|Washington Watch||Clinical Issues||Vital Signs||Health & Safety|
The 106th Congress is expected to give serious consideration to various proposals addressing the quality-of-care issues that have risen with the proliferation of managed care systems. These proposals will impact women’s health— an area where the ANA has long served as advocate, and as advisor to policy makers. Last summer, the ANA House of Delegates affirmed this commitment in a resolution that outlined health care financing, research and prevention efforts, and appropriate access to care and treatment as key areas of concentration for the association. Thanks to the efforts of the ANA and other health care organizations, Congress is now examining these issues in several pieces of legislation.
The Patients’ Bill of Rights Act is especially valuable to women because women are the primary consumers of health care services and comprise the majority of managed care enrollees. They also make most of the health care decisions for their families. Key provisions for women in the Patients’ Bill of Rights include
During his State of the Union address, President Clinton called for congressional passage of a solid patients’ bill of rights. Said ANA president Beverly L. Malone, PhD, RN, FAAN, “A strong patients’ bill of rights will go far in protecting the American public from current practices that often place profit before patients. The public supports this kind of legislation, as do nurses and other providers. It’s time for Congress to take action.”
A separate initiative, meaningful to women both in terms of research and access to care, is the Genetic Information Nondiscrimination in Health Insurance Act (H.R. 306), introduced by Representative Louise Slaughter (D-NY). This bill, which the ANA first endorsed in 1996 and which has since been receiving increased attention and support, would protect consumers from denial, cancellation, or alteration of health insurance coverage on the basis of genetic information. It would also prohibit insurance providers from requiring an individual to disclose genetic information.
“It is a terrible irony that advances in research that could provide information crucial to disease prevention and wellness are instead inducing refusals to have tests and appropriate care because of fears of disclosure and discrimination,” said Malone. “An emphasis on prevention and wellness are hallmarks of the nursing profession, and, as patient advocates, nurses strongly support the effort to prohibit these discriminatory insurance practices.”
To further federal research and prevention initiatives, the Women’s Health Research and Prevention Amendments of 1998 were passed in the last hours before adjournment of the 105th Congress last fall, and set federal policy for women’s health programs at the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) until 2003. The women’s research authorization creates a new program at NIH to educate health professionals and the public concerning diethylstilbestrol (DES). It also provides for continued research on osteoporosis, Paget’s disease, and related bone disorders as well as breast cancer, ovarian cancer, and other cancers of the female reproductive system. It mandates additional efforts at the National Heart, Lung, and Blood Institute regarding heart attack, stroke, and other cardiovascular diseases in women. And at the CDC, the bill provides for the National Breast and Cervical Cancer Early Detection Program and community projects for the intervention and prevention of domestic violence.
The ANA will collaborate with other advocates of women’s health to secure funding for these programs—an annual process for so-called discretionary programs. One factor to consider in this appropriations process is the need to balance the ANA’s advocacy for women’s health programs with its strong support for a number of other health care and workplace programs. These projects all compete for the limited pool of funds allotted for the full range of federal health, education, and labor programs.
The ANA will continue its efforts to make reproductive health services accessible to all women, and to keep therapeutic decision making in the hands of patients and their health providers. The ANA will also support provision of appropriate prenatal and postpartum care for mothers and their infants, including postpartum home visits and protections for new mothers who breastfeed their infants. In addition, the ANA will support proposals to require health plans with prescription drug coverage to pay for contraceptives, and will continue to advocate population planning throughout the world.