Saturday, November 21, 2009

I Will Survivor

It's been a rough month to be a woman.

First, the US House of Representatives finally passes a comprehensive Health Insurance Reform bill and - in order to get it done - incorporates an extremely restrictive provision regarding abortion that goes much further than current law.  (Brief civics lesson, since 1976 (and ratified by the Supreme Court in 1980) the Hyde Amendment - named for former Illinois Congressman Henry Hyde, who was somewhere to the right of Hitler, has prohibited the use of federal funds to provide abortions.  Because the House bill includes a government-sponsored health insurance plan (the infamous "public option") the House wrestled with how to leave the Hyde Amendment intact.  Rather than choose the path ultimately selected by the current version of the Senate bill which requires that the plan segregate federal funds and subsidies form the premiums all participants in that plan must pay, Indiana Representative Bart Stupak offered an amendment which forbids the government-sponsored plan from permitting abortions at all, regardless of whether the money comes out of the customer's pocket or from the federal government.

Fortunately, since the Senate does not have such language, and since the votes to add it by Amendment probably aren't there, there will be a version of the bill without this provision.  When the House and Senate meet in conference to reconcile their bills, it is likely to come out altogether.

In other news, it is also believed by some that Henry Hyde was a reactionary bigot in order to cover up a secret passion for wearing pantyhose, singing jazz standards, and fooling around with boys (possibly Indiana Representative Bart Stupak.)  Or maybe not.

Then, the past week has brought news that the U.S. Preventive Services Task Force - some of whose current members were appointed under the Bush presidency - announced new breast cancer screening findings that increase the recommended age for mammography screening from 40 to 50, except where an individual has certain risk factors such as a family history.  The guidelines further recommend screening every other year, instead of every year - again, in the absence of risk factors.

The report further called into question the value of breast self-exams.  Now, here's where my knowledge of women hits the wall.  But - as a guy - I can say that the half the fun of being told to regularly do a testicular self exam is the medical encouragement to play with my balls.  So I'd be pretty pissed if, all of a sudden, I was told to stop touching my body in a way that could save my life, not to mention salvage a rainy afternoon at home.

It is worth noting that there wasn't a single oncologist on the Task Force.

Finally, the tail end of the week brought news of a report from the American College of Obstetricians and Gynecologists which recommends beginning cervical cancer screenings at age 21, instead of 18.  The guidelines also increase the period between screenings from every year to every other year.

In the midst of moving toward comprehensive health insurance reform, the insurance industry is pushing back against the bills moving through Congress.  (This, by the way, is comical, since they don't do much to control costs, allow insurers to charge whatever the heck they want, don't create government plans with nearly enough leverage to create cost controls, and require everyone to have insurance.  This, the insurers get millions of new customers, can charge whatever they want, and don't get more than token competition.  Sure, they can no longer rescind insurance or deny coverage for pre-existing conditions, but that's small potatoes compared to what they're getting.)

So, the worry is that these new guidelines will ultimately be reflected in an industry that chooses to cover mammography and pap smears only once every two years, and only after the ages of 50 and 21, respectively.  Combine that with the abortion restrictions in the House bill and it all adds up to a pretty crappy month.

I'm not really going to get into abortion politics here - I'm with Obama on this one: this is a health insurance bill, not an abortion bill, and there's no reason to do anything other than preserve the status quo.  Nor am I an expert in women's reproductive health.

I do, however, have a sense of fairness and common decency.  Setting aside the politics of these issues - whatever side you're on - it's a little scary to look at how many choices that they are taking away.  

None of these issues are simple.  If one is compelled by the research that led to the new guidelines, fine.  But then why aren't we also compelled by the data from countries with national health insurance that indicate they spend much less and get much better outcomes.  Or our own data that shows that people without health insurance - particularly those of certain income levels - see health declines but if they can hang on until 65 - when they become Medicare eligible - their life expectancy and health condition dramatically improves.

I remember, during the primaries running up to the 2008 election, a lot of women under the age of about 30 or 32, expressing distaste for Hillary Clinton, believing that the gender wars were over and there was no need for second-wave feminism anymore.  They were wrong then, and they're clearly wrong now.  There may be a lot more women in a lot more professions with a lot more opportunity, but women still don't have the choices that men do.

And now some of the choices they had may be taken away.  It's unconscionable really.

Oh, and now you know how gays in California and Maine felt when they had something taken way from them.

I've written on this topic before and I stand by this: if we don't stand up and stand together we're doomed.  You never know when your "group" is the next to become a minority, the next to lose something because a majority decided you shouldn't have it.

On to other topics...

I'm home from my sojourn out west, and just in time to spend my Saturday having lunch with my husband and our friend, Brette, at the Spring Street Natural.  On Spring and Lafayette in SoHo, think of it as a healthy diner.  Brette had a steak stir fry that looked scrumptious, while Neil and I both got the chicken sandwich on rosemary ciabatta.  A sandwich you can really sink your teeth into, and served with a mountain of fries, I'm still full five hours later.  We also got to meet Brette's charming mother, visiting from Maryland, who got a frittata of asparagus, broccoli, shiitake mushroom and ricotta that looked wonderful.  The dining room is a bit noisy, and pack your patience for sitting amongst the stroller set (instead of congestion pricing, I'm voting we charge a fee for bring children under the age of 18 into Manhattan.)  Still, a worthwhile dining spot.

And speaking of outer borough activity, Neil regaled us with tales of the Beauty and the Beast National Tour.  This is a licensed production, not a Disney-produced show, and is called a "second class" production, which sounds like what used to be called a "bus and truck" tour.  He had us laughing out loud as I imagined the singing candelabra scaled down to a lit match, and the teapot replaced by a styrofoam cup.

Well, that's pretty much it.  I'm sitting here watching Survivor on the TiVo.  Are you watching this season?  You should be.  Best season in years.  There's so much drama and so many surprises, I'm literally cheering at the TV and jumping out of my seat during tribal council.

Of course, I'm a loser, so there's that....


DO THIS, New York:

Get your reproductive health checkups now, while they're still covered by insurance.  If you have insurance.

Go to the Spring Street Natural

Watch Survivor.

DON'T DO THIS, New York:

Keep your hands off my body.  Well, ok, put them on my body.  But buy me a drink first.  Or some health insurance.


  1. Thank you for covering the health issue news for me, a woman. Preventative healthcare is the only way to cut cost of medical care...yet the insurance companies and half the government is too pig headed and stubborn...AND stupid to see this....because in the end it always amounts to one thing: MONEY. Whatever makes more money will win. Cancer will NEVER be cured because it is such a big money maker....think of all the drugs, doctors, etc. that are making money from this disease...if cancer were cured they'd all be out of work and the drug companies would lose money. Makes me sick with the thought...but I'm a realist...I don't donate money to cancer research any is a waste of my hard earned money. My body is my body does not belong to the men who sit in government and bicker about control over human beings. Okay. I've said my daily rant. Thank you.

  2. Hi there! First let me apologize for my "Do This" cramming ... I haven't read in a while but I always enjoy it!

    Second, thank you for the multiple Titanic and Melrose references. Love it.

    Third, favorite recent quote: "... with a peppermill that looks like it's been torn off a four poster bed." That made me spit a little. But I caught it. Still ... FUNNY.
    Now you and Susan are probably going to say people like me are the problem with society. I probably need to question my trust in "the experts", but here's the thing: I am tired of seeing new policies and procedures piled on to old without any "reasonable" test given to the previous procedures. Even with the expense out of the equation, I tend to agree that if the data over the years has shown that mammograms and cervical tests for certain demographics (in this case, age groups) have resulted in excessive surgical procedures (mainly biopsies) that have resulted in DECREASING overall public health - in both of these cases, women's health - then we should recommend discontinuing them. When you add the expense of these tests into the equation, I tend to agree even further. As I understand it, if you are genetically predispositioned (is that a word?) to these conditions, the mammograms are still paid for by insurance companies, but they are simply not standard procedure. I think it's pretty brave to stand up and say "Hey, it turns out the Emperor is naked and someone better go put some clothes on that guy."

    Then there's abortion. Firstly, before I potentially start to contradict myself, I DEFINITELY believe that an abortion is a medical procedure! It is only optional in some cases but many times it saves a woman's life! However (preparing to be tarred and feathered now), again, we're negotiating public policy here. In terms or a National Healthcare Bill, fine! Use it as a negotiation point! I’m perfectly willing to exclude a controversial procedure that represents a MINI-MICRO-NANO-portion of the medical procedures if it will get me the votes we need to move forward. Furthermore I’m sure that the insurance companies will respond to the market by offering the Cadillac plans to rich people like me. That’s how I think it works out there.

    Keep in mind I have never been a government policy maker OR a doctor in my entire life. It is just my semi-educated, irrationally strong opinion. And I’d love to discuss either or both of these issues. I learn a lot from these discussions and have been known on occasion to change my mind! Hell, I even supported the invasion into Iraq after watching Colin Powell for 2+ hours. I GLADLY admit I was way off on that one. :-(

    Lastly, I was so, so sorry to hear about Maine last week, Eric. What a disappointment. I was disgusted.

    Later tater...