American Forum Op-Ed

By Willie J. Parker, MD, MPH

Despite the shouting and name-calling at the town hall meetings, I remain hopeful about health care reform. I have no other choice. As an obstetrician-gynecologist, I spent years learning how to keep women healthy. Too often, I find myself telling patients with easily treatable conditions that I can’t help them -- they don’t have the money to get well. Denying women care and watching them suffer rips me apart. That’s why I’ve become an ardent advocate for health care reform.

I am not talking about withholding the latest, cutting-edge, exorbitantly priced medications or treatments. No -- I’ve had patients whose health insurance doesn’t cover such basic health needs as Pap smears and birth control prescriptions. And forget about having a baby -- many insurance policies don’t cover prenatal care or labor and delivery, or they treat pregnancy as a pre-existing condition.

As a country, we need to give women a better chance at staying healthy. Through health care reform, Washington could guarantee affordable reproductive health care to every woman and every girl in the nation, no matter who is insuring her.

Recently I had a patient, Celia, who made too much money to qualify for Medicaid. Her employer didn’t offer insurance. She had fibroids, a common condition of the uterus. But because Celia couldn’t afford to see a doctor, her fibroids grew unchecked to the point of interfering with her monthly cycles. She bled so heavily that she became severely anemic. I had to send her to the ER where she was hospitalized to receive a blood transfusion.

Celia’s hemorrhaging was an unnecessary risk to her health. Moreover, the hospital paid for her trip to the ER, the kind of expenditure that makes health care more expensive for everyone. If she had health coverage, her fibroids could have been managed by a solution as simple as birth control pills, sparing the toll her illness took on her family, her coworkers, and everyone else who depends on her.

As a physician, I could take some satisfaction in helping Celia get better -- not so with Maureen, the mother of four I saw some years ago. I gave Maureen her first pelvic exam ever. She was 29. I found a large growth on her cervix that was almost certainly cancer, yet I could not do a biopsy or otherwise continue her treatment because she could not pay for it.

Maureen had no insurance and little money. Like many of my fellow doctors in situations like this, I tried desperately to find funding for her. I came up empty. I ended up feeling I had done something immoral by telling Maureen about a potentially deadly medical problem she could do nothing about.

For Celia, Maureen, and every other woman, reproductive health is at the core of their well-being. Yet insurance companies treat reproductive health care as a luxury and charge accordingly. Some make a woman pay as much as 45 percent more than a man for an individual policy, only because she happens to be female. Health care reform must treat women’s health as a rule, not as an exception. We must change American health insurance so that it covers women’s needs at prices they can afford.

As a nation, we can no longer dismiss Celia’s and Maureen’s situations as “woman problems.” Women make up half our population. Their reproductive health cannot be separated from their overall health, and their overall health impacts their families, their jobs, and our society as a whole. Congress must place reproductive health care at the center of reform. Women should have affordable access to pelvic exams, cancer and STD screenings, contraception, prenatal care, miscarriage treatment, maternity services, and abortion care. Helping women stay healthy will help us all.
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Parker, MD, MPH, is a board member of Physicians for Reproductive Choice and Health and an obstetrician-gynecologist in Washington, DC.
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Copyright (C) 2009 by the American Forum. 9/09