Sunday September 22, 2019

US: Planned Parenthood Clinics Charging New Fees, Tapping Financial Reserves, Intensifying Fundraising

The fallout is especially intense in Utah, where Planned Parenthood has been the only provider participating

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Misty Dotson hugs her son's at their home Tuesday, Aug. 20, 2019, in Murray, Utah. Dotson is a 33-year-old single mother of two boys, ages 12 and 6, who goes to Planned Parenthood for care through the Title X program. VOA

Planned Parenthood clinics in several states are charging new fees, tapping financial reserves, intensifying fundraising and warning of more unintended pregnancies and sexually transmitted diseases after its decision to quit a $260 million federal family planning program in an abortion dispute with the Trump administration.

The fallout is especially intense in Utah, where Planned Parenthood has been the only provider participating in the nearly 50-year-old Title X family planning program and will now lose about $2 million yearly in federal funds that helped 39,000 mostly low-income, uninsured people. It plans to maintain its services — which include contraception, STD testing and cancer screening — but is considering charging a small copay for patients who used to get care for free.

Planned Parenthood in Minnesota is in a similar situation, serving about 90% of the state’s Title X patients, and plans to start charging fees due to the loss of $2.6 million in annual funding.

The organization is concerned about the spread of unintended pregnancies and sexually transmitted diseases.

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FILE – New Hampshire Governor Chris Sununu. VOA

“We believe there will be a public health crisis created by this denial of care,” said Sarah Stoesz, the Minnesota-based president of Planned Parenthood North Central States. “It’s a very sad day for the country.”

Planned Parenthood and several other providers withdrew from the program earlier this week rather than comply with a newly implemented rule prohibiting participating clinics from referring women for abortions.

Anti-abortion activists who form a key part of President Donald Trump’s base have been campaigning to “defund Planned Parenthood.” Among its varied services it is a major abortion provider, and the activists viewed the grants as an indirect subsidy.

About 4 million women are served nationwide by the Title X program, which makes up a much bigger portion of Planned Parenthood’s patients than abortion. But the organization said it could not abide by the abortion-referral rules because it says they would make it impossible for doctors to do their jobs.

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Misty Dotson, a single mother in Utah, started going to Planned Parenthood as doctors’ bills for treating recurring yeast infections mounted. The services became even more important when she gave up her employer-sponsored health insurance because she couldn’t afford the $500 monthly bill.

She is unsure what she’d do if the family planning services she gets stop.

“It would put me in a very dangerous position,” said Dotson, who works as an executive assistant for an accounting and consulting firm. “It covers so many things: STD testing, emergency contraception, birth control, lifesaving cancer screenings … you name it, they have treated me for it.”

Planned Parenthood said it’s dedicated to maintaining its current services in Utah, but CEO Karrie Galloway acknowledged it won’t be easy and could cause some “pain on all sides.”

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Planned Parenthood clinics in several states are charging new fees, tapping financial reserves, intensifying fundraising and warning of more unintended pregnancies. Pixabay

She said the organization plans to lean heavily on donors to make up the funding gap while staff members assess how they’ll cope. Among the possibilities are instituting copays of $10-$15 per visit, shortening hours and trimming spending. She doesn’t plan to lay off staff, but said she may not be able to fill jobs when people leave or retire.

Minnesota is planning fees as well.

“We’ll continue to offer all services, and keep clinic doors open, but we’ll be charging patients on a sliding scale who we didn’t charge before,” Stoesz said. “Vulnerable people who previously were able to access birth control and STD testing for free will no longer be able to do so.”

Elsewhere, the impact of Planned Parenthood’s withdrawal will vary from state to state.

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Governments in some states, including Hawaii, Illinois, New York and Vermont, say they will try to replace at least some of the lost federal funding. In the Deep South there will be little impact because Planned Parenthood did not provide Title X services in most of the region’s states.

The chief operating officer for Planned Parenthood of the Greater Northwest and Hawaiian Islands, Rebecca Gibron, said Southern Idaho could be hit hard by the changes, with other health care providers in the area saying they can’t fill the gap if the roughly 1,000 low-income women served by Planned Parenthood in Twin Falls are no longer able to receive care.

“This was not money that can simply be made up by raising dollars from donors,” Gibron said. “We have rent to pay, we have staff salaries … there are limits to what we are able to do in terms of providing free care without the Title X program.”

Gibron said Planned Parenthood is working with Washington state officials in hopes of securing “bridge funding” to keep operating more than 20 Title X clinics serving roughly 90,000 people.

“We’re going to do everything we can to provide care for patients in the same way, but we know that it’s not sustainable and we’re looking at all of our options,” she said.

Among other providers withdrawing from Title X is Maine Family Planning, which oversees a network that serves about 23,000 patients per year and will be losing $1.8 million in annual funding. Its CEO, George Hill, said the organization will rely on reserves and intensify fundraising efforts to bridge the gap while seeking more aid from the state.

In anticipation of the changes, Democrats in neighboring New Hampshire added about $3.2 million in the state budget they passed earlier this year to make up for the federal funding. But that’s on hold after Republican Gov. Chris Sununu vetoed the budget in June for other reasons.

Planned Parenthood will continue to participate in Medicaid, the federal health-coverage program for low-income Americans. That’s Planned Parenthood’s biggest source of government funding — about $400 million or more annually in recent years. The Republican-controlled legislatures in Texas, Iowa and Missouri have taken steps to block that flow of funds in their states.

Maryann Martindale, executive director of the Utah Academy of Family Physicians, said most Title X clients earn slightly too much money to qualify for Medicaid but cannot afford employer-based or private health insurance. (VOA)

Next Story

U.S. Media Industry Going Through A Bad Phase

On the surface, it may look as though the average U.S. media consumer is awash in choices: websites, podcasts, cable and broadcast TV, satellite, but this is not the reality

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Some front pages and section fronts of the Orange County Register are seen in the newsroom in Santa Ana, Calif., Dec. 27, 2012. VOA

On the surface, it may look as though the average U.S. media consumer is awash in choices: websites, podcasts, cable and broadcast TV, satellite and over-the-air radio, and yes, even printed newspapers. But the reality is different.

There is an oft-quoted line from Thomas Jefferson about the importance of a free press to the stability of the newly formed United States: “Were it left to me to decide whether we should have a government without newspapers or newspapers without a government,” he wrote to a colleague, “I should not hesitate a moment to prefer the latter.”

Almost always, though, the words Jefferson wrote next are forgotten. He added, “But I should mean that every man should receive those papers & be capable of reading them.”

His insight was that a press free from government interference is a necessary condition for a healthy democracy, but not a sufficient one. A free press isn’t very useful if nobody has access to relevant reporting on the issues that affect them.

If Jefferson were able to look at the media landscape in his country today, particularly at the local level, he would almost certainly be worried.

Consolidation

News sources, particularly local ones, are increasingly controlled by a limited number of companies that have bought up smaller news organizations and consolidated them.

This is perhaps most visible in the world of newspapers. Twenty percent of the newspapers that were active 15 years ago have been shut down, according to the University of North Carolina, leaving hundreds of locales without a local paper.

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A specialist works at the post that handles Gannett on the floor of the New York Stock Exchange, Aug. 5, 2014. VOA

Employment in newspaper newsrooms has fallen by 47% since 2004, according to the Pew Research Center. Meanwhile, companies like GateHouse Media and Gannett  control hundreds of publications using centralized news gathering that decreases the focus on their communities.

In August, the two companies announced a plan to merge, a deal that would create a company controlling more than 250 daily newspapers, as well as hundreds more weeklies and community papers. The merged companies would be several times larger than the next biggest newspaper company, Digital First Media, which in 2018 owned 51 daily papers and 158 other publications.

Digital First, which is owned by the hedge fund Alden Global Capital, has been at the forefront of another troubling trend: buying up newspapers, laying off newsroom staff, and liquidating the papers’ real estate assets.

Digital First, which also goes by MediaNews Group, or MNG, did not respond to a request for comment from VOA. However, in response to a Washington Post story earlier this year, the company said “MNG is committed to the newspaper business and a long-term investor in the space. MNG’s focus is on getting publications to a place where they can operate profitably and sustainably and continue to serve their communities.”

Job cuts, quick profits

“They’re owned, essentially, by private equity companies, or even hedge funds at times, and they don’t particularly care about the quality of the journalism,” said Margaret Sullivan, media columnist for The Washington Post and former public editor of The New York Times.

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Two New York Daily News employees leave the newspaper’s office after they were laid off, in New York, July 23, 2018. VOA

“What they’re there to do is to strip mine these properties and get as much profit from them as they can in the short term. And that is very bad for journalism. It’s very bad for journalists, because it often means round after round of job reductions, cutting costs in really draconian ways that hurt the news gathering process.”

Newspapers are not typically seen as a major profit-making venture. While they generate significant cash flow through advertising sales, that is offset by high production costs of personnel and the logistics of printing and delivery. Many are run by family foundations and other organizations that place some value on their public mission.

The strategy of many investment firms buying up newspaper chains has been to increase profits by slashing personnel costs.

In the broadcast world, the story is similar. Large companies have been buying up local stations and cutting costs by centralizing the production of much of the content they air. Most notorious among them is Sinclair Broadcast Group, which owns 193 stations across the country, reaching up to 40% of the U.S. population.

Sinclair is known for enforcing a sharply conservative political slant on its broadcasts, providing “must-run” content that appears on every station the company owns. It regularly requires its stations to air commentary by Boris Epshteyn, a friend of President Donald Trump’s family and a former political consultant to the president.

Last year, a video went viral in which dozens of Sinclair anchors could be seen repeating, verbatim, a script that echoed Trump’s complaints about “fake news.”

Easing antitrust

Rules that formerly limited the ability of individual companies to own a dominant share of the media outlets in a specific market have been slowly eased over the years. Then, in 2017, the Federal Communications Commission gutted many of the remaining restrictions, opening the door to single companies dominating individual markets in both broadcast and print.

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Hundreds of old newspaper vending machines are shown in a vacant lot near the former offices of the Alaska Dispatch News in Anchorage, Alaska, Sept. 11, 2017. VOA

The resulting consolidation has been “disastrous for local communities,” said Craig Aaron, president and CEO of Free Press, an organization that advocates for the decentralization of media. “We’ve gone from a more diverse localized media system to one increasingly controlled by a small handful of companies.”

 

“You used to get in your car in New York and drive to, I don’t know, Phoenix,” said Aaron. “Everywhere along the way, you would get incredibly different local voices, local flavors, local music. Now, you’re much more likely to get the same hit songs and Rush Limbaugh. So, we’ve lost some of that, you know, which I think has huge cultural value.”

The impact goes beyond culture, though, as Aaron and others have pointed out. It also has a direct impact on how Americans govern themselves.

“When sources of local and regional news dry up or go away,” Sullivan said, “there’s research that shows that the way people engage politically changes. They are going to be less likely to vote, they become more polarized, because for many years, the local newspaper might have been a way that people in that community were sharing a set of facts. Now, that’s gone or diminished.”

Last year, the Shorenstein Center on Media, Politics, and Public Policy at Harvard Universityassembled a list of academic studies that tied the loss of local news sources to a decline in both the quantity and quality of citizens’ civic engagement.

Social media news

To fill the gap, Sullivan said, people turn to less objective sources of news, like Facebook, or politically partisan cable television programming.

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An iPhone displays the app for Facebook in New Orleans, Aug. 11, 2019. VOA

“It is really a very damaging thing for the way we talk to each other, the way we feel as a community and the way we deal with politics,” Sullivan said.

Identifying the disease and cataloging the symptoms is one thing. But finding a cure that will return the U.S. to a more Jeffersonian media model won’t be easy.

Sullivan argued that the growth of nonprofit news organizations is a hopeful sign that an alternative to corporatized media may be available. Groups such as Report for America provide funding so that young journalists can work in local media outlets, providing them important training while supplementing understaffed news outlets.

Some nonprofit publications like The Texas Tribune and Voice of San Diego have been able to make important contributions to their communities.

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But nonprofits can’t bridge the gap entirely, and Sullivan and others worry that the advertising-dependent business model of traditional journalism — particularly newspapers — has been so thoroughly broken by the rise of digital media that trying to rebuild it on the same design will be impossible.

That’s why Aaron and his organization want the federal government to get involved. Free Press argues for a return to tighter federal restrictions on media consolidation, including the breakup of existing conglomerates. They also call for f