Sunday, February 12, 2012

Women, Healthcare and Political Will

Breast cancer obeys no political guidelines, follows no ideological dictums, disrespects age, race, gender and sexual orientation.

Reproductive options through birth control, which first allowed women to dictate their pregnancy choices, came of age in the 60s. Subsequently women began to make demands on the social and political systems for equality. Concurrent with the civil rights advances being made at the same time, women wanted equal pay for equal work, parity in athletic and scholastic opportunities, and the chance to push through the glass ceilings and mommy tracks common at that time.

Now some 40 years later we unfortunately are fighting the same battles with women's bodies as the field of battle.

The Obama administration, under the Affordable Care Act (ACA), had broadened access to birth control methods as a health care right and, following the advice from the respected Institute of Medicine, expanded coverage mandates as a way to improve women's health care over the long term. Exemptions were maintained for objections of any religious core group employees, but expanded following the regulations of many states which pertained to institutions such as colleges and hospitals, which may have had a more diverse body of employees. Then the uproar became viral, with the right claiming that the President has waged a war on religion and infringed upon constitutional separations which they held dear. The war has become drawn also along party lines with most conservative voices supporting a return to the past and many Democrats urging a more expansive agenda. The Catholic religion hierarchy jumped into the argument, claiming that because any use of contraception is contrary to the church teachings, the government can have no say. Catholic women responded by claiming that 98% of their cohort uses birth control at some point in their reproductive history. At a meeting held at the National Press Club, former Maryland Lieutenant Governor and prominent Catholic Kathleen Kennedy Townsend spoke in favor of options for broader choices. A telling ad in the Washington Post made such a point quite graphically and is reproduced on their web site.

The Obama White House tweaked the regulation a bit, in an attempt to put out this sudden firestorm, and announced that the insurance industry would cover the BCP as a health maintenance issue, since prevention of pregnancies would reduce long term expenses to the system. This would be done at no cost to the insured, so religious institutions and employers would not be able to claim any coercion of their views, and parity would apply to all female employees who could then make a private choice for their healthcare. This is a system similar to one in place currently in Hawaii. The White House moved quickly to diffuse this hot political issue, and has received praise for trying to listen quickly and well.

However the increasingly strident rhetoric from the bishops, who still do not feel this is a negotiable point, may lead to a rift within their ranks as was and reported by the New York Times. I do hope that a sensible solution respective of all points of view has now been found.

Now, back to the breast cancer Komen vs. Planned Parenthood dispute. Breast cancer struck Democrat Elizabeth Edwards and Republican Betty Ford, to mention a few prominent victims of this disease who have political ties. Although breast cancer is not limited by race to any one group, more white women are diagnosed with the disease than any other group proportionately, but more African American women die of the disease than any other. This is often thought to be due to the lack of early diagnoses and access to health care for many of these women.

The women in the top 1% do not get their health care from clinics; middle and lower economic class women are increasingly served by Planned Parenthood, where women can get well women exams, HPV and STD tests, family planning advice and referrals for cancer screenings. (Note: Undocumented immigrants do not qualify for Medicaid coverage or the ACA.) These underserved are the women whom Komen's Race for the Cure was ready to throw under the proverbial bus in order to satisfy some suspect ideological purity. Komen has accepted support from chemical and cosmetics companies suspected of using carcinogens in products they market to women. Other promotions have included purveyors of alcohol and fatty foods, known to increase incidence-rates such as vodka and fried chicken. Of the hundreds of millions raised by Komen over the years, much has gone to salaries and promotions with less than 30 cents of each dollar going to research.

Money is made by the medical industry from breast cancer treatment and follow-up with chemotherapy or radiation. Many drugs are quite expensive. These are only options, however, for those who can afford adequate insurance coverage. Some women are dropped from coverage after diagnosis. One of the pluses about the ACA is that insurance companies will not be able to deny coverage to anyone diagnosed with a pre-existing condition such as this. This provision is the underpinning for the individual mandate. If it is turned down by the Supreme Court then the pre-existing exclusions will again be the rule.

Surgeon Susan Love wrote recently that we are no closer to finding a cure after 50 years of money raised and spent because we have not determined what causes breast cancer and adequate research has not been done.

In my opinion, this is what we as women and all those who love their mothers, their children and friends who are women, should be demanding. (I do know that a small percentage of men also get this disease, but use women as the predominant examples here.) Find the cause. Do the research, learn what in our genes, diets, environment, lifestyles or medications are causing this disease. Ask the hard questions. Demand the tough remedies. And, most of all, take politics out of women's healthcare. Let me hear from you. What are you doing in this fight? Will you run the Race for the Cure again, now that you are better informed? I know I will not.

No comments:

Post a Comment

All comments are reviewed prior to posting.