7 Things Obama’s Win Could Mean for Women’s Health
November 11, 2008 | General
On Women by Deborah Kotz
Women’s health activists are fist-bumping each other over Obama’s slam-dunk win, and they’re hoping that he’ll reverse some of the policies put in place by Bush. Yesterday, I had a chance to catch up with Planned Parenthood President Cecile Richards in between her strategy meetings and blogging for the Huffington Post. She predicted seven things that would change in the new administration.
1. No more federal funds for abstinence-only education. Two years ago Obama told a conservative Christianaudience that abstinence-only education was not enough to prevent teen pregnancy and that he “respectfully but unequivocally” disagrees with those who oppose condom distribution to prevent HIV transmission, according to the reproductive health blog Reality Check. He’s also an original co-sponsor of the Prevention First Act, which mandates that all federal sex-education programs be medically accurate and include information about contraception. That legislation could be resurrected in the new Congress.
2. No more global gag rule. On Bush’s first day in office in 2001, he reinstituted the “global gag rule” that restricted federally funded health clinics in foreign countries from performing abortions or even providing referrals or medical counseling on abortion. “We think there’s going to be a change in that approach and that these clinics will be allowed once again to offer a full range of family planning services,” Richards says.
3. Better coverage for contraception and pregnancy. While Richards says women’s health activists had to “battle the current administration to get emergency contraception approved over the counter,” they’re now hoping that Obama’s proposed health plan will make contraception more affordable to women. It could force drug plans to cover birth control pills as they would any other drug. (Many still do not.) And it could include more comprehensive prenatal coverage; some women shell out $5,000 or more to have a baby. I’m also curious to see whether Obama reverses a Medicaid rule that last year stopped allowing discounted birth control pills to be dispensed on college campuses.
4. Reversal of the “conscience” regulation that threatens women’s access to birth control. Obama will probably reverse a new rule, opposed by most medical organizations including the American Medical Association and the American College of Obstetricians and Gynecologists, that’s slated to be enacted in the next few weeks by the Department of Health and Human Services. It allows doctors and other healthcare workers to opt out of certain practices that some of them find morally objectionable—like prescribing birth control pills, inserting IUDs, or dispensing emergency contraception (a.k.a. the morning-after pill) to rape victims—without fear of losing their jobs. Read more about this here.
5. Increases in funding for reproductive health clinics serving uninsured. While Title X federal funds were recently increased for Planned Parenthood and other family planning clinics, Richards hopes an Obama administration will provide further increases. “We’re currently meeting the needs of 3 million women,” she says, “but an additional 14 million who need our services aren’t getting them.”
6. Fixing gender disparities in health insurance premiums. While Obama’s proposed health plan is probably a pipedream in this economic climate, it could (if ever enacted) ensure that women who buy individual policies aren’t discriminated against because of their gender. A recent analysis of 3,500 health plans from the National Women’s Law Center found that insurers charged 40-year-old women anywhere from 4 percent to 48 percent more than they charged men of the same age. “The average woman uses healthcare more because she spends an average of 5 years getting pregnant and 30 years trying not to,” explains Richards. “It’s certainly not fair that she pays more, and this is the kind of issue that Obama wants to address.”
7. Improved access to morning after pills and abortions for U.S. military women serving overseas. Women who become pregnant while serving overseas are immediately shipped home. They aren’t allowed to get surgical abortions in military hospitals, nor do they have access to medical abortions early in the pregnancy using Mifeprex, a combination of two medications. Obama’s health plan includes coverage for abortions, and he could join with the Democrat-led Congress to enact legislation that ensures that soldiers get the same health benefits as the rest of us.
Deborah Kotz, senior writer for U.S. News & World Report
RSS
Comment by Jean Drogus November 13, 2008
Needless to say, Healthcare reform is sorely needed in this country. Working in the Group Health Insurance industry in Dade and Broward counties in South Florida, we are constantly exposed to the inequities of the system. Things such as women having to pay so much more than men. The extremely high costs of the plans in south florida due to the extremely high cost of prescirption drugs which the retired population in Dade and Broward counties need so many of. Hopefully the new administration will require the insurance companies to scale the cost of their plans back, so that we won’t have to spend our annuities to pay for our group health care insurance.
Jean Drogus
http://www.securefloridian.com
Comment by H. Green November 18, 2008
The following 9 steps will simply suggest how, without the inefficiencies and burden to productivity of private insurance corporations, we can deliver efficient and effective comprehensive health care to women, men and children with great savings and no sacrifice of jobs. In fact, we may be able to decrease morbidity and mortality in this Country with one coordinated system which cares for all Americans, and concurrently analyzes optimal diagnoses and treatment modalities through its integrated computerized billing system. The savings incurred insuring all Americans through the more efficient Medicare system will benefit all citizens of our Country.
9 Steps to Comprehensive Quality Health Care in America
1) Shut down the private health insurance corporations.
2) Enroll all Americans (including Veterans) and the 40 million uninsured citizens into the Medicare Health Insurance Corporation. Since the current functioning Medicare Insurance Company is already accepted by almost all physicians, Hospitals and clinics in the Country, hardly any infrastructure investments on the health care delivery end will be necessary. Have all private businesses pay a Medicare premium for their employees instead of private health insurance premiums. Let employees as well as businesses contribute a fixed premium amount based on their age up until 65 for their Medicare services and drugs. Freeze current premiums for all Americans over 65 and adjust in the future according to the cost of living index. These premiums paid by businesses to Medicare for their employees should be less than that paid to current private insurance companies because of the lower overhead costs of the Medicare Corporation and improved risk distribution.
3) Hire the now unemployed former private health insurance corporate bureaucrats to actually deliver and not inhibit health care by working in hospitals, doctors’ offices, clinics and nursing homes around our Country. Demographically, the percentage of elderly Americans is rapidly increasing. With every American now insured through Universal Medicare Insurance, real health care workers will be in desperate need. For the first time in the brief but bloody history of managed care, these former private insurance corporation employees will actually touch and improve care for patients by working in physical therapy, nursing, home health care and other ancillary patient care capacities.
4) Obtain by eminent domain (for the public good) the best of the intellectual property protected computer codes which the closed private insurance businesses previously used to monitor patient care and doctors utilization and performance. Private health insurance companies have used these computer programs exclusively for the purpose of strong-arming their contracted health care providers into doing less for their patients and increasing the premium costs for sicker patients in order to achieve higher corporate profits. Medicare on the other hand can use these same computer programs for the common good; to monitor, collect data and eventually improve the efficacy of diagnoses and the treatment of diseases and medical outcomes every time a doctor submits a bill. For example, wouldn’t it be nice to know as a medical consumer (patient) which oncology groups in Boston, New York or Houston have the highest cure rates for stage III breast cancer or Stage II prostate cancer? All those numbers currently exist in cancer registries nation wide and just need to be collected and honestly disseminated. Currently, instead of solid medical data which delineates morbidity and mortality and performance, the medical consumer when choosing an oncologist must rely on word of mouth, physician referrals or advertisements in the local papers which show photographs of smiling doctors in white coats who claim to be the ‘best’ doctors in town. In addition to garnering invaluable instantaneous epidemiologic data on diagnoses and treatment of diseases based on severity and other variables, a strong Medicare based utilization review computer code would also allow Medicare to monitor doctors and hospitals who abuse a fee-for-service billing system. Any physician, institution or service found to abuse the Medicare fee for service billing system after proper review and appeal should be dealt with severely through stiff penalties and loss of their Universal Medicare provider contract.
5) Freeze Medicare physician, hospital and ancillary services reimbursements at current 2007-2008 levels. Adjust reimbursements for future services yearly by Cost of Living increases, or in the event of a deflationary economy a decreases in doctor and hospital payments. Ask any physician and they’ll tell you they would accept current reimbursement rates with COLA over the current mysterious illogical fee adjustment system of Medicare, or the physician population density reimbursement formula used by most private insurance corporations. Two tiered medical systems separating the “haves and have not’s” of society have and will always exist. Therefore, we must allow physicians to practice medicine without enrolling in or accepting the Universal Medicare reimbursement. With private medical insurance no longer available, and no performance based evidence for improved morbidity and mortality among their private for-pay patients, these extraordinarily expensive private ‘VIP’ practices will be limited.
6) Allow Medicare, much like the current Veterans Administration System and every private health insurance company and government health care system around the world, to bid on medications from pharmaceutical corporations for its Medicare drug formulary. Every physician recognizes that we don’t need a choice of a dozen redundant drugs in each pharmaceutical category. For example, we need only 2-3 statins for cholesterol, a handful of antibiotics for infections, 2 beta blockers for hypertension, and a few pain killers. Once the Government bids on pharmaceuticals for the Medicare Corporation formulary, macro economics will force prices to massively decrease to levels identical to that which all the other people of the world outside of America are paying for the same medicines. Since it has not effectively decreased morbidity or mortality in this Country, and only wastes money, we should also prohibit pharmaceutical companies and their workers from contributing to political campaigns or buying commercials on the public airways. We need to also prohibit the current practice whereby your local pharmacy and pharmacist sells your private medical diagnoses and your doctors private prescribing drug information to pharmaceutical companies so the pharmaceutical companies in-turn can directly pressure-market physicians. Prohibit pharmaceutical companies from contributing to organized medicine societies, colleges or associations because the doctors can’t rely on soft bribes or free lunches to prescribe what’s best for their patients. Prevent pharmaceutical representatives from visiting doctors’ offices or hospital pharmacies directly. Allow delivery of Medicare formulary approved sample medications for patients to physicians’ offices via post office mail only. Allow pharmaceutical companies to market products to physicians only via peer reviewed publications delivered by email or snail mail.
7) With the savings incurred from closing the private insurance corporations and paying less for drugs, have the American government fully fund the National Institutes of Health (NIH) and the National Cancer Institute (NCI) and Small Business Innovative Research (SBIR) programs. Emphasis should be placed on basic bench research carried out at not-for-profit American Institutions which employ or utilize a majority of American Citizens in their laboratories and clinics. Too often American Universities rely on free overseas labor to conduct bench research. Clinical trials should emphasize new drugs and devices which have promise to significantly decrease morbidity and mortality for any disease, including orphan diseases. Since a large percentage of private funding for drug and device studies will originate in the expanding financial liquidity and innovations and patients of the emerging developing world, we should allow the FDA to utilize research data obtained by reproduced laboratory and clinical studies performed overseas as well as in this Country.
Corruption of honest academics should be curtailed. Force all investigators to release reproduced publicly funded scientific data for all scientists to review on the internet via the Freedom of Information act (The Senator Shelby Amendment). Prohibit rights of first refusal on scientific data for private companies performing research in non-for profit institutions which receive public funding. Any rights to profits obtained from intellectual property and patents invented with combined funding from government and private sources should be split fairly among the contributing government institutions and any other private corporations funding the research, as well as with the individual inventor. Prevent organized medicine societies, associations or colleges from contributing to political campaigns since campaign donations have no relevance for physician performance or patient morbidity or mortality.
9) The quality of current medical records software lags two decades behind business software. Therefore, we need to fund and challenge America’s best software corporations to finally develop standardized electronic medical records software for use in doctors’ offices and hospitals in order to increase the efficiency and productivity of physician charting, billing and prescribing. We should use the integrated medical records system to instantaneously and confidentially gather important epidemiologic data on physicians’ performance, patient diseases, and treatments. With new potent viruses and unsophisticated biomedical and nuclear warfare on the horizon, this system will be absolutely necessary for rapid National Security responses. Protect patient confidentiality at all costs to prevent the commercialization and abuse of patient data like that which the pharmacies trade today.
Lastly, some argue that Universal Government run health care in America will result in delays in diagnosis and treatment similar to those experienced in Britain and Canada. One can not simply compare the massive extremely functional Medicare insurance corporation based infrastructure which seamlessly delivers health care to tens of millions of people yearly in the USA to the government run westernized health care systems of Canada and Britain, France, Switzerland, Netherlands, Scandinavia, and Israel. America, for the last 40 years, thanks to the government run health insurance corporation-Medicare, has built an incredibly dense and fluid public insurance system involving almost all doctors’ offices, hospitals, clinics and ancillary services. The Medicare system dwarfs in breadth and actual practitioners and efficacy the lesser insurance systems established in all other countries. The billing and reimbursement bureaucracy for health care providers contracted with Medicare Insurance is already relatively streamlined and efficiently centralized in America thanks to 40 years of physician, hospitals and government cooperation.
We all know that the medically bankrupt private health insurance corporations and medical malpractice lawsuit threats have caused many disheartened physicians to quit practicing or downsize their practices in America. A continuation and technological upgrading of our most fair Universal Medicare based health insurance Corporation based on the concepts outlined above would undoubtedly motivate those disenfranchised physicians to return to the profession and bright younger physicians to invigorate the field. If patients, physicians and the Medicare Corporation continue to work together, without the deleterious interference of private for-profit health insurance corporations, malpractice threats and overt pharmaceutical marketing, the future for American health care will be healthy indeed.. A continuation of the status-quo mixture of a government subsidized private health maintenance insurance industry operating parallel to and within Medicare is wasteful, and will continue to provide no potential future health improvements for America.
Comment by g.perry December 4, 2008
H. Green has carefully thought out this scenario, and some of the plan is quite spot on . There are just some assumptions in it that I do not believe are true. First, Medicare is not the entity to run this operation. It is not the model of efficiency you make it seem and it is not set up for preventive care effectively. Also , no office or hospital can survive on current Medicare payment levels, although going to a single payor system would provide some relief in reduction of overhead by eliminating coding jobs. Private insurers simply don’t employ many people with usable health care skills, so there would be aglut of these unemployed coders dumped into this economy. Lastly, those performance indicators can realistically only establish a minimum standard level of competency. One can easily skew the stats of cancer survival by simply not accepting the sickest patients. Yes, there should be more transparency and a way to know who not to go see, but pure consumer choice does not exist in any national system.
Comment by Benjamin E December 6, 2008
An Obama win will also help because we might be able to get medicines over here in the states that don’t make the big drug companies rich. Did you know that they have cold laser treatment and tecnology over in Europe that works great to manage pain, but doctors here don’t even recommend it on a regular basis? Makes you wonder who is getting rich in this country.