Update (2:52 p.m.): Final vote — Senate Finance Committee passes health reform bill by a vote of 14-9, with Sen. Olympia Snowe the lone Republican voting in favor.
Update: Public option supporter Sen. Jay Rockefeller will also vote “yes.”
The Senate Finance Committee is expected to vote on health reform legislation proposed by Sen. Max Baucus (D-Mont.) this afternoon or evening. The bill is expected to make it out of committee, but one of the lingering questions had been whether it would pass with or without the support of Sen. Olympia Snowe (R-Maine). It’s no longer a question — Snowe announced she will break with her party and support the Finance Committee bill.
“Is this bill all that I want? Far from it,” Snowe said. “Is it all that it can be? Far from it. But when history calls, history calls.”
She noted that consequences of inaction “dictate the urgency of Congress to take every opportunity to demonstrate its capacity to solve the monumental issues of our time.” (Listen to Snowe’s full statement at NPR.)
There’s no guarantee Snowe will vote for future versions of the legislation, and it remains to be seen how much Democrats will have to bend to keep the Maine Republican on board.
For more from today’s committee vote, Katherine Q. Seelye is live blogging at The New York Times blog Prescriptions.
More healthcare reading:
- “As the manipulation, posturing and bickering over health reform led primarily by conservative male congressional leaders, pundits, anti-choice organization leaders and ‘anti-reform town hall’ groupies drones on, the Democratic women of the Senate stepped up,” writes Jodi Jacobson at RH Reality Check, describing the actions of eight female senators last week.
“The Senators’ obvious frustrations — and even anger — at the slow progress on health reform legislation, the fact that untold numbers of Americans continue to become ill or die due to lack of timely health care, and the political games being with played reproductive health services was refreshing, frank, and long overdue,” continues Jacobson.
- Clark Hoyt, The New York Times public editor, on Sunday provided a behind-the-scenes look at the newspaper’s approach to covering health care reform, and he explained new features created to help readers understand the policy debate. In addition to the Prescriptions blog mentioned above, OBOS readers may also be interested in a new online forum, Health Care Conversations, which invites readers to comment on 20 healthcare-related topics, including popular conversation starters such as the public option and single-payer healthcare. Less busy is the forum on women and healthcare.
Chronic fatigue syndrome (CFS) is a somewhat mysterious condition, as while it causes serious impairment, the cause is currently unknown, and there is no known cure. The illness, which is characterized by a constellation of symptoms including incapacitating exhaustion, cognitive problems, nonrestorative sleep, and severe exercise intolerance (when exercise makes symptoms worse), is thought to occur 4 times more frequently in women than in men. A new paper published by the journal Science suggests an association between chronic fatigue syndrome and a virus previously associated with prostate cancer. The virus in question is xenotropic murine leukemia virus-related virus (XMRV).
For the study, the researchers examined samples from 101 patients with chronic fatigue syndrome and 218 healthy controls to see if they could detect the virus. They were able to detect the virus in 67% of those with CFS, and 3.7% of controls, leading them to conclude that the virus is perhaps somehow associated with the disease.
The link between XMRV and either prostate cancer or chronic fatigue syndrome is not fully understood and may not be causative. The authors of the current study themselves conclude with several questions about whether the virus is a causal factor for CFS or simply more readily hosted in immunosuppressed patients. In a commentary on the findings for Science, two authors write:
There is still much that we do not understand. Whether the virus plays a causative role in either chronic fatigue syndrome or prostate cancer is unknown. For example, XMRV infection might, coincidentally, be more frequent in the same geographical region as a cluster of patients with chronic fatigue syndrome. And individuals with either disease might be more readily infected due to immune activation.
The research team plans further investigation into the association, including whether – because both are a type of virus called a retrovirus – drugs for the treatment of HIV may have some effect against CFS.
The latest newsletter from Women and Their Bodies (WTB), an Israeli-Palestinian initiative that is adapting “Our Bodies, Ourselves” into Hebrew and Arabic (see our previous post), includes this update:
We continue to undergo the massive and vital task of creating local and culturally adapted Hebrew and Arabic editions of ‘Our Bodies, Ourselves’ (OBOS). Women and Their Bodies is fortunate to have generous an unbelievable network of over 300 devoted women volunteers giving of their time and their skills towards the writing, editing, research, etc. of the book.
We are women from a wide spectrum of Israeli society, including religious, progressive and secular women of the Muslim, Christian and Jewish communities around the country. We come from a wide range of backgrounds and specializations: psychologists, facilitators of women’s groups, gynecologists, midwives, sexologists, gender and social studies researchers and more. We are all activists, each in our own way, promoting women’s equality, justice and human rights.
After 4 years of hard work, out of the 32, 20 Hebrew chapters are complete and 12 in various stages of preparation. 10 Arabic chapters are complete and 22 in various stages of preparation. The book in Hebrew shall be published in June 2010. Initially we intended to publish the Arabic edition a year after that. Instead, we have decided to publish the Arabic in three parts. The first part, including 10 chapters shall also be published in June 2010. We feel that it is essential to get this information out in the first part due to the general lack of accessibility to information of this kind within the Palestinian community.
WTB’s online information and action center, http://wtb.org.il/, is scheduled to go live this month. It too, will feature information in both Hebrew and Arabic.
Want to help support this project? WTB is raising support for the book by offering “social stock” in their organization. Your investment of $150 includes a copy of the Hebrew edition of “Our Bodies Ourselves” and printed acknowledgement of your investment in the the book. Secure online donations can be made here. Tax deductible donations can be made by check, payable to: The New Israel Fund. On the memo line, please write “for Women and Their Bodies” and the NIF identification number, 5459. Mail checks to NIF / P.O.Box 91588 / Washington, D.C. 20090-1588
The vote on the Senate Finance Committee health reform bill has a date: Tuesday, Oct. 13.
The decision comes one day after the Congressional Budget Office reported that the committee’s legislation would cover 29 million uninsured Americans but would still slow the growth of spending and would reduce deficits by a total of $81 billion over a decade.
“Despite the expansion of coverage at a cost of $829 billion over 10 years, the budget office said 25 million people — about one-third of them illegal immigrants — would still be uninsured in 2019,” reports The New York Times. “In all, it said, the proportion of nonelderly Americans with insurance would rise over the 10 years to 94 percent, from 83 percent today.”
Meanwhile, House Speaker Nancy Pelosi (D-Calif.) today said that she’s going to send the CBO multiple variations of a health care bill that combines legislation from three different House committees. Ben Pershing at the Washington Post writes:
Pelosi said Thursday that she would send one bill to the CBO with what she called a “robust public option,” that would reimburse health-care providers at 5 percent above Medicare rates. The other two versions would have rates negotiated between the government and providers. “There’s no question that the robust public option scores very well,” Pelosi said, emphasizing that the first version would cost less but acknowledging that it might not be able to garner the 218 votes needed for passage. (Democrats hold 256 seats in the House.) “It’s very close,” she said.
Despite that split in her caucus, Pelosi said she felt “we’re in a very good place, because we have many good options. … There will be the votes for a public option. Now it’s a question of which one.”
After Pelosi gets the CBO’s analysis back, Democratic leaders and the House Rules Committee will complete the job of assembling a bill for floor consideration. The leadership has already ruled out bringing a bill to the floor next week, so the week of Oct. 19 would be the earliest time a vote would occur.
Speaking of a government-run insurance option, a new Qunnipiac University poll shows public support is running 2-to-1, with 61 percent in favor and 34 percent opposed. Other findings: “By a 57-37 percent margin, voters say Congress should not approve a health care overhaul with only Democratic votes. Democrats are OK with a one-party bill 63-29 percent, but opposition is 88-9 percent from Republicans and 62-32 percent from independent voters.”
* Health Care Bills Tackle Gender Gap in Coverage: USA Today reports on efforts to include provisions in health care legislation that would ban insurance companies from charging women more for the same policies as men and require companies to provide maternity coverage in their basic plans.
See our previous coverage on this subject, featuring the best line of the 2009 HCR debates: The response by Sen. Debbie Stabenow (D-Mich.) to Sen. John Kyl (R-Ariz.) when he questioned why maternity coverage should be mandatory when he doesn’t need it — “I think your mom probably did.”
* Health-Reform Anxiety: One Doctor’s Perspective: Anne Brewster, an internist and instructor in medicine at Harvard Medical School, left primary care medicine because she says she “felt unable to care for patients the way I wanted to within the constraints of the current system.”
Now an an urgent-care provider in Boston, Brewster, who is also an Our Bodies Ourselves board member, has written an essay for WBUR public radio on whether health reform will empower doctors.
“Reform should make my job more, not less, satisfying,” writes Brewster. “Of course, doctors should be expected to offer the highest quality care in the most cost-effective manner, but policies must be built on a foundation of trust in physician motivation and competency. Most physicians have a sound knowledge base, and are driven by a genuine desire to take care of people and ‘do no harm.’ Professional autonomy must be protected. Instead of imposing mandates and restrictions from above like an authoritarian parent, policy makers should work to provide physicians with the tools to meet these expectations.” Continue reading …
We have written in recent months about the inclusion of money for comparative effectiveness research (CER) in the stimulus bill, the call for comments as to priorities for that research, and the subsequent list of priorities for funding of that research.
Comparative effectiveness research and the associated process isn’t always easy to explain, though, and was the focus of some drama when the stimulus bill was debated, with some arguing that the research would lead to rationing of care.
To help understand the topic, the Kaiser Family Foundation has released a brief on the topic, Explaining Health Reform: What is Comparative Effectiveness Research?. The document reviews the purpose of CER, recent federal actions, and where/how it is included in proposed health reform legislation. It also provides discussion of key questions such as whether this type of research should include cost (in addition to clinical efficacy), how the results will be disseminated, and how those results might affect coverage decisions and health care costs.
The National Partnership for Women and Families is also addressing this topic with their Myths & Facts about Comparative Effectiveness Research [PDF]. It responds to some ideas about CER such as whether the research might lead to rationing of health care, “one size fits all” medicine, or exclusion of special or minority populations, and whether drug and device makers might lose the incentive to create new treatments.
The Kaiser Family Foundation has also released a second brief on health care reform, Health Reform: Implications for Women’s Access to Coverage and Care. It discusses women’s access to insurance through various avenues and benefits of importance to women including preventive, reproductive health, and long-term care, providing relevant information about the current state of women’s access to care and where improvements might be made via health reform.
Full disclosure: one project I contribute to in my work is funded through the AHRQ, an agency which receives some of the comparative effectiveness dollars included in the stimulus package.
As an Our Bodies, Our Blog reader, you know that the specific interests of women and health are intricately connected to broader issues of social change. For just this reason, OBOS has been a proud, longtime member of Community Works, a cooperative fundraising effort involving more than 30 Massachussetts social justice organizations.
Community Works is currently offering a special incentive that I wanted to share with our Massachusetts friends. You might be able to directly support OBOS’s work without even making a donation yourself.
Community Works receives donations largely through the convenience of payroll deductions at 52 private, public and nonprofit employers in the greater Boston area, representing more than120,000 employees. Such payroll deduction contributions to Community Works help to support the work of member organizations such as OBOS.
Any member group that enlists a new workplace that will offer Community Works as one of its employee charitable giving options will receive half of the proceeds of the first year’s campaign. So if you help OBOS enlist a new employer, you will help raise valuable funds for OBOS in the coming year.
The set-up is simple: Visit the Community Works website to see where campaigns are already underway. Then contact your friends in workplaces that don’t already offer Community Works as a charitable option. If you know anyone who can help bring Community Works to their workplace, please email me: judy (at) bwhbc (dot) org
If we are successful in securing the workplace you suggest, OBOS co-founders (myself included) will send inscribed copies of any of OBOS’s books to the person or institution of your choice.
This is a wonderful opportunity for those of you who value what OBOS does to provide concrete support to both our organization and the other social change groups that are part of Community Works. Whether working to address environmental justice, sexual assault, youth and community violence or health care access, each Community Works member operates within a framework of equality, justice and peace.
Remember, it takes a village and more to sustain the work of public interest organizations like ours. Take a look at the current employer partner list and let us know who’s missing. Your help with this effort is much appreciated!
Judy Norsigian is executive director of Our Bodies Ourselves.
The horror of rape as a weapon of war in Africa is all too common. Just in Congo, hundreds of thousands of women have been raped in the last 10 years, their stories documented by award-winning radio programs, ongoing news stories and even an HBO documentary.
International awareness and outcry against these crimes is not always swift or widespread. But an attack last month by government troops on women in Conarky, Guinea seems to be drawing a quick response.
Photos of the brutal crimes, which took place during a peaceful stadium rally protesting Guinea’s ruling military junta, are circulating on cell phones, and today The New York Times published a horrific account based on interviews with witnesses and women who had been assaulted:
“I can’t sleep at night, after what I saw,” said one middle-aged woman from an established family here, who said she had been beaten and sexually molested. “And I am afraid. I saw lots of women raped, and lots of dead.”
One photograph shows a naked woman lying on muddy ground, her legs up in the air, a man in military fatigues in front of her. In a second picture a soldier in a red beret is pulling the clothes off a distraught-looking woman half-lying, half-sitting on muddy ground. In a third a mostly nude woman lying on the ground is pulling on her trousers.
The cellphone pictures are circulating anonymously, but multiple witnesses corroborated the events depicted.
The attacks were part of a violent outburst on Sept. 28 in which soldiers shot and killed dozens of unarmed demonstrators at the main stadium here, where perhaps 50,000 had assembled. Local human rights organizations say at least 157 were killed; the government puts the figure at 56.
But even more than the shootings, the attacks on women — horrific anywhere, but viewed with particular revulsion in Muslim countries like this one — appear to have traumatized the citizenry and hardened the opposition’s determination to force out the leader of the military junta, Capt. Moussa Dadis Camara.
Bernard Kouchner, the foreign minister of France, told the Times France could no longer work with Camara and urged “international intervention.” Camara seized power in a bloodless coup in December. He had promised he would not run in January’s presidential election but has since changed his mind. As the Times notes, growing internal opposition could force Camara to leave power, or the government could become even more authoritarian. Camara contends that members of the opposition, not the military, were responsible for the assaults and killings.
Amnesty International is calling for an international commission to investigate the human rights violations that occurred.
“The perpetrators of these brutal attacks must be identified and brought to justice,” said Erwin van der Borght, director of Amnesty International’s Africa Program. “This can only be achieved through an international inquiry as the Guinean authorities have already been discredited by their lack of political will to carry out a national investigation into accusations of human rights violations by security forces in 2007.”
Rape is a fairly common tool of military repression in Africa, but large-scale violence against women has not been a previous government tactic here. “This time, a new stage has been reached,” said Sidya Touré, a former prime minister who was also beaten at the stadium and said he had witnessed brutalities there. “Women as battlefield targets. We could never have imagined that.”
“Where could people get the idea to start raping women in broad daylight?” Mr. Touré asked, in an interview at his home here. “It’s so contrary to our culture. To molest women using rifle barrels. … ”
While rape as a tool of military oppression is all too common, it previously has not been used as government tactic in Guinea.
“This time, a new stage has been reached,” Sidya Touré, a former prime minister who was beaten during the opposition rally, told the Times. “Women as battlefield targets. We could never have imagined that. [...] Where could people get the idea to start raping women in broad daylight?”
“They especially tore into the women,” François Lonsény Fall, another former prime minister who was also at the stadium, said. “They were seeking to humiliate them.”
The FC2 female condom is a second generation product developed by the Chicago-based Female Health Company. Currently available only to state health agencies and nonprofit organizations, the FC2 will be sold in CVS stores in the Washington, D.C. area starting in December, FHC’s senior strategic adviser Mary Ann Leeper told Reuters.
Washington, D.C. health officials released a report in March showing that at least 3 percent of District residents have HIV or AIDS — a rate that is on par with Uganda and some parts of Kenya.
Female Health Company is looking for a marketing partner to help promote FC2 directly to consumers.
“We need the other company to really make a dent into the consumer market,” said Leeper.
According to the Centers for Disease Control and Prevention (CDC), over the past two decades, the percentage of women among all people living with HIV in the United States has increased from 8 percent to 27 percent. African American women account for 66 percent of new AIDS cases among American women; they are 21 times more likely to contract HIV than white women, while Latino women are five times more likely.
“America’s HIV epidemic isn’t going away. In fact, it’s getting worse, and African American and Latino women are disproportionately impacted,” said Dazon Dixon Diallo, founder and president of SisterLove, a grassroots service organization that supports HIV/AIDS prevention and reproductive health programs for women in the Atlanta area. “It’s time to provide women in heavily impacted communities with expanded access to affordable women-controlled options, and the female condom becomes that choice. Women will use it if they have it.”
Female Health Company says the FC2 is thinner and quieter than its predecessor, the FC1 female condom. The FC2 is made of synthetic nitrile, a latex alternative, so it’s safe to use with both oil and water-based lubricants. Here’s information (pdf) about how to insert the condom. There’s also an animated video demonstration. More resources from FCH are available here.
FHC has also launched a new site, www.fc2femalecondom.com, which includes tiered pricing information for ordering female condoms directly (minimum of 25,000). The maximum price of 82 cents per condom is 30 percent less than the price paid for FC1. A retail price has not been determined.
Though female condoms are not popular in the United States, the FC2 has been available in other countries since 2006. The U.S. Agency for International Development had lobbied for the FDA’s approval — a lengthy and expensive process – so it could be purchased for U.S.-funded global HIV-prevention programs.
A new report released by the Massachusetts Department of Public Health Family Planning Program and Ibis Reproductive Health examines the barriers low-income Massachusetts women face in accessing contraception services since Massachusetts implemented a universal health care bill.
The bill, enacted in 2006, allows low-income residents who are not eligible for Medicaid or Medicare and don’t have insurance through an employer to join one of four government-subsidized private insurance plans. In addition to these government plan options, low-income women without health insurance can also access contraceptive and reproductive health services at sliding-scale fees through family planning clinics and community health centers.
To document the perspectives of low-income women about these services and identify barriers to services (comparing access before and after reform), the researchers reviewed the four public plans to determine how readily a user could understand them and get needed coverage information, surveyed family planning agency staff and conducted in-depth interviews with family planning and clinic staff, and held focus group discussions with low-income women.
Among their findings:
There was no central source of information on contraceptive coverage that would allow a woman to compare whether her method would be covered by each of the four government plans. Although each plan provided information on all drugs covered, it was difficult to search and use.
Providers and women both generally reported easy access to contraception before and after reform, but some women reported experiencing barriers to accessing contraception using a prescription at pharmacies. In some cases, this was because of the pharmacists’ lack of information about the plans’ coverage, and in others there were barriers for the women of time, information, location, and cost. For example, the plans apparently only allow one month of oral contraceptive pills to be filled at a time, creating time/access barriers for some women.
Women and providers felt that some populations – especially immigrants, young women, those with unstable employment or income, and those experiencing life changes – had been “left out” of the benefits for reform, citing problems of ineligibility, changing eligibility, and confidentiality.
In general, women needed more information about contraceptive coverage, how to enroll, and how to document their eligibility for the government plans.
The authors made a series of recommendations, such as better educating providers and pharmacists about coverage under the government plans, developing more user-friendly information about coverage (especially of contraceptives), better supporting family planning clinics, and improving contraception coverage and access (such as allowing receipt of multiple months of hormonal contraception at one time, like 90-day or mail-order options provided by many insurers). Because Massachusetts is currently a unique model for health care reform, these findings may provide points of consideration if a public option is part of the national health care reform.
For more health reform-related discussion, see Christine’s posts on the Healthcare System.
Comedian Chris Rock’s disbelief over the reaction captured our own. During an interview on The Jay Leno Show, Rock cut through the messy rhetoric and exclaimed, “Rape! It’s rape!”
“People are defending Roman Polanski because he made some good movies?” Rock continued. “Are you kidding me? He made good movies 30 years ago, Jay! Even Johnnie Cochran don’t have the nerve to go, ‘Well, did you see O.J. play against New England?’”
As Rock says at the end of the clip: “The United States, we want to capture Osama Bin Laden, and murder him. We don’t want to rape him – that would be barbaric!”
Rape is a barbaric act.
And I’m amazed it took a comedian to say it outright.
So am I. Yet while I want to cheer Rock on, a quick search shows that in 2001, when a woman accused Rock of rape (after first claiming she was pregnant with Rock’s child, which proved to be false), Rock turned to Anthony Pellicano, one of Hollywood’s sleaziest private detectives.
Their conversation, which came to light during Pellicano’s 2008 trial on charges of wiretapping and racketeering, was excerpted on Gawker. Pellicano describes how he would ruin the woman, and his comments are pretty ugly. As for Rock, Ryan Tate sums it up at Gawker: “For most of the call, Rock sounds annoyed and aloof, if shifty about his story. But however annoyed he might sound, he is the one who hired this guy.”
Compiled by Anna Clark, who blogs at Isak, these texts cover not only the basics, but the complex policies and politics surrounding birth control, gender, race, abortion, adoption and more. From the introduction:
If we can agree that few teens learn about sexuality in an accurate, age-appropriate, and comprehensive way, then where does that leave adults who came through the same school systems they did? Many of us are still full of questions that we aren’t quite sure how to articulate. Few can claim that they’ve figured sex — and its social influence — out.
If you want to graduate to the next level of sexual health, pleasure, and social awareness, now’s your chance. Get yourself schooled with a crash course in sex ed for adults. From orgasms to organs, from contraceptives to court decisions, look to the reading list below for the can’t-miss books and articles about sex.
The health care reform debate hasn’t been encouraging for reproductive health advocates, but on Wednesday the Senate Finance Committee pushed back against a Republican amendment designed to “doubly triply restrict abortion coverage in the bill,” as Rachel Maddow described it last night.
Republican Olympia Snowe of Maine joined almost all of the Democrats to defeat the amendment 13-10. Sen. Kent Conrad of North Dakota, a Democrat, voted for the restrictions along with the rest of the Republicans. Robert Pear of The New York Times explains the framework of the amendment:
The bill, written by the chairman of the Finance Committee, Senator Max Baucus, Democrat of Montana, says that no tax credits could be used to pay for abortions except as allowed in the latest appropriations for the Department of Health and Human Services — in case of rape or incest or if the life of a pregnant woman was in danger.
Under the bill, some health plans would cover abortion, and some would not. Private insurers that chose to cover abortion would be required to segregate money, taken from private premiums, to cover the procedure.
The amendment, offered Wednesday by Senator Orrin G. Hatch, Republican of Utah, would have gone much further. It said that no money provided under the legislation could be used to pay “any part of the costs of any health plan that includes coverage of abortion,” with a few limited exceptions. Under the proposal, insurers could have offered “a separate supplemental policy” to cover abortions. Such policies would have been financed “solely by supplemental premiums paid by individuals choosing to purchase the policy.”
Once again, Sen. Debbie Stabenow (D-Mich.), who demonstrated last week during a debate about pregnancy coverage that she is a no-nonsense force to be reckoned with, fired back against treating women as second-class citizens. She argued that the amendment goes far beyond existing law, which already prohibits spending federal dollars to pay for abortions for women on Medicaid, and it would restrict access to abortion for all women. Here’s my transcript of the video above:
In fact, with all respect to my friend, as a woman, I find it offensive that in [this amendment], any woman, any family purchasing through the exchange — if they did not receive any tax credit — would be prohibited from having the full range of health care options that they may need covered. This doesn’t just refer to the tax credits. As I read this: “prohibit private insurers operating through the exchange from offering coverage” — this is an unprecedented restriction on people who paid for their own health care insurance.
Then, when we look at the fact that this offers, that people could have a supplemental single-service rider, the assumption that somehow a woman or family would say, “You know, some day we may have an unintended pregnancy, so we’re going to get a separate rider. Or maybe my pregnancy is going to have a crisis — many, many crises — and so we’re going to try to find some other rider.”
In my judgment, I don’t even know how that would work. In the few states that have tried to do that, there’s no evidence that even those kinds of riders are available.
It’s remarkable that discussions about abortion conveniently leave out that it is a legal, medical procedure. Or that one in three women will have had an abortion by age 45. Or that three-fourths of women who obtain an abortion say they cannot afford to have a child. Or — as we saw in the weeks after the murder of Dr. George Tiller, when women stepped forward to reveal their stories — the decision is sometimes heartbreakingly, medically necessary.
We’re not the only ones frustrated by the way abortion has turned into a wedge issue for health care reform.
“In a rational system of medical care, there would be virtually no restrictions on financing abortions,” reads an editorial published in today’s New York Times. ”But abortion is not a rational issue, and opponents have succeeded in broadly denying the use of federal dollars to pay for them, except in the case of pregnancies that result from rape or incest or that endanger a woman’s life.”
“There should be no restrictions on abortion coverage in the exchanges,” the editorial concludes. “Health care reformers should not retreat on this issue, but we recognize that principle is often sacrificed in Congressional bargaining. Democrats who support the compromise must find a way to prevent it from being used later to go after other tax subsidies and thus further deny Americans’ rights to make their own health-care decisions.”
Hatch put forth a second amendment to strengthen existing “conscience clause” laws protecting healthcare workers from performing abortions or other services to which they have moral or ethical objections. It also failed on the same on the same 10-13 margin; Snowe voted with the Democrats, and Conrad with the Republicans.
Funding for Abstinence Only Education
On Tuesday night, the committee approved a comprehensive sex education funding stream, the Personal Responsibility Education for Adulthood Training. That amendment, proposed by Baucus, provides $75 million for states, according to the Sexuality Information and Education Council of the United States (SIECUS), “$50 million of which would be geared to evidence-based, medically accurate, age-appropriate programs to educate adolescents about both abstinence and contraception in order to prevent unintended teen pregnancy and sexually transmitted infections, including HIV/AIDS. The remaining funds would be for innovative programs as well as research and evaluation.”
Snowe joined all Democrats in passing the amendment; the vote was 14–9.
Yet on the same night, the committee voted for an amendment introduced by Hatch to restore federal funding for abstinence-only education — “better known,” said Maddow, “as the best teen pregnancy and STD delivery system politicians have ever devised.”
Democrats Conrad and Blanche Lincoln of Arkansas joined all 10 Republicans on the Finance Committee to vote in favor of adding $50 million-a-year funding for the Title V abstinence-only program to the health care bill, despite the fact that President Obama’s 2010 budget eliminated funding for abstinence-only education programs — because they simply don’t work.
Even Texas got the message. The state that ranks first in spending on sexual abstinence has the third-highest teen birth rate in the country and the highest percentage of teen mothers giving birth more than once. As the Austin American-Statesman reported on Sunday, some school districts are giving up the abstinence-only model and adopting a more comprehensive sex education curriculum, also called “abstinence-plus.”
Both amendments still have to pass the full House and Senate, so it’s anyone guess where the dollars will fall, but SEICUS is optimistic that legislators will wake up and reject the abstinence-only funding.
“This amendment takes a giant step backward by restoring funding for the failed and discredited abstinence-only-until-marriage program for the states,” said William Smith, vice president for public policy at SEICUS. “However, because this program so clearly doesn’t work and half the states don’t even participate, we are confident it will be stripped from the final bill and ask Congressional leaders and the White House to ensure this happens.”
The American College of Obstetricians and Gynecologists has recently released findings from its 2009 Survey on Professional Liability, which asked practicing ob/gyns and ob/gyn residents if and how their practices have been affected by liability concerns. Respondents were asked whether they had made any practice changes since January 2006 because of the affordability or availability of professional liability insurance, or because of fear of liability claims or litigation.
Among the findings, 59.2% (of 5,644 respondents) reported having made one or more changes to their practice since 2006 for reasons related to the availability and affordability professional liability insurance. Of those reporting making changes for this reason, 19.5% reported increasing the number of cesarean deliveries and 19.5% indicated they stopped performing or offering VBACs.
In addition to making changes based on the availability and affordability of insurance, many ob/gyns report having made changes to their practices because of fear of professional liability or litigation (in other words, out of fear of being sued or being held responsible for a negative outcome). 62.9% (of the 5,644) reported having made one or more changes to their practice for this reason. Of those, 29.1% reported increasing the number of cesarean deliveries, and 25.9% stopped offering and performing VBACs. 20-30% (depending on whether the question was about availability of liability insurance or fear of liability claims) also reported decreasing the number of high-risk obstetric patients they cared for.
These findings probably don’t surprise many birth advocates, who have expressed concern that ob/gyns are limiting women’s birth options for reasons other than medical evidence and an individual woman’s preferences.
For more discussion of this topic, see Why is Maternity Care Like This?, an excerpt from “Our Bodies, Ourselves: Pregnancy and Birth.”
The Senate Finance Committee today rejected two proposals to add a public option — a government-sponsored insurance policy that would compete with private plans — to the health care reform bill put forth by Senator Max Baucus (D-Mont.).
David M. Herszenhorn of The New York Times writes:
The committee on Tuesday afternoon voted, 15 to 8, to reject an amendment proposed by Senator John D. Rockefeller IV, Democrat of West Virginia, to add a public option called the Community Choice Health Plan, an outcome that underscored the lack of support for a government plan among many Democrats.
Mr. Baucus voted no, as did Senators Thomas R. Carper of Delaware, Kent Conrad of North Dakota, Blanche Lincoln of Arkansas, and Bill Nelson of Florida, joining all 10 Republicans in opposition.
A second amendment by Senator Charles E. Schumer, Democrat of New York, to create a different version of a public plan was also defeated, though by a closer margin, 13 to 10, with the added support of Mr. Carper and Mr. Nelson.
Mr. Schumer who voted in favor of both proposals, said supporters of the public option would keep on fighting.
“We are going to keep at this and at this and at this until we succeed, because we believe in it so strongly,” he said.
This story in The Hill on the public option was published before today’s vote, but it’s worth reading for a look at the compromise Senate Majority Leader Harry Reid (D-Nev.) will try to forge between what emerges from the Finance Committee and the Senate’s Health, Education, Labor and Pensions Committee bill, which includes a strong public option. Polls show solid public support for a public option.
Plus: Have you seen this video of Robert Reich explaining the public option? He’s quite clear and concise.
Women received a serious wake-up call Friday when Sen. John Kyl (R-Ariz.) questioned why his insurance should include maternity care. A comment left on my post asks, “Why require this in EVERY plan? Won’t that just raise costs? Men don’t need it, working feminist women who don’t have children certainly don’t either.”
Hmmm. Without taking that bait, I will say that the commenter, as well as the senator, apparently is unaware that insurance works on pooling of risks. While it might be interesting to see what Kyl’s personal a la carte health insurance plan might look like, such individual choice would not be practical or affordable so long as insurance companies seek to maintain the same level of profit. Not to mention that what one person thinks he or she needs today can change overnight. Can you imagine all the “pre-existing condition” denials?
There’s also the issue of wanting to improve health outcomes for all mothers and children, but clearly that’s not Kyl’s priority.
Already, insurance carriers are free in most states to charge women and men different premiums for individually purchased insurance under a practice known as gender rating, as this report (pdf) from the National Women’s Law Center explains.
Nancy Folbre, an economics professor at the University of Massachusetts, Amherst, notes that women are often discriminated against when they try to buy individual health insurance, in part because pregnancy and family planning require more health care. “The typical American woman who wants to have two children will spend about five years being pregnant, recovering from pregnancy or trying to get pregnant, and about 30 years trying to avoid unintended pregnancies,” Folbre writes in a post at the The New York Times Economix blog.
Maternity isn’t the only way in which women are penalized. Looking at health care coverage over a lifetime, Folbre makes a clear case for why reform is essential for women, starting with the point that for many women, their insurance is tied to their husband’s work. A job loss or divorce leaves them vulnerable to having no insurance. (This is one of the reasons Our Bodies Ourselves is in favor of a single-payer system, because coverage would be independent from marriage or employment.)
Folbre continues:
Although fewer adult women than men lack health insurance, they seem to be more affected by insurance-related problems, including inadequate coverage. A Commonwealth Fund study released last May found that about 52 percent of working-age women, compared to 39 percent of working-age men, reported in 2007 that they had to forgo filling a prescription, seeing a specialist, obtaining a recommended medical test or seeing a doctor at all as a result of medical costs.
In striking testimony to financial vulnerability, more than one-half of all bankruptcies related to medical costs in the United States in 2007 were filed by female-headed households.
Women in their 50s and early 60s who are married to older men face a distinctive risk — loss of access to their husband’s employer-related coverage when he makes the transition to Medicare but they are not yet old enough to be eligible. The resulting disruption in coverage often has adverse effects on their health.
Women are important health care providers as well as consumers. Over 59 percent of informal, unpaid caregivers are women, and women devote significantly more time to the care of sick, disabled and elderly family members than men do. Indeed, such commitments help explain why women are more likely than men to work part time and to exit the paid labor force for longer periods of time.
You’re so right! Thanks for this well-written commentary. Women’s health activists have known all this for a long-time & many of us are organizing in support of health reform. Remember Our Bodies, Ourselves? They’re just one of many women’s health groups working on this issue. Check out Raising Women’s Voices for the Health Care We Need, SisterSong, National Women’s Health Network and others.
Plus: In other health care news today –
* Katherine Seelye is live blogging the Senate Finance Committee debate on the public option. Democratic senators Charles Schumer of New York and David Rockefeller of West Virginia have proposed separate public option amendments (view Rockefeller’s and Schumer’s, both pdf’s). The debate was postponed from Friday. You can watch live here.
* David Kirkpatrick writes about how the health care reform debate has become a fight over abortion.
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