Reform recommendations lack discussion of how to pay
A subcommittee of the House Education and Labor Committee met yesterday with a group of invited speakers to weigh the pros and cons of several strategies on the table for reforming the health care system.
One speaker stressed that guaranteeing coverage for all Americans would create a larger pool of risk across which costs can be spread more efficiently, whereas smaller pools of risk leave individuals and small businesses with more expensive coverage. Since 2000, it was said goverment statistics show, employees’ health insurance premiums have doubled, increasing at a rate more than six times faster than wage increases.
Representative John Kline (R-Minn.) stressed, however, that 160 million Americans get their insurance from employers and whatever reforms made “must build on what works in [the existing] structure.”
Another speaker denounced the so-called “play or pay” approach, which would give employers the option of either providing insurance to employees or paying someone else, such as the state government, to do so.
“Such an approach could “result in a net reduction in employer sponsored coverage by leading some companies to pay rather than play. This would lower the level of active employer engagement and their important role as innovative and demanding purchasers of health care services.”
Representative Robert E. Andrews (D-NJ), chairman of the subcommittee hosting the hearing, commented afterward that a range of strategy recommendations had been proposed but discussion of how to pay for them had been “incomplete.”
To read more about the hearing, go here.
Women’s access to care in immigration detention centers
The Women’s Rights division of Human Rights Watch released a report last month – and held a rountable discussion today – on the poor standard of women’s health care in immigration detention centers. The report is based on interviews conducted with 48 detainees and visits to nine detention centers in Florida, Texas, and Arizona.
Immigration detention is the fastest growing form of incarceration in the country. Last year, more thatn 300,000 people were held in immigration custody, of which 10 percent were women. By international standards, the level of medical care provided to detainees must be equivalent to that available to the general population. However, immigration detention policy is largely limited to emergency care and it is women who especially suffer from insufficient routine care.
Researchers point to lack of oversight and accountability of the facilities. Many of the women are not properly informed of the available services and know little of the rights they have to access to medical care in this country. Researchers recommended a “detainee handbook” be devised and handed out to all those taken into custody so that they are made familiar with facility procedures and available services.
Some women also reported difficulty reporting their medical needs to the medicual unit within the facility, and/or gaining access to a doctor once they had reported the need.
Testimony provided to Human Rights Watch suggests that the relationship of security personnel to the individuals in their custody may seriously undermine access to health care. In the most benign instances, some women said that they did not feel comfortable sharing private health information with the individuals with whom they interacted day in and day out. In other cases women alleged mistreatment by security staff in the course of requesting medical care or being transported for treatment.
The report discusses language barriers, neglect of mental health needs, insufficien routine gynecologolical care, utter lack of prenatal care, lack of access to abortion, and other issues that severely compromise the standard of care available to women in immigration custody. Read more on these issues and see how the report uses international and domestic legal standards to outline these women’s right to care and define what a basic standard of care might look like.
EC Now Available to 17-Year-Olds!
On Wednesday the FDA lowered the age at which men and women can purchase emergency contraception, or Plan B, without a prescription. Since 2006, emergency contraception has been available to 18-year-olds over the counter at drugstores, and has had no measurable effect on the nation’s abortion or teenage pregnancy rates.
Last month Judge Edward R. Korman of Federal District Court in NY ruled that the FDA’s decision to allow only those 18 or older to purchase the pills was motivated by politics, not science. He gave the FDA 30 days to lower the age limit.
Contraceptive advocates have thought that wide access to Plan B would lower both abortion and teen pregnancy rates. But up to 1 in 3 girls will get pregnant under the age of 20–with 80% of these pregnancies unplanned. Much more will need to be done to counter this ‘epidemic’.
This is a step in the right direction, though, as under the Bush administration, the agency’s scientists supported access to those at least as young as 17. It is generally acknowledged that no amount of scientific evidence would have caused Bush appointees to approve this.
Another score for women’s health outweighing politics.
For the full article click here
The Rise of the C-Section
From Our Bodies Our Blog:
A statistical brief from The Healthcare Cost and Utilization Project entitled Hospitalizations Related to Childbirth, 2006 finds that there has been a 40% increase in repeat cesarean sections, up from 64.7% in 1997 to 90.3% in 2006.
Other findings conclude that uninsured women have the lowest c-section rates, that delivery via c-section rose from 21% in 1997 to 31.6% in 2006, and that c-sections were “overall, the most commonly performed operating room procedures in U.S. hospitals” in 2006.
C-sections tend to be costlier than vaginal deliveries. Without complications, C-sections run on average $4,500 to vaginal delivery’s $2,600. With complications, those numbers increase to $6,100 and $3,500 respectively.
Another question to ask is how much insurance covers each type of delivery.
In light of the shocking increases in both c-section deliveries as well as repeat cesareans, Obstetrician/gynecologist Lauren Plante has written an article in the International Journal of Feminist Approaches to Bioethics. She argues that c-sections present women with a pain-free, risk-free method of childbirth that takes away their autonomy and removes them from what their bodies are capable of doing. And that the ‘autonomy’ women have in childbirth options is really only supported when it gives more power to the doctor (such as choosing c-section over home-birth).
For the Our Bodies Our Blog synopsis, click here.
For the full article click here.
One-Fifth of U.S. Adults Underinsured in 2007
“Consumers facing increased medical expenses are likely to report decreasing their contributions to retirement savings plans (29 percent), taking on credit card debt (22 percent), and experiencing difficulty paying for basic necessities like food, heat and housing (27 percent) as a result of their medical costs” according to Community Catalyst’s report, When Coverage Fails: Causes and Remedies for Inadequate Health Insurance.
The report discusses the ramifications of being under-insured, such as poor health and financial difficulties. According to the report, 50% of bankruptcies in 2007 were the result of medical debt. That same year, 25 million were under-insured–a 60% increase from 2003–meaning their insurance was not comprehensive, forcing them to forgo or delay medical treatments, preventative tests and doctor visits. The report concluded that the federal government could help alleviate the situation by setting standards for coverage and limiting deductibles.
There are many ways in which the term under-insured is used. How does Community Catalyst define ‘underinsured’? By analyzing the income of those with insurance and the out-of-pocket costs of health care they pay, and determining when those costs become too great of a barrier to overcome. The Commonwealth Fund classifies individuals as under-insured when more than 10% of their income (which is 200% below the federal poverty level) on out-of-pocket health expenses, or whose deductible consumed 5% of their income. The report found that families paid the highest deductibles, and those purchasing their insurance on their own (not through their employer) are more likely to be under-insured.
Health Insurance “Options”
Last Sunday, a piece in the Wall Street Journal took a strong stand against a public health insurance option. The writer complains that government–namely Democrats–will coerce consumers from private insurance to government insurance until a public option is the only ‘option’ left.
Kudos to Our Bodies Ourselves Executive Director Judy Norsigian who, in response, highlights the fact that a single-payer plan is routinely overlooked as an option, and that oftentimes it is the private insurers who do the coercing, denying consumers full adequate coverage.
Compromise on Public Plan Within Reach
Nancy-Ann DeParle, director of the White House Health Reform office, said on Wednesday that a compromise on a government-sponsored public health option is within reach. 
The announcement of the possibility of a public plan has alienated and angered many Republicans, but DeParle insists there are ways of bridging gaps. The public plan could pay hospitals and doctors rates similar to those that private insurers pay, rather than paying lower prices for medical services and forcing private insurers out of business by offering consumers lower premiums. This would still cut costs, as the government would not need to turn a profit, and it would cut down on administrative expenses.
The ideological fears are harder to assuage. But, though many Americans may not realize it, the government already pays for almost half the nation’s healthcare anyway, covering seniors, poor families, and many children. Obama has proposed a plan to expand this to middle class workers and their families, via a purchasing pool through which they could enroll in a public plan if they choose.
Obama has remained vague on the details, which make all the difference, leaving himself open to compromise. If open to all individuals and employees, and offering hospitals and doctors Medicare rates, the public plan could phase out private insurers. But if open to individuals and small businesses only, and offering similar rates as private insurers, the public plan’s impact would be limited and ultimately help those who currently have difficulty getting coverage.
For the full article click here
Screening of “Unnatural Causes”
Join NARAL Pro-Choice NY for a screening of Unnatural Causes, the PBS documentary series on racial and socioeconomic inequities in health, from 4-6 pm on Friday, May 1, 2009.
The official website for the series provides more information about the topics that are covered: http://www.unnaturalcauses.org. The segments watched will explore the health connections between racism and birth outcomes as well as how the economy affects healthy bodies.
The screening will be followed by a discussion on issues of health inequities in reproductive health and potential solutions that reproductive health organizations can utilize.
Everyone who plans to attend must RSVP to pawatramani@prochocieny.org by Friday, April 24th.
The office is located at 470 Park Avenue South, 7th Floor between 31st Street and 32nd Street and is very close to the 6 train subway station at 33rd Street.
Raising Our Voices in Madison, WI and Atlanta, GA
In Atlanta, RWV co-founder and NWHN ED Cindy Pearson will participate in shaping our vision of health reform on Wednesday, April 29, 2009 at 6 pm at Agnes Scott College. This event is free and is co-sponsored by Sistersong Collective, Feminist Women’s Health Center, the local chapter of National Council of Jewish Women and many more! For more information call 404-756-2680.
In Madison, the Wisconsin Alliance for Women’s Health is joining with Planned Parenthood Advocates of Wisconsin and Raising Women’s Voices to host a Women’s Health Day of Action on Tuesday, April 28, 2009.
There is a $25 fee for this event ($10 student/limited income; scholarships available). Register here. For more information call RWV regional coordinator Sara Finger at 866-399-WAWH.
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