MISSOURI FORUM
By Dr. Stephen Radinsky
As a retired radiologist, I will never forget the day when I had to tell a woman that her free mammogram, provided through a state initiative, had shown that she had breast cancer. I began telling her about the next steps in diagnosis and treatment and she interrupted me, saying, "You don't understand, I don't have health insurance. I can't afford any of this."
I have spent years wondering what happened to that woman. With the health reform legislation just enacted by Congress, scenarios like this will disappear.
Our healthcare system has been broken for many years. One of the major problems in reforming the system was due to the unwillingness of the insurance companies to compromise. The insurance systems had a virtual monopoly in every state and were unwilling to sell insurance across state lines. Thus, the insurance companies made huge amounts of money. Last year, the CEO of United Healthcare made $1.6 billion in stock options alone. Several years ago, a Blue Cross Blue Shield CEO had a salary and bonus of $337.5 million.
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LOUISIANA FORUM
By Mike Stagg
Since President Obama signed it into law, Jindal has ordered Attorney General Buddy Caldwell to file suit against the law. He has reversed Insurance Commissioner Jim Donelon’s plan to participate in the high-risk pools the law creates which provide coverage to adults who have been denied coverage due to pre-existing conditions. And he’s had DHH Secretary Alan Levine act as the administration’s public face in the effort to pass a constitutional amendment here to nullify aspects of the ACA, particularly the individual mandate to buy coverage.
These moves might advance the governor’s national political ambitions, but they are bad for Louisiana and harmful to its citizens.
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By F. Scott McCown
Texas Attorney General Greg Abbott is asking a federal court to declare national health care reform unconstitutional.
I respect Abbott, having served with him as a state judge, so I carefully read his legal papers, only to discover he is terribly wrong.
Under reform, Congress expanded Medicaid to cover more poor people and created federally subsidized state exchanges where everyone else can buy private health insurance. With some exceptions, everyone must obtain health insurance or pay a tax.
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By Susan Wysocki and Susan Scanlan
It’s not surprising that women are confused about the recently changed recommendations for cancer screening and prevention. New guidelines from the American College of Obstetricians and Gynecologists (ACOG) – the leading medical group that provides health care for women – say women should wait longer to begin cervical-cancer screening and that they should be screened less frequently. On the heels of similar changes to breast-cancer screening guidelines, it’s understandable that many women might see this as a step backward.
On the contrary, the new cervical-cancer screening recommendations reflect advances in our understanding of this disease and in tools now available to prevent it. More importantly, they present an opportunity to educate women about the significant opportunity we have to further prevent – if not eliminate – cervical cancer.
New ACOG screening guidelines recommend women should begin getting Pap tests at age 21 (as opposed to within three years of becoming sexually active) and that, from ages 21 to 29, most women should have Pap tests every two years instead of annually. Additionally, screening for women 30 and older with a history of normal Pap test results now moves to every three years.
MISSOURI FORUM
By Timothy D. McBride
Much of this is due to overheated rhetoric, a misunderstanding of the proposals by the press, purposeful distortions by both sides of the debate, and the complexity of health reform. For example, much attention has been paid to the so-called “public option” which the right wing has described as a “government takeover of health care,” and the left wing has described as the only provision worth fighting for because it will keep the insurance plans “honest.” Both claims overstate the significance of the public option since by all estimates, even if it survives, not many will sign up for it, and the plan will resemble private plans, not a Medicare plan.
When the reforms are phased in, 96 percent of American citizens will be covered by health insurance -- up from an insurance rate of 83 percent today -- according to Congressional Budget Office estimates. Contrary to fears that the legislation will lead to a government-run health system, 58 percent of the persons obtaining coverage will obtain coverage from private insurers, in a new Health Insurance Exchange. This Exchange will be much like the array of private insurance plans offered to Congress and the President today. The remaining persons insured under the plan would be low-income children and adults insured through Medicaid and the children’s health insurance plan.
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GEORGIA FORUM
By Timothy Sweeney, MPA
Despite the obvious and significant benefits to the state’s economy and its citizens, Gov. Perdue, Lt. Gov. Cagle, and others opposed to reform are arguing that Georgia cannot afford its share of the proposed Medicaid expansion in either the House or Senate proposal.
They claim that expanding Medicaid will cost Georgia more than $2 billion over six or seven years, but they rarely mention the billions in new federal funds that would flow to Georgia’s economy during this time.
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A glaring absence of the Emperor’s clothing seems to be escaping our attention in the recent House health care reform proposal with the inclusion of the Stupak amendment. The Emperor is naked and while everyone is critiquing, arguing and validating the fabrics, thread and adornment of his new clothes, those of us looking at his bare bottom wonder how everyone became so deluded.
The collective blindness of the Kingdom is truly exposed in the concession of excluding abortion care to pass a House proposal that included a public option. Using women’s health and reproductive justice as the deal breaker once again demonstrates that reform is not intended to address basic issues of health care disparity in our country.
Similar to the members of the Emperor’s Kingdom, who believed there was substance to the garments, we are overcome with disillusionment. The grand solution of tweaking health insurance to magically cure the ingrained, systemic issues at the core of our health care failure is the ultimate fairytale.
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GEORGIA FORUM
By Kathie McClure
It can be challenging to find an organ donor for someone who needs a transplant.
But when a donor and desperately sick person are matched up, living donors should not be “punished” for their gift, especially by the health insurance industry.
This is a little-known aspect of the health care debate that should be brought to light -- the fact that there is nothing that prevents health insurance companies from either denying coverage or charging higher premiums to those who donate an organ by categorizing them as people with “pre-existing conditions.”
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By Anne R. Davis, MD, MPH
Every day, I hear from another woman who is losing her job and her health insurance. Every day, I worry. As an obstetrician/gynecologist, I know firsthand what can happen when a woman can’t afford reproductive health care, whether she has lost her insurance or her insurance doesn’t cover women’s basic needs. Cervical cancer develops unnoticed. Pregnant women go without critical prenatal care. Sexually transmitted diseases progress unchecked. We see the results in the emergency room.
Congress must give women a better shot at staying well. Health care reform must change the rules: Health insurance must be affordable to all women, and the insurance we buy must cover our reproductive health care.
In my own life, I’ve always had good health insurance. I go to my ob/gyn each year for a well-woman exam, my birth control is covered, and my hospital bills were paid when I had my two children. These are medical fundamentals -- women’s health care 101-- yet I consider myself lucky to have them. Too many women are not as fortunate. According to the Guttmacher Institute, more than one in four women or their partners have lost their jobs or health insurance in the past year. The institute also reports that one in four women delayed an ob/gyn visit in the last year to save money.
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