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.
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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By Wendy C. Wolf
Breast cancer often can be treated with early detection. That's why health insurance that pays for mammograms is especially important. But mammography rates declined between 2003 and 2005, with a notable decrease for Hispanic women (from 65 percent to 59 percent) and African-American women (from 70 percent to 65 percent). An estimated one in five women over 50 has not received a mammogram in the past two years.
Everyone needs health insurance to keep healthy, yet women are disproportionately underinsured. An estimated 21 million women and girls went without health insurance in 2007, according to the U.S. Census Bureau. And a recent congressional report found that 18 percent of all women not eligible for Medicare are uninsured, which translates to 28 percent of 19 to 24 year olds and 26 percent of single mothers without insurance.
Why are so many women left uncovered? Perhaps it’s because many medical situations faced by women are treated as pre-existing conditions, including breast cancer. The National Cancer Institute estimated that in 2004 approximately 2.4 million women had a history of breast cancer. But without continuing coverage, cancer survivors face steep risks.
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WISCONSIN FORUM
By Dr. Doug Laube
Following President Obama’s historic address to the nation, America is poised for the first dramatic public health achievement of the 21st century.
What makes this moment truly life-changing in every sense of the word is that, for the first time, more women and their families will have coverage than ever before in our nation’s history.
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By Donna P. HallWhile television networks and newspapers were recently full of commentary and reporting on Rep. Joe Wilson’s loud outburst, the quiet fact remains that when health care reform passes, more women and their families will have coverage than ever before in our nation’s history.
That is no small thing, in a country where an estimated 21 million women lack health insurance, where over half of all medical bankruptcies are filed by female-headed households, and where single mothers and young women dominate the ranks of the uninsured.
The pending reform of the American health care system will -- for the first time ever -- create a seamless, lifelong continuum of care for women, for whom the status quo health care system has been an abject failure.
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COLORADO EDITORIAL FORUM
By Emilie C. Ailts
Access to abortion is being used to hijack legitimate debate about the scope and type of health care reform.
While it’s true that abortion is a complex issue that brings out strong emotions from all ends of the spectrum, it’s important to remember that abortion is just one aspect of the full range of reproductive health care services a woman may seek throughout her lifetime. This headline-grabbing focus on the “a-word” means opportunities to use health care reform to increase access to and use of other vital reproductive services could be lost to political gamesmanship.
Take, for example, gaps for those women who choose to carry their pregnancies to term. In 2007, the National Women's Law Center ranked Colorado 42nd overall when it came to women receiving adequate prenatal care. Research has tied inadequate prenatal care to premature and low-weight births -- which in turn can lead to children exhibiting behavioral and developmental problems.
How can health care reform address this gap? We know that some insurance companies consider pregnancy a pre-existing condition -- grounds to deny coverage. In addition, rates for some insurance plans are based on gender; as a result, women get charged more for the same coverage as men their age even though pregnancy usually isn’t covered in these plans. Because of these practices, women face financial hurdles in obtaining the prenatal care they need to have a healthy pregnancy and to deliver a healthy baby. There’s clearly room for improvement in just those aspects of the health care system.
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