We have reached The Summit.

Thursday’s bipartisan meeting at the White House (which you can follow live) promises to kick-start what may be the final descent toward healthcare reform. An overview:

Does healthcare reform have a chance? Is bipartisanship a real possibility? David Leonhardt of The New York Times provides some provisional answers.

Igor Volsky over at the Wonk Room brings us up to speed by providing a nice, clear comparison of the House bill, the Senate bill and President Obama’s new proposal.

As far as questions women should be asking about their stake and status in the debate, Lisa Codispoti and Brigette Courtot at the National Women’s Law Center remind us of the “8 Questions” they have been asking all along — and how Obama’s proposal addresses (or fails to address) the issues.

Writing at Raising Women’s Voices, Amy Allina identifies ways in which Obama’s proposal builds on the Senate bill but also notes that it  “does not include the changes that Raising Women’s Voices has been urging Congress to make to the restrictive abortion provisions in [the Senate] bill” — namely by eliminating the requirement that policyholders make two separate monthly payments if they want a policy that includes abortion coverage.

It’s also worth taking a look at The National Partnership for Women and Families’ “The Top Ten Best Kept Secrets About Health Insurance Reform and Why Congress Should Pass It Without Delay” [pdf].

Finally, this is politics, and political agendas and expediency can often trump what’s right. Brian Beutler and Christina Bellantoni at Talking Points Memo dissect each party’s strategies, and Ezra Klein at the Washington Post provides a viewer’s guide.

All of this may come down to an arcane Senate procedure known as reconciliation. David M. Herszenhorn at The New York Times offers a primer.

When you feel yourself getting tired of all the red tape, get a pep talk from Ellen Schaffer and Joe Brenner at EQUAL/Center for Policy Analysis, whose PowerPoint — “The Truth About Health Reform: It’s Up to Us” — helps to put priorities in order.

Publicado por Rachel / del orginial en inglés: January 21, 2009

OBOS is committed to expanding our audience and in this spirit we’ve asked former board member Moises Russo to translate into Spanish several of our blog entries. We hope to translate more entries in the coming year.

En OBOS estamos comprometidos a expandir nuestra audiencia de lector@s  y en este espíritu le hemos solicitado a Moisés Russo, ex-miembro de la Junta de OBOS, que traduzca al español varios de los blogs que tenemos en la página electrónica. Esperamos continuar con dichas traducciones durante este año.

Un informe dado a conocer este mes por el Instituto Southwest de Investigación sobre las Mujeres y el James E. Rogers Collage de Derecho en la Universidad de Arizona, ha expresado preocupación por el trato a mujeres que se mantienen en centros de detención de inmigración en Arizona.

El informe “Prisioneras Invisibles” (PDF), describe condiciones en tres instalaciones penitenciarias de Arizona. La información fue obtenida a través de entrevistas llevadas a cabo con mujeres actual y anteriormente detenidas en las instalaciones y a abogados y proveedores de servicios sociales “que han trabajado de cerca con mujeres detenidas en el estado”.

Las demoras en recibir servicios médicos, cuidados inadecuados, y la falta de atención a los asuntos de salud mental son algunos de los problemas descritos. Los alegatos incluyen la negación de una bomba mamaria (sacaleche) a una mujer que se encontraba separada de su lactante, el rechazo a proveer vitaminas prenatales, una mujer con cáncer cervicouterino con meses de espera para poder ser atendida por una enfermera y una mujer que había sido víctima de mutilación genital femenina y que estaba teniendo dolor abdominal severo a la cual se le dijo que debía “ejercitarse y cuidar su dieta”, cuando la verdadera causa del dolor era un gran quiste que necesitaba extracción quirúrgica.

Según un artículo del New York Times en el informe, “Katrina S. Kane, quien dirige las operaciones de detención y remoción para la Autoridad de Seguridad  de Inmigración y Aduanas de Arizona, descarto el estudio como declaraciones faltas de evidencias de un número limitado de detenidas y sus abogados”.

Ella también afirmó que las denuncias de que una detenida no había recibido tratamiento para cáncer cervicouterino son falsas. Según el Times, un abogado de inmigraciones que tomó parte en el estudio “contrarrestó que las entrevistas con detenidas y mujeres anteriormente detenidas y sus abogados corroboraron el patrón de maltrato endémico”.

Last week, Raising Women’s Voices and Women of Color United for Health Reform delivered a letter [PDF] to House Speaker Nancy Pelosi, Senate Majority Leader Harry Reid and several committee chairs on health care reform. The letter — signed by Our Bodies Ourselves and many other supporting organizations — thanks these leaders for their support of healthcare reform and provides recommendations related to women’s health for inclusion in the final legislation.

The signing organizations believe that the final legislation must not add new barriers or burdens to women’s access to abortion coverage and should eliminate the controversial Nelson/Stupak amendments. Instead, they argue, the legislation should return to the Capps amendment [PDF], which “preserves the ban on use of federal funds for abortion coverage, but does not exclude abortion from private insurance policies for which women will be using their own funds.” (See the Planned Parenthood Action Center for a good discussion of the three provisions.)

The groups also recommend a requirement that women’s preventive health services and screenings be covered without co-pays or deductibles; coverage of more people through expansion of Medicaid eligibility; establishment of an “exchange”; coverage for legal immigrants without a five-year waiting period; and making coverage more affordable while keeping penalties for violating coverage mandates less burdensome for low-income people.

The letter also expresses support for expansion of translation/language services; bringing Medicaid payment rates up to the same level as Medicare payments (in order to increase the number of providers accepting Medicaid); and a mandate that all Health and Human Services agencies collect data on ethnicity and primary language along with gender, race and other categories .

RWV is also running a cartoon postcard campaign to encourage people to contact their legislators and express their dissatisfaction with current versions of health care reform.

Related: The Center for Reproductive Rights recently released a video questioning the singling out of abortion for restriction in health reform legislation. The video asks what else an individual might not want to pay for with their own tax dollars. Watch it below, or read the transcript at Feministe.

That’s the topic of this live, interactive webcast, scheduled for today – Wednesday, Dec. 16 — at 1 p.m. ET.

Sponsored by the Kaiser Family Foundation, the webcast will examine aspects of the current Senate and House health reform bills that particularly affect women of color, who face additional health and access challenges.

You can join the live webcast here. An archived version, as well as a podcast and transcript, will be available later today.

Today’s panel will also address provisions in the bills that would affect access to and coverage of abortions, and recent findings from the U.S. Preventive Services Task Force.

Cara James, KFF senior policy analyst on race, ethnicity and health care, will moderate the discussion with:

• Alina Salganicoff, Ph.D., vice president, director, Women’s Health Policy, Kaiser Family Foundation
• Judy Waxman, J.D., vice president of Health and Reproductive Rights at the National Women’s Law Center
• Paula Johnson, M.D., M.P.H., executive director of the Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital and associate professor of Medicine, Harvard Medical School

Panelists will take questions before or during the live program. Send questions to ask [at] kff.org.

The webcast is part of KFF’s series examining current issues in health disparities.

Last week, TPMMuckraker ran a story by Zachary Roth, “Drug-Makers Paying Off Competitors To Keep Cheap Generics Off Market,” about the deals (sometimes called “reverse payment settlements” or “reverse settlements”) made between drug companies in order to keep generic drugs off the shelves after the original patents protecting the brand name drugs have expired.

As Roth explains:

When a generic drug is approved to come to market, the maker of the more expensive name-brand drug sues the generic for patent infringement. But instead of a conventional settlement, in which the generic pays the patent-holder to settle the claim that it infringed the patent, the payment goes the other way: the patent-holder pays the maker of the generic, in exchange for a pledge to delay bringing the generic to market.

As a result of these “pay-for-delay” deals, cheaper generic drugs are often kept off the market for a longer period than they otherwise would be.

While the TPM story doesn’t mention any drugs specific only to women’s health, Prescription Access Litigation provides at least one relevant example — a patent litigation/generic case from the late 1990s over the breast cancer drug Tamoxifen. The Centers for Disease Control and Prevention estimates that 46 percent of Americans used at least one prescription drug in the past month, so many consumers (male and female) are affected by drug prices on a regular basis.

There’s been little action in recent years on proposed legislation to prevent such deals. The “Protecting Consumer Access to Generic Drugs Act of 2009″ — HR 1706 — was introduced earlier this year by Rep. Bobby Rush (D-Ill.), and so far, like similar bills introduced the past, it has not made it past the committee stage.

The House Subcommittee on Commerce, Trade and Consumer Protection held a hearing on the proposed legislation in March and apparently referred the bill on to the full Committee on Energy and Commerce, which does not seem to have considered it.

The Federal Trade Commission has also come out against the practice. FTC Chairman Jon Leibowitz said during a talk at the Center for American Progress in June that ”American consumers would save $35 billion dollars over the next decade if these deals were banned.”

This past summer, the Department of Justice weighed in on one such case and concluded: “a settlement involving a payment to the alleged drug patent infringer in exchange for its agreement to withdraw its challenge to the patent and delay bringing its generic drug to market is presumptively unlawful and requires the defendant to offer justifications in order to avoid antitrust liability.”

The passage is bittersweet, but finally it’s done … With 6:51 time remaining to vote, Democrats have secured the 218 “yea” votes needed to pass the Affordable Health Care for America Act (HR 3962).

Final tally 220-215; 39 Democrats voted “no.” One Republican — Rep. Joseph Cao, who represents the New Orleans area — voted “yea.”

“Democrats have sought for decades to provide universal health care, but not since the 1965 passage of Medicare and Medicaid has a chamber of Congress approved such a vast expansion of coverage,” reports the Washington Post. “Action now shifts to the Senate, which could spend the rest of the year debating its version of the health-care overhaul. Majority Leader Harry M. Reid (D-Nev.) hopes to bring a measure to the floor before Thanksgiving, but legislation may not reach Obama’s desk before the new year.”

As I watched Democrats congratulate themselves, it was difficult to feel celebratory. Passage of the Stupak amendment — which bars a government-run insurance plan from offering abortion *and* prohibits women who receive government insurance subsidies from purchasing private plans that include abortion coverage — sucked a lot of the energy out of the room.

As Princeton professor Melissa Harris Lacewell said on Twitter, “Stupak feels like Prop 8 [which overturned same-sex marriage in California the same night President Obama was elected]. When the ‘win’ is accompanied by legislation that attacks the most marginal it doesn’t feel like a win.”

For a look at how each House member voted, check out this Washington Post graphic. You can sort the list by how much money each member has received in campaign contributions from the health industry and by the percent of people without health insurance in each district . The New York Times does a nice job of showing the geography of the vote (mouseover the states to reveal individual districts).

We close tonight with a reminder of what this bill provides — and the work still left to be done. Read Maggie Mahar’s in-depth post “Heath Care Reform — Looking at the Glass Half-Full.” The National Women’s Law Center breaks down what this bill means for women in every state.

The House is debating the Stupak amendment limiting access to abortion services — you can watch it on C-SPAN.org, or follow along on the Twitters (hashtag #stupak), where many of us are quoting the representatives for and against. I’m @cmc2

For more background, read “Abortion Fight Erupts in Health Care Debate” at The New York Times, and “House Democrats Will Consider Stupak’s Abortion Amendment On The Floor” at Think Progress’ Wonk Room.

And in case the current House bill’s provisions on abortion are in doubt, read Maggie Mahar’s analysis: “The fact of the matter is that the House bill contains more than two dozen references to abortion and virtually all of them describe how insurers can restrict or deny coverage for the procedure.”

Update: Amendment passed 240-194-1 (Republican Rep. John Shadegg of Arizona cast the lone “present” vote). A surprising number of Democrats – 64 — joined Republicans in passing the amendment. View the roll call here.

Jodi Jacobson just posted a piece at RH Reality Check that begins:

Tonight, with the aide of some 60 Democrats, women’s rights were effectively negated by the US Congress as the House passed the Stupak amendment to HR 3200, the Affordable Health Care Act of 2009.

More in-depth analysis of how we got here is forthcoming. But one thing is clear: The US Conference of Catholic Bishops (USCCB) apparently is running the US government, aided by a cadre of “faith-based advocacy groups,” the House Democratic leadership, the White House and members of the Senate.

Remember, this amendment is not a done deal. It still has to pass Senate and then survive the conference committee, and women’s groups are already mulling action in the weeks to come. But what a sad day it is when the only way to gain health care coverage is to lose a legitimate, legal health care procedure.

Another distressing point: The New York Times reports that only one male lawmaker — Rep. Jerrold Nadler of New York — joined women who spoke against the amendment on the House floor. A correction, however, is in order: My own Congressman here in Chicago, Mike Quigley, also spoke out (cheers!). But that may have been it.

Here, from the Times, are bits of what other lawmakers said during the debate:

Representing the abortion-rights segments of the Democratic membership, Representative Diana DeGette of Colorado called the amendment a “wolf in sheep’s clothing” that would deny women access to care. Representative Lois Capps of California argued that the underlying bill already prohibited federal financing of abortions. The amendment, she said, “Actually restricts coverage of a legal medical procedure.”

“Not one other medical procedure is singled out for rationing” in the larger bill, she said.

Others contended that this amendment would result in women having to go out and buy insurance that would cover such a procedure, a prospect one lawmaker scoffed at, saying a woman does not plan for an unplanned pregnancy.

Representative Nita Lowey, Democrat of New York, called it “a disappointing distraction” from the main event. Representative Barbara Lee, Democrat of California, said the amendment would take women “one step back” toward the dark days of back-alley abortions. Representative Rosa DeLauro, Democrat of Connecticut, said, “We should not be injecting this divisive and polarizing issue into our debate.”

And the full speech by Rep. Jan Schakowsky of Illinois:

This Stupak-Pitts Amendment goes way beyond current law. It says a woman cannot purchase coverage that includes abortion services using her own dollars — even middle-class women using exclusively their own money will be prohibited from purchasing a plan including abortion coverage in every single public or private insurance plan in the new Health Care Exchange.

Her only option is to buy a seperate insurance policy that covers an abortion — a ridiculous and unworkable approach since no woman plans an unplanned pregnancy.

This amendment is a radical departure from current law that will result in million of women losing the coverage they already have. Our bill is about lowering health care costs for millions of women and their families, not for further marginalizing women by forcing them to pay more for their care. This amendment is a disservice and an insult to millions of women throughout the country, and I urge a NO vote on this amendment.

These strong responses ultimately weren’t enough to kill the amendment, but they did serve as a reminder of the urgency of electing more pro-choice women to Congress. Anyone else have points to share?

We’ve received news that these Democrats are on the fence about the Stupak amendment that would restrict abortion coverage in the health reform bill (read this post for background).

If you live in any of these districts, or know someone who does, please call your representative *now* and let him know (yep, they’re all men) that women’s healthcare should not be negotiable.

Rep. Chris Carney (Pennsylvania – 10th district)

Rep. Ben Chandler (Kentucky – 6th district)

Rep. Jim Cooper (Tennessee – 5th district)

Rep. Henry Cuellar (Texas – 28th district)

Rep. Artur Davis (Alabama – 7th district)

Rep. Joe Donnelly (Indiana – 2nd district)

Rep. Richard Neal (Massachusetts – 2nd district)

Rep. Earl Pomeroy (North Dakota – at large)

Rep. Vic Snyder (Arkansas  - 2nd district)

Rep. John Tanner (Tennessee – 8th district)

Rep. Peter Visclosky (Indiana – 1st district)

The House is expected to vote today on a $1.055 trillion health care package that would expand coverage for up to 36 million people — but first there will be a vote on an amendment that severely limits abortion coverage in a new government-run insurance plan and through private insurance that is bought using government subsidies.

After a back-room fight last night, House Speaker Nancy Pelosi agreed to allow the amendment proposed by Rep. Bart Stupak (D-MI). It reads:

The amendment will prohibit federal funds for abortion services in the public option. It also prohibits individuals who receive affordability credits from purchasing a plan that provides elective abortions. However, it allows individuals, both who receive affordability credits and who do not, to separately purchase with their own funds plans that cover elective abortions. It also clarifies that private plans may still offer elective abortions.

If you are reading this on Saturday, stop. Call your representatives and tell them this amendment is unacceptable. Go, now. We’ll wait. [Update: See this list of 11 representatives who are on the fence. These members, in particular, need to hear from you.]

It looks likes the amendment has enough votes to pass may be a close vote, and lawmakers need to know that a health care bill that tosses out a legal medical procedure used by millions of women every year is unacceptable.

The Washington Post’s Ezra Klein writes:

The amendment is expected to pass with relative ease. Republicans will join with anti-choice Democrats to push it over the finish line. Once the amendment passes, the bill is cleared for a vote, and all parties expect that vote to succeed. Today looks likely to end with a historic, and important, vote. A vote that is a first step towards helping more than 30 million people secure health-care coverage, and making sure hundreds of millions are better protected from the vagaries of the insurance industry. But Stupak’s amendment is a bitter start. It is, however, not the end. Even if it muscles into the House bill, it will also have to pass in the Senate, and then survive conference, before it becomes law.

Illinois Democrat Jan Schakowsky told C-SPAN’s “Washington Journal” that she’ll vote for the bill’s passage today, even with the Stupak amendment, but would opposed the final bill if the amendment survives the conference committee.

“If that language were in the final final bill, I certainly couldn’t support it,” Schakowsky said.

Plus: This morning, members of the Democratic Women’s Caucus went to the microphone, one by one, to explain how the overall health care bill would benefit women. Republican Rep. Tom Price of Georgia responded with a stream of “I object. I object. I object.” It got ugly.

Here’s a five-minute video showing what went down; if you’re short for time, below is the “I object” mashup created by Media Matters.

A new, freely available, open-access journal that launched this month reflects a position Our Bodies Ourselves has long held: Healthcare is better, and people are healthier and more empowered, when individuals are informed and can actively participate in their own care.

The Journal of Participatory Medicine, launched at last week’s Connected Health Symposium in Boston, will publish online peer-reviewed articles that “explore the extent to which shared decision-making in health care, and deep patient engagement, affect outcomes.” The inaugural issue includes articles from all stakeholders, including patients, healthcare providers, payers, and others.

The journal’s significance is underscored by the fact that current or former editors of three of the most prominent medical journals – JAMA, BMJ, and the Annals of Family Medicine – also contributed to the first issue. As Amy Romano at Science & Sensibility points out, even the journal’s peer review process is participatory and values the input of all stakeholders, especially patients themselves.

The journal is being published by the relatively new Society for Participatory Medicine. The organization also has a blog, e-patients.net, which focuses on and includes stories from patients becoming informed, connecting with other patients, finding support, and exploring potential treatments for their healthcare concerns.

The existence of this organization and its publications reflect a growing trend toward patient involvement in health care that has been inspired and enabled by the internet. The Pew Internet and American Life Project released a report earlier this year indicating that 61 percent of American adults look online for health information, and that “six in ten e-patients … say their most recent search had an impact, mostly minor, on their own health or the way they care for someone else.”

More than half said information they found online lead them to ask their physician new questions or to get a second opinion on their care.

The internet is also enabling access to personal health records and new ways of collecting and sharing health data. The Society and the Journal will promote efforts to encourage these developments while protecting patient confidentiality.

As one physician wrote of the e-patient phenomenon in 2008:

Patients want information, ideally tailored to their needs. They want to discuss this with their physicians without being shooed away, and would appreciate getting pointers. They even want access to their test results and medical records. Although many physicians feel threatened by all this, engaging the patient as a partner in her own care can be quite gratifying, improves patient satisfaction, and may even lead to better outcomes.

As an organization that has long held that women can become their own health experts and that women, as informed health consumers, are catalysts for social change, we agree.

Those of you who are engaged in conversations with opponents to a public health insurance option might want to try pulling them away from Fox News for a moment and ask them to read Ellen Shaffer’s new piece, “U.S Health Care: Myths and Facts.”

Schaffer is co-director of the Center for Policy Analysis, which runs the EQUAL Health listserv (Equitable, Quality, Universal, Affordable Health). List members contributed to this comprehensive document, which answers such questions as:

• Who’s More Efficient, Government or the Private Insurance Market?
• Are We Spending Too Much on Health Care?
• Do We Pay Too Much for Drugs?
• Could Importing Drugs Reduce Prices?
• Can Prevention Programs Reduce Health Care Costs?
• Is Health Information Technology a Silver Bullet for Reducing Costs?
• Are there really 46 Million Americans Who Can’t Get Health Care?
• Can Universal Coverage Be Achieved by Mandating Everyone to Buy Insurance?
• Do We Need More Government Programs to Cover Low-Income People?

Action Items:
- If you or your friends live in states where Democrats (or pretend-Democrats) are hesitating over the public option, call or write your elected officials and urge support.

- Starting Oct. 28 and running at least through Nov. 4, Healthcare-NOW is organizing Patients Not Profit Sit-Ins. Learn more at MobilizeForHealthcare.org.

- Raising Women’s Voices has coverage of a teach-in on health reform held at Columbia University on Oct. 22. Sponsored by the Student Committee of the Public Health Association of NYC and the Black and Latino Caucus of the Mailman School of Public Health, the event drew nearly 60 students, faculty and members of the community.

If you want to sponsor a teach-in on a college campus, contact RWV: info [at] raisingwomensvoices [dot] org for sample materials and programs. And check RWV’s calendar for upcoming events and speak-outs.

- Organizing for America received around a thousand videos made by healthcare advocates; here are the 20 finalists for your vote. The winner’s video will air on national television.

The matter of how much personal information to share with patients comes up frequently for practitioners, and there are times when it can be most helpful. But it is a difficult decision.

In an essay online at WBUR public radio, Our Bodies Ourselves board member Anne Brewster, an internist who works at Massachusetts General Hospital, discusses her decision to disclose something about herself to a 30-year-old patient diagnosed with multiple sclerosis, an autoimmune disease of the central nervous system. When Brewster calls to give her the news, she shares that she has the same disease:

In revealing personal information, physician to patient, I had crossed a line. I did so intentionally, in an effort to bring compassion to our exchange, but still today, I cannot shake the slightly uneasy feeling that I have somehow breached medical etiquette.

When we enter medical school and don our white coats for the first time, the division between doctor and patient begins – “us” and “them.” We start our education by dissecting a human corpse, and in so doing, learn early on to separate the body from the person. We master the parts — the Ischial Tuberosity, the Latissimus Dorsi, the Sternocleidomastoid, the Flexor Digitorum Longus. We think about lymphatic drainage, muscle insertions, arterial supply, and nerve innervation. We divide the body into sections: distal and proximal, dorsal and ventral, lateral and medial.

We go on to study disease processes — so many that our heads spin. Eventually, we begin to take care of patients and are encouraged to remember the person behind the disease. We are instructed to make eye contact, to sit on the edge of the bed when we speak to a hospitalized patient, and to use touch when appropriate, by holding a hand or squeezing a shoulder. Empathy is cultivated, but at the same time, explicitly and implicitly, we are taught to keep an emotional distance. Sharing personal information is taboo.

Part of this is for survival. None of us could bear to feel all of the pain, the fear, the loss that we encounter daily in medical practice. If we allowed ourselves to realize that we are vulnerable to all of the diseases we treat, all the time, we could not function. And part of this is about being a good doctor. Emotions can cloud judgment, and the preservation of professional boundaries is essential to quality care.

But true objectivity is a myth.

Continue reading this excellent essay.

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.

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.”

Plus:

* Domestic Abuse Victims Struggle with Another Blow: Difficulty Getting Health Insurance: Good story at Kaiser Health News. For background, see this report from the National Women’s Law Center on how the individual health insurance market fails women.

* 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.