Medical Monday: Breaking News from the World of Obstetrircs and Gynecology

We start with encouraging policy news. Republican Kevin Brady of Texas, Chairman of the House Ways and Means Committee, has asked that Congress “ immediately provide funding for subsidies to insurance companies to keep insurance premiums affordable for subscribers in 2018. This is a provision of the current law of the land, the Affordable Care Act (ACA) . It basically means that, under the Affordable Care Act, the Federal Government pays a good chunk of the originally high insurance premiums to keep them affordable for consumers. I can appreciate Texas Representative Brady’s concerns. Health care is a huge focus in his ethnically diverse state, which is part of the so called "fat-belt", and also has the highest maternal mortality rates in the Union. Keeping his poorer constituents in health insurance costs federal tax dollars to be sure. Yet these subsidies will go to provide low priced preventive measures which will in turn prevent high priced diseases. Chairman Brady knows that beyond Texas, America, the economy and the budget cannot afford for these people to lose their health care. 

In other encouraging policy news, the board of pharmacy in New Mexico has ruled to allow pharmacists to write for oral contraceptive pills. This way, most of the time, a woman will not have to visit a physician to obtain a prescription. Physicians, especially Obstetricians and Gynecologists applaud the measure since it removes barriers to contraception, and because the safety profile of oral contraceptive pills is so good. 

Delaware has had its share of abortion restrictions, including waiting periods, parental consents, provisions that there need be maternal risk, fetal abnormalities or rape, etc, etc. However Roe vs. Wade established in the 1970s that abortion is permissible until viability, and that remains the Federal Law. Delaware recently rescinded all of of these and simply reinstated the consistency of its State Law with existing Federal law. 

Connecticut failed to pass a bill to insure, on a statewide basis, the coverage of women’s health care services through insurers operating in their state. The bill tried to ensure 21 essential benefits for women, including breast cancer screenings. The bill passed the Connecticut Senate unanimously, but died on the floor when attempts were made to amend it pursuant to abortion. Hopefully it will be edited and brought forward again, in a way that will get results. 

New York is working to safeguard coverage in their state. They have drawn up their own plan to ensure the 10 basic benefits as identical to those in the ACA, which include prescriptions, hospitalizations and maternity care. 

States handle health care for their low income populations through either the ACA or Medicaid. This was possible in part due to the Medicaid expansions that took place under the ACA. A new Kaiser Family Foundation report has shown that fully 71% of Republicans, 93% of Democrats, and 83% of Independents feel that this Medicaid expansion funding should continue. Countrywide, Medicaid covers 70 million low income children, pregnant women, disabled and elderly. I do not think, especially after seeing this data, that the American people are grudging about this expenditure of their tax dollars. They do want to know, however, that that those dollars are buying them something. There is a burden on government and the medical profession alike to demonstrate with data how Medicaid dollars spent on routine care save huge monetary and societal costs later. In the field of Obstetrics and Gynecology, this sort of research has been done. For example, it has been shown that birth control is the best value on the dollar anywhere. 

Medical Monday will conclude there for tonight, at the end of our policy section. Tomorrow I will tackle the medical news, as tonight has gotten rather short.