American Forum Op-Ed

Ten years ago, the Centers for Disease Control listed the top 10 achievements of public health in the 20th century -- among them, family planning, control of infectious disease, and vaccinations. These achievements vastly improved our quality of life, resulting in an increase in life expectancy, worldwide reduction in infant and child mortality, and the elimination or reduction of many communicable diseases.

Following President Obama’s historic address to the nation, America is poised for the first dramatic public health achievement of the 21st century.

What makes this moment truly life-changing in every sense of the word is that, for the first time, more women and their families will have coverage than ever before in our nation’s history.

However, if a new national health plan is to fulfill the goal of correcting our fragmented health system and improving America’s health, then it must address the specific health needs of women. That’s why earlier this year, I and a group of medical and public health colleagues contributed to a scientific, data-driven report stating that reproductive health should be an essential part of any national health plan. Our statement was endorsed by 39 deans of schools of public health.

According to the report, issued under the aegis of Columbia University’s Mailman School of Public Health, “a well-woman standard of care -- one that includes access to comprehensive care and services essential to reproductive health -- will ensure that women can attain good health, maintain it through their reproductive years and age well.”

Put simply: without making women’s reproductive health a central component of health care reform, we will not have real reform in the 21st century.

The scientific data point to the compelling need to improve the reproductive health of all Americans. Rates of maternal and infant mortality, low birth weight, unintended pregnancy and sexually transmitted infections are much too high for a nation that is rich in resources and technical competence. Moreover, health problems are concentrated among disadvantaged groups, and these disparate rates have stagnated or worsened over the past three decades.

The good news is that the proposals currently being considered in the House and Senate contain many of the critical elements that will help us address these problems. For the first time, women will be able to participate in a health care system in which:

The reforms currently on the horizon are significant not just for women but also for their families, because women act as gatekeepers for the health care that their children, spouses or parents receive. According to the Department of Labor, women make approximately 80 percent of all family health care decisions. But until now, these gatekeepers have all too often been denied the keys to the health care kingdom.

Nearly one-quarter of all women depend on coverage through their husbands’ employment, leaving them vulnerable to the loss of coverage if divorced or widowed, or if their husbands lose their jobs. Recent years have seen an overall decline in health insurance coverage for women. In 2006, 10 percent of American women received coverage through Medicaid, while 18 percent of women were completely uninsured.

For all of these women, including the 21 million American women and girls currently without health insurance, change cannot come soon enough.

As the president said in his speech, health care reform is not about politics -- it is about shaping the future. But in order to bring about that future, we must show what is at stake and why it is in everyone’s interest to demand coverage that recognizes women’s basic needs and is truly health care, not just sick care.

Without these critical changes, our current system may well top the list of the biggest health care disasters of the 21st century.
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Dr. Laube is Professor of Obstetrics and Gynecology at the University of Wisconsin and Past President of the American College of Obstetricians and Gynecologists.
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Copyright (C) 2009 by the Wisconsin Forum. 10/09

By Ellen Bravo

It can happen anywhere.

Recently, I sat in a room in Milwaukee filled with people clutching Bibles and babies and spewing venom. They were visibly enraged.

Granted, there’s a lot to be angry about these days: the persistence of poverty in our community, the lack of resources for our children’s education, the number of people who can’t afford health care, the gang of hoodlums on Wall Street holding a gun to our heads, the fact that hard-working parents can be fired for staying home to care for a sick child, and the continuing number of soldiers in harm’s way.

But the object of the rage of folks surrounding me wasn’t any of these things. It was the loving, long-term, committed relationships of people who happen to love someone of the same gender.

We were at a Milwaukee school board meeting, debating a resolution to end discrimination in benefits for same-sex couples in non-bargaining unit positions – estimated to be about 1 percent of staff in those jobs. The cost isn’t very much, especially considering an earlier item on the agenda about the need to retain experienced employees. Treat people right and they’re more likely to stick around.

Opponents weren’t content with expressing disagreement with the proposal. They littered their comments with hateful remarks about real people sitting directly across the aisle or in some cases in the next chair – people who simply want to build strong families and contribute what they can to their communities and who would certainly have preferred to be spending a warm fall evening playing in the park.

Someone had convinced this group that the loving couples they targeted were responsible for the problems in our society. Somewhere along the way, making life miserable for same-sex partners had become a path to easing the misery in one's own lives.

The angry speakers in the room, apparently without exception, consider themselves to be people of faith. I doubt any of them would condone physical violence against those they railed about. But I couldn’t help thinking how much their words of hate translate every day into acts that demean, diminish and discriminate against people whose chosen (and under-paid) profession is to educate our kids.

The opponents’ words, spoken defiantly in front of their own children – girls in pinafores and boys with scrubbed faces brandishing signs – in fact create the climate that leads to more than hurtful words or daily indignities. Their speeches give permission to those who beat people and tie them to a rail to die.

Fortunately, there were a number of others in the room, teachers and parents and a sprinkling of students who’d taken time to voice their support for domestic partner benefits. Among them were three clergy, each of whom reminded the audience that whatever one’s faith, we are called upon to act justly and promote community, not divisiveness.

The proposal passed the committee by one vote. The school board member casting that vote had been wavering on which way to go. Addressing the opponents, he announced his decision: “You swayed me to vote yes.”

His position reminds us that sometimes there is no middle ground. Either we stand with those who spread hate, or we stand on the side of the most basic American values of justice, equality and fairness.

Measures like this are on the ballot in several states and are increasingly coming up in legislatures, city councils and school boards around the country.

Regardless of where it happens, we must stand together to protect justice, equality and fairness for all Americans.
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Bravo is an author and activist who teaches women’s studies at University of Wisconsin-Milwaukee.
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Copyright (C) 2008 by the Wisconsin Forum.