Women have a lot at stake in the debate over health care reform. Some seven in ten women are either uninsured or underinsured, and more than half report forgoing care or preventive visits because they can’t afford it. Meanwhile, insurance companies can charge women more for coverage, and can exclude them from plans because of “pre-existing conditions” like pregnancy or being victims of domestic abuse. Finally, women facing cancer or other serious illnesses are far more likely to suffer financial collapse when faced with benefit caps and high out-of-pocket spending limits.

This state of affairs is unacceptable and achieving affordable, comprehensive and accessible care for all Americans should be the goal of any final health reform bill. Both the House and Senate bills would end gender rating (the practice of charging higher premiums for women) in the individual and small business markets. Both bills also would end the practice of denying coverage because of pre-existing conditions and would set minimum benefit standards that ensure access to primary care and preventive services. Finally, the two versions both cap out-of-pocket spending and get rid of lifetime or annual benefit limits.

Yet, despite these important initiatives, controversy over women’s health issues remains strong in the reform debate—even among Democrats and traditional women’s advocates.

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Monday, December 7th @ 7:00 PM
Cinema Village
22 E 12th Street
New York , NY10003
212-924-3363
featuring a Q&A with producer Alex Gibney

Below a snapshot of how health care reform would help one underinsured household.

A single profile is hardly a definitive assessment of how reform will affect the many  families that are now paying far too much for far too little insurance.

But so much commentary on health care reform focuses on the uninsured or the well-insured. Most middle-class American families fall somewhere in the middle. This ProPublica assessment throws a spotlight on how reform would change their lives. (The analysis is based on results of a questionnaire that ProPublica did with American Public Media’s Public Insight Network.)

At the end of the Kroner’s story, I comment on what it highlights about reform legislation.

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News reports on the mammography controversy reached a pitch of high hysteria last week, the baseline syncopated with the language of hate and fear.

Minnesota journalism professor Gary Scwitzer tracked the dismal progress (“descent” might be the better word), of the debate over the US Preventive Services Task Force (USPSTF) recommendations regarding mammography on his blog, Health News Review. There, he points to the fear-mongering and rampant exaggeration that has distorted media coverage.  For example, “On ABC’s daytime talk show, ‘The View,’ co-host Elisabeth Hasselbeck made the stunning claim that the recommendations [represent] ‘gender genocide.’” 

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If an expensive, name-brand cholesterol drug costs four times more than a generic but provides no clear clinical benefit, why do insurers—both public and private—continue to pay for it? The answer, in the case of Vytorin, a combination of two drugs designed to lower LDL or bad cholesterol, is that the influence of big Pharma in maintaining the status quo—even when unsupported by evidence—remains a formidable barrier. By suppressing negative studies, relentlessly pursuing positive trial results, and paying academic researchers to promote their therapy, Merck Schering-Plough has managed to hold onto a $4.6 billion market for a drug that has never been proven to be better than cheaper generics in preventing heart attacks or death.

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Money Driven Medicine will be playing at 10 a.m. at the Texas Capitol Auditorium in Austin, and at 7 p.m. at the Millennium Youth Center Complex. Both shows are free and followed by a discussion with Consumers Union and the Center for Public Policy Priorities.

Consumers Union—publisher of Consumer Reports—has been sponsoring screenings throughout the country. Thank you CU!   

For more information about the film, see www.moneydrivenmedicine.org.

Over the weekend, Senate Democrats found the 60 votes needed to press forward with the health care debate. I wasn’t surprised. As I have suggested in the past, I doubted that three or four moderates really wanted to be remembered as the Senators who let the conservatives talk health care reform to death.

This doesn’t tell us what will happen in the weeks ahead, but I remain hopeful that, in the end, we will wind up with a bill that closely resembles the current Senate and House proposals (which are not that far apart)—one that includes a public option.

My confidence is buoyed by the opposition’s growing virulence. Fear has turned to rage as they realize that the liberals may win.

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What if in 2012, unemployment remains relatively high, the recession continues, and voters blame President Obama, voting him and his Congressional supporters out of office?

Consider how that would affect health care reform. If the House bill prevails on the timing of reform, the the Exchanges will open in 2013, subsidies will be available, private insurers will be regulated, and the Public Plan will be available to tens of millions of Americans. Conservatives elected in November of 2012 would have only two months to try figure  out how to derail the roll-out scheduled for January 1, 2013.

By contrast, the Senate legislation now under consideration would push reform forward to 2014. The Exchange, the public plan, the subsidies –none of the above  would be scheduled to become  a reality until one year after Conservatives took control of both the White House and Congress.  In a year, determined politicians could repeal and dismantle most if not all of the reform plan.

Could they do such a thing? Yes, particularly if, during the 2012 election they continued to fuel voters’ fears about the upcoming overhaul of  the U.S. health care system.

I haven’t had time to think this through. I may be missing something.  But on the face of it, I have to say that I'm  opposed to delaying reform until 2014.

 I understand that this gives reformers more time to bring down the cost of care, and find the funds needed to fund the overhaul. But, much as I hate to say it, we can’t afford to ignore the possibility that the conservatives return in 2012—even if only for one term. In a single term, they could undo everything that reformers had achieved.

As Naomi has pointed out below, the news about mammograms is not brand-new information based on one study that just can out.

The recommendations that the Preventive Services Task Force (PSTF) has released is based on research that experts have known about for some time. Thanks to reader Greg Pawelski for calling attention to this post by Dr. Herman Kattlove, a retired medical oncologist who did research on mammograms in the early 1990s.  For the last seven years, Kattlove has served as a medical editor for the American Cancer Society where he has helped develop much of the information about specific cancers that is posted on the website at www.cancer.org

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