Blogs Comment On Health Reform, CDC Abortion Surveillance Report, World AIDS Day

Main Category: Abortion
Also Included In: HIV / AIDS;  Public Health
Article Date: 02 Dec 2009 - 5:00 PDT

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The following summarizes selected women's health-related blog entries.

~ "Sex, Abortions and Health Insurance," Nancy Folbre, New York Times' "Economix": While some argue that reproductive-rights advocates are "overreacting" to the Stupak amendment in the House health care reform bill (HR 3962) that would prohibit companies from offering policies covering abortion in subsidized health insurance exchanges, "I remain unconvinced" that the "expansion of medical services to low-income women, including improved family planning services, would compensate for the risks of paying for abortion out of pocket," according to Folbre, an economics professor at the University of Massachusetts-Amherst. "Neither of the bills currently before either the House or Senate mandates coverage of contraceptive services, pelvic exams or counseling for sexually transmitted diseases," she writes. She adds that if the abortion restrictions included in the Stupak amendment are put into effect, "a significant number of low-income women would be required to pay for abortions out of pocket or to continue an unwanted pregnancy." The "cumulative effects -- compounded by the spillovers on private insurance practices -- would be large," Folbre continues, noting that almost 50% of all pregnancies and about one-third of pregnancies carried to term are unplanned. "With sex, ... Americans don't seem, on average, to be very good at planning," she writes, concluding, "We need insurance for a reason" (Folbre, "Economix," New York Times, 11/30).

~ "CDC Releases Its Annual 'Abortion Surveillance' Report," Amie Newman, RH Reality Check: The Centers for Disease Control and Prevention released its Abortion Surveillance report last Friday, Newman writes. The report provides information on how many abortions are performed in this country, at what gestational age, and with what medical procedure broken down by age, ethnicity and race. The U.S. abortion rate in 2006 was 16.1 abortions per 1,000 women ages 15 to 44, while the abortion ratio was 236 abortions per 1,000 live births, Newman writes. There were a total of 846,181 abortions reported to CDC in 2006. In the previous decade (1997-2006), the number of abortion procedures, abortion rates and abortion ratios decreased by 5.7%, 8.8% and 14.8%, respectively, Newman notes, adding that "most of these declines occurred before 2001." According to the report, the decrease in abortion could be due to several factors, including a "decline in the availability of abortion providers; the adoption of legislative restrictions and barriers to abortion services like mandatory waiting periods and parental involvement laws; and increasing acceptance of nonmarital childbearing." The report also said, "Providing women with the knowledge and resources necessary to make decisions about their sexual behavior and use of contraception can help women avoid unintended pregnancies and thus reduce the number of abortions performed in the United States." Newman writes, "If there is anything we can take from reports like these it is that an increased focus on ensuring that all women in this country have access to the education and tools necessary to prevent unintended pregnancy should be accessible health care for all women of reproductive health age" (Newman, RH Reality Check, 11/25).

~ "Health Care Rationing, American-Style," Uwe Reinhardt, New York Times' "Economix": In an appearance last week on NBC's "Meet the Press," Sen. Kay Bailey Hutchison (R-Texas), "whether she realized it or not," made a "clear clarion call for comprehensive, universal health insurance in America," Princeton University economics professor Reinhardt writes. Hutchison, discussing a recent U.S. Preventive Services Task Force recommendations that women begin biennial mammograms at age 50, said such recommendations would lead to rationing of heath care under reform legislation. She said, "The key is that these [screenings] are covered by insurance so women will not have to decide if they're going to spend $250 to get a mammogram because they and their doctors believe it is right to do so." According to Reinhardt, Hutchison was proposing that women should not have to make the choice between spending the $250 or going without a mammogram and "that the key here is to get someone else -- either public or private health insurance -- to pay for it." Reinhardt also notes that about 25% of residents of Hutchison's home state of Texas lack insurance, compared with 15% nationwide, and that Texans reported higher-than-average rates of going without cancer screenings. "To paraphrase Sen. Hutchison," Reinhardt writes, "they were being rationed out of health care." He concludes that "rationing of health care is nothing new. It has long been as American as apple pie" (Reinhardt, "Economix," New York Times, 11/27).

~ "Mammography Screening: Clearing Up Some Confusion," Deborah Kotz, U.S. News & World Report's "On Women": The controversy over USPSTF's recommendation on breast cancer screening "has confused and even angered some women," and many health officials cannot agree on whether to endorse the new guidelines, Kotz writes. Two commentaries in the most recent edition of the New England Journal of Medicine "may help clear up some confusion," she says, adding that "the bottom line is that mammograms reduce a woman's risk of dying from breast cancer even if she's in her 40s." One commentary explains that studies indicate that it costs nearly $14 million to provide one 40-year-old woman an extra 20 years of life as a result of screenings. Still, there is a benefit to women getting earlier screenings -- even if that benefit is "tiny and expensive," Kotz writes. The second commentary explains five facts to help put the task force recommendations in context, including that the debate of screenings is not new and that the task force wants women to make individual decisions about when to begin mammograms (Kotz, "On Women," U.S. News & World Report, 11/25).

~ "Celebrating the Possible in the Fight Against AIDS," Mitchell Warren, Huffington Post blogs: "[W]e have some good news to celebrate" on World AIDS Day this year, according to Warren, executive director of AVAC, an HIV/AIDS advocacy group. He writes that the good news includes a new UNAIDS report showing a decrease in HIV infections in "some of the hardest hit areas of the world" during the past eight years, results from a trial that "will give researchers clues that can help speed the development of a safe and effective AIDS vaccine" and anticipated results from two other trials -- one testing a microbicide gel that could help protect women from HIV and the other investigating whether antiretroviral drugs can lower the risk of HIV infection. According to Warren, "A decade of increasing funding for HIV programs -- in prevention, treatment and research -- is paying off," but the global economic crisis threatens that funding. Warren continues, "The possibilities and the victories that we celebrate this World AIDS Day could sadly be transitory unless we act now to solidify and sustain funding and support for HIV treatment, prevention and research programs" (Warren, Huffington Post blogs, 12/1).

~ "My Baby Would Have Died Under the Stupak Amendment," Tiffany Campbell, RH Reality Check: Campbell describes receiving the diagnosis during her 2006 pregnancy of Twin-to-Twin Transfusion Syndrome, meaning that one fetus was getting too much blood in the womb while the other was not getting enough. According to Campbell, the "only hope for saving this pregnancy was to have a selective termination on one of the babies, and hope the other twin would survive." Campbell used her story to fight against South Dakota's two unsuccessful ballot initiatives that would have banned abortion in the state. She is now retelling the story with the hope that it will encourage abortion-rights supporters to fight the antiabortion amendment by Reps. Bart Stupak (D-Mich.) and Joe Pitts (R-Pa.) to the House reform bill (HR 3962). "The selective termination that saved my baby's life would not be covered under the Stupak-Pitts Amendment," Campbell writes. She and other abortion-rights supporters have started a Facebook group opposing the amendment, called Stupak Amendment REVOLT, and they will be joining other advocates in Washington, D.C., on Wednesday for a national lobby day (Campbell, RH Reality Check, 11/30).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

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