list of meaningful (and low-budget) gifts that your bridesmaids will absolutely love.

1. These hilarious Bridesmaid’s Survival Kits are everything!

[Image description: A tin saying "Bridesmaid Survival Kit, Day of emergency essentials from The Mr. and Mrs" lies in the middle of the frame. Surrounding it are different items like a plaster, hairpins, chewing gum, and a toothbrush.]
[Image description: A tin saying “Bridesmaid Survival Kit, Day of emergency essentials from The Mr. and Mrs” lies in the middle of the frame. Surrounding it are different items like a plaster, hair pins, chewing gum, and a toothbrush.]
This personalized “Bridesmaid Survival Kit” is the perfect gift if you’re looking for something fun, lighthearted, but useful to give to your bridesmaids. Stock your kit full of goodies like tampons, paracetamol, wet wipes, chewing gum, and even a sneaky bottle of Whiskey. Your bridesmaids will be prepared to handle any crisis with this completely affordable pocket-sized kit. Head down to stores like Daiso or Target for some budget-friendly ideas.

2. Super-soft & oh-so-cute customized robes!

[Image description: A girl with long, black hair stands with her back to the camera. She is wearing a floral, satin robe with the word "Bridesmaid" printed on the back alongside an outline of a heart.]
[Image description: A girl with long, black hair stands with her back to the camera. She is wearing a floral, satin robe with the word “Bridesmaid” printed on the back alongside an outline of a heart.]
Nothing says besties like matching robes! These handmade satin robes will ensure that everyone’s comfortable while they get their hair and make-up done for the big day. The options for customization are limitless and can be found online at places like Etsy and even Amazon. There are so many budget-friendly options out there, but if you want to get fancy with DIY, follow this easy tutorial. You can get them for your bridesmaids, flower girls, maid of honor, and mother of the bride!

3. Every bridesmaid needs comfy slippers & a cute tote!

[Image description: A pair of white slippers and a cream tote bag with the name "Sarah" written in modern calligraphy. A white rose lies next to them.]
[Image description: A pair of white slippers and a cream tote bag with the name “Sarah” written in modern calligraphy. A white rose lies next to them.]
Your bridesmaids will adore these vinyl slippers and tote sets with personalized messages. Whether you choose to get their names printed or simply have them say “bridesmaid,” the sets are super affordable and made to order – so you know they’ll turn out great! Check out stores like this on Etsy for great deals!

4. Have your bridesmaids’ names engraved on these gorgeous handmade bracelets.

[Image description: A woman's hand displays a minimalistic, rose-gold engraved bracelet that says "Sophia" on it.]
[Image description: A woman’s hand displays a minimalistic, rose-gold engraved bracelet that says “Sophia” on it.]
Simple is always beautiful, so keep it classy with these stunning engraved bracelets that are perfect for any occasion. Jewelry can be expensive, but these gold-plated necklaces are durable and affordable from stores like this!

It can be hard to find the perfect gift to thank your besties for standing with you on what might be the most important day of your life. The truth is that there’s no reason to spend big on gifts for them to be meaningful, fun, and sophisticated!

Policy Inequality

This bill could provide expanded maternity care for millions of women

Today, we’re tackling  the Improving Access to Maternity Care Act and its subsequent effects on women. 

1. What’s this bill about? 

H.R. 315 is the official name for the Improving Access to Maternity Care Act – an amendment to the Public Health Service Act, first passed in 1944. H.R. 315 passed unanimously in the House January 9th, 2017 (405-0) and has moved to the Senate docket for a vote. A very similar bill was brought to the House of Representatives in March of 2015 but was referred to committee and never reached a vote. Until now.

This sounds promising…

2. What’s it provide?

This bill calls for a collection of data about the availability of maternity care in areas where there are already shortages of healthcare professionals and the subsequent “assigning to such identified areas maternity care health professionals who…would otherwise be eligible for such assistance, [and] distribute maternity care health professionals within health professional shortage areas using the maternity care health professional target areas identified.”

This is an amendment to the Public Health Service Act, a bill which includes a section that calls for dispersion of healthcare services in areas where there is little to no existing access. These services previously included dental, primary care, and mental health, but not maternity care. This bill changes the game. 

Yes! Easier access to professional maternity care is great! 

3. This is a huge deal for millions of women across the country. 

Offering access to maternity care for those with little to no access to it, including prenatal, birth and labor, and postpartum care. This is a huge deal for millions of women. A quick look at some statistics from 2015 reveals that for every 10,000 women in need of maternity care, there are only 4 health care providers available. And, the number of medical students pursuing OB/GYN careers has remained stagnant, while needs are increasing across the country. That only means that shortages are going to become more severe in the coming years.

The way things currently stand means that every year, thousands of women go unseen by maternity care health professionals. This bill would make sure that maternity care is included in the research of neighborhoods and communities across the country, something that has heretofore been neglected. Women who have foregone regular recommended medical visits while pregnant and likely delivered without a doctor presence or without any postpartum care, now have a greater likelihood of being seen and being cared for as they go through the experience of birth.

Applause! About time! In fact — long overdue.

4. Providing access for expectant mothers is a huge help.

This simple amendment offers the full scope of care for women who would otherwise have to either travel for maternity care or forego it altogether. It will affect those living in neglected or impoverished areas of the country. In an era when affordable and accessible women’s healthcare is at risk with Congress’s threat to de-fund Planned Parenthood, providing access for expectant mothers can be a big help. There’s an estimated one million babies born to mothers who did not receive the recommended care. The risk of death is five times higher for these babies and the risk of being underweight is three times as high than for those who were offered prenatal care. It is so preventable, it’s long overdue that this should be included in what the Public Health Service Act includes in dispersing care to underserved communities.

This definitely needs to get pushed through the Senate. 

5. What you can do to help this pass. 

Let’s make sure it gets a similarly strong pass through the Senate as it did in the House. You can call your Senators and ask them to vote YES on HR 315. Find their contact information here!