Men to Benefit More from Healthcare Reform Expanded Coverage
Posted by on September 14, 2010 - 9:15am

Contrary to some commonly held beliefs, men, more than women will likely benefit more from expanded healthcare coverage.   According to the Institute for Women's Policy Research June 2010 Fact Sheet,  men represent a majority of non-elderly US adults who lack health insurance across all age groups but particularly ages 18-34.    Under age 18, boys and girls with health insurance have nearly the same coverage with many insured under public plans.   The jump begins when students leave their parents' plan at either high school or college graduation.  This will definitely improve when the Affordable Care Act of 2010 (ACA) becomes effective on September 23, 2010 and raises the age a young adult can stay on their parents' plans.

One of the reasons young women have better coverage is the fact that they have access to healthcare through Medicaid which has traditionally provided a safety net for family planning and pregnancy coverage for those with low or no income.

As we age, and reach 55 years and older, this difference is less between men and women.   Medicare coverage that generally begins at age 65 is universal and fewer than 2 % of men or women lack health insurance once they reach this age group.

If you are interested in reading more about insurance differences between the sexes, visit the IWPR site

Health Care Reform Navigation Tools
Posted by on July 9, 2010 - 11:37am

In March 2010, Congress passed and President Obama signed the Affordable Care Act--the new health care reform law.  It will take several years for all provisions of the Act to be implemented but there are a variety of tools becoming available to help guide the way as provisions are implements.   The Our Bodies, Ourselves Blog has posted one such tool.   To access it, click here

Making a Strong Case for Sex-based Research and Implementation
Posted by on July 8, 2010 - 11:18am

Several Northwestern researchers, including our own Institute director, Teresa K. Woodruff, PhD, have been making a strong case for more sex-based research that is making waves in several prestigious journals including Nature and Women's Health.   Readers interested in reading these articles should click here

Many Physicians Not in Line with Cervical Cancer Screening Guidelines
Posted by on July 6, 2010 - 10:28am

A survey of more than 1,200 primary care physicians indicates that many are not following clinical practice guidelines on recommended screening intervals for cervical cancer, both with regard to traditional Pap testing as well as a newer screening method, a DNA test for the human papillomavirus (HPV). The FDA has approved HPV DNA testing for use in conjunction with Pap testing, a process called co-testing, for women age 30 and older.

At the time the survey was conducted, guidelines from the American Cancer Society and those from the American Congress of Obstetricians and Gynecologists advised extending the interval between screenings to 3 years for low-risk women over the age of 30 after three consecutive normal Pap tests or a single normal co-test (a normal Pap test plus a negative HPV DNA test). Guidelines from the U.S. Preventive Services Task Force also are consistent with a longer interval between screening tests.

In the survey, based on a hypothetical clinical vignette of a 35-year-old, low-risk woman with three prior normal Pap tests, only 32 percent of respondents reported that they would comply with guideline recommendations, researchers from the CDC and NCI reported in the June 14 Archives of Internal Medicine. Even fewer respondents, 19 percent, would comply when, during a single visit, the low-risk woman had a normal co-test result. Approximately 60 percent of those surveyed—which included general internal medicine physicians, family practice doctors, and obstetrician-gynecologists—said they would still recommend that the woman undergo annual Pap screening.

Although the Pap test is the most commonly used cervical cancer screening method, a number of studies have shown that the DNA test for HPV—the cause of the vast majority of cervical cancer cases—is more sensitive than the Pap test in detecting high-grade precancerous lesions, spurring discusions about the optimal approach to cervical cancer screening in the United States.

This new study, however, suggests that guidelines for extending screening intervals have not influenced current clinical practice, wrote Dr. Mona Saraiya of the CDC’s Division of Cancer Prevention and Control and her colleagues. “When offered the choice for HPV testing,” they wrote, “many physicians deferred to the same pattern they used for Pap testing,” annual screening with both tests or no recommendation for HPV testing.

“These practice patterns are not likely to lead to much improvement in cervical cancer outcomes, but may result in unnecessary follow-up testing, increased risk of colposcopy-associated morbidities, and distress for patients,” said Dr. Robin Yabroff, a study co-author from NCI’s Division of Cancer Control and Population Sciences.

“New HPV infections are extremely common but overwhelmingly benign; they almost always go away by themselves,” said Dr. Mark Schiffman of NCI’sDivision of Cancer Epidemiology and Genetics. “Only persistent infections are a risk factor for cancer. If you screen for HPV too often, you will detect new infections rather than persistent infections, and this poses the risk of overtreatment.”

The Shriver Report: A Woman's Nation Changes Everything
Posted by on November 13, 2009 - 5:53pm

Women now comprise half of all American workers, and women are either the primary or co-breadwinners for two thirds of all American families. Maria Shiver, in conjunction with the Center for American Progress, published a fascinating new report last month that outlines the ways that having a large female workforce is changing the landscape of American business, family, and health status.  The entire 400 page report can be downloaded by chapter, or read online here.

Image: americanprogress.com

Image: americanprogress.com

Of primary interest to the readers of this blog is the chapter about the health of the working woman entitled, "Sick and Tired: Working Women and their Health" by Jessica Arons and Dorothy Roberts. A few really interesting points that I'd like to pull out:

  • A quarter of women still receive insurance through their husband's employers. This means if something happens to her husband, or a couple decides to divorce, a woman could very quickly lose her coverage.
  • There currently seems to be a two-tier system in the business place with regards to breastfeeding: professional mothers are accommodated, while working-class mothers are not.
  • Women are often exposed to chemicals that can impair fertility while in the workplace. Alternatively they are excluded from certain male-dominated fields because of concerns over these chemical impacts, rather than just making these workplaces safer.
  • The act of being a caregiver, which is usually done by women, can have health impacts: caregivers are more likely to report having heart disease, cancer, diabetes, and arthritis. The chronic stress felt causes women to also be more likely to suffer from stress-induced headaches, sleeplessness, irritability, and depression.
  • Women are more likely than men to work in jobs that are low-wage, part-time, or for small businesses; all are positions that infrequently offer employer-based insurance.
  • The practice of "gender rating," or charging women more than men for insurance premiums, is common among private insurers. They are also more likely to deny coverage or increase premiums for women based on preexisting conditions that only or disproportionately affect women.
  • Because they have to pay more for insurance, and make less than men, women spend a higher percentage of their income on healthcare. They are more likely to be forced into medical bankruptcy when things go wrong.

The article has a lot of good personal stories to illustrate some of the hardships encountered with healthcare for working women, and really touches on the ways that race and economic status can put certain women at even more of a disadvantage. The chapter is such a great look at the ways that we, as working women, are impacted differently by the types of jobs we have, the influences of these jobs (and our non-paying jobs as caregivers) on our health, and the ways we are able to afford our healthcare. I highly recommend checking it out; it can be directly downloaded here.

The President's Speech On Health Care Reform
Posted by on September 11, 2009 - 12:19pm

On September 9, President Obama gave a speech to the joint houses of Congress laying out his plan for health care reform. No matter what your personal politics, the outcome of such reform regulation is going to affect us all. With that in mind, we thought it would be helpful to lay out some of the basic tenets of the President's plan, at least as it was outlined in the speech. A full transcript of the speech can be found here.

According to the President, his proposed changes will:

Photo: Whig.com

Photo: Whig.com

  • Not require the Americans who already have health insurance through their job, Medicare, Medicaid, or the VA to change the coverage or the doctor you have.
  • Make it against the law for insurance companies to deny you coverage because of a preexisting condition.
  • Make it against the law for insurance companies to drop your coverage when you get sick or “water it down when you need it the most."
  • Prevent insurance companies from placing an arbitrary cap on the amount of coverage you can receive in a given year or in a lifetime.
  • Place  a limit on how much you can be charged for out-of-pocket expenses
  • Require insurance companies to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies.
  • Creating a new insurance exchange, "a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices."
  • Provide tax credits, the size of which will be based on need for those individuals and small businesses who can't afford the lower-priced insurance available in the exchange.
  • Immediately offer low-cost coverage to Americans who can't get insurance today because they have preexisting medical conditions, in order to protect them against financial ruin if they become seriously ill.
  • Require individuals to carry basic health insurance.
  • Require businesses to either offer their workers health care, or chip in to help cover the cost of their workers. There will be a hardship waiver for those individuals who still can't afford coverage, and 95 percent of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements.
  • Not insure illegal immigrants.
  • Have no “panels of bureaucrats with the power to kill off senior citizens.”
  • Use no federal dollars to fund abortions, and federal conscience laws will remain in place.
  • Create a not-for-profit public option available in the insurance exchange that is only an option for those who don't have insurance.
  • Have a public insurance option that is not funded by the tax-payers, but is instead self-sufficient and rely on the premiums it collects.
  • Not add anything to the national deficit. There will be a provision in this plan that requires Congress to come forward with more spending cuts if the savings they promised don't materialize.
  • Cost around $900 billion over 10 years, that will be paid for by finding savings within the existing health care system, and using revenues from drug and insurance companies.
  • Charge insurance companies a fee for their most expensive policies, which will encourage them to provide greater value for the money.
  • Protect Medicare. The Medicare trust fund will be used to pay for this plan.
  • Create an independent commission of doctors and medical experts charged with identifying more in the health care system.
  • Reform current medical malpractice regulations.

So what did you think of the speech? Do you think all these goals are realistic or realizable. What would your ideal health care system entail. All comments are welcome