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Web Letter

Ms. Lerner seems not to have carefully read the bills pending before Congress.

While I agree that there is much healthcare reform ought to do, including cover prescription contraceptive drugs and devices, the bills do mandate coverage for some of the services Ms. Lerner names, despite her assertion to the contrary.

For example, in the just-released Senate version (and in the HELP Committee draft released in July 2009) the minimum benefits package is required to cover--with no cost-sharing--anything that receives an A or B rating from the US Preventive Services Task (USPSTF) Force (see section 2713 here, for example).

If you read the latest report from the USPSTF, you can see beginning on p. 83 that they recommend routine chlamydial, gonorrhea, syphilis and HIV screening (and some limited screening for Hep B). They also recommend "high-intensity behavioralcounseling to prevent sexually transmitted infections (STIs) for all sexually active adolescents and for adults at increased risk for STIs."

Again, due to the A or B rating, these services would not be subject to cost-sharing in either the House or Senate bill.

It is true that the USPSTF found "insufficient evidence" to recommend partner violence screening. This is unfortunate, but does not close the issue forever. If good data points for the efficacy of routine partner violence screening can be gathered and published, the USPSTF may yet change the I to an A or B.

As for birth control, it is true that the bill does not require coverage for prescription contraceptive drugs or devices. However, neither does the bill pre-empt the coverage required in twenty-seven states (see Guttmacher Institute's "State Policies in Brief").

Melissa Schober

Baltimore, MD

Nov 20 2009 - 11:49am

Web Letter

I'd like to thank Sharon Lerner for her thoughtful piece on women's reproductive health issues in healthcare reform. Ms. Lerner underscores the very important point that women's preventive healthcare coverage is in everyone's best interests. It prevents infertility, cancer and abortions. More than 90 percent of the care that Planned Parenthood health clinics provide every day is primary and preventive, including wellness exams, cancer screenings, immunizations, contraception and STD testing and treatment.

Unfortunately, the process of crafting a healthcare reform package has provided a platform for single-issue advocates to advance their extreme, ideological agenda at the expense of tens of millions of women. As Lerner points out in her piece, there are lawmakers who treat birth control and other basic women's health services as a proxy for advancing their views on abortion.

Ms. Lerner's article provided an incomplete view of Minnesota Senator Franken's position on women's health and national reform. Remember, Senator Franken, a member of the Senate Health, Education, Labor and Pensions committee (HELP), wasn't added to the committee until after it finished work on its healthcare reform bill. Since his arrival in the Senate, he has been a champion for women's reproductive healthcare. Senator Franken is actively working to strengthen the women's health provisions of the Senate's health reform bill by supporting Senator Mikulski's women's health amendment and engaging in ongoing discussion with local and national women's health advocates. At the October 15 hearing of the HELP Committee, Senator Franken was the only senator to clearly state that a reformed health system must include access to affordable family planning services.

Senator Franken is an unwavering ally of the women's health community. In his short time in the Senate, he has been a strong voice for women's issues. He has championed the Jamie Leigh Jones amendment to ensure that victims of sexual assault and rape have their day in court, and that no federal funds would go to companies who require arbitration in cases of rape and sexual assault. He's introduced the "Justice for Survivors of Sexual Assault Act" to address the backlog of rape kits, which is estimated to be as high as 500,000.

Senator Franken has stated that women's health is fundamental to our nation's health. His words and actions make it clear that women's healthcare must include access to contraception and safe abortion services.

Sarah Stoesz

Minneapolis, MN

Nov 9 2009 - 1:19pm

Web Letter

As a woman who relies on fertility awareness and barrier methods to avoid pregnancy, I'm always wary of how "birth control" in political discourse often actually means "hormonal contraception."

I think it would be great if birth control were provided at no cost to the consumer. All methods of birth control, including OTC methods such as condoms and sponges. Including classes on fertility awareness. And including prescribed barriers such as diaphragms and caps.

The language of the article, which exclusively associates birth control with doctor's visits, implies that only common prescription methods (pill, patch, ring, shot and Mirena) are counted as birth control. If such language made it into a national health bill, women who chose hormonal methods would get their birth control paid for entirely by the goverment. Women who chose barrier methods or fertility awareness would bear the entire cost themselves.

Hormonal methods, while the best option for many women, are over-hyped. Institutionalizing such methods as "best for everyone" by making taxpayers cover the entire cost--but leaving women 100 percent responsible for cost if they choose any other method--is an idea I oppose.

Virginia Brock

Rock Island, IL

Nov 7 2009 - 7:46pm

Web Letter

I just wrote my senator, Debbie Stabenow, asking her to introduce a floor amendment addressing this glaring omission. Equating birth control with abortion is nonsense, especially for anyone who seriously wishes to reasonably curtail the number of abortions performed each year. Since Debbie had to remind her Finance Committee colleague that his mother needed the maternity care that he cavalierly dismissed as unnecessary, I trust she'll do the right thing. Senator Stabenow has always had a keen eye for the obvious when it comes to gender discrimination.

Susan L. Smith

Clinton Township, MI

Oct 30 2009 - 2:03pm

Web Letter

Interesting exercise in self-flagellation over the last few months watching politicians and pundits align themselves with every useless cause they can think of trying to gain a skirmish advantage over their grunting partners.

Fear this, wave that, tea, napalm, heavy water and dirty diapers. What a myriad of insane images we have to deal with all coming from a medium that strives to tell us the truth when they don't have a clue what the truth is and wouldn't if it hit them all in the head at once. The mainstream media (whatever that means) is a self-indulgent collection of garbagemen (term used generally to describe all that participate) trying their collective bests to pry that last truth dollar out of our masses' hands so they can buy a martini tonight.

Well, I hope you all collectively choke on them. Not the easy, correctable choke but the chicken bone down the throat kinda choke. Enjoy that moment, media titans--it's the beginning of the end for you chumps.

When the people labeled "the Republicans" or anyone that the conservative movement puts out in public with that sticky label draped across their foreheads come out and declare that any legislation that has anything to do with any subject relating to a woman's choice of what happens to her body concerning birth control, the choice can't be made by mere mortals, it has to be taken up to the hall of the "church" to get a reasoned reply. What a charade of fairy tales these clowns regurgitate. What bile. Their scepters made of Republican/conservative/hatemonger bile should no longer be acknowledged but swept away by waves of anti-stupidity vibrations coming from those who have woken up from this seemingly perpetual nightmare.

Birth control should be a natural part of healthcare and we should treat it just like any other human condition and treat it the same way. But no, stupidity seems to get in our way because we tell ourselves we believe something that we don't. And then, all of this stupidity starts to happen and everything good about us goes away too. Shame.

Ron Baldwin

Chicago, IL

Oct 30 2009 - 12:49pm

Web Letter

I guess there's going to be so much money spent on coverage of Viagra and Cialis that there won't be enough left to cover women's contraceptives.

I'd like to suggest a tactic from the days of budget debates over Vietnam: pick a weapons system, any one. Identify its cost. Then talk about what we could cover in healthcare needs (or education, or jobless benefits, or housing) if Congress eliminated just one airplane or system, or whatever.

I am so tired of hearing these "budget hawks" bleat about the cost of healthcare (or any other domestic program) at the same time as they vote again and again for wasteful war spending and refuse to install any means of oversight and control and refuse to prosecute those who commit fraud.

Obama deserves a huge helping of shame for his "it must be budget-neutral" BS re the healthcare bill, and his quixotic, useless pursuit of "bipartisanship."

As it says across my chest, "I voted for change in 2008, and all I got was this lousy T-shirt."

Donna Middlehurst

Kula, HI

Oct 30 2009 - 10:59am

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