The Realization of a Feminist Healthcare System
The realization of a feminist healthcare system is both a theoretical and practical project. The theoretical aspect can be said to consist of the ethical commitments that constitute a feminist world-view: the autonomy and individual rights of women and the overall equality of the healthcare system, irrespective of gender, class or race. Such a universalism is the basic definition of feminism in this context. The practical aspect consists in the specific healthcare practices that must be put into action in order to realize the theoretical aims, for example, a general quality and non-capitalization of healthcare.
The logic behind these specific theoretical and practical aims can be most clearly understood by firstly grasping what is wrong with the current U.S. healthcare system, a system that is largely the product of a patriarchal and capitalist discourse of inequality that informs current decisions about health care. Atchison describes health care in the U.S. as a “commodity”, (110) which means that the importance of healthcare in the American context is diminished in favor of the importance of the capitalist ideology itself. In other words, the healthcare system exists fully within the paradigm of the competition of the free market, as opposed to existing outside of this paradigm. This demonstrates the underlying theoretical decision that constitutes the current healthcare system, leading to problems such as the poor being denied access to healthcare – inequality is the model of this approach. In contrast, a feminist health care system would necessarily be a commitment to a universalized form of healthcare, namely, health care that is available to everyone, precisely because social inequalities can be viewed as symptomatic of the patriarchal and capitalist system, which by definition is based on inequality. A feminist health care system does not only oppose patriarchy, but opposes the idea of inequality on any level, whether it be gender, race or class based. The feminist health care system would, in other words, be grounded on a notion of what is called in feminist theory intersectionality, insofar as one realizes that the oppression of women also can overlap with issues of race and class – the complicated manner in which women are oppressed must necessarily lead to a universal and emancipatory approach to health care, in order to subvert the different ways whereby inequality manifests itself throughout society.
Feminist healthcare theory is, in this sense, radically critical of the current lack of universal healthcare, precisely because this lack promotes and creates inequality - it is a symptom of a greater social construct and political system that allows for instances of inequality and the non-democratic treatment of its citizens. For example, the fact that African-American women are statistically “less likely to have health insurance, more likely to face great financial barriers to adequate healthcare, less likely to have information about symptoms and less likely to have healthcare facilities in their neighborhoods” (Atchison, 108) demonstrates that the inequality experienced is a systematic inequality, in other words, the system itself produces an uneven distribution of access to healthcare. Certainly, concrete cases in U.S. History of such inequality are prevalent, for example, the Tuskegee Syphilis Study, in which “black men from Macon County, Alabama, were deliberately denied effective treatment for syphilis in order to document the natural history of the disease.” (Gamble, 111) This is an explicit case of the government creating a tiered healthcare system, in which minorities are deliberately treated in an extremely harmful manner. The effects of such historical incidents nevertheless remain pertinent, as the Tuskegee Syphilis Study “predisposed many African Americans to distrust medical and public health authorities.” (Gamble, 111) Insofar as many African Americans are hesitant towards the effectiveness of the healthcare system, this demonstrates that something is clearly wrong with this system.
For the feminist healthcare system, such race based inequalities are also important, because it allows the theoretician to diagnose the endemic failures of current healthcare. Moreover, it strengthens the imperative of a universal healthcare without exception, in order to combat such inequality. Such inequality is a societal inequality and is not present only in healthcare – according to Glasford and Huang “among the estimated 37.5 million foreign-born people living in the United States, there are probably tens of thousands more women experiencing serious health and reproductive health problems that are being made worse by the violence, discrimination, and hurdles that U.S. immigration policy perpetuates.” (123) The greater societal commitment to inequality finds one of its manifestations in current healthcare. Revising the latter becomes a means with which to forward a greater goal that is the elimination of such inequality.
The strategies to realize such a healthcare system cannot take hold without clearly defined aims of medical praxis. Crucial in this regard is that women are granted freedom regarding their health and in issues related to their own bodies. Restrictions on autonomy in relation to issues such as abortion are symptomatic of greater societal inequality: women are burdened with various social normativities, such as the traditional family. Restricting choice is a manifestation of this inequality. Hence, women’s rights groups such as the NAPAWF “seek to broaden the prochoice framework beyond the constitutional right to access abortion and provide…women with real choices in their sexual and reproductive decisions.” (Chappell, 120) As opposed to the false choice of the capitalist and patriarchal healthcare system, the aim is to promote individual autonomy as crucial to the possibility of universal healthcare. As Chappell writes: “What is ‘choice’ if a woman can’t talk to her doctor confidentially, understand her provider’s recommendations, access preventive care because of immigration restrictions, or ensure that her workplace is safe and healthy?” (120) The true choice here is not, for example, the choice of a product or healthcare provider, since this is merely indicative of the capitalist foundation of this choice, one which is unequal. A true freedom, in this regard, is an unrestricted freedom of the individual to make decisions regarding his or her own body.
In this regard, the praxis of the capitalization of health care needs to be opposed by a prospective feminist healthcare system. For example, the commercial advertising of hormonal birth control is primarily “designed to increase sales of products and to generate profits, not to educate consumers, and they therefore contain misleading and manipulative messages designed to favorably position the products in consumers’ eyes.” (Popkin, 244) In other words, the utilization of pharmaceuticals as a type of profit-making industry must be rejected by the feminist perspective, insofar as such an approach does not emphasize health and education, but rather posits health in terms of profit. Such an attitude is present throughout the system, as, for example, “the rush to make a new vaccine compulsory appears to be all about…making as much money as possible.” (Healthfacts, 247) In the current system, the main concern appears to be profit; in a feminist healthcare system health issues are the chief concern. The first is an approach that the feminist must oppose, according to the exploitative nature of capitalism and the notion of “selling sickness.” (Popkin, 237) – feminist healthcare takes the non-commodification of healthcare as a guiding imperative.
Accordingly, the feminist healthcare system supports universality, precisely because it believes that healthcare should be without exception. However, for this reason, the feminist healthcare system must also reject capitalist models of healthcare, in which emphases on profit encourage inequality along, class race and gender lines. Autonomy in healthcare is thus established by asserting the individual’s right to choose – the market of healthcare does not dictate healthcare practice; rather, the needs of individuals must dictate healthcare practice.