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Copyright 1999 Gannett Company, Inc.  

November 2, 1999, Tuesday, FINAL EDITION


LENGTH: 465 words

HEADLINE: States move ahead on easing access to gynecologists

BYLINE: Rita Rubin

   While proposed federal legislation languishes, many states have
expanded contraceptive coverage and women's access to obstetrician/gynecologists.

Since 1995, 35 states and the District of Columbia have adopted
policies allowing women in managed care plans to see OB/GYNs without
a referral from a family doctor or internist, according to a report
by the Kaiser Family Foundation, which is holding a news briefing
today on women's health policy. And 10 states -- nine in the past
year -- have passed laws requiring private insurers to cover all
contraceptives, according to the foundation.

"The regulation of insurance has always been a state responsibility,"
says Diane Rowland, executive vice president of the foundation.
A stand-alone federal law improving women's access to OB/GYNs
is unlikely, Rowland says, but such a measure is part of the omnibus
patients' rights bills pending in Congress.

A September 1998 survey by the National Partnership for Women
and Families in Washington, D.C., found that women strongly supported
direct access to the doctors, says Judith Lichtman, president
of the organization. "Women have very different primary-care
needs than men," Lichtman says. "Often, maybe always, those
needs are best met by having direct access to OB/GYN services."

Research suggests that women are much more likely to get preventive
services such as pelvic exams and Pap smears if they go to an
obstetrician/gynecologist instead of another type of doctor, according
to the Kaiser report.

Although women in 15 states and D.C. can pick an OB/GYN as their
primary-care provider, many doctors in that specialty would rather
not fill that role, says Richard Bondi, a board-certified OB/GYN
who serves as Northeast medical director for women's health for
Aetna U.S. Healthcare.

"They don't want to be treating broken bones or pneumonia,"
Bondi says.

Many OB/GYNs would like to be able to prescribe the birth control
that best meets their patients' needs. But cost is sometimes an
obstacle because many health plans do not cover the full range
of options, according to Kaiser. In a survey, Kaiser found that
39% of fee-for-service health plans cover reversible contraceptives
such as the diaphragm and IUD.

Proposed federal legislation would require all health plans that
cover prescription drugs to cover contraceptives, but its chances
of being enacted any time soon are remote, says Kathryn Kolbert,
a senior researcher at the University of Pennsylvania's Annenberg
Public Policy Center.

"Both as a public health matter and a matter of equity, women
and their male partners ought to have a choice of the method they
use," Kolbert says. "Where you live shouldn't determine the
quality of the care you receive."


LOAD-DATE: November 02, 1999

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