Yesterday, surrounded by many powerful women at his side, President Obama proclaimed Thursday, January 29th ” a wonderful day” as he signed into law the Lilly Ledbetter Fair Pay Act of 2009 — a powerful tool to fight discrimination.  (Watch the video http://www.whitehouse.gov/blog_post/AWonderfulDay/).

What a difference two days can make.  On Tuesday, January 27th, miles away from the White House, clear across the country in fact, the City of San Francisco filed a law suit against California’s insurance regulators claiming that they allowed health plans to discriminate against women–by imposing gender ratings when pricing policies.

The Bottom Line:  the Department of Managed Health Care and Insurance Commissioner approved a system allowing health plans to charge more for women’s individual health policies than for men — as much as 39% more.

According to an article in this week’s LA Times (http://www.latimes.com/features/health/la-fi-insure28-2009jan28,0,6014453.story) “These policies are often purchased by people who are unemployed or work for businesses that don’t offer health insurance or adequate coverage.”

Given today’s economic fiasco, it’s pretty clear to me that the number of women this will impact is only going to swell.

Lilly–how fast can you be on a plane to the West Coast?  As you know first hand, a woman’s work is never done….

Childhood obesity accounts for about 9 million children in the U.S. A series of social, economic and environmental changes have occurred over the past few decades contributing to childhood obesity. As a society, we have reacted to those changes, but we have not managed our reactions. Some argue that the root of our nutritional problems began with the Regan administration’s encouragement of Wall Street rewarding firms for hitting short term gains, regardless of the methodology used to get there. The processing, refinement and other adulterations that lengthen the shelf life and decrease the nutritional value of food, and add calories and weight are largely a result of this economic policy. Also contributing to the obesity epidemic is the fact that on average, a child watches 4 hours of TV, spends one hour using a computer, and 49 minutes playing video games per day.

If childhood obesity  is rooted in mindless choices, then mindfulness may be the first step for each of us , to take. Making thoughtful, healthful decisions in our nutritional choices is a first step towards mindfully managing our reaction to stress and change Let’s make food decisions based primarily on their impact on the mental, emotional and physical impact they have on us, and not primarily on their economic impact. Take the “Vision for California” example, which includes a Ten Steps Towards Healthy Living statement for every Californian. You can view the statement at  http://www.cnr.berkeley.edu/cwh/PDFs/Summit_Governors_Vision.pdf. If, like the IOM said in 2005, “the prevention of obesity in children and youth should be a national public health priority”, then we need national-level marketing about the issue as well as action. Instead of a vision for California, what about a vision for the USA? The obesity epidemic is deserving of marketing at the level of the anti-smoking campaigns funded by the tobacco companies as part of their class action settlements. Healthy people, and in the case of childhood obesity, healthy future generations lay the groundwork for a healthy nation. The time for collective action, for each of us individually and for society as a whole, is now.

This past weekend, I made several new Facebook friends, one of whom, Dr. Rick Lippin, is a leader in the field of occupational and environmental medicine.

We exchanged a bit of information about our work, and I of course suggested he take a look at our blog, Disruptive Women.

Not missing a beat, he immediately thought of a talk he had given, almost a decade ago and sent me a link to it.  He suggested it was still relevant today.

His talk, which was delivered at the Women’s Health Conference in 2000 is entitled Work Stress in Women–From Stress to Strength. Dr. Lippin believes that work stress and work satisfaction are understudied major health issues.  (I concur, by the way).

I wanted to share his talk with you.  I am interested in what others thought of the ideas Dr. Lippin raised but also in how the work environment and stress levels (not to mention how the number of jobs) have changed over the last 9 years.

Here is the link to his talk http://www.ricklippin.com/papers8.htm

Disruptive Women in Health Care is starting a new feature:  The Man of the Month.  Not to worry–nothing in bad taste  (although the thought did cross our minds, but only for a moment).

We admit it, there are some pretty interesting male policy wonks out there and we are interested in learning what they are thinking.

We have an exciting first entry for January–stay tuned as Google’s Missy Krasner interviews Health 2.0 guru Matt Holt at the end of January.

If you know–or if you are–a fascinating fellow with something interesting to share about health care–please let us know.  We would like to highlight you in our new segment.

The following is a guest post from Tamar Abrams, a communications strategist working with nonprofits, individuals and foundations.  Until August 2008, Ms. Abrams was Vice President of Communications at Population Action International and has also been on staff at NARAL and Planned Parenthood Federation of America.

Below, Ms. Abrams shares her thoughts on the new administration.

When my 16 year old daughter handed me a report card full of A’s, B’s and one C, I first congratulated her and then asked why she hadn’t worked harder to bring that C up to a B. The only thing worse than not trying at all is failing to reach your full potential. This is true for teenager daughters and also for U.S. presidents.

President George W. Bush, last seen climbing into a helicopter bearing him away from the seat of power, claims that his greatest achievement is PEPFAR – the President’s Emergency Plan for AIDS Relief. I’m sure it was chosen from a very short list. Cynicism aside, its very creation must be applauded. Hundreds of thousands of people in the developing world – primarily in Africa – have benefited from this far-reaching program. Unfortunately, narrow ideology and religious views imposed on the program by the Bush administration prevented it from reaching its full potential. With a skewed emphasis on treatment over prevention, the major prevention strategy was based on the ABCs of “Abstinence, Be Faithful and Condoms” in that order. With a blind eye to the cultural imperatives of the developing countries the program targets, PEPFAR fell far short of reaching its full potential.

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As Mark Senak noted on his Eye on FDA blog, in effort “to distinguish itself quickly,” the 111th Congress is officially on YouTube. The House and Senate each launched their own channels (The Senate Hub and The House Hub) earlier this week. A number of video clips of Representatives’ floor statements about the SCHIP bill (that ultimately passed in the House) can be found at The House Hub. (more…)

Anthropologist Christine Gray, PhD became a healthcare activist when her daughter Sophia was diagnosed with a sarcoma in 2003. Dr. Gray used to teach gender studies as well as anthropology.

“I’m trying to find a way to get women active in breast cancer advocacy to examine the early detection/referral issues very seriously in the same way that gender bias has been dealt with in diagnosis and treatment of women’s heart disease.”

Dr. Gray has written several posts on http://e-patients.net/, one of which addresses health care disparities regarding the early detection of breast cancer, and another one of which can be found below:

My quest for a second qualified opinion on an abnormal mammogram (microcalcifications) began in October, Breast Cancer Awareness Month. Two days before the end of the year, a sharp surgical resident put an end to the spin. The solution was simple – and not high tech. She got on the phone and spoke to the various physicians involved. She was proactive where the system was flawed or obviously broken. Most important, she listened to me, the patient.

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Among the barrage of strange events assaulting even the most durable citizen watching the transition of federal power these days, one of the most interesting is the long line of pundits and purported experts queuing up to give the Obama administration lengthy and often preachy doses of advice. I don’t remember us doing this for George Bush…hmmm. While chagrined, here I am getting in line. My intent is to balance the discourse a little.

My advice is about the undertow. The often unacknowledged subtext of much of the advice now being offered is an enormous expectation that somehow Obama will magically restore our collective capacity for ethical choice and conduct. The undertow, of course, is that we all participated in a frenzy of unethical behaviors of one kind or another to get us into the mess we are in. Many seem to me more passive than active: things fell apart and we did nothing or very little. One does not see the whistleblowers receiving Medals of Honor. Yet somehow we want Obama to single-handedly reverse this collapse of communal values and moral conduct. It seems kind of unrealistic to me. I took seriously his contention that all of us were going to have to do our share.

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It’s already been a big week for anyone interested in health care, and as such, the blogosphere has been buzzing over all the news and developments. Last week was HHS Secretary nominee Tom Daschle’s Senate Health, Education, Labor, and Pensions committee hearing, yesterday President-elect Barack Obama announced his pick of William Corr to be Daschle’s deputy, and all week, Congress has been working on health care funding legislation, as Jacob Goldstein reported on the WSJ Health Blog:

…the House of Representatives is likely to vote today on a bill that would add about 4 million kids to the State Children’s Health Insurance Program, which already covers some 7 million kids in poor families. A companion bill is moving through the Senate. The program would be funded largely by a hike in cigarette taxes.
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Since Obama backs the expansion, the only remaining bone of contention seems to be whether states should have the option of covering the children of legal immigrants. The SCHIP plan will cost about $33 billion over four years. A bigger, quicker infusion of cash is likely to come from the big stimulus package Obama hopes to sign not long after he takes office. Word is, that plan will have $100 billion in aid to states to prop up Medicaid.

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The following is guest post from Megan Kamerick, a local reporter from Albuquerque, who shares some of her OB/GYN experiences following her diagnosis of infertility.

Let’s start with some numbers.

* Number of women ages 15-44 with impaired ability to have children: 6.1 million
* Number of women who’ve ever used infertility services: 9.2 million
* Number of married couples that are infertile: 2.1 million
* Number of women using infertility services: 9.3 million

These figures, from the National Center for Health Statistics, are a bit dated, but hopefully all of you OB/GYN practitioners and staff out there get the point. A good number of your patients are likely infertile. We’re not very noticeable because many of us walk around in silence, often with serious mental anguish over our inability to conceive. But we’re here. I’d just like you to keep that in mind.

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We are at the beginning of a powerful week.  A week when we celebrate the life of Dr. Martin Luther King, Jr. and a week when we inaugurate America’s first African American President.

We, as a nation, have made progress and I believe Dr. King would be proud.  But our work is far from complete–particularly where health care is concerned.  Another doctor, Dr. John M. Eisenberg, a physician of tremendous stature whose life was also tragically cut short (not by an assassin’s bullet but by brain cancer) was equally passionate about the dignity of life and justice for all Americans.   Dr. Eisenberg, who among other things, served as the Director of the Agency for Health Care Policy and Research (as AHRQ was known back in the day), cared deeply about access to and the integrity of health care for all Americans– regardless of skin color.

Nine years ago, on January 14, 2000, Dr. Eisenberg gave what is, in my opinion, a brilliant speech to the employees of the Department of Health and Human Services.  I want to share his words with all of you today — as a reminder of how far we’ve come, and how far we still have to go.

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This is the first in a series of roundups of multimedia content about healthcare: images, video, and audio of news reports, hearings, advertisements, and commentary. If you create content that we should include, please let us know.

“Even Insured Patients Struggle as Health Care Costs Rise” was the first in a series of in-depth stories on The Newshour (PBS) about health care policy challenges facing the new administration. Watch the report, or read the transcript.

Many Americans heeded President-elect Obama and HHS Secretary designee Daschle’s call for community discussions on health care policies over the holidays:

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What’s not to like about the idea of Sanjay Gupta being the next Surgeon General of the United States?

It may be viewed as a brilliant move since Gupta is widely known because of his work on CNN and well known among journalists. It could be a great way to get media to pay attention to your message when you’re in a position that may be considered by some to be largely ceremonial.

But that should not be the case. Certainly, C. Everett Koop learned how to use the position as a platform to advance important public health initiatives, such as quitting smoking. The surgeon general heads up the large Public Health Service that does important work on things like disaster preparedness and response, disease control and prevention, mental health, and even international health. Gupta is a neurosurgeon. The Public Health Services Act specifies that the Surgeon General be experienced in public health.

Of course, his role with CNN has equipped him—out of necessity—to focus more on public health matters. But why would President-elect Obama not select one of the many highly qualified public health professionals? For example, Thomas Frieden is the bold commissioner of health for New York City. He’s been brilliant on issues such as diabetes, changing what people know about healthy versus unhealthy foods, banning transfats from restaurants, and more. He knows the breadth of public health, what works and what doesn’t in this field, and is a pretty good spokesperson. I’ve interviewed him on a radio program I produce in New York City and he was excellent in discussing the priority issues for promoting the health of New Yorkers. (Note: He has not told me that he wants the position.)

I also don’t believe that the position has to be filled by a physician. For example, Kristine Gebbie is a nurse who is the former commissioner of health for Washington State and Oregon. (Note: She has not told me that she wants the position.) And other non-nurses with public health experience should be considered.

Regardless, it will be interesting to see what unfolds. Koop’s appointment was not supported by the American Public Health Association because he was a pediatric surgeon, not a public health expert. But by most counts, Koop’s performance as Surgeon General earned him kudos for taking on some controversial issues. Perhaps the lack of unanimous support from the public health community spurred him to rise to the occasion.

Maybe Gupta will do likewise.

Note: While Disruptive Women in Healthcare is designed as a platform for women to present their ideas and concerns on today’s health issues, we occasionally allow posts from men who we feel will add to the discussion.  This guest post is from Peter Pitts, the President of the Center for Medicine in the Public Interest:

“President Bush leaves office with a health care legacy in bricks and mortar: he has doubled federal financing for community health centers, enabling the creation or expansion of 1,297 clinics in medically underserved areas.”

Says who? The New York Times. (Ergo, it must be true.) The article, “Expansion of Clinics Shapes a Bush Legacy.” All the news that’s fit to print? Well almost. It’s pretty amazing that the Gray Lady opted to leave out any mention of Part D in the President’s legacy. But maybe that article’s on the way.

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The following post appeared today on the Get Better Health Blog:

Intense debate has broken out across the blogosphere regarding the candidacy of CNN medical correspondent, Sanjay Gupta, for the Office of Surgeon General of the United States. Some argue that he is not qualified for the position, others say that his charisma would be a boon to public health communications. But before we draw conclusions about who’s right for the job, we need to understand what the job entails.

I asked Dr. Richard Carmona, 17th Surgeon General of the United States, to explain the roles and responsibilities of the office. You may read the summary of our conversation that follows.

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